Which of the following is an

advantage of a cervical cap

over a diaphragm?
a) It can be left in place
longer.
b) It needs no spermicidal
jelly.
c) It does not need to be
refitted after pregnancy.
d) No initial fitting is
required.
A young female client visits a
clinic for guidance on using a
barrier method of
contraception. Which method
would be most appropriate
method to recommend to the
client?
a) Femcap
b) Copper IUD
c) Ortho-Evra
d) Lunelle

Which of the following best

describes the
hysterosalpingogram
procedure?
a) Passage of an endoscope
through a small abdominal
incision to inspect the
reproductive organs
b) Instillation of carbon
dioxide through the cervix
into the uterus and fallopian
tubes
c) Radiograph of the uterus

It can be left in place longer.

Correct
Explanation:
Because a cervical cap does not
press against the sides of the
vagina, possibly interfering with
blood supply, it can be left in
place longer. p107

Femcap
Correct
Explanation:
The nurse should recommend
Femcap to the client. Femcap is a
cervical cap and, hence, a barrier
method of contraception. The
copper IUD, Lunelle, and OrthoEvra are not barrier methods of
contraception. The copper IUD is
a copper-based intrauterine
contraceptive; Lunelle is a
combined injectable
contraceptive; and Ortho-Evra is
a transdermal contraceptive
patch. p99
Radiograph of the uterus and
fallopian tubes following
introduction of a radiopaque
medium through the cervix
Explanation:
Hysterosalpingogram is a
procedure to document the
potency of the fallopian tubes
through the use of a radiopaque
medium. p97

and fallopian tubes following

introduction of a radiopaque
medium through the cervix
d) Insertion of an endoscope
through the posterior fornix to
visualize the reproductive
organs
A nurse is instructing a
patient on birth control
methods. The patient asks
about the cervical mucus
method. When should the
nurse tell the patient she is
fertile in relation to her
mucus?
a) Cervical mucus is not a
reliable indicator
b) When it is thick
c) When it is thin, watery, and
copious
d) When it does not stretch
You are counseling women on
birth control choices. Which
woman is the best candidate
for an IUD? A woman who:
a) Has one partner, her
husband and 3 children
b) Has a history of PID
c) Has multiple sex partners
d) Is in her early twenties and
wants children later in life

A 52-year-old patient is
perimenopausal and asks
about the severity of her
symptoms. What can you
accurately tell her is the only
potentially life-threatening

When it is thin, watery, and

copious
Correct
Explanation:
The cervical mucus method relies
on the changes that occur
naturally with ovulation. Before
ovulation, cervical mucus is thick
and does not stretch when
pulled. With ovulation, the
mucus becomes thin, copious,
watery, transparent, and
stretchy. p104

Has one partner, her husband

and 3 children
Correct
Explanation:
A women who is in a stable
monogamous relationship and
has already had one successful
pregnancy; IUD is one method
for birth control but is not
without risk to the women. IUD's
do not protect agains STI's. PID
may be caused by IUD's. A
woman in her twenties has
several better, lower risk options.
p113
Bone mineral density decreases.
Explanation:
The older women become, the
decrease in hormone levels place
women at increased risk for
osteoporosis. This is a potential

effect of menopause?
a) Bone mineral density
decreases.
b) Dense breast tissue is
replaced with adipose tissue.
c) The uterus and ovaries
decrease in size.
d) Pelvic support muscles lose
tone.
When using the contraceptive
patch, a patient should
understand that it
a) should be applied to the
breasts, hips, or back.
b) should be applied to the
abdomen, buttocks, or back.
c) is immediately effective
after application.
d) should be covered when
swimming because of
chlorine's effect on the
adhesive.
A couple is seeking guidance
for their inability to conceive a
child after trying for 15
months. They are morbidly
obese but state they have
friends with the same weight
problem who have had no
difficulty conceiving. What
education can the nurse
provide this couple to increase
their chances of success?
a) "Weight has no bearing on
the ability to conceive.
Something else must be going
on with your reproductive
organs."
b) "Obesity may interfere with
effective penetration and

concern which can impact life

and bone mineral density should
be monitored. There is no
evidence of atrophy in the pelvic
muscles, nor in the uterus or
ovaries as related to menopause.
Breast tissue changes at the same
rate that all other tissue changes.
p123

should be applied to the

abdomen, buttocks, or back.
Correct
Explanation:
The patch should be applied only
to the buttocks, back, abdomen,
or torso (never the breasts). The
patch is safe for wearing during
swimming and bathing. The
patch requires application for 1
week before becoming effective.
p112

