family planning

A client visits a healthcare facility for information on a vasectomy. Which of the following would best describe the initial information a nurse should provide? a) The procedure cannot be reversed b) Regular sperm counts are not essential c) Vasectomy is a relatively easy procedure with few complications d) Birth-control measures are not required

c) The nurse should inform the client that vasectomy is a relatively easy procedure with few complications. Regular sperm counts following a vasectomy are important. Reversals (reattaching the vas deferens) of vasectomies are not uncommon, but these are often unsuccessful. The client should use birth-control measures until his sperm count remains at zero for 6 weeks

Which of the following is considered a barrier method of contraception? a) Condom b) IUD c) Vaginal ring d) Depo-Provera

a) Condoms are considered a barrier method of contraception. The other choices given are all hormonal methods

A woman and her partner have been trying to conceive for over 2 years without success. Ultrasound imaging reveals scarring of her fallopian tubes, which appears to be the primary cause of subfertility. The nurse knows that which of the following is the most likely cause of the scarring? a) Ruptured appendix b) Pelvic inflammatory disease c) Abdominal surgery d) Turner syndrome

b) Difficulty with tubal transport usually occurs because scarring has developed in the fallopian tubes typically caused by chronic salpingitis (chronic pelvic inflammatory disease [PID]). This could also result from a ruptured appendix or from abdominal surgery which involved infection that spread to the fallopian tubes and left adhesion formation in the tubes, but these causes are less likely. Turner syndrome is an underlying cause for anovulation, not tubal scarring

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

b) The cervical mucus method relies on the changes that occur naturally with ovulation. Before ovulation, cervical mucus is thick and does not stretch when pulled. With ovulation, the mucus becomes thin, copious, watery, transparent, and stretchy

A woman visits your family-planning clinic to request a prescription for birth-control pills. Which of the following factors would indicate that an ovulation suppressant would not be the best contraceptive method for her? a) She has irregular menstrual cycles. b) She has a family history of thromboembolism. c) She has a history of allergy to foreign protein. d) She is 30 years old.

b) 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

A young female client visits a clinic for guidance on using a barrier method of contraception. Which method would be most appropriate method to recommend to the client? a) Lunelle b) Femcap c) Copper IUD d) Ortho-Evra

b) The nurse should recommend Femcap to the client. Femcap is a cervical cap and, hence, a barrier method of contraception. The copper IUD, Lunelle, and Ortho-Evra are not barrier methods of contraception. The copper IUD is a copper-based intrauterine contraceptive; Lunelle is a combined injectable contraceptive; and Ortho-Evra is a transdermal contraceptive patch

The nurse should carefully screen a client who insists on using only combined oral contraceptives for which of the following? a) Use of alcohol b) Deep vein thrombosis c) Gastrointestinal diseases d) Impaired absorption

b) The nurse should screen the client for deep vein thrombosis (DVT), migraine headaches, neurological symptoms, coronary artery disease or cerebral vascular disease, severe diabetes, hypertension, liver disease, breast or endometrial cancer, and unexplained vaginal bleeding when combined oral contraceptives are used. Gastrointestinal diseases are contraindicated in the use of progestin-only pills. Combined oral contraceptives are not contraindicated in clients who drink alcohol. Impaired absorption is a contraindication for the use of progestin-only pill

Your client is taking oral contraceptives. If she reports all of these symptoms, which one should the client report to the primary care provider? a) Cramping during menses b) Abdominal pain c) Small amount of breakthrough bleeding d) Light menstrual flow

b) The warning signs to report for a client on oral contraceptives are severe abdominal or chest pain, dyspnea, headache, weakness, numbness, blurred or double vision, speech disturbances, or severe leg pain and edema. Light bleeding, light flow, and cramping are all normal

Which of the following would be most appropriate when explaining endometriosis as a cause of a woman's infertility? a) "You do not ovulate because of endometrial implants on the ovaries." b) "Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum." c) "Your uterine cervix fails to close because it is engorged with tissue." d) "Menstrual sloughing does not occur, so there is never a new base for embryo growth."

b) With endometriosis, endometrial tissue migrates into the fallopian tubes and peritoneum or other sites outside of the uterus. Ovulation occurs, but the egg may be trapped by the misplaced tissue

You are the nurse in a primary care clinic and your patient has come to see the physician because she is getting married and wants to have a prenuptial gynecologic examination. After the exam the nurse asks about the woman's plan to have a family. The woman responds, "why do I have to plan for a family?" What would be your best response? a) You and your husband need to decide on a method of birth control b) You can control the time between births when you plan your family c) Families are always best when you don't plan your pregnancies d) You can always abort an unwanted pregnancy

b) Women and couples can avoid unwanted pregnancies, bring about wanted births, and control the intervals between births

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? a) They are considered a permanent end to fertility. b) They present a high risk of respiratory failure. c) They are available only in the form of suppositories. d) They can be taken only in the first trimester.

d) The client is seeking a medical abortion. The nurse should inform the client that such medications are effectively used to terminate a pregnancy only during the first trimester, not the second. The medications are available as a vaginal suppository or in oral form and do not present a high risk of respiratory failure. Sterilization, not abortion, is considered a permanent end to fertility

A male client has undergone a semen analysis for evaluation of fertility. The nurse understands that a sperm count of which of the following would suggest infertility? a) 18 million/mL b) 100 million /mL c) 50 million/mL d) 75 million/mL

a) A sperm count of fewer than 20 million spermatozoa per milliliter results in infertility. Normal sperm count ranges on average from 60 to 100 million /mL.

A male client visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. Which of the following is a risk factor associated with male infertility? a) No or few sperm cells produced b) Morphology of sperm within normal limits c) Sperm density about 20 million/mL d) 2 to 5 mL of semen ejaculated

a) Azospermia or oligospermia (no or few sperm cells produced) is a risk factor affecting male infertility. Normally, the volume of semen ejaculated needs to be about 2-5 mL, with a density of sperm at about 20 million/mL. In addition to the number of sperm, the motility (movement), viability, and morphology (shape) of the sperm must be within normal limits

A couple comes to the clinic stating that they have one child who is 4 years old, but they have been trying to have another child for 1 year without success. What type of subfertility would this be considered? a) Secondary subfertility b) Sterility c) Erectile dysfunction d) Primary subfertility

a) In secondary infertility, there has been a previous viable pregnancy, but the couple cannot conceive at present

The nurse is planning to speak at a local community center to a group of middle-aged women about osteoporosis. Which of the following would the nurse be sure to include as effective in reducing the risk for osteoporosis? a) Drinking at least 1 glass of wine/day b) Engaging in daily weight-bearing exercise c) Decreasing vitamin D intake d) Limiting intake of cholesterol and saturated fats

b) Engaging in daily weight-bearing exercise such as walking helps to reduce a woman's risk for osteoporosis. To prevent osteoporosis, women should increase their calcium and vitamin D intake. Avoiding excessive alcohol ingestion helps prevent osteoporosis. Limiting intake of cholesterol and saturated fats helps reduce the risk for cardiovascular disease, not osteoporosis

