Maternity PrepU Chapter 4.

A nurse is preparing a client for intrauterine device (IUD) insertion. Which education will the nurse provide to the client? a. "Checking the strings is recommended following insertion." b. "Expect to have continuous uterine cramps after insertion." c. "An IUD will prevent sexually transmitted infections (STIs)." d. "The insertion procedure for an IUD is painless."

a. "Checking the strings is recommended following insertion."

A nurse is completing an informed consent on a client preparing for a tubal ligation. Which statement by the client would require the nurse to notify the health care provider? a. "I will be able to have my third child in about a year from now." b. "I will not be able to have children after this procedure." c. "I will continue to have my menstrual cycle every month." d. "I may need to use a second form of contraception for a while."

a. "I will be able to have my third child in about a year from now."

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? a. "It can take up to 1 year of regular, unprotected intercourse to conceive." b. "The problem can be with the man, woman, or both. We will explore all possibilities." c. "Do you or your partner have a family history of subfertility?" d. "It is time to talk to your health care provider about hormone testing."

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

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? a. "Some oral contraceptive pills protect against STIs." b. "Hormonal oral contraceptive pills reduce the risk of ovarian cancer." c. "Oral contraceptive pills need to be taken on a daily basis." d. "Some hormonal contraceptives do not contain estrogen and rely instead on progestin only."

a. "Some oral contraceptive pills protect against STIs."

The nurse is caring for four female clients, all prescribed oral contraceptive pills (OCPs). The nurse will question giving an oral contraceptive pill to which client? a. 37-year-old client who has migraines with aura several times a week and smokes. b. 25-year-old client who has had three miscarriages and leads a sedentary lifestyle. c. 30-year-old client who drinks a glass of wine daily and whose aunt had breast cancer. d. 40-year-old client who has a history of asthma and a total cholesterol level of 170 mg/dl (4.40 mmol/L).

a. 37-year-old client who has migraines with aura several times a week and smokes.

The nurse is caring for a client at the ambulatory care clinic who questions the nurse for information about contraception. The client reports that she is not comfortable about using any barrier methods and would like the option of regaining fertility after a couple of years. Which method should the nurse suggest to this client? a. CycleBeads or medroxyprogesterone injection. b. coitus interruptus. c. lactation amenorrhea method. d. basal body temperature (BBT).

a. CycleBeads or medroxyprogesterone injection.

A couple who has not conceived after 6 years of not using birth control are being seen in the infertility clinic. In assessing the client's psychosocial response to infertility, which might the nurse expect to find? Select all that apply. a. Fear of the possible outcome of the testing. b. Guilt related to the lack of conception. c. Excitement at the possibility of conceiving. d. Anger toward others who have conceived. e. Sexual stimulation and excitement.

a. Fear of the possible outcome of the testing. b. Guilt related to the lack of conception. d. Anger toward others who have conceived.

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. a. Increase water consumption. b. Increase intake of salty foods. c. Avoid keeping legs elevated while lying down. d. Increase exercise and physical activity. e. Use heating pads or take warm baths.

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

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? a. She has a family history of thromboembolism. b. She is 30 years old. c. She has irregular menstrual cycles. d. She has a history of allergy to foreign protein.

a. She has a family history of thromboembolism.

The nurse is preparing a teaching session for a client considering tubal ligation. Which factor should the nurse prioritize in this session? a. This is a permanent and irreversible procedure for birth control. b. The procedure is easy to perform and will be painless. c. She must have signed consent from her partner. d. Wait several months after birth, and schedule the surgery as an outpatient.

a. This is a permanent and irreversible procedure for birth control.

The nurse has assessed several clients who have arrived for routine appointments. The nurse predicts the health care provider will prioritize a bone density scan for which client? a. a 55-year-old white client who smokes and has family history of osteoporosis. b. a 45-year-old Hispanic client with a vitamin D deficiency. c. a 25-year-old Asian client, 5 ft 7 in (1.7 m) tall, 129 lbs (58.5 kg), with two children. d. a 40-year-old black client, 5 ft 4 in (1.62 m) tall, 172 lbs (78 kg), inactive lifestyle.

a. a 55-year-old white client who smokes and has family history of osteoporosis.

A client prescribed oral contraceptive pills (OCPs) has presented for a routine visit. Which finding, if reported by the client upon assessment, should the nurse prioritize? a. abdominal pain. b. small amount of breakthrough bleeding. c. light menstrual flow. d. cramping during menses.

a. abdominal pain.

When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to: a. pelvic inflammatory disorder. b. toxic shock syndrome. c. cervical inflammation. d. sexually transmitted infections.

b. toxic shock syndrome.

A woman and her partner have been unable to conceive. The female client's chart reveals a history of pelvic inflammatory disease (PID), oral contraceptive usage for 5 years, blood pressure 98/72 mm Hg, pulse 78 beats/min, temperature 99°F (37.2°C), and white blood cell (WBC) count 9,500 mm3 (9.5 x 109/l). Which order will the nurse anticipate for this client? a. hysterosalpingography. b. oral antibiotic therapy. c. serum estrogen and progesterone testing. d. urinalysis.

a. hysterosalpingography.

