Question 1

What should the nurse be aware of with regard to the assessment of female,male,and couple infertility?&#10;A) The couple's religious, cultural, and ethnic backgrounds provide emotional clutter that does not affect the clinical scientific diagnosis.&#10;B) The investigation takes 3 to 4 months and a lot of money.&#10;C) The woman is assessed first; if she is not the problem, the male partner is analyzed.&#10;D) Semen analysis is for men; the postcoital test is for women.

Accepted Answer

Fertility assessment and diagnosis take time,money,and commitment from the couple.Religious,cultural,and ethnic-bred attitudes about fertility and related issues always have an impact on diagnosis and assessment.Both partners are assessed systematically and simultaneously,as individuals and as a couple.Semen analysis is for men,but the postcoital test is for the couple.

Question 2

A man smokes two packs of cigarettes a day.He wants to know if smoking is contributing to the difficulty he and his wife are having getting pregnant.What is the nurse's most appropriate response?&#10;A) &#34;Your sperm count seems to be okay in the first semen analysis.&#34;&#10;B) &#34;Only marijuana cigarettes affect sperm count.&#34;&#10;C) &#34;Smoking can give you lung cancer, but it has no effect on sperm.&#34;&#10;D) &#34;Smoking can reduce the quality of your sperm.&#34;

Accepted Answer

Use of tobacco,alcohol,and marijuana may affect sperm counts."Your sperm count seems to be okay in the first semen analysis" is inaccurate.Sperm counts vary from day to day and depend on emotional and physical status and sexual activity.Therefore,a single analysis may be inconclusive.A minimum of two analyses must be performed several weeks apart to assess male fertility.

Question 3

A woman was treated recently for toxic shock syndrome (TSS).She has intercourse occasionally and uses over-the-counter protection.On the basis of her history,which contraceptive method should she and her partner avoid?

A) Cervical cap
B) Condom
C) Vaginal film
D) Vaginal sheath

Cervical cap

Accepted Answer

Women with a history of TSS should not use a cervical cap.Condoms,vaginal films,and vaginal sheaths are not contraindicated for a woman with a history of TSS.

Question 4

A couple is trying to cope with an infertility problem.They want to know what they can do to preserve their emotional equilibrium.What is the nurse's most appropriate response?&#10;A) &#34;Tell your friends and family so they can help you.&#34;&#10;B) &#34;Talk only to other friends who are infertile because only they can help.&#34;&#10;C) &#34;Get involved with a support group. I'll give you some names.&#34;&#10;D) &#34;Start adoption proceedings immediately because it is a lengthy process.&#34;

Accepted Answer

Venting negative feelings may unburden the couple.A support group may provide a safe haven for the couple to share their experiences and gain insight from others' experiences.Although talking about their feelings may unburden them of negative feelings,infertility can be a major stressor that affects the couple's relationships with family and friends.Limiting their interactions to other infertile couples may be a beginning point for addressing psychosocial needs,but depending on where the other couple is in their own recovery process,this may or may not help them.The statement about adoption proceedings is not supportive of the psychosocial needs of this couple and may be detrimental to their well-being.

Question 5

A woman has chosen the calendar method of conception control.During the assessment process,what is most important for the nurse to do?&#10;A) Obtain a history of menstrual-cycle lengths for the past 6 months.&#10;B) Determine the patient's weight gain and loss pattern for the previous year.&#10;C) Examine skin pigmentation and hair texture for hormonal changes.&#10;D) Explore the patient's previous experiences with conception control.

Accepted Answer

The calendar method of conception control is based on the number of days in each cycle,counting from the first day of menses.The fertile period is determined after the lengths of menstrual cycles have been accurately recorded for 6 months.Weight gain or loss may be partly related to hormonal fluctuations,but it has no bearing on use of the calendar method.Integumentary changes may be related to hormonal changes,but they are not indicators for use of the calendar method.Exploring previous experiences with conception control may demonstrate patient understanding and compliancy,but it is not the most important aspect to assess for discussion of the calendar method.

Question 6

Which test used to diagnose the basis of infertility is done during the luteal or secretory phase of the menstrual cycle?&#10;A) Hysterosalpingogram&#10;B) Endometrial biopsy&#10;C) Laparoscopy&#10;D) Follicle-stimulating hormone (FSH) level

Accepted Answer

Endometrial biopsy is scheduled after ovulation,during the luteal phase of the menstrual cycle.A hysterosalpingogram is scheduled in the early proliferative phase to avoid flushing potentially fertilized ovum out through a uterine tube into the peritoneal cavity.Laparoscopy usually is scheduled early in the menstrual cycle.Hormone analysis is performed to assess endocrine function of the hypothalamic-pituitary-ovarian axis when menstrual cycles are absent or irregular.