A woman is inquiring about the effectiveness of birth control methods. She is considering diaphragm, condoms, oral contraceptives, and Nexplanon. Of these choices, which method can you advise her is the most reliable? a) Diaphragms b) Nexplanon c) Oral contraceptives d) Condoms

b) Nexplanon is a small flexible, plastic rod implanted into the arm of the patient. This method requires replacement only every 3 years and high success rate for pregnancy prevention. The failure of diaphragms, condoms, and oral contraceptives has been well documented

A patient in the clinic requests birth control pills to prevent pregnancy. Upon taking a sexual history, the nurse realizes that the patient has multiple partners. Which type of contraception would be the best for the nurse to suggest? a) birth control pills b) calendar method c) condoms d) natural method

c) Because this patient has multiple partners, there is concern over risk for sexually transmitted infections (STIs) as well as pregnancy. Condoms are the only contraception that protects against STIs, which is an important concern if the patient is not in a monogamous relationship

A young patient comes to the clinic and requests birth control pills to prevent a pregnancy. She tells the nurse that she is worried that she will get mixed up on what days to take the pills. Which would be the best type of pills to prescribe this patient? a) COCs packaged with 21 pills b) COCs packaged with 30 pills c) COCs packaged with 28 pills d) COCs packaged with 14 pills

c) COCs are packaged with 21 or 28 pills. To eliminate having to count days between pill cycles, most brands are packaged with 28 pills: 21 active pills and 7 placebo pills. There is no need to skip days, because the menstrual flow will begin during the 7 days on which she takes the placebo tablets

A client is being prepared for artificial insemination. Which finding is the most suggestive to determine if the client is ovulating? a) Abdominal cramps b) Slight weight gain c) Change in the cervical mucus d) Fall in body temperature

c) Change in the appearance and consistency of cervical mucus is an indication of ovulation. Slight weight gain and abdominal cramps are not signs used to determine ovulation. At the time of ovulation, body temperature is slightly elevated

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 which of the following? a) Three days before and three days after ovulation b) Five days after the first day of the menstrual cycle c) Midway between the normal menstrual cycle d) Six days before the onset of menstruation

a) 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 patient you care for had an intrauterine device (IUD) inserted 2 weeks ago. In which of the following women would IUDs be contraindicated? a) Women with hypertension b) Women with histories of thromboembolic disease c) Women over 35 years of age who smoke d) Women with multiple sexual partners

d) The use of an IUD may increase the risk of pelvic inflammatory disease; women with multiple sexual partners are at risk for PID and should not compound their risk further

Your patient regularly travels internationally for work and has a lot of job anxiety. She also uses an electric heating blanket every night she is at home. Which of these fertility awareness methods would you discourage her from using? a) Cervical mucus method b) Calendar method c) Symptothermal method d) Basal body temperature (BBT) method

d) BBT is a method where the body temperature should be check first things in the morning and recorded, immediately after waking and before getting out of bed. It is important for the patient to maintain a normal bed-time routine. Use of the electric blanket can cause a false elevation in the BBT. The calendar method would depend upon her schedule. Cervical mucus and symptothermal methodology would still be options

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 three assessments does the nurse anticipate will be performed for this couple? (Select all that apply.) a) Tubal patency b) Semen analysis c) Fertility drugs d) In vitro fertilization counseling e) Ovulation monitoring

a,b,e) Today, a subfertility investigation usually is limited to three assessments: semen analysis, ovulation monitoring, and tubal patency

A nurse is preparing a client for intrauterine device (IUD) insertion. What should the nurse inform the client when educating her on IUDs? a) Reduced menstrual flow after insertion b) Regular check of threads must be done c) Insertion procedure is painless d) Continuous cramps after insertion

b) The nurse should instruct the client to check the threads regularly to make sure that the IUD is in place. Menstrual flow may be heavier, or last longer than normal, after IUD insertion. It will not decrease. The client may feel a sharp pain when the IUD is inserted. The client may have cramps for a few days, but these should not continue.

You are asked to schedule a hysterosalpingogram. Which of the following questions would be most important to ask the woman before scheduling the procedure? a) Are you allergic to any sedatives? b) When did you have coitus last? c) When do you expect your next menstrual flow? d) What is your blood type and Rh factor?

c) Because a radiograph is involved, the procedure should be done in the few days following a menstrual flow when she is not apt to be pregnant

A young patient who is about to go overseas on active duty in the army comes to the clinic and asks for birth control. After discussing the different options with the patient, which of the following would the nurse suggest as best for this patient? a) COCs packaged with 21 pills b) COCs packaged with 28 pills c) lybrel d) morning-after pills

c) Lybrel is a new U.S. FDA-approved low-dose combination estrogen and progestin pill taken 365 days a year without a placebo or pill-free interval, so menstrual periods are completely eliminated. Such pills are attractive to physically active women and those who work long schedules such as military deployment

When do condoms need to be applied to be effective? a) At least 1 hour prior to coitus b) Before penile-vulvar contact c) As soon as the penis becomes erect d) Immediately after ejaculation

b) Some sperm may be released with pre-ejaculation semen, so a condom needs to be used with any penile-vulvar contact.

Dilation and curettage is the method of abortion used when the gestational age of a pregnancy is still less than 13 weeks. a) True b) False

a)

Men who want their sperm to be available for the future can have it sperm banked before vasectomy. a) True b) False

a)

Couples who engage in coitus daily, hoping to cause early impregnation, may actually have more difficulty conceiving than those who space coitus to every other day. a) False b) True

b)

What suggestions can the nurse make to the subfertile couple trying to work through the the stress that fertility testing is placing on their lives? a) Encourage them to join a support group for subfertile couples. b) Inform them that results are not instantaneous and they will have to deal with the stresses and disappointments. c) Encourage them to see a psychiatrist. d) Inform them that other people are going through the same thing.

a) Participation in a support group may allow a couple to work through the stress that fertility testing places on their lives. Resolve (http://www.resolve.org), a national support group for couples with subfertility, can be helpful in offering referral sources and support that a couple can use in planning

A 30-year-old client tells the nurse that she would like to use a contraceptive sponge but does not know enough about its use and whether it will protect her against sexually transmitted infections (STIs). Which information should the nurse provide the client about using a contraceptive sponge? Select all that apply. a) Leave the sponge in place for at least 6 hours following intercourse. b) Wet the sponge with water before inserting it. c) Keep the sponge for more than 30 hours to prevent STIs. d) Insert the sponge 24 hours before intercourse. e) Replace sponge every 2 hours for the method to be effective.

