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The Preconception Client

A 20-year-old nulligravida visits a family planning clinic. She states that she and her boyfriend
are planning their wedding and want to plan the spacing of their children.
1. Before beginning to counsel the client about sexuality, the nurse should first:
a. Obtain a sexual history from the client in a private setting
b. Have the client undergo a complete physical examination
c. Suggest that the clients sexual partner attend the counseling sessions
d. Discuss reproductive system anatomy and physiology with the client
2. Most authorities recommend that the nurse can best prepare to counsel clients concerning
sexuality when the nurse first has:
a. Personal experience in a sexual relationship
b. Reviewed the extensive literature on human sexuality
c. Developed an awareness of his or her own feelings, values, and attitudes related to
sexuality
d. Completed a formal educational program for preparation as a clinical specialist in
sexual counseling
3. The nurse formulates a nursing diagnosis of Knowledge Deficit related to ovulation and
fertility management due to misinformation. Which of the following statements related to
ovulation should be included in the clients teaching plan?
a. Ovulation only occurs during the menstrual period, so precautions need not be taken
only during this period
b. Women who practice natural methods of family planning usually do not know when
they have ovulated
c. Most women can tell they have ovulated by the severe pain that accompanies
ovulation
d. Most women ovulate about 2 weeks before the beginning of the next menstrual
period
4. Following a discussion about conception and fertilization, the client asks the nurse, How
long does it take for sperm to reach an ovum? What is the nurses best response?
a. Under ideal conditions, sperm can reach the ovum in 1 to 5 minutes.
b. Millions of sperm reach the ovum within an hour.
c. Thousands of sperm enter the fallopian tube within 30 minutes.
d. Only one sperm will actually fertilize the ovum, and this usually takes 48 hours.
5. The client asks the nurse, Why do people who use natural methods to prevent pregnancy
have a high failure rate? The nurses best response is based on the knowledge that natural
methods:
a. are very frustrating for both partners
b. require extensive record keeping
c. can be 100% effective if done correctly
d. depend on knowing when ovulation occurs
6. The nurse instructs the client about oral contraceptive agents. Following instruction, the
nurse knows that the client has understood the instructions from what client statement?
a. Oral contraceptives need to be used with spermacides during the first year of use.
b. Only a few minor side effects are associated with oral contraceptives.

c. Oral contraceptives work by inhibiting ovulation and changing the consistency of


cervical mucous.
d. Persons with history of thromboembolic disease can use oral contraceptives if they
are carefully monitored.
A 34-year-old multigravida is seen in the family planning clinic following the delivery of her fourth
child 6 months ago.
7. The client says that her husband objects to using rubbers (condoms) for contraception.
What is the nurses best response?
a. Most men think that its the female who doesnt like condoms.
b. Why do you think he objects?
c. A lot of men dont like to use condoms.
d. Skin condoms, rather than latex, can prevent sexually transmitted diseases.
8. The client inquires about using a diaphragm for contraception. In planning the teaching for
this client, the nurse should include which of the following?
a. The diaphragm should be removed once every 48 hours
b. Most women who use diaphragm develop symptoms of toxic shock syndrome
c. A diaphragm can be obtained without a prescription
d. The diaphragm should be left in for 6-8 hours after intercourse
9. The client asks the nurse What do men do if they want to be sterilized? The nurse should
respond that a commonly used procedure involves clamping or cutting the:
a. Epididymis
c. Ejaculatory duct
b. Seminal vesicle
d. Ductus deferens
10. Following a discussion about various sexual myths with the client, the nurse realizes that he
client needs further instruction when she says:
a. Alcohol acts as a depressant for sex.
b. Sexual intercourse should be avoided during menstruation.
c. Masturbation can be used to achieve orgasm.
d. Having an orgasm is not necessary part of a satisfactory sexual experience.
11. The nurse discusses sexual arousal and orgasm with the client. The nurse asks the client
which primary anatomic structure in the female is involved in sexual arousal and orgasm.
The nurses teaching will be considered effective if the clients answer is the:
a. Vagina
c. Mons pubis
b. Clitoris
d. Labia minora
12. In preparing for the presentation, the nurse plans to include a discussion of why foreplay
during intercourse in important. Which of the following should be included in the teaching
plan? In addition to arousing the sexual urge, foreplay helps to:
a. Relax the vaginal orifice
b. Increase vaginal secretions
c. Delay premature clitoral orgasm
d. Prevent early ejaculation in the male
13. One of the class participants asks several questions about becoming pregnant. She says
How do sperm ever manage to reach the ovum? The nurses best response is that Sperm
are propelled in the female primarily by:

a.
b.
c.
d.

Cilia in the female reproductive tract.