"Obesity may interfere with

effective penetration and
deposition of sperm. We will look
at several factors to discover
what issues you may be
encountering."
Correct
Explanation:
Extreme obesity in a male may
interfere with effective
penetration and deposition of
sperm, compromising the ability
to conceive. p94

deposition of sperm. We will

look at several factors to
discover what issues you may
be encountering."
c) "Being this overweight is
unhealthy for you and for any
child that you may bring into
the world. Before you consider
conceiving, you should lose
weight."
d) "If you have been trying for
this long without success,
something must be wrong. So
we will need to run a series of
tests to see what that is."
Which of the following best
explains the action of the
lactational amenorrhea
method (LAM) of fertility
control?

a) LAM prevents fertilization

between the egg and sperm
b) LAM prevents introduction
of sperm into vagina
c) LAM thickens the cervical
mucus and blocks sperm
d) LAM causes suppression of
the ovulation process

A client desires protection

from unwanted pregnancies.
However, the client does not
enjoy sex when her partner
wears a male condom. Also,
the client experiences breast
tenderness, headache, and
nausea after taking oral
contraceptives. Which method
would be the most likely
choice for the couple to help

LAM causes suppression of the

ovulation process
Correct
Explanation:
LAM prevents pregnancy by
suppressing the ovulation
process. Withdrawal and barrier
methods of contraception
prevent the introduction of
sperm into the vagina. The
copper IUD, combined hormonal
methods, and combined oral
contraceptives prevent
fertilization between the egg and
the sperm. The Norplant system
thickens the cervical mucus and
blocks sperm. p106
Transdermal contraceptive
Correct
Explanation:
Application of transdermal
contraceptive patches to the skin
would most likely be the option
for this couple. These patches
will not hamper the sexual
experience nor cause side effects
such as those caused by oral
contraceptives. Natural

them enhance their sexual

experience as well as prevent
any side effects?
a) Natural membrane condom
b) Transdermal contraceptive
c) Ethinyl estradiol
d) Polyurethane condom

The nurse is developing a

presentation for a group of
young adult women about
premenstrual syndrome.
Which of the following would
the nurse include as possible
treatment options? Select all
that apply.
a) NSAIDs
b) Decrease in water intake
c) Antipsychotic medications
d) Reduction of caffeine
intake
e) Vitamin and mineral
supplements
f) Diuretic therapy
What can the nurse educate a
subfertile couple about to
avoid the problem with lower
sperm counts in the male
partner?

membrane and polyurethane

condoms are forms of male
condoms, which the client does
not like. Ethinyl estradiol is a
combined oral contraceptive
which would most likely cause
the client to experience breast
tenderness, headache, and
nausea. p112
Reduction of caffeine intake
Vitamin and mineral
supplements
Diuretic therapy
NSAIDs
Explanation:
Treatment options for PMS
include lifestyle changes such as
reduction in caffeine intake, a
well-balanced diet with increased
water intake, and limited alcohol
intake. Vitamin and mineral
supplements, NSAIDs, and
diuretic therapy may be used.
Antidepressants and antianxiety
agents, not antipsychotic agents,
may also be options. p88

a) Sit in a hot bath twice daily

to increase the scrotal heat.
b) Minimize actions that
increase scrotal heat.
c) Avoid exercise regimens.
d) Use the sauna after an
exercise regimen to "sweat
out" the toxins.

Minimize actions that increase

scrotal heat.
Correct
Explanation:
Actions that increase scrotal
heat, such as working at desk
jobs or driving a great deal every
day, may produce lower sperm
counts compared with men
whose occupations allow them to
be ambulatory at least part of
each day. Frequent use of hot
tubs or saunas may also lower
sperm counts appreciably. p94

You are asked to schedule a

hysterosalpingogram. Which
of the following questions

When do you expect your next

menstrual flow?
Correct

would be most important to

ask the woman before
scheduling the procedure?
a) What is your blood type and
Rh factor?
b) Are you allergic to any
sedatives?
c) When did you have coitus
last?
d) When do you expect your
next menstrual flow?
A female client comes to the
clinic and asks the nurse what
would be the most cost
effective method for her to
determine her ovulation
patterns. What is the best
response by the nurse?
a) "The least costly method to
determine ovulation patterns
is to record the basal body
temperature for at least 4
months."
b) "The least costly method
would be a surgical procedure
to determine if your fallopian
tubes are blocked."
c) "The least costly method
would be to purchase a
commercial kit from the store
to assess the upsurge of LH
that occurs just after
ovulation."
d) "The testing kit, Fertell,
should be purchased, as well
as a sperm kit for your male
partner."
Your patient wants to discuss
birth control options. She is a
36-year-old woman who is in
a long-term, monogamous