a,b,d) The nurse should instruct the client to wet the sponge before inserting it, to insert it 24 hours before intercourse, and to leave it in place for at least 6 hours following intercourse, to be effective. The sponge should not be replaced every 2 hours because this will reduce its efficacy. A contraceptive sponge covers the cervix and releases spermicide. It does not protect against STIs. Therefore, keeping the sponge for more than 30 hours will not prevent STIs, but will increase risk of toxic shock syndrome

A sexually active patient comes to the clinic. She tells the nurse she is monogamous but does not want to get pregnant. After doing an assessment the nurse informs the patient that she is a good candidate for birth control pills. The patient tells the nurse that she has heard that these pills have bad effects. What things could the nurse tell the patient about birth control pills that are positive? (Select all that apply.) a) decrease iron-deficiency anemia b) increase menstrual flow c) decrease incidence of dysmenorrhea d) decrease acute pelvic inflammatory disease e) decrease acne

a,c,d,e) Although birth control pills have many side effects and some of them serious, they also have non-contraceptive benefits, such as decreased incidences of dysmenorrhea, premenstrual dysphoric syndrome, acne, iron-deficiency anemia, and acute PID and resulting tubal scarring

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which of the following should the nurse say is a mechanical barrier contraceptive? a) Spermicidal creams b) Vaginal foams c) Cervical cap d) Spermicidal jellies

c) A cervical cap is a mechanical barrier contraceptive that interferes with conception by physically preventing sperm from fertilizing ova. Vaginal foams and spermicidal creams and jellies are chemical barrier contraceptives.

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? a) Endometriosis b) Stenotic cervical os c) Anovulation d) Tubal transport problems

c) Anovulation is absence of ovulation or release of ova from the ovary. The most frequent cause for anovulation is naturally occurring variations in ovulatory patterns or polycystic ovary syndrome, a condition in which the ovaries produce excess testosterone lowering FSH and LH levels, which then causes irregular and unpredictable menstrual cycles. Based on the woman's symptoms and test results, anovulation is the most likely cause of her subfertility. The other conditions listed would not have the same symptoms and test results

A woman uses a diaphragm for contraception. You would instruct her to return to the clinic to have her diaphragm fit checked after which of the following? a) Cervical infection b) Six months of nonuse c) A vaginal infection d) A weight gain of 10 lb.

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

A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend? a) Vasectomy b) Postcoital douching c) Diaphragm d) Oral contraception

d) An oral contraceptive would be the best choice of those listed for this client, as it is a temporary contraceptive that also can help relieve dysmenorrhea. Postcoital douching is ineffective as a contraceptive measure as sperm may be present in cervical mucus as quickly as 90 seconds after ejaculation. Diaphragms are contraindicated for women with a history of recurrent urinary tract infections. Vasectomy is a permanent measure, and thus inappropriate in this situation

A man is interested in artificial insemination if he is proven to be infertile. He asks you if this procedure would be appropriate for him and his sexual partner. Which of the following statements would be your best response? a) "Artificial insemination is useful only if your sexual partner has an allergy to your sperm, not if you are infertile." b) "The chance of twins is increased with artificial insemination." c) "You and your sexual partner should consider embryo transfer first, because it is safer." d) "You need to consider donor-therapeutic insemination if you are found to be infertile."

d) Donor-therapeutic insemination involves the donation of sperm from another fertile male; it is used when the primary sexual partner is infertile

The estrogen content in the contraceptive pill performs which of the following actions? a) Increases the level of luteinizing hormone (LH) b) Decreases the permeability of cervical mucus c) Interferes with endometrial proliferation d) Suppresses follicle-stimulating hormone (FSH)

d) Estrogen has a direct effect on the pituitary gland suppressing FSH; progesterone increases permeability of cervical mucus and endometrial proliferation

You are 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 a) increase a degree. b) decrease a degree. c) fluctuate a degree daily. d) no longer reflect basal body temperature.

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

A female client comes to the clinic and asks the nurse what would be the most cost effective method for her to determine her ovulation patterns. What is the best response by the nurse? a) "The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months." b) "The least costly method would be a surgical procedure to determine if your fallopian tubes are blocked." c) "The testing kit, Fertell, should be purchased, as well as a sperm kit for your male partner." d) "The least costly method would be to purchase a commercial kit from the store to assess the upsurge of LH that occurs just after ovulation."

a) The least costly way to determine a woman's ovulation pattern is to ask her to record her basal body temperature (BBT) for at least 4 months

A young newly married woman comes to the clinic and asks about ways to prevent pregnancy. When the nurse begins to talk about oral contraceptives, the patient says that she is Catholic and against this form of birth control. What can the nurse recommend for this patient? a) rhythm method b) IUD c) condoms d) transdermal patch

a) The nurse should instruct the patient on the calendar or rhythm method. This method requires the couple to abstain from coitus on the days of the menstrual cycle when the woman is most likely to conceive (3 to 4 days before until 3 to 4 days after ovulation). The other options are forms of contraception prohibited by the Catholic religion

A client is being prepared for artificial insemination. Which finding is the most suggestive to determine if the client is ovulating? a) Abdominal cramps b) Change in the cervical mucus c) Fall in body temperature d) Slight weight gain

b) Change in the appearance and consistency of cervical mucus is an indication of ovulation. Slight weight gain and abdominal cramps are not signs used to determine ovulation. At the time of ovulation, body temperature is slightly elevated

A client asks the nurse, "What would be the best way to get pregnant." The nurse would incorporate which of the following in the response? a) Conception is more likely if the sperm has just been ejaculated b) Conception is more likely when intercourse occurs within 72 hours of ovulation c) Conception is more likely in the presence of orgasm d) The timing of intercourse and conception affects the sex of the pregnancy

b) Conception is more likely when sexual intercourse occurs within 72 hours of ovulation. There is no evidence that age of sperm in the ejaculate affects its viability or that the timing of intercourse affects the sex of the pregnancy. Studies have also shown that conception is more likely in the absence of orgasm

Inability to conceive can be very stressful on a couple. What is one psychological aspect of infertility? a) Growth of intimacy b) Loss of intimacy c) Emotional stability d) Couple becomes closer

b) Intimacy, love, and support—essential components of a couple's sexual relationship—may be lost because intercourse takes on a clinical and mechanical tone

Which of the following best describes the hysterosalpingogram procedure? a) Passage of an endoscope through a small abdominal incision to inspect the reproductive organs b) Instillation of carbon dioxide through the cervix into the uterus and fallopian tubes c) Radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix d) Insertion of an endoscope through the posterior fornix to visualize the reproductive organs

c) Hysterosalpingogram is a procedure to document the potency of the fallopian tubes through the use of a radiopaque medium.

