O'meara Prep U CH29

A nurse is providing education to a client with infertility concerns. Which statement by the client indicates appropriate understanding of the Spinnbarkeit Test

"Halfway in my cycle I will need to check my cervical mucus to see if I can stretch it in to long strands, indicating I am close to ovulating."

The nurse instructs a patient on the use of a vaginal estrogen/progestin rings (NuvaRing) for contraception. Which patient statement indicates that additional instruction is needed

"I am to take the ring out overnight."

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

"Last year I was diagnosed with HPV." The client has already contracted HPV; to prevent further spread of it—or contracting others—the nurse should recommend the client use male or female condoms.

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 client has been given instructions about a scheduled sonohysterosalpingogram. Which statement, if made by the client, should indicate to a nurse that the client has an adequate understanding of the instructions

"They will place a catheter in my uterus and use an ultrasound to see what the problem is."

A 25 year old having a yearly check-up informs the nurse that she has stopped taking birth control pills because she and her husband want to start a family. She states, "I know I will get pregnant right away, because my mother was very fertile." What is the nurse's best response

"Women who used oral birth control pills may have difficulty becoming pregnant for several months after discontinuing them."

After reviewing the various types of contraception available and discussing the pros and cons about each with the nurse, a young woman decides to use a spermicidal cream. When teaching the woman about this type of contraception, the nurse would instruct the woman to insert the cream at which time frame before intercourse

1 hour Spermicidal gels or creams are easily inserted into the vagina before coitus with the provided applicator. The woman should do this no more than 1 hour before coitus.

The health care provider prescribes 50 mg daily by mouth of clomiphene for a client having fertility problems. The client cannot swallow pills. Available is 200 mg/5 mL elixir. How many milliliters of the medication would the nurse administer? Record your answer using two decimal points

1.25ml

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

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?

A 40-year-old woman who smokes desires a reliable contraceptive method. Which should the nurse recommend to this patient

A condom and spermicide

A young woman is having trouble conceiving and has come in to the office for fertility testing. She states that she has irregular and unpredictable menstrual cycles. On blood testing, it is found that her ovaries are producing excess testosterone, which is lowering her follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. Which of the following is the most likely cause of her subfertility

Anovulation

The experienced nurse working in a fertility clinic understands the stress couples experience when they have to "schedule" sexual relations. Which suggestion would be most helpful to a couple to help prevent further stress on their relationship

Begin a new activity together.

The female partner of a young couple is concerned about what the results of fertility tests might reveal. Which nursing diagnosis should the nurse use to plan care for this patient

Fear related to possible outcome of subfertility studies

A client is beginning to take a combined oral contraceptive. Which of the following side effects will the nurse caution the client might be expected? Select all that apply

Headache Breast tenderness Nausea

A patient comes into the family planning clinic and requests a prescription for birth control pills. Which assessment finding indicates that an ovulation suppressant would not be the best contraceptive method for the patient

History of thromboembolism

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

The nurse is assessing a young couple who desire to get pregnant. The 38-year-old husband and 29-year-old wife report they had used oral contraceptive pills (OCPs); however, they have now been trying unsuccessfully to conceive over the past 4 months. What is the best response for the nurse to make

Increase intercourse frequency to four times a week around the time of ovulation

A young woman comes into the clinic stating that she is pregnant and does not want to have a baby. After counseling, the woman decides to terminate the pregnancy by having an abortion. The nurse explains that the procedure will be what type of abortion

Induced Abortion

A patient asks the nurse if a cervical cap is better than a diaphragm for contraception. What should the nurse explain is the advantage of a cervical cap

It can be left in place longer.

Inability to conceive can be very stressful on a couple. What is one psychological aspect of infertility

Loss of intimacy

Blood work results show that a client has a luteal defect, which is suspected to be the primary cause of her subfertility. The nurse explains that this condition is generally corrected by which of the following

Progesterone vaginal suppositories

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 26-year old mother of three children tells the nurse at her annual check-up that she does not want to have any more children; however, her religion forbids the use of contraceptive devices. Which of the following methods would be the best option for this client

Rhythm method

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.

Which information is important for a woman to understand before undergoing a scheduled tubal ligation

She must think of the procedure as irreversible.

Why is fertility testing initiated with sperm analysis of the male partne

Sperm analysis is one of the easiest tests to complete.

A couple comes in and tells the nurse that they have been trying diligently to conceive for the last 3 months and are subfertile. What should the nurse explain to the couple about the definition of subfertility

Subfertility is said to exist when a pregnancy has not occurred after at least 1 year of engaging in unprotected coitus.

What important information should the nurse give a client about the use of a diaphragm during menstruation

Toxic shock syndrome is possible

The nurse is teaching a client about a vasectomy. The nurse determines the session is successful when the client correctly chooses which fact concerning the vasectomy

Usually done as an office procedure

A client with liver disease is seen in the clinic wanting to begin contraception. The nurse recognizes that which type of contraception is best for this client

Vaginal estrogen/progestin ring (hormones are released into membranes of vagina and avoid the first pass through the liver

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 diaphragm and spermicide Women over 40 who smoke should not take ovulation suppressants; irregular menstrual cycles make natural methods difficult; women over 40 may have vaginal dryness, so a spermicidal suppository would not be activated.

