Patho - Ch. 32

At what typical age should the nurse assess a boy for puberty?

11 Puberty begins at about age 11 in boys. Puberty usually begins at about age 8 to 9 for girls. Age 7 is too young, and 13 is too old.

A nurse is asked by a client where spermatogenesis takes place. Which area (see diagram) should the nurse choose to illustrate the location of spermatogenesis?

Area 3 (seminiferous tubules) Spermatogenesis takes place within the seminiferous tubules of the testes. Sperm leave the epididymides and travel to the vas deferens. The ejaculatory duct joins the urethra, where both pass through the prostate gland. The tunica vaginalis has a visceral layer that surrounds the testes.

A nurse is teaching a male client the basic anatomy of the male external genitalia. Which area (see diagram) should the nurse choose to illustrate the epididymis?

Area two (epididymis is the coiled tubule that lies on top of testes within scrotum; stores sperm as they are produced and turns into vas deferens) The epididymis is comma-shaped and curves over the posterior portion of each of the testes. Its structural function is to conduct sperm from the efferent tubules to the vas deferens, whereas its physiologic functions include sperm maturation, mobility, and fertility. The vas deferens is the duct with muscular layers capable of powerful peristalsis that transports sperm toward the urethra. The tunica dartos forms a septum that separates the two testes. The testis is oval and is an essential organ of male reproduction.

A nurse is teaching about the male embryo and how it differentiates under the influence of testes-determining factor (TDF). During the teaching session which gestational timeline should the nurse give for the beginning of this process?

Between 6 and 7 weeks Between 6 and 7 weeks' gestation the male embryo differentiates under the influence of TDF. The TDF is encoded by a gene in the sex-determining region on the Y chromosome. The other options are too late in the gestation period.

A client is undergoing thelarche. Which area should the nurse assess?

Breast Thelarche is the development of breasts. Menarche is the onset of menses. Although the vagina matures and body fat is deposited in the hips during puberty, thelarche refers to breast development.

Which information from the nurse indicates a correct understanding of the structure that secretes hormones to maintain and support pregnancy?

Corpus luteum Having ejected a mature ovum, the follicle develops into another structure, the corpus luteum. If fertilization occurs, the corpus luteum enlarges and secretes hormones to maintain and support the pregnancy. The uterus anchors and protects a fertilized ovum and provides an optimal environment while the ovum develops. The vagina allows mucosal secretions from the upper genital organs, menstrual fluids, and the products of conception to leave the body. The fallopian tubes serve as the site of ovum fertilization.

A client is an elderly woman. Which structural change associated with aging should the nurse monitor for in this client?

Decrease in bone density Bone mass is lost, leading to increased brittleness and porosity and possibly osteoporosis. The epidermis of the skin becomes thinner and less elastic. The labia may also lose their underlying fat and become thinner. The vaginal epithelium may become thin and atrophied.

A nurse hears in report that a client has cancer in the inner epithelial lining of the uterus. The nurse uses which term to describe this layer of the client's uterus?

Endometrium The inner lining of the uterus is called the endometrium. There is no layer of the uterus called the epometrium. The perimetrium is the outer serous membrane that covers the uterus. The myometrium is the middle, muscular layer of the uterus.

A client has an infection in the structure that conducts sperm from the tubules in the testes to the vas deferens. A nurse will plan interventions focusing on which infected area?

Epididymis The epididymis conducts sperm from the tubules in the testes to the vas deferens. The rete testis is the central portion of the testes. The tunica vaginalis is the outer covering of the testis. Two corpora cavernosa are internal structures of the penis.

The nurse preparing to explain the anatomy of the breast to a community group knows that the male breast fails to develop in puberty owing to a lack of which two hormones?

Estrogen and progesterone In the absence of sufficiently high levels of estrogen and progesterone, the male breast does not develop any further. Testosterone is responsible for male sex characteristics. Oxytocin is responsible for milk ejection (let down) after delivery. Prolactin is responsible for milk production. Inhibin inhibits follicle-stimulating hormone.

A woman has a disorder that affects the duct that carries an ovum to the uterus. Which term should the nurse use to describe the structure that is affected?

Fallopian tube An ovum travels from the ovary to the uterus via the fallopian tube. The fundus is the top of the corpus (uterus) above the insertion of the fallopian tubes. The vas deferens is part of the male reproductive organs. The endocervical canal is the opening through the cervix.

A nurse in a women's health clinic is educating a client about the functions of female reproductive hormones. The nurse should include which hormone that is responsible for ripening the ovarian follicle?

Follicle-stimulating hormone Follicle-stimulating hormone is responsible for development of the ovarian follicle. Progesterone promotes changes to the uterine lining during pregnancy that help to maintain pregnancy. Estrogen is responsible for the development of female sex characteristics. Luteinizing hormone triggers ovulation.

A nurse in a reproductive endocrinology clinic is educating an infertile couple about male reproductive hormones. Which hormone should the nurse include that stimulates spermatogenesis by Sertoli cells?

Follicle-stimulating hormone Follicle-stimulating hormone promotes development of the testes and stimulates spermatogenesis by Sertoli cells. Estrogen is responsible for growth plate fusion in bone and growth at puberty in males. Progesterone is not produced in males. Luteinizing hormone stimulates testosterone production in the testes.

What is another term the nurse can use to describe the prepuce of a male client's genitalia?

Foreskin The skin of the glans folds over the tip of the penis, forming the prepuce, or foreskin. Glans, urethra, and prostate are separate structures and are not known as the prepuce.

The nurse preparing an educational presentation on puberty recognizes that gonadarche represents which point on the timeline of development?