Movement of the sperms tail-like portion.
Peristalsis-like contractions in the cervix and uterus.
Gravity and the force generated by ejaculation.

14. One of the participants says that her sister-in-law is unable to become pregnant. The nurse
explains that one reason for the diagnosis of infertility in a female is:
a. Absence of an ovary
b. Dilated hymenal ring
c. Blocked fallopian tubes
d. Obstructed Bartholins gland duct
15. After learning about fertilization, one of the participants asks where it occurs in the body. The
nurse responds correctly that fertilization of the ovum normally occurs in the:
a. Ovary
c. Corpus luteum
b. Uterus
d. Fallopian tube
A 21-year-old client visits the obstetricians office because she thinks I might be pregnant. She
has missed one menstrual period.
16. The client tells the nurse that she wants to find out if she is pregnant. A radioimmunoassay
test is performed. The nurse instructs the client that this pregnancy test is:
a. Highly accurate within 7 days after conception
b. Identical to a home pregnancy test
c. A positive sign of pregnancy
d. Based on an antigen-antibody reaction
17. After instructing the client about the radioimmunoassay test, the nurse knows that the client
understands the instructions when she says which hormone is used for this test?
a. Estrogen
b. Luteinizing hormone
c. Follicle-stimulating hormone
d. Human chorionic gonadotrophin
18. The client reports that she has had urinary frequency, breast tenderness, and occasional
nausea. The nurse determines that the client may be experiencing signs of pregnancy
considered:
a. Presumptive
c. Positive
b. Probable
d. Pervasive
19. While waiting for the results of the pregnancy test, the client says that she has heard that
women still die during childbirth from hemorrhage. What is the nurses best response?
a. Tel the client not to worry about that right now
b. Instruct the client that maternal deaths do not occur as a result of modern technology
c. Ask the client why she would ask about death when she isnt certain she is pregnant
d. Gather additional data related to the clients concerns about pregnancy and delivery
20. The client tells the nurse that she is a junior in college and plans to marry her boyfriend in a
year. She says, A baby right now will sure affect us financially. Neither one of us wants to
quit college. What is a priority nursing diagnosis for this client at this time?
a. Knowledge Deficit related to lack of understanding about first trimester changes

b. Fear related to lack of desire to be pregnant


c. High Risk for Altered Nutrition related to the desire to conceal pregnancy
d. Anxiety related to initial encounter with the health care system

A 20-year-old nulligravida visits a family planning clinic. She states that she and her boyfriend
are planning their wedding and want to plan the spacing of their children.
21. Before beginning to counsel the client about sexuality, the nurse should first:
a. Obtain a sexual history from the client in a private setting
b. Have the client undergo a complete physical examination
c. Suggest that the clients sexual partner attend the counseling sessions
d. Discuss reproductive system anatomy and physiology with the client
22. Most authorities recommend that the nurse can best prepare to counsel clients concerning
sexuality when the nurse first has:
e. Personal experience in a sexual relationship
f. Reviewed the extensive literature on human sexuality
g. Developed an awareness of his or her own feelings, values, and attitudes related to
sexuality
h. Completed a formal educational program for preparation as a clinical specialist in
sexual counseling
23. The nurse formulates a nursing diagnosis of Knowledge Deficit related to ovulation and
fertility management due to misinformation. Which of the following statements related to
ovulation should be included in the clients teaching plan?
a. Ovulation only occurs during the menstrual period, so precautions need not be taken
only during this period
b. Women who practice natural methods of family planning usually do not know when
they have ovulated
c. Most women can tell they have ovulated by the severe pain that accompanies
ovulation
d. Most women ovulate about 2 weeks before the beginning of the next menstrual
period
24. Following a discussion about conception and fertilization, the client asks the nurse, How
long does it take for sperm to reach an ovum? What is the nurses best response?
a. Under ideal conditions, sperm can reach the ovum in 1 to 5 minutes.
b. Millions of sperm reach the ovum within an hour.
c. Thousands of sperm enter the fallopian tube within 30 minutes.
d. Only one sperm will actually fertilize the ovum, and this usually takes 48 hours.
25. The client asks the nurse, Why do people who use natural methods to prevent pregnancy
have a high failure rate? The nurses best response is based on the knowledge that natural
methods:
a. are very frustrating for both partners
b. require extensive record keeping
c. can be 100% effective if done correctly
d. depend on knowing when ovulation occurs

