Family Planning- NCLEX/MNL
A patient states that she and her husband have been trying to conceive for over 3 months and are concerned that something is wrong with one of them. Which statement should the nurse include in response to the patient's concerns? A. "Infertility is the inability to conceive after 1 year of unprotected regular intercourse." B. "Infertility is on the rise in the United States." C. "Infertility is likely related to an underlying medical condition." D. "Infertility is likely associated with the patient's age."
A. "Infertility is the inability to conceive after 1 year of unprotected regular intercourse."
A couple expecting their first child in a few weeks voices concerns about sickle cell disease, and asks the nurse if their child will be affected. Which response by the nurse is accurate regarding sickle cell disease? A. "It is an autosomal recessive disorder requiring two abnormal genes for an individual to have the disease." B. "It is more prevalently found in metropolitan areas." C. "It is a dominant disorder, and the child is at high risk related to heredity." D. "It is not linked to either parent, and therefore it is difficult to predict whether the child will be affected."
A. "It is an autosomal recessive disorder requiring two abnormal genes for an individual to have the disease."
The nurse is teaching a client about oral contraceptives. Which client statement indicates a need for additional teaching? (Select all that apply.) A. "Oral contraceptives are not very effective at preventing pregnancy." B. "Oral contraceptives require a medical prescription." C. "Oral contraceptives carry an increased risk of blood clots." D. "Oral contraceptives require daily use of medication." E. "Oral contraceptives often increase menstrual cramping."
A. "Oral contraceptives are not very effective at preventing pregnancy." E. "Oral contraceptives often increase menstrual cramping."
The nurse is caring for a couple who has been undergoing infertility treatments without success. Which statement should the nurse make to promote healthy sexual function? A. "Tell me about your usual sexual habits, outside of trying to conceive." B. "What sexual dysfunctions are occurring?" C. "Can you explain back to me the cause of the infertility?" D. "What efforts have you put into improving sexual function?"
A. "Tell me about your usual sexual habits, outside of trying to conceive."
A patient is discussing an intrauterine contraceptive (IUC) device with the nurse. The patient states that she does not want to use one because she does not believe in abortions. Which response by the nurse is appropriate? A. "The IUC prevents sperm from reaching the ovum, which means conception never occurs." B. "If you do not wish to use an abortifacient, there are other options." C. "The IUC is a type of barrier contraception, not an abortifacient." D. "If you apply spermicide to the IUC, then you do not have to worry about an abortion."
A. "The IUC prevents sperm from reaching the ovum, which means conception never occurs."
The nurse is teaching a woman about the barrier method of contraception. Which patient statement indicates that teaching was effective? A. "The cervical sponge is good for up to 24 hours, but it may cause allergic reactions." B. "The diaphragm should be inserted prior to intercourse without lubricant or spermicidal jelly." C. "Diaphragms cannot be used if I have a latex allergy." D. "The cervical cap does not require the use of spermicide."
A. "The cervical sponge is good for up to 24 hours, but it may cause allergic reactions."
The nurse is instructing a couple on the correct use of male condoms. Which statement from the couple indicates the need for further teaching? A. "The condom should be pulled taut against the tip of the penis." B. "The penis should be withdrawn while still erect to prevent spillage." C. "Water-soluble lubricants can be used to prevent irritation and breakage." D. "Male condoms should be stored in a cool dry environment."
A. "The condom should be pulled taut against the tip of the penis."
The nurse is counseling a woman who will have a surgical interruption of pregnancy during the first trimester. Which patient statement indicates that the teaching is effective? A. "The doctor will perform a dilation and curettage (D&C)" B. "Medical interruption of pregnancy poses no serious risks." C. "I will take two medications for this procedure, one to change the endometrium and one to expel the fetus." D. "Waiting may be preferred, because surgical abortion in the second trimester is safer than in the first trimester."
A. "The doctor will perform a dilation and curettage (D&C)"
The nurse is counseling a couple who have been trying to conceive for 18 months. The male partner has been diagnosed with oligospermia. Which statement of understanding by the patient indicates the need of further information? A. "To ensure pregnancy, assisted reproductive technology (ART) is the best option." B. "Avoid wearing tight-fitting underwear or 'skinny' jeans." C. "Therapeutic husband insemination (THI) is one option that involves mechanically depositing semen into the cervix or uterus." D. "In most cases of in vitro fertilization, eggs are retrieved through a transvaginal ultrasound guided procedure."