female client is interested in knowing what the most effective procedure for permanent sterilization in women is. The nurse should mention to the client which of the following? a) Diaphragm b) Vasectomy c) Tubal ligation d) Spermicidal creams

c) Tubal ligation is the most common and effective procedure for permanent sterilization in women. It involves ligating or tying off the fallopian tubes so that ova cannot travel through them to the uterus, thus preventing conception. Vasectomy is a sterilization treatment for men, which involves ligating or tying off the vas deferens, the tube that transports sperm from the testes to outside the body, thus preventing conception. A diaphragm is a mechanical barrier contraceptive, and spermicidal creams are chemical barrier contraceptives. Neither of these is a procedure for permanent sterilization

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

c) Women who are premenopausal are, overall, good candidates for intrauterine devices (IUDs). In this case, the IUD is the best choice because this method is almost 100% effective, is long-term, and does not involve any hormones. Both the transdermal patch and the subdermal progestin implant involve hormones, which rules each out in this case. Also, tubal ligation is a surgical procedure, which also rules it out for this client

After teaching a woman who has chosen the vaginal ring as her method of contraception, the nurse determines that the client needs additional teaching when she states which of the following? a) "I don't have to worry so much about the exact placement." b) "I'll compress the ring, inserting it as far back as possible." c) "Once I remove the ring, I'll discard it." d) "I will insert a new ring at the same time and day of every week."

d) The vaginal ring involves a 3-week period of continuous use followed by a ring-free week to allow withdrawal bleeding. The ring is compressed and inserted into the vagina, as far back as possible, but precise placement is not critical. After 3 weeks, the ring is removed and discarded

A male patient has requested information on vasectomy. Which of the following would you include in your education to him? a) He will no longer ejaculate b) His testes will no longer produce sperm c) He may notice permanent increased scrotal swelling d) It is usually done as an office procedure

d) Vasectomy does not stop sperm production; it is an office procedure done to halt the flow of sperm. There is no swelling, and he will have normal sexual function

A female patient 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) A hysterosalpingography b) A uterine endometrial biopsy c) A sonohysterography d) A hysteroscopy

a) A hysterosalpingography, a radiologic examination of the fallopian tubes using a radiopaque medium, is a frequently used technique.

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

b,c,d) Female factors that cause subfertility are problems with ovulation, tubal transport, and implantation

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 contraceptives. 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) Transdermal contraceptive b) Ethinyl estradiol c) Polyurethane condom d) Natural membrane condom

a) Application of transdermal contraceptive patches to the skin would most likely be the option for this couple. These patches will not hamper the sexual experience nor cause side effects such as those caused by oral contraceptives. Natural membrane and polyurethane condoms are forms of male condoms, which the client does not like. Ethinyl estradiol is a combined oral contraceptive which would most likely cause the client to experience breast tenderness, headache, and nausea.

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 should the nurse suggest for this client? a) Condoms b) Tubal ligation c) Intrauterine device (IUD) d) Oral contraceptives (OCs)

a) 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

A woman is to receive methotrexate and misoprostol to terminate a first-trimester pregnancy. When preparing the teaching plan for this client, the nurse understands that misoprostol works by: a) Causing uterine contractions to expel the uterine contents b) Dilating the cervix c) Blocking the action of progesterone on the endometrium d) Acting as a toxin to the trophoblastic tissue

a) Misoprostol works by causing uterine contractions, which help to expel the uterine contents. It has no effect on cervical dilation. Methotrexate is toxic to the trophoblastic tissue. Mifepristone blocks the action of progesterone, which is responsible for preparing the endometrium for implantation and then maintenance of the pregnan

A woman using the basal body temperature method of contraception should refrain from having sexual intercourse a) 3 days after she records a slight drop in her temperature followed by an increase. b) 4 days after she notices her temperature rise. c) 3 to 4 days after she records a slight increase followed by a dip in her temperature. d) 14 days after the last day of her menstrual period.

a) Ovulation occurs after a slight drop in temperature followed by an increase. The ovum has a life span of 3 days

One rationale for including preconception care in general health care is to: a) Decrease the number of unwanted pregnancies b) Establish lifestyle behaviors to maintain optimum health c) Determine her interest in starting a contraceptive method d) Evaluate her pelvic capacity for vaginal childbirth

a) Preconception counseling with general health care is a health promotion activity to help prevent unwanted pregnancies and allow for family planning. There is no need for invasive or persuasive measures

Which of the following is most important when providing contraceptive care to the client? a) Providing detailed education to the client b) Offering emergency contraception to the client c) Fitting contraceptives for the client to determine size d) Discussing preferences with the client's partner

a) Providing detailed education to the client regarding various methods of contraception is a critical nursing intervention. Fitting contraceptives for the client to determine size, offering emergency contraception to the client, and evaluating the side effects of contraceptives in the client are important but education is the priority because the contraceptive is only as effective as the client's consistent use of the method.

Prevention of pregnancy is a major factor in the sex lives of many couples. One method of contraception is the female condom. It is a thin tube made of polyurethane, with flexible rings at both ends. What is a disadvantage of the female condom? a) Can slip into the vagina during vigorous intercourse b) The external ring decreases stimulation to the clitoris c) Can't be used by people sensitive to latex d) Need an erection to remain in place

a) Reported disadvantages are that the condom may be difficult to apply, make noise, cause vaginal or penile irritation, or slip into the vagina during vigorous intercourse, a condition that decreases its effectiveness

The nurse is assessing a couple who has come to the health care facility because they have been unable to conceive a child. When assessing the woman, which factor would the nurse identify as increasing the woman's risk for infertility? a) Endometriosis b) Dysmenorrhea c) Age of 25 years d) Patent fallopian tubes

a) Risk factors for infertility include endometriosis, age older than 27 years, tubal blockages, weight variations, hormonal imbalances, fibroids, reduced oocyte quality, chromosomal abnormalities, congenital anomalies of the cervix and uterus, immune system disorders, chronic illnesses, sexually transmitted infections, history of PID, smoking and alcohol consumption, multiple miscarriages, and psychological stress. Dysmenorrhea is not an associated risk factor

A male client asks the nurse to explain which structure is cut during a vasectomy. What should the nurse respond to the client? a) The vas deferens b) The epididymis c) The scrotum d) The ejaculatory ducts

a) The two vas deferens or ductus deferentia are ligated and cut in the male sterilization procedure, called a vasectomy. The epididymis serves as a site for sperm to mature and be stored until ejaculation occurs. The ejaculatory ducts empty into the urethra and receive secretions from the prostate gland to make up semen. The scrotum is a sac-like structure that sits behind the penis and houses the testicles

A 16-year-old girl is brought to the clinic by her mother because she has not had a menstrual period for the past 8 months. Which of the following findings might alert the nurse to the possibility that anorexia nervosa may be contributing to the client's amenorrhea? Select all that apply. a) Evidence of secondary sex characteristics b) Hypotension c) Reduced subcutaneous fat d) Hyperthermia e) Bradycardia

b,c,e) Hypothermia, bradycardia, hypotension, and reduced subcutaneous fat may be observed in women with amenorrhea with anorexia nervosa as the contributing factor. Evidence of secondary sex characteristics would be a normal finding for a girl of this age

