OB Chapter 4: Common Reproductive Issues

A nurse is preparing a client for intrauterine device (IUD) insertion. Which education will the nurse provide to the client?

"Checking the strings is recommended following insertion."

A woman is going to have in vitro fertilization. When preparing her for this, the nurse would make which statement?

"It can be done with frozen donor sperm."

The nurse is reviewing a client's electronic health record and notices that the client has recently experienced dyspareunia. The nurse knows that this is an effect of aging on the female reproductive system. What is the best description of dyspareunia that the nurse can share with the nursing student?

A woman experiences painful sexual intercourse.

A nurse is teaching a female client who is unable to conceive how to monitor her basal body temperature. Which instruction would the nurse prioritize for this client?

Chart body temperature for at least a month

Throughout life, a woman's most proactive activity to promote her health would be to engage in

Consistent exercise

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 method should the nurse suggest to this client?

CycleBeads or medroxyprogesterone injection

A community health nurse is preparing a presentation for a health fair on the topics of planning for a pregnancy. Which major goal has the nurse determined should be accomplished with this presentation?

Decrease the number of unwanted pregnancies.

___________ refers to a condition in which functioning endometrial tissue is found outside the uterine cavity.

Endometriosis

Bone loss accelerates in the third or fourth decade and declines rapidly after menopause.

False

Is the following statement true or false? Primary amenorrhea occurs in women who have previously menstruated regularly.

False

What is an advantage of a cervical cap over a diaphragm?

It can be left in place longer.

The DEXA scan is a screening test for detecting _____________.

Osteoporosis

Which combination contraceptive has been approved for extended continuous use?

Seasonale

Which activity will increase a woman's risk of CVD if she is taking oral contraceptives?

Smoking cigarettes

The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurse's best response?

The couple can control the time between births when they plan their family.

When assessing a woman for premenstrual syndrome, which of the following would the nurse be least likely to find?

Weight loss

A healthy 28-year-old female client is planning a pregnancy with the support of a female partner. What does the nurse anticipate will be the first method of assisting this client to achieve a pregnancy?

artificial insemination

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus?

when it is thin, watery, and copious

Which comment by a woman would indicate that a diaphragm is not the best contraceptive device for her?

"I am not comfortable touching myself down there."

A client states she has purchased home-use ovulation strips to help her know when she is ovulating. Which response by the nurse is most appropriate?

"You can also test your vaginal discharge to determine if you are ovulating."

A couple is considered infertile after how many months of trying to conceive?

12 months

Monitoring basal body temperature is an example of a _____________ method of contraception.

Behavioral

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 is an example of a vasomotor symptom experienced by menopausal women?

Hot flashes

The cessation of regular menstrual cycles is termed ____________.

Menopause

A female client 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 hysterosalpingography

The absence of menses is called _____________.

amenorrhea

The most common cause of menstrual abnormality in a reproductive-age woman is

anovulation.

The school nurse is preparing a health education session on the topic of birth control for a college group. Which method should the nurse emphasize for this group?

barrier

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What assessments does the nurse anticipate will be performed for this couple? Select all that apply.

semen analysis ovulation monitoring tubal patency

When using the contraceptive patch, a client should understand that it:

should be applied to the abdomen, buttocks, or back.

The nurse is educating a class of high school students on safe sexual practices. The nurse knows the group understood the content when a group member makes which statement?

"Abstinence is the only way to prevent the spread of sexually transmitted infections."

Semen analysis has been ordered for the partner of a client who has been unable to become pregnant. What instructions should the nurse provide to the partner?

"Bring the sample to the lab immediately after you collect it."

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which statement is appropriate for the nurse to include in the response?

"Cervical caps are most effective when used along with a spermicidal agent."

The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client? Select all that apply.

"Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?"

A 52-year-old client reports to the nurse the recent onset of hot flashes, fatigue, and vaginal dryness. Which response by the nurse is most appropriate?

"Tell me what you are currently doing to manage these symptoms?"