Explanation:
Because a radiograph is involved,
the procedure should be done in
the few days following a
menstrual flow when she is not
apt to be pregnant. p97

"The least costly method to

determine ovulation patterns is
to record the basal body
temperature for at least 4
months."
Correct
Explanation:
The least costly way to determine
a woman's ovulation pattern is to
ask her to record her basal body
temperature (BBT) for at least 4
months. p105

Combination oral contraceptives

Correct
Explanation:
Oral contraceptives are

relationship. She runs 2 miles

a day but also smokes a pack
of cigarettes a day. Which
birth control method would
you discourage her from
using?

contraindicated for women who

smoke, they would be at a higher
risk for blood clots. Condoms,
coitus interruptus, and
spermicidals can be used at no
risk. p111

a) Combination oral
contraceptives
b) Condoms
c) Coitus interruptus
d) Spermicides
Your patient regularly travels
internationally for work and
has a lot of job anxiety. She
also uses an electric heating
blanket every night she is at
home. Which of these fertility
awareness methods would you
discourage her from using?
a) Cervical mucus method
b) Symptothermal method
c) Basal body temperature
(BBT) method
d) Calendar method

A young woman comes to the

free clinic asking for birth
control pills. Which of the
following best indicates that
another type of contraception
would be better for this
patient?
a) history of noncompliance
with medications
b) age of her partner
c) frequency of sexual

Basal body temperature (BBT)

method
Correct
Explanation:
BBT is a method where the body
temperature should be check first
things in the morning and
recorded, immediately after
waking and before getting out of
bed. It is important for the
patient to maintain a normal
bed-time routine. Use of the
electric blanket can cause a false
elevation in the BBT. The
calendar method would depend
upon her schedule. Cervical
mucus and symptothermal
methodology would still be
options. p105
history of noncompliance with
medications
Correct
Explanation:
If a woman has a history of poor
compliance with medication, it
might not be realistic for her to
plan on taking an oral
contraceptive every day. p110-112

encounters
d) cost of the pills
A client is being prepared for
artificial insemination. Which
finding is the most suggestive
to determine if the client is
ovulating?
a) Slight weight gain
b) Fall in body temperature
c) Change in the cervical
mucus
d) Abdominal cramps
A nurse is preparing a client
for intrauterine device (IUD)
insertion. What should the
nurse inform the client when
educating her on IUDs?
a) Reduced menstrual flow
after insertion
b) Insertion procedure is
painless
c) Continuous cramps after
insertion
d) Regular check of threads
must be done

A nurse is teaching a class on

preventing pregnancy to high
school students. Which of the
following would the nurse
identify as the best method to
prevent both pregnancy and
sexually transmitted
infections (STIs)?

Change in the cervical mucus

Correct
Explanation:
Change in the appearance and
consistency of cervical mucus is
an indication of ovulation. Slight
weight gain and abdominal
cramps are not signs used to
determine ovulation. At the time
of ovulation, body temperature is
slightly elevated. p104
Regular check of threads must be
done
Correct
Explanation:
The nurse should instruct the
client to check the threads
regularly to make sure that the
IUD is in place. Menstrual flow
may be heavier, or last longer
than normal, after IUD insertion.
It will not decrease. The client
may feel a sharp pain when the
IUD is inserted. The client may
have cramps for a few days, but
these should not continue. p113
abstinence
Correct
Explanation:
Abstinence is refraining from
sexual relations. It has a 0%
failure rate, so it is considered
the most effective way to prevent
both pregnancies and STIs. p104

a) condoms
b) morning-after pills
c) birth control pills
d) abstinence
The nurse informs the patient

mechanical barrier

that a diaphragm is an
example of which of the
following types of
contraception?
a) transdermal
b) mechanical barrier
c) intrauterine
d) chemical barrier
A woman opts to use a
diaphragm for contraception.
Which instruction would be
most important for the nurse
to provide?
a) "Keep the diaphragm in
place for no more than 4
hours after intercourse."
b) "Wet the diaphragm with
water first before inserting it."
c) "Replace the diaphragm
every 6 months."
d) "Have your diaphragm
refitted if you lose 10 pounds
or more."
Which of the following factors
is it most important for the
nurse to consider when
recommending different types
of contraceptives to a female
client?
a) Client's partner's desire for
pregnancy
b) Client's ability to tolerate
side effects
c) Desire for protection
against sexually transmitted
infections (STIs)
d) Sexual orientation of the
client

Correct
Explanation:
The diaphragm is an example of
a mechanical barrier. It is a
circular rubber disk placed over
the cervix before intercourse.
p106

"Have your diaphragm refitted if

you lose 10 pounds or more."
Correct
Explanation:
Diaphragms should be refitted
after pregnancy, abdominal or
pelvic surgery, or weight loss or
gain of 10 pounds or more. A
diaphragm usually is replaced
every 1 to 2 years. A diaphragm
should remain in place for at
least 6 hours after intercourse. A
contraceptive sponge, not a
diaphragm, should be wetted
with water before insertion. p107

Client's ability to tolerate side

effects
Explanation:
The client's ability to tolerate side
effects is one of the most
important factors that the nurse
must consider when determining
the best type of contraceptive
method for a client. This ability
directly influences the client's
adherence to the method's use.
The client's partner's desire for
pregnancy, the sexual orientation
of the client, and desire for
protection against STIs are
criteria that the nurse should
consider when assessing a
woman's need for contraceptives;

however, these are not as critical

as assessing the client's
tolerability of side effects. p116
A couple who is in for fertility
testing ask the nurse what
tests are commonly performed
to assess fertility. The nurse
replies that there are only
three primary tests that are
used; these include which of
the following?
a) Pelvic sonogram, ovulation
monitoring, and semen
analysis
b) Serologic test for syphilis,
semen analysis, and tubal
patency assessment
c) Semen analysis, ovulation
monitoring, and tubal patency
assessment
d) Semen analysis, urinalysis,
and ovulation monitoring
A female patient is having a
procedure this morning that
involves radiologic
examination of the fallopian
tubes using a radiopaque
medium. What procedure
should the nurse document as
being performed?
a) A uterine endometrial
biopsy
b) A hysterosalpingography
c) A hysteroscopy
d) A sonohysterography

Subfertility/infertility is said
to exist when a couple has
failed to achieve pregnancy
after how many months of

Semen analysis, ovulation

monitoring, and tubal patency
assessment
Correct
Explanation:
Only three tests are commonly
used to test fertility: semen
analysis in the male and
ovulation monitoring and tubal
patency assessment in the
female. Additional testing may be
performed both on the man and
the woman, which may include
urinalysis, serologic test for
syphilis, and pelvic sonogram,
but these are not the primary
tests used.

A female patient is having a

procedure this morning that
involves radiologic examination
of the fallopian tubes using a
radiopaque medium. What
procedure should the nurse
document as being performed?
You selected: A
hysterosalpingography
Correct
Explanation:
A hysterosalpingography, a
radiologic examination of the
fallopian tubes using a
radiopaque medium, is a
frequently used technique.
12
Correct
Explanation:
Infertility is the failure to achieve

unprotected sexual
intercourse? Fill in the blank
with a number.

conception after 1 year of

unprotected intercourse.

____months
Sperm analysis is often the
first fertility test to be
completed, why?
a) Asking the male partner to
undergo diagnostic
procedures is the best way to
assess his interest in
treatment of infertility
b) Male fertility testing is
time-consuming and therefore
should be initiated early
c) The man is found to be
fertile in over 75 percent of
couples with infertility
problems
d) Sperm analysis is one of the
easiest tests to complete
Couples who engage in coitus
daily, hoping to cause early
impregnation, may actually
have more difficulty
conceiving than those who
space coitus to every other
day.

Sperm analysis is one of the

easiest tests to complete
Correct
Explanation:
Because sperm analysis is
noninvasive, it is one of the
easiest tests (and therefore costeffective) to complete. There is
no bias in male vs. female with
regard to being the cause of
infertility.

True

a) True
b) False
A woman visits your familyplanning clinic to request a
prescription for birth-control
pills. Which of the following
factors would indicate that an
ovulation suppressant would
not be the best contraceptive
method for her?
a) She has irregular menstrual

She has a family history of

thromboembolism.
Correct
Explanation:
The estrogen content of birthcontrol pills may lead to
increased blood clotting, leading
to an increased incidence of
thromboembolism. Women who
already are prone to this should

cycles.
b) She has a history of allergy
to foreign protein.
c) She is 30 years old.
d) She has a family history of
thromboembolism.

not increase their risk further.

The nurse is counseling a

sexually active 16-year-old
adolescent regarding
contraception. The adolescent
explains that she is afraid of
getting pregnant or of getting
a sexually transmitted
infection, but her boyfriend
refuses to use a condom. She
knows that she needs to use
some kind of contraception
but doesn't know which would
be best. Which of the
following would be the best
choice for this patient?

