Maternal Health

A client is to have a hysterosalpingogram. Which of the following information should the nurse provide to the client prior to the procedure? A. The test will be performed through a small incision next to your belly button B. You will be on bedrest for a full day following the procedure C. An antibiotic fluid will be instilled through a tube in your cervix D. You will be asked to move from side to side so that x-ray pictures can be taken

D. A number of pictures will be taken throughout the procedure. The client will be awake and will be asked to move from side to side. Option A is incorrect because no incision is created for a hysterosalpingogram. Option B is incorrect because the client will be able to ambulate normally after the procedure. Option C is incorrect because a dye is instilled into the uterine cavity. Some doctors do prescribe antibiotics in order to prevent infection.

A client, 36 weeks gestation, has been diagnosed with complete placenta previa. On nursing rounds, the client tells the nurse that she has a bad backache that comes and goes. Which of the following should the nurse perform first? A. Give client a backrub B. Assess client vital signs C. Time the back pains D. Assess for vaginal bleeding

D. Backaches are a sign of early labor. Dilation of cervix may lead to bleeding. The nurse must assess for placental injury.

The nurse caring for a client with placenta previa must determine how much blood the client has lost. The nurse weighs a clean vaginal pad (5g) and the client's saturated pad (25g). How many ml of blood has the client lost?

20 ml 1 g = 1 ml Subtract clean pad from saturated pad

A nurse is caring for a client, 28 weeks gestation, with placenta previa. Which of the following physician orders should the nurse question? A. Encourage Ambulation B. Weigh all vaginal pads C. Assess cervical dilation daily D. Perform nonstress test every morning E. Administer colace 100mg 3x daily PO

A and C Placenta previa patients should be on bedrest and should not have vaginal examinations

A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? A. The couple has established a set schedule for their sexual encounters B. The couple has been married for more than eight years C. The couple lives with one set of parents D. The couple has close friends who gave birth to a baby within the past year

A. Couples who schedule intercourse often complain that their sexual relationship is unsatisfying. Options B , C and D are unrelated to sexual dysfunction.

A nurse is teaching an infertile couple about how sperm travel through the man's body during ejaculation. Put the following five major structures in order beginning with the place where spermatogenesis occurs and continuing through the path that the sperm and semen travel until ejaculation. A. Epididymis B. Prostate C. Testes D. Urethra E. Vas Deferens

C, A, E, B, D The sperm are produced in the testes then they proceed to the epididymis where they mature. The vas deferens is the conduit through which the sperm travel during ejaculation. The prostate encircles the neck of the urethra and produces a fluid that protects the sperm and finally the sperm exit through the urethra.

The nurse must administer a blood transfusion to a client with placenta previa who has lost a significant amount of blood. Put the following nursing actions in chronological order in which they should be performed. A. Stay with client for five minutes and obtain a full set of vital signs B. Compare client name and hospital identification number with name and number on blood product C. Check physician order for type of transfusion D. Regulate infusion as prescribed

C, B, D, A

A client is hospitalized in the acute phase of severe ovarian hyperstimulation syndrome. The following nursing diagnosis has been identified: fluid volume excess (extravascular) related to third spacing. Which of the following nursing goals is highest priority in relation to this diagnosis? A. Client's weight will be within normal limits by date of discharge B. Client's skin will show no evidence of breakdown throughout hospitalization C. Client's electrolyte levels will be within normal limits within one day D. Client's lung fields will remain clear throughout hospitalization

D. Ovarian hyperstimulation syndrome (OHSS) is a medical condition that can occur in some women who take fertility medication to stimulate egg growth, and in other women in very rare cases. OHSS can affect the kidneys, liver and lungs. All other goals are important but are not priority.

A pregnant woman and her husband are both heterozygous for achondroplastic dwarfism, an autosomal dominant disease. The nurse advises the couple that their unborn child has which of the following probabilities of being of normal stature? A. 25% B. 50% C. 75% D. 100%

A. 25% After completing a Punnett square: Mother: Aa Father: Aa Results: AA Aa Aa aa

A couple who has sought fertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur? A. The testes are overheated B. The vas deferens is ligated C. The prostate gland is enlarged D. The flagella are segmented

A. Spermatogenesis occurs in the testes. High temperatures harm in the development of the sperm. Option B is incorrect because when the vas deferens is ligated it means that a man has had a vasectomy and is sterile. The sterility is not due to impaired spermatogenesis but due to the inability of the sperm to migrate to the woman's reproductive tract. Option C is incorrect because the prostate does not affect spermatogenesis. An enlarged prostate or hypertrophied prostate is an issue that affects older men. Option D is incorrect because the flagella are normally divided into a middle and end segments.

Where does spermatogenesis occur? A. Vas deferens B. Testes C. Prostate D. Epididymis

B. Testes

A Roman Catholic couple is infertile. Their healthcare provider advises them that their best chance of getting pregnant is via in-vitro fertilization with a mixture of the man's sperm and donor sperm. Which of the following issues related to this procedure should the nurse realize may be in conflict with the couple's religious beliefs? Select all that apply A. The man will ejaculate by masturbation into a specially designed condom B. The woman may become pregnant with donor sperm C. Fertilization is occurring in the artificial environment of a laboratory D. More embryos may be created than will be used to inseminate the woman E. The woman will receive medications to facilitate the ripening of her ova

A., B., C. and D. Masturbation and the use of a condom are considered sins in the Catholic tradition. In the Catholic tradition, a woman should only become pregnant by her husband, not a sperm donor. In the Catholic tradition, fertilization may only occur in the body of a woman. It is immoral in the Catholic tradition to create more embryos than needed to conceive. Option D is incorrect because medications alone are not contraindicated by the Catholic church. These medications will be allowed if the ova are becoming ripened for fertilization in her own body.

A couple who have been attempting to become pregnant for five years is seeking assistance from a fertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? Select all that apply. A. Anger at other who have babies B. Feelings of failure because they can't make a baby C. Sexual excitement because they want so desperately to conceive a baby D. Sadness because of the perceived loss of being a parent E. Guilt on the part of one partner because he or she is not able to give another a baby

A., B., D., E. All of these feelings are common of infertile couples. Option C is incorrect because infertile couples usually express an aversion to sex because of the many restrictions/schedules/intrusions that are placed on their sexual relationship.

