Exam 2: Family Planning

The nurse is providing information to a woman deciding on a form of contraception. What should be considered when determining the best contraceptive​ method? ​(Select all that​ apply.) Affordability Ease of use Safety Effectiveness Accountability

Affordability Ease of use Safety Effectiveness Rationale Nurses should provide contraceptive information to the individual to assist in making the decision. In deciding on the best​ method, the individual will need to consider​ safety, effectiveness, ease of​ use, side​ effects, whether it is easily​ available, and whether it is affordable.

A client with sickle cell disease asks the nurse to explain how she has this disease when no one else in her family is affected. The nurse understands that sickle cell disease follows what type of genetic inheritance​ pattern? Autosomal dominant disorder Autosomal recessive disorder Mendelian inheritance disorder ​Sex-linked inheritance disorder

Autosomal recessive disorder Rationale Autosomal recessive disorders require two abnormal genes for an individual to be affected. If the individual has only one affected​ gene, he or she is considered a carrier of the disorder. For this client to be diagnosed with sickle cell​ disease, both parents are carriers of the genetic disorder. Autosomal dominant disorders are inherited if the disease trait is​ heterozygous; the abnormal trait overpowers the normal​ gene, producing the disorder. For these disorders to be​ diagnosed, one of the parents is affected by the disorder. Mendelian inheritance disorders are mathematically predictable and have fixed occurrence rates. The characteristics are inherited from the genes in each chromosome and are classified as dominant​ (strong) or recessive​ (weak). Inheritance is also determined by whether the chromosome is located on an autosome​ (body) or a gamete. Normal and abnormal characteristics are transmitted this​ way, and a parent can be a carrier for a​ single-gene disorder without having any observable characteristics.​ X-linked, or​ Sex-linked, inheritance disorders can be dominant or recessive and are carried on the X chromosome.​ X-linked recessive disorders are expressed in males who carry the disorder on their X chromosome. There are some conditions where the female will be​ affected, but the symptoms tend to be milder.

Ibrahim​ Moussad, an​ 18-year-old male, has come to the neighborhood clinic for an exam that is required before he can play sports. Ibrahim requests a male nurse. What will the nurse keep in mind as he takes​ Ibrahim's medical history and prepares to discuss contraceptive​ use? Be aware of the​ client's cultural and religious beliefs Influence the client so that he makes the choice recommended by the nurse Remember that a teenager will not be truthful about his sexual history Obtain​ Ibrahim's height and weight when obtaining the health history

Be aware of the​ client's cultural and religious beliefs

A​ 35-year-old client is interested in starting oral contraceptives. She smokes one pack of cigarettes a day. About which side effect should the nurse be most​ concerned? Vaginal infection Hypertension Allergic reaction Blood clot

Blood clot Rationale Women on oral contraceptives are at risk of developing blood clots. Women over the age of 35 who smoke are at an even greater risk. Some women may experience an increase in blood pressure while taking oral​ contraceptives, but it would not take priority over the possibility of the formation of blood clots. Vaginal infections are not the result of oral contraceptive use. Allergic reactions to oral contraceptives are rare.

The nurse is educating a​ client, who is trying to​ conceive, about nutrition. Which essential nutrients should the client include in her daily​ diet? ​(Select all that​ apply.) Calcium Iron Vitamin E Vitamin A Protein

Calcium Iron Protein Rationale A woman who is trying to conceive should include ample quantities of essential nutrients with emphasis on​ calcium, iron, and protein. Vitamin E and A are not essential for a client who is trying to conceive

A sexually active​ 33-year-old woman is interested in using a natural​ (fertility awareness​ based) contraceptive method. She works rotating shifts and has an irregular menstrual cycle. Which method would be best for the nurse to​ recommend? Calendar method Cervical mucus method Abstinence Basal body temperature

Cervical mucus method Rationale The cervical mucus method evaluates the changes in cervical mucus as ovulation​ approaches; this method is not affected by irregular menses or rotating shifts. Working rotating shifts can affect the basal body​ temperature, making the outcome difficult to determine. The calendar method is less effective if the woman​'s cycles are variable. Abstinence would not be recommended if the client has chosen to be sexually active.

