Chapter 4

A nurse should instruct a client who has premenstrual syndrome (PMS) to make which of these lifestyle modifications? Walk every day, increase caffeine and salt intake, and sleep 8 to 10 hours a night. Reduce caffeine, perform cardio exercise 3 times a week, and sleep 12 hours every other night. Walk several times a week, maintain a regular sleep schedule, decrease complex carbohydrates, and avoid complex sugars. Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule.

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

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. fertility drugs ovulation monitoring semen analysis in vitro fertilization counseling tubal patency

ovulation monitoring semen analysis tubal patency

A couple who have been experiencing infertility have been prescribed clomiphene citrate. What information should be included in teaching about the medication therapy? Select all that apply. The medication is usually used for no more than 3 cycles at a time. This medication therapy will promote ovulation in the woman. The medication will work to increase progesterone levels. While on the medication, it is important to engage in sexual intercourse daily during the period of suspected ovulation. Hot flashes are a common side effect of the medication.

The medication is usually used for no more than 3 cycles at a time. This medication therapy will promote ovulation in the woman.

A nurse is providing follow-up teaching to a client regarding the medically induced termination of her pregnancy. Which assessment finding should the nurse tell the client to report to the health care provider? Select all that apply. Vaginal bleeding of more than two pads per hour Severe depression or sadness Severe abdominal pain Oral temperature of 101.5°F (38.6℃) Mild cramping

Vaginal bleeding of more than two pads per hour Severe depression or sadness Severe abdominal pain

The nurse is preparing to assess a client who is noted to have a history of dysmenorrhea. The nurse predicts the client will report which potential symptom during the examination? abnormally long, heavy menstrual periods intermittent, sharp suprapubic pain chronic pelvic pain dysphoria

intermittent, sharp suprapubic pain

A young couple is having difficulty getting pregnant. The nurse is preparing the couple for the initial tests to determine their fertility. When asked by the couple why they need to start with a sperm analysis, what will be the nurse's best response? The man is found to be fertile in over 75 percent of couples with infertility problems. Asking the male to undergo diagnostic procedures first is the best way to assess interest in treatment of infertility. Male fertility testing is time-consuming and therefore should be initiated early. Sperm analysis is one of the easiest tests to complete.

Sperm analysis is one of the easiest tests to complete.

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? May notice permanent increased scrotal swelling Usually done as an office procedure Will no longer ejaculate Testes will no longer produce sperm.

Usually done as an office procedure

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? multigravida status endometriosis hormonal imbalance perimenopause

endometriosis

The nurse is preparing a teaching session for a client considering tubal ligation. Which factor should the nurse prioritize in this session? The procedure is easy to perform and will be painless. This is a permanent and irreversible procedure for birth control. Wait several months after birth, and schedule the surgery as an outpatient. She must have signed consent from her partner.

This is a permanent and irreversible procedure for birth control.

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? bisphosphonates long-term hormone replacement therapy lipid-lowering agents selective estrogen receptor modulators

long-term hormone replacement therapy

A couple in their mid-30s are at their primary care provider's office because they have been unable to conceive for 3 years. They already have one child who is 4 years of age. The care provider explains to them that they are dealing with what kind of infertility? secondary infertility tertiary infertility There is no name for different kinds of infertility. primary infertility

secondary infertility

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for: a pelvic X-ray. an ultrasound. an MRI. a DEXA scan.

a DEXA scan.

A nurse is counseling with a couple in the fertility clinic. In discussing the plan of care, which aspect should the nurse anticipate as being most stressful for the couple? Tracking daily basal body temperatures Obtaining the necessary fertility testing Planning intercourse around ovulation Frequent visits to the fertility clinic

Planning intercourse around ovulation

Which statement would be most appropriate when explaining endometriosis as a cause of a woman's infertility? "Your uterine cervix fails to close because it is engorged with tissue." "You do not ovulate because of endometrial implants on the ovaries." "Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum." "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 is providing education to a male client on vasectomy. What teaching should the nurse include? Select all that apply. "You can resume sexual intercourse in about one week." "The procedure will stop the production of sperm." "You will be placed under general anesthesia for the procedure." "There will be a significant amount of pain following the procedure." "The vas deferens is cut or cauterized to stop the passage of sperm."

"The vas deferens is cut or cauterized to stop the passage of sperm." "You can resume sexual intercourse in about one week."

A client is seen in the clinic requesting an emergency postcoital contraception pill levonorgestrel (Plan B). The client states that she had unprotected sex 3 ½ days ago. What is the most appropriate response by the nurse? "You should contact the local abortion clinic to set up an appointment." "You will need to also be treated with antibiotics for an STI." "Unfortunately you are past the time frame to take that prescription." "The pill will cause you to begin menstruating within a day.

"Unfortunately you are past the time frame to take that prescription."