A client is scheduled to have in vitro fertilization (IVF) in 1 week. Which statement made by the client indicates that the client needs further teaching?

"The primary care provider will transfer the egg and sperm into the fallopian tube where the egg will become fertilized."

In teaching a fertility class, what is the most appropriate method for the nurse to explain self-ovulation monitoring that promotes conception?

14 days before the next menses is expected

A nurse is reading a journal article about premenstrual syndrome (PMS) and the millions of women affected by it during their reproductive years. The nurse would expect to find approximately what percentage of women meeting the American College of Obstetricians and Gynecologists criteria for PMS?

75%

A newly married couple is meeting with the nurse to discuss a temporary method of birth control that is both a natural form and does not employ birth control pills/devices, in keeping with their religious beliefs. Which method should the nurse point out will best meet their request to delay conception until they are ready?

CycleBeads

A couple is being assessed for infertility. The male partner is required to collect a semen sample for analysis. What instruction should the nurse give him?

Deliver sample for analysis within 1 to 2 hours after ejaculation.

Most girls in the United States menstruate by the age 14.

False

When conducting a health history with a couple who are experiencing subfertility, the nurse will include which of the following? Select all that apply.

General health Medication history Sexual history Surgical history

A nurse is planning care for a client and her husband recently diagnosed with multiple sclerosis and wanting to prevent pregnancy for now. What is the most appropriate nursing diagnosis for this couple?

Readiness for enhanced knowledge regarding contraception options

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

She has a family history of thromboembolism.

The nurse has been working with a subfertile couple through the process of determining their best plan of action to conceive a child. Which action should the nurse prioritize to provide emotional support to this couple?

Speak both separately and together with both partners.

A client is to take clomiphene citrate for infertility. Which outcome should the nurse explain is the expected action of this medication?

Stimulate the release of ova

The nurse is conducting a well-visit physical assessment on a 29-year-old female. The nurse determines the client is probably ovulating based on which condition of the cervical mucus?

Thin, slippery, and stretchy

Estrogen deficiency is commonly manifested by hot flashes and night sweats.

True

Which measure helps prevent osteoporosis?

Weight-bearing exercise (Walking)

A client prescribed oral contraceptive pills (OCPs) has presented for a routine visit. Which finding, if reported by the client upon assessment, should the nurse prioritize?

abdominal pain

The nurse is assessing a client for amenorrhea. During the assessment, the nurse notes facial hair and acne. The nurse knows this could be related to:

an androgen excess secondary to a tumor.

A client is being prepared for intrauterine (artificial) insemination. Which finding is the most suggestive to determine if the client is ovulating?

change in the cervical mucus

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 method should the nurse suggest for this client?

condoms

The nurse is assessing the health history of a male partner. Which data is most likely to be related to an infertility problem?

employment as a taxi driver

A nurse is conducting education classes at the local high school on reproductive life planning. Which would be appropriate for the nurse to implement during the teaching? Select all that apply.

encouragement of abstinence proper condom application sexually transmitted infection statistics

A client is desiring to start birth control and is questioning the nurse concerning the best options. Which option should the nurse point out is the most reliable?

hormonal implant

A nurse is 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:

increase a degree.

The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptives (OCs) in the past and would like a long-term, nonhormone-based method that has a high rate of success. Neither she nor her husband wants to undergo surgery, however. Which method should the nurse recommend?

intrauterine device

A client is to be examined for the presence and extent of endometriosis. For which test should the nurse prepare the client?

laparoscopy

A healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client?

oral contraceptive pills (OCPs)

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about?

overstimulation of the ovary resulting in potential multiple births

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 at which time?

three days before and three days after ovulation

When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to:

toxic shock syndrome.

A young woman says she needs a temporary contraceptive but has a latex allergy. She mentions that she has had a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend?

transdermal contraception

Which statement best explains the action of the lactational amenorrhea method (LAM) of fertility control?

LAM causes suppression of the ovulation process.

Is the following statement True or False? Endometriosis is the most common cause of secondary dysmenorrhea.

