Infertility

44- A client is receiving Pergonal (menotropins) intramuscularly for ovarian stimulation. Which of the following is a common side effect of this therapy? 1. Piercing rectal pain. 2. Mood swings. 3. Visual disturbances. 4. Jerky tremors.

2

A female client seeks care at an infertility clinic. Which of the following tests may the client undergo to determine what, if any, infertility problem she may have? (SATA) A. CVS B. Endometrial biopsy C. Hysterosalpingogram D. Serum progesterone assay E. Postcoital test

B C D E

25- A client is to receive Pergonal (menotropins) injections for infertility prior to in-vitro fertilization. Which of the following is the expected action of this medication? 1. Prolongation of the luteal phase. 2. Stimulation of ovulation. 3. Suppression of menstruation. 4. Promotion of cervical mucus production.

2

A couple is seeking advice regarding what they can do to increase the chances of becoming pregnant. What recommendation can the nurse give to the couple? A. The couple could use vaginal lubricants during intercourse. B. The couple should delay having intercourse until the day of ovulation. C. The woman should refrain from douching. D. The woman should be on top during intercourse.

C

28- A couple who has sought fertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occurs? 1. The testes are overheated. 2. The vas deferens is ligated. 3. The prostate gland is enlarged. 4. The flagella are segmented.

1

23- A Roman Catholic couple is infertile. Their healthcare practitioner advises them that their best chance of getting pregnant is via in-vitro fertilization with a mixture of the man's sperm and donor sperm. Which of the following issues, related to this procedure, should the nurse realize may be in conflict with the couple's religious beliefs? Select all that apply. 1. The man will ejaculate by masturbation into a specially designed condom. 2. The woman may become pregnant with donor sperm. 3. Fertilization is occurring in the artificial environment of the laboratory. 4. More embryos may be created than will be used to inseminate the woman. 5. The woman will receive medications to facilitate the ripening of her ova.

1 2 3 4

30- An infertile man is being treated with Viagra (sildenafil citrate) for erectile dysfunction (ED). Which of the following is a contraindication for this medication? 1. Preexisting diagnosis of herpes simplex 2. 2. Nitroglycerin ingestion for angina pectoris. 3. Retinal damage from type I diabetes mellitus. 4. Complications after resection of the prostate.

2

40-Which instruction by the nurse should be included in the teaching plan for an infertile woman who has been shown to have a 28-day biphasic menstrual cycle? 1. Douche with a cider vinegar solution immediately before having intercourse. 2. Schedule intercourse every day from day 8 to day 14 of the menstrual cycle. 3. Be placed on follicle-stimulating hormone therapy by the fertility specialist. 4. Assess the basal body temperature pattern for at least 6 more months.

2

46- A nurse is educating a client who has been diagnosed with infertility on how to complete a basal body temperature chart to determine her ovulation pattern. The client states, "I really don't want to take my temperature every day. Is there any other way to find out if and when I ovulate?" 1. "There are a number of other ways to determine ovulation, but they all require you to be examined by an obstetrician every month." 2. "A test you can do at home requires you to spit on a microscopic slide and then look at the slide under a microscope." 3. "You can test your vaginal discharge each day to determine when you should have intercourse because the hormone progesterone is elevated. " 4. "Although there are some tests that you can perform at home, they all cost well over a hundred dollars to purchase."

2

33- A client who is undergoing ovarian stimulation for infertility calls the infertility nurse and states, "My abdomen feels very bloated, my clothes are very tight, and my urine is very dark." Which of the following is the appropriate statement for the nurse to make at this time? 1. "Please take a urine sample to the lab so they can check it for an infection." 2. "Those changes indicate that you are likely already pregnant." 3. "It is important for you to come into the office to be examined today." 4. "Abdominal bloating is an expected response to the medications."

