Chapter 63: Drug Therapy of Infertility

Chapter 63: Drug Therapy of Infertility

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient is being treated for infertility. An examination reveals cervical mucus that is scant, thick, and sticky. The nurse suspects that the patient has been taking which medication?

a.	Clomiphene [Clomid]
b.	Estrogen
c.	Follicle-stimulating hormone (FSH)
d.	Progesterone

 

 

ANS:  A

Because clomiphene has antiestrogenic actions, it can force the production of scant and viscous cervical mucus, which interferes with conception. Estrogen is given to create a favorable cervical mucous environment that is more hospitable to sperm. FSH and progesterone do not alter cervical mucus in this way.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 770-771

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. An infertile patient has received two 5-day courses of clomiphene [Clomid] to help her conceive. An ultrasound 1 week after the last dose reveals that follicular maturation has occurred without ovulation. The nurse expects the next step for this patient to be:

a.	administration of human chorionic gonadotropin (hCG).
b.	an order for cabergoline to be given twice weekly.
c.	evaluation of ovarian and pituitary function.
d.	repeating clomiphene once daily for 5 days.

 

 

ANS:  A

When treatment with clomiphene has failed to produce ovulation after two courses, hCG is used to promote ovulation after follicular maturation has occurred. Cabergoline is used to treat hyperprolactinemia when excessive prolactin secretion occurs. Ovarian and pituitary function should be evaluated before a patient begins treatment with clomiphene. If ovulation had occurred, another cycle of clomiphene would be indicated.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 770-771 | pp. 772-773

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A patient who has endometriosis has been unable to conceive. She asks the nurse about medications to treat the condition. What will the nurse tell the patient?

a.	Combination oral contraceptives are effective for improving fertility.
b.	Gonadotropin-releasing hormone agonists are used for long-term treatment.
c.	Nonsteroidal anti-inflammatory drugs are second-line agents for treating pain.
d.	Pharmacologic agents used to treat endometriosis do not enhance fertility.

 

 

ANS:  D

Surgery reduces symptoms of endometriosis and improves fertility; drugs used to treat endometriosis only reduce discomfort. Combination oral contraceptives only treat symptoms; they do not improve fertility. Gonadotropin-releasing hormone agonists cannot be used long term because of side effects of osteoporosis and hot flashes. Nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line agents for endometriosis pain.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 770

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. An infertile couple begins treatment with menotropins. To enhance the therapeutic effects of the medication, the nurse will advise the patients to have intercourse:

a.	before hCG injection and the following 2 to 3 days.
b.	the morning of the hCG injection and later that evening.
c.	the evening of the injection and the following day.
d.	the evening of the injection and the following morning.

 

 

ANS:  A

The nurse should advise the patients to have intercourse the evening before the injection and on the following 2 to 3 days (during the probable period of ovulation). Having intercourse the morning of the hCG injection and later that evening will not enhance the effects of menotropins. Avoiding intercourse the evening of the injection and on the following day will not enhance the effects of menotropins. Having intercourse the evening of the injection and on the following morning will not enhance the effects of menotropins.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 771-772

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies