NUR 420 MATERNITY PREPU
Which question would be most appropriate for a nurse to ask a client to assist in establishing a nursing diagnosis of Deficient knowledge related to measure to promote fertility?
"How often do you and your partner engage in intercourse?"
The nurse instructs a patient on the use of a vaginal estrogen/progestin rings (NuvaRing) for contraception. Which patient statement indicates that additional instruction is needed?
"I am to take the ring out overnight."
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."
A female client comes to the clinic and asks the nurse what would be the most cost-effective method for her to determine her ovulation patterns. What is the best response by the nurse?
"The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months."
A 40-year-old woman who smokes desires a reliable contraceptive method. Which should the nurse recommend to this patient?
A condom and spermicide
A female patient being treated for infertility is completing the third course of clomiphene citrate. What information should the nurse prepare for the patient in the event this course does not result in conception?
Additional options to achieve conception
A young woman comes into the clinic stating that she is pregnant and does not want to have a baby. After counseling, the woman decides to terminate the pregnancy by having an abortion. The nurse explains that the procedure will be what type of abortion?
Induced abortion
What can the nurse educate a subfertile couple about to avoid the problem with lower sperm counts in the male partner?
Minimize actions that increase scrotal heat.
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 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.
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?
Sperm analysis is one of the easiest tests to complete.
A nurse is instructing a client on the use of home-use ovulation determination kits. What is most appropriate for the nurse to tell the client?
The kit will help determine when your body is preparing for ovulation."
The nurse completes instructing a patient on the use of the contraceptive patch. Which patient response indicates that teaching has been effective?
The patch should be applied to the abdomen, buttocks, or back.
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
A nurse has completed her assessment of a male patient for subfertility. Which finding would the nurse interpret as increasing the patient's risk for experiencing a limited sperm count?
Working at a desk job
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
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 comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk?
age of 25 years
The nurse is preparing a presentation for a group of adolescents and young adults about sexually transmitted infections and the use of condoms. Which information would the nurse most likely include?
applying the condom before there is any penile-vulvar contact
The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptive pills (OCPs) 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 woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event?
ovulation
A nurse is helping a couple choose a contraception method that is right for them. Which is the least likely factor the nurse should consider?
the popularity of the method among the couple's friends
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 contraceptive pills (OCPs). 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?
transdermal contraceptive
Which statement best indicates that a client has taken self-care measures to reduce her risk for cervical cancer?
"My partner always uses a condom when we have sexual intercourse."
The nurse instructs a patient on cervical mucus changes that occur during ovulation. Which statement indicates that teaching has been effective?
"When the mucus is thin and watery, then ovulation is occurring."
A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student?
"Withdraw the penis erect, holding the condom firmly against the penis."
A client has been given instructions about a scheduled sonohysterosalpingogram. Which statement, if made by the client, should indicate to a nurse that the client has an adequate understanding of the instructions?
Altered sexual pattern related to fear of pregnancy
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
A young patient comes to the clinic and requests birth control pills to prevent a pregnancy. She tells the nurse that she is worried that she will get mixed up on what days to take the pills. Which would be the best type of pills to prescribe this patient?
COCs packaged with 28 pills
A patient who has unprotected intercourse has obtained the morning after pill but has not yet taken the prescribed dosage. What nursing diagnosis should the nurse identify as appropriate for the patient at this time?
Decisional conflict
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.
A patient comes into the family planning clinic and requests a prescription for birth control pills. Which assessment finding indicates that an ovulation suppressant would not be the best contraceptive method for the patient?
History of thromboembolism
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 22-year-old female client asks about forms of chemical barrier contraception. The nurse tells the client that which is a form of a chemical barrier contraceptive?
Vaginal foam
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 client is being prepared for artificial insemination. Which finding is the most suggestive to determine if the client is ovulating?
change in the cervical mucus
The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication?
deep vein thrombosis
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
A nurse is assessing a man who, along with his partner, has been having trouble conceiving. When assessing the man, which area would the nurse most likely include as possibly affecting his fertility?
A 24-hour food intake History of a sexually transmitted disease Testes exposed to radiation A job that requires sitting all day
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 26-year old mother of three children tells the nurse at her annual check-up that she does not want to have any more children; however, her religion forbids the use of contraceptive devices. Which of the following methods would be the best option for this client?
Rhythm method
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
A female patient has forgotten to take an ovulation suppressant for two mornings in a row. What should the nurse advise the patient to do?
Take two pills now and use a second method of contraception for the remainder of the month.
A woman telephones the nurse after taking an ovulation suppressant for 3 months to state that she has forgotten to take her pill two mornings in a row. What would be the best advice to give her regarding this?
Take two pills now and use a second method of contraception for the remainder of the month.
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?
"Unfortunately you are past the time frame to take that prescription."
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."
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 will be able to have my third child in about a year from now."
A newly married couple asks the nurse which "natural" way of family planning would be most effective in preventing pregnancy. What is the most appropriate response by the nurse?
"The basal body temperature method is simple and has a low failure rate."
A nurse is preparing to sign an informed consent form for a client undergoing an hysterosalpingogram. Which statement by the client indicates a correct understanding of the procedure?
