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A provider has ordered several diagnostic procedures for a couple with suspected infertility. Which diagnostic procedure is useful for determining if ovulation has occurred?
- A. FSH level
- B. Progesterone level
- C. Estrogen level
- D. Vaginal ultrasound
Correct Answer: B
Rationale: The correct answer is B: Progesterone level. Progesterone is the hormone secreted after ovulation, indicating that ovulation has occurred. Monitoring progesterone levels can confirm ovulation. FSH (A) and estrogen (C) levels reflect the ovarian function but do not directly confirm ovulation. Vaginal ultrasound (D) can visualize the ovaries but does not definitively confirm ovulation.
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A newly married woman states, "My friend told me I would never have a baby because I had pelvic inflammatory disease when I was younger. I don't understand how that can affect whether or not I get pregnant." The nurse's most appropriate response is
- A. "Your friend may be right. The disease may affect your ability to conceive."
- B. "Pelvic inflammatory disease may damage the ovaries and prevent ovulation."
- C. "Your friend has been misinformed. Fallopian tube damage occurs only following gonorrhea."
- D. "Infection may cause scarring and obstruction of the fallopian tubes, which can prevent the fertilized egg from reaching the uterus."
Correct Answer: D
Rationale: The correct answer is D because pelvic inflammatory disease (PID) can lead to scarring and obstruction of the fallopian tubes. This can prevent the fertilized egg from traveling to the uterus for implantation, thus affecting fertility. Choice A is incorrect as it makes a definitive statement without considering individual variations in the impact of PID. Choice B is incorrect because while PID can lead to ovarian damage, it primarily affects the fallopian tubes. Choice C is incorrect as fallopian tube damage can result from various infections, not just gonorrhea. Thus, the most appropriate response is D, as it directly addresses how PID can impact fertility through fallopian tube obstruction.
What is the significance of a hysteroscopy in infertility evaluation?
- A. To measure hormone levels in the uterus.
- B. To visualize and treat abnormalities within the uterine cavity.
- C. To monitor egg development during ovulation induction.
- D. To assess ovarian reserve through imaging.
Correct Answer: B
Rationale: The correct answer is B: To visualize and treat abnormalities within the uterine cavity. A hysteroscopy is a minimally invasive procedure that allows direct visualization of the inside of the uterus using a thin, lighted tube. In infertility evaluation, it helps identify and treat issues such as polyps, fibroids, adhesions, or other abnormalities that may be interfering with implantation or causing recurrent miscarriages. It is crucial for improving fertility outcomes.
Choice A is incorrect because a hysteroscopy does not measure hormone levels in the uterus. Choice C is incorrect because monitoring egg development is typically done through ultrasound imaging, not hysteroscopy. Choice D is incorrect because assessing ovarian reserve is usually done through blood tests and ultrasound evaluation of the ovaries, not hysteroscopy.
A nurse is instructing a patient on the role of folic acid in preconception care. What is the correct explanation?
- A. Folic acid prevents iron deficiency anemia in pregnancy.
- B. Folic acid reduces the risk of neural tube defects in the fetus.
- C. Folic acid is only necessary during the first trimester of pregnancy.
- D. Folic acid enhances the absorption of calcium and vitamin D.
Correct Answer: B
Rationale: The correct answer is B because folic acid plays a crucial role in reducing the risk of neural tube defects in the fetus during early pregnancy. Folic acid is essential for proper development of the neural tube, which forms the baby's brain and spinal cord. This is why it is particularly important during preconception care and in the early stages of pregnancy.
Choice A is incorrect because folic acid is not specifically for preventing iron deficiency anemia in pregnancy. Choice C is incorrect as folic acid is important throughout pregnancy, not just in the first trimester. Choice D is incorrect because folic acid does not directly enhance the absorption of calcium and vitamin D.
The nurse is counseling a couple about ovulation predictor kits. What is the most important advice?
- A. They require a prescription.
- B. They detect the LH surge, signaling ovulation within the next 24 to 36 hours.
- C. They are most effective when used randomly during the cycle.
- D. They confirm pregnancy rather than ovulation.
Correct Answer: B
Rationale: The correct answer is B because ovulation predictor kits detect the LH surge, which occurs approximately 24 to 36 hours before ovulation. This information is crucial for timing intercourse to maximize the chances of conception. Choice A is incorrect because ovulation predictor kits are typically available over the counter and do not require a prescription. Choice C is incorrect because these kits should be used strategically around the expected time of ovulation for accurate results. Choice D is incorrect because ovulation predictor kits do not confirm pregnancy; they only indicate the LH surge and impending ovulation.
Which type of breech presentation is identified when the buttocks present first, with both legs extended up toward the face?
- B. A. frank
- C. B. full
- D. C. complete
Correct Answer: A
Rationale: In a frank breech presentation, the buttocks present first, with both legs extended up toward the face. This is a common breech presentation that requires careful monitoring during labor and birth to ensure a safe delivery. In a full or complete breech, the fetus sits cross-legged above the cervix, while in a footling breech, one or both legs are presenting. Understanding the different types of breech presentations is crucial for providing appropriate care and support during labor and birth.