Female condom
Correct
Explanation:
The female condom would be the
best choice for this patient, as it
provides protection against both
sexually transmitted infections
(STIs) and conception. A tubal
ligation would not be
recommended for a 16-year-old
girl, as it is a permanent measure
and she may decide to have
children in the future. Neither an
oral contraceptive nor coitus
interruptus would provide
protection against STIs.

a) Oral contraceptive
b) Female condom
c) Coitus interruptus
d) Tubal ligation
The nurse is providing
contraception counseling to a
perimenopausal woman who
has had negative reactions to
oral contraceptives in the past
and would like a long-term,
non-hormone based method
that has a high rate of success.
Neither she nor her husband
wants to undergo surgery,
however. Which of the
following should the nurse
recommend?
a) Transdermal patch
b) Intrauterine device
c) Tubal ligation

Intrauterine device
Correct
Explanation:
Women who are premenopausal
are, overall, good candidates for
intrauterine devices (IUDs). In
this case, the IUD is the best
choice because this method is
almost 100% effective, is longterm, and does not involve any
hormones. Both the transdermal
patch and the subdermal
progestin implant involve
hormones, which rules each out
in this case. Also, tubal ligation is
a surgical procedure, which also
rules it out for this client.

d) Subdermal progestin
implant
Dilation and curettage is the
method of abortion used when
the gestational age of a
pregnancy is still less than 13
weeks.

True

a) False
b) True
A couple is considering
vasectomy as a contraception
option. However, the husband
is nervous about how such a
procedure would affect his
sexual functioning. Which of
the following statements that
the nurse might mention to
the man is true?
a) The man will still have full
erection capacity
b) The man will no longer
produce testosterone
c) The man will no longer
ejaculate seminal fluid
d) The man will continue to
ejaculate sperm

Which of the following best

defines the term
"subfertility/infertility"?
a) Failure to achieve
pregnancy after 1 year of
unprotected intercourse
b) Inability to achieve
pregnancy because of a known
factor that prevents
conception

The man will still have full

erection capacity
Correct
Explanation:
Some men resist the concept of
vasectomy because they are not
sufficiently aware of their
anatomy to know exactly what
the procedure will involve. They
can be assured vasectomy does
not interfere with the production
of sperm; the testes continue to
produce sperm as always, but the
sperm simply do not pass beyond
the plugged vas deferens and are
absorbed at that point. The man
will still have full erection
capacity and continue to produce
testosterone. Because he also
continues to form seminal fluid,
he will ejaculate seminal fluid; it
will just not contain sperm. (less)
Failure to achieve pregnancy
after 1 year of unprotected
intercourse
Correct
Explanation:
Infertility is the failure to achieve
conception after 1 year of
unprotected intercourse.

c) Failure to achieve
pregnancy after 6 months of
unprotected intercourse
d) Inability to achieve
pregnancy following a
previous viable pregnancy
A nurse is preparing a client
for intrauterine device (IUD)
insertion. What should the
nurse inform the client when
educating her on IUDs?
a) Continuous cramps after
insertion
b) Regular check of threads
must be done
c) Reduced menstrual flow
after insertion
d) Insertion procedure is
painless

A clinic nurse is interviewing a

young patient during a
subfertility work-up. When
the patient asks the nurse
what causes infertility, the
nurse informs the patient that
the problem can rest with the
man, the woman, or both.
What does the nurse tell the
patient are common problem
areas related to the woman?
(Select all that apply.)

Regular check of threads must be

done
Correct
Explanation:
The nurse should instruct the
client to check the threads
regularly to make sure that the
IUD is in place. Menstrual flow
may be heavier, or last longer
than normal, after IUD insertion.
It will not decrease. The client
may feel a sharp pain when the
IUD is inserted. The client may
have cramps for a few days, but
these should not continue.
tubal transport
impaired implantation
ovulation
Correct
Explanation:
Female factors that cause
subfertility are problems with
ovulation, tubal transport, and
implantation.

a) diabetes
b) lack of exercise
c) tubal transport
d) impaired implantation
e) ovulation
Which of the following best
explains the action of the
lactational amenorrhea
method (LAM) of fertility

LAM causes suppression of the

ovulation process
Correct
Explanation:

control?
a) LAM prevents introduction
of sperm into vagina
b) LAM causes suppression of
the ovulation process
c) LAM prevents fertilization
between the egg and sperm
d) LAM thickens the cervical
mucus and blocks sperm

Which of the following body

system changes would the
nurse associate with
menopause? Select all that
apply.