Question 7

A male patient asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide).What is the nurse's most appropriate response?&#10;A) &#34;The lubricant prevents vaginal irritation.&#34;&#10;B) &#34;Nonoxynol-9 has been linked to HIV transmission and can cause genital herpes.&#34;&#10;C) &#34;The additional lubrication improves sex.&#34;&#10;D) &#34;Nonoxynol-9 improves penile sensitivity.&#34;

Accepted Answer

Nonoxynol-9 does not provide protection against sexually trAnswermitted infections; it has also been linked to an increase in the trAnswermission of HIV and can cause genital lesions.Nonoxynol-9 may cause vaginal irritation.Nonoxynol-9 has no effect on the quality of sexual activity.Nonoxynol-9 has no effect on penile sensitivity.

Question 8

A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice.What is the nurse's most appropriate response?&#10;A) &#34;This is a highly effective method, but it has some adverse effects.&#34;&#10;B) &#34;Your current medications will reduce the effectiveness of the pill.&#34;&#10;C) &#34;The pill will reduce the effectiveness of your seizure medication.&#34;&#10;D) &#34;This is a good choice for a woman of your age and personal history.&#34;

Accepted Answer

"Your current medications will reduce the effectiveness of the pill" is a true statement.It is not highly effective for her because the liver metabolizes oral contraceptives and their effectiveness is reduced when they are taken simultaneously with anticonvulsants.The anticonvulsant will reduce the effectiveness of the pill,not the other way around."This is a good choice for a woman of your age and personal history" does not teach the patient that the effectiveness of the pill may be reduced because of her anticonvulsant therapy.

Question 9

A woman is 16 weeks pregnant and has elected to terminate her pregnancy.Which is the most common technique used for medical termination of a pregnancy in the second trimester?&#10;A) Dilation and evacuation (D&E)&#10;B) Instillation of hypertonic saline into the uterine cavity&#10;C) Intravenous administration of oxytocin&#10;D) Vacuum aspiration

Accepted Answer

The most common technique for medical termination of a pregnancy in the second trimester is D&E.It is usually performed between 14 and 18 weeks.Hypertonic solutions injected directly into the uterus account for less than 1% of all abortions because other methods are safer and easier to use.Intravenous administration of oxytocin is used to induce labour in a woman with a third-trimester fetal demise.Vacuum aspiration is used for abortions in the first trimester.

Question 10

Although remarkable developments have occurred in reproductive medicine,assisted reproductive therapies are associated with a number of legal and ethical issues.Nurses can provide accurate information about the risks and benefits of treatment alternatives so that couples can make informed decisions about their choice of treatment.Which issue would need to be addressed by an infertile couple before treatment?

A) Risk of multiple gestations
B) Ways to avoid disclosing the facts of conception to offspring
C) Inability to freeze embryos for later use
D) Financial ability to cover the cost of treatment

Accepted Answer

The risk of multiple gestations is indeed a risk of treatment that the couple needs to be aware of.In order to minimize the chance of multiple gestations,generally only three or fewer embryos are trAnswerferred.The couple should be informed that there may be a need for multifetal reduction.Nurses can provide anticipatory guidance on this matter.Although the method of payment is important,obtaining this information is not the responsibility of the nurse.All provinces in Canada provide coverage for diagnostic testing and some medical treatment.Teaching regarding disclosure of the facts of conception should provide neutral information and not assume that the couple only wants information on how to avoid disclosure.It is possible to freeze embryos for later use.Couples who have excess embryos frozen for later trAnswerfer must be fully informed before consenting to the procedure.A decision must be made regarding the disposal of embryos in the event of death or divorce or if the couple no longer wants the embryos at a future time.

Question 11

An unmarried young woman describes her sex life as "active" and involving "many" partners.She wants a contraceptive method that is reliable and does not interfere with sex.She requests an intrauterine device ( IUD ).What is the nurse's most appropriate response?

A) "The IUD does not interfere with sex."
B) "The risk of pelvic inflammatory disease ( PID ) will be higher for you."
C) "The IUD will protect you from sexually transmitted infections ( STIs )."
D) "Pregnancy rates are high with the IUDs."

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Question 12

When working with patients who are experiencing infertility,the nurse should be aware of which of the following related to infertility?&#10;A) Infertility is perceived differently by women and men.&#10;B) Fertility has a relatively stable prevalence throughout a woman's reproductive years.&#10;C) Infertility is more likely the result of a physical deviation in the woman than one in the man.&#10;D) Infertility is the same thing as sterility.

