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Test Prep NCLEX-PN Exam
National Council Licensure Examination(NCLEX-PN) (Page 34 )

Updated On: 30-Jan-2026
Page 34 of 204
PDF with 1015 Questions

When a client who is 25 years of age asks the nurse when she should seek fertility counseling, the best response by the nurse is ______________.

  1. “Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse.”
  2. “Fertility couseling should be sought when you have not been able to conceive after 6-9 months of unprotected intercourse.”
  3. “The average time it takes someone your age to conceive is 51⁄2 months, so if you haven’t conceived by then, we can refer you.”
  4. “We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn’t happen within a year.”

Answer(s): D

Explanation:

The guidelines for a fertility workup are to refer after the couple has not conceived after one year of unprotected intercourse. So, Choice “Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse.” is technically correct, but it doesn’t consider the immediate need for the couple to have some counseling.
Choice “We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn’t happen within a year.” is the best answer because it gives the couple guidance now and the referral at the appropriate time.
If the woman is over the age of 35, an earlier referral, at six to nine months of unprotected intercourse, is appropriate.

It is true that the average time it takes a 25-year-old woman to conceive is 5.3 months, but that does not address the concern the client is expressing. Choice “We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn’t happen within a year.” is still the most caring and correct answer.
Couples conceive within the first month of unprotected intercourse 20% of the time.



When a couple experiencing infertility presents for a fertility workup, which of the following procedures should the nurse prepare the couple to have first?

  1. hysterosalpingography
  2. semen analysis
  3. endometrial biopsy
  4. transvaginal ultrasound

Answer(s): B

Explanation:

Because semen analysis is the least invasive of the tests listed and because in 35% of the cases the infertility is related to a male factor, semen analysis should be one of the first diagnostic tests performed.
Hysterosalpingography fills the uterus and fallopian tubes with a radiopaque substance that can be seen with an X ray. It demonstrates tubal patency or any distortion of the uterine cavity.
Endometrial biopsy provides information about the effects of progesterone after ovulation and the endometrial receptivity.
Transvaginal ultrasound is mostly used in the treatment of infertility. For diagnosis it allows the endocrinologist to evaluate the developing follicle, assess oocyte maturity, and diagnose luteal phase defects.
Hysterosalpingography, endometrial biopsy and transvaginal ultrasound are more invasive, require greater expertise to evaluate and treat, and are more costly.
If the semen analysis is normal, the couple can expect to progress through these tests as well.



If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?

  1. retrograde ejaculation
  2. decreased plasma testosterone
  3. hypertrophy of testicles
  4. state of euphoria

Answer(s): B

Explanation:

Untreated chronic renal failure causes decreased testosterone levels, atrophy of testicles, and decreased spermatogenesis.
Retrograde ejaculation is not a complication of chronic renal failure. It is a complication of transurethral resection of the prostate.
In chronic renal failure, the testicles atrophy; they do not hypertrophy. Chronic renal failure produces a state of depression, not euphoria.



When an elder client asks the nurse whether he will be capable of sexual activity in old age, the best response by the nurse is ______________.

  1. “Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age- related changes.”
  2. “If you haven’t been sexually active throughout your life, you will not be able to participate in sexual activity in old age.”
  3. “When intercourse isn’t possible, many of your sexual needs can be met through intimacy and touch.”
  4. “You might find it takes longer for you to achieve an erection, but you can maintain it for a longer time.”

Answer(s): A

Explanation:

To provide the best response, the nurse must identify what the elder is asking. Concern is being expressed about whether elders can engage in sexual activity.
The most therapeutic response by the nurse is Choice “Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age-related changes.”. In this choice, the nurse acknowledges that elders can physically engage in sexual activity and have no psychological barriers to the same.
All of the other choices contain facts but are not the best initial response. Choice “Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age-related changes.” opens the conversation for the expression of further concerns about sexual issues.
Choice “If you haven’t been sexually active throughout your life, you will not be able to participate in sexual activity in old age.” is true; past sexual function is predictive of sexual function in elder adults. An elder adult must have been sexually active as a younger adult to engage in intercourse in old age. This does not mean, however, that the elder adult cannot experience sexual intimacy in other ways.
The need for intimacy is especially important for elder adults. If they have lost meaningful relationships or are having difficulty with intercourse, they might be able to experience intimacy through touch. As males age, they find it takes longer to achieve an erection, but that when it’s achieved, the erection lasts longer. In addition, elder males require direct stimulation to achieve an erection.



The teaching plan for gay or lesbian parents who want to disclose their homosexuality to their children should include all of the following instructions except ______________.

  1. disclose the information before the child knows or suspects
  2. be comfortable with your sexual preference first
  3. have the discussion in a quiet place where interruptions are unlikely
  4. explain how your relationship with the child changes because of the discussion

Answer(s): D

Explanation:

Children of gay and lesbian parents should be reassured that their relationship with their parent will not change because of the discussion.
Choices “disclose the information before the child knows or suspects”, “be comfortable with your sexual preference first” and “have the discussion in a quiet place where interruptions are unlikely” are all important aspects of the disclosure.
As children grow, they might have additional questions. Preschool children might not understand the absence of a father or mother. Schoolage children might be troubled that their family isn’t like their friends’ families.
Adolescents might become reluctant to discuss it or accept it even though they expressed acceptance at an earlier age. In general the earlier children are informed, the easier it is for them to accept and assimilate the information. Nurses need to be nonjudgmental and learn how to express and accept these differences so that they can keep the nurse-child-family relationship intact.



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