Deck 12: Special Reproductive Concerns: Infertility and Genetics

Question 1

A patient calls the urologist's office to receive instructions about semen analysis. The nurse instructs the patient to:

A) Avoid sexual intercourse 24 hours prior to obtaining a specimen.
B) Use a latex condom to collect the specimen.
C) Expect that a repeat test might be required.
D) Expect a small sample.

Answer 1

Expect that a repeat test might be required.

Question 2

A male patient visits the infertility clinic for the results of his comprehensive exam. The exam indicated oligospermia. The patient asks the nurse which procedure would assist him and his wife to conceive. The nurse's best response is:

A) "You might want to consider adoption."
B) "An option you might consider is in vitro fertilization."
C) "Surrogacy might be your best option."
D) "Many couples utilize therapeutic husband insemination."
E) "The GIFT procedure has had much success."

Answer 2

"An option you might consider is in vitro fertilization."
"Many couples utilize therapeutic husband insemination."

Question 3

The nurse is reviewing assessment data from several different male patients. Which one should receive information about causes of infertility?

A) Circumcised patient
B) Patient with a history of premature ejaculation
C) Patient with a history of measles at age 12
D) Patient employed as an engineer

Answer 3

Patient with a history of premature ejaculation

Question 4

An infertile couple confide in the nurse at the infertility clinic that they feel overwhelmed with the decisions facing them. Which nursing strategy would be most appropriate?

A) Refer them to a marriage counselor.
B) Provide them with information and instructions throughout the diagnostic and therapeutic process.
C) Express concern and caring.
D) Inquire about the names they have chosen for their baby.

Question 5

A patient scheduled a laparoscopy. After the procedure, the nurse instructs the patient to:

A) Stay on bed rest for 48 hours.
B) Expect to have shoulder and arm pain.
C) Purchase a rectal tube to relieve the gas.
D) Lie on her back to relieve the gas pain after the procedure.

Question 6

The nurse in a fertility clinic is working with a woman who has been undergoing infertility treatment with clomiphene citrate (Clomid) and menotropin (Repronex). Which statement would the nurse expect the woman to make?

A) "I feel moody so much of the time."
B) "If this doesn't work, I think my husband will leave me."
C) "This combination of medications will guarantee a pregnancy."
D) "My risk of twins or triplets is the same as the general population's."

Question 7

The nurse working with an infertile couple has made the following diagnosis: Sexual Dysfunction related to decreased libido. Which assessment is most likely the reason for this diagnosis?

A) The couple have established a set schedule for having sexual intercourse.
B) The couple have been married for more than 10 years.
C) The couple live with his parents.
D) The couple have close friends who gave birth to a baby within the last year.

Question 8

A couple who have sought fertility counseling have been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which condition occurs?

A) The vas deferens is ligated.
B) The testes are overheated.
C) The prostate gland is enlarged.
D) The flagella are segmented.

Question 9

A patient is to receive fetility drugs prior to in vitro fertilization. The expected action of this medication is:

A) Prolonging of the luteal phase.
B) Stimulation of ovulation.
C) Suppression of menstruation.
D) Promotion of cervical mucus production.

Question 10

A patient and her husband have contacted their physician about fertility problems. At the initial visit, the nurse instructs them about the infertility workup. Which statement by the patient would indicate that the instructions have been successful?

A) "The first test that we need to schedule is a semen analysis."
B) "We need to schedule the Huhner test first."
C) "We need to schedule an appointment with the social worker in order to adopt."
D) "We need to schedule an appointment with a marriage counselor."

Question 11

The nurse is teaching an infertile couple about the causes of infertility. The nurse tells them that infertility can be caused by:

A) Immunological responses.
B) Congenital anomalies.
C) Patent fallopian tubes.
D) Hypothyroidism.
E) Favorable cervical mucus.

Question 12

A couple are 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.

Question 13

A couple are requesting fertility counseling. The nurse practitioner has identified the factors listed below in the woman's health history, and knows that which of them could be contributing to the couple's infertility?