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 weight gain of 10 lb (4.5 kg) A substantial weight gain or weight loss of 10 pounds (4.5 kilograms) or more may shift the relationship of pelvic organs enough that the diaphragm no longer fits correctly.

A client prescribed oral contraceptive pills (OCPs) has presented for a routine visit. Which finding upon assessment should the nurse prioritize

abdominal pain

The nurse is preparing a presentation for a group of adolescents and young adults about sexually transmitted infections and the use of condoms. Which information would the nurse most likely include

applying the condom before there is any penile-vulvar contact

The school nurse is preparing a health education session on the topic of birth control for a college group. Which method should the nurse emphasize for this group

barrier

A woman in the 15th week of gestation is planning on terminating the pregnancy. The procedure done for second trimester terminations is which of the following

dilation and extraction

A nurse is asked to teach a woman to take her basal body temperature daily to assess the time of ovulation. She can detect her day of ovulation, following ovulation, because her temperature will

increase a degree. The effect of progesterone, released with ovulation, is to increase body temperature.

The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptive pills (OCPs) 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

intrauterine device

When discussing contraceptive options, the nurse would recommend which option as being the most reliable

intrauterine system

The nurse informs the client that a diaphragm is an example of which type of contraception

mechanical barrier

A nurse is providing a client with information on hormonal contraception. Which could the nurse use as an example of hormonal contraception

medroxyprogesterone

The client is interested in using an injectable contraceptive that works by suppressing pituitary secretions. The nurse provides the client with literature and discusses which contraceptive with her

medroxyprogesterone acetate Medroxyprogesterone acetate is an injectable form of a progesterone-only contraceptive that is given every 12 weeks.

A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event

ovulation

A female patient who has been trying to conceive for 1 year comes to the fertility clinic and will be undergoing a subfertility evaluation. When discussing the components involved, which information would the nurse most likely include? Select all that apply

semen analysis of the partner ovulation monitoring tubal patency assessment

The estrogen content in the contraceptive pill performs which action

suppresses follicle-stimulating hormone (FSH) Estrogen has a direct effect on the pituitary gland suppressing FSH; progesterone increases permeability of cervical mucus and endometrial proliferation.

A nurse is helping a couple choose a contraception method that is right for them. Which is the least likely factor the nurse should consider

the popularity of the method among the couple's friends

A male client asks the nurse to explain which structure is cut during a vasectomy. What response should the nurse give the client

the vas deferens

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

transdermal contraception The fact that this woman has a latex allergy rules out the female condom, cervical cap, and diaphragm. Moreover the diaphragm is contraindicated in her case, due to her papillomavirus infection. The best choice for her is the transdermal contraception, which involves wearing a patch for a week at a time and does not require taking pills daily

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

DVT (deep vein thrombosis)

A patient who has unprotected intercourse has obtained the morning after pill but has not yet taken the prescribed dosage. What nursing diagnosis should the nurse identify as appropriate for the patient at this time

Decisional conflict

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. The estrogen content of birth-control pills may lead to increased blood clotting, leading to an increased incidence of thromboembolism. Women who already are prone to this should not increase their risk further.

The nurse is planning an educational session on contraceptives for a group of adolescent high school students. What does the nurse need to do when planning this session

Teaching about contraceptive options while avoiding indirect encouragement of sexual activity.

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 Therapy with clomiphene citrate may be used to stimulate ovulation. Administration of either clomiphene citrate or gonadotropins may overstimulate an ovary, causing multiple ova to come to maturity and possibly resulting in multiple births. The nurse should counsel women who receive these agents that this is a possibility. None of the other answers is a common effect of clomiphene citrate use

A female patient being treated for infertility is completing the third course of clomiphene citrate. What information should the nurse prepare for the patient in the event this course does not result in conception

Additional options to achieve conception

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

coitus interruptus method Fertility awareness refers to any natural contraceptive method that does not require hormones, pharmaceutical compounds, physical barriers, or surgery to prevent pregnancy. Fertility awareness-based methods (FAMs) use physical signs and symptoms that change with hormone fluctuations throughout a woman's menstrual cycle to predict a woman's fertility. Techniques used to determine fertility include the cervical mucus ovulation method, the basal body temperature method, the symptothermal method, standard day's method, and two-day method. Coitus interruptus or withdrawal is not considered a fertility awareness based method.

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

three days before and three days after ovulation Typically, the unsafe period during the menstrual cycle is approximately 3 days before and 3 days after ovulation. An ovum is released from the ovary 14 days before the next menstrual period.

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

condoms Because the client has multiple sex partners, condoms will help offer protection against sexually transmitted infections (STIs) and are best suited for her needs. The client cannot use an IUD because of her history of various pelvic infections. Although OCs will help the client as a means of contraception, this method is not the best choice for her because it does not offer protection against STIs. Tubal ligation is a sterilization procedure and does not suit the client's purpose.