The nurse is providing education to a community group. Which disorders presented are considered multifactorial inheritance​ disorders? ​(Select all that​ apply.) Huntington disease Cleft lip Clubfoot Spina bifida Neural tube defect

Cleft lip Clubfoot Spina bifida Neural tube defect Rationale Multifactorial inheritance disorders are a combination of environmental and genetic factors. Examples of multifactorial inheritance disorders include neural tube​ defects, spina​ bifida, clubfoot, and cleft lip. Huntington disease is an autosomal dominant disorder.

During a woman​'s ​pre-pregnancy physical​ exam, what referral is essential for the nurse to​ make? Dentist Occupational therapist Ophthalmologist Social worker

Dentist Rationale During a woman​'s ​pre-pregnancy physical​ exam, the nurse should refer the client to a dentist in order to avoid exposure to radiation or infection while pregnant. Referral to a social​ worker, ophthalmologist, or occupational therapist is not essential.

What preconception counseling may the nurse provide to the individual or couple who is of childbearing​ age? ​(Select all that​ apply.) Discuss the unreasonableness of not planning for a pregnancy Discuss the benefits of good nutrition and obtaining and maintaining a normal weight for the​ client's height . Encourage discussion of each​ partner's goals,​ expectations, and desire to be a parent Provide information on good exercise habits that can be maintained with the​ client's lifestyle Provide information on different kinds of birth control and their advantages and risks

Discuss the benefits of good nutrition and obtaining and maintaining a normal weight for the​ client's height . Encourage discussion of each​ partner's goals,​ expectations, and desire to be a parent Provide information on good exercise habits that can be maintained with the​ client's lifestyle Provide information on different kinds of birth control and their advantages and risks

When planning care for a client with family planning​ needs, which interventions should the nurse​ include? ​(Select all that​ apply.) Encourage client to verbalize feelings about sexual health Consult social worker for genetic counseling Provide environment that promotes discussion Teach client about fertility and contraception Emphasize the importance of using condoms for disease prevention

Encourage client to verbalize feelings about sexual health Provide environment that promotes discussion Teach client about fertility and contraception Emphasize the importance of using condoms for disease prevention Rationale When planning care for a client with family planning​ needs, the nurse needs to provide a​ nonjudgmental, accepting atmosphere to promote discussion. Other interventions should include encouraging the client to verbalize feelings of sexual​ health, teaching regarding fertility and​ contraception, and to emphasize the importance of condom use for disease prevention. The social worker is not the appropriate person to provide genetic counseling.

During a preconception​ visit, the nurse recognizes that a​ 33-year-old client may benefit from genetic counseling based on what​ data? Exposure to secondhand smoke History of alcohol use Client​'s age Family history of genetic disorders

Family history of genetic disorders Rationale The nurse should suggest genetic counseling based on the couple​'s family history of genetic disorders. Genetic counseling should be suggested for a woman over 35 years. Genetic counseling is not recommended for a client exposed to secondhand smoke or with a history of alcohol use.

The nurse is discussing the need for therapeutic donor insemination​ (TDI) with a client. Which would be an indication for​ TDI? ​(Select all that​ apply.) Epispadias Genetic male​ sex-linked disorder Erectile dysfunction Severe oligospermia Azoospermia

Genetic male​ sex-linked disorder Severe oligospermia Azoospermia Rationale TDI is used in cases of severe oligospermia​ (low sperm​ count), in cases of azoospermia​ (absence of​ sperm), or in those with a history of genetic male​ sex-linked disorders. Epispadias is a penile anatomic abnormality. The male​'s sperm can be used for​ insemination; donor sperm is not needed. Sperm from men with erectile dysfunction can still be used for​ insemination; donor sperm is not needed.

