Chapter 09: Infertility Lowdermilk:
Maternity & Women's Health Care, 12th
Edition Guaranteed Correct Answers For
High-level Exam
1. Which test is performed around the time of ovulation to diagnose the basis of
infertility?
a. Hysterosalpingogram
b. Vaginal ultrasonography
c. Laparoscopy
d. Follicle-stimulating hormone (FSH) level - ANSWER-ANS: B
Ultrasonography is performed around the time of ovulation to assess pelvic structures
for abnormalities, to verify follicular development, and to assess the thickness of the
endometrium. A hysterosalpingogram is scheduled 2 to 5 days after menstruation to
avoid flushing a potentially fertilized ovum out through a uterine tube into the peritoneal
cavity. Laparoscopy is usually scheduled early in the menstrual cycle. Hormone
analysis is performed to assess endocrine function of the hypothalamic-pituitary-ovarian
axis when menstrual cycles are absent or irregular.
2. A man smokes two packs of cigarettes a day. He wants to know if smoking is
contributing to the difficulty he and his wife are having getting pregnant. Which guidance
should the nurse provide?
a. "Your sperm count seems to be okay in the first semen analysis."
b. "Only marijuana cigarettes affect sperm count."
c. "Although smoking has no effect on sperm count, it can give you lung cancer."
d. "Smoking can reduce the quality of your sperm." - ANSWER-ANS: D
Cigarette smoking has detrimental effects on sperm and has been associated with
abnormal sperm, a decreased number of sperm, and chromosomal damage. The nurse
, may suggest a smoking cessation program to increase the fertility of the male partner.
Sperm counts vary from day to day and are dependent on emotional and physical status
and sexual activity. Therefore, a single analysis may be inconclusive. A minimum of two
analyses must be performed several weeks apart to assess male fertility. Marijuana use
may depress the number and motility of sperm. Smoking is indeed a causative agent for
lung cancer.
3. A couple comes in for an infertility workup, having attempted to achieve pregnancy
for 2 years. The woman, 37 years of age, has always had irregular menstrual cycles but
is otherwise healthy. The man has fathered two children from a previous marriage and
had a vasectomy reversal 2 years ago. The man has had two normal semen analyses,
but the sperm seem to be clumped together. What additional testing is needed?
a. Testicular biopsy
b. Antisperm antibodies
c. Serum prolactin level
d. Examination for testicular infection - ANSWER-ANS: C
This scenario does not indicate that the woman has had any testing related to her
irregular menstrual cycles. Hormone analysis is performed to assess endocrine function
of the hypothalamic-pituitary-ovarian axis when menstrual cycles are absent or irregular.
Determining the blood levels of prolactin, FSH, luteinizing hormone (LH), estradiol,
progesterone, and thyroid hormones may be necessary to diagnose the cause of the
woman's irregular menstrual cycles. A testicular biopsy is indicated only in cases of
azoospermia (no sperm cells) or severe oligospermia (low number of sperm cells).
Although unlikely to be the case because the husband has already produced children,
antisperm antibodies may be produced by the man against his own sperm. Examination
for testicular infection would be performed before semen analysis. Furthermore,
infection would affect spermatogenesis.
4. A couple is attempting to cope with an infertility problem. They want to know what
they can do to preserve their emotional equilibrium. What is the nurse's most
appropriate response?
a. "Tell your friends and family so that they can help you." b. "Talk only to other friends
who are infertile, because only they can help."
c. "Get involved with a support group. I'll give you some names."
Maternity & Women's Health Care, 12th
Edition Guaranteed Correct Answers For
High-level Exam
1. Which test is performed around the time of ovulation to diagnose the basis of
infertility?
a. Hysterosalpingogram
b. Vaginal ultrasonography
c. Laparoscopy
d. Follicle-stimulating hormone (FSH) level - ANSWER-ANS: B
Ultrasonography is performed around the time of ovulation to assess pelvic structures
for abnormalities, to verify follicular development, and to assess the thickness of the
endometrium. A hysterosalpingogram is scheduled 2 to 5 days after menstruation to
avoid flushing a potentially fertilized ovum out through a uterine tube into the peritoneal
cavity. Laparoscopy is usually scheduled early in the menstrual cycle. Hormone
analysis is performed to assess endocrine function of the hypothalamic-pituitary-ovarian
axis when menstrual cycles are absent or irregular.
2. A man smokes two packs of cigarettes a day. He wants to know if smoking is
contributing to the difficulty he and his wife are having getting pregnant. Which guidance
should the nurse provide?
a. "Your sperm count seems to be okay in the first semen analysis."
b. "Only marijuana cigarettes affect sperm count."
c. "Although smoking has no effect on sperm count, it can give you lung cancer."
d. "Smoking can reduce the quality of your sperm." - ANSWER-ANS: D
Cigarette smoking has detrimental effects on sperm and has been associated with
abnormal sperm, a decreased number of sperm, and chromosomal damage. The nurse
, may suggest a smoking cessation program to increase the fertility of the male partner.
Sperm counts vary from day to day and are dependent on emotional and physical status
and sexual activity. Therefore, a single analysis may be inconclusive. A minimum of two
analyses must be performed several weeks apart to assess male fertility. Marijuana use
may depress the number and motility of sperm. Smoking is indeed a causative agent for
lung cancer.
3. A couple comes in for an infertility workup, having attempted to achieve pregnancy
for 2 years. The woman, 37 years of age, has always had irregular menstrual cycles but
is otherwise healthy. The man has fathered two children from a previous marriage and
had a vasectomy reversal 2 years ago. The man has had two normal semen analyses,
but the sperm seem to be clumped together. What additional testing is needed?
a. Testicular biopsy
b. Antisperm antibodies
c. Serum prolactin level
d. Examination for testicular infection - ANSWER-ANS: C
This scenario does not indicate that the woman has had any testing related to her
irregular menstrual cycles. Hormone analysis is performed to assess endocrine function
of the hypothalamic-pituitary-ovarian axis when menstrual cycles are absent or irregular.
Determining the blood levels of prolactin, FSH, luteinizing hormone (LH), estradiol,
progesterone, and thyroid hormones may be necessary to diagnose the cause of the
woman's irregular menstrual cycles. A testicular biopsy is indicated only in cases of
azoospermia (no sperm cells) or severe oligospermia (low number of sperm cells).
Although unlikely to be the case because the husband has already produced children,
antisperm antibodies may be produced by the man against his own sperm. Examination
for testicular infection would be performed before semen analysis. Furthermore,
infection would affect spermatogenesis.
4. A couple is attempting to cope with an infertility problem. They want to know what
they can do to preserve their emotional equilibrium. What is the nurse's most
appropriate response?
a. "Tell your friends and family so that they can help you." b. "Talk only to other friends
who are infertile, because only they can help."
c. "Get involved with a support group. I'll give you some names."