A woman's temperature has just risen .4 degrees Fahrenheit and will remain elevated during the remainder of her cycle. She expects to menstruate in 2 weeks. Which of the following hormones is responsible for the change? A. Estrogen B. Progesterone C. Luteinizing hormone (LH) D. Follicle stimulating hormone (FSH)

B. Progesterone spikes 5 to 6 days after ovulation and is heat producing. Option A is incorrect because estrogen elevates before ovulation and is not responsible for temperature changes. Option C is incorrect because LH spikes during ovulation Option D is incorrect because FSH promotes maturation of ovum

A couple is seeking advice regarding actions that they can take to increase their potential of becoming pregnant. Which of the following recommendations should the nurse give to the couple? A. The couple should use vaginal lubricants during intercourse B. The couple should delay intercourse until the day of ovulation C. The woman should refrain from douching D. The man should be on top during intercourse

C. Douching can change the normal flora and pH in the vagina making it a hostile environment for sperm Option A is incorrect because vaginal lubricants may alter the pH of the reproductive system Option B is incorrect because sperm live for about three days. The couple should have daily intercourse beginning 5 or 6 days before ovulation in order to maximize their potential of becoming pregnant Option D is incorrect because positioning will not affect the potential fertility of a woman.

A 54 y.o. client calls her healthcare provider complaining of frequency and burning when she urinates. Which of the following factors that occurred within the preceding 3 days likely contributed to the client's problem? A. Intercourse B. Returning from a trip abroad C. Stopping hormone replacement therapy D. Starting a weight lifting exercise program

A. Intercourse can lead to a UTI All other options are likely unrelated to a UTI

A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the following may have contributed to her problem? A. Athletic activities B. Vaccination history C. Pet ownership D. History of asthma

A. If a young woman exercises excessively, her body fat index could become so low that she becomes amenorrheic which is the absence of a menstrual period. All other options are unrelated to amenorrhea

An infertility specialist is evaluating whether a woman's cervical mucus contains enough estrogen to support sperm motility. Which of the following tests is the physician conducting? A. Ferning capacity B. Basal body temperature C. Colposcopy D. Hysterotomy

A. When a woman's cervical mucus is estrogen rich, it is slippery, elastic and thread like. When assessed under a microscope, the practicioner will look for ferning (an image that looks like a fern). This means that the woman is fertile. When the woman is not fertile, the cervical mucus is thick and gluey. Option B is performed to determine if and when ovulation occurs. Option C is performed to examine the cervix closely. It is not performed to evaluate the receptivity of a woman's cervical mucus to sperm. Option D is a procedure in which an incision is made into the uterus.

A client is to receive Pergonal (menotropins) injections for infertility prior to in-vitro fertilization. Which of the following is the expected action of this medication? A. Prolongation of the luteal phase B. Stimulation of ovulation C. Suppression of menstruation D. Promotion of cervical mucus production

B. Pergonal is administered to infertile women to increase follicular growth and maturation of follicles and to stimulate ovulation. Option A is incorrect because the luteal phase occurs after ovulation Option C and D and incorrect because Pergonal does not suppress menstruation or promote cervial mucus production

A couple has been told that the male partner, who is healthy, is producing no sperm "because he has cystic fibrosis." Which of the following explanation is accurate in relation to this statement? A. Since the man is healthy, he could not have cystic fibrosis B. Men with cystic fibrosis often have no epididymis C. The expressiveness of cystic fibrosis is variable D. Cystic fibrosis is a respiratory illness having nothing to do with reproduction

C. Cystic fibrosis can be expressed in a number of ways. Some affected by individual have very serious illness resulting in early death while other experience no symptoms. Option A is incorrect because the man may have both recessive genes for cystic fibrosis but is not ill. Option B is incorrect because it is not true but some men with cystic fibrosis have no vas deferens. Option D is incorrect because some males with cystic fibrosis have no vas deferens and even if the vas deferens is present, the man is producing large amounts of thick mucus and the vas deferens may be obstructed. In women with cystic fibrosis, the fallopian tubes may be obstructed with mucus.

Which of the following client responses indicates that the nurse's teaching about care following chorionic villus sampling (CVS) has been successful? A. If the baby stops moving, the woman should immediately go to the hospital. B. The woman should take oral terbutaline every 2 hours for the next day. C. If the woman starts to bleed or contract, she should call her physician. D. The woman should stay on complete bedrest for the next 48 hours.

C. The mother should notify her physician if she begins to bleed or contract. Option A is incorrect because CVS performed well before quickening occurs. Option B is incorrect because tocolytics such as terbutaline is not routinely administered following CVS. Option D is incorrect because it is unnecessary for the mother to stay on complete bedrest following CVS.

Under which condition should a woman taking hormone injections use a backup method of contraception? A. If the injection site is still tender B. If the injection was given subcutaneously 14 days ago C. If it has been 15 weeks since the last injection was given D. If the injection was given three days after the start of the woman's menstrual period

C. Hormone injections prevent ovulation for 14 weeks, and injections should be scheduled every 12 weeks. If 15 weeks have passed since the previous injection, the woman should use a backup method of contraception. Option A is incorrect because Tenderness at the injection site does not indicate decreased effectiveness and is not a reason for the woman to use a backup method of contraception. Option B is incorrect because It is not necessary for a woman to use a backup method of contraception 14 days after the injection is administered. Option D is incorrect because If the injection is given within five days after a menstrual period starts, it is not necessary for the woman to use a backup method of contraception.

A perimenopausal woman wishes to discontinue all contraception. The woman has not had a menstrual period in six months. Which is the appropriate nursing education on contraception during perimenopause? A. "You should consider tubal sterilization, just to be sure." B. "We would need to taper off your oral contraceptives to reduce the risk of blood clots." C. "You can stop your oral contraceptives, but you should still use a barrier method to prevent STDs." D. "We can change your method of contraception, but you should not stop it completely for another six months."

