Nurs 4560 - Exam 1 - Aug 25 - Ch 5 Infertility, Contraception, and Abortion Practice Qs
A patient wants to have an abortion during the 18th week of pregnancy. What abortion technique should the nurse suggest to the patient? 1 Dilation and evacuation 2 A surgical (aspiration) abortion 3 Administration of methotrexate (Trexal) 4 Administration of mifepristone (Mifeprex)
1 Dilation and evacuation The patient is in her second trimester of pregnancy. Therefore, the nurse should suggest the dilation and evacuation method of abortion. This method is safe and can be used until 20 weeks of gestation. Surgical (aspiration) methods and use of medications such as methotrexate (Trexal), mifepristone (Mifeprex), and misoprostol (Cytotec) are effective for abortion during the first trimester of pregnancy. These methods are not suitable as the patient is in the 18th week of pregnancy.
After having a discussion with a patient, the nurse finds that the patient has regular menstrual cycles every 28 days. What instructions should the nurse give to the patient to prevent conception? 1 The couple should abstain from sexual intercourse from days 10 through 17. 2 The couple should abstain from sexual intercourse from days 6 through 19. 3 It is safe to have unprotected sexual intercourse from days 11 through 17. 4 It is safe to have unprotected sexual intercourse from days 12 through 16.
1 The couple should abstain from sexual intercourse from days 10 through 17. The patient has regular menstrual cycles of 28 days. The beginning of the fertile period is estimated by subtracting 18 days from the length of the shortest cycle. The end of the fertile period is determined by subtracting 11 days from the length of the longest cycle. Therefore, according to the formula, the fertile days are from day 10 through day 17 (shortest cycle, 28 - 18 = day 10, and longest cycle, 38 - 11 = day 17). Therefore, the nurse should advise the patient to abstain from sexual intercourse between days 10 and 17. If the woman has a shortest cycle of 24 days and a longest cycle of 30 days, then the couple should abstain from sexual intercourse from days 6 through 19. As per the calculation, women who have regular cycles of 28 days should not have unprotected sexual intercourse between days 11 and 17 and days 12 through 16 because it is a fertile period.
The nurse is caring for a patient who is scheduled to undergo a hysterosalpingogram. What possible abnormalities can be detected through the procedure? 1 Presence of infection 2 Blockage in the fallopian tubes 3 Decrease in ovarian reserve 4 Abnormal endometrial tissu
2 Blockage in the fallopian tubes A hysterosalpingogram is an X-ray film on which the uterus and fallopian tubes can be visualized for abnormalities. The procedure can help to determine if the fallopian tubes are blocked. Presence of infection cannot be assessed with a hysterosalpingogram. Abnormalities in endometrial tissue are found when endometrial tissue implants itself outside the uterus and is observed by doing an ultrasound. Diagnostic laparoscopy may be indicated for this condition.
The nurse teaches a patient how to detect ovulation and suggests having intercourse the day before and on the day of ovulation. Which patient need is the nurse addressing? The patient: 1Is looking for methods to increase the probability of conception. 2Wants to prevent transmission of sexually transmitted diseases. 3Is researching methods of contraception to prevent a pregnancy. 4Needs advice on ways to prevent excessive menstrual bleeding.
1Is looking for methods to increase the probability of conception. To increase the probability of conceiving, the nurse should suggest that the patient has intercourse the day before and on the day of ovulation. Preventing sexually transmitted diseases is a patient need addressed by encouraging the use of a condom. When counseling about methods of contraception, the patient is advised to abstain from intercourse during the time of ovulation. If the patient wants to control menstruation, the nurse would counsel the patient regarding the use of birth control pills.