A nurse is counseling a 17-year-old girl on the importance of contraception. The girl states that she is not really concerned about getting pregnant; she says that she will deal with it if and when it happens. Which of the following points should the nurse emphasize with the patient regarding the risks of unintended pregnancies? (Select all that apply.) a) The woman is less likely to seek prenatal care b) The woman is less likely to protect her fetus from harmful substances c) The woman is more likely to require public assistance d) The woman is more likely to have a baby with birth defects e) The woman is less likely to complete high school or college f) The woman is less likely to breastfeed

a,b,c,e,f) It is important for the health of children that as many pregnancies as possible be intended as when a pregnancy is unintended or mistimed, both short-term and long-term consequences can result. Among the many consequences are all of the answers listed above, except for increased likelihood of having a baby with birth defects, which is not mentioned in the chapter

The nurse is developing a presentation for a group of young adult women about premenstrual syndrome. Which of the following would the nurse include as possible treatment options? Select all that apply. a) Diuretic therapy b) NSAIDs c) Vitamin and mineral supplements d) Decrease in water intake e) Antipsychotic medications f) Reduction of caffeine intake

a,b,c,f) Treatment options for PMS include lifestyle changes such as reduction in caffeine intake, a well-balanced diet with increased water intake, and limited alcohol intake. Vitamin and mineral supplements, NSAIDs, and diuretic therapy may be used. Antidepressants and antianxiety agents, not antipsychotic agents, may also be options

Which of the following couples would most likely benefit from in vitro fertiliziation (IVF) after trying unsuccessfully to conceive? (Select all that apply.) a) A woman who has blocked or damaged fallopian tubes b) A man who has oligospermia c) A woman who has had a hysterectomy d) A couple with unexplained subfertility of long duration e) A woman who lacks cervical mucus

a,b,d,e) IVF is most often used for couples who have not been able to conceive because a woman has blocked or damaged fallopian tubes. It is also used when the man has oligospermia, or a very low sperm count, because the controlled, concentrated conditions in the laboratory require only one sperm. IVF may be helpful to couples when an absence of cervical mucus prevents sperm from traveling to or entering the cervix, or antisperm antibodies cause immobilization of sperm. In addition, IVF may help couples with unexplained subfertility of long duration

A nursing student identifies which of the following to be methods for delivering hormonal contraception? (Select all that apply.) a) implantation b) orally c) rectally d) vaginally e) transdermally f) injection

a,b,d,e,f) Methods to deliver hormonal contraception include orally, transdermally, vaginally, implantation, and injection

A nurse is preparing a presentation for a local community women's group about menopause. When describing the body system changes that occur, the nurse would include which change? Select all that apply. a) Vaginal dryness b) Decreased waist size c) Moist, supple skin d) Hot flashes e) Decreased bone density f) Increased abdominal fat

a,d,e,f) Menopause may be associated with hot flashes, increased abdominal fat, vaginal dryness, decreased bone density, dry, thinning skin, and increased waist size

About 75% of pregnancies caused by in vitro fertilization end in spontaneous miscarriage. a) True b) False

b) About 25% of pregnancies caused by in vitro fertilization end in spontaneous miscarriage (the same rate as for natural pregnancies

Which of the following is an advantage of a cervical cap over a diaphragm? a) It needs no spermicidal jelly. b) It can be left in place longer. c) It does not need to be refitted after pregnancy. d) No initial fitting is required

b) Because a cervical cap does not press against the sides of the vagina, possibly interfering with blood supply, it can be left in place longer

Combination oral contraceptives (COCs), also known as "the pill," are the most commonly used reversible method of contraception. COCs can have either fixed dosages of estrogen and progestin or they can be made to change the amount of progestin and estrogen during the cycle. What type of birth control pills are COCs that alter the amount of hormones throughout the cycle? a) Primary b) Phasic c) Secondary d) Monophasic

b) COCs can be monophasic or phasic. Monophasic pills provide fixed doses of estrogen and progestin, whereas phasic pills (biphasic, triphasic, and multiphasic) are formulated to alter the amount of progestin, and, in some cases, estrogen within each cycle. Phasic preparations reduce the total dosage of hormones in a cycle without sacrificing effectiveness

The nurse is counseling a couple regarding contraception. The couple states that they want a natural family planning method, as their religious beliefs prohibit them from using birth control pills or devices. They plan on having children in the future, so they simply want a temporary method. They are interested in a fertility awareness method. Which of the following should the nurse recommend? a) Coitus interruptus b) CycleBeads c) Lactation amenorrhea method d) Vasectomy

b) CycleBeads is a natural fertility awareness method in which a woman purchases a circle of beads that helps her predict fertile days so that she can abstain from sex on those days. This method meets all of the requirements of the couple. Lactation amenorrhea is a natural method, but it would not apply in this situation, as the woman is not currently breastfeeding. Coitus interruptus is also a natural method, but it is not a fertility awareness method. Vasectomy is a surgical procedure that results in permanent sterility. As the couple would like to have children in the future, this method would not be appropriate

Your patient wants to discuss birth control options. She is a 36-year-old woman who is in a long-term, monogamous relationship. She runs 2 miles a day but also smokes a pack of cigarettes a day. Which birth control method would you discourage her from using? a) Condoms b) Combination oral contraceptives c) Coitus interruptus d) Spermicides

b) Oral contraceptives are contraindicated for women who smoke, they would be at a higher risk for blood clots. Condoms, coitus interruptus, and spermicidals can be used at no risk.

A couple comes to the clinic for subfertility assessment. They are discouraged over their previous attempts to conceive. The nurse overhears the husband say, "I am ready to just give up. Let's go." What can the nurse say to the couple to allow them to express their concerns? a) "I know just what you are going through. We have a lot of couples in the same boat." b) "How do you feel about what is happening?" c) "I heard you say that you want to give up. If so, this process is very time-consuming, and we need to know if you are committed." d) "Are you blaming each other that you can't conceive? This is a problem with nature."

b) Questions such as, "How do you feel about what has happened" or "How do you think your partner feels about not being able to conceive" may be enough to encourage partners to express their concerns

A woman is preparing for therapeutic insemination because she has been unable to conceive with her husband for more than 18 months. What must she do in preparation for the therapeutic insemination? (Select all that apply.) a) Take Clomid. b) Record her basal body temperature (BBT). c) Use an ovulation predictor kit. d) Douche prior to the procedure. e) Assess her cervical mucus.

