health Chapt 4 Common Reproductive Issues (NCLEX QUESTION)
About 75% of pregnancies caused by in vitro fertilization end in spontaneous miscarriage. a) False b) True
False Correct Explanation: 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 can be left in place longer. b) It needs no spermicidal jelly. c) It does not need to be refitted after pregnancy. d) No initial fitting is required.
It can be left in place longer. Correct Explanation: 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. p107
For natural reproductive life planning, which of the following is characteristic of cervical mucus during ovulation? a) High viscosity and alkalinity b) Thin and watery c) Properties of acidity and ferning d) Increased number of leukocytes
Thin and watery Correct Explanation: Because cervical mucus is thin and watery at the time of ovulation, sperm can penetrate it easily.
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) True b) False
True
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) Cervical mucus is not a reliable indicator b) When it is thick c) When it is thin, watery, and copious d) When it does not stretch
When it is thin, watery, and copious Correct Explanation: 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. p104
The nurse informs the patient that a diaphragm is an example of which of the following types of contraception? a) transdermal b) mechanical barrier c) intrauterine d) chemical barrier
mechanical barrier Correct Explanation: The diaphragm is an example of a mechanical barrier. It is a circular rubber disk placed over the cervix before intercourse. p106
The nurse is counseling a sexually active 16-year-old adolescent regarding contraception. The adolescent explains that she is afraid of getting pregnant or of getting a sexually transmitted infection, but her boyfriend refuses to use a condom. She knows that she needs to use some kind of contraception but doesn't know which would be best. Which of the following would be the best choice for this patient? a) Oral contraceptive b) Female condom c) Coitus interruptus d) Tubal ligation
Female condom Correct Explanation: The female condom would be the best choice for this patient, as it provides protection against both sexually transmitted infections (STIs) and conception. A tubal ligation would not be recommended for a 16-year-old girl, as it is a permanent measure and she may decide to have children in the future. Neither an oral contraceptive nor coitus interruptus would provide protection against STIs.
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) He may notice permanent increased scrotal swelling c) His testes will no longer produce sperm d) It is usually done as an office procedure
It is usually done as an office procedure Correct Explanation: 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 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) Six days before the onset of menstruation c) Midway between the normal menstrual cycle d) Five days after the first day of the menstrual cycle
Three days before and three days after ovulation Correct Explanation: 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 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) Transdermal contraception b) Diaphragm c) Female condom d) Cervical cap
Transdermal contraception Explanation: 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.
Which of the following best explains the action of the lactational amenorrhea method (LAM) of fertility control? a) LAM prevents fertilization between the egg and sperm b) LAM prevents introduction of sperm into vagina c) LAM thickens the cervical mucus and blocks sperm d) LAM causes suppression of the ovulation process
LAM causes suppression of the ovulation process Correct Explanation: 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. p106
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) tubal transport c) impaired implantation d) ovulation e) diabetes
• tubal transport • impaired implantation • ovulation Correct Explanation: Female factors that cause subfertility are problems with ovulation, tubal transport, and implantation.
Subfertility/infertility is said to exist when a couple has failed to achieve pregnancy after how many months of unprotected sexual intercourse? Fill in the blank with a number. ____months
12 Correct Explanation: Infertility is the failure to achieve conception after 1 year of unprotected intercourse.
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 woman with a vitamin D deficiency b) A 55-year-old Caucasian woman who smokes and whose 80-year-old mother has osteoporosis c) An African American woman, 5 feet and 4 inches tall, 172 pounds, with an inactive lifestyle d) A 25-year-old Asian woman, 5 feet and 7 inches tall, 129 pounds, with two children
A 55-year-old Caucasian woman who smokes and whose 80-year-old mother has osteoporosis Correct Explanation: 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.
When do condoms need to be applied to be effective? a) At least 1 hour prior to coitus b) Immediately after ejaculation c) Before penile-vulvar contact d) As soon as the penis becomes erect
Before penile-vulvar contact Correct Explanation: Some sperm may be released with pre-ejaculation semen, so a condom needs to be used with any penile-vulvar contact
A client is being prepared for artificial insemination. Which finding is the most suggestive to determine if the client is ovulating? a) Slight weight gain b) Fall in body temperature c) Change in the cervical mucus d) Abdominal cramps
Change in the cervical mucus Correct Explanation: 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. p104
The majority of pregnancy terminations are done in cases in which the pregnancy threatens the mother's life. a) True b) False
False Correct Explanation: The majority of pregnancy terminations are done for the following reasons: the pregnancy is unwanted because a woman chooses not to have a child at this time in her life for such reasons as being too young, not wanting to be a single parent, wanting no more children, having financial difficulties, or from failed contraception
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) Extensive bleeding during menstruation b) Hypertension c) Overstimulation of the ovary resulting in potential multiple births d) Elevation of her blood glucose level
Overstimulation of the ovary resulting in potential multiple births Correct Explanation: 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.
