Nokea
The nurse is instructing a couple in the early stages of infertility testing who has just found that the male has a slightly low sperm count. Which easy change can a nurse suggest to a male client?
- A. Avoid riding on motorcycles
- B. Wear loose fitting underwear instead of tight ones.
- C. Take a general multivitamin.
- D. Increase sexual intercourse to every day.
Correct Answer: B
Rationale: Wearing loose fitting underwear allows the scrotum to pull the testes closer to the body to maintain proper temperature for sperm production or allow the testes to be farther from the body. Because the testes cannot produce viable sperm when temperatures are at or above body temperature, their location within the scrotal sac ensures optimal conditions. There is no evidence that the client cannot ride motorcycles. Taking a general multivitamin is encouraged for overall health. Daily sexual intercourse is not encouraged because it is most important to have sufficient sperm present during a female's ovulation period.
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The nurse is conducting a health history. When a middle-aged client reports last having a menstrual period 6 months ago. Upon further questioning, the client also states symptoms of hot flashes and mood fluctuations. Which question should the nurse ask next?
- A. Do you feel like hurting yourself?
- B. Are you finished having children?
- C. When was your first menstrual period?
- D. Are you taking any hormone replacement therapy?
Correct Answer: D
Rationale: To ensure a thorough health history, a client who exhibits symptoms of perimenopause should be assessed for the use of hormone replacement therapy to alleviate the symptoms. This information adds to the data reported by the client. Asking if the client is having thoughts of self-harm may be extreme with the report of mood fluctuations. Asking if the client is finished having children produces little additional data. Asking the first menstrual period is part of the health history but not the best question to ask after the client's statement.
The expert nurse is assisting a novice nurse insert a Foley catheter. The novice nurse has tried unsuccessfully to insert the catheter, and the expert nurse is providing verbal guidance while spreading which area to reveal the urethral opening?
- A. Labia majora and minora
- B. Meatus
- C. Clitoris
- D. Fourchette
Correct Answer: A
Rationale: The labia majora and minora are a portion of the external genitalia and when parted reveals the urethral opening. The meatus refers to an opening or passage. The clitoris is sensitive erectile tissue considered the site of sexual pleasure. The fourchette is the area beneath the vaginal opening at the base of the labia majora.
A nurse is caring for a client following a culdoscopy. Which assessment data would the licensed practical nurse report to the registered nurse?
- A. Pain level of 7 on the 0-to-10 pain scale
- B. Skin, cold, pulse, 110 beat/minute, blood pressure, 104/64 mm Hg
- C. Dark drainage noted on surgical pad
- D. Fleshy smell noted to perineal region
Correct Answer: B
Rationale: Culdoscopy is performed to visualize the uterus, broad ligaments, and fallopian tubes. An endoscope is inserted through a small incision made in the posterior vaginal wall. Afterward, the nurse must observe for signs of internal bleeding and shock. A client with cold and clammy skin, a rapid pulse, and low blood pressure indicates shock and the need to consult the registered nurse and even the physician. All of the other symptoms are able to be addressed by the licensed practical nurse. The client is to be medicated. Dark drainage and a fleshy smell to the perineal area are normal for old surgical drainage.
Which of the following would be most important for the nurse to include to ensure a thorough baseline history related to the reproductive system?
- A. Age of menarche
- B. Nutritional history
- C. Exercise and fitness routine
- D. Cultural history
Correct Answer: A
Rationale: To ensure a thorough baseline history, the nurse obtains information on the client's general health and family history, age of menarche, and menstrual history. Although the client's nutritional history, exercise and fitness routines, and cultural history are important, they are part of the overall client health history and not specific to the reproductive system.
The nurse is caring for a client who states having an irregular menstrual period. Which diagnostic test provides information of the body's ability to ovulate?
- A. Thyroid level
- B. Serum luteinizing hormone
- C. Serum follicle-stimulating hormone
- D. Estrogen level
Correct Answer: C
Rationale: The anterior pituitary hormone known as follicle-stimulating hormone (FSH) initiates ovulation monthly. Monitoring the FSH level provides information about the timing of ovulation. Thyroid level, estrogen level, and serum luteinizing hormone do not give information about the ability to ovulate.