Mrs. Savitri, a 23 years old female was married 11 years ago. Even after regular sexual act without using any contraceptive device, she is failure to conceive what will be the diagnosis of mrs. Savitri?

1. A

   Secondary infertility

2. B

   Primary amenorrhea

3. C

   Primary infertility

4. D

   Secondary amenorrhea

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

• Primary infertility is defined as the inability of a couple to ever achieve a pregnancy after at least 12 months of regular, unprotected intercourse.
• The patient's history states she has been married for 11 years and has never conceived, which perfectly aligns with the definition of primary infertility.
• The diagnosis is based on the complete absence of any prior pregnancies throughout the reproductive history.

Why Other Options Were Wrong

• Option A: This diagnosis is incorrect because it requires the patient to have had at least one previous pregnancy.
• Option B: This is a menstrual disorder, not a diagnosis for infertility in this context. It refers to the absence of the first menstrual period by age 15.
• Option D: This is also a menstrual disorder. It describes the cessation of periods after they have already been established. While it can cause infertility, it is not the primary diagnosis for a long-term failure to conceive.

Related Visual

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Definition and classification of infertility (Primary vs. Secondary) in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• Nurses play a vital role in providing emotional support and education to couples experiencing infertility, which is often a significant psychosocial stressor.
• A key nursing responsibility is to conduct a thorough health history for both partners, including sexual practices, menstrual history, and lifestyle factors, to identify potential causes of infertility.
• What if? If Mrs. Savitri had a child 8 years ago but has been unable to conceive for the past 5 years, the diagnosis would change to Secondary Infertility.

How to Approach the Question

• First, carefully read the patient's history provided in the clinical scenario. Note the key details: age (23), duration of marriage (11 years), regular unprotected intercourse, and the chief complaint ('failure to conceive').
• Identify the central problem. The core issue is the inability to get pregnant, which points towards infertility.
• Analyze the given options. Two options relate to infertility (Primary, Secondary) and two relate to menstrual problems (Primary Amenorrhea, Secondary Amenorrhea).
• Eliminate the less relevant options. Since the question is about the failure to conceive over a long period, the infertility diagnoses are more direct and appropriate than the amenorrhea diagnoses.
• Recall the specific definitions of the remaining options. Primary infertility means never having conceived. Secondary infertility means being unable to conceive after a previous pregnancy.
• Apply the correct definition to the patient's case. The scenario explicitly states she has been unable to conceive for 11 years, implying she has never been pregnant. This matches the definition of Primary Infertility.

Concept Tested & Keywords

• Concept Tested: Definition and classification of infertility (Primary vs. Secondary)
• Stem keywords: 23 years old, married 11 years ago, failure to conceive, regular sexual act, without using any contraceptive device
• Lead-in keywords: diagnosis
• Clinical cues: The duration of 11 years without conception is a significant indicator of an underlying fertility issue.
• Clinical cues: The term 'failure to conceive' points directly towards a diagnosis of infertility.

Question ID

QtW_Y8IoWxlgxPspqYnW23

Copy ID

Reference Book

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 28-36

E6 Medicine Harrison 22e Part 2 p. 1053-1055