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What assessments does the nurse anticipate will be performed for this couple? Select all that apply. a. ovulation monitoring. b. tubal patency. c. semen analysis. d. in vitro fertilization counseling. e. fertility drugs.

a. ovulation monitoring. b. tubal patency. c. semen analysis.

A client comes to the clinic for termination of pregnancy via medication. Which potential complication(s) will the nurse point out as possible with this type of procedure? Select all that apply. a. prolonged bleeding. b. hypoglycemia. c. infection. d. incomplete abortion. e. pneumonia.

a. prolonged bleeding. c. infection. d. incomplete abortion.

A clinic nurse is interviewing a young client during a subfertility work up. When the client asks the nurse what causes infertility, the nurse informs the client that the problem can rest with the man, the woman, or both. What does the nurse tell the client are common problem areas related to the woman? Select all that apply. a. tubal transport. b. impaired implantation. c. diabetes. d. ovulation. e. lack of exercise.

a. tubal transport. b. impaired implantation. d. ovulation.

Semen analysis has been ordered for the partner of a client who has been unable to become pregnant. What instructions should the nurse provide to the partner? a. "Keep the sample refrigerated to ensure the sperm survive." b. "Bring the sample to the lab immediately after you collect it." c. "Collect the sample after two consecutive days of ejaculating." d. "If possible, collect the sample first thing in the morning."

b. "Bring the sample to the lab immediately after you collect it."

The nurse working in a free health clinic assesses a 17-year-old client interested in contraceptives. Which statement by the client would indicate that female or male condoms would be the appropriate recommendation? a. "I do not want to follow in my sister's footsteps." b. "Last year I was diagnosed with HPV." c. "I have no problems swallowing medications." d. "I am leaving for college in just a few months."

b. "Last year I was diagnosed with HPV."

A client expresses interest in having an intrauterine device (IUD) placed for contraception. Which finding noted in the health history would indicate to the nurse that this would not be an appropriate contraceptive option? a. Sexually active since 16. b. Bicornuate uterus. c. G1P0. d. Dysmenorrhea.

b. Bicornuate uterus.

A nurse is performing discharge teaching for a client who just had an uterine endometrial biopsy. What is the nurse's priority discharge teaching? a. Client should call the health care provider with a fever of 100°F (37.8°C). b. Client should call clinic with the date of her next menses. c. Client should call the health care provider for vaginal spotting. d. Client should call the clinic for pain medication refill.

b. Client should call clinic with the date of her next menses.

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? a. Powerlessness related to infertility. b. Spiritual distress related to inability to conceive. c. Anticipatory grieving related to infertility. d. Hopelessness related to inability to conceive.

b. Spiritual distress related to inability to conceive.

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation? a. an ovulation suppressant. b. a diaphragm and spermicide. c. a spermicidal suppository. d. the rhythm (calendar) method.

b. a diaphragm and spermicide.

The nurse is assessing the health history of a male partner. Which data is most likely to be related to an infertility problem? a. 30 years of age. b. employment as a taxi driver. c. intercourse approximately every third day. d. immunization against mumps as a child.

b. employment as a taxi driver.

The estrogen content in the contraceptive pill performs which action? a. increases the level of luteinizing hormone (LH). b. suppresses follicle-stimulating hormone (FSH). c. decreases the permeability of cervical mucus. d. interferes with endometrial proliferation.

b. suppresses follicle-stimulating hormone (FSH).

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? a. cervical cap. b. transdermal contraception. c. diaphragm. d. sterilization.

b. transdermal contraception.

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus? a. when it is thick. b. when it is thin, watery, and copious. c. Cervical mucus is not a reliable indicator. d. when it does not stretch.

b. when it is thin, watery, and copious.

The nurse is conducting a health history on a couple planning to become pregnant over the next few months. Which statement by the male client most concerns the nurse? a. "I have severe asthma and use my inhaler several times each month." b. "I consume fast food a few times each week and enjoy a few beers on the weekends." c. "I have a degree as a chemical engineer and work at the local plant." d. "My uncle and his wife have not been able to conceive a child."

c. "I have a degree as a chemical engineer and work at the local plant."

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? a. "I will be able to go back to work in a day or two." b. "I will have this done in my urologist's office." c. "Right after surgery, my semen will be sperm-free." d. "I will be awake and will get local anesthesia."

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

A client states she has purchased home-use ovulation strips to help her know when she is ovulating. Which response by the nurse is most appropriate? a. "It is a lot more accurate if you come to the clinic routinely to get tested." b. "I am sure these strips will help you become pregnant faster." c. "You can also test your vaginal discharge to determine if you are ovulating." d. "These strips are often not reliable and end up being a waste of money."

c. "You can also test your vaginal discharge to determine if you are ovulating."