LAM prevents pregnancy by

suppressing the ovulation
process. Withdrawal and barrier
methods of contraception
prevent the introduction of
sperm into the vagina. The
copper IUD, combined hormonal
methods, and combined oral
contraceptives prevent
fertilization between the egg and
the sperm. The Norplant system
thickens the cervical mucus and
blocks sperm.

a) Vaginal dryness
b) Decreased bone density
c) Hot flashes
d) Decreased waist size
e) Moist, supple skin
f) Increased abdominal fat

Vaginal dryness
Decreased bone density
Hot flashes
Increased abdominal fat
Correct
Explanation:
Menopause may be associated
with hot flashes, increased
abdominal fat, vaginal dryness,
decreased bone density, dry,
thinning skin, and increased
waist size.

A woman is 40 years old and a

heavy smoker. She has a
single sexual partner but has
very irregular menstrual
cycles. She wants a highly
reliable contraceptive.
Assuming that all of the
following methods of birth
control are acceptable to her,
which of the following would
be the best recommendation?

A diaphragm and spermicide

Correct
Explanation:
Women over 40 who smoke
should not take ovulation
suppressants; irregular
menstrual cycles make natural
methods difficult; women over
40 may have vaginal dryness, so
a spermicidal suppository would
not be activated.

a) An ovulation suppressant
b) A diaphragm and
spermicide
c) A spermicidal suppository
d) The rhythm (calendar)
method

A nurse is instructing a
patient on birth control
methods. The patient asks
about the cervical mucus
method. When should the
nurse tell the patient she is
fertile in relation to her
mucus?
a) When it is thin, watery, and
copious
b) Cervical mucus is not a
reliable indicator
c) When it is thick
d) When it does not stretch
A male patient has requested
information on vasectomy.
Which of the following would
you include in your education
to him?
a) He will no longer ejaculate
b) He may notice permanent
increased scrotal swelling
c) His testes will no longer
produce sperm
d) It is usually done as an
office procedure
A woman has just been
prescribed clomiphene citrate
to stimulate ovulation. Which
of the following is an effect of
the drug that the nurse should
warn the woman about?
a) Extensive bleeding during
menstruation
b) Hypertension
c) Overstimulation of the
ovary resulting in potential
multiple births
d) Elevation of her blood
glucose level

When it is thin, watery, and

copious
Correct
Explanation:
The cervical mucus method relies
on the changes that occur
naturally with ovulation. Before
ovulation, cervical mucus is thick
and does not stretch when
pulled. With ovulation, the
mucus becomes thin, copious,
watery, transparent, and stretchy

It is usually done as an office

procedure
Correct
Explanation:
Vasectomy does not stop sperm
production; it is an office
procedure done to halt the flow
of sperm. There is no swelling,
and he will have normal sexual
function.

Overstimulation of the ovary

resulting in potential multiple
births
Correct
Explanation:
Therapy with clomiphene citrate
(Clomid, Serophene) may be
used to stimulate ovulation.
Administration of either
clomiphene citrate or
gonadotropins may
overstimulate an ovary, causing
multiple ova to come to maturity
and possibly resulting in multiple
births. Counsel women who

receive these agents this is a

possibility. None of the other
answers is a common effect of
clomiphene citrate use.
Now that you are familiar with
the risk factors for
osteoporosis, to which of these
patients would you be most
eager to suggest a bone
mineral density test?
a) A woman with a vitamin D
deficiency
b) A 55-year-old Caucasian
woman who smokes and
whose 80-year-old mother has
osteoporosis
c) An African American
woman, 5 feet and 4 inches
tall, 172 pounds, with an
inactive lifestyle
d) A 25-year-old Asian
woman, 5 feet and 7 inches
tall, 129 pounds, with two
children
Prevention of pregnancy is a
major factor in the sex lives of
many couples. One method of
contraception is the female
condom. It is a thin tube made
of polyurethane, with flexible
rings at both ends. What is a
disadvantage of the female
condom?
a) Can slip into the vagina
during vigorous intercourse
b) Need an erection to remain
in place
c) Can't be used by people
sensitive to latex
d) The external ring decreases
stimulation to the clitoris

A 55-year-old Caucasian woman

who smokes and whose 80-yearold mother has osteoporosis
Correct
Explanation:
Older women and those who
smoke are at more risk for
osteoporosis. This client should
be referred to bone scan or
density testing. Vitamin D levels,
body weight, and race are not
factors heavily weighted in
osteoporosis.

Can slip into the vagina during

vigorous intercourse
Explanation:
Reported disadvantages are that
the condom may be difficult to
apply, make noise, cause vaginal
or penile irritation, or slip into
the vagina during vigorous
intercourse, a condition that
decreases its effectiveness.

