COURSE POINT chapter 3/4

The nurse is meeting with a young couple who have undergone the initial screenings for infertility. The man is questioning the possibility of using intrauterine (artificial) insemination if he is found to be infertile. Which response should the nurse prioritize?

"Intrauterine (artificial) insemination is your best option if you are found to be infertile.

The nurse is caring for a client requesting oral contraceptive pills (OCPs). She has multiple sexual partners. The nurse recommends condoms to the client, but the client states, "I cannot use condoms because I am allergic to latex." Which response by the nurse is appropriate?

"You can still use condoms because they make latex-free condoms."

A woman has opted to use medroxyprogesterone injections for birth control. The client receives the first injection today. The nurse instructs the woman to return to the clinic in how many months for the next injection?

3

he nurse is examining a pregnant female in her third trimester and measuring to determine if fetal growth has increased. Where would the nurse place the measuring tape?

At the top of the fundus

A female client is having a procedure this morning that involves radiologic examination of the fallopian tubes using a radiopaque medium. What procedure should the nurse document as being performed?

a hysterosalpingography

A nurse is counseling women on birth control choices. Which woman is the best candidate for an IUD?

a woman who has one partner and three children

A woman has been assessing her basal body temperature for 4 months. Upon reviewing her temperature history log, the nurse notes no change in her daily temperatures. Which should the nurse expect the health care provider to prescribe first?

serum progesterone level

Which client should the nurse flag for the health care provider to assess first?

the male client with three palpable masses in the testes

A young woman says she needs a temporary contraceptive but has a latex allergy. She mentions that she has had a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend?

transdermal contraception

A nurse is discussing sexual intercourse during pregnancy with a client. Which statement by the client would indicate that learning has occurred?

As long as the baby and I both continue to do well, I can have intercourse."

The nurse is caring for a female client who is a victim of intimate partner violence (IPV). The client has experienced traumatic injury to the clitoris. Which statement will the nurse include when providing discharge education to this client?

Damage to your clitoris may lead to decreased stimulation in future sexual experiences."

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply. Increase intake of salty foods. Increase water consumption. Avoid keeping legs elevated while lying down. Use heating pads or take warm baths. Increase exercise and physical activity.

Increase water consumption. Use heating pads or take warm baths. Increase exercise and physical activity.

A client is to take clomiphene citrate for infertility. Which outcome should the nurse explain is the expected action of this medication?

Stimulate the release of ova

A 30-year-old client would like to try using basal body temperature (BBT) as a fertility awareness method. Which instruction should the nurse provide the client?

Take temperature before rising, and record it on a chart.

A couple is considering vasectomy as a contraception option. However, the husband is nervous about how such a procedure would affect his sexual functioning. Which information should the nurse mention to the man?

The man will still have full erection capacity.

A nurse is assessing a 45-year-old client. The client asks for information regarding the changes that are most likely to occur with menopause. Which should the nurse tell the client?

The uterus shrinks and gradually atrophies

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of nursing students. What would be the correct response by a nursing student about the function of the ovaries?

They produce female gametes or ova and secrete female sex hormones.

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication?

deep vein thrombosis

A young mother is expressing frustration of not being able to breastfeed her infant. A potential cause could be the lack of the hormone

prolactin

A young mother is expressing frustration of not being able to breastfeed her infant. A potential cause could be the lack of the hormone:

prolactin.

When using the contraceptive patch, a client should understand that it

should be applied to the abdomen, buttocks, or back

A 12-year-old girl expresses concern to the nurse because she has not begun her period yet. The nurse notes that the girl has grown 6 in (15 cm) in the past year and a half and is beginning to develop breast buds. Which response by the nurse is appropriate?

"It is normal for females to begin menstruating between the ages of 12 and 15."

A couple is deciding about contraceptive measures. The male partner has decided to undergo a vasectomy. After teaching the client about this procedure, which client statement indicates the need for additional teaching?

"Right after surgery, my semen will be sperm-free."

A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize?

"Start taking the medication when you first get your period."

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which information?

A primary function of the female breast is to produce milk.

A client who delivered her baby 3 months ago is seen in the clinic and tells the nurse that she and her husband have yet to resume a sexual relationship. The nurse notes that no contraception is currently being used. What is the most appropriate nursing diagnosis for this client?