A client has been following the conventional 28-day regimen for contraception. She is now considering switching to an extended oral contraceptive pills (OCPs) regimen. She is seeking information about specific safety precautions. Which is true for the extended OCP regimen? a. It prevents pregnancy for 3 months at a time. b. It is not as effective as the conventional regimen. c. It carries the same safety profile as the 28-day regimen. d. It does not ensure restoration of fertility if discontinued.

c. It carries the same safety profile as the 28-day regimen.

The nurse is assessing a 52-year-old perimenopausal female who is concerned about the changes occurring in her body. When questioned about the most serious changes, which effect should the nurse point out? a. dense breast tissue is replaced with adipose tissue. b. the uterus and ovaries decrease in size. c. bone mineral density decreases. d. pelvic support muscles lose tone.

c. bone mineral density decreases.

The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptives (OCs) in the past and would like a long-term, nonhormone-based method that has a high rate of success. Neither she nor her husband wants to undergo surgery, however. Which method should the nurse recommend? a. transdermal patch. b. subdermal progestin implant. c. intrauterine device. d. tubal ligation.

c. intrauterine device.

A client desires protection from unwanted pregnancies. However, the client does not enjoy sex when her partner wears a male condom. Also, the client experiences breast tenderness, headache, and nausea after taking oral contraceptive pills (OCPs). Which method would be the most likely choice for the couple to help them enhance their sexual experience as well as prevent any side effects? a. polyurethane condom. b. natural membrane condom. c. transdermal contraceptive. d. ethinyl estradiol.

c. transdermal contraceptive.

A nurse is teaching a female client who is unable to conceive how to monitor her basal body temperature. Which instruction would the nurse prioritize for this client? a. Record menses and time of intercourse. b. Record body temperature every night. c. Record body weight along with the temperature. d. Chart body temperature for at least a month.

d. Chart body temperature for at least a month.

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? a. Write up an incident report for the medication error. b. Thank the nurse for excellent client care. c. Call the health care provider immediately. d. Remind the nurse that this injection should absorb slowly.

d. Remind the nurse that this injection should absorb slowly.

A client is to take clomiphene citrate for infertility. Which outcome should the nurse explain is the expected action of this medication? a. Break down scar tissue. b. Reduce inflamed endometrium. c. Decrease testosterone levels. d. Stimulate the release of ova.

d. Stimulate the release of ova.

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence? a. six months of nonuse. b. cervical infection. c. a vaginal infection. d. a weight gain of 10 lb (4.5 kg).

d. a weight gain of 10 lb (4.5 kg).

The nurse is assessing a client for amenorrhea. During the assessment, the nurse notes facial hair and acne. The nurse knows this could be related to: a. enlarged thyroid gland. b. excessive prostaglandin production. c. anorexia nervosa. d. an androgen excess secondary to a tumor.

d. an androgen excess secondary to a tumor.

A client is being prepared for intrauterine (artificial) insemination. Which finding is the most suggestive to determine if the client is ovulating? a. abdominal cramps. b. slight weight gain. c. fall in body temperature. d. change in the cervical mucus.

d. change in the cervical mucus.

The public health nurse is teaching a community class of couples on fertility awareness-based methods. The nurse determines that additional teaching is needed when one of the couples states that they will be using which method? a. cervical mucus ovulation method. b. basal body temperature method. c. symptothermal method. d. coitus interruptus method.

d. coitus interruptus method.

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client? a. oral contraceptive pills (OCPs). b. tubal ligation. c. intrauterine device (IUD). d. condoms.

d. condoms.

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common? a. hormonal imbalance. b. multigravida status. c. perimenopause. d. endometriosis.

d. endometriosis.

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about? a. elevation of her blood glucose level. b. hypertension. c. extensive bleeding during menstruation. d. overstimulation of the ovary resulting in potential multiple births.

d. overstimulation of the ovary resulting in potential multiple births.

Which description best explains the hysterosalpingogram procedure? a. passage of an endoscope through a small abdominal incision to inspect the reproductive organs. b. insertion of an endoscope through the posterior fornix to visualize the reproductive organs. c. instillation of carbon dioxide through the cervix into the uterus and fallopian tubes. d. radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix.

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

A couple who is in for fertility testing ask the nurse what tests are commonly performed to assess fertility. The nurse replies that there are only three primary tests that are used. What are these tests? a. pelvic sonogram, ovulation monitoring, and semen analysis. b. serologic test for syphilis, semen analysis, and tubal patency assessment. c. semen analysis, urinalysis, and ovulation monitoring. d. semen analysis, ovulation monitoring, and tubal patency assessment.

d. semen analysis, ovulation monitoring, and tubal patency assessment.

A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time? a. five days after the first day of the menstrual cycle. b. midway between the normal menstrual cycle. c. six days before the onset of menstruation. d. three days before and three days after ovulation.

d. three days before and three days after ovulation.