When a client being seen in a fertility clinic doesn’t respond to the clomiphene citrate, the physician prescribes IM menotropins (Pergonal). This drug increases her risk of producing multiple follicles that could mature to ovulation. To reduce the high risk of multifetal pregnancy and its possible adverse effects the nurse should monitor（）
A. ultrasound study results and serum estradiol levels.
B. ultrasound study results and serum progesterone levels.
C. results of tests to detect luteinizing hormone (LH) in urine.
D. serum levels of human chorionic gonadotropin (HCG).
参考答案：A
解析：
The objective of menotropins therapy is to produce one or two healthy follicles; by carefully monitoring the client’s ultrasound study results and serum estradiol levels, the nurse can determine the number of maturing follicles. Serum progesterone levels indicate whether ovulation has occurred and correlate well with basal body temperature changes but don’t indicate the number of follicles. The test to detect urinary levels of LH is a hormonal assessment of ovulatory function--not an assessment of the number of maturing cells. Serum levels of HCG indicate whether the corpus luteum is producing enough estrogen and progesterone to maintain the pregnancy until the placenta develops further.