b,c,e) To prepare for therapeutic insemination, a woman must record her BBT, assess her cervical mucus, or use an ovulation predictor kit to predict her likely day of ovulation. On the day after ovulation, the selected sperm are instilled into her cervix using a device similar to a cervical cap or diaphragm, or they are injected directly into the uterus using a flexible catheter

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 of the following statements that the nurse might mention to the man is true? a) The man will continue to ejaculate sperm b) The man will still have full erection capacity c) The man will no longer ejaculate seminal fluid d) The man will no longer produce testosterone

b) Some men resist the concept of vasectomy because they are not sufficiently aware of their anatomy to know exactly what the procedure will involve. They can be assured vasectomy does not interfere with the production of sperm; the testes continue to produce sperm as always, but the sperm simply do not pass beyond the plugged vas deferens and are absorbed at that point. The man will still have full erection capacity and continue to produce testosterone. Because he also continues to form seminal fluid, he will ejaculate seminal fluid; it will just not contain sperm

A client who has been unable to conceive will have a procedure that involves use of an oocyte donated by her sister that will be fertilized in the laboratory with sperm from the client's husband. The fertilized oocyte will be placed in the client's uterus. What type of procedure will this client have? a) Zygote intrafallopian transfer b) Surrogate embryo transfer c) In vitro fertilization d) Gamete intrafallopian transfer

b) Surrogate embryo transfer is an assisted reproductive technique for women who do not ovulate. The process involves use of an oocyte donated by a friend, relative, or anonymous donor. The menstrual cycles of the donor and recipient are synchronized by administration of gonadotropic hormones. At the time of ovulation, the donor's ovum is removed by a transvaginal, ultrasound-guided procedure. The oocyte is then fertilized in the laboratory, using sperm from the recipient woman's male partner, and placed in the recipient woman's uterus by embryonic transfer. Once pregnancy occurs, it progresses the same as an unassisted pregnancy

A young woman says she is 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? a) Diaphragm b) Transdermal contraception c) Cervical cap d) Female condom

b) 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. (less)

A newly married couple worried about fertility has asked you for counseling. They have been trying to conceive for 4 months with no success. The husband is 38 and the wife is 29. They had previously used combination oral contraceptives as a way to prevent pregnancy. What is the best advice to give them? a) They are not considered infertile until they have spent 12 months trying to conceive. b) They should increase intercourse frequency to four times a week around the time of ovulation. c) They should seek fertility counseling. d) They should undergo comprehensive diagnostic testing

b) The most fertile time is the ovulation period of the woman's ovarian cycle. Increasing the frequency of intercourse around ovulation will increase the chance of conception. They are too young and have not been trying long enough to warrant further testing or counseling

A client needs additional information about the cervical mucus ovulation method after having read about it in a magazine. She asks the nurse about cervical changes during ovulation. About which should the nurse inform the client? a) Cervical mucus breaks when stretched b) Cervix is high or deep in the vagina c) Cervical mucus is dry and thick d) Cervical os is slightly closed

b) The nurse should explain that during ovulation, the cervix is high or deep in the vagina. The os is slightly open during ovulation. Under the influence of estrogen during ovulation, the cervical mucus is copious and slippery and can be stretched between two fingers without breaking. It becomes thick and dry after ovulation, under the influence of progesterone

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. Assuming that all of the following methods of birth control are acceptable to her, which of the following would be the best recommendation? a) The rhythm (calendar) method b) A diaphragm and spermicide c) An ovulation suppressant d) A spermicidal suppository

b) 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

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

b, c, d) When instructing a client with dysmenorrhea on how to manage her symptoms, the nurse should ask her to increase water consumption, use heating pads or take warm baths, and increase exercise and physical activity. Water consumption serves as a natural diuretic, heating pads or warm baths help increase comfort, and exercise increases endorphins and suppresses prostaglandin release. The nurse should also tell the client to limit salty foods to prevent fluid retention during menstruation and to keep legs elevated while lying down, because this helps increase comfort

The nurse is assessing a male patient who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this patient? (Select all that apply.) a)"Do you have a regular girlfriend?" b)"Have you ever had any type of trauma or surgery on or near your testicles?" c)"Are you exposed to x-rays or other radioactive substances?" d)"Do you use drug or excessive alcohol use? e)"When was the last time you had sex?"

b,c,d) Conditions that may inhibit sperm production are trauma to the testes, surgery on or near the testicles that results in impaired testicular circulation, and endocrine imbalances, particular of the thyroid, pancreas, or pituitary glands. Drug use or excessive alcohol use and environmental factors such as exposure to x-rays or radioactive substances have also been found to negatively affect spermatogenesis. Men exposed to radioactive substances in their work environments should be provided adequate protection for the testes

The nurse informs the patient that a diaphragm is an example of which of the following types of contraception? a) chemical barrier b) intrauterine c) mechanical barrier d) transdermal

c) The diaphragm is an example of a mechanical barrier. It is a circular rubber disk placed over the cervix before intercourse

You are instructing a woman on BBT method for fertility awareness. Which information would you provide? a) Is the average temperature taken each morning b) Can be taken with any type of thermometer c) Temperature should be taken prior to any activity every morning d) Is the best method for predicting ovulation

c) BBT is the basal body temperature method and requires the women to take her temperature and record it every morning, first activity of the day before exiting the bed or other activities. A digital thermometer and using the same thermometer every day for accuracy should be taught

Why is fertility testing initiated with sperm analysis of the male partner? a) Asking the male partner to undergo diagnostic procedures is the best way to assess his interest in treatment of infertility. b) The man is found to be fertile in over 75% of couples with infertility problems. c) Sperm analysis is one of the easiest tests to complete. d) Male fertility testing is time-consuming and, therefore, should be initiated early.

c) Because sperm analysis is noninvasive, it is one of the easiest tests (and, therefore, most cost-effective) to complete

A woman opts to use a diaphragm for contraception. Which instruction would be most important for the nurse to provide? a) "Keep the diaphragm in place for no more than 4 hours after intercourse." b) "Replace the diaphragm every 6 months." c) "Have your diaphragm refitted if you lose 10 pounds or more." d) "Wet the diaphragm with water first before inserting it."

c) Diaphragms should be refitted after pregnancy, abdominal or pelvic surgery, or weight loss or gain of 10 pounds or more. A diaphragm usually is replaced every 1 to 2 years. A diaphragm should remain in place for at least 6 hours after intercourse. A contraceptive sponge, not a diaphragm, should be wetted with water before insertion

A couple is seeking guidance for their inability to conceive a child after trying for 15 months. They are morbidly obese but state they have friends with the same weight problem who have had no difficulty conceiving. What education can the nurse provide this couple to increase their chances of success? a) "Weight has no bearing on the ability to conceive. Something else must be going on with your reproductive organs." b) "If you have been trying for this long without success, something must be wrong. So we will need to run a series of tests to see what that is." c) "Obesity may interfere with effective penetration and deposition of sperm. We will look at several factors to discover what issues you may be encountering." d) "Being this overweight is unhealthy for you and for any child that you may bring into the world. Before you consider conceiving, you should lose weight."

c) Extreme obesity in a male may interfere with effective penetration and deposition of sperm, compromising the ability to conceive.