D. Perimenopausal women should continue to use an effective method of contraception until one year after the last menstrual period. This woman's contraception should not be stopped at this time, so this education is appropriate for a perimenopause woman. Option A is incorrect because This response does not address the woman's wishes and is not appropriate. Tubal sterilization is an invasive procedure that carries risks that are not necessary for a perimenopausal woman. Option B is incorrect because Tapering off oral contraceptives decreases their effectiveness and does not reduce the risk of thromboembolic disorders. This education is not appropriate for a perimenopausal woman. Option C is incorrect because The woman's need for a barrier to prevent STDs depends on whether sexual activity is non-monogamous or monogamous and may not be necessary. This statement is also inaccurate and inappropriate for a perimenopausal woman.

The nurse is providing counseling to a group of sexually active single women. Most of the women have expressed a desire to have children in the future but not within the next few years. Which of the following actions should the nurse suggest the women take to protect their fertility for the future? Select all that apply. A. Use condoms during intercourse B. Refrain from smoking cigarettes C. Maintain an appropriate weight for height D. Exercise in moderation E. Refrain from drinking carbonated beverages

A, B, C and D Condoms should be worn during intercourse to prevent STIs. STIs can affect a women's reproductive system. Women who smoke have a higher incidence of infertility. Women who are overweight or underweight have an increased incidence of infertility. Body mass index (BMI) is related to exercise. Fertility is related to body weight. Women should exercise in moderation to avoid becoming underweight. Option E is incorrect because although some carbonated have caffeine which in large amounts can cause infertility, there is not much research done of decaffeinated beverages that are carbonated.

A woman in a non-monogamous relationship expresses the desire to stop using condoms after the placement of an intrauterine device (IUD). Which is the appropriate nursing education on first-time IUD use? A. "IUD strings can puncture the condom, so there is no point in using them once it has been inserted." B. "Since you are not in a monogamous relationship, you should still use condoms to protect against STDs." C. "You should wait until after your first menstrual period with the IUD inserted before you stop using condoms." D. "IUDs should only be used by women in long-term monogamous relationships, so it wouldn't be a good fit for you."

B. An IUD will not protect against STDs, and a woman in a non-monogamous relationship should still use measures to prevent STD infection. This education is appropriate for this woman. Option A is incorrect because IUD strings have not been shown to damage condoms, and condoms can be used safely with an IUD. This teaching is not appropriate for the woman. Option C is incorrect because Copper IUDs are effective immediately. Hormonal IUDs are effective immediately if inserted within seven days after the start of a menstrual period. This teaching ignores the fact that the woman is at higher risk for complicated sexually transmitted infections because of being non-monogamous with an IUD in place and that condom use is essential in this situation. Option D is incorrect because IUDs can be used regardless of woman's relationship status. It is not necessary for the woman to be in a mutually monogamous relationship to receive an IUD. This teaching is not appropriate for the woman.

A woman reports discontinuing the use of a diaphragm because of uncertainty about its proper use. Which steps can a nurse take to help the woman better understand this method of contraception? Select all that apply. A. Tell the woman she will get better at it with practice. B. Demonstrate proper usage with a sample diaphragm. C. Ask the woman how she normally uses the diaphragm. D. Ask the woman what led her to choose the diaphragm initially. E. Suggest the woman switch to a less complicated method of contraception.

B., C., and D. Demonstrating is a helpful way to instruct the woman on proper use in a clear and tangible way. This will facilitate learning and help the woman better understand the contraceptive method. Assessing the woman's current understanding of the contraceptive method is an effective way to determine whether further education is needed. Assessing the woman's choice of contraception helps the nurse better understand the woman's contraceptive needs. Using this information, the nurse can help the woman better understand her method of contraception. Option A is incorrect because This statement dismisses the woman's concerns and is not appropriate, since it does not help her better understand her chosen method of contraception. Option E is incorrect because Suggesting the woman change contraceptive methods does not help her understand her current method, and it can be harmful in that it shows a lack of confidence in the woman's ability to learn. This would not be an appropriate action by the nurse.

A client who is undergoing ovarian stimulation for infertility calls the infertility nurse and states, "My abdomen feels very bloated, my clothes are very tight and my urine is very dark." Which of the following is the appropriate statement for the nurse to make at this time? A. Please take a urine sample to the lab so they can check it for an infection B. Those changes indicate that you are likely pregnant C. It is important for you to come into the office to be examined today D. Abdominal bloating is an expected response to the medications

C. The woman should be seen by her doctor since abdominal bloating is a sign of ovarian hyper-stimulation. Options A and B are unlikely. Option D is incorrect.

In analyzing the need for teaching regarding sexual health in a client who is sexually active, which of the following questions is the most important for a nurse to ask? A. How old are your children? B. Did you have intercourse last evening? C. With whom do you have intercourse? D. Do you use a vaginal lubricant?

C. This is the most important question because it determines how many partners the client has and if the partners are men or women. Clients who engage in sexual activity with more than one partner are at high risk for STIs and pregnancy. All other options are important pieces of information but not as important as option C.

A woman has been advised that the reason she has had a number of spontaneous abortions is because she has an inheritable mutation. Which of the following situations is consistent with this statement? A. A client developed skin cancer after being exposed to the sun. B. A client developed colon cancer from an inherited dominant gene. C. A client's genetic analysis report revealed a reciprocal translocation. D. A client's left arm failed to develop when she was a fetus.

C. A reciprocal translocation can result in infertility. Option A is incorrect because the DNA in the client's skin cells did mutate but the mutation will not affect the woman's ovaries. Option B is incorrect because the inherited gene affects a client's risk of contracting colon cancer not affecting fertility. Option D is incorrect because failure of one arm to develop in utero is related to an environmental insult than a genetic insult.

Infertility increases a client's risk of which of the following disease? A. Diabetes mellitus B. Nystagmus C. Cholecystitis D. Ovarian cancer

D. Infertility has been shown to increase a woman's risk for ovarian cancer. Option A is incorrect because infertility has not been shown to cause diabetes mellitus but diabetes mellitus can affect a woman's fertility. Option B is incorrect because infertility has not been shown to cause nystagmus. Option C is incorrect because infertility has not been shown to cause cholecystitis.