3

37- A client is to undergo a postcoital test for infertility. The nurse should include which of the following statements in the client's preprocedure counseling? 1. "You will have the test the day after your menstruation ends." 2. "You will have a dye put into your vein that will show up on x-ray." 3. "You should refrain from having intercourse for the four days immediately before the test." 4. "You should experience the same sensations you feel when your doctor does your Pap test."

4

38- A client is to have a hysterosalpingogram. In this procedure, the physician will be able to determine which of the following? 1. Whether or not the ovaries are maturing properly. 2. If the endometrium is fully vascularized. 3. If the cervix is incompetent. 4. Whether or not the fallopian tubes are obstructed.

4

A client asks the nurse about the gamete intrafallopian transfer (GIFT) procedure. Which of the following responses would be appropriate for the nurse to make? A. Fertilization takes place in the woman's body B. Zygotes are placed in the fallopian tubes C. Donor sperm are placed in a medium with donor eggs D. A surrogate carries the infertile woman's fetus

A

A couple is seeking infertility counseling. The practitioner has identified the factors listed below in the woman's healthy history. Which of these findings may be contributing to the couple's infertility? A. The client is 36 years old B. The client was 13 when she started to menstruate C. The client works as a dental hygienist 3 days a week D. The client jogs 2 miles every day

A

A nurse working in an infertility clinic should include which of the following in her discussions with the couple? A. Adoption as an alternative to infertility treatments B. The legal controversy surrounding intrauterine insemination C. The need to seek marriage counseling before undergoing infertility treatments D. Statistics regarding the number of couples who never learn why they are infertile

A

The nurse is providing counseling to a group of sexually active single women. Most of the women have expressed a desire to have children in the future but not within the next few years. Which of the following actions should the nurse suggest the women take to protect their fertility for the future. (Select All That Apply) A. Use condoms during intercourse B. Refrain from smoking ciggarettes C. Maintain an appropriate weight for height D. Exercise in moderation E. Refrain from drinking carbonated beverages

A B C D

A couple is seeking infertility counseling. During the history, it is noted that the man is a cancer survivor, drinks one beer every night with dinner, and takes a sauna every day after work. The response provided by the nurse should be based on which of the following? A. It is unlikely that any of these factors is affecting his fertility B. Daily alcohol consumption could be altering his sperm count C. Sperm may be malformed when exposed to the heat of the sauna D. Cancer survivors have the same fertility rates as healthy males

C

Nurses working in a midwifery office have attended a conference to learn about factors that increase a woman's risk of becoming infertile. To evaluate the nurses' learning, the conference coordinator tests the nurses' knowledge at the conclusion of the seminar. Which of the following problems should the nurses state increase a client's risk of developing infertility problems? (SATA) A. Women who have menstrual cycles that are up to 30 days long B. Women who experience pain during intercourse C. Women who have had pelvic inflammatory disease D. Women who have excess facial hair E. Women who have menstrual periods that are over 5 days long

B C D

39- A client's basal body temperature (BBT) chart for one full month is shown below. Based on the temperatures shown, what can the nurse conclude? 1. It is likely that she has not ovulated. 2. The client's fertile period is between 12 and 18 days. 3. The client's period is abnormally long. 4. It is likely that her progesterone levels rose on day 15.

1

29- A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? 1. The couple has established a set schedule for their sexual encounters. 2. The couple has been married for more than eight years. 3. The couple lives with one set of parents. 4. The couple has close friends who gave birth to a baby within the past year.

1

32- A client asks the nurse about the gamete intrafallopian transfer (GIFT) procedure. Which of the following responses would be appropriate for the nurse to make? 1. Fertilization takes place in the woman's body. 2. Zygotes are placed in the fallopian tubes. 3. Donor sperm are placed in a medium with donor eggs. 4. A surrogate carries the infertile woman's fetus.