A woman is going to have in vitro fertilization. When preparing her for this, you would tell her which of the following? a) "This is dangerous if there is ovarian cancer in your family." b) "Most procedures are effective the first time tried." c) "It can be done with frozen donor sperm." d) "You will need to select a surrogate mother."

c) Fresh or frozen sperm may be used. The success of in vitro fertilization is not related to the incidence of ovarian cancer in the family. Often more than one attempt is needed before successful implantation

A clinic nurse explains to a patient who is undergoing an infertility workup that the patency of her fallopian tubes will be checked. Which test is currently used to do this? a) Computed tomography scan b) Uterine biopsy c) Hysterosalpingography d) Magnetic resonance imaging

c) Hysterosalpingography is radiologic examination with radiopaque contrast of the fallopian tubes. It is widely used to assess the patency of the fallopian tubes in women who are subfertile

Which of the following best explains the action of the lactational amenorrhea method (LAM) of fertility control? a) LAM prevents introduction of sperm into vagina b) LAM prevents fertilization between the egg and sperm c) LAM causes suppression of the ovulation process d) LAM thickens the cervical mucus and blocks sperm

c) LAM prevents pregnancy by suppressing the ovulation process. Withdrawal and barrier methods of contraception prevent the introduction of sperm into the vagina. The copper IUD, combined hormonal methods, and combined oral contraceptives prevent fertilization between the egg and the sperm. The Norplant system thickens the cervical mucus and blocks sperm

Now that you are familiar with the risk factors for osteoporosis, to which of these patients would you be most eager to suggest a bone mineral density test? a) A 25-year-old Asian woman, 5 feet and 7 inches tall, 129 pounds, with two children b) A woman with a vitamin D deficiency c) A 55-year-old Caucasian woman who smokes and whose 80-year-old mother has osteoporosis d) An African American woman, 5 feet and 4 inches tall, 172 pounds, with an inactive lifestyle

c) Older women and those who smoke are at more risk for osteoporosis. This client should be referred to bone scan or density testing. Vitamin D levels, body weight, and race are not factors heavily weighted in osteoporosis

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; these include which of the following? a) Pelvic sonogram, ovulation monitoring, and semen analysis b) Serologic test for syphilis, semen analysis, and tubal patency assessment c) Semen analysis, ovulation monitoring, and tubal patency assessment d) Semen analysis, urinalysis, and ovulation monitoring

c) Only three tests are commonly used to test fertility: semen analysis in the male and ovulation monitoring and tubal patency assessment in the female. Additional testing may be performed both on the man and the woman, which may include urinalysis, serologic test for syphilis, and pelvic sonogram, but these are not the primary tests used

What is the correct direction to provide on the way to take oral contraceptives? a) Same day of the week, once a week b) Empty stomach, full glass of water c) Same time of day, each day d) Days of expected intercourse

c) Oral contraceptives are to be taken daily at the same time of day every day. Absorption is not affected by the stomach contents. Oral contraceptives must be taken every day to be effective

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

c) Recent studies have shown that the extended use of active OC pills carries the same safety profile as the conventional 28-day regimen. This option helps reduce the number of periods and is as effective as the conventional regimen. There is no evidence to suggest that discontinuation of active OCs will not ensure restoration of fertility. Depo-Provera, not active OC pills, prevents pregnancy for 3 months at a time

A female client who has chosen the cervical cap as her method of contraception states that she knows how to use it. Which statement by the client would indicate to the nurse that the client does understand this method of contraception? a) "This method will help protect me from getting STIs." b) "I will remove the cap immediately after every intercourse and reinsert it later." c) "I do not have any spermicidal allergies, so this method is OK for me." d) "I do not need any follow-up procedures for this method."

c) Spermicidal allergies are contraindications for the cervical cap. The client should leave the cervical cap in place for at least six hours after intercourse. The cervical cap does not protect against STIs. The woman should have a follow-up Pap test three months after beginning to use the cap

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? a) Subfertility is said to exist when a pregnancy has not occurred after at least 2 years of engaging in unprotected coitus. b) Subfertility is said to exist when a pregnancy has not occurred after at least 3 months of engaging in unprotected coitus. c) Subfertility is said to exist when a pregnancy has not occurred after at least 1 year of engaging in unprotected coitus. d) Subfertility is said to exist when a pregnancy has not occurred after at least 6 months of engaging in unprotected coitus.

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

A couple is being assessed for infertility. The male partner is required to collect a semen sample for analysis. What instruction should the nurse give him? a) Avoid strenuous activity for 24 hours before collecting the sample. b) Abstain from sexual activity for 10 hours before collecting the sample. c) Deliver sample for analysis within 1 to 2 hours after ejaculation. d) Collect a specimen by ejaculating into a condom or plastic bag.

c) The nurse should instruct the client to deliver the semen sample to the laboratory for analysis within 1 to 2 hours after ejaculation. The client should also be instructed to collect the sample in a specimen container, not a condom or plastic bag. The client needs to abstain from sexual activity for at least 24 hours before giving the sample, but he need not avoid strenuous activity

A 52-year-old patient is perimenopausal and asks about the severity of her symptoms. What can you accurately tell her is the one of the potentially life-threatening effects of menopause? a) Dense breast tissue is replaced with adipose tissue. b) Pelvic support muscles lose tone. c) Bone mineral density decreases. d) The uterus and ovaries decrease in size

c) The older women become, the decrease in hormone levels place women at increased risk for osteoporosis. This is a potential concern which can impact life and bone mineral density should be monitored. There is no evidence of atrophy in the pelvic muscles, nor in the uterus or ovaries as related to menopause. Breast tissue changes at the same rate that all other tissue changes

When using the contraceptive patch, a patient should understand that it a) should be applied to the breasts, hips, or back. b) should be covered when swimming because of chlorine's effect on the adhesive. c) should be applied to the abdomen, buttocks, or back. d) is immediately effective after application.

c) The patch should be applied only to the buttocks, back, abdomen, or torso (never the breasts). The patch is safe for wearing during swimming and bathing. The patch requires application for 1 week before becoming effective

A nurse is helping a couple choose a contraception method that is right for them. Which of the following is the least likely factor the nurse should consider? a) Financial factors b) Ability to use a method correctly c) Whether the method will affect sexual enjoyment d) The popularity of the method among the couple's friends

d) Important things to consider when helping a couple to choose a method that will be right for them include the following: personal values, ability to use a method correctly, whether the method will affect sexual enjoyment, financial factors, whether a couple's relationship is short-term or long-term, prior experiences with contraception, and future plans. The popularity of the method is the least likely factor the nurse should consider

Which of the following best defines the term "subfertility/infertility"? a) Inability to achieve pregnancy following a previous viable pregnancy b) Inability to achieve pregnancy because of a known factor that prevents conception c) Failure to achieve pregnancy after 6 months of unprotected intercourse d) Failure to achieve pregnancy after 1 year of unprotected intercourse

d) Infertility is the failure to achieve conception after 1 year of unprotected intercourse.