A couple inquire about the inheritance of Huntington disease (HD) because the prospective father's mother is dying of the illness. There is no history of the disease in his partner's family. The man has never been tested for HD. Which of the following responses by the nurse is appropriate? A. Because HD is an autosomal dominant disease, each and every one of your children will have 1 out of 4 chances of having the disease. B. Because only one if you has a family history of HD, the probability of any of your children having the disease is less than 10%. C. Because HD is such a devastating disease, if there is any chance of passing the gene on, it would be advisable for you to adopt. D. Because neither of you have been tested for HD, the most information I can give you is that each and every one of your children may or may not have the disease.

D. No specific information can be given until the parents are tested for HD. Option A is incorrect because if the father possesses the gene, it is a 50% chance that his children will inherit HD. Option B is completely false. Option C is incorrect because it is unprofessional for the nurse to recommend that the clients do not procreate.

A client has been notified that because of a fallopian tube obstruction, her best option for becoming pregnant is through in-vitro fertilization. The client asks the nurse about the procedure. Which of the following responses is correct? A. During the stimulation phase of the procedure, the physician will make sure that only one egg reaches maturation B. Preimplantation genetic diagnosis will be performed on your partner's sperm before they are mixed with your eggs C. After ovarian stimulation, you will be artificially inseminated with your partner's sperm D. Any extra embryos will be preserved for you if you wish to conceive again in the future

D. Since multiple embryos are usually created during the in vitro process, there are often more embryos created than implanted. The couple may choose to preserve the embryos. Option A is incorrect. Physicians usually want multiple eggs to reach maturation. Option B is incorrect because preimplantation is performed on the fertilized ova not on the sperm or unfertilized ova. Option C is incorrect because intrauterine insemination (IUI) cannot be performed because the client's tubes are blocked.

A woman whose menstrual cycle is 35 days long, states that she often has a slight pain on one side of her lower abdomen on day 21 of her cycle. She wonders whether she has ovarian cancer. Which of the following is the nurse's best response? A. Women often feel a slight twinge when ovulation occurs B. You should seek medical attention as soon as possible since ovarian cancer is a possibility C. Ovarian cancer is unlikely because the pain is not constant D. It is more likely that this pain indicates an ovarian cyst because pain is more common with this issue

A. Mittelschmerz causes discomfort when ovulation occurs. Option B is incorrect because the history given does not indicate ovarian cancer Option C and D are incorrect because timing of pain is more significant than the type of pain

A 15-year-old female reports being curious about methods of contraception but is hesitant to further discuss it with the nurse. Which steps should the nurse take to facilitate effective discussion? Select all that apply. A. Demonstrate proper contraceptive use to the female. B. Reassure the female that the discussion is confidential. C. Provide the female with written material about different methods of contraception. D. Ask the female about what she has learned about contraception from her peers. E. Inform the female that a discussion about contraception cannot occur without a parent present.

A., B., C., and D. Demonstration can help the female better understand methods of contraception, which in turn may help the female use their chosen method of contraception more effectively. Adolescents often do not discuss contraception with health care providers because they do not want anyone to know they are sexually active. Reassurance of confidentiality can facilitate better communication between the nurse and the female. Providing written material can help the female by giving an accurate reference to take home. This can help the female better understand contraception and use it more effectively. Asking the adolescent female what she has learned from her peers about contraception is an important step in facilitating education. Adolescents frequently have erroneous beliefs about contraception, and determining where the female may lack accurate knowledge helps the nurse effectively educate the female about effective contraceptive use. Option E is incorrect because Nurses who counsel adolescents about sexuality must be accepting of the female regardless of personal feelings about adolescent sexuality. Refusing to discuss contraception without a parent present may lead the female to retreat even further or to hesitate to trust the nurse's education about other aspects of their health care. This action does not facilitate effective discussion with the female.

A nurse is on the phone with a woman three weeks after her intrauterine device (IUD) insertion. Which symptoms should be reported to the woman's health care provider immediately? A. Smelly vaginal discharge B. Strings can be felt during intercourse C. Stronger cramps during menstruation D. Strings are the same length as the day of insertion

A. Unusual or malodorous vaginal discharge is a sign of infection and may indicate serious complications. Women with an IUD are at greater risk for pelvic inflammatory disease (PID), and symptoms of infection should be reported to the health care provider immediately. Potential Complications Related to IUDs (PAINS) Period late, abnormal bleeding or spotting Abdominal pain, pain with intercourse Infection exposure, abnormal vaginal discharge Not feeling well, fever, chills String missing, shorter or longer Option B is incorrect because The IUD strings can sometimes be felt during intercourse. This is a common side effect and does not necessitate immediate reporting to the health care provider. Option C is incorrect because Women with an IUD may experience stronger menstrual cramps after insertion. This is a common side effect and does not necessitate immediate reporting to the health care provider. Option D is incorrect because The IUD strings should not change in length after insertion. This is a normal finding and does not necessitate immediate reporting to the health care provider.

A client asks the nurse about the gamete intrafallopian transfer (GIFT) procedure. Which of the following responses would be appropriate for the nurse to make? A. Fertilization takes place in the woman's body B. Zygotes are placed in the Fallopian tubes C. Donor sperm are placed in a medium with donor eggs D. A surrogate carries the infertile woman's fetus

A. Although the gametes are placed in the Fallopian tubes artificially, fertilization does occur within the woman's body. Option B is true of Zygote intrafallopian transfer (ZIFT) not GIFT Option C is incorrect because although donor egg and sperm can be used usually the couple's own gametes are used. These gametes are placed directly into the woman's Fallopian tubes when harvested. Option D is incorrect because this describe surrogacy which occurs through intrauterine insemination (IUI)

It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long Which of the following is an appropriate reply by the nurse? A. You're probably ovulating B. Your hormone levels should be checked C. You will probably menstruate early D. Your breast changes are a worrisome sign

A. Breast tenderness and mittelschmerz occur during ovulation. Option B is incorrect because breast tenderness and mittelschmerz are unrelated to abnormal hormone levels Option C is incorrect because menstruation occurs about 14 days after ovulation Option D is incorrect because breast changes are normal and often felt by women at the time of ovulation

