Nokea
The nurse responsible for completing the medical history during a couple's initial visit to the reproductive medicine clinic recognizes which of the following as the leading cause of tubal factor infertility in the female?
- A. History of endometriosis
- B. History of pelvic inflammatory disease
- C. History of ectopic pregnancy
- D. History of Asherman's syndrome
Correct Answer: B
Rationale: Rationale:
B: History of pelvic inflammatory disease (PID) is the leading cause of tubal factor infertility as it can lead to scarring and blockages in the fallopian tubes, hindering the passage of eggs.
A: Endometriosis can affect fertility but is not the leading cause of tubal factor infertility.
C: Ectopic pregnancy can result from tubal issues but is not the leading cause of tubal factor infertility.
D: Asherman's syndrome involves scarring in the uterus, not the fallopian tubes, making it less likely to be the leading cause of tubal factor infertility.
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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.
A nurse has just taken a family history on a 10-week gravid client and created the family pedigree shown below. Each of the darkened symbols represents a person with a serious illness. Which of the following actions should the nurse take at this time?
- A. Advise the woman that she should have an amniocentesis.
- B. Encourage the doctor to send her for genetic counseling.
- C. Ask the woman if she knew any of the relatives who died.
- D. Inform the woman that her pedigree appears normal.
Correct Answer: B
Rationale: Genetic counseling is warranted when a family history suggests inherited disorders.
A genetic counselor's report states, 'The genetic nomenclature for this fetus is 46, XX.' How should the nurse who reads this report interpret the cytogenetic results?
- A. The baby is female with a normal number of chromosomes.
- B. The baby is hermaphroditic male with female chromosomes.
- C. The baby is male with an undisclosed genetic anomaly.
- D. There is insufficient information to answer this question.
Correct Answer: A
Rationale: 46, XX indicates a genetically normal female.
The nurse discusses the results of a 3-generation pedigree with the proband who has breast cancer. Which of the following information must the nurse consider?
- A. The proband should have a complete genetic analysis done.
- B. The proband is the first member of the family to be diagnosed.
- C. The proband's first degree relatives should be included in the discussion.
- D. The proband's sisters will likely develop breast cancer during their lives.
Correct Answer: C
Rationale: First-degree relatives are at increased risk and should be involved in discussions.
Lori, who is 32 years old, is taking clomiphene citrate to induce ovulation and presents to the office for a vaginal ultrasound. She mentions experiencing abdominal bloating, nausea, and weight gain of 5 pounds over the past 12 hours. What condition do these symptoms indicate?
- A. Ovulation
- B. Premenstrual syndrome
- C. Ovarian hyperstimulation syndrome
- D. Failed ovulation induction
Correct Answer: C
Rationale: The correct answer is C: Ovarian hyperstimulation syndrome (OHSS). OHSS is a potential complication of ovulation induction with medications like clomiphene citrate. The symptoms of abdominal bloating, nausea, and rapid weight gain indicate fluid accumulation in the abdominal cavity, a hallmark of OHSS. This occurs due to enlarged ovaries releasing excessive fluid into the abdomen. It is important to monitor patients like Lori closely for signs of OHSS to prevent severe complications.
Incorrect choices:
A: Ovulation - Symptoms described are not typical of normal ovulation.
B: Premenstrual syndrome - Symptoms are not consistent with typical PMS symptoms.
D: Failed ovulation induction - Symptoms of weight gain and bloating are not indicative of failed ovulation induction but rather a complication of the treatment.