Question 1

A patient with infertility will begin taking menotropins [Repronex]. The nurse will evaluate this patient's history to determine whether the:

Accepted Answer

A)  patient has a history of hyperinsulinemia. 
B)  patient has excessive prolactin secretion. 
C)  patient's pituitary can produce LH and FSH. 
D)  patient's ovaries are capable of responding to gonadotropins. 
A)  patient has a history of hyperinsulinemia. 
B)  patient has excessive prolactin secretion. 
C)  patient's pituitary can produce LH and FSH. 
D)  patient's ovaries are capable of responding to gonadotropins. D

Question 2

A nurse is explaining to a nursing student how clomiphene [Clomid] works to improve fertility. Which statement by the student indicates a need for further teaching?

Accepted Answer

A)  "Clomiphene blocks estrogen receptors to cause increased secretion of gonadotropins." 
B)  "Clomiphene directly stimulates the ovary, causing follicular maturation and ovulation." 
C)  "If follicular maturation is the only result of clomiphene therapy, human chorionic gonadotropin may be given." 
D)  "If the pituitary gland cannot produce LH and FSH, clomiphene will not be effective." 
A)  "Clomiphene blocks estrogen receptors to cause increased secretion of gonadotropins." 
B)  "Clomiphene directly stimulates the ovary, causing follicular maturation and ovulation." 
C)  "If follicular maturation is the only result of clomiphene therapy, human chorionic gonadotropin may be given." 
D)  "If the pituitary gland cannot produce LH and FSH, clomiphene will not be effective." B

Question 3

A patient who has endometriosis has been unable to conceive. She asks the nurse about medications to treat the condition. What will the nurse tell the patient?

Accepted Answer

A)  Combination oral contraceptives are effective for improving fertility. 
B)  Gonadotropin-releasing hormone agonists are used for long-term treatment. 
C)  Nonsteroidal anti-inflammatory drugs are second-line agents for treating pain. 
D)  Pharmacologic agents used to treat endometriosis do not enhance fertility. 
A)  Combination oral contraceptives are effective for improving fertility. 
B)  Gonadotropin-releasing hormone agonists are used for long-term treatment. 
C)  Nonsteroidal anti-inflammatory drugs are second-line agents for treating pain. 
D)  Pharmacologic agents used to treat endometriosis do not enhance fertility. D

Question 4

A patient with polycystic ovary syndrome (PCOS) asks the nurse what she can do to improve her chances of getting pregnant. Which statement by the patient indicates a need for further teaching?

Accepted Answer

A)  "Clomiphene will help induce ovulation but will not treat the other symptoms of polycystic ovarian disease." 
B)  "If I lose weight, my infertility and irregular periods could resolve without medications." 
C)  "Metformin improves insulin sensitivity and reduces male hormone levels." 
D)  "Spironolactone, which reduces androgens and facial hair, is helpful if I'm trying to conceive." 
A)  "Clomiphene will help induce ovulation but will not treat the other symptoms of polycystic ovarian disease." 
B)  "If I lose weight, my infertility and irregular periods could resolve without medications." 
C)  "Metformin improves insulin sensitivity and reduces male hormone levels." 
D)  "Spironolactone, which reduces androgens and facial hair, is helpful if I'm trying to conceive."

Question 5

A patient receiving menotropins [Repronex] for infertility comes to the clinic for evaluation on the ninth day of treatment. Her serum estrogen level is 200 pg/mL per maturing follicle. An ultrasound reveals that follicles have enlarged to 22 mm. The patient complains of left lower abdominal pain. What will the nurse do?

Accepted Answer

A)  Administer human chorionic gonadotropin, because the ovary has ripened. 
B)  Assess for abdominal fullness and distension and auscultate lung sounds. 
C)  Inform the patient that the pain is associated with ovulation. 
D)  Recommend ibuprofen for pain and administer the next dose of menotropins. 
A)  Administer human chorionic gonadotropin, because the ovary has ripened. 
B)  Assess for abdominal fullness and distension and auscultate lung sounds. 
C)  Inform the patient that the pain is associated with ovulation. 
D)  Recommend ibuprofen for pain and administer the next dose of menotropins.