The nurse has provided information to a patient about oral contraceptives. Which statement by the patient would indicate a need for further education? a) "Oral contraceptives need to be taken on a daily basis." b) "Some hormonal contraceptives do not contain estrogen and rely instead on progestin only." c) "Hormonal oral contraceptives reduce the risk of ovarian cancer." d) "Some oral contraceptives protect against STDs."

d) Oral contraceptives need to be taken on a daily basis to prevent breakthrough ovulation. Oral contraceptives do not protect against STDs and patients still need to use STD protection such as condoms. In addition to preventing pregnancy, hormonal contraceptives have many health benefits including reduction in risk of ovarian cancer and endometrial cancer, reducing symptoms of premenstrual discomforts, decreasing blood loss and anemia, reducing symptoms of endometriosis, and many other benefits

A young sexually active woman asks the nurse what type of birth control would help prevent sexually transmitted infections as well as pregnancy. Which of the following would the nurse recommend? a) Intrauterine device b) Oral contraceptives c) Withdrawal d) Condom

d) STIs and birth control must be considered as connected but separate issues. Certain birth control methods—such as withdrawal, IUDs, and oral or implanted contraceptives—factor into the spread of STIs. These birth control methods have no mechanism to prevent the spread of bacteria, viruses, or other microorganisms. Many barrier methods, such as latex condoms, provide some protection against both STIs and pregnancy. Safer sex, but not safe sex, is possible with the use of condoms

A couple in their early 30s is concerned because they have been trying to get pregnant for 4 months without success. The woman says that she had been on oral contraceptives before they began trying. Which of the following should the nurse say to the couple? a) "You are experiencing sterility. Have you considered adoption or child-free living?" b) "You are experiencing subfertility related to your age. I recommend beginning fertility testing next week." c) "You are experiencing subfertility. Increase your frequency of coitus to every day." d) "Oral contraceptives may delay conception for a few months. Give it another 6 to 8 months."

d) Some couples, because they are unaware of the average length of time it takes to achieve a pregnancy, may worry they are subfertile when they are not. If engaging in coitus about four times per week, 90% of couples will conceive within 12 months. Moreover, women who are using oral, injectable, or implanted hormones for contraception may have difficulty becoming pregnant for several months after discontinuing these medications, because it takes that long for the body to restore normal functioning. Couples who engage in coitus daily, hoping to cause early impregnation, may actually have more difficulty conceiving than those who space coitus to every other day. It is far too soon to conclude that the couple is sterile or to suggest alternatives to childbirth or even to begin fertility testing. The couple is not old enough to be experiencing age-related subfertility

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) Lactational amenorrhea method b) Basal body temperature (BBT) c) Coitus interruptus d) Cycle Beads or medroxyprogesterone injection

d) The best option for a client who is not well educated would be the Standard Days Method with CycleBeads, as the 32 color-coded CycleBeads are easy to use and understand. An injection of medroxyprogesterone would also suit this client, as it works by suppressing ovulation and the production of follicle stimulating hormone and leutinizing hormone by the pituitary gland and prevents pregnancy for 3 months at a time. BBT requires the client to take and chart her body temperature; this may be difficult for the client to follow. Coitus interruptus is a method in which the man controls his ejaculation and ejaculates outside the vagina; this suggests that the client rely solely on the cooperation and judgment of her spouse. The lactational amenorrhea method works as a temporary method of contraception only for breastfeeding mothers

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) Avoid using other fertility awareness methods along with BBT. b) Use the axillary method of taking the temperature. c) Avoid unprotected intercourse until BBT has been elevated for 6 days. d) Take temperature before rising and record it on a chart.

d) The client should be instructed to take her temperature before rising and record it on a chart. If using this method by itself, the client should avoid unprotected intercourse until the BBT has been elevated for 3 days. The client should be informed that other fertility awareness methods should be used along with BBT for better results. The oral method is better suited than the axillary method for taking the temperature in this case

A nurse is teaching a female client about fertility awareness as a method of contraception. Which should the nurse mention as an assumption for this method? a) The exact time of ovulation can be determined. b) Sperm can live up to 24 hours after intercourse. c) The "safe period" is 3 days after ovulation. d) The "unsafe period" is approximately 6 days.

d) The nurse should explain to the client that the fertility awareness method relies on the assumption that the "unsafe period" is approximately 6 days; 3 days before and 3 days after ovulation. The method also assumes that sperm can live up to 5 days, not just 24 hours after intercourse. An ovum lives up to 24 hours after being released from the ovary. The exact time of ovulation cannot be determined, so 2 to 3 days are added to the beginning and end to avoid pregnancy

A client has opted to use an intrauterine device (IUD) for contraception. About which effect of the device on monthly periods should the nurse inform the client? a) Periods become longer b) Periods become more painful c) Periods reduce in number d) Periods become lighter

d) The nurse should inform the client that IUDs cause monthly periods to become lighter, shorter, and less painful. Monthly periods reduce in number with use of oral contraceptives, but not with use of IUDs

What important information should the nurse give a client about the use of a diaphragm during menstruation? a) Vaginal discharges may occur b) It may cause genital burning c) Use during menstruation can lead to abdominal pain d) Toxic shock syndrome is possible

d) The nurse should inform the client that using a diaphragm during menstruation can lead to toxic shock syndrome. Vaginal discharge is associated with the use of a vaginal contraceptive ring. Genital burning may occur when spermicidal products are used along with the barrier methods of contraception. Abdominal pain is a side effect reported during the use of combined oral contraceptives and intrauterine contraceptives

A nurse is reviewing sperm count results for a couple trying to conceive. About which results would the nurse be concerned? a) 20 million per mL of seminal fluid b) 30 million per mL of seminal fluid c) 40 million per mL of seminal fluid d) 10 million per mL of seminal fluid

d) The sperm count is the number of sperm in a single ejaculation or in a milliliter of semen. The minimum sperm count considered normal is 20 million per milliliter of seminal fluid, or 50 million per ejaculation

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which of the following is an effect of the drug that the nurse should warn the woman about? a) Hypertension b) Elevation of her blood glucose level c) Extensive bleeding during menstruation d) Overstimulation of the ovary resulting in potential multiple births

d) Therapy with clomiphene citrate (Clomid, Serophene) 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. Counsel women who receive these agents this is a possibility. None of the other answers is a common effect of clomiphene citrate use