Nokea
A patient and her husband have just been told their unborn child has Down syndrome. The patient's husband becomes upset, stating, 'There is no way this can be possible as we have no one in the family with this problem! You must run the test again because the results cannot be correct.' What does the husband's behavior represent?
- A. Denial
- B. Sorrow
- C. Anger
- D. Bargaining
Correct Answer: A
Rationale: The correct answer is A: Denial. The husband's behavior of refusing to accept the test results and requesting them to be run again indicates denial. Denial is a common defense mechanism where individuals reject reality to avoid facing uncomfortable truths. The husband's disbelief due to lack of family history reflects denial in coping with the unexpected news. Sorrow (B), Anger (C), and Bargaining (D) are not applicable in this context as the husband's reaction does not demonstrate sadness, hostility, or attempts to negotiate a different outcome.
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What is the purpose of performing a hysterosalpingogram (HSG) during fertility evaluation?
- A. To determine ovarian reserve and egg quality.
- B. To visualize the fallopian tubes and check for blockages.
- C. To assess hormone levels during the menstrual cycle.
- D. To evaluate the sperm motility in the uterine cavity.
Correct Answer: B
Rationale: Performing a hysterosalpingogram (HSG) during fertility evaluation helps visualize the fallopian tubes and check for blockages. This is crucial as blocked fallopian tubes can prevent eggs from meeting sperm, leading to infertility. By injecting contrast dye into the uterus and taking X-ray images, doctors can assess tubal patency. This procedure is not aimed at determining ovarian reserve or egg quality (option A), assessing hormone levels (option C), or evaluating sperm motility in the uterine cavity (option D), as these factors are assessed through different tests and procedures.
During fertility counseling, a patient asks about the impact of age on female fertility. What should the nurse explain?
- A. Female fertility remains constant until menopause.
- B. Fertility begins to decline significantly after age 35.
- C. Age only affects fertility if other health issues are present.
- D. Fertility is unaffected by age until the age of 50.
Correct Answer: B
Rationale: The correct answer is B because fertility significantly declines after age 35 due to a decrease in the quantity and quality of eggs. As women age, the risk of chromosomal abnormalities in eggs increases, impacting fertility. Other choices are incorrect because fertility does not remain constant until menopause (A), age affects fertility regardless of other health issues (C), and fertility starts declining well before the age of 50 (D).
What is the significance of timing in intrauterine insemination (IUI)?
- A. IUI is effective regardless of ovulation timing.
- B. IUI must be timed closely with ovulation for optimal success.
- C. IUI should only be done after the implantation window opens.
- D. Timing is irrelevant as long as sperm quality is high.
Correct Answer: B
Rationale: The correct answer is B because timing is crucial in IUI to increase the chance of fertilization. Intrauterine insemination must be done close to ovulation to ensure that the sperm meets the egg for successful conception. Timing is essential to maximize the chances of successful fertilization.
Choice A is incorrect because timing is indeed important for the success of IUI. Choice C is incorrect because the implantation window is not related to the timing of IUI. Choice D is incorrect because high sperm quality alone is not sufficient for successful IUI; timing is a critical factor in achieving pregnancy through IUI.
An Orthodox Jewish couple is seeking infertility counseling. The woman states that her menstrual cycle is 21 days long. After testing, no physical explanation is found for the infertility. Which of the following may explain why the woman has been unable to conceive?
- A. Her kosher diet is lacking the essential nutrients needed for achieving optimal reproductive health.
- B. The positions allowed Orthodox Jewish couples during intercourse hinder the process of fertilization.
- C. Orthodox Jewish couples are known to have a high rate of infertility because of inborn genetic diseases.
- D. Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends.
Correct Answer: D
Rationale: Orthodox Jewish couples abstain from intercourse during menstruation and the subsequent week, potentially missing the fertile window.
Which of the following client responses indicates that the nurse's teaching about care following chorionic villus sampling (CVS) has been successful?
- A. If the baby stops moving
- B. the woman should immediately go to the hospital.
- C. The woman should take oral terbutaline every 2 hours for the next day.
- D. If the woman starts to bleed or to contract
Correct Answer: C
Rationale: Bleeding or contractions after CVS warrant medical attention.