Altered sexual pattern related to fear of pregnancy

The nurse is examining a pregnant female in her third trimester and measuring to determine if fetal growth has increased. Where would the nurse place the measuring tape?

At the top of the fundus

A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because:

ECs simply prevent embryo creation and uterine implantation from occurring in the first place.

A young woman is trying to get pregnant. She asks the nurse to recommend a practical way that she can tell the point in her monthly cycle when she will have the best odds of getting pregnant. Which recommendation by the nurse would be best?

Have sex when the cervical mucus is thin, stretchy, and copious

A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client?

In vitro fertilization

As part of caring for childbearing families, the nurse must be able to educate families regarding which topic?

Knowledge of reproductive anatomy and physiology

The vagina is at risk for infection because of its location and because it opens to the outside of the body. What is a protective mechanism of the vagina to keep it from becoming infected?

Normal vaginal pH is acidic (4 to 5), which protects from infection.

Which of a client's cells are most likely to reproduce by meiosis?

Ova

The nurse is educating a pregnant woman who is planning to breast feed her newborn about the events associated with it. Which hormone would the nurse explain as being reponsible for the let-down reflex?

Oxytocin

The nurse is caring for a client experiencing perimenopausal symptoms. The client states intercourse has become painful. Which nursing action is appropriate?

Recommend the client use lubrication during intercourse.

A nurse is preparing a presentation for a health fair on the topic of vasectomy. Which information should the nurse point out in the presentation?

Relatively easy procedure with few complications

A nurse supervisor observes a nurse massage a client's injection site after giving a dose of depot medroxyprogesterone acetate (Depo-Provera). What is the priority response by the nurse supervisor?

Remind the nurse that this injection should absorb slowly.

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

She has a family history of thromboembolism

A client is at the clinic for her yearly physical and is found to be anemic. What information from her history would most likely be a contributory factor to this finding?

She reports that her menstrual cycle is irregular and often lasts 7 to 10 days.

A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize?

Start taking the medication when you first get your period.

A nurse is assessing a 45-year-old client. The client asks for information regarding the changes that are most likely to occur with menopause. Which should the nurse tell the client?

The uterus shrinks and gradually atrophies.

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of nursing students. What would be the correct response by a nursing student about the function of the ovaries?

They produce female gametes or ova and secrete female sex hormones

A nurse is caring for an adolescent girl experiencing menstruation for the first time. What are the changes that occur in the body at this stage that the nurse should share with the adolescent girl?

breast development

A client is being prepared for intrauterine (artificial) insemination. Which finding is the most suggestive to determine if the client is ovulating?

change in the cervical mucus

The nurse is assessing the health history of a male partner. Which data is most likely to be related to an infertility problem?

employment as a taxi driver

A group of nursing students are preparing a presentation for a health fair illustrating what happens to the body during pregnancy. Which structure will the students point out is influenced the most by hormones to prepare for conception?

endometrium

Which hormone stimulates the release of the follicle-stimulating hormone (FSH) from both male and female glands?

gonadotropin-releasing hormone (GnRH)

The nurse, while teaching a group of pregnant women about the production of breast milk, describes colostrum and compares it with mature breast milk. Which characteristic would the nurse identify as associated with colostrum?

high mineral content

A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs:

in the fallopian tubes.

An anatomy professor is teaching a class of pre-nursing students about the female reproductive system. One student asks, "Where is the opening to the vagina?" The best answer the professor can give is:

in what is called the vestibule, which is located between the labia minora.

A nurse caring for a 43-year-old client explains to the client that ovarian functions gradually decrease around this age. What is the implication of decreased ovarian function?

inability to become pregnant

A male client visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. What is a risk factor associated with male infertility?

no or few sperm cells produced

A healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client?

oral contraceptive pills (OCPs)

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about?

overstimulation of the ovary resulting in potential multiple births

Which hormone is called the hormone of pregnancy because it reduces uterine contractions during pregnancy?

progesterone

Which description best explains the hysterosalpingogram procedure?

radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix

There are two major functions of the reproductive system, continuation of the species and sexual pleasure. In the male, the reproductive system has a third function. What is this third function?

urinary elimination

A nurse is teaching a group of women at the local health clinic about reproduction. After describing the various internal structures involved, the nurse determines that the teaching was successful when the group identifies which structure as connecting the external structures with the cervix?

vagina

Which statement best explains the action of the lactational amenorrhea method (LAM) of fertility control?

