Question 1

A female college student is planning to become sexually active.She is considering birth control options and desires a method in which ovulation will be prevented.To prevent ovulation while reaching 99% effectiveness in preventing pregnancy,which option should be given the strongest consideration?

A) Intrauterine device
B) Coitus interruptus
C) Natural family planning
D) Oral contraceptive pills

Oral contraceptive pills

Accepted Answer

Oral contraceptive pills prevent ovulation and are 99% effective in preventing pregnancy when taken as directed.Intrauterine devices,coitus interruptus,and natural family planning will not prevent ovulation while reaching 99% effectiveness in preventing pregnancy,so they are not recommended for this college student.

Question 2

A female infertility patient is found to be hypoestrogenic at the preconceptual clinic visit.She asks the nurse why she has never been able to get pregnant.Which response is best?&#10;A) Circulating estrogen contributes to secondary sex characteristics.&#10;B) Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.&#10;C) Hyperestrogen may be preventing the zona pellucida from forming an ovum protective layer.&#10;D) The corona radiata is preventing fertilization of the ovum.

Accepted Answer

The cilia in the tubes are stimulated by high estrogen levels,which propel the ovum toward the uterus.Without estrogen,the ovum won't reach the uterus.The results of a series of events occurring in the ovary cause an expulsion of the oocyte from the ovarian follicle known as ovulation.The ovarian cycle is driven by multiple important hormones: 1)gonadotropic hormone,2)follicle stimulating hormone (FSH),and 3)luteinizing hormone (LH).The cilia in the tubes are stimulated by high 4)estrogen levels,which propel the ovum toward the uterus.The zona pellucida (inner layer)and corona radiata (outer layer)form protective layers around the ovum.If an ovum is not fertilized within 24 hours of ovulation by a sperm,it is usually reabsorbed into a woman's body.A patient who is hypoestrogenic would not have excess circulating estrogen.A patient with low estrogen would not be classified as hyperestrogenic.Without sufficient estrogen,there can be no fertilization of the ovum.

Question 3

Many females experience problems achieving and maintaining a pregnancy.The ER nursing assessment of a child-bearing-age female shows back pain,elevated blood pressure,and leaking of clear fluid from the vagina.Maternal-fetal complications described above are most often associated with which child-bearing stage?

A) Preconception
B) First trimester
C) Second-third trimester
D) Postpartum

Second-third trimester

Accepted Answer

Second and third trimester complications include anencephalus,chromosomal anomalies,gestational diabetes,group B strep,cystitis,pyelonephritis,cholecystitis,hypertension,preeclampsia,oligohydramnios,polyhydramnios,and premature rupture of membranes,etc.Leaking of clear fluid from the vagina with back pain and elevated BP is associated with premature rupture of membranes,a second trimester complication of pregnancy.Preconception is prior to becoming pregnant; postpartum is after delivery of the infant; and first trimester is not associated with premature rupture of the membranes usually.

Question 4

The RN at the Preconception Counseling Clinic takes a male history for infertility evaluation.Which finding has the greatest implication for this patient's care?&#10;A) Practice of nightly masturbation&#10;B) Primary anovulation&#10;C) High testosterone levels&#10;D) Impotence due to alcohol ingestion

Accepted Answer

Factors affecting male infertility include impotence due to alcohol.Nightly masturbation and high testosterone levels do not have the greatest implication on male infertility in a patient with admitted alcohol issues.Primary anovulation refers to female infertility,so it is not a consideration for this question about male infertility.

Question 5

A female patient comes to the clinic after missing one menstrual period.She lives in a house beneath electrical power lines which is located near an oil field.She drinks two caffeinated beverages a day,is a daily beer drinker,and has not stopped eating sweets.She takes a multivitamin and exercises daily.She denies drug use.Which finding in the history has the greatest implication for this patient's plan of care?

A) Electrical power lines are a potential hazard to the woman and her fetus.
B) Living near an oil field may mean the water supply is polluted.
C) Alcohol exposure should be avoided during pregnancy due to teratogenicity.
D) Eating sweets may cause gestational diabetes or miscarriage.

Accepted Answer

Stages of development include ovum,embryonic,and fetal.The beginning of the fourth week to the end of the eighth week comprise the embryonic period.Teratogenicity is a major concern because all external and internal structures are developing in the embryonic period.A pregnant woman should avoid exposure to all potential toxins during pregnancy,especially alcohol,tobacco,radiation,and infections during embryonic development.Living in a house beneath power lines is not the greatest implication in this patient's plan of care as there are no definite risks to the developing fetus.Living near an oil field has no definite risks to the fetus.Eating sweets may contribute to maternal obesity,large for gestational age fetus,and maternal gestational diabetes but does not have the immediate implication of a daily beer drinker which can cause fetal alcohol syndrome.

Question 6

An obstetric multipara with triplets is placed on bed rest at 24 weeks' gestation.Her perinatologist is managing intrauterine growth restriction with serial ultrasounds.This is an example of&#10;A) antenatal diagnostics.&#10;B) primary prevention.&#10;C) secondary prevention.&#10;D) tertiary prevention.

Accepted Answer

An example of tertiary prevention relating to reproductive health would be managing fetal intrauterine growth restriction by serial ultrasounds.This type of diagnostic maternal/fetal monitoring is performed to determine the best time for delivery due to potential fetal nutritional,circulatory,or pulmonary compromise.A cesarean section (operative delivery)may be performed if maternal or fetal conditions indicate that delivery is necessary.Antenatal diagnostics refers to prior to pregnancy.An example of primary prevention is teaching a high school class about reproductive health.An example of secondary prevention is prenatal care in the second trimester of pregnancy to prevent problems for the developing fetus.

Question 7

The nurse is admitting a prenatal patient for diagnostic testing.While eliciting the psychosocial history,the nurse learns the patient smokes a pack of cigarettes daily,drinks a cup of cappuccino with breakfast,has smoked weed in the remote past,and is a social drinker.Which action should the nurse first take?

A) Strongly advise immediate tobacco cessation
B) Elimination of all caffeinated beverages
C) Serum and urine testing for drug use and alcohol use
D) Referral to a 12-step program

Accepted Answer

There are numerous risk factors for women and men affecting reproductive health and pregnancy outcomes.These can be categorized into biophysical,psychosocial,sociodemographic,and environmental factors.Some of the risk factors for human reproduction fit into multiple categories.Psychosocial factors cover smoking,excessive caffeine,alcohol and drug abuse,psychologic status including impaired mental health,addictive lifestyles,spouse abuse,and noncompliance with cultural norms.Drinking a cup of a caffeinated beverage a day is not associated with adverse fetal outcomes usually.Serum and urine testing for drug/alcohol use is not required for stated marijuana use in the remote past.Patient referral to a 12-step program is usually advisable for current alcohol and/or drug use.

Deck 18: Reproduction