A. "To ensure pregnancy, assisted reproductive technology (ART) is the best option."
A couple who is going through fertility treatment is reviewing the process of in vitro fertilization (IVF) with the nurse. Which statement by the couple indicates that the teaching has been effective? (Select all that apply.) A. "We can freeze embryos if we have extras." B. "The sperm will be deposited into my uterus." C. "The embryos will be placed in my uterus 7-10 days after retrieval." D. "An ultrasound will be used during the procedure to remove my eggs." E. "My wife will have to have injections prior to the procedure."
A. "We can freeze embryos if we have extras." D. "An ultrasound will be used during the procedure to remove my eggs." E. "My wife will have to have injections prior to the procedure."
The nurse is caring for a female patient who is unable to conceive after undergoing multiple failed fertility treatments. The patient is visibly upset and crying. Which topic would be appropriate at this time? A. Asking the patient if she wants to discuss other options for fertility treatments B. Providing information on the adoption process C. Discussing the potential rationale for why the couple is infertile D. Asking if anyone else in the family has struggled with infertility
A. Asking the patient if she wants to discuss other options for fertility treatments
A patient with sickle cell disease who wishes to become pregnant asks the nurse to explain how she has the disease when no one else in her family is affected. When providing an explanation, which type of genetic inheritance pattern should the nurse explain? A. Autosomal recessive disorder B. Autosomal dominant disorder C. Mendelian inheritance disorder D. Sex-linked inheritance disorder
A. Autosomal recessive disorder
A patient is interested in starting oral contraceptives. She smokes one pack of cigarettes a day. For which side effect should the nurse be most concerned? A. Blood clot B. Pneumonia C. Allergic reaction D. Hypertension
A. Blood clot
The nurse is discussing the risks and benefits of therapeutic insemination as compared with in vitro fertilization with a couple. Which teaching should the nurse include in the discussion? A. Both therapies can use the husband's sperm to fertilize the wife's egg. B. Therapeutic insemination involves placing 3-4 embryos into the uterus. C. In vitro fertilization involves depositing semen at the cervical os or in the uterus. D. In vitro fertilization has a very high rate of success.
A. Both therapies can use the husband's sperm to fertilize the wife's egg.
Which factor should the nurse identify as a health risk that may affect pregnancy outcomes? (Select all that apply.) A. Caffeine intake B. Secondhand smoke C. Migraines D. Alcohol use E. Diabetes mellitus
A. Caffeine intake B. Secondhand smoke D. Alcohol use E. Diabetes mellitus
A sexually active patient is interested in using a natural (fertility awareness-based) contraceptive method. She works rotating shifts and has an irregular menstrual cycle. Which method would be best for the nurse to recommend? A. Cervical mucus method B. Calendar method C. Basal body temperature D. Abstinence
A. Cervical mucus method
The nurse is providing teaching to a community group. Which disorders should the nurse include that are considered multifactorial inheritance disorders? (Select all that apply.) A. Clubfoot B. Neural tube defect C. Cystic fibrosis D. Cleft lip E. Huntington disease
A. Clubfoot B. Neural tube defect D. Cleft lip
The nurse is performing a health history on a client with family planning needs. Which data should the nurse collect? (Select all that apply.) A. Family history of breast cancer B. Number of sexual partners C. Vital signs D. Medication history E. Genital exam
A. Family history of breast cancer B. Number of sexual partners D. Medication history
The nurse is teaching a couple who are planning to become pregnant. Which behavior can be excluded as a health risk that must be immediately covered before the pregnancy? A. Getting a flu shot B. Drinking coffee C. Breathing secondhand smoke D. Taking prescription medicine
A. Getting a flu shot
The nurse is assessing a couple who have been trying to conceive for 15 months. Which information in the woman's medical history requires follow-up? A. History of treatment for pelvic inflammatory disease (PID) B. History of sinusitis C. History of treatment for asthma D. History of breast augmentation
A. History of treatment for pelvic inflammatory disease (PID)
A female patient is being seen after trying to conceive for 14 months. Which is the most common noninvasive method for assessing ovulation that the nurse could recommend? A. Measuring basal body temperature B. Conducting a postcoital examination C. Mapping menstrual cycles for 3 months D. Performing an endometrial biopsy
A. Measuring basal body temperature
Which procedure of clinical interruption of a pregnancy is most likely to be performed for a woman in the first 7 to 9 weeks of a pregnancy? A. Medical abortion by administration of mifepristone and misoprostol B. Surgical abortion by dilation and extraction (D&E) and hypertonic saline C. Surgical abortion by dilation and curettage (D&C) and minisuction D. Medical abortion by dilation and curettage (D&C) and minisuction
A. Medical abortion by administration of mifepristone and misoprostol
The nurse is teaching a woman planning to begin hormonal birth control about how to prevent blood clots. Which teaching should the nurse include in the discussion? A. Medications such as anti-epileptics can reduce the effectiveness of hormonal birth control. B. Women who take hormonal birth control should reduce how much they smoke. C. The method can be used with a history of thrombophlebitis. D. Women with a history of severe menstrual cramps will be at an increased risk of clots.