"This will break up the scar tissue from the infection that I had 3 years ago."
A 25 year old having a yearly check-up informs the nurse that she has stopped taking birth control pills because she and her husband want to start a family. She states, "I know I will get pregnant right away, because my mother was very fertile." What is the nurse's best response?
"Women who used oral birth control pills may have difficulty becoming pregnant for several months after discontinuing them."
After reviewing the various types of contraception available and discussing the pros and cons about each with the nurse, a young woman decides to use a spermicidal cream. When teaching the woman about this type of contraception, the nurse would instruct the woman to insert the cream at which time frame before intercourse?
1 hour
A nursing instructor is teaching about subfertility to nursing students and perceives their understanding when they define subfertility existing when a pregnancy has not occurred after how much time of engaging in unprotected coitus?
12 months
A couple is undergoing fertility testing. The male partner is scheduled for semen analysis. When teaching the male partner about this procedure, the nurse would instruct him to refrain from sexual intercourse for which time frame before the analysis?
2 to 4 days
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?
Anovulation
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.
Which of the following would NOT be considered a disadvantage of the calendar/rhythm method of family planning?
Cost
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
The female partner of a young couple is concerned about what the results of fertility tests might reveal. Which nursing diagnosis should the nurse use to plan care for this patient?
Fear related to possible outcome of subfertility studies
Inability to conceive can be very stressful on a couple. What is one psychological aspect of infertility?
Loss of intimacy
A client is beginning to take a combined oral contraceptive. Which of the following side effects will the nurse caution the client might be expected? Select all that apply.
Nausea Headache Breast tenderness
A patient received a scheduled dose of depot medroxyprogesterone acetate (DMPA) 6 weeks ago. Today, the patient reports that a regular menstrual cycle is 2 weeks late. What is the first thing that should be done for this patient?
Perform a pregnancy test.
Blood work results show that a client has a luteal defect, which is suspected to be the primary cause of her subfertility. The nurse explains that this condition is generally corrected by which of the following?
Progesterone vaginal suppositories
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
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 is planning instruction for a patient desiring to have a tubal ligation. Which information should the nurse emphasize when teaching the patient?
She must think of the procedure as irreversible.
Which information is important for a woman to understand before undergoing a scheduled tubal ligation?
She must think of the procedure as irreversible.
A couple consults with the nurse regarding their infertility issues. The female says "I don't know what I have done so bad that God would punish me like this." What would be the mostappropriate nursing diagnosis for this couple?
Spiritual distress related to inability to conceive
The nurse is planning an educational session on contraceptives for a group of adolescent high school students. What does the nurse need to do when planning this session?
Teaching about contraceptive options while avoiding indirect encouragement of sexual activity.
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 nurses's best response?
The couple can control the time between births when they plan their family.
A couple comes to the clinic and informs the nurse that they have been trying to conceive for 6 months with no success. The husband states that they have coitus at least 5 or 6 times per week to optimize their chance of success. What can the nurse educate the couple about frequency of coitus?
The couple should consider decreasing the frequency of coitus to 2 to 3 times per week to increase the male partner's sperm count.
The nurse is preparing a teaching session for a client considering tubal ligation. Which factor should the nurse prioritize in this session?
This is a permanent and irreversible procedure for birth control.
The nurse is teaching a young couple who desire to start their family the various methods for determining fertility. After discovering the woman regularly travels internationally for work, deals with a lot of job anxiety, and frequently uses an electric blanket at home, the nurse will discourage the use of which method?
basal body temperature method
A nurse is teaching a couple about how to use a condom. The nurse determines the couple can properly apply the condom when they state that it should be applied at which time to be most effective?
before penile-vulvar contact
An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which contraceptive should the nurse say is a mechanical barrier contraceptive?
cervical cap
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?
combination oral contraceptives
Which method of contraception is considered a barrier method?
condom
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
An intrauterine device (IUD) has been inserted into a client as a requested birth control method. What is an advantage of IUDs?
continuous protection without client's active participation
A young couple is exploring their contraceptive options and are curious about using an intrauterine contraceptive device. The nurse explains that there are two types, one that uses hormones and one that uses:
copper.
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 comes to the free clinic asking for oral contraceptive pills. Which factor bestindicates that another type of contraception would be better for this client?
history of noncompliance with medications
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
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.
When discussing contraceptive options, the nurse would recommend which option as being the most reliable?
intrauterine system
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?
irregular menstruation
The nurse informs the client that a diaphragm is an example of which type of contraception?
mechanical barrier
A nurse in a fertility clinic counsels a subfertile couple to have intercourse daily.
no
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 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 woman and her partner have been trying to conceive for over 2 years without success. Ultrasound imaging reveals scarring of her fallopian tubes, which appears to be the primary cause of subfertility. What is the most likely cause of the scarring?
pelvic inflammatory disease
Which description best explains the hysterosalpingogram procedure?
radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix
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
A female patient who has been trying to conceive for 1 year comes to the fertility clinic and will be undergoing a subfertility evaluation. When discussing the components involved, which information would the nurse most likely include? Select all that apply.
semen analysis of the partner ovulation monitoring tubal patency assessment