Dilation and curettage is the method of abortion used when the gestational age of a pregnancy is still less than 13 weeks. a) False b) True
True
A nurse is teaching a class on preventing pregnancy to high school students. Which of the following would the nurse identify as the best method to prevent both pregnancy and sexually transmitted infections (STIs)? a) condoms b) morning-after pills c) birth control pills d) abstinence
abstinence Correct Explanation: Abstinence is refraining from sexual relations. It has a 0% failure rate, so it is considered the most effective way to prevent both pregnancies and STIs. p104
A young woman comes to the free clinic asking for birth control pills. Which of the following best indicates that another type of contraception would be better for this patient? a) history of noncompliance with medications b) age of her partner c) frequency of sexual encounters d) cost of the pills
history of noncompliance with medications Correct Explanation: If a woman has a history of poor compliance with medication, it might not be realistic for her to plan on taking an oral contraceptive every day. p110-112
Which of the following body system changes would the nurse associate with menopause? Select all that apply. a) Vaginal dryness b) Decreased bone density c) Hot flashes d) Decreased waist size e) Moist, supple skin f) Increased abdominal fat
• Vaginal dryness • Decreased bone density • Hot flashes • Increased abdominal fat Correct Explanation: Menopause may be associated with hot flashes, increased abdominal fat, vaginal dryness, decreased bone density, dry, thinning skin, and increased waist size.
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) "Wet the diaphragm with water first before inserting it." c) "Replace the diaphragm every 6 months." d) "Have your diaphragm refitted if you lose 10 pounds or more."
"Have your diaphragm refitted if you lose 10 pounds or more." Correct Explanation: 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. p107
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) "Obesity may interfere with effective penetration and deposition of sperm. We will look at several factors to discover what issues you may be encountering." c) "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." d) "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."
"Obesity may interfere with effective penetration and deposition of sperm. We will look at several factors to discover what issues you may be encountering." Correct Explanation: Extreme obesity in a male may interfere with effective penetration and deposition of sperm, compromising the ability to conceive. p94
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 least costly method would be to purchase a commercial kit from the store to assess the upsurge of LH that occurs just after ovulation." d) "The testing kit, Fertell, should be purchased, as well as a sperm kit for your male partner."
"The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months." Correct Explanation: 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. p105
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) An ovulation suppressant b) A diaphragm and spermicide c) A spermicidal suppository d) The rhythm (calendar) method
A diaphragm and spermicide Correct Explanation: Women over 40 who smoke should not take ovulation suppressants; irregular menstrual cycles make natural methods difficult; women over 40 may have vaginal dryness, so a spermicidal suppository would not be activated.
A 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 uterine endometrial biopsy b) A hysterosalpingography c) A hysteroscopy d) A sonohysterography
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? You selected: A hysterosalpingography Correct Explanation: A hysterosalpingography, a radiologic examination of the fallopian tubes using a radiopaque medium, is a frequently used technique.
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) Tubal transport problems c) Stenotic cervical os d) Anovulation
Anovulation Correct Explanation: 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.
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) Symptothermal method c) Basal body temperature (BBT) method d) Calendar method
Basal body temperature (BBT) method Correct Explanation: 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. p105
A 52-year-old patient is perimenopausal and asks about the severity of her symptoms. What can you accurately tell her is the only potentially life-threatening effect of menopause? a) Bone mineral density decreases. b) Dense breast tissue is replaced with adipose tissue. c) The uterus and ovaries decrease in size. d) Pelvic support muscles lose tone.
Bone mineral density decreases. Explanation: 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. p123
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) Need an erection to remain in place c) Can't be used by people sensitive to latex d) The external ring decreases stimulation to the clitoris
Can slip into the vagina during vigorous intercourse Explanation: 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.