True

The diaphragm is an example of a barrier method of contraception.

True

There are no diagnostic tests to reliably determine the existence of premenstrual disorder.

True

A nurse is preparing a presentation for a local community women's group about menopause. When describing the body system changes that occur, the nurse would include which changes? Select all that apply.

hot flashes increased abdominal fat vaginal dryness decreased bone density

A clinic nurse explains to a client who is undergoing an infertility workup that the patency of her fallopian tubes will be checked. Which test is currently used to do this?

hysterosalpingography

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

12

The client has heard of extended-cycle oral contraceptive regimens and desires more information. The nurse explains that these regimens consist of active combination pills, followed by placebo pills. How many days of active combination pills and placebo pills are contained in these regimens?

84 active; 7 placebo

A nurse is developing a plan of care with a client and significant other; both have been diagnosed as being sterile. Which outcome should receive priority in the plan?

Clients state they are taking steps to remain close in light of stress.

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?

Endometriosis

A client is requesting information on the various available contraceptives. When explaining a vaginal spermicide, which information should the nurse prioritize?

Insert the product by applicator in the vagina prior to intercourse.

A client has opted to use an intrauterine device (IUD) for contraception. About which effect of the device on monthly periods should the nurse inform the client?

Periods become lighter.

A nurse should instruct a client who has premenstrual syndrome (PMS) to make which lifestyle modification?

Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule.

A client with liver disease is seen in the clinic wanting to begin contraception. The nurse recognizes that which type of contraception is best for this client?

Vaginal estrogen/progestin (contraceptive) ring

Which definition best explains the term "subfertility/infertility"?

failure to achieve pregnancy after 1 year of unprotected intercourse

The client is interested in using an injectable contraceptive that works by suppressing pituitary secretions. The nurse provides the client with literature and discusses which contraceptive with her?

medroxyprogesterone acetate

A nurse is preparing a presentation for a health fair on the topic of vasectomy. Which information should the nurse point out in the presentation?

Relatively easy procedure with few complications

The nurse is developing a presentation for a group of young adult women about premenstrual syndrome. Which treatment options should the nurse point out as most appropriate? Select all that apply.

reduction of caffeine intake vitamin and mineral supplements NSAIDs

A couple reports that the condom broke while they were having sexual intercourse last night. What would you advise to prevent pregnancy?

Obtain emergency contraceptives and take them immediately.

The nurse determines client understanding of causes of infertility when the client states the following:

"Abnormalities of the uterus may contribute to infertility." , "Women older than 35 may have difficulty conceiving." "A history of sexually transmitted infections may cause infertility.".

The nurse is providing care to a female client and spouse who have completed several rounds of unsuccessful in vitro fertilization. The client still desires to have a child. Which response by the nurse is appropriate?

"Have you and your spouse considered using a surrogate mother?"

The nurse is conducting a health history on a couple planning to become pregnant over the next few months. Which statement by the male client most concerns the nurse?

"I have a degree as a chemical engineer and work at the local plant."

After teaching a woman who has chosen the vaginal ring as her method of contraception, the nurse determines that the client needs additional teaching when she makes which statement?

"I will insert a new ring at the same time and day of every week."

A female client has been trying to conceive for 3 months. She tells the nurse, "I just know something is wrong with me." Which response by the nurse is best?

"It can take up to 1 year of regular, unprotected intercourse to conceive."

A couple is deciding about contraceptive measures. The male partner has decided to undergo a vasectomy. After teaching the client about this procedure, which client statement indicates the need for additional teaching?

"Right after surgery, my semen will be sperm-free."

A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize?

"Start taking the medication when you first get your period."

The nurse is caring for a client requesting oral contraceptive pills (OCPs). She has multiple sexual partners. The nurse recommends condoms to the client, but the client states, "I cannot use condoms because I am allergic to latex." Which response by the nurse is appropriate?

"You can still use condoms because they make latex-free condoms." A

The nurse is caring for four female clients, all prescribed oral contraceptive pills (OCPs). The nurse will question giving an oral contraceptive pill to which client?

