33. A 30-year-old client has been trying to conceive for about a year. A physician prescribes clomiphene citrate. A nurse is teaching the client about the drug's potential side effects. Which statement, if made by the client, would indicate that the teaching was effective?
. "I have a possibility of having more than one fetus."
. "I have an increased chance of spontaneous abortion."
. "I have an increased risk of Down syndrome."
. "I should take this medication throughout my pregnancy."
Test-Taking Tip
Drugs used for fertility treatments have an increased risk of multiple gestation. Eliminate the options that suggest the drugs increase the chance of teratogenic effects (e.g., miscarriage, trisomy 21).
Content Area: Women's Health, Family Planning; Integrated Process: Nursing Process, Evaluation; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is correct because clomiphene citrate may result in multiple births (e.g., twins, triplets) due to the stimulation of ovulation, when more than one egg may be released and fertilized. Answer 2 is incorrect because clomiphene citrate stimulates ovulation; it does not result in an increased risk of miscarriage. Answer 3 is incorrect because clomiphene citrate stimulates ovulation; it does not have an effect on the incidence of spontaneous trisomy 21. Answer 4 is incorrect because clomiphene citrate must not be used during pregnancy.