Accepted Answer

The answer of When working with patients who are experiencing...

Question 13

In vitro fertilization-embryo transfer (IVF-ET)is a common approach for women with blocked fallopian tubes or unexplained infertility and for men with very low sperm counts.A husband and wife have arrived for their preprocedural interview.The husband asks the nurse to explain what the procedure entails.What is the nurse's most appropriate response?

A) "Eggs from your wife's ovaries are fertilized in the lab with your sperm and the embryo is transferred to her uterus."
B) "A donor embryo will be transferred into your wife's uterus."
C) "Donor sperm will be used to inseminate your wife."
D) "Don't worry about the technical stuff; that's what we are here for."

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The answer of In vitro fertilization-embryo transfer (IVF-ET)is a common...

Question 14

A couple comes in for an infertility workup,having attempted to get pregnant for 2 years.The woman,37,has always had irregular menstrual cycles but is otherwise healthy.The man has fathered two children from a previous marriage and underwent a vasectomy reversal 2 years ago.The man has had two normal semen analyses,but the sperm seem to be clumped together.What additional test is needed?

A) Testicular biopsy
B) Antisperm antibodies
C) Follicle-stimulating hormone (FSH) level
D) Examination for testicular infection

Accepted Answer

The answer of A couple comes in for an infertility...

Question 15

Injectable progestins ( DMPA,Depo-Provera )are a good contraceptive choice for which of the following women?&#10;A) Women who want menstrual regularity and predictability&#10;B) Women who have a history of thrombotic problems or breast cancer&#10;C) Women who have difficulty remembering to take oral contraceptives daily&#10;D) Women who are homeless or mobile and rarely receive health care

Accepted Answer

The answer of Injectable progestins ( DMPA,Depo-Provera )are a good...

Question 16

A woman is using the basal body temperature (BBT)method of contraception.She calls the clinic and tells the nurse,"My period is due in a few days,and my temperature has not gone up." What is the nurse's most appropriate response?

A) "This probably means that you're pregnant."
B) "Don't worry; it's probably nothing."
C) "Have you been sick this month?"
D) "You probably didn't ovulate during this cycle."

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Question 17

A woman inquires about herbal alternative methods for improving fertility.Which statement by the nurse is most appropriate when instructing the patient about which herbal preparations to avoid while trying to conceive?

A) "You should avoid nettle leaf, dong quai, and vitamin E while you are trying to get pregnant."
B) "You may want to avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceive."
C) "You should not take anything with vitamin E, calcium, or magnesium. They will make you infertile."
D) "Herbs have no bearing on fertility."

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Question 18

A woman currently uses a diaphragm and spermicide for contraception.She asks the nurse what the major differences are between the cervical cap and diaphragm.What is the nurse's most appropriate response?

A) "No spermicide is used with the cervical cap, so it's less messy."
B) "The diaphragm can be left in place longer after intercourse."
C) "Repeated intercourse with the diaphragm is more convenient."
D) "The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later."

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Question 19

A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs).What is the nurse's most appropriate response?&#10;A) &#34;They're not very effective, and it's very likely you'll get pregnant.&#34;&#10;B) &#34;They can be effective but they require adherence to strict record keeping.&#34;&#10;C) &#34;These methods have a few advantages and several health risks.&#34;&#10;D) &#34;You would be much safer going on the pill and not having to worry.&#34;

Accepted Answer

The answer of A married couple is discussing alternatives for...

Question 20

What should the nurse do when implementing a plan of care for infertile couples?&#10;A) Reserve judgement about the couple until the relationship develops.&#10;B) Avoid discussion of lifestyle changes that may enhance fertility.&#10;C) Promote the use of herbs that might help the couple conceive.&#10;D) Be knowledgeable about potential drug and surgical remedies.

Accepted Answer

The answer of What should the nurse do when implementing...

Question 21

A woman will be taking oral contraceptives using a 28-day pack.What should the nurse advise this woman for protection against pregnancy?&#10;A) Limit sexual contact for one cycle after starting the pill.&#10;B) Use condoms and foam instead of the pill for as long as she takes an antibiotic.&#10;C) Take one pill at the same time every day.&#10;D) Stop taking the pills and use a backup method if she misses two pills during week 1 of her cycle.

Accepted Answer

The answer of A woman will be taking oral contraceptives...