A man and a woman who have not achieved a successful pregnancy are scheduled to meet with a fertility specialist. Which simple evaluation is usually the first test to be performed? 1Semen analysis 2Testicular biopsy 3Endometrial biopsy 4Hysterosalpingogram
1Semen analysis Semen analysis is usually the first test to be performed because it is least costly and noninvasive. A testicular biopsy is an invasive examination using a local anesthetic. Endometrial biopsy determines whether the endometrium is responding to ovarian stimulation. Hysterosalpingogram uses contrast medium to evaluate the structure and patency of the uterus and tubes.
While assessing a patient, the nurse finds that the patient's shortest and longest amount of time between menstrual periods is 25 and 28 days, respectively. The nurse teaches the patient the method to calculate the fertile period. The nurse then asks the patient which day carries the maximum chances of conception. Which response by the patient indicates effective learning? 1 2nd day 2 6th day 3 10th day 4 19th day
3 10th day In the calendar rhythm method, the fertile period is calculated by subtracting 18 days from the shortest amount of time between menstrual periods and subtracting 11 from the longest amount of time between menstrual periods. The patient's fertile period would last from 25 - 18 = 7 days to 28 - 11 = 17 days. Therefore, on the 10th day, there would be maximum chances of conceiving. Ovulation might not happen on the 2nd and the 6th day; therefore, chances of conception are less. The ovum may not be viable till the 19th day; therefore, conception may not happen.
Which contraceptive method provides protection against sexually transmitted infections? 1 Oral contraceptives 2 Tubal ligation 3 Male or female condoms 4 Intrauterine device (IUD)
3 Male or female condoms Because condoms provide the best protection available, they should be used during any potential exposure to a sexually transmitted infection. Only the barrier methods provide some protection from sexually transmitted infections. A tubal ligation is considered a permanent contraceptive method but does not offer any protection against sexually transmitted infections. IUDs are inserted in the uterus but do not block or inhibit sexually transmitted infections.
When using the basal body temperature method of family planning, the woman should know that: 1She will remain fertile for five days after ovulation. 2She should take her temperature each night before going to bed. 3Her temperature will increase about 0.4° to 0.8° F after ovulation. 4Her temperature is normally lower during the second half of her cycle.
3Her temperature will increase about 0.4° to 0.8° F after ovulation. The basal body temperature will increase about 0.4° to 0.8° F when ovulation occurs The woman is fertile for up to 18 days. She should take her temperature upon rising in the morning. A woman's temperature is usually higher in the second half of her cycle.
During a bimanual examination of a patient, the nurse finds abnormal contours of the uterus and uterine tube. What should the nurse infer from these findings? The patient: 1Is at risk for endometriosis. 2Is at risk of uterine fibroid. 3Is at risk for an early miscarriage. 4Has polycystic ovarian disease
3Is at risk for an early miscarriage. Uterine abnormalities increase the risk of early miscarriages. Bimanual examination of internal organs is helpful for identifying any abnormalities in the uterus and fallopian tubes. Abnormality in the contours of the uterus and fallopian tubes indicate that the patient has a risk of an early miscarriage. Endometriosis is a condition in which endometrial tissue appears outside the uterus. It is not caused by abnormal contours of the uterus and fallopian tubes. Uterine fibroids develop as benign tumors in the uterus. Polycystic ovarian disease is a genetic disorder and does not occur due to abnormal contours of the uterus and fallopian tubes.
The nurse is briefing a patient about the changes in the cervical mucus during the menstrual cycle. Which statement should the nurse include? The mucus becomes: 1Yellowish during the ovulation period. 2Clear during the ovulation period. 3Thick during the ovulation period. 4Watery during the ovulation period.
3Thick during the ovulation period.
A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." The nurse's most appropriate response is: 1 "This probably means you're pregnant." 2 "Don't worry; it's probably nothing." 3 "Have you been sick this month?" 4 "You probably didn't ovulate during this cycle."
4 "You probably didn't ovulate during this cycle." Pregnancy cannot occur without ovulation (which is being measured using the BBT method). Dismissing the woman's concerns is not appropriate. Illness would most likely cause an increase in BBT. The absence of a temperature decrease most likely is the result of lack of ovulation.
