Lisa, a 35-year-old practicing attorney and marathon runner, presents to the clinic with a complaint of irregular menses. She tells the nurse, 'My husband and I want to start a family but it hasn't happened yet. We stopped using birth control 6 months ago. Should we be concerned?' What is the nurse's best response?

Correct Answer: C

Rationale: The correct answer is C because it acknowledges the potential impact of aging and extreme exercise on fertility, prompting further evaluation by the healthcare provider. Lisa's age and intense exercise regimen are important factors to consider since they can affect her ability to conceive. By addressing her concerns during the visit, the nurse can gather more information, assess potential fertility issues, and provide appropriate guidance or referrals. Choice A is incorrect because it dismisses Lisa's concerns without addressing potential underlying issues. Choice B is incorrect as it sets a timeline for infertility diagnosis that is generally accepted after 1 year of unprotected intercourse for women under 35 years old, but Lisa's age and lifestyle may warrant earlier evaluation. Choice D is incorrect as it oversimplifies the issue by suggesting only a change in exercise routine as a solution without considering other potential factors impacting fertility.

Correct Answer: C

Rationale: The correct answer is C: Maintain a balanced diet and healthy weight. This suggestion is crucial for improving fertility as it promotes overall health, hormonal balance, and reproductive function in both partners. A balanced diet provides essential nutrients for reproductive health, while maintaining a healthy weight reduces the risk of infertility related to obesity or underweight. Option A is incorrect as excessive protein intake can negatively impact fertility. Option B is incorrect as excessive rigorous exercise may disrupt hormonal balance and affect fertility. Option D is incorrect as proper hydration is essential for reproductive health and reducing water consumption is not recommended for fertility improvement.

Correct Answer: B

Rationale: The correct answer is B because smoking has been proven to negatively impact male fertility by reducing sperm count, motility, and morphology. Nicotine and other harmful chemicals in cigarettes can damage sperm DNA and affect reproductive health. Choice A is incorrect as smoking actually decreases testosterone levels. Choice C is incorrect as smoking does have a significant impact on male reproductive health. Choice D is incorrect because smoking alone can still affect male fertility without the need for alcohol use.

Correct Answer: A

Rationale: The correct answer is A because intrauterine insemination (IUI) involves placing washed sperm directly into the uterus, increasing the chances of fertilization. This method bypasses potential obstacles in the reproductive tract, aiding sperm in reaching the egg. Choice B is incorrect because IUI is not primarily used to treat structural abnormalities in the uterus but rather to facilitate fertilization. Choice C is incorrect as IUI does not guarantee fertilization since other factors can still affect the success of conception. Choice D is incorrect because ovulation tracking is still important in IUI to ensure optimal timing for the procedure.

Correct Answer: B

Rationale: The correct answer is B: Progesterone injections support the uterine lining for implantation and pregnancy maintenance. Progesterone is essential for preparing the uterus for implantation and maintaining a pregnancy. After embryo transfer, progesterone helps thicken the uterine lining, making it more receptive to the embryo for successful implantation. Other choices are incorrect: A is incorrect because progesterone does not affect the number of eggs released in future cycles; C is incorrect because progesterone does not prevent ovarian cyst formation; D is incorrect because while progesterone can help alleviate some pregnancy symptoms, its primary role is in supporting the uterine lining for pregnancy.