A) The patient is 38 years old.
B) The patient was 13 years old when she started her menses.
C) The patient works as a dental hygienist 3 days a week.
D) The patient jogs 2 miles a day.

Question 14

The nurse is talking with a couple who have been trying to get pregnant for 5 years. They are now at the fertility clinic seeking help. The nurse assesses their emotional responses as part of the workup. Which response would the nurse expect to hear?

A) Anger at others who have babies
B) Feelings of failure because they cannot make a baby
C) Sexual excitement because they want so desperately to conceive a baby
D) Sadness because of the perceived loss of being a parent
E) Guilt on the part of one partner because he or she is not able to give the other a baby

Question 15

During the initial visit with the nurse at the fertility clinic, the patient asks what effect cigarette smoking has on the ability to conceive. The nurse's best response is:

A) "Smoking has no effect."
B) "Only if you smoke more than one pack a day will you experience difficulty."
C) "After your first semen analysis, we will determine whether there will be any difficulty."
D) "Smoking can affect sperm motility."

Question 16

A nurse working in an infertility clinic should include which information in her discussions with the patients?

A) It is important to know the statistics surrounding couples who never learn why they are infertile.
B) Couples should understand the legal controversy concerning artificial insemination.
C) Couples should seek marriage counseling before undergoing fertility treatments.
D) Couples should discuss therapeutic insemination and in vitro fertilization as alternatives.

Question 17

The physician has prescribed the medication clomiphene citrate (Clomid) for a patient with infertility. The nurse's instructions to the woman should be:

A) "Have sexual intercourse every day for 1 week, starting 5 days after completion of medication."
B) "Take a pregnancy test before restarting medication."
C) "Contact the doctor if visual disturbances occur."
D) "Discontinue the medication if hot flashes occur."

Question 18

The nurse at the fertility clinic instructs a couple on the Huhner test. The nurse knows that the teaching has been effective when they state:

A) "We must have sexual intercourse 1 day prior to the menstrual cycle."
B) "This test removes the spontaneity from our sex lives."
C) "The specimen is collected in a sterile cup."
D) "This test counts the number of sperm my husband produces."

Question 19

The nurse is planning a group session for parents who are beginning infertility evaluation. Which statement should be included in this session?

A) "Infertility can be stressful for a marriage."
B) "The doctor will be able to tell why you have not conceived."
C) "Your insurance will pay for the infertility treatments."
D) "Keep communicating with one another through this process."
E) "Taking a vacation usually results in pregnancy."

Question 20

The nurse is planning to teach couples factors that influence fertility. Which factor should not be included in the teaching plan?

A) Sexual intercourse should occur four times a week.
B) Get up to urinate 1 hour after intercourse.
C) Do not douche.
D) Institute stress-reduction techniques.

Question 21

A nurse counsels a couple on sex-linked disorders. Both the man and the woman are carriers of the disorder. They ask the nurse how this disorder will affect any children they might have. The nurse's best response is:

A) "If you have a daughter, she will not be affected."
B) "Your son will be affected, since the father has the disorder."
C) "There is a 25% chance that your son will have the disorder, since the mother has the disorder."
D) "There is a 50% chance that your son will be a carrier only."

Question 22

The couple has had an ultrasound at 19 weeks' gestation, and their fetus was found to have anencephaly. The nurse is completing counseling for the couple on the ultrasound findings. Which statement indicates that additional teaching is needed?

A) "Our baby has an incomplete brain, and might not be born alive."
B) "This problem is not caused by one of us having a genetic problem."
C) "We won't know whether something is wrong until the baby's chromosomes are tested."
D) "Waiting until our 30s did not cause this problem to develop."

Question 23

A woman who has had multiple miscarriages is advised to go through genetic testing. The patient asks the nurse the rationale for this recommendation. The nurse will explain that:

A) The woman's pedigree might exhibit a problem carrying a fetus to term.
B) The majority of miscarriages are caused by genetic defects.
C) A woman's chromosomal pattern determines her fertility.
D) There is a genetic marker that detects the presence of an incompetent cervix.

Question 24

Type: SEQ The clinic nurse is teaching a patient about how to take the basal body temperature (BBT). Place the steps in the order that the nurse provides to the patient. Standard Text: Click and drag the options below to move them up or down.

