Chapter 09: Infertility
MULTIPLE CHOICE
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
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.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
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? NURSINGTB.COM
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.”
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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
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
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.
PTS: 1 DIF: Cognitive Level: Analyze
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
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 suN URrtSgIroNupG. TI’Bll .giCveOyMou some names.”
ppo
d. “Start adoption proceedings immediately, because adopting an infant can be very
difficult.”
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. However, depending on where the other couple is in their own recovery
process, limiting their interactions may not be of assistance to them. Telling the couple to
start adoption proceedings immediately is not supportive of the psychosocial needs of this
couple and may be detrimental to their well-being.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
5. A couple have arrived for their preprocedural In vitro fertilization–embryo transfer
(IVF-ET) interview. Which explanation regarding the procedure is most accurate?
a. “The procedure begins with collecting eggs from the woman’s ovaries.”
b. “A donor embryo will be transferred into the woman’s uterus.”
c. “Donor sperm will be used to inseminate the woman.”
d. “Don’t worry about the technical stuff; that’s what we are here for.”
MULTIPLE CHOICE
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
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.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
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? NURSINGTB.COM
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.”
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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
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
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.
PTS: 1 DIF: Cognitive Level: Analyze
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
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 suN URrtSgIroNupG. TI’Bll .giCveOyMou some names.”
ppo
d. “Start adoption proceedings immediately, because adopting an infant can be very
difficult.”
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. However, depending on where the other couple is in their own recovery
process, limiting their interactions may not be of assistance to them. Telling the couple to
start adoption proceedings immediately is not supportive of the psychosocial needs of this
couple and may be detrimental to their well-being.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
5. A couple have arrived for their preprocedural In vitro fertilization–embryo transfer
(IVF-ET) interview. Which explanation regarding the procedure is most accurate?
a. “The procedure begins with collecting eggs from the woman’s ovaries.”
b. “A donor embryo will be transferred into the woman’s uterus.”
c. “Donor sperm will be used to inseminate the woman.”
d. “Don’t worry about the technical stuff; that’s what we are here for.”