Which of the following factors is it most important for the nurse to consider when recommending different types of contraceptives to a female client? a) Client's partner's desire for pregnancy b) Client's ability to tolerate side effects c) Desire for protection against sexually transmitted infections (STIs) d) Sexual orientation of the client
Client's ability to tolerate side effects Explanation: The client's ability to tolerate side effects is one of the most important factors that the nurse must consider when determining the best type of contraceptive method for a client. This ability directly influences the client's adherence to the method's use. The client's partner's desire for pregnancy, the sexual orientation of the client, and desire for protection against STIs are criteria that the nurse should consider when assessing a woman's need for contraceptives; however, these are not as critical as assessing the client's tolerability of side effects. p116
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) Combination oral contraceptives b) Condoms c) Coitus interruptus d) Spermicides
Combination oral contraceptives Correct Explanation: 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. p111
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 when intercourse occurs within 72 hours of ovulation b) Conception is more likely in the presence of orgasm c) Conception is more likely if the sperm has just been ejaculated d) The timing of intercourse and conception affects the sex of the pregnancy
Conception is more likely when intercourse occurs within 72 hours of ovulation Correct Explanation: 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.
A woman calls your clinic to report that she has had some cramping since the insertion of her IUD and that her present menstrual flow is heavy. You would advise her to do which of the following? a) Come to the clinic as soon as possible b) Change her method of reproductive life planning c) Consider this normal, because her IUD has been newly inserted d) Take her blood pressure daily for the rest of the month
Consider this normal, because her IUD has been newly inserted Explanation: Insertion of an IUD may lead to mild cramping during the first month of use.
Which of the following best defines the term "subfertility/infertility"? a) Failure to achieve pregnancy after 1 year of unprotected intercourse 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) Inability to achieve pregnancy following a previous viable pregnancy
Failure to achieve pregnancy after 1 year of unprotected intercourse Correct Explanation: Infertility is the failure to achieve conception after 1 year of unprotected intercourse.
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) Femcap b) Copper IUD c) Ortho-Evra d) Lunelle
Femcap Correct Explanation: 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. p99
You are counseling women on birth control choices. Which woman is the best candidate for an IUD? A woman who: a) Has one partner, her husband and 3 children b) Has a history of PID c) Has multiple sex partners d) Is in her early twenties and wants children later in life
Has one partner, her husband and 3 children Correct Explanation: A women who is in a stable monogamous relationship and has already had one successful pregnancy; IUD is one method for birth control but is not without risk to the women. IUD's do not protect agains STI's. PID may be caused by IUD's. A woman in her twenties has several better, lower risk options. p113
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) Transdermal patch b) Intrauterine device c) Subdermal progestin implant d) Tubal ligation
Intrauterine device Correct Explanation: 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.
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) Transdermal patch b) Intrauterine device c) Tubal ligation d) Subdermal progestin implant
Intrauterine device Correct Explanation: 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.
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 causes suppression of the ovulation process c) LAM prevents fertilization between the egg and sperm d) LAM thickens the cervical mucus and blocks sperm
LAM causes suppression of the ovulation process Correct Explanation: 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.
What can the nurse educate a subfertile couple about to avoid the problem with lower sperm counts in the male partner? a) Sit in a hot bath twice daily to increase the scrotal heat. b) Minimize actions that increase scrotal heat. c) Avoid exercise regimens. d) Use the sauna after an exercise regimen to "sweat out" the toxins.
Minimize actions that increase scrotal heat. Correct Explanation: Actions that increase scrotal heat, such as working at desk jobs or driving a great deal every day, may produce lower sperm counts compared with men whose occupations allow them to be ambulatory at least part of each day. Frequent use of hot tubs or saunas may also lower sperm counts appreciably. p94
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
Radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix Explanation: Hysterosalpingogram is a procedure to document the potency of the fallopian tubes through the use of a radiopaque medium. p97
A nurse is preparing a client for intrauterine device (IUD) insertion. What should the nurse inform the client when educating her on IUDs? a) Continuous cramps after insertion b) Regular check of threads must be done c) Reduced menstrual flow after insertion d) Insertion procedure is painless
Regular check of threads must be done Correct Explanation: 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.
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) Insertion procedure is painless c) Continuous cramps after insertion d) Regular check of threads must be done
Regular check of threads must be done Correct Explanation: 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. p113
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
Semen analysis, ovulation monitoring, and tubal patency assessment Correct Explanation: 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.