An infertile woman has been diagnosed with endometriosis. She asks the nurse why that diagnosis has made her infertile. Which of the following explanations is appropriate for the nurse to make? A. Scarring surrounds the ends of your tubes, preventing your eggs from being fertilized by your partner's sperm B. You are producing insufficient quantities of follicle stimulating hormone that is needed to mature your egg each month C. Inside your uterus is a benign tumor that makes it impossible for the fertilized egg to implant D. You have a chronic infection of the vaginal tract that makes the secretions hostile to your partner's sperm

A. Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity. The tissue may be on the tubes, ovaries or colon. Adhesions develop from the monthly bleeding at the site of the misplaced endometrial tissue resulting in infertility. Option B is incorrect because endometriosis is not characterized by hormonal imbalances. However, hormonal imbalances can lead to infertility. Option C is incorrect because a benign tumor of the muscle of the uterus is called a fibroid. It can interfere with pregnancy but is not related to endometriosis. Option D is incorrect because endometriosis is not caused by an infection.

A nurse working in the fertility clinic should include which of the following in her discussions with the couple? A. Adoption is an alternative to infertility treatments B. The legal controversy surrounding intrauterine insemination C. The need to seek marriage counseling before undergoing infertility treatments D. Statistics regarding the number couples who never learn why they are infertile

A. It is important for a couple to be provided with all relevant information and alternatives. Option B is incorrect because although it is a legal procedure, there are no legal controversies Option C is incorrect because marriage counseling is not mandatory Option D is incorrect because in the majority of cases, a cause of infertility is found

The nurse is teaching a class on reproduction. When asked about the development of the ova, the nurse would indicate which of the following? A. Meiotic divisions begin during puberty in girls B. At the end of meiosis, four ova are created C. Each ovum contains the diploid number of chromosomes D. Like sperm, ova have the ability to propel themselves

A. Meiosis I occurs during puberty Option B is incorrect because at the completion of oogenesis only one ovum is created. At the end of spermatogenesis, four sperm are created. Option C is incorrect because each ovum contains a haploid number of chromosomes, not a diploid number Option D is incorrect because ovum cannot be propelled like sperm because they do not have a flagella. Ovum are propelled externally by the cilia in the Fallopian tubes.

Under which circumstances might a woman need to seek an alternative natural family planning method? A. A woman using the Standard Days method has a menstrual cycle that is 36 days long. B. A woman using the symptothermal method has a thermometer that displays temperature in tenths of a degree. C. A woman recording basal body temperature (BBT) experiences a slight drop in temperature just before ovulation. D. A woman using the two-day method is unable to distinguish normal cervical secretions from secretions with a sticky, egg-white consistency.

A. The Standard Days method can be used by women whose cycles range from 26 to 32 days in length but is ineffective for other women. This woman would need to seek an alternative natural family planning method. Option B is incorrect because The symptothermal method requires a thermometer that displays temperature in tenths of a degree. This woman has the necessary equipment and would not need to seek an alternate natural family planning method. Option C is incorrect because A slight drop in temperature before ovulation is normal and can be used by women recording basal body temperature (BBT) to determine when ovulation occurs. This woman would not need to seek an alternate natural family planning method. Option D is incorrect because Using the two-day method, the woman notes the presence of vaginal secretions of any kind today or yesterday. It does not rely on evaluation of the quality of secretions, so this woman would not need to seek an alternate natural family planning method.

The nurse is creating a pedigree from a client's family history. Which of the following symbols should the nurse use to represent a female? A. Circle B. Square C. Triangle D. Diamond

A. The circle represents a female. Option B represents a male. Option C represents a stillborn. Option D represents a child of an unknown sex.

A couple is seeking infertility counseling. Their healthcare provider has identified the factors listed below in the woman's health history. Which of these findings may be contributing to the couple's infertility? A. The client is 36 y.o. B. The client was 13 y.o. when she started to menstruate C. The client works as a dental hygienist 3 days a week D. The client jogs 2 miles every day

A. The eggs of an older woman (35 and older) age and fertility is reduced. Option B is incorrect because this is not a significant factor Option C is incorrect because this has not been shown to affect fertility Option D is incorrect because this is a moderate exercise pattern. Only excessive exercise can interrupt hormonal function

Which contraception methods would be appropriate for a woman who is intolerant to hormonal therapy? Select all that apply. A. Tubal sterilization B. Emergency contraception (EC) C. Contraceptive vaginal ring D. Diaphragm with spermicide E. Copper intrauterine device (IUD)

A. D. and E. Tubal sterilization is a surgical procedure that uses no hormones, and the procedure is an appropriate method of contraception for a woman who is intolerant to hormonal therapy. A diaphragm does not contain hormones, nor does the spermicide used with it, and the combination of the two would be appropriate for a woman who is intolerant to hormonal therapy. The Paragard copper intrauterine device does not contain any hormones and is appropriate for a woman who is intolerant to hormonal therapy. Option B is incorrect because Emergency contraception contains progestin and is not appropriate for a woman who is intolerant to hormonal therapy. Option C is incorrect because The NuvaRing contraceptive vaginal ring contains ethinyl estradiol and is not appropriate for a woman who is intolerant to hormonal therapy.

A woman reports dissatisfaction when using her vaginal hormonal ring and asks about starting another method of contraception. Which steps should the nurse take? Select all that apply. A. Ask the woman what qualities she is looking for in a contraceptive method. B. Provide the woman with information about multiple other contraceptive methods. C. Ask the woman what she finds dissatisfying about her current contraceptive method. D. Instruct the woman about proper vaginal ring usage and plan on discussing switching methods at the next visit. E. Inform the woman that learning how to use another contraceptive method may decrease the overall effectiveness of her contraception.

