Chapter 7 Families with Special Reproductive Concerns

Chapter 7   Families with Special Reproductive Concerns

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

1) A client who has been unable to conceive asks the nurse if it is her fault or her husband’s fault that they have not been able to become pregnant. The best response by the nurse is:

1. “The male infertility factors are more common than female.”
2. “Female infertility issues are more common than male issues.”
3. “The testing the doctor will order will determine who is at fault.”
4. “We will know more about what is causing your infertility after some tests are done.”

Answer:  4

Explanation:  1. This statement is not true. Because of the complexity of ovulation and maintaining a pregnancy, it is more likely that a female issue is causing the infertility. Regardless, using the term “at fault” is blaming and should be avoided.

2. Although this statement is true because of the complexity of ovulation and maintaining a pregnancy, using the term “at fault” is blaming and should be avoided.
3. Testing will determine what the infertility issue is, but using the term “at fault” is blaming and should be avoided.
4. This is a factual answer that avoids using the term “at fault.” This statement is therapeutically worded and therefore is the best answer.

Page Ref: 115

Cognitive Level:  Application

Client Need&Sub:  Psychosocial Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 7.1-Compare the essential components of fertility with the possible causes of infertility.

MNL LO:  Explain infertility and its associated risk factors.

2) The client experiencing infertility is to complete three months of documenting her basal body temperatures. Which statement by the client indicates a need for additional teaching?

1. “I should check my temperature with this special thermometer before I get out of bed each day.”
2. “I will track my temperatures and the consistency of my cervical mucus for the next 3 months.”
3. “If I am ovulating, my temperature will be a smooth, even line on the graph that does not go up or down.”
4. “The point of checking my basal body temperature is to determine whether I am ovulating regularly.”

Answer:  3

Explanation:  1. The basal body temperature is most accurate prior to arising each day. A thermometer with larger spaces between tenths of a degree is used to facilitate accurate recording.

2. Taking the temperature each morning will help detect ovulation. Checking cervical mucus daily for changes in consistency and stretchiness is another method to detect ovulation. Combining the two methods gives better information on when ovulation is occurring than one method does alone.
3. A flat line on the graph is a monophasic cycle indicating a lack of ovulation. An ovulating woman will have a biphasic pattern to her basal body temperature. The temperature will drop slightly prior to ovulation, and rise about .5 to 1.0°F as ovulation occurs, remaining elevated if conception occurs or dropping just prior to onset of menses.
4. Basal body temperatures are less predictive of when ovulation occurs, but an increase in the latter half of the cycle indicates that ovulation has occurred.

Page Ref: 116, 117

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 7.2-Describe the elements of the preliminary investigation of infertility and the nurse’s role in supporting/teaching patients during this phase.

MNL LO:  Recognize the various strategies for managing infertility.

3) A 31-year-old woman with normal ovaries, a normal prolactin level, and an intact pituitary gland is undergoing initial pharmacologic treatment of anovulation. Which medication would the nurse anticipate being prescribed for this client?

1. Clomiphene citrate (Clomid or Serophene)
2. Glucophage (Metformin)
3. Human menopausal gonadotropins (hMGs)
4. Bromocriptine (Parlodel)

Answer:  1

Explanation:  1. Clomiphene citrate (Clomid or Serophene) is a common first-line therapy for inducing ovulation in women with normal ovaries, normal prolactin level, and intact pituitary gland.

2. Oral hypoglycemic agents such as glucophage (Metformin) are used for inducing ovulation in women with polycystic ovary disease (PCOS).
3. hMGs is a second line of therapy in women who fail to ovulate or conceive with clomiphene citrate therapy.
4. Bromocriptine (Parlodel) is used to treat hyperprolactinemia accompanied by anovulation.

Page Ref: 114, 115

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Quality of practice

Learning Outcome:  LO 7.3-Compare the indications for the tests with the associated treatments, including assisted reproductive technologies that are done in an infertility workup.

MNL LO:  Examine the assessment process for male and female infertility.

4) A nurse is reviewing the basal body temperature method with a couple. Which of the following statements would indicate that the teaching has been successful?

1. “I have to go buy a special type of thermometer.”
2. “I need to wait five minutes after smoking a cigarette before I take my temperature.”
3. “I need to take my temperature before I get out of the bed in the morning.”
4. “I need to take my temperature for at least two minutes every day.”

Answer:  3

Explanation:  1. The temperature can be taken with a standard oral or rectal thermometer.

2. In the basal body temperature method, the woman takes her temperature every day before starting any activity, including smoking.
3. In the basal body temperature method, the woman takes her temperature every day before arising.
4. In the basal body temperature method, the woman takes her temperature every day for five minutes.

Page Ref: 116. 117

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 7.3-Compare the indications for the tests with the associated treatments, including assisted reproductive technologies that are done in an infertility workup.

MNL LO:  Recognize the various strategies for managing infertility.