Question 6

A patient with endometriosis is being treated with the gonadotropin-releasing hormone (GnRH) agonist leuprolide [Lupron Depot]. A nurse is teaching the patient about the drug. Which statement by the patient indicates understanding of the teaching?

Accepted Answer

A)  "I can continue to take the medication if I get pregnant." 
B)  "I can expect the medication to cure my symptoms." 
C)  "I may have menopausal-like symptoms when taking this medication." 
D)  "I will need to take the medication for several years." 
A)  "I can continue to take the medication if I get pregnant." 
B)  "I can expect the medication to cure my symptoms." 
C)  "I may have menopausal-like symptoms when taking this medication." 
D)  "I will need to take the medication for several years."

Question 7

A patient receives an injection of human chorionic gonadotropin after follicular maturation has been induced with another agent. The patient comes to the clinic 2 days later complaining of headache, irritability, and fatigue. What will the nurse do?

Accepted Answer

A)  Perform a urine pregnancy test. 
B)  Reassure the patient that these are known adverse effects. 
C)  Request an order for a serum estrogen level. 
D)  Review the patient's abdominal ultrasound. 
A)  Perform a urine pregnancy test. 
B)  Reassure the patient that these are known adverse effects. 
C)  Request an order for a serum estrogen level. 
D)  Review the patient's abdominal ultrasound.

Question 8

An infertile couple begins treatment with menotropins. To enhance the therapeutic effects of the medication, the nurse will advise the patients to have intercourse:

Accepted Answer

A)  before hCG injection and the following 2 to 3 days. 
B)  the morning of the hCG injection and later that evening. 
C)  the evening of the injection and the following day. 
D)  the evening of the injection and the following morning. 
A)  before hCG injection and the following 2 to 3 days. 
B)  the morning of the hCG injection and later that evening. 
C)  the evening of the injection and the following day. 
D)  the evening of the injection and the following morning.

Question 9

A patient is being treated for infertility. An examination reveals cervical mucus that is scant, thick, and sticky. The nurse suspects that the patient has been taking which medication?

Accepted Answer

A)  Clomiphene [Clomid] 
B)  Estrogen 
C)  Follicle-stimulating hormone (FSH) 
D)  Progesterone 
A)  Clomiphene [Clomid] 
B)  Estrogen 
C)  Follicle-stimulating hormone (FSH) 
D)  Progesterone

Question 10

An infertile patient has received two 5-day courses of clomiphene [Clomid] to help her conceive. An ultrasound 1 week after the last dose reveals that follicular maturation has occurred without ovulation. The nurse expects the next step for this patient to be:

Accepted Answer

A)  administration of human chorionic gonadotropin (hCG). 
B)  an order for cabergoline to be given twice weekly. 
C)  evaluation of ovarian and pituitary function. 
D)  repeating clomiphene once daily for 5 days. 
A)  administration of human chorionic gonadotropin (hCG). 
B)  an order for cabergoline to be given twice weekly. 
C)  evaluation of ovarian and pituitary function. 
D)  repeating clomiphene once daily for 5 days.

Question 11

The nurse counseling a couple who cannot conceive learns that female infertility problems have been ruled out. What will the nurse expect to tell this couple?

Accepted Answer

A)  "If medication is necessary for male infertility, treatment will last a few months." 
B)  "Male infertility is usually treatable with a combination of medications." 
C)  "Most male infertility is not linked to known endocrine disorders." 
D)  "Treatment with sildenafil [Viagra] will be necessary to improve fertility." 
A)  "If medication is necessary for male infertility, treatment will last a few months." 
B)  "Male infertility is usually treatable with a combination of medications." 
C)  "Most male infertility is not linked to known endocrine disorders." 
D)  "Treatment with sildenafil [Viagra] will be necessary to improve fertility."

Exam 63: Drug Therapy of Infertility

A patient with infertility will begin taking menotropins [Repronex]. The nurse will evaluate this patient's history to determine whether the:

A nurse is explaining to a nursing student how clomiphene [Clomid] works to improve fertility. Which statement by the student indicates a need for further teaching?