A., B., and C. Assessing the woman's contraceptive needs helps the nurse determine which contraceptive methods may be right for the woman. It increases the efficacy of nursing education. Providing the woman with information about multiple other methods gives the woman a choice, and it allows the woman to determine which methods she believes would be right for her. Asking what the woman finds dissatisfying about her current method of contraception allows the nurse to determine which methods might be better suited for the woman's needs. Option D is incorrect because While educating the woman about proper use of her current method may be helpful, deferring discussion of a change in contraceptive method does not acknowledge the woman's needs and does not promote effective communication. Option E is incorrect because When used properly, a change in contraceptive methods does not decrease the overall efficiency of contraception. This statement does not acknowledge the woman's needs, and it is dismissive of her desire to change contraceptive methods. This statement would not be appropriate for the woman.

A nurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, place the following four hormones in chronological order in which they elevate during the menstrual cycle. A. Follicle stimulating hormone (FSH) B. Gonadotropin releasing hormone C. Luteinzing hormone (LH) D. Progesterone

B, A, C, D Gonadotropin releasing hormone stimulates production of FSH and LH. FSH rises first and LH follows. After ovulation, progesterone rises.

A client, G4 P4004, states that her husband has just been diagnosed with polycystic kidney disease (PKD), an autosomal dominant disease. The husband is heterozygous for PKD while the client has no PKD genes. The client states, "I have not had our children tested because they have such a slim chance of inheriting the disease. We intend to wait until they are teenagers to do the testing." The nurse should base the reply on which of the following? A. Because affected individuals rarely exhibit symptoms before age 60, the children should be allowed to wait until they are adults to be tested. B. The woman may be exhibiting signs of denial since each of the couple's children has a 50/50 chance of developing the disease. C. Because the majority of the renal cysts that develop in an affected individual are harmless, it is unnecessary to have the children tested. D. The woman's husband should be seen by a genetic specialist since he is the person who is carrying the affected gene.

B. After completing a Punnett square, the children have a 50/50 chance of developing the disease. Mother: aa Father: Aa Results: Aa Aa aa aa Option A is incorrect because symptoms appear when an individual is in their 30s and 40s but symptoms can appear in children. Option C is incorrect because PKD is a very serious disease which may require dialysis or a kidney transplant. Option D is incorrect because the husband's genotype is already known, a genetic specialist is unnecessary.

The antepartum nurse is caring for a patient carrying twins. While educating the patient about what to expect during labor, the patient states, "I thought all twins were delivered by C-section." Which response from the nurse is appropriate? A. "Cesarean delivery is usually started after labor has begun." B. "There is a very realistic possibility that the twins may be delivered vaginally." C. "Many health care providers prefer to deliver one baby vaginally and one by cesarean section." D. "That's correct. The latest evidence shows that cesarean delivery is the safest option for multiple births."

B. Although twins are often delivered by cesarean delivery, it is possible that delivery may be vaginal. It is also important that the nurse know the plan of care and history of the patient so that he or she does not contradict a patient-centered plan that was already in place. Option A is incorrect because Cesarean delivery is not usually started after labor has begun. Option C is incorrect because This is a clinical possibility, but it is not a preferred approach because it places the patient at risk for the complications of both types of delivery. Option D is incorrect because Twins may be delivered vaginally or by cesarean on the basis of maternal health, preferences, fetal health, and other factors. It is inaccurate to tell the patient that a cesarean delivery is the preferred option in all multiple births.

A patient whose labor was complicated by shoulder dystocia reports that one of her infant's arms is "floppy." The nurse examines the infant and finds flaccid muscle tone on one side. Which is the most appropriate nursing education for this patient? A. "This is a normal effect of shoulder dystocia and should resolve in a few days." B. "Your health care provider will likely recommend physical therapy to treat this injury." C. "This could be a symptom of a permanent neurologic condition. I will notify the health care provider immediately." D. "Your baby's collarbone may have fractured as a result of shoulder dystocia. I will notify the health care provider immediately."

B. Flaccid muscle tone in one arm is a presentation of Erb's palsy, or nerve injury to the brachial plexus. Most cases resolve in a few weeks, but physical therapy may be started in the immediate postpartum period. The nurse is justified in providing this anticipatory guidance to the patient on the basis of the health care provider's most likely recommendation. Option A is incorrect because Flaccid muscle tone in one arm is not an effect of shoulder dystocia that resolves in a matter of days. Option C is incorrect because Flaccid muscle tone in one arm is not a symptom of an irreversible neurologic condition. This is not within the scope of practice for the nurse to diagnose and, if suspected, should be brought to the attention of the neonatal care provider. Option D is incorrect because Flaccid muscle tone in one arm does not indicate clavicular fracture. This is not within the scope of practice for the nurse to diagnose and, if suspected, should be brought to the attention of the neonatal care provider.

An infertile man is being treated with Viagra (sildenafil citrate) for erectile dysfunction (ED). Which of the following is a contraindication for this medication? A. Preexisting diagnosis of herpes simplex 2 B. Nitroglycerin ingestion for angina pectoris C. Retinal damage from type I diabetes mellitus D. Complications after resection of the prostate

B. It is unsafe to take Viagra while also taking nitroglycerin for angina. Option A is not a contraindication. Option C is incorrect because Viagra is often prescribed for clients with ED from diabetes mellitus. Option D is incorrect because Viagra is often prescribed for clients with ED from prostate resection.

A client is receiving Pergonal (menotropins) intramuscularly for ovarian stimulation. Which of the following is a common side effect of this therapy? A. Piercing rectal pain B. Mood swings C. Visual disturbances D. Jerky tremors

B. Mood swings and depression are common side effects of hormonal therapy. All other options have not been cited as a side effect of Pergonal.

A patient in prolonged labor expresses frustration when changing positions and states, "I didn't have to move around so much last time I had a baby." Which nursing intervention is most appropriate for this patient? A. Reduce the frequency of position changes to promote patient comfort B. Inform the patient that repositioning is necessary to promote progress of labor C. Educate the patient about how repositioning provides distraction, reducing pain perception D. Explain to the patient that repositioning is necessary to ensure adequate fetal oxygenation during prolonged labor

B. Repositioning during prolonged labor is indicated to promote natural progress of labor. Option A is incorrect because Reducing the frequency of repositioning is not indicated for a patient in prolonged labor because static positioning can impede the progression of labor and exacerbate discomfort. Option C is incorrect because Position changes can promote comfort by altering the stressors on the patient's musculoskeletal system. This effect is not due to the fact that the patient is distracted when repositioned. Option D is incorrect because Repositioning during prolonged labor is not indicated for promoting fetal oxygenation.