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 history of allergy to foreign protein. c) She is 30 years old. d) She has a family history of thromboembolism.
She has a family history of thromboembolism. Correct Explanation: 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.
Sperm analysis is often the first fertility test to be completed, why? a) Asking the male partner to undergo diagnostic procedures is the best way to assess his interest in treatment of infertility b) Male fertility testing is time-consuming and therefore should be initiated early c) The man is found to be fertile in over 75 percent of couples with infertility problems d) Sperm analysis is one of the easiest tests to complete
Sperm analysis is one of the easiest tests to complete Correct Explanation: Because sperm analysis is noninvasive, it is one of the easiest tests (and therefore cost-effective) to complete. There is no bias in male vs. female with regard to being the cause of infertility.
A perimenopausal woman asks for help in selecting a contraceptive. She complains of vaginal dryness during intercourse and says that her partner does not like the feel of condoms. Which method should the nurse recommend? a) Female condom b) Diaphragm c) Cervical cap d) Spermicide
Spermicide Explanation: Women older than 35 years have a higher incidence of cystocele or rectocele than younger women so diaphragms or cervical caps may not be the ideal contraceptive for them. Spermicide foam can help lubricate the vagina to increase sexual enjoyment in women nearing menopause. Her partner's dislike of condoms rules out the female condom.
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) Suppresses follicle-stimulating hormone (FSH) d) Interferes with endometrial proliferation
Suppresses follicle-stimulating hormone (FSH) Correct Explanation: Estrogen has a direct effect on the pituitary gland suppressing FSH; progesterone increases permeability of cervical mucus and endometrial proliferation.
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 still have full erection capacity b) The man will no longer produce testosterone c) The man will no longer ejaculate seminal fluid d) The man will continue to ejaculate sperm
The man will still have full erection capacity Correct Explanation: 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. (less)
A woman is seeking information on tubal ligation as a form of birth control. What information should the nurse provide to the patient? a) She must have signed consent from her husband b) The procedure is easy to perform and will be painless c) Wait several months after birth and schedule the surgery as an outpatient d) This is a permanent and irreversible procedure for birth control
This is a permanent and irreversible procedure for birth control Explanation: The procedure is considered permanent and irreversible. This is a procedure not for routine birth control, but for permanent birth control. If the women elects for this procedure, it can be done immediately following the birth of the child, lessening the inconvenience or hospitalization of the patient. The procedure is not painless, nor easy. A consent form from the partner is not always required.
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) Natural membrane condom b) Transdermal contraceptive c) Ethinyl estradiol d) Polyurethane condom
Transdermal contraceptive Correct Explanation: 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. p112
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) Vasectomy is a relatively easy procedure with few complications c) Regular sperm counts are not essential d) Birth-control measures are not required
Vasectomy is a relatively easy procedure with few complications Explanation: 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.
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) What is your blood type and Rh factor? b) Are you allergic to any sedatives? c) When did you have coitus last? d) When do you expect your next menstrual flow?
When do you expect your next menstrual flow? Correct Explanation: 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. p97
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 is thin, watery, and copious b) Cervical mucus is not a reliable indicator c) When it is thick d) When it does not stretch
When it is thin, watery, and copious Correct Explanation: 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
When using the contraceptive patch, a patient should understand that it a) should be applied to the breasts, hips, or back. b) should be applied to the abdomen, buttocks, or back. c) is immediately effective after application. d) should be covered when swimming because of chlorine's effect on the adhesive.
should be applied to the abdomen, buttocks, or back. Correct Explanation: 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. p112
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) Bradycardia b) Evidence of secondary sex characteristics c) Reduced subcutaneous fat d) hypotension
• Bradycardia • Hypotension • Reduced subcutaneous fat Explanation: 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.
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) NSAIDs b) Decrease in water intake c) Antipsychotic medications d) Reduction of caffeine intake e) Vitamin and mineral supplements f) Diuretic therapy
• Reduction of caffeine intake • Vitamin and mineral supplements • Diuretic therapy • NSAIDs Explanation: 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. p88
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) diabetes b) lack of exercise c) tubal transport d) impaired implantation e) ovulation
• tubal transport • impaired implantation • ovulation Correct Explanation: Female factors that cause subfertility are problems with ovulation, tubal transport, and implantation.