LAM causes suppression of the ovulation process.

What is the intended purpose of the alkaline environment of prostatic fluids found in ejaculation? Select all that apply. Enhancement of sperm longevity Protection of sperm Nourishment of sperm Reducing prostatic infections Increasing fertility of the female

Protection of sperm Nourishment of sperm

Which definition best explains the term "subfertility/infertility"?

failure to achieve pregnancy after 1 year of unprotected intercourse

A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important?

genetics

A nurse is conducting an orientation at a health clinic for newly hired nurses comparing normal and abnormal findings from a female physical assessment. The nurse determines the session is successful when they correctly point out which structure's secretions assist with sexual intercourse?

Bartholin glands

A young male asks the nurse at the clinic about what he can do to maintain his sperm production. The nurse would instruct him to take which action?

It is recommended that men wear boxer-style underwear.

The nurse is caring for a 16-year-old female client. The client states, "I recently had sex for the first time and I had some bleeding afterward. It was not time for my period. Could something bad have happened?" Which action will the nurse complete next?

Provide education to the client on sexual intercourse.

Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the sex hormones produced?

Testes

A woman is going through the luteal phase of her ovarian cycle. What changes are taking place during this period of time?

The follicle develops into the corpus luteum

A client in her second trimester of pregnancy asks the nurse for information regarding certain oral medications to induce a miscarriage. What information should this client be given about such medications?

They can be taken only in the first trimester.

It is important that a nurse recognizes there are cultural differences that will have an influence on the care of the client. Some cultures practice female circumcision, which involves the removal of the:

clitoris.

Which of a client's cells are most likely to reproduce by meiosis

ova

After teaching a group of women about reproduction and the structures involved, the nurse determines that the teaching was successful when the group identifies which female reproductive structure as comparable to the male testes?

ovaries

A female client has been trying to conceive for 3 months. She tells the nurse, "I just know something is wrong with me." Which response by the nurse is best?

"It can take up to 1 year of regular, unprotected intercourse to conceive."

A nurse is reviewing sperm count results for a couple trying to conceive. Which results would concern the nurse?

10 million per ml of seminal fluid

The nurse is caring for a client requesting oral contraceptive pills (OCPs). She has multiple sexual partners. The nurse recommends condoms to the client, but the client states, "I cannot use condoms because I am allergic to latex." Which response by the nurse is appropriate?

You can still use condoms because they make latex-free condoms."

A mother comes to the clinic nurse concerned about whether her adolescent daughter is sexually active. She requests a physical examination of the daughter's hymen. Which statement by the nurse accurately addresses this issue?

A torn hymen can result from heavy exertion or the use of tampons and is not a reliable method of determining virginity.

A nurse is developing a plan of care for a 7-year-old client who has experienced early development of secondary sex characteristics. Which would be the priority nursing diagnosis for this client?

Risk for disturbance in body image related to early development of secondary sex characteristics.

A nurse is teaching a sex education class and is discussing sexual response. She describes a 30-minute period during which external and internal genital organs return to an unaroused state. What is this phase of sexual response known as?

resolution

The nurse has provided information to a client about oral contraceptive pills (OCPs). Which statement by the client would indicate a need for further education?

"Some oral contraceptive pills protect against STIs."

A sexually active 14-year-old male presents at the local clinic seeking birth control. What reproductive education would the nurse provide for this client at this time? Select all that apply. Constrictive clothing such as briefs may cause an increased sperm count. Beginning next year, the client should begin monthly testicular self-examinations. It is normal for the left testicle to hang lower that the one on the right. The sperm are formed and matured within the testes. The male sex hormone estrogen is produced within the testicle.

Beginning next year, the client should begin monthly testicular self-examinations. It is normal for the left testicle to hang lower that the one on the right. The sperm are formed and matured within the testes.

A nurse should instruct a client who has premenstrual syndrome (PMS) to make which lifestyle modification?

Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule.

A couple consults with the nurse regarding their infertility issues. The female says "I don't know what I have done so bad that God would punish me like this." What would be the most appropriate nursing diagnosis for this couple?

Spiritual distress related to inability to conceive