A patient who has endometriosis has been unable to conceive. She asks the nurse about medications to treat the condition. What will the nurse tell the patient?

A patient with polycystic ovary syndrome (PCOS) asks the nurse what she can do to improve her chances of getting pregnant. Which statement by the patient indicates a need for further teaching?

A patient with endometriosis is being treated with the gonadotropin-releasing hormone (GnRH) agonist leuprolide [Lupron Depot]. A nurse is teaching the patient about the drug. Which statement by the patient indicates understanding of the teaching?

A patient receives an injection of human chorionic gonadotropin after follicular maturation has been induced with another agent. The patient comes to the clinic 2 days later complaining of headache, irritability, and fatigue. What will the nurse do?

An infertile couple begins treatment with menotropins. To enhance the therapeutic effects of the medication, the nurse will advise the patients to have intercourse:

A patient is being treated for infertility. An examination reveals cervical mucus that is scant, thick, and sticky. The nurse suspects that the patient has been taking which medication?

An infertile patient has received two 5-day courses of clomiphene [Clomid] to help her conceive. An ultrasound 1 week after the last dose reveals that follicular maturation has occurred without ovulation. The nurse expects the next step for this patient to be:

The nurse counseling a couple who cannot conceive learns that female infertility problems have been ruled out. What will the nurse expect to tell this couple?

Orientation to Pharmacology

Application of Pharmacology in Nursing Practice

Drug Regulation, Development, Names, and Information

Pharmacokinetics

Pharmacodynamics

Drug Interactions

Adverse Drug Reactions and Medication Errors

Individual Variation in Drug Responses

Drug Therapy During Pregnancy and Breast-Feeding

Drug Therapy in Pediatric Patients

Drug Therapy in Geriatric Patients

Basic Principles of Neuropharmacology

Physiology of the Peripheral Nervous System

Muscarinic Agonists and Antagonists

Cholinesterase Inhibitors and Their Use in Myasthenia Gravis

Drugs That Block Nicotinic Cholinergic Transmission: Neuromuscular Blocking Agents

Adrenergic Agonists

Adrenergic Antagonists

Indirect-Acting Antiadrenergic Agents

Introduction to Central Nervous System Pharmacology

Drugs for Parkinson Disease

Drugs for Alzheimers Disease

Drugs for Multiple Sclerosis

Drugs for Seizure Disorders

Drugs for Muscle Spasm and Spasticity

Local Anesthetics

General Anesthetics

Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics

Pain Management in Patients With Cancer

Drugs for Headache

Antipsychotic Agents and Their Use in Schizophrenia

Antidepressants

Drugs for Bipolar Disorder

Sedative-Hypnotic Drugs

Management of Anxiety Disorders

Central Nervous System Stimulants and Attention-Deficithyperactivity Disorder

Drug Abuse I: Basic Considerations

Drug Abuse II: Alcohol

Drug Abuse III: Nicotine and Smoking

Drug Abuse IV: Major Drugs of Abuse Other Than Alcohol and Nicotine

Diuretics

Agents Affecting the Volume and Ion Content of Body Fluids

Review of Hemodynamics

Drugs Acting on the Renin-Angiotensin-Aldosterone System

Calcium Channel Blockers

Vasodilators

Drugs for Hypertension

Drugs for Heart Failure

Antidysrhythmic Drugs

Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

Drugs for Angina Pectoris

Anticoagulant, Antiplatelet, and Thrombolytic Drugs

Management of St-Elevation Myocardial Infarction

Drugs for Hemophilia

Drugs for Deficiency Anemias

Hematopoietic Agents

Drugs for Diabetes Mellitus

Drugs for Thyroid Disorders

Drugs Related to Hypothalamic and Pituitary Function

Drugs for Disorders of the Adrenal Cortex

Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications

Birth Control

Drugs That Affect Uterine Function

Androgens

Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia

Review of the Immune System

Childhood Immunization

Immunosuppressants

Antihistamines