A) Choose one site for taking the temperature.
B) Use the chosen site consistently.
C) Take the temperature before arising.
D) Immediately record the temperature.
E) Shake down the thermometer.

Question 25

The nurse in the OB-GYN clinic counsels a couple that in autosomal dominant inheritance, which of the following occur?

A) An affected individual might have an affected parent.
B) The affected individual has a 75% chance of passing on the abnormality.
C) Males and females are equally affected by the gene.
D) A father can pass the defective gene to a son.
E) There are no variances in the genetic pattern for autosomal dominant disorders.

Question 26

A couple is at the clinic for preconceptual counseling. Both parents are 40 years old. The nurse knows that the education session has been successful when the wife states:

A) "We are at low risk for having a baby with Down syndrome."
B) "Our children are more likely to have genetic defects."
C) "Children born to parents this age have sex-linked disorders."
D) "The tests for genetic defects can be done early in pregnancy."
E) "It will be almost impossible for us to conceive a child."

Question 27

The clinic nurse assesses a newborn who is not progressing as expected. Genetic tests are ordered. The nurse explains to the parents that the laboratory tests to be done include:

A) Chromosome analysis.
B) Complete blood count.
C) Phenylketonuria.
D) Enzyme assay.
E) Antibody titers.

Question 28

A patient has been diagnosed with fallopian tube obstruction and told that her best option for becoming pregnant is with in vitro fertilization. The patient asks the nurse about the procedure. The best explanation by the nurse is:

A) "During the stimulation phase of the procedure, the physician will make sure that only one egg reaches maturation."
B) "Pre-implantation genetic diagnosis will be performed on your partner's sperm to make sure that the sperm are normal."
C) "After ovarian stimulation, you will be inseminated with your partner's sperm."
D) "Any extra embryos will be preserved for you if you wish to conceive again in the future."

Question 29

A pregnant patient asks the nurse, "What is this 'knuckle test' that is supposed to tell whether my baby has a genetic problem?" The nurse correctly explains that:

A) "The term is nuchal, and it refers to the neck. The test is a special ultrasound that measures the thickness of the back of the baby's neck."
B) "You will need to ask the physician for an explanation."
C) "It tests for Down syndrome."
D) It tests for neural tube defects."

Question 30

A newborn has been diagnosed with a disorder that occurs through an autosomal recessive inheritance pattern. The parents ask the nurse, "Which of us passed on the gene that caused the disorder?" The nurse tells them it was:

A) The female.
B) The male.
C) Neither.
D) Both.

Question 31

The couple at 12 weeks' gestation has been told that their fetus has sickle-cell disease. Which statement by the couple indicates that they are adequately coping?

A) "We knew we were both carriers of sickle cell. We shouldn't have tried to have a baby."
B) "If we had been healthier when we conceived, our baby wouldn't have this disease now."
C) "Taking vitamins before we got pregnant would have prevented this from happening."
D) "The doctor told us there was a 25% chance that our baby would have sickle disease."

Question 32

A nurse working with couples undergoing genetic testing recognizes which of the following as nursing responsibilities?

A) Allowing the family to interact with the genetic counselor without interference
B) Giving information about support groups when asked
C) Identifying families at risk for genetic problems
D) Aiding families in coping with the crisis
E) Ensuring continuity of nursing care to the family

Question 33

A 58-year-old father and a 45-year-old mother gave birth to a baby boy 2 days ago. The nurse assesses a single palmar crease and low-set ears on the newborn. The nurse plans to counsel the couple about which chromosomal abnormality?

A) Trisomy 13
B) Trisomy 18
C) Trisomy 21
D) Trisomy 26

Question 34

The nurse is reviewing preconception questionnaires in charts. Which couple are the most likely candidates for preconceptual genetic counseling?

A) Wife is 30 years old, husband is 31 years old.
B) Wife and husband are both 29 years old, first baby for husband, wife has a normal 4-year-old.
C) Wife's family has a history of hemophilia.
D) Single 32-year-old woman is using donor sperm.