The nurse is reviewing a client's electronic medical 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 who is going to see this client with the nurse? Bones become brittle and porous and fracture more easily. A woman experiences female climacteric. A woman experiences painful intercourse. The uterus prolapses and falls into the vagina.

A woman experiences painful intercourse.

A woman at the infertility clinic for the first time asks, "What could have caused my infertility?" After teaching the woman about possible causes, the nurse determines that the teaching was successful when the woman identifies which condition as a common cause? Anovulation Vaginal pH of 4.2 Pelvic inflammatory disease Endometriosis History of ovarian tumor

Anovulation Pelvic inflammatory disease Endometriosis

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? Abstain from sexual activity for 10 hours before collecting the sample. Avoid strenuous activity for 24 hours before collecting the sample. Collect a specimen by ejaculating into a condom or plastic bag. Deliver sample for analysis within 1 to 2 hours after ejaculation.

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

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? Procedure is effective immediately Regular sperm counts are not essential Birth control measures are not required Relatively easy procedure with few complications

Relatively easy procedure with few complications

A nurse supervisor observes a nurse massage a client's injection site after giving a dose of depot medroxyprogesterone acetate (Depo-Provera). What is the priority response by the nurse supervisor? Remind the nurse that this injection should absorb slowly. Call the health care provider immediately. Thank the nurse for excellent client care. Write up an incident report for the medication error.

Remind the nurse that this injection should absorb slowly.

The nurse has assessed several clients who have arrived for routine appointments. The nurse predicts the health care provider will prioritize a bone density scan for which client? a 55-year-old white client who smokes and has family history of osteoporosis a 25-year-old Asian client, 5 ft 7 in (1.7 m) tall, 129 lbs (58.5 kg), with two children a 45-year-old Hispanic client with a vitamin D deficiency a 40-year-old black client, 5 ft 4 in (1.62 m) tall, 172 lbs (78 kg), inactive lifestyle

a 55-year-old white client who smokes and has family history of osteoporosis

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription? spermicide condom diaphragm basal body temperature

diaphragm

A woman at the infertility clinic for the first time asks, "What could have caused my infertility?" Learning has taken place when the woman can identify which common causes of infertility? Select all that apply. blocked fallopian tubes cervical factors endometriosis absence of uterus ovarian dysfunction

endometriosis ovarian dysfunction blocked fallopian tubes

A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions? "I have to abstain from sexual activity for about 2 to 5 days before the sample." "I will place the specimen in a special plastic bag to transport it." "I will withdraw before I ejaculate during sex to collect the specimen." "I need to bring the specimen to the lab the day after collecting it."

"I have to abstain from sexual activity for about 2 to 5 days before the sample."

A male client being evaluated for subfertility has been instructed to provide a sperm sample for analysis. Which instructions would be most appropriate for the nurse to provide? Select all that apply. Do not use any lubricants with the sample. You should be abstinent 2 to 4 days prior. Put the sample on ice until delivery. Deliver it within 1 hour of collection. You can use the withdrawal method.

Do not use any lubricants with the sample. Deliver it within 1 hour of collection. You can use the withdrawal method.

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

"Some hormonal contraceptives do not contain estrogen and rely instead on progestin only."

The nurse is planning to speak at a local community center to a group of middle-aged women about osteoporosis. Which measure would the nurse be sure to include as effective in reducing the risk for osteoporosis? engaging in daily weight-bearing exercise drinking at least 1 glass of wine per day limiting intake of cholesterol and saturated fats decreasing vitamin D intake

engaging in daily weight-bearing exercise

A woman and her partner have been unable to conceive. The female client's chart reveals a history of pelvic inflammatory disease (PID), oral contraceptive usage for 5 years, blood pressure 98/72 mm Hg, pulse 78 beats/min, temperature 99°F (37.2°C), and white blood cell (WBC) count 9,500 mm3 (9.5 x 109/l). Which order will the nurse anticipate for this client? serum estrogen and progesterone testing oral antibiotic therapy hysterosalpingography urinalysis

hysterosalpingography

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? condoms spermicides oral contraceptive pills (OCPs) coitus interruptus

oral contraceptive pills (OCPs)

A nurse is assessing a 26-year-old married female client for use of oral contraceptive pills (OCPs). Which findings in her health history would suggest that natural family planning may be a better option? Select all that apply. smokes 1 pack per day migraine headaches abortion at age 18 menses at age 11 blood pressure 138/88 mm Hg

smokes 1 pack per day migraine headaches blood pressure 138/88 mm Hg

Which action would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis? taking calcium supplements using hormone replacements swimming daily taking vitamin A

taking calcium supplements

A male client asks the nurse to explain which structure is cut during a vasectomy. What response should the nurse give the client? the scrotum the vas deferens the ejaculatory ducts the epididymis

the vas deferens

The nurse is assessing a 52-year-old perimenopausal female who is concerned about the changes occurring in her body. When questioned about the most serious changes, which effect should the nurse point out? dense breast tissue is replaced with adipose tissue bone mineral density decreases the uterus and ovaries decrease in size pelvic support muscles lose tone