A young woman is having

trouble conceiving and has
come in to the office for
fertility testing. She states that
she has irregular and
unpredictable menstrual
cycles. On blood testing, it is
found that her ovaries are
producing excess testosterone,
which is lowering her folliclestimulating hormone (FSH)
and luteinizing hormone (LH)
levels. Which of the following
is the most likely cause of her
subfertility?
a) Endometriosis
b) Tubal transport problems
c) Stenotic cervical os
d) Anovulation

The majority of pregnancy

terminations are done in cases
in which the pregnancy
threatens the mother's life.
a) True
b) False

A woman is seeking
information on tubal ligation
as a form of birth control.
What information should the
nurse provide to the patient?
a) She must have signed
consent from her husband

Anovulation
Correct
Explanation:
Anovulation is absence of
ovulation or release of ova from
the ovary. The most frequent
cause for anovulation is naturally
occurring variations in ovulatory
patterns or polycystic ovary
syndrome, a condition in which
the ovaries produce excess
testosterone lowering FSH and
LH levels, which then causes
irregular and unpredictable
menstrual cycles. Based on the
woman's symptoms and test
results, anovulation is the most
likely cause of her subfertility.
The other conditions listed would
not have the same symptoms and
test results.
False
Correct
Explanation:
The majority of pregnancy
terminations are done for the
following reasons: the pregnancy
is unwanted because a woman
chooses not to have a child at this
time in her life for such reasons
as being too young, not wanting
to be a single parent, wanting no
more children, having financial
difficulties, or from failed
contraception
This is a permanent and
irreversible procedure for birth
control
Explanation:
The procedure is considered
permanent and irreversible. This
is a procedure not for routine
birth control, but for permanent

b) The procedure is easy to

perform and will be painless
c) Wait several months after
birth and schedule the surgery
as an outpatient
d) This is a permanent and
irreversible procedure for
birth control

birth control. If the women elects

for this procedure, it can be done
immediately following the birth
of the child, lessening the
inconvenience or hospitalization
of the patient. The procedure is
not painless, nor easy. A consent
form from the partner is not
always required.

The estrogen content in the

contraceptive pill performs
which of the following
actions?

Suppresses follicle-stimulating
hormone (FSH)
Correct
Explanation:
Estrogen has a direct effect on
the pituitary gland suppressing
FSH; progesterone increases
permeability of cervical mucus
and endometrial proliferation.

a) Increases the level of

luteinizing hormone (LH)
b) Decreases the permeability
of cervical mucus
c) Suppresses folliclestimulating hormone (FSH)
d) Interferes with endometrial
proliferation
A perimenopausal woman
asks for help in selecting a
contraceptive. She complains
of vaginal dryness during
intercourse and says that her
partner does not like the feel
of condoms. Which method
should the nurse recommend?
a) Female condom
b) Diaphragm
c) Cervical cap
d) Spermicide
A couple has chosen fertility
awareness as their method of
contraception. The nurse
explains that the unsafe
period for them during the
menstrual cycle would be
which of the following?

Spermicide
Explanation:
Women older than 35 years have
a higher incidence of cystocele or
rectocele than younger women so
diaphragms or cervical caps may
not be the ideal contraceptive for
them. Spermicide foam can help
lubricate the vagina to increase
sexual enjoyment in women
nearing menopause. Her
partner's dislike of condoms
rules out the female condom.
Three days before and three days
after ovulation
Correct
Explanation:
Typically, the unsafe period
during the menstrual cycle is
approximately 3 days before and
3 days after ovulation. An ovum

a) Three days before and three

days after ovulation
b) Six days before the onset of
menstruation
c) Midway between the
normal menstrual cycle
d) Five days after the first day
of the menstrual cycle

is released from the ovary 14 days

before the next menstrual period.

A young woman says she is

needs a temporary
contraceptive but has a latex
allergy. She mentions that she
has a papillomavirus
infection. Also, she says she is
terrible about remembering to
take pills. Which method
should the nurse recommend?

Transdermal contraception
Explanation:
The fact that this woman has a
latex allergy rules out the female
condom, cervical cap, and
diaphragm. Moreover the
diaphragm is contraindicated in
her case, due to her
papillomavirus infection. The
best choice for her is the
transdermal contraception,
which involves wearing a patch
for a week at a time and does not
require taking pills daily.

a) Transdermal contraception
b) Diaphragm
c) Female condom
d) Cervical cap
When do condoms need to be
applied to be effective?
a) At least 1 hour prior to
coitus
b) Immediately after
ejaculation
c) Before penile-vulvar contact
d) As soon as the penis
becomes erect
A 16-year-old girl is brought to
the clinic by her mother
because she has not had a
menstrual period for the past
8 months. Which of the
following findings might alert
the nurse to the possibility
that anorexia nervosa may be
contributing to the client's
amenorrhea? Select all that
apply.

