A woman who is infertile has taken 50 mg of clomiphene citrate ...

[TVarnum]

A woman who is infertile has taken 50 mg of clomiphene citrate (Clomid) from days 5 through 9 of a cycle and has not ovulated. The nurse will anticipate that the provider will perform which action?
 
  a. Begin recombinant follicle-stimulating hormone therapy.
  b. Increase the dose to 100 mg on days 5 through 9 of her next cycle.
  c. Order clomiphene citrate to be given throughout her next cycle.
  d. Repeat the 50 mg of clomiphene citrate for 2 more cycles.

Question 2

A young woman reports not having a period for 7 months. Which test will the provider likely order first to evaluate the cause of amenorrhea in this patient?
 
  a. Pelvic ultrasound
  b. Pregnancy test
  c. Progestational challenge test
  d. Serum insulin levels

[shaikhs]

Answer to Question 1

ANS: B
If clomiphene is unsuccessful, the provider may increase the dose by 50-mg increments for 2 each cycles up to 250 mg until ovulation occurs. Recombinant FSH may be used if this fails. It is not correct to administer the drug throughout the cycle or to continue with the initial dose.

Answer to Question 2

ANS: B
When secondary amenorrhea occurs, pregnancy must be ruled out prior to performing other tests. A progestational challenge test will be performed if the patient is not pregnant. If polycystic ovarian syndrome is suspected, serum insulin levels and possibly a pelvic ultrasound will be performed.

[TVarnum]

TYSM

[olderstudent]

Excellent