bone mineral density decreases

After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)? tubal ligation intrauterine system oral contraceptives condoms

condoms

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? dilation and curettage uterine artery embolization hysterectomy endometrial ablation

hysterectomy

A male client visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. What is a risk factor associated with male infertility? sperm density about 20 million/ml morphology of sperm within normal limits no or few sperm cells produced 2 to 5 ml of semen ejaculated

no or few sperm cells produced

The nurse was teaching a college student how to properly take the prescribed oral contraceptive pills (OCPs). The nurse determines the session is successful when the client correctly chooses which instruction to follow when taking the OCP? same time of day, each day take with a meal empty stomach, full glass of water same day of the week, once a week

same time of day, each day

Which definition best explains the term "subfertility/infertility"? inability to achieve pregnancy following a previous viable pregnancy failure to achieve pregnancy after 1 year of unprotected intercourse failure to achieve pregnancy after 6 months of unprotected intercourse inability to achieve pregnancy because of a known factor that prevents conception

failure to achieve pregnancy after 6 months of unprotected intercourse

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? "I get really irritable and moody about a week before my period." "I get sharp pain in my lower abdomen usually starting soon after my period comes." "I've been having bleeding off and on that's irregular and sometimes heavy." "My periods have been unusually long and heavy lately."

"I've been having bleeding off and on that's irregular and sometimes heavy."

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? "Do you or your partner have a family history of subfertility?" "It can take up to 1 year of regular, unprotected intercourse to conceive." "It is time to talk to your health care provider about hormone testing." "The problem can be with the man, woman, or both. We will explore all possibilities."

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

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. "Are you exposed to X-rays or other radioactive substances?" "Do you have a regular girlfriend?" "Have you ever had any type of trauma or surgery on or near your testicles?" "Do you use drugs or use alcohol excessively? "When was the last time you had sex?"

"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?" "Do you use drugs or use alcohol excessively?

client 6 weeks postpartum is preparing to receive a depot medroxyprogesterone acetate (Depo-Provera) injection. Which statement by the client indicates that further teaching is necessary? "By increasing my activity and watching my diet I will better control my weight." "I will need to return every 3 months for a follow-up." "I need to be patient as it will take a while before I can get pregnant." "This does not affect my milk supply so I can continue to breastfeed."

"I need to be patient as it will take a while before I can get pregnant."

A nurse is completing an informed consent on a client preparing for a tubal ligation. Which statement by the client would require the nurse to notify the health care provider? "I may need to use a second form of contraception for a while." "I will not be able to have children after this procedure." "I will continue to have my menstrual cycle every month." "I will be able to have my third child in about a year from now."

"I will be able to have my third child in about a year from now."

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. hypoglycemia infection incomplete abortion pneumonia prolonged bleeding

infection incomplete abortion prolonged bleeding

A health care provider has ordered a medically induced termination of pregnancy for a client. Which findings in the client's health history would require the nurse to question the order? Select all that apply. Severe asthma with inhaler use Weight gain of 10 pounds in 1 year An intrauterine device is placed Identical twin died in car accident Rh-negative blood type

An intrauterine device is placed Severe asthma with inhaler use

A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). What information would the nurse need to stress to the group? Select all that apply. ECs induce an abortion-like reaction. ECs are birth control pills in higher, more frequent doses. ECs are not to be used in place of regular birth control. ECs provide little protection for future pregnancies. ECs provide some protection against STIs.

ECs are birth control pills in higher, more frequent doses. ECs are not to be used in place of regular birth control. ECs provide little protection for future pregnancies.

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 can help prevent STIs. ECs simply prevent embryo creation and uterine implantation from occurring in the first place. ECs are more effective than regular birth control. ECs can induce an abortion of a recently implanted embryo.

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

A client is to take clomiphene citrate for infertility. Which outcome should the nurse explain is the expected action of this medication? Break down scar tissue Reduce inflamed endometrium Stimulate the release of ova Decrease testosterone levels

Stimulate the release of ova

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? Obtain a prescription for CBC and PT blood test. Tell the client she will need to learn to live with the problems. Prepare her for an ultrasound to check internal pelvic structures. Obtain a prescription for pregnancy test to rule out ectopic pregnancy.

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

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 information should the nurse mention to the man? The man will no longer produce testosterone. The man will no longer ejaculate seminal fluid. The man will continue to ejaculate sperm. The man will still have full erection capacity.

The man will still have full erection capacity.

A client in her second trimester of pregnancy asks the nurse for information regarding certain oral medications to induce a miscarriage. What information should this client be given about such medications? They are considered a permanent end to fertility. They present a high risk of respiratory failure. They can be taken only in the first trimester. They are available only in the form of suppositories.

They can be taken only in the first trimester.

When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which primary cause? changes in vaginal pH poor dietary intake active lifestyle estrogen deficiency

estrogen deficiency