OB - Chapter 4 Common reproductive issues

After the nurse teaches a client about ways to reduce the symptoms of premenstrual syndrome, which client statement indicates a need for additional teaching? a) "I'll cut down on the amount of coffee and colas I drink." b) "I quit smoking about a month ago, so that should help." c) "I will make sure to take my estrogen supplements a week before my period." d) "I've signed up for an aerobic exercise class three times a week."

"I will make sure to take my estrogen supplements a week before my period."

Which of the following measures helps prevent osteoporosis? a) Supplementing with iron b) Sleeping 8 hours nightly c) Eating lean meats only d) Doing weight-bearing exercises

Doing weight-bearing exercises

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

Temperature should be taken prior to any activity every morning

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 thin, watery, and copious c) When it is thick d) When it does not stretch

When it is thin, watery, and copious

The nurse is assessing a client for amenorrhea. Which of the following should the nurse document as evidence of androgen excess secondary to a tumor? a) Facial hair and acne b) Hypothermia c) Reduced subcutaneous fat d) Irregular heart rate and pulse

Facial hair and acne

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

Femcap

What comment by a woman would indicate that a diaphragm is not the best contraceptive device for her? a) "My husband says it is my job to keep from getting pregnant." b) "I have a hard time remembering to take my vitamins daily." c) "Hormones cause cancer and I don't want to take them." d) "I am not comfortable touching myself down there."

"I am not comfortable touching myself down there."

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

"The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months."

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which of the following should the nurse suggest for this client? a) Condoms b) Tubal ligation c) Intrauterine device (IUD) d) Oral contraceptives (OCs)

Condoms

Throughout life, a woman's most proactive activity to promote her health would be to engage in: a) Consistent exercise b) Socialization with friends c) Quality quiet time with herself d) Consuming water

Consistent exercise

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

CycleBeads

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) Inability to achieve pregnancy following a previous viable pregnancy d) Failure to achieve pregnancy after 6 months of unprotected intercourse

Failure to achieve pregnancy after 1 year of unprotected intercourse

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

It carries the same safety profile as the 28-day regimen.

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

It is usually done as an office procedure

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

LAM causes suppression of the ovulation process

Which of the following combination contraceptives has been approved for extended continuous use? a) Seasonale b) Triphasil c) Ortho Evra d) Mirena

Seasonale

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) Semen analysis, urinalysis, and ovulation monitoring c) Serologic test for syphilis, semen analysis, and tubal patency assessment d) Semen analysis, ovulation monitoring, and tubal patency assessment

Semen analysis, urinalysis, and ovulation monitoring

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.

Which of the following is important for a woman scheduled to undergo a tubal ligation to understand? a) The procedure will reduce her menstrual flow in amount. b) She will have lessened dysmenorrhea following the procedure. c) She should schedule it to be done just before a menstrual flow. d) She must think of the procedure as irreversible.

She must think of the procedure as irreversible.

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

Suppresses follicle-stimulating hormone (FSH)

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

Suppresses follicle-stimulating hormone (FSH)

A young woman says she is needs a temporary contraceptive but has a latex allergy. She mentions that she has a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend? a) Diaphragm b) Cervical cap c) Transdermal contraception d) Female condom

Transdermal contraception

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

Transdermal contraceptive

If the couple desires, any eggs not used in the process of in vitro fertilization can be cryopreserved for use at a later time. a) True b) False

True

Which of the following body system changes would the nurse associate with menopause? Select all that apply. a) Moist, supple skin b) Hot flashes c) Vaginal dryness d) Increased abdominal fat e) Decreased waist size f) Decreased bone density

• Increased abdominal fat • Decreased bone density • Hot flashes • Vaginal dryness

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."

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

"Oral contraceptives may delay conception for a few months. Give it another 6 to 8 months."

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

"Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum."

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

"Some oral contraceptives protect against STDs."