A. Medications such as anti-epileptics can reduce the effectiveness of hormonal birth control.
The nurse is preparing a presentation about chromosome abnormalities and is focusing on nondisjunction—an addition or deletion of a chromosome occurring after fertilization, which may result in the embryo having two or more chromosomes that evolve into more than one cell line. Which term describes this phenomenon? A. Mosaicism B. Trisomy 21 C. Trisomy 13 D. Monosomy
A. Mosaicism
The nurse is caring for a patient who came to the emergency department as a victim of rape. The woman is concerned about the possibility of pregnancy. The nurse should include which information about emergency contraception in response to the patient's concern? A. Oral progestin-only contraceptives stop or delay ovulation by thickening the cervical mucus and making the endometrium less receptive to implantation. B. Oral progestin-only contraceptives must be taken within 48 hours of intercourse to induce rejection of the ovum. C. The Mirena intrauterine system (IUS) will prevent implantation if implanted within 12 hours after intercourse. D. Emergency contraception works by preventing implantation of a fertilized ovum by causing a debridement effect on the uterus, sloughing off endometrial cells.
A. Oral progestin-only contraceptives stop or delay ovulation by thickening the cervical mucus and making the endometrium less receptive to implantation.
The nurse recognizes that family planning care involves more than preventing pregnancy. Which goal should the nurse consider to be a part of family planning care? (Select all that apply.) A. Promoting healthy sexual function B. Encouraging acceptance of all available forms of contraception methods C. Encouraging the use of preferred contraceptive methods D. Promoting a healthy body image E. Providing knowledge about sexual and reproductive health
A. Promoting healthy sexual function D. Promoting a healthy body image E. Providing knowledge about sexual and reproductive health
A couple has just been informed of the results of their genetic testing and the risk of a genetic anomaly is high. Which is the most important step for the nurse to take next? A. Referring the couple to a genetic counselor B. Instructing the couple about clinical interruption of pregnancy C. Advising the couple on the options for contraceptives D. Teaching the couple about adoptive services
A. Referring the couple to a genetic counselor
The nurse is caring for a woman who is taking the infertility medication clomiphene. Which assessment finding would indicate to the nurse that the client is potentially experiencing adverse effects from the medication? (Select all that apply.) A. Reports of mood swings B. Reduction in urine output C. Weight gain of 10 pounds in 1 month D. Changes in the client's vision E. Hot flashes
A. Reports of mood swings D. Changes in the client's vision E. Hot flashes
A couple is beginning evaluation for infertility. Which diagnostic test should the nurse expect to be done first for evaluation of the male partner? A. Semen analysis B. Scrotal ultrasound C. Testicular biopsy D. Hormonal evaluation
A. Semen analysis
The nurse is creating a plan of care for a couple undergoing fertility treatments. Which nursing outcome should the nurse include? A. The patient will correctly describe treatment options, including the risks and benefits of each. B. The patient will overcome the impact of infertility on personal relationships and lifestyle. C. The patient will successfully complete in vitro fertilization treatment. D. The patient will repair personal relationships and social interactions.
A. The patient will correctly describe treatment options, including the risks and benefits of each.
The nurse has been caring for a couple planning to undergo in vitro fertilization. Which statement reflects an expected nursing outcome? A. The patient will make an informed decision about the treatment. B. The patient will schedule the egg-retrieval procedure. C. The patient will express their desire to conceive naturally. D. The patient will successfully undergo in vitro fertilization.
A. The patient will make an informed decision about the treatment.
The nurse is caring for a patient about to undergo egg retrieval for in vitro fertilization. Which teaching should the nurse include in preprocedure discussion? A. The procedure will be completed using an intravenous sedation and cervical block. B. The procedure will require a 2-day stay in the hospital for egg retrieval and embryo placement. C. No supplements will be needed after the procedure. D. Regular activity can be resumed after the procedure.