A nurse is educating a client who has been diagnosed with infertility on how to complete a basal body temperature chart to determine her ovulation pattern. The client states, "I really don't want to take my temperature every day. Is there any other way to find out if and when I ovulate?" Which of the following is an appropriate response from the nurse? A. There are a number of other ways to determine ovulation, but they all require you to be examined by an obstetrician every month. B. A test you can do at home requires you to spit on a microscopic slide and then look at the slide under a microscope. C. You can test your vaginal discharge every day to determine when you should have intercourse because the hormone progesterone is elevated. D. Although there are some tests you can perform at home, they all cost well over a hundred dollars to purchase.

B. One of the at home evaluation kits requires ovulation predictor kits requires women to place saliva on a microscopic slide and after allowing the saliva to dry, to look at the slide under a microscopic. If ovulation is occurring, the saliva appears ferned (leaflike). The test detects the presence of high levels of estrogen in the women's saliva. Option A is incorrect because there is a number of ovulation tests that women can use at home to determine when they are ovulating. Option C is incorrect because although vaginal discharge does change during women's menstrual cycles, there are no ovulation detection tests that require women to test their vaginal discharge. Option D is incorrect because although some ovulation detection kits are very expensive, while others require a minimal expense. The women may have to test their saliva and urine repeatedly over the course of many days or months, however it requires them to purchase multiple test kits.

Which instruction by the nurse should be included in the teaching plan for an infertile woman who has been shown to have a 28 day biphasic menstrual cycle? A. Douche with cider vinegar solution immediately before having intercourse B. Schedule intercourse every day from day 8 to day 14 of the menstrual cycle C. Be placed on follicle stimulating hormone therapy by a fertility specialist D. Assess the basal body temperature pattern for at least 6 more months

B. Pregnancy is more likely to occur with daily intercourse from 6 days before ovulation up to the day of ovulation. Option A is incorrect because unless it is medically indicated, douching should never be performed. Sperm are unable to survive in an acidic environment. Option C is incorrect because FSH is not indicated if the patient has a biphasic cycle. A biphasic cycle is when the temperatures rise around mid-cycle and stay up until the next menstrual period. Option D is incorrect because the basal body temperature (BBT) chart does not need to be monitored for 6 more months although it can be used to time intercourse.

A woman is seeking a long-term contraceptive method that does not require taking daily medication or the application of a device before intercourse. Which contraceptive methods would be appropriate? Select all that apply. A. Lea's Shield B. Nexplanon implant C. Contraceptive sponge D. Intrauterine device (IUD) E. Combined oral contraceptives (COCs)

B. and D. The Nexplanon progestin implant can provide up to three years of contraception after insertion. Since it does not require daily medication or the application of a device before intercourse, it would be an appropriate method of contraception for this woman. Intrauterine devices (IUDs) provide either five years (hormonal IUD) or ten years (copper IUD) of contraception after insertion. Since they do not require daily medication or the application of a device before intercourse, this would be an appropriate method of contraception for this woman. Option A is incorrect because Lea's Shield is a device that fits over the cervix and must be inserted before intercourse. This would not be an appropriate method for this woman. Option C is incorrect because The contraceptive sponge must be inserted before intercourse and provides contraception for 24 hours. This would not be an appropriate method for this woman. Option E is incorrect because Combined oral contraceptives are pills that must be taken daily to continue effective contraception. This would not be an appropriate contraception method for this woman.

Nurses working in a midwifery office have attended a conference to learn about factors that increase a woman's risk of becoming infertile. To evaluate the nurses' learning, the conference coordinator tests the nurses' knowledge at the conclusion of the seminar. Which of the following problems should the nurses state increase a client's risk of developing infertility problems? Select all that apply. A. Women who have menstrual cycles that are up to 30 days long B. Women who experience pain during intercourse C. Women who have pelvic inflammatory disease D. Women who have excess facial hair E. Women who have menstrual periods that are over 5 days long

B., C., D. Dyspareunia (pain during intercourse) is a symptom of a STI or a symptom of endometriosis. Both can affect a woman's fertility. A woman with pelvic inflammatory disease (PID) is more likely to have blocked fallopian tubes. Women who have hirsutism (excess facial hair) often have polycystic ovarian syndrome (PCOS). Women with PCOS are often infertile and have irregular menses, elevated serum cholesterol and insulin resistance. Options A and D are incorrect because they are within normal menstrual limits.

A female client seeks care at an infertility clinic. Which of the following tests may the client undergo to determine what, if any, infertility problem she may have? Select all that apply. A. Chorionic villus sampling B. Endometrial biopsy C. Hysterosalpinogram D. Serum progesterone assay E. Postcoital test

B., C., D., and E. Endometrial biopsy is performed about 1 week following ovulation to detect the endometrium's response to progesterone. Hysterosalpinogram is performed after menstruation to detect whether or not the Fallopian tubes are patent. Serum progesterone assay is performed about 1 week following ovulation to determine whether or not the woman's corpus luteum produces enough progesterone to sustain a pregnancy. Postcoital tests are performed about 1 to 2 days before ovulation to determine whether healthy sperm are able to survive in the cervical mucus.

A nurse id discussing sexual arousal during a preadolescent boys' sex education class. Which of the following should the nurse base the reply on when a boy asks, "What exactly happens when my body gets aroused anyway?" A. Vans deferens thickens and expands B. Sympathetic nerves of penis are stimulated C. Corpora of penis become engorged D. Prepuce of penis elongates

C. Penile blood vessels (corpora) become engorged with blood during arousal and cause erections. Option A is incorrect because the vans deferens does not change shape during arousal. The vans deferens is where semen passes from the testes to the urethra. Option B is incorrect because the sympathetic nerves are not stimulated during arousal, the parasympathetic nerves are stimulated. Option D is incorrect because prepuce (foreskin) does not increase in length during arousal.

