A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first?

Correct Answer: B

Rationale: The correct answer is B because it aligns with standard medical guidelines. Couples are typically considered infertile after 1 year of trying to conceive without success. This timeframe allows for natural variations in fertility and is when medical intervention is usually recommended. A: Ascertain antibiotic use is not the first step as it may not be directly related to infertility. C: Referring to pelvic inflammatory disease assumes a diagnosis without proper evaluation. D: Incorrect timeline of 3 months and immediate referral to a fertility expert is premature without giving time for natural conception.

Correct Answer: A

Rationale: The correct answer is A: Ovarian cancer often does not show symptoms until late stages. This is true because ovarian cancer is often asymptomatic in the early stages, making it difficult to detect. By the time symptoms appear, the cancer is usually at an advanced stage. Choice B is incorrect because the Pap smear test is used to detect cervical cancer, not ovarian cancer. Choice C is incorrect because while some high-risk women may benefit from periodic ultrasound screenings, it is not recommended for all women at high risk. Choice D is incorrect because there is no specific annual screening recommendation for ovarian cancer in women over the age of 50.

Correct Answer: D

Rationale: I must clarify that the correct answer should be A: Decreased estrogen levels. In the peri-menopausal stage, a woman's ovaries produce less estrogen, leading to symptoms like hot flashes, night sweats, and vaginal dryness. Option B is incorrect because increased estrogen levels are not typical during peri-menopause. Option C is vague and does not specifically address the primary reason for the symptoms. Option D, psychological stress, may exacerbate symptoms but is not the primary cause in this scenario.

Correct Answer: B

Rationale: The correct answer is B: A large, irregular, and tender uterus. Fibroids are non-cancerous growths that can cause heavy menstrual bleeding and frequent urination. During the pelvic examination, the nurse would expect to find a large uterus due to the presence of fibroids. The irregular shape is indicative of the growths, and tenderness may be present due to inflammation or pressure on surrounding tissues. Choices A, C, and D do not align with the typical characteristics of fibroids, making them incorrect. A smooth, enlarged uterus (A) is not characteristic of fibroids. A firm, mobile, and non-tender uterus (C) is more indicative of a normal uterus. A hard, irregular, fixed uterus (D) may suggest a different pathology, such as endometriosis.

Correct Answer: B

Rationale: The correct answer is B: Salts. During filtration in the kidneys, salts (such as sodium, potassium, and chloride) are removed from the blood to maintain proper electrolyte balance. Carbon dioxide (A) is primarily eliminated through respiration, not filtration by the kidneys. Oxygen (C) is essential for cellular respiration and is not typically removed by the kidneys. Red blood cells (D) are not filtered out by the kidneys unless there is a medical condition affecting the kidneys' function. Thus, the correct answer is B as salts are one of the key substances removed during kidney filtration to regulate electrolyte levels in the body.