Review Practice Exercise 3

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Practice Exercise 3

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Total Questions : 5

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Question 1:

Which of the following lifestyle modifications should a nurse emphasize to a male patient seeking to improve his sperm health?

A. Increasing hot tub usage B. Wearing tight-fitting underwear C. Limiting alcohol intake and cessation of smoking D. Engaging in high-intensity endurance exercise daily

Answer and Explanation

Choice A:

Increased hot tub usage exposes the testes to high temperatures. The scrotum normally maintains a temperature 2–4°C below core body temperature. Prolonged heat exposure impairs Sertoli cell function, disrupts spermatogenesis, and reduces sperm quality.

Choice B:

Tight-fitting underwear elevates testicular temperature, contributing to scrotal hyperthermia. Sustained heat exposure reduces sperm concentration and motility by affecting the seminiferous epithelium and hormone regulation in the testes.

Choice C:

Smoking and alcohol are well-established negative influences on sperm health. Nicotine increases oxidative stress and DNA fragmentation, while alcohol disrupts testosterone synthesis and impairs spermatogenesis. Limiting alcohol intake and quitting smoking improves sperm count, motility, and morphology.Rationale for incorrect answers

Choice D:

High-intensity endurance exercise, especially daily, elevates cortisol levels and suppresses the hypothalamic-pituitary-gonadal axis. This leads to reduced luteinizing hormone and testosterone levels, which impairs spermatogenesis and may result in oligozoospermia or azoospermia in extreme cases.

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Question 2:

A nurse is monitoring a patient undergoing IVF. What is a potential complication of controlled ovarian stimulation?

A. Hypothyroidism B. Ovarian hyperstimulation syndrome (OHSS) C. Hyperprolactinemia D. Varicocele

Answer and Explanation

Choice A:

Hypothyroidism is an endocrine disorder affecting ovulatory function and fertility but is not caused by IVF or ovarian stimulation. It is associated with high TSH (>4.0 mIU/L) and low free T4 (<0.8 ng/dL), and may contribute to menstrual irregularities and miscarriage risk.

Choice B:

OHSS is a well-known complication of IVF, triggered by excessive ovarian response to gonadotropins. Elevated VEGF levels from granulosa cells increase capillary permeability, leading to ascites, pleural effusions, and hypovolemia. Severe forms may involve electrolyte imbalance, oliguria, and thromboembolism.Rationale for incorrect answers

Choice C:

Hyperprolactinemia results from pituitary dysfunction, medication (e.g., antipsychotics), or hypothyroidism. It suppresses GnRH and impairs ovulation, but it is not a complication of IVF or gonadotropin use.

Choice D:

Varicocele is a dilation of the pampiniform plexus and is a male factor infertility cause. It does not occur in females and is unrelated to IVF procedures or ovarian stimulatio

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Question 3:

A nurse is explaining the procedure of Intrauterine Insemination (IUI) to a couple. Where is the washed and concentrated sperm typically placed during this procedure?

A. Into the fallopian tube B. Directly into the ovarian follicle C. Into the uterus D. Into the vaginal canal

Answer and Explanation

Choice A:

Direct placement into the fallopian tube refers to a different procedure called gamete intrafallopian transfer (GIFT), which is no longer commonly used due to invasiveness and lower success rates compared to IVF and IUI.

Choice B:

Placement into the ovarian follicle is not performed in any standard fertility treatment. Follicular aspiration occurs in IVF, where oocytes are retrieved from follicles—not inseminated directly.

Choice C:

In IUI, the sperm is placed directly into the uterine cavity using a sterile catheter passed through the cervix. This technique increases the number of motile sperm reaching the fallopian tubes and reduces the distance they must travel to fertilize the egg.Rationale for incorrect answers

Choice D:

Placement into the vaginal canal is the natural site during intercourse or artificial insemination via intracervical methods. However, IUI bypasses the cervix and vagina to improve fertilization chances by depositing sperm directly into the uterus.

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Question 4:

Which of the following are Assisted Reproductive Technologies (ART)? Select all that apply.

A. Intrauterine insemination (IUI) B. Clomiphene citrate C. In vitro fertilization (IVF) D. Varicocelectomy E. Intracytoplasmic sperm injection (ICSI)

Answer and Explanation

Choice A:

Intrauterine insemination (IUI) is a form of ART where washed and concentrated sperm are placed directly into the uterus to improve the chance of fertilization. It is often used in conjunction with ovulation induction.

Choice B:

Clomiphene citrate is an ovulation induction medication that stimulates the hypothalamic-pituitary-ovarian axis by blocking estrogen receptors. It is not ART because it does not involve handling of gametes or embryos.

Choice C:

In vitro fertilization (IVF) involves retrieval of oocytes, fertilization outside the body, and transfer of the embryo into the uterus. It is one of the most widely used ART methods.

Choice D:

Varicocelectomy is a surgical procedure to correct varicocele and improve sperm quality. It is a surgical treatment for male infertility but not an ART, as it does not involve assisted fertilization.

Choice E:

Intracytoplasmic sperm injection (ICSI) is a specialized form of IVF in which a single sperm is injected directly into the cytoplasm of an egg. It is used for severe male factor infertility or failed fertilization in prior IVF cycles.Rationale for incorrect answers

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Question 5:

Which of the following are important aspects of the nursing role in infertility care? Select all that apply.

A. Providing comprehensive education and counseling B. Offering emotional support and advocacy C. Coordinating care among healthcare providers D. Prescribing fertility medications E. Performing surgical sperm retrieval

Answer and Explanation

Choice A:

Nurses provide comprehensive education on fertility processes, procedures like IVF, and medication protocols. They ensure that patients understand timelines, instructions, and risks involved in treatment, improving adherence and outcomes.

Choice B:

Infertility is emotionally distressing. Nurses offer counseling, normalize emotional responses, and refer to mental health services when needed. They support individuals and couples experiencing grief, anxiety, and frustration.

Choice C:

Nurses coordinate care by scheduling tests, tracking cycle timing, and facilitating communication between reproductive endocrinologists, labs, and other providers, which is essential in time-sensitive fertility treatments.Rationale for incorrect answers

Choice D:

Prescribing fertility medications such as gonadotropins or clomiphene citrate is beyond the scope of practice for most registered nurses. This responsibility lies with physicians or advanced practice providers (e.g., nurse practitioners with prescriptive authority).

Choice E:

Surgical sperm retrieval (e.g., testicular sperm aspiration or extraction) is a urologic procedure performed by physicians, not nurses. N

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