A couple is seeking infertility counseling. During the history, it is noted that the man is a cancer survivor, drinks one beer every night with dinner and takes a sauna every day after work. The response provided by the nurse should be based on which of the following? A. It is unlikely that any of these factors is affected his fertility B. Daily alcohol consumption could be altering his sperm count C. Sperm may be malformed when exposed to the heat of the sauna D. Cancer survivors have the same fertility rates as healthy males

C. The high temperature of a sauna could alter the number of sperm and morphology of the sperm Option A is incorrect because exposing the testes to the heat of the sauna can alter sperm count and morphology Option B is incorrect because one beer per night will not alter spermatogenesis, only excessive amounts of alcohol will alter spermatogenesis Option D is incorrect because chemotherapy affects a man's ability to create sperm

Where does fertilization take place in the uterus? A. Ovaries B. Cervix C. Fallopian tube D. Vagina

C. Fallopian tube

A 35 y.o. client is being seen for her yearly gynecological examination. She states that she and her partner have been trying to become pregnant for a little over 6 months and that a friend has recently advised her partner to take ginseng to improve the potency of his sperm. The woman states that they have decided to take their friend's advice. On which of the following information should the nurse base his or her reply? A. Based on their history, the client and her partner have made appropriate decision regarding their fertility B. Ginseng can cause permanent chromosomal mutations and should be stopped immediately C. It is unnecessary to become concerned about this woman's fertility because she has tried to become pregnant for only a few months D. Although ginseng may be helpful, it would be prudent to encourage the woman to seek fertility counseling

D. Fertility drops as a woman ages, it is advisable to encourage the couple to use conventional therapies in conjunction with the complementary therapy to maximize their potential of becoming pregnant. Option A is incorrect because there is no strong evidence to show if ginseng can promote fertility in men or women. There is also no history to indicate that infertility is caused by the male's poor sperm quality. Option B is incorrect because there is no evidence that ginseng causes chromosomal mutations Option C is incorrect because there is cause for concern because this woman is 35 and has been unable to get pregnant for more than 6 months

A nurse teaches a woman who wishes to become pregnant that if she assesses for spinnbarkeit she will be able to closely predict her time of ovulation. Which technique should the client be taught to assess for spinnbarkeit? A. Take her temperature each morning before rising B. Carefully feel her breasts for glandular development C. Monitor her nipples for tingling and sensitivity D. Assess her vaginal discharge for elasticity and slipperiness

D. Spinnbarkeit is defined as the thread that is created when vaginal discharge is slippery and elastic at the time of ovulation. The changes are in response to high estrogen levels. When a woman is not in her fertile period, the mucous is thick and gluey. Option A is not defined as spinnbarkeit but temperature rise does occur with ovulation Option B is not significant although nodules can be felt in the breasts during ovulation and the breasts can become sensitive Option C is not indicative of spinnbarkeit although the nipples may become sensitive and may tingle

A client is to undergo a post-coital test for infertility. The nurse should include which of the following statements in the client's preprocedure counseling? A. You will have the test the day after your menstruation ends B. You will have a dye put into your vein that will show up on X-ray C. You should refrain from having intercourse for the four days immediately before the test D. You should experience the same sensations you feel when your doctor does your Pap test

D. The client will undergo a speculum exam when cervical mucus will be harvested. Option A is incorrect because the post-coital test is done 1 to 2 days prior to ovulation. Option B is incorrect because no dye is administered and there are no X-ray pictures in a post-coital test. Option C is incorrect because the test is performed a few hours after intercourse.

A client is to have a hysterosalpingogram. In this procedure, the physician will be able to determine which of the following? A. Whether or not the ovaries are maturing properly B. If the endometrium is fully vascularized C. If the cervix is incompetent D. Whether or not the Fallopian tubes are obstructed

D. The primary goal is to learn whether or not the Fallopian tubes are patent. Option A is incorrect because only the uterus and the Fallopian tubes are evaluated during a hysterosalpingogram. Option B is incorrect because the vascularization of the endometrium is beyond the scope of the test. Tumors and other gross assessments of the uterus can be made out. Option C is incorrect because the cervix cannot be evaluated during a hysterosalpingogram.

An Orthodox Jewish couple is seeking infertility counseling. The woman states that her menstrual cycle is 21 days long. After testing, no physical explanation is found for the infertility. Which of the following may explain why the woman has been unable to conceive? A. Her kosher diet is lacking the essential nutrients needed for achieving optimal reproductive health B. The positions allowed Orthodox Jewish couples during intercourse hinder the process of fertilization C. Orthodox Jewish couples are known to have a high rate of infertility because of inborn genetic diseases D. Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends

D. Jewish law prohibits intercourse during menses and for seven days after menses. The woman then goes through a cleansing bath called a mikvah before she and her husband may have intercourse. With a such a short cycle, she is ovulating during the time frame which intercourse is restricted. Option A is incorrect because a Kosher diet provides all nutrients, vitamins and minerals needed by the body Option B is incorrect because there are no specific positions mandated by Jewish law that inhibit fertilization Option C is incorrect because they are not more prone to infertility than the general population

When teaching a woman about correct diaphragm usage, the nurse should include which information? A. A diaphragm can be used with oil-based lubricants. B. A diaphragm can be used with or without spermicide. C. A diaphragm is suitable for women with a latex allergy. D. A diaphragm must be fitted by a health care practitioner.

D. The diaphragm must be fitted by a health care practitioner before use. This information should be included when teaching about correct diaphragm usage. Option A is incorrect because Oil-based lubricants may damage the diaphragm. This inaccurate information about oil-based lubricants should not be included when teaching about correct diaphragm usage. Option B is incorrect because spermicide should be placed into the dome and around the rim before insertion. The diaphragm must be used with spermicide to be effective. This inaccurate information about spermicides should not be included when teaching about correct diaphragm usage. Option C is incorrect because Women with a latex allergy should not use a diaphragm. This inaccurate information about latex allergy should not be included when teaching about correct diaphragm usage.

A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormonal levels would the nurse expect to see? A. Both estrogen and progesterone are high B. Estrogen is high and progesterone is low C. Estrogen is low and progesterone is high D. Both estrogen and progesterone are low

D. When the ovum is not fertilized, both estrogen and progesterone drop. The hormonal drop is followed by menstruation.