When assessing a woman who has been unable to conceive, which factor would the nurse least likely identify as a potential risk in her history?

Choice A (Prepare for a vaginal delivery) is incorrect. Vaginal delivery is generally not recommended for women with active genital herpes lesions present during labor due to the high risk of transmitting the virus to the newborn. This risk is especially high when the mother experiences a primary infection (first outbreak) during the third trimester or has visible lesions at the time of delivery.
Choice B (Administer antiviral medication) is partially correct. While antiviral medications can be helpful in managing and potentially shortening outbreaks, they alone are not enough to prevent transmission during delivery. Antiviral medication can be used in combination with cesarean delivery to further reduce the risk of transmission.
Choice C (Prepare for a cesarean delivery) is correct. A cesarean delivery is the preferred method of delivery for women with active genital herpes lesions present during labor because it significantly reduces the risk of the virus being transmitted to the newborn. This risk can be as high as 50% during vaginal delivery with active lesions, while the risk with cesarean delivery is significantly lower, typically around 1% or less.
Choice D (Discharge the patient) is incorrect. Discharging a patient in active labor with active genital herpes lesions is not a safe or appropriate course of action. The patient needs to be carefully monitored and managed in a healthcare setting to minimize the risk of transmission to the newborn and ensure the safety of both mother and baby.

Choice A rationale
Age of 25 years is not typically identified as a potential risk factor for infertility. Women in their mid-twenties are often in their peak reproductive years.
Choice B rationale
A history of smoking can potentially impact fertility. Smoking can harm the ovaries and the eggs they produce, potentially leading to fertility issues.
Choice C rationale
Diabetes since the age of 15 could potentially impact fertility. Diabetes can cause irregular menstrual cycles and other reproductive issues, which could lead to difficulty conceiving. Choice D rationale
Weight below the standard for height and age could potentially impact fertility. Being underweight can lead to irregular menstrual cycles and ovulation, which could lead to difficulty conceiving.