Which data are included in a physical examination of a male with family planning​ needs? ​(Select all that​ apply.) Postcoital exam Genital examination Monitor weight Blood pressure . Inspect for varoceles

Genital examination Monitor weight Blood pressure . Inspect for varoceles

Which action is not a suspected or known health risk for the couple planning a​ pregnancy? Breathing secondhand smoke Getting a flu shot Taking prescription medicine Drinking coffee

Getting a flu shot

In the nursing​ assessment, what health history questions may be asked of both male clients and female clients in need of family planning​ care? ​(Select all that​ apply.) History of contraceptive use with barriers to prevent STIs History of​ menses, including regularity and first onset History of sexual​ activity, including age at first intercourse History of premature ejaculation or impotence History of sexual​ trauma, including rape and incest

History of contraceptive use with barriers to prevent STIs History of sexual​ activity, including age at first intercourse History of sexual​ trauma, including rape and incest

Sally​ Jones, a​ 25-year-old client, visits the clinic for evaluation of possible infertility. She states that she and her husband have been trying to conceive for over 3 months and are concerned that something is wrong with one of them. On what knowledge is the​ nurse's response​ based? Infertility is on the rise in the United States. Infertility is likely related to an underlying medical condition. Infertility is likely associated with​ Sally's age. Infertility is the inability to conceive after one year of unprotected regular intercourse.

Infertility is the inability to conceive after one year of unprotected regular intercourse.

The nurse is preparing teaching for home care to a client with family planning needs. What topics should the nurse​ address? ​(Select all that​ apply.) Participating in a weekly exercise class Maintaining a​ balanced, nutritional diet Making a dental appointment Avoiding all vaccines Smoking cessation

Maintaining a​ balanced, nutritional diet Making a dental appointment Smoking cessation Rationale When teaching on home care to a client with family planning​ needs, the nurse should include the importance of maintaining a​ balanced, nutritional diet and making a dental appointment. The nurse should also include smoking cessation or the importance of reducing the number of​ cigarettes, if possible. The client should maintain a regular exercise routine and not just participate in a weekly exercise class. The client should also receive the flu vaccine.

What is the most common noninvasive method for assessing ovulation in female​ clients? Performing an endometrial biopsy Conducting a postcoital examination Mapping menstrual cycles for 3 months Measuring basal body temperature

Measuring basal body temperature

Clinical interruption of a pregnancy in the first 7 to 9 weeks may be performed by what​ procedure? Surgical abortion by dilation and extraction and hypertonic saline Medical abortion by administration of mifepristone and misoprostol Medical abortion by dilation and curettage and minisuction Surgical abortion by dilation and curettage and minisuction

Medical abortion by administration of mifepristone and misoprostol

When contrasting Mendelian inheritance disorder with autosomal dominant​ disorder, the nurse needs to understand the characteristics of each disorder. Which statement about both disorders is​ correct? Mendelian inheritance disorders are mathematically​ predictable, whereas autosomal dominant disorders are inherited if the disease trait is heterozygous. Mendelian inheritance disorders are mathematically​ predictable, whereas autosomal dominant disorder is a combination of environmental and genetic factors. Mendelian inheritance disorders require two abnormal genes for an individual to be​ affected, whereas autosomal dominant disorders are inherited if the disease is heterozygous. Mendelian inheritance disorders are​ inherited, whereas autosomal dominant disorders are mathematically predictable.

Mendelian inheritance disorders are mathematically​ predictable, whereas autosomal dominant disorders are inherited if the disease trait is heterozygous. Rationale: Mendelian inheritance disorders are mathematically​ predictable. Autosomal dominant disorders are inherited if the disease trait is heterozygous. Two abnormal genes for an individual to be affected describe an autosomal recessive disorder. A combination of environmental and genetic factors refers to a multifactorial inheritance disorder.

