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What is the role of pelvic ultrasound in infertility evaluation?
- A. To evaluate ovarian reserve directly.
- B. To visualize uterine and ovarian structures.
- C. To measure hormone levels in the bloodstream.
- D. To identify genetic abnormalities in embryos.
Correct Answer: B
Rationale: The correct answer is B, as pelvic ultrasound allows visualization of uterine and ovarian structures. This is essential in assessing conditions like fibroids, polyps, ovarian cysts, and structural abnormalities that may affect fertility. Ovarian reserve evaluation (A) involves separate tests like AMH levels. Hormone levels (C) are typically measured through blood tests. Genetic abnormalities in embryos (D) are usually identified through preimplantation genetic testing, not pelvic ultrasound.
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A 44-year-old woman presents with an unexpected pregnancy. She asks the nurse, 'Is my baby going to have a birth defect? My third cousin has Down syndrome.' What is the nurse's best response?
- A. Tell the patient she is at risk for gene mutation because a birth defect in a distant relative places the woman at increased risk.
- B. Discuss the potential risk for intrauterine growth retardation due to the mother's advanced age.
- C. Discuss the patient's situation with the physician to ask for a referral to high-risk obstetrics.
- D. Discuss the potential risk for a chromosomal abnormality based on the patient's advanced age.
Correct Answer: D
Rationale: Step 1: The correct answer is D because advanced maternal age (AMA), generally defined as 35 years or older, is a well-known risk factor for chromosomal abnormalities, such as Down syndrome.
Step 2: Down syndrome is more common in babies born to mothers over the age of 35 due to the increased likelihood of errors in cell division during egg development.
Step 3: Given the patient's age of 44, she falls into the category of AMA and is at an increased risk for chromosomal abnormalities in her baby.
Step 4: Option A is incorrect as the risk is not solely based on gene mutation but rather on the increased chance of chromosomal abnormalities due to age.
Step 5: Option B is incorrect as it focuses on intrauterine growth retardation, which is not directly related to the patient's query about birth defects.
Step 6: Option C is incorrect as a referral to high-risk obstetrics may not be necessary solely based on the patient's
Analyze the pedigree below. Which of the following inheritance patterns does the pedigree depict?
- A. Autosomal recessive.
- B. Mitochondrial inheritance.
- C. X-linked recessive.
- D. Y-linked trait.
Correct Answer: A
Rationale: The pattern suggests autosomal recessive inheritance.
Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in:
- A. latent phase of the first stage.
- B. active phase of the first stage.
- C. pelvic phase of the second stage.
- D. early phase of the third stage.
Correct Answer: A
Rationale: The client's cervical dilation, effacement, and contraction pattern indicate that she is in the latent phase of the first stage of labor. This phase is characterized by cervical dilation of 0 to 3 cm, effacement of 0% to 40%, and contractions every 5 to 10 minutes lasting 30 to 40 seconds. The active phase of the first stage occurs with cervical dilation of 4 to 7 cm, effacement of 40% to 80%, and contractions every 2 to 5 minutes lasting 45 to 60 seconds. The perineal phase of the second stage and early phase of the third stage have different characteristics, making them incorrect choices.
A couple who has not achieved a successful pregnancy is scheduled to meet with a fertility specialist. Which simple evaluation is usually the first test to be performed?
- A. Semen analysis
- B. Testicular biopsy
- C. Endometrial biopsy
- D. Hysterosalpingography
Correct Answer: A
Rationale: The correct answer is A: Semen analysis. This is the first test performed because it helps assess male fertility by evaluating sperm count, motility, and morphology. It is a non-invasive and cost-effective test that can provide valuable insights into the couple's fertility issues. Testicular biopsy (B) is an invasive procedure and typically not the initial test. Endometrial biopsy (C) evaluates the uterine lining and is usually performed later in the evaluation process. Hysterosalpingography (D) is a test to assess the fallopian tubes and uterus in females, which is also not typically the first test performed when evaluating infertility in a couple.
An infertile man is being treated with Viagra (sildenafil citrate) for erectile dysfunction (ED). Which of the following is a contraindication for this medication?
- A. Preexisting diagnosis of herpes simplex 2.
- B. Nitroglycerin ingestion for angina pectoris.
- C. Retinal damage from type I diabetes mellitus.
- D. Postsurgical care for resection of the prostate.
Correct Answer: B
Rationale: Viagra interacts dangerously with nitroglycerin, potentially causing severe hypotension.