37-year-old client who has migraines with aura several times a week and smokes

The nurse is working with and teaching a young couple at the infertility clinic who have been trying to get pregnant for the past year. What percentage of couples are noted to get pregnant after trying during the proper time within the year?

85% to 90%

After assessing a client, a nurse determines that an IUD as a method of contraceptive would be contraindicated based on a history of which finding?

Abnormal uterine shape

A client who delivered her baby 3 months ago is seen in the clinic and tells the nurse that she and her husband have yet to resume a sexual relationship. The nurse notes that no contraception is currently being used. What is the most appropriate nursing diagnosis for this client?

Altered sexual pattern related to fear of pregnancy

Which method would the nurse identify as a barrier method of contraception?

Diaphragm

A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because:

ECs simply prevent embryo creation and uterine implantation from occurring in the first place.

A couple who has not conceived after 6 years of not using birth control are being seen in the infertility clinic. In assessing the client's psychosocial response to infertility, which might the nurse expect to find? Select all that apply.

Guilt related to the lack of conception Anger toward others who have conceived Fear of the possible outcome of the testing

A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client?

In vitro fertilization

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply.

Increase water consumption. Use heating pads or take warm baths. Increase exercise and physical activity.

The nurse is teaching a client about a vasectomy. The nurse determines the session is successful when the client correctly chooses which fact concerning the vasectomy?

It's usually done as an office procedure.

Why is fertility testing initiated with sperm analysis of the male partner?

Sperm analysis is one of the easiest tests to complete.

The client presents reporting irregular menstrual cycles, bleeding between periods, mood swings, hot flashes and vaginal tenderness. After an examination, the nurse suspects abnormal uterine bleeding. Which approach would be inappropriate?

Tell the client she will need to learn to live with the problems.

The nurse is preparing to teach a client how to conduct the basal body temperature method to determine her fertile window. Which instruction should the nurse prioritize?

Temperature should be taken prior to any activity every morning.

A nurse is providing medication education to a teen client who is being prescribed oral contraceptive pills (OCPs). Which of the side effects are more important for the nurse to discuss with the client? Select all that apply.

Weight gain Breakthrough bleeding Depression

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. Which method would be the best recommendation?

a diaphragm and spermicide

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence?

a weight gain of 10 lb (4.5 kg)

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:

causing uterine contractions to expel the uterine contents.

The nurse is providing care to a client with abnormal uterine bleeding. Treatment with medications has been unsuccessful, and surgical intervention is being considered. The nurse identifies which technique as being the last resort?

hysterectomy

A client comes to the clinic for a medical termination of pregnancy. Which potential complications should the nurse point out are possible with this type of procedure? Select all that apply.

incomplete abortion prolonged bleeding infection

A middle-aged woman with a history of hypertension and high cholesterol levels asks the nurse about ways to reduce her risk for heart disease as she approaches menopause. Which area would the nurse emphasize as most important?

lifestyle modification

A 52-year-old client is seeking treatment for menopause. She is not very active and has a history of cardiac problems. Which therapy option should the nurse recognize as contraindicated for this client?

long-term hormone replacement therapy

A nurse is providing a client with information on hormonal contraception. Which could the nurse use as an example of hormonal contraception?

medroxyprogesterone

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client?

oral contraceptive pills (OCPs)

A clinic nurse is interviewing a young client during a subfertility work up. When the client asks the nurse what causes infertility, the nurse informs the client that the problem can rest with the man, the woman, or both. What does the nurse tell the client are common problem areas related to the woman? Select all that apply.

ovulation tubal transport impaired implantation

A client is diagnosed with endometriosis. As part of the teaching plan, the nurse is explaining the condition, including the ways that the diagnosis would be confirmed. The nurse determines that the teaching was successful when the client states that which test would confirm the diagnosis?

pelvic laparoscopy

A male client is being evaluated for subinfertility. What additional data should a nurse obtain?

testosterone, Rh factor, blood type, UA