The nurse is preparing a presentation about chromosome abnormalities. Nondisjunction involves an addition or deletion of a​ chromosome, and if it occurs after​ fertilization, the embryo may have two or more chromosomes that evolve into more than one cell line. What is this known​ as? Monosomy Trisomy 13 Mosaicism Trisomy 21

Mosaicism Rationale Mosaicism is nondisjunction that occurs after​ fertilization, and the embryo may have two or more chromosomes that evolve into one cell​ line, each with a different number of chromosomes. Trisomy 13 and 21 occur during the second meiotic division of a gamete before​ fertilization; the embryo or fetus will have abnormal chromosomes added to every cell. Monosomy is nondisjunction that deletes a chromosome and can result in Turner syndrome.

A client has just been fitted for a diaphragm. What information about the diaphragm should the nurse include in the client​ education? Must be left in place for 12 hours after intercourse Must be refitted after childbirth Can be used during menstrual period Should be replaced every 3 years

Must be refitted after childbirth Rationale: The nurse needs to educate the client being fitted for a diaphragm that it must be refitted after childbirth. The diaphragm must be left in place for 6 hours after intercourse. Diaphragms should not be used during a menstrual period. The diaphragm should be replaced every 2 years.

The nurse is performing a health history on a woman with family planning needs. What data should the nurse​ collect? ​(Select all that​ apply.) Genital exam Vital signs Number of sexual partners Medication history Family history of breast cancer

Number of sexual partners Medication history Family history of breast cancer Rationale When performing a health history on a client with family planning​ needs, the nurse needs to obtain information on the client​'s medication​ history, family history of breast​ cancer, and number of sexual partners. Vital signs and genital exam are part of the physical examination of a woman with family planning needs.

What are the disadvantages of oral​ contraceptives? ​(Select all that​ apply.) Oral contraceptives often reduce menstrual cramping. Oral contraceptives carry an increased risk of blood clots. Oral contraceptives require daily use of medication. Oral contraceptives are extremely effective at preventing pregnancy. Oral contraceptives require a medical prescription.

Oral contraceptives require daily use of medication. Oral contraceptives are extremely effective at preventing pregnancy. Oral contraceptives require a medical prescription.

Jim and Barbara Hernandez are attending a preconception appointment. During this​ appointment, Barbara becomes tearful and​ states, "I​ don't think that​ we'll ever have​ children." What recommendation should the nurse make to increase​ Barbara's chances of becoming​ pregnant? Request spouse to limit cigarette smoking Take​ 5,000 units of vitamin A each day Participate in 30 minutes of aerobic exercises daily Restrict alcohol intake to 1 glass of wine in the evenings

Participate in 30 minutes of aerobic exercises daily

The nurse recognizes that family planning care involves more than preventing pregnancy. What are some other goals of family planning​ care? ​(Select all that​ apply.) Promoting a healthy body image Encouraging the use of one contraceptive method over another Promoting healthy sexual function Providing knowledge about sexual and reproductive health Recognizing acceptance of all available forms of fertility treatment and contraception methods

Promoting a healthy body image Promoting healthy sexual function Providing knowledge about sexual and reproductive health Rationale The role of the nurse is to help the client by promoting a healthy body​ image, promoting healthy sexual function and providing knowledge of sexual and reproductive health. The nurse does not encourage one contraceptive practice over another or try to influence a client to accept all available forms of fertility treatment or contraception. Nurses should present all the options available to the client.

During a preconception exam of a​ 28-year-old client, the nurse identifies that which health risks may affect the pregnancy​ outcome? ​(Select all that​ apply.) Secondhand smoke Alcohol use Diabetes mellitus Hypotension Caffeine intake

Secondhand smoke Alcohol use Diabetes mellitus Caffeine intake Rationale Risk factors that may affect the client​'s pregnancy outcome include secondhand​ smoke, caffeine​ intake, alcohol​ use, and diabetes mellitus.​ Hypertension, not​ hypotension, is a risk factor.

