Question 1

A couple, in which both members are 22 years of age, wants to know what it can do to improve the chances of conceiving. What should the nurse respond to this couple?

Accepted Answer

Although frequent intercourse may stimulate sperm production, men need sperm recovery time after ejaculation to maintain an adequate sperm count. This is why coitus every other day, rather than every day, during the fertile period will probably yield faster results. A diet that is low in fat and moderate in protein is recommended. The male-superior position is the best for conception because the sperm will be closer to the cervical opening.

Question 2

The nurse is assessing a male for sperm count. Which circumstance would be most important to ask about during the health history?

Accepted Answer

Actions that directly increase scrotal heat, such as working at a desk job, may cause sperm counts to be lower compared with men whose occupations allow them to be ambulatory at least part of each day. Jogging, a low-lipid diet, and vitamin supplementation are not as important as physical posturing when beginning an analysis for a low sperm count.

Question 3

The nurse is planning an education session for couples planning to conceive. What should the nurse include to support the 2020 National Health Goals? (Select all that apply.)

Accepted Answer

To support the 2020 National Health Goals, the nurse should focus on health promotion, early identification of problems that could lead to subfertility such as poor nutrition, and teaching patients about safer sex practices so the incidence of sexually transmitted infections and pelvic inflammatory disease can be reduced. It is best to have coitus every other day so that the sperm have adequate time to mature. Ninety percent of couples who have routine unprotected sex conceive within a year.

Question 4

A male is diagnosed as being infertile, but he wants to have children with his spouse. Which response should the nurse provide to this patient?

Accepted Answer

Donor sperm (alternative insemination by donor) is used if the man has no sperm. There is no evidence to support that the chance of conception is slight with artificial insemination. Embryo transfer is for the female partner who does not produce ova.
Artificial insemination is useful for many different situations.

Question 5

The nurse is teaching a female to take her basal body temperature daily to assess the time of ovulation. What will the patient's body temperature reflect as the day of ovulation?

Accepted Answer

At the time of ovulation, the basal body temperature can be seen to dip slightly (about 0.5ºF); it then rises to a level no higher than normal body temperature; it then stays at that level until 3 or 4 days before the next menstrual flow. This increase in basal body temperature marks the time of ovulation because it occurs immediately after ovulation. Upon ovulation, the basal body temperature will not decrease a degree, fluctuate, or spike and then drop.

Question 6

The nurse is scheduling a female patient for a hysterosalpingogram. Which question would be most important to ask the patient before scheduling the procedure?

Accepted Answer

Because X-ray, which might be harmful to a growing pregnancy, is used, the procedure must be scheduled immediately following a menstrual flow when pregnancy could not be present. Asking about coitus, sedative allergies, or blood time and Rh factor are not the most important when scheduling the patient for a hysterosalpingogram.

Question 7

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?

Accepted Answer

The nursing diagnosis that would be the most appropriate to address concerns about the outcome of subfertility studies would be fear related to possible outcome. There is no information to support this patient having a knowledge deficit. The patient already had the testing so anxiety regarding these procedure processes would not be appropriate at this time. It is unknown if the patient will experience situational low self-esteem because the results of the fertility tests have not be disclosed to the patient.

Question 8

The nurse instructs a couple on the process of basic fertility testing. Which patient statements indicate that teaching has been effective? (Select all that apply.)

Accepted Answer

There are three parts to basic fertility testing. The sperm are analyzed for number and quality, ovulation is determined, and the environment for the sperm and egg to meet is analyzed. In vitro fertilization is not a part of basic fertility testing.

Question 9

What should the nurse include when explaining endometriosis as a cause for a female patient's infertility?

Accepted Answer

Endometriosis refers to the implantation of uterine endometrium, or nodules, that have spread from the interior of the uterus to locations outside the uterus. If viable particles of endometrium enter a tube, they can cause tubal obstruction; growths on the ovaries can displace fallopian tubes away from the ovaries, preventing the entrance of ova into the tubes. Peritoneal macrophages, which are drawn to nodules of endometrium, can destroy sperm. Endometriosis does not affect ovulation, cervix competence, or menstruation.

Question 10

Before signing the consent form for a myomectomy, the patient asks why an intrauterine device (IUD) is being inserted because the goal is to become pregnant. What should the nurse respond to the patient?

Accepted Answer

During a myomectomy, an IUD may be inserted to prevent the uterine sides from touching and forming new adhesions. This treatment can be difficult for a woman to accept because preventing pregnancy through an IUD is exactly what she does not want to do. The IUD is not inserted to prevent pregnancy. An IUD will prevent pregnancy even after a myomectomy. The IUD is not used to ensure an adequate menstrual blood flow.

Question 11

The nurse completes instructing a female patient on the process of in vitro fertilization. Which statement indicates that patient teaching has been effective?

Accepted Answer

Fresh or frozen sperm can be used for in vitro fertilization. A surrogate mother is not needed for this procedure. Often, more than one attempt is needed before successful implantation occurs. The success of in vitro fertilization is not related to the incidence of ovarian cancer in the family.

Question 12

The nurse has completed a fertility assessment on a couple and is preparing outcomes for care. Which statement indicates that the couple wants to continue with the process, regardless of the outcome?

Accepted Answer

The outcome statement that indicates the couple wants to continue with the process would be "couple desires to continue with testing after it is determined that one partner is fertile." The interest in learning about other options, having limited resources, and minimizing disruptions do not indicate that the couple desires to continue with testing.

Question 13

A female patient is willing to alter nutrition and activity status in an attempt to conceive. What teaching should the nurse provide to support this patient's desire? (Select all that apply.)

Accepted Answer

Nutrition, body weight, and exercise are all important for adequate ova production because they all influence the blood glucose/insulin balance. The patient should be instructed to exercise 30 minutes each day, ingest vegetables that are high in fiber, and reduce every day stressors. In addition, eating slowly digested carbohydrate foods such as brown rice and dark bread rather than food such as white bread, which has easily digested carbohydrates, cannot only increase fertility by keeping insulin levels balanced. Decreased body weight or a body/fat ratio of less than 10% can reduce pituitary hormones such as FSH and LH and halt ovulation.

Question 14

A female patient being treated for infertility is completing the third course of clomiphene citrate (Clomid). What information should the nurse prepare for the patient in the event this course does not result in conception?

Accepted Answer

Clomiphene citrate (Clomid) has a 5-day initial course. Then two additional courses of 5 days each can be provided. If the last course does not result in conception, the nurse should prepare additional options to achieve conception. It is premature to begin discussing adoption with the patient. Sperm motility is not an issue at this time. There is no need for informed consent for a fourth course of the medication.

Question 15

An adolescent is diagnosed with pelvic inflammatory disease believed to have been caused by abdominal adhesions after an appendectomy. What should the nurse explain to the patient about future success with fertility?

Accepted Answer

Pelvic inflammatory disease could result from a ruptured appendix or from abdominal surgery that left adhesions in the tubes. About 12% of those who acquire PID will be left subfertile because of tubal scarring. Pelvic inflammatory disease does not affect ovulation. It will not cause the rejection of embryo transplantation, and it does not change the cervical mucus.

Quiz 8: Nursing Care of the Family Having Difficulty Conceiving a Child