An Orthodox Jewish couple is seeking infertility counseling. The woman states that her menstrual cycle is 21 days long. After testing, no physical explanation is found for the infertility. Which of the following may explain why the woman has been unable to conceive?

Correct Answer: D

Rationale: The correct answer is option D: "Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends." This practice, known as the laws of niddah in Jewish tradition, involves abstaining from sexual intercourse during menstruation and for a specified period afterward. This can impact conception because it restricts the timing of intercourse to specific phases of the woman's menstrual cycle when conception is less likely to occur. Option A is incorrect because a kosher diet, when followed properly, should provide the essential nutrients needed for reproductive health. Option B is incorrect as the positions allowed during intercourse are not a factor in infertility. Option C is also incorrect as there is no scientific evidence to suggest that Orthodox Jewish couples have a higher rate of infertility due to genetic diseases specific to their community. In an educational context, it is essential for healthcare providers to be knowledgeable about cultural practices and beliefs that may impact a couple's fertility journey. Understanding the religious practices of Orthodox Jewish couples, such as the laws of niddah, can help healthcare professionals provide more tailored and effective counseling and support for couples experiencing infertility within this community. It highlights the importance of culturally competent care in addressing infertility issues across diverse populations.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Ferning capacity. The physician is evaluating the woman's cervical mucus for estrogen levels to support sperm motility. Ferning capacity refers to the formation of a fern-like pattern in dried cervical mucus, indicating the presence of estrogen, which helps sperm survive and swim effectively. Option B) Basal body temperature is used to track ovulation by monitoring subtle temperature changes, not to assess cervical mucus quality. Option C) Culposcopy is a diagnostic procedure to visually examine the cervix and vagina, not to assess cervical mucus quality. Option D) Hysterotomy is a surgical procedure involving incisions into the uterus, not a test for evaluating cervical mucus estrogen levels. Educationally, understanding the different tests and procedures used in infertility assessments is crucial for both medical professionals and patients seeking fertility assistance. Knowing the specific purposes and applications of each test helps in accurate diagnosis and treatment planning for infertility issues.

Correct Answer: B

Rationale: The correct answer is B) he could not possibly have cystic fibrosis. This is because cystic fibrosis is an autosomal recessive genetic disorder that primarily affects the lungs and digestive system. It does not directly cause male infertility by inhibiting sperm production. The male partner's infertility is likely due to another unrelated factor. Option A is incorrect because the man can still have cystic fibrosis even if he appears healthy. C) Men with cystic fibrosis often have no epididymis is incorrect as cystic fibrosis does not directly cause absence of the epididymis. D) The expressivity of cystic fibrosis is variable is also incorrect as it refers to the range of symptoms that may be present in individuals with the same genetic condition, which is not relevant to the infertility issue in this case. In an educational context, it is important to understand the genetic basis of cystic fibrosis and its effects on the body. This question highlights the need for a comprehensive understanding of genetic disorders and their implications on reproductive health. It also underscores the importance of considering all possible factors when investigating infertility in couples.

Correct Answer: C

Rationale: The correct answer is C) The woman should take oral terbutaline every 2 hours for the next day. This response indicates successful teaching about care following chorionic villus sampling (CVS) because terbutaline is commonly prescribed to prevent preterm labor after the procedure. By taking terbutaline as instructed, the woman can help reduce the risk of contractions and premature birth. Option A) If the baby stops moving, the woman should immediately go to the hospital, is incorrect because fetal movement is not directly related to care following CVS. It is more indicative of fetal well-being. Option B) The woman should take oral terbutaline every 2 hours for the next day, is incorrect because taking terbutaline every 2 hours is not a standard recommendation and could lead to potential overdose or adverse effects. Option D) If the woman starts to bleed or to contract, is incorrect because while bleeding or contractions are potential complications following CVS, the immediate response should involve contacting the healthcare provider rather than self-medicating with terbutaline. In an educational context, it is crucial for nurses to provide clear and accurate instructions to patients undergoing CVS to ensure their safety and well-being. Teaching about post-procedural care helps patients understand what to expect and how to respond to potential complications effectively. It is essential for nurses to reinforce proper medication administration and when to seek medical attention to promote positive outcomes for patients.

Correct Answer: A

Rationale: The correct response for the nurse to make in this scenario is option A) Because Duchenne muscular dystrophy is inherited through the woman. This response is appropriate because Duchenne muscular dystrophy is an X-linked recessive disorder, meaning the gene responsible for the condition is located on the X chromosome. Since males have only one X chromosome (inherited from their mother), they are more likely to be affected by X-linked recessive disorders like Duchenne muscular dystrophy. Females, on the other hand, have two X chromosomes, so they would need to inherit the defective gene from both parents to be affected. Option B) advising the individual to see a genetic counselor is a valid response as well, as genetic counseling can provide more personalized information and guidance based on the individual's specific situation and family history. Option C) stating that Duchenne muscular dystrophy usually occurs as a spontaneous mutation and is unlikely that the fetus is affected is incorrect. While spontaneous mutations can occur, Duchenne muscular dystrophy is primarily an inherited genetic condition. Option D) indicating that the child could acquire Duchenne muscular dystrophy only if both parents carry the gene and advising to check the husband's family history is incorrect as it oversimplifies the inheritance pattern of X-linked recessive disorders like Duchenne muscular dystrophy. In an educational context, it is crucial for healthcare professionals to have a deep understanding of genetic disorders and their inheritance patterns to provide accurate information and support to individuals and families. By explaining the correct inheritance pattern of Duchenne muscular dystrophy, nurses can empower individuals to make informed decisions about genetic testing, family planning, and seeking appropriate medical care.