Chapter 08: Infertility, Contraception, and Abortion
MULTIPLE CHOICE
1. Which test used to diagnose the basis of infertility is done during the late follicular or
early proliferative phase of the menstrual cycle?
a. Hysterosalpingogram
b. Endometrial biopsy
, c. Laparoscopy
d. Follicle-stimulating hormone (FSH)
level
ANS: A
A hysterosalpingogram is scheduled in the late follicular or early proliferative phase to
avoid flushing potentially fertilized ovum out through a uterine tube into the peritoneal
cavity. Endometrial biopsy is generally not done for a diagnosis of infertility.
Laparoscopy usually is 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.
DIF: Cognitive Level: Knowledge REF: p. 148 | Table 8-1
OBJ: Nursing Process: Planning
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. What
information is the basis for the nurse’s response?
a. Indicating that the first sperm count
seems okay
b. Informing that only marijuana
cigarettes affect sperm count
c. Providing information about smoking
and lung cancer and its lack of effect
on sperm
d. Providing education that smoking can
reduce the quality of sperm
ANS: D
Use of tobacco, alcohol, and marijuana may affect sperm counts. Indicating that the first
sperm count seems to be okay in the first semen analysis is inaccurate. Sperm counts
vary from day to day and depend 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.
DIF: Cognitive Level: Application REF: p. 146 | Box 8-2
OBJ: Nursing Process: Diagnosis
3. A couple comes in for an infertility appointment, having attempted to get pregnant for 2
years. The woman, 37, has always had irregular menstrual cycles but is otherwise
healthy. The man has fathered two children from a previous marriage and underwent a
vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the
sperm seem to be clumped together. What additional test is needed?
, a. Testicular biopsy
b. Antisperm antibodies
c. Follicle-stimulating hormone (FSH)
level
d. Examination for testicular infection
ANS: C
The woman has irregular menstrual cycles. The scenario does not indicate that she has
had any testing related to this irregularity. Hormone analysis is performed to assess
endocrine function of the hypothalamic-pituitary-ovarian axis when menstrual cycles are
absent or irregular. Determination of blood levels of prolactin, FSH, luteinizing hormone
(LH), estradiol, progesterone, and thyroid hormones may be necessary to diagnose the
cause of irregular menstrual cycles. A testicular biopsy would be indicated only in cases
of azoospermia (no sperm cells) or severe oligospermia (low number of sperm cells).
Antisperm antibodies are produced by a man against his own sperm. This is unlikely to
be the case here, because the husband has already produced children. Examination for
testicular infection would be done before semen analysis. Furthermore, infection would
affect spermatogenesis.
DIF: Cognitive Level: Analysis REF: p. 147 OBJ: Nursing Process: Diagnosis
4. A couple is trying to cope with an infertility problem. They want to know what they can
do to preserve their emotional equilibrium. What is the basis for the nurse’s response?
a. Encourage the couple to share the
information with friends so they can
talk more about it.
b. Suggest they only discuss their
infertility problem with friends that do
not have children.
c. Provide information about local
support groups for infertile couples.
d. Suggest they initiate adoption
proceedings immediately because it is
a lengthy process.
ANS: C
Venting negative feelings may unburden the couple. A support group may provide a safe
haven for the couple to share their experiences and gain insight from others’
experiences. Although talking about their feelings may unburden them of negative
feelings, infertility can be a major stressor that affects the couple’s relationships with
family and friends. Limiting their interactions to other infertile couples may be a
beginning point for addressing psychosocial needs, but, depending on where the other
MULTIPLE CHOICE
1. Which test used to diagnose the basis of infertility is done during the late follicular or
early proliferative phase of the menstrual cycle?
a. Hysterosalpingogram
b. Endometrial biopsy
, c. Laparoscopy
d. Follicle-stimulating hormone (FSH)
level
ANS: A
A hysterosalpingogram is scheduled in the late follicular or early proliferative phase to
avoid flushing potentially fertilized ovum out through a uterine tube into the peritoneal
cavity. Endometrial biopsy is generally not done for a diagnosis of infertility.
Laparoscopy usually is 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.
DIF: Cognitive Level: Knowledge REF: p. 148 | Table 8-1
OBJ: Nursing Process: Planning
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. What
information is the basis for the nurse’s response?
a. Indicating that the first sperm count
seems okay
b. Informing that only marijuana
cigarettes affect sperm count
c. Providing information about smoking
and lung cancer and its lack of effect
on sperm
d. Providing education that smoking can
reduce the quality of sperm
ANS: D
Use of tobacco, alcohol, and marijuana may affect sperm counts. Indicating that the first
sperm count seems to be okay in the first semen analysis is inaccurate. Sperm counts
vary from day to day and depend 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.
DIF: Cognitive Level: Application REF: p. 146 | Box 8-2
OBJ: Nursing Process: Diagnosis
3. A couple comes in for an infertility appointment, having attempted to get pregnant for 2
years. The woman, 37, has always had irregular menstrual cycles but is otherwise
healthy. The man has fathered two children from a previous marriage and underwent a
vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the
sperm seem to be clumped together. What additional test is needed?
, a. Testicular biopsy
b. Antisperm antibodies
c. Follicle-stimulating hormone (FSH)
level
d. Examination for testicular infection
ANS: C
The woman has irregular menstrual cycles. The scenario does not indicate that she has
had any testing related to this irregularity. Hormone analysis is performed to assess
endocrine function of the hypothalamic-pituitary-ovarian axis when menstrual cycles are
absent or irregular. Determination of blood levels of prolactin, FSH, luteinizing hormone
(LH), estradiol, progesterone, and thyroid hormones may be necessary to diagnose the
cause of irregular menstrual cycles. A testicular biopsy would be indicated only in cases
of azoospermia (no sperm cells) or severe oligospermia (low number of sperm cells).
Antisperm antibodies are produced by a man against his own sperm. This is unlikely to
be the case here, because the husband has already produced children. Examination for
testicular infection would be done before semen analysis. Furthermore, infection would
affect spermatogenesis.
DIF: Cognitive Level: Analysis REF: p. 147 OBJ: Nursing Process: Diagnosis
4. A couple is trying to cope with an infertility problem. They want to know what they can
do to preserve their emotional equilibrium. What is the basis for the nurse’s response?
a. Encourage the couple to share the
information with friends so they can
talk more about it.
b. Suggest they only discuss their
infertility problem with friends that do
not have children.
c. Provide information about local
support groups for infertile couples.
d. Suggest they initiate adoption
proceedings immediately because it is
a lengthy process.
ANS: C
Venting negative feelings may unburden the couple. A support group may provide a safe
haven for the couple to share their experiences and gain insight from others’
experiences. Although talking about their feelings may unburden them of negative
feelings, infertility can be a major stressor that affects the couple’s relationships with
family and friends. Limiting their interactions to other infertile couples may be a
beginning point for addressing psychosocial needs, but, depending on where the other