A couple is beginning evaluation for infertility. Which diagnostic test would the nurse expect to be done first for evaluation of the male​ partner? Testicular biopsy Hormonal evaluation Semen analysis Scrotal ultrasound

Semen analysis Rationale Male infertility is usually identified from an abnormal semen analysis. This test is noninvasive and should be completed as the first step in assessment for male infertility. A scrotal ultrasound may be needed to help identify any structural​ abnormalities, a testicular biopsy is an invasive surgery that may be required for some​ conditions, and an evaluation of the male hormones may need to be​ done; however, a semen analysis should be completed first.

Alicia and Jeremy Brown are expecting their first child in a few weeks. Alicia voices concerns about sickle cell​ disease, a genetic disorder associated with the African American​ population, and asks you if their child will be affected. How do you​ respond? Sickle cell disease is not linked to either parent and therefore it is difficult to predict whether the child will be affected. Sickle cell disease is an autosomal recessive disorder requiring two abnormal genes for an individual to be affected. Sickle cell disease is a dominant disorder and the child is at high risk related to heredity. Sickle cell disease is more prevalently found in metropolitan areas.

Sickle cell disease is an autosomal recessive disorder requiring two abnormal genes for an individual to be affected.

What is a​ phenotype? The pattern of an​ individual's genetic makeup on the chromosomes The person who can pass on a​ single-gene disorder but has no observable characteristics of it The inherited disorders that are carried on the X chromosome The translation of an​ individual's genetic makeup into observable characteristics

The translation of an​ individual's genetic makeup into observable characteristics

Which contraceptive is not a barrier method of​ contraception? Contraceptive sponge Diaphragm Vaginal contraceptive ring Spermicide

Vaginal contraceptive ring

An infertile couple will have follicular stimulation and retrieval of​ ovum, followed by mixing with washed donor sperm. One day​ later, the fertilized ovum will be placed in the fallopian tube. The nurse knows that education has been successful if the client says she is having what​ procedure? Tubal embryo transfer​ (TET) Zygote intrafallopian transfer​ (ZIFT) In vitro fertilization​ (IVF) Gamete intrafallopian transfer​ (GIFT)

Zygote intrafallopian transfer​ (ZIFT) Rationale ZIFT is the return of fertilized​ ovum, at the zygote​ stage, into the fallopian tube 18dash-24 hours after retrieval. GIFT is placing retrieved ovum and washed sperm into the fimbriated end of the fallopian tube. TET is placing embryos into the fallopian tube 42dash-72 hours after retrieval. IVF is the placement of embryos into the uterus 2dash-3 days after the ova are retrieved.

In autosomal dominant​ disorders, the affected parent has what chance of passing the abnormal gene to each​ child? ​25% ​75% ​50% ​100%

​50%

The nurse is discussing contraceptive options with Tina Jacobs. Tina is interested in information about intrauterine contraception​ (IUC). Which statement would the nurse include when discussing the disadvantages of these​ devices? ​"The device may cause cramping and heavier​ bleeding." ​"This type of contraceptive causes the loss of bone​ density." ​"You will need to insert the device​ daily." ​"These require the use of daily​ medication."

​"The device may cause cramping and heavier​ bleeding."

A couple going through fertility treatment is reviewing the process of in vitro fertilization​ (IVF) with the nurse. Which statement by either the man or woman indicates that the teaching has been​ effective? ​(Select all that​ apply.) ​"We can freeze embryos if we have​ extras." ​"The embryos will be placed in my uterus 7dash-10 days after​ retrieval." ​"My wife will have to have injections prior to the​ procedure." ​"An ultrasound will be used during the procedure to remove my​ eggs." ​"The sperm will be deposited into my​ uterus.

​"We can freeze embryos if we have​ extras." "My wife will have to have injections prior to the​ procedure." ​"An ultrasound will be used during the procedure to remove my​ eggs." Rationale For​ IVF, the woman will have to have injections to help the ova develop and to help prepare them for retrieval. Any extra embryos remaining after the IVF procedure can be frozen for use at a later date. With​ IVF, the ova and sperm will be manipulated in the lab for fertilization. The embryos will be placed in the uterus 2dash-3 days after retrieval. With​ IVF, ultrasound is used during the procedure to remove the​ woman's eggs.