26. The nurse instructs the client about oral contraceptive agents. Following instruction, the
nurse knows that the client has understood the instructions from what client statement?
a. Oral contraceptives need to be used with spermacides during the first year of use.
b. Only a few minor side effects are associated with oral contraceptives.
c. Oral contraceptives work by inhibiting ovulation and changing the consistency of
cervical mucous.
d. Persons with history of thromboembolic disease can use oral contraceptives if they
are carefully monitored.
A 34-year-old multigravida is seen in the family planning clinic following the delivery of her fourth
child 6 months ago.
27. The client says that her husband objects to using rubbers (condoms) for contraception.
What is the nurses best response?
a. Most men think that its the female who doesnt like condoms.
b. Why do you think he objects?
c. A lot of men dont like to use condoms.
d. Skin condoms, rather than latex, can prevent sexually transmitted diseases.
28. The client inquires about using a diaphragm for contraception. In planning the teaching for
this client, the nurse should include which of the following?
a. The diaphragm should be removed once every 48 hours
b. Most women who use diaphragm develop symptoms of toxic shock syndrome
c. A diaphragm can be obtained without a prescription
d. The diaphragm should be left in for 6-8 hours after intercourse
29. The client asks the nurse What do men do if they want to be sterilized? The nurse should
respond that a commonly used procedure involves clamping or cutting the:
a. Epididymis
c. Ejaculatory duct
b. Seminal vesicle
d. Ductus deferens
30. Following a discussion about various sexual myths with the client, the nurse realizes that he
client needs further instruction when she says:
a. Alcohol acts as a depressant for sex.
b. Sexual intercourse should be avoided during menstruation.
c. Masturbation can be used to achieve orgasm.
d. Having an orgasm is not necessary part of a satisfactory sexual experience.
31. The nurse discusses sexual arousal and orgasm with the client. The nurse asks the client
which primary anatomic structure in the female is involved in sexual arousal and orgasm.
The nurses teaching will be considered effective if the clients answer is the:
a. Vagina
c. Mons pubis
b. Clitoris
d. Labia minora
32. In preparing for the presentation, the nurse plans to include a discussion of why foreplay
during intercourse in important. Which of the following should be included in the teaching
plan? In addition to arousing the sexual urge, foreplay helps to:
a. Relax the vaginal orifice
b. Increase vaginal secretions
c. Delay premature clitoral orgasm
d. Prevent early ejaculation in the male

33. One of the class participants asks several questions about becoming pregnant. She says
How do sperm ever manage to reach the ovum? The nurses best response is that Sperm
are propelled in the female primarily by:
a. Cilia in the female reproductive tract.
b. Movement of the sperms tail-like portion.
c. Peristalsis-like contractions in the cervix and uterus.
d. Gravity and the force generated by ejaculation.
34. One of the participants says that her sister-in-law is unable to become pregnant. The nurse
explains that one reason for the diagnosis of infertility in a female is:
a. Absence of an ovary
b. Dilated hymenal ring
c. Blocked fallopian tubes
d. Obstructed Bartholins gland duct
35. After learning about fertilization, one of the participants asks where it occurs in the body. The
nurse responds correctly that fertilization of the ovum normally occurs in the:
a. Ovary
c. Corpus luteum
b. Uterus
d. Fallopian tube
A 21-year-old client visits the obstetricians office because she thinks I might be pregnant. She
has missed one menstrual period.
36. The client tells the nurse that she wants to find out if she is pregnant. A radioimmunoassay
test is performed. The nurse instructs the client that this pregnancy test is:
a. Highly accurate within 7 days after conception
b. Identical to a home pregnancy test
c. A positive sign of pregnancy
d. Based on an antigen-antibody reaction
37. After instructing the client about the radioimmunoassay test, the nurse knows that the client
understands the instructions when she says which hormone is used for this test?
a. Estrogen
b. Luteinizing hormone
c. Follicle-stimulating hormone
d. Human chorionic gonadotrophin
38. The client reports that she has had urinary frequency, breast tenderness, and occasional
nausea. The nurse determines that the client may be experiencing signs of pregnancy
considered:
a. Presumptive
c. Positive
b. Probable
d. Pervasive
39. While waiting for the results of the pregnancy test, the client says that she has heard that
women still die during childbirth from hemorrhage. What is the nurses best response?
a. Tel the client not to worry about that right now
b. Instruct the client that maternal deaths do not occur as a result of modern technology
c. Ask the client why she would ask about death when she isnt certain she is pregnant
d. Gather additional data related to the clients concerns about pregnancy and delivery

40. The client tells the nurse that she is a junior in college and plans to marry her boyfriend in a
year. She says, A baby right now will sure affect us financially. Neither one of us wants to
quit college. What is a priority nursing diagnosis for this client at this time?
a. Knowledge Deficit related to lack of understanding about first trimester changes
b. Fear related to lack of desire to be pregnant
c. High Risk for Altered Nutrition related to the desire to conceal pregnancy
d. Anxiety related to initial encounter with the health care system