Question 22

The nurse is reviewing the educational packet provided to a patient about tubal ligation.What is an important fact he or she should point out?&#10;A) &#34;It is highly unlikely that you will become pregnant after the procedure.&#34;&#10;B) &#34;This is a 100% effective form of permanent sterilization. You won't be able to get pregnant.&#34;&#10;C) &#34;Sterilization offers some form of protection against sexually transmitted infections (STIs).&#34;&#10;D) &#34;Your menstrual cycle will greatly increase after your sterilization.&#34;

Accepted Answer

The answer of The nurse is reviewing the educational packet...

Question 23

Which statement is true about the term contraceptive failure rate?&#10;A) It refers to the percentage of users expected to have an accidental pregnancy over a 5-year span.&#10;B) It refers to the minimum level that must be achieved to receive a government license.&#10;C) It increases over time as couples become more careless.&#10;D) It varies from couple to couple, depending on the method and the users.

Accepted Answer

The answer of Which statement is true about the term...

Question 24

Which statement is the most complete and accurate description of induced abortions?&#10;A) They are performed only for maternal health.&#10;B) They can be achieved only through surgical procedures.&#10;C) They are mostly performed in the second trimester.&#10;D) They can be either medically or surgically induced.

Accepted Answer

The answer of Which statement is the most complete and...

Question 25

While instructing a couple regarding birth control,what should the nurse be aware of in relation to the method called natural family planning?&#10;A) It's the same as coitus interruptus, or &#34;pulling out.&#34;&#10;B) It involves the calendar method to align the woman's cycle with the natural phases of the moon.&#10;C) Is the only contraceptive practice acceptable to Catholic-centred organizations.&#10;D) It relies on barrier methods during fertility phases.

Accepted Answer

The answer of While instructing a couple regarding birth control,what...

Question 26

Nurses,certified nurse-midwives,and other advanced-practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception.A multidisciplinary approach should ensure that the woman's social,cultural,and interpersonal needs are met.Which action should the nurse take first when meeting with a new patient to discuss contraception?

A) Obtain data about the frequency of coitus.
B) Determine the woman's level of contraceptive knowledge.
C) Assess the woman's willingness to touch her genitals and cervical mucus.
D) Evaluate the woman's contraceptive life plan.

Accepted Answer

The answer of Nurses,certified nurse-midwives,and other advanced-practice nurses have the...

Question 27

Which contraceptive method best protects against sexually transmitted infections (STIs)and human immunodeficiency virus (HIV)?&#10;A) Periodic abstinence&#10;B) Barrier methods&#10;C) Hormonal methods&#10;D) They all offer about the same protection.

Accepted Answer

The answer of Which contraceptive method best protects against sexually...

Question 28

When completing discharge teaching for the patient after an induced abortion,the nurse should inform the patient to report which of the following immediately to her health care provider?&#10;A) Temperature of 37.8&#176;C&#10;B) Spotting or flow on day 4&#10;C) Abdominal tenderness when no pressure is applied&#10;D) No return of menstrual period within 6 weeks

Accepted Answer

The answer of When completing discharge teaching for the patient...

Question 29

Which of the following contraceptive methods is least effective?&#10;A) Standard days method&#10;B) Periodic abstinence&#10;C) Postovulation&#10;D) Coitus interruptus

Accepted Answer

The answer of Which of the following contraceptive methods is...

Question 30

A woman had unprotected intercourse 36 hours ago and is concerned that she may become pregnant because it is her "fertile" time.In response to her question about emergency contraception,what should the nurse tell her?

A) It is too late; she needed to begin treatment within 24 hours after intercourse.
B) Plan B, an emergency contraceptive method, is 98% effective at preventing pregnancy.
C) An over-the-counter antiemetic can be taken 1 hour before each contraceptive dose to prevent nausea and vomiting.
D) The most effective approach is to use a progestin-only preparation.

Accepted Answer

The answer of A woman had unprotected intercourse 36 hours...

Question 31

What should nurses be aware of with regard to the use of intrauterine devices (IUDs)?&#10;A) Return to fertility can take several weeks after the device is removed.&#10;B) IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse.&#10;C) IUDs offer the same protection against sexually transmitted infections as that of the diaphragm.&#10;D) Consent forms are not needed for IUD insertion.

Accepted Answer

The answer of What should nurses be aware of with...

Question 32

With regard to the noncontraceptive medical effects of combined oral contraceptive pills (COCs),what should the nurse be aware of?&#10;A) COCs can cause toxic shock syndrome if the prescription is wrong.&#10;B) Hormonal withdrawal bleeding usually is a bit more profuse than in normal menstruation and lasts a week.&#10;C) COCs increase the risk of endometrial and ovarian cancer.&#10;D) The effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

Accepted Answer

The answer of With regard to the noncontraceptive medical effects...

Deck 7: Infertility, contraception, and Abortion