1

A client has been notified that because of fallopian tube obstruction, her best option for becoming pregnant is through in-vitro fertilization. The client asks the nurse about the procedure. Which of the following responses is correct? A. During the stimulation phase of the procedure, the physician will make sure only one egg reaches maturation B. Preimplantation genetic diagnosis will be performed on your partner's sperm before they are mixed with your eggs C. After ovarian stimulation, you will be artificially inseminated with your partner's sperm D. Any extra embryos will be preserved for you if you wish to conceive again in the future

D

Infertility increases a client's risk of which of the following? A. Diabetes mellitus B. Nystagmus C. Cholecystitis D. Ovarian Cancer

D

36- A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? Select all that apply. 1. Anger at others who have babies. 2. Feelings of failure because they can't make a baby. 3. Sexual excitement because they want so desperately to conceive a baby. 4. Sadness because of the perceived loss of being a parent. 5. Guilt on the part of one partner because he or she is not able to give the other a baby.

1 2 4 5

41- A couple has been told that the male partner, who is healthy, is producing no sperm "because he has cystic fibrosis." Which of the following explanations is accurate in relation to this statement? 1. Since the man is healthy, he could not possibly have cystic fibrosis. 2. Men with cystic fibrosis often have no epididymis. 3. The expressivity of cystic fibrosis is variable. 4. Cystic fibrosis is a respiratory illness having nothing to do with reproduction.

3

45- A client is to have a hysterosalpingogram. Which of the following information should the nurse provide to the client prior to the procedure? 1. "The test will be performed through a small incision next to your belly button." 2. "You will be on bedrest for a full day following the procedure." 3. "An antibiotic fluid will be instilled through a tube in your cervix." 4. "You will be asked to move from side to side so that x-ray pictures can be taken."

4

An infertile woman has been diagnosed with endometriosis. She asks the nurse why that diagnosis has made her infertile. Which of the following explanations is appropriate for the nurse to make? A. Scarring surrounds the ends of your tubes, preventing your eggs from being fertilized by your partners sperm B. You are producing insufficient quantities of FSH that is needed to mature an egg every month C. Inside your uterus is a benign tumor that makes it impossible for the fertilized egg to implant D. You have a chronic infection of the vaginal tract that makes the secretions hostile to your partner's sperm

A

An infertility specialist is evaluating whether a woman's cervical mucus contains enough estrogen to support sperm motility. Which of the following tests is the physician conducting? A. Ferning capacity B. Basal body temperature C. Colposcopy D. Hysterotomy

A

43- A client is hospitalized in the acute phase of severe ovarian hyperstimulation syndrome. The following nursing diagnosis has been identified: Fluid volume excess (extravascular) related to third spacing. Which of the following nursing goals is highest priority in relation to this diagnosis? 1. Client's weight will be within normal limits by date of discharge. 2. Client's skin will show no evidence of breakdown throughout hospitalization. 3. Client's electrolyte levels will be within normal limits within one day. 4. Client's lung fields will remain clear throughout hospitalization.

4

A 35-year-old client is being seen for her yearly gynecological examination. She states that she and her partner have been trying to become pregnant for a little over 6 months and that a friend had recently advised her partner to take ginseng to improve the potency of his sperm. The woman states that they have decided to take their friend's advise. On which of the following information should the nurse base his or her reply? A. Based on their history, the client and her partner have made the appropriate decision regarding their infertility B. Ginseng can cause permanent chromosomal mutations and should be stopped immediately C. It is unnecessary to become concerned about this womans infertility because she has tried to become pregnant for only a few months D. Although Ginseng may be helpful, it would be prudent to encourage the woman to seek fertility counseling

D

An Orthodox Jewish couple is seeking infertility counseling. The woman states that her menstrual cycle is 21 days long. After testing, no physical explanation is found for the infertility. Which of the following may explain why the woman has been unable to conceive? A. Her kosher diet is lacking the essential nutrients needed for achieving optimal reproductive health B. The positions allowed Orthodox Jewish couples during intercourse hinder the process of fertilization C. Orthodox Jewish couples are known to have a high rate of infertility because of inborn genetic diseases D. Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends

D