A nurse is explaining to a nursing student how clomiphene [Clomid] works to improve fertility. Which statement by the student indicates a need for further teaching?
a. "Clomiphene blocks estrogen receptors to cause increased secretion of gonadotro-pins."
b. "Clomiphene directly stimulates the ovary, causing follicular maturation and ovulation."
c. "If follicular maturation is the only result of clomiphene therapy, human chorionic gonadotropin may be given."
d. "If the pituitary gland cannot produce LH and FSH, clomiphene will not be effec-tive."
B
Clomiphene blocks receptors for estrogen; it does not directly stimulate the ovary. When estrogen receptors are blocked, the pituitary increases production of the gonadotropins LH and FSH. Clomiphene may produce follicular maturation without ovulation, and hCG will be given to produce ovulation. Without a pituitary capable of producing LH and FSH, clomiphene will not be effective.
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