A. The procedure will be completed using an intravenous sedation and cervical block.
The nurse is caring for a couple experiencing infertility who will have follicular stimulation and retrieval of ovum, followed by mixing with washed donor sperm. One day later, the fertilized ovum will be placed in the fallopian tube. Which procedure should the nurse identify the couple is scheduled to have? A. Zygote intrafallopian transfer (ZIFT) B. Tubal embryo transfer (TET) C. In vitro fertilization (IVF) D. Gamete intrafallopian transfer (GIFT)
A. Zygote intrafallopian transfer (ZIFT)
The nurse is providing information to a client deciding on a form of contraception. Which aspect should be considered when determining the best contraceptive method? (Select all that apply.) A.Ease of use B. Safety C. Affordability E. Effectiveness
A.Ease of use B. Safety C. Affordability E. Effectiveness
Which statement should the nurse include in preconception counseling for the individual or couple of childbearing age? (Select all that apply.) A. "Preconception counseling must be started at least 6 months before attempting to conceive." B. "Maintaining a healthy weight for your height is important for both partners." C. "Even if you do not want to have children now, it is helpful to discuss future goals with your partner." D. "Once you become pregnant, it will be helpful to start working on good exercise habits." E. "There are many different methods of birth control; you can choose which fits your lifestyle and plan."
B. "Maintaining a healthy weight for your height is important for both partners." C. "Even if you do not want to have children now, it is helpful to discuss future goals with your partner." E. "There are many different methods of birth control; you can choose which fits your lifestyle and plan."
When performing a preconception visit, which assessment finding by the nurse would necessitate a recommendation for genetic counseling? A. History of heavy alcohol use 2 years prior B. Family history of genetic disorders C. Client is 33 years old D. Exposure to secondhand smoke
B. Family history of genetic disorders
The nurse is discussing the need for therapeutic donor insemination (TDI) with a client. Which finding should the nurse identify as an indication for TDI? (Select all that apply.) A. Erectile dysfunction B. Genetic male sex-linked disorder C. Azoospermia D. Severe oligospermia E. Epispadias
B. Genetic male sex-linked disorder C. Azoospermia D. Severe oligospermia
The nurse is teaching a client who is trying to conceive about proper nutrition. Which essential nutrient should the client include in her daily diet? (Select all that apply.) A. Vitamin E B. Iron C. Vitamin A D. Calcium E. Protein
B. Iron D. Calcium E. Protein
The nurse is preparing teaching for home care to a client with family planning needs. Which topic should the nurse address? (Select all that apply.) A. Participating in a weekly exercise class B. Maintaining a balanced, nutritional diet C. Making a dental appointment D. Avoiding all vaccines E. Smoking cessation
B. Maintaining a balanced, nutritional diet C. Making a dental appointment E. Smoking cessation
When planning care for a client with family planning needs, which intervention should the nurse include? (Select all that apply.) A. Consulting a social worker for genetic counseling B. Providing an environment that promotes discussion C. Encouraging the client to verbalize feelings about sexual health D. Teaching the client about fertility and contraception E. Emphasizing the importance of using condoms for disease prevention
B. Providing an environment that promotes discussion C. Encouraging the client to verbalize feelings about sexual health D. Teaching the client about fertility and contraception E. Emphasizing the importance of using condoms for disease prevention
The nurse is discussing contraceptive options with a woman who is interested in information about intrauterine contraception (IUC). Which statement should the nurse include when discussing the disadvantages of these devices? A. "This type of contraceptive causes loss of bone density." B. "These require the use of daily medication." C. "The device may cause cramping and heavier bleeding." D. "You will need to insert the device daily."
C. "The device may cause cramping and heavier bleeding."
An 18-year-old man presents to the neighborhood clinic for an exam and requests a male nurse. Which aspect should the nurse keep in mind while taking the client's medical history and preparing to discuss contraceptive use? A. Influencing the client so that he makes the choice recommended by the nurse B. Obtaining the client's height and weight when obtaining the health history C. Being aware of the client's cultural and religious beliefs D. Remembering that teenagers will not be truthful about their sexual history
C. Being aware of the client's cultural and religious beliefs
A client has just been fitted for a diaphragm. Which information about the diaphragm should the nurse include in the client teaching? A. It should be replaced every 3 years. B. It must be left in place for 12 hours after intercourse. C. It must be refitted after childbirth. D. It can be used during a menstrual period.
C. It must be refitted after childbirth.
The nurse is speaking to a group of young women about methods of contraception. The nurse asks the group to name a barrier method of contraception. Which response from a participant indicates the need for further teaching? A. Diaphragm B. Contraceptive sponge C. Vaginal contraceptive ring D. Spermicide
C. Vaginal contraceptive ring