Before penile-vulvar contact

Correct
Explanation:
Some sperm may be released
with pre-ejaculation semen, so a
condom needs to be used with
any penile-vulvar contact

Bradycardia
Hypotension
Reduced subcutaneous fat
Explanation:
Hypothermia, bradycardia,
hypotension, and reduced
subcutaneous fat may be
observed in women with
amenorrhea with anorexia
nervosa as the contributing
factor. Evidence of secondary sex

a) Bradycardia
b) Evidence of secondary sex
characteristics
c) Reduced subcutaneous fat
d) hypotension

characteristics would be a normal

finding for a girl of this age.

For natural reproductive life

planning, which of the
following is characteristic of
cervical mucus during
ovulation?

Thin and watery

Correct
Explanation:
Because cervical mucus is thin
and watery at the time of
ovulation, sperm can penetrate it
easily.

a) High viscosity and

alkalinity
b) Thin and watery
c) Properties of acidity and
ferning
d) Increased number of
leukocytes
The nurse is providing
contraception counseling to a
perimenopausal woman who
has had negative reactions to
oral contraceptives in the past
and would like a long-term,
non-hormone based method
that has a high rate of success.
Neither she nor her husband
wants to undergo surgery,
however. Which of the
following should the nurse
recommend?
a) Transdermal patch
b) Intrauterine device
c) Subdermal progestin
implant
d) Tubal ligation
A client asks the nurse, "What
would be the best way to get
pregnant." The nurse would
incorporate which of the
following in the response?

Intrauterine device
Correct
Explanation:
Women who are premenopausal
are, overall, good candidates for
intrauterine devices (IUDs). In
this case, the IUD is the best
choice because this method is
almost 100% effective, is longterm, and does not involve any
hormones. Both the transdermal
patch and the subdermal
progestin implant involve
hormones, which rules each out
in this case. Also, tubal ligation is
a surgical procedure, which also
rules it out for this client.

Conception is more likely when

intercourse occurs within 72
hours of ovulation
Correct
Explanation:
Conception is more likely when

a) Conception is more likely

when intercourse occurs
within 72 hours of ovulation
b) Conception is more likely in
the presence of orgasm
c) Conception is more likely if
the sperm has just been
ejaculated
d) The timing of intercourse
and conception affects the sex
of the pregnancy

sexual intercourse occurs within

72 hours of ovulation. There is no
evidence that age of sperm in the
ejaculate affects its viability or
that the timing of intercourse
affects the sex of the pregnancy.
Studies have also shown that
conception is more likely in the
absence of orgasm.

A clinic nurse is interviewing a

young patient during a
subfertility work-up. When
the patient asks the nurse
what causes infertility, the
nurse informs the patient that
the problem can rest with the
man, the woman, or both.
What does the nurse tell the
patient are common problem
areas related to the woman?
(Select all that apply.)

tubal transport
impaired implantation
ovulation
Correct
Explanation:
Female factors that cause
subfertility are problems with
ovulation, tubal transport, and
implantation.

a) lack of exercise
b) tubal transport
c) impaired implantation
d) ovulation
e) diabetes
A client visits a healthcare
facility for information on a
vasectomy. Which of the
following would best describe
the initial information a nurse
should provide?
a) The procedure cannot be
reversed
b) Vasectomy is a relatively
easy procedure with few
complications
c) Regular sperm counts are
not essential

Vasectomy is a relatively easy

procedure with few
complications
Explanation:
The nurse should inform the
client that vasectomy is a
relatively easy procedure with
few complications. Regular
sperm counts following a
vasectomy are important.
Reversals (reattaching the vas
deferens) of vasectomies are not
uncommon, but these are often
unsuccessful. The client should

d) Birth-control measures are

not required

use birth-control measures until

his sperm count remains at zero
for 6 weeks.

About 75% of pregnancies

caused by in vitro fertilization
end in spontaneous
miscarriage.

False
Correct
Explanation:
About 25% of pregnancies caused
by in vitro fertilization end in
spontaneous miscarriage (the
same rate as for natural
pregnancies).

a) False
b) True

A woman calls your clinic to

report that she has had some
cramping since the insertion
of her IUD and that her
present menstrual flow is
heavy. You would advise her
to do which of the following?
a) Come to the clinic as soon
as possible
b) Change her method of
reproductive life planning
c) Consider this normal,
because her IUD has been
newly inserted
d) Take her blood pressure
daily for the rest of the month

Consider this normal, because

her IUD has been newly inserted
Explanation:
Insertion of an IUD may lead to
mild cramping during the first
month of use.