Subfertility/infertility is said to exist when a couple has failed to achieve pregnancy after how many months of unprotected sexual intercourse? ______ months

12

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) An African American woman, 5 feet and 4 inches tall, 172 pounds, with an inactive lifestyle c) A 25-year-old Asian woman, 5 feet and 7 inches tall, 129 pounds, with two children d) A 55-year-old Caucasian woman who smokes and whose 80-year-old mother has osteoporosis

A 55-year-old Caucasian woman who smokes and whose 80-year-old mother has osteoporosis

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Assuming that all of the following methods of birth control are acceptable to her, which of the following would be the best recommendation? a) The rhythm (calendar) method b) An ovulation suppressant c) A diaphragm and spermicide d) A spermicidal suppository

A diaphragm and spermicide

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 hysterosalpingography

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

Anovulation

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) Anovulation c) Tubal transport problems d) Stenotic cervical os

Anovulation

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) Symptothermal method b) Cervical mucus method c) Calendar method d) Basal body temperature (BBT) method

Basal body temperature (BBT) method

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

Before penile-vulvar contact

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

Can slip into the vagina during vigorous intercourse

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

Causing uterine contractions to expel the uterine contents

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

Causing uterine contractions to expel the uterine contents

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) Coitus interruptus b) Condoms c) Spermicides d) Combination oral contraceptives

Combination oral contraceptives

The nurse is caring for a client at the ambulatory care clinic who questions the nurse for information about contraception. The client reports that she is not comfortable about using any barrier methods and would like the option of regaining fertility after a couple of years. Which of the following methods should the nurse suggest to this client? a) Basal body temperature (BBT) b) Coitus interruptus c) Cycle Beads or Depo-Provera d) Lactational amenorrhea method

Cycle Beads or Depo-Provera

The nurse is preparing to teach a class to a group of middle aged women regarding the most common vasomotor symptoms experienced during menopause and possible modalities of treatment available. Which of the following would be a vasomotor symptom experienced by menopausal women? a) Weight gain b) Bone density c) Hot flashes d) Heart disease

Hot flashes

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) Subdermal progestin implant b) Transdermal patch c) Intrauterine device d) Tubal ligation

Intrauterine device

A 52-year-old client is seeking treatment for menopause. She is not very active and has a history of cardiac problems. Which of the following therapy options should the nurse recognize as contraindicated for this client? a) Lipid-lowering agents b) Long-term hormone replacement therapy c) Selective estrogen receptor modulators d) Bisphosphonates

Long-term hormone replacement therapy

A 52-year-old client is seeking treatment for menopause. She is not very active and has a history of cardiac problems. Which of the following therapy options should the nurse recognize as contraindicated for this client? a) Long-term hormone replacement therapy b) Bisphosphonates c) Lipid-lowering agents d) Selective estrogen receptor modulators

Long-term hormone replacement therapy

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

Loss of intimacy

A couple reports that their condom broke while they were having sexual intercourse last night. What would you advise to prevent pregnancy? a) Inject a spermicidal agent into the woman's vagina immediately. b) Obtain emergency contraceptives and take them immediately. c) Douche with a solution of vinegar and hot water tonight. d) Take a strong laxative now and again at bedtime.

Obtain emergency contraceptives and take them immediately.

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

Regular check of threads must be done

Which of the following activities will increase a woman's risk of cardiovascular disease if she is taking oral contraceptives? a) Eating a high-fiber diet b) Smoking cigarettes c) Taking daily multivitamins d) Drinking alcohol

Smoking cigarettes

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

Sperm analysis is one of the easiest tests to complete.

A woman telephones you after taking an ovulation suppressant for 3 months to tell you that she has forgotten to take her pill two mornings in a row. What would be the best advice to give her regarding this? a) Take three pills immediately and avoid coitus for the remainder of the month. b) Start a new cycle of 21 pills immediately plus additional estrogen for the next 3 days. c) Take two pills now and use a second method of contraception for the remainder of the month. d) Take two pills a day for the rest of the month.

Take two pills now and use a second method of contraception for the remainder of the month.

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

Three days before and three days after ovulation

You are asked to teach a woman to take her basal body temperature daily to assess the time of ovulation. She can detect her day of ovulation, following ovulation, because her temperature will a) increase a degree. b) decrease a degree. c) fluctuate a degree daily. d) no longer reflect basal body temperature.

increase a degree.

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

mechanical barrier

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

Abdominal pain

The majority of pregnancy terminations are done in cases in which the pregnancy threatens the mother's life. a) True b) False

False

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 no longer produce testosterone b) The man will no longer ejaculate seminal fluid c) The man will still have full erection capacity d) The man will continue to ejaculate sperm

The man will still have full erection capacity

For natural reproductive life planning, which of the following is characteristic of cervical mucus during ovulation? a) Properties of acidity and ferning b) Increased number of leukocytes c) Thin and watery d) High viscosity and alkalinity

Thin and watery

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

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

condoms