Gonadal maturation Gonadarche is gonadal maturation. Thelarche is the development of breasts. Menarche is the onset of menses. Adrenarche is the increased production of adrenal androgens.

A nurse is teaching the staff about sexual fetal development. The nurse should include which substance that is produced in the hypothalamus by 10 weeks' gestation and controls the production of two hormones released by the anterior pituitary gland?

Gonadotropin-releasing hormone (GnRH) Gonadotropin-releasing hormone is produced by the hypothalamus and controls the production of follicle-stimulating hormone and luteinizing hormone by the anterior pituitary gland. Follicle-stimulating hormone and luteinizing hormone control the production of estrogen and progesterone. Estrogen is the primary female hormone.

Which area (see diagram) should the nurse identify to illustrate the "thin, perforated membrane that covers the vaginal introitus"?

Hymen

The nurse is teaching about the hormone that inhibits follicle-stimulating hormone (FSH) secretion. Which information indicates teaching was successful?

Inhibin Inhibin inhibits the secretion of FSH, whereas activin stimulates the secretion of FSH. GnRH controls the gonadotropin production of FSH and LH and stimulates the secretion of FSH and LH. LH stimulates the corpus luteum to secrete progesterone.

A nurse is teaching a group of women about the vagina. Which information from the women indicates the teaching was effective?

It has an acid-base balance that discourages growth of bacteria. Two factors help to maintain the self-cleansing action of the vagina and to defend it from infection, particularly during the reproductive years. They are (1) an acid-base balance that discourages the proliferation of most pathogenic bacteria and (2) the thickness of the vaginal epithelium. During sexual arousal, the vagina lengthens and widens. The vaginal wall is composed of four layers. The length of the vagina is 9 to 10 cm.

Which information from the client indicates teaching by the nurse was successful about the primary function of the female breast?

It nourishes newborns. The function of the female breast is primarily to provide a source of nourishment for the newborn. Although the breasts do provide sexual stimulation and symbolize femininity to some individuals, that is not their primary function. The breasts do not secrete estrogen.

A nurse practitioner is performing a pelvic examination. Which term should the nurse use to describe the area that protects the inner structures of the vulva?

Labia majora The labia majora protect the inner structures of the vulva. The mons pubis protects the pubic symphysis during sexual intercourse. The labia minora swell with blood during sexual intercourse. The clitoris plays a major role in sexual arousal.

A nurse is reviewing the medical record after a woman's health examination. Which assessment finding best indicates the woman is still in perimenopause rather than menopause?

Last menstrual period 5 months ago Menopause is defined by 12 consecutive months of amenorrhea. Dry vaginal epithelium, cervical atrophy, and vasomotor flushes can occur either in perimenopause or menopause.

A nurse is talking about the hormone that stimulates ovulation followed by the development of the corpus luteum (luteal phase). Which hormone is the nurse describing?

Luteinizing hormone (LH) LH causes ovulation, which is followed by the development of the corpus luteum (luteal phase). High FSH levels stimulate follicle and ovum maturation (follicular phase). Estrogen has numerous biologic effects. It is required for the maturation of reproductive organs and is produced by cells in the developing ovarian follicle. Testosterone is found in the female and is the major hormone in males.

Which term should the nurse use to describe the disintegration of the endometrium that is discharged through the vagina?

Menstruation Menstruation is the functional layer of the endometrium disintegrating and being discharged through the vagina. Ovulation marks the beginning of the luteal/secretory phase of the menstrual cycle. The secretory phase is when the glands begin to secrete a thin glycogen-containing fluid. The follicular/proliferative phase represents the maturation of the ovarian follicle and proliferation of the endometrium.

A girl has early reproductive maturation. What factor should the nurse consider when planning care for this client?

Presence of leptin Girls who are obese mature earlier, perhaps from higher estrogen levels related to leptin and gonadotropin secretion, and girls who have low body fat, have reduced body weight, and perform intense exercise may experience delayed maturation. Decreased growth hormone has not been linked with early pubertal development.

Which information from the pregnant client indicates teaching by the nurse was effective regarding the hormone that stimulates the production of breast milk?

Prolactin Lactation (milk production) occurs after childbirth in response to increased levels of prolactin. After the birth of the infant, the hormone prolactin secreted by the mother's anterior pituitary gland stimulates milk production. Oxytocin from the posterior pituitary gland promotes the release of milk, called the "milk-ejection reflex." Estrogen is responsible for development of secondary sex characteristics. Luteinizing hormone is involved with ovulation.

Which term should the nurse use to describe the structure that is located just below the urinary bladder in a male client?

Prostate gland The prostate gland is located just below the urinary bladder in males and surrounds the first part of the urethra. Cowper (bulbourethral) glands are located below the prostate gland. The seminal vesicles are paired glands that lie behind the urinary bladder. Glands of Montgomery are located in the breast.

The nurse preparing to explain the anatomy of the breast to a community group knows that the breast is composed of what type of lobes?

Pyramid shaped The breast is composed of 15 to 25 pyramid-shaped lobes. The epididymis is comma shaped. The uterus is pear shaped. The nipple is circular.

A nurse is teaching school-age boys about the anatomy of the male reproductive system. Which structures should the nurse include when describing the external genitalia? Select all that apply.

Testes, scrotum, and epididymis The external genitalia of the male include the epididymis, scrotum, penis, and testes. The prostate, seminal vesicles, and Cowper (bulbourethral) glands are components of the internal genitalia.

A nurse in a reproductive endocrinology clinic is educating an infertile couple about male reproductive hormones. Which information from the couple indicates teaching was successful about the hormone responsible for spermatogenesis?

Testosterone

A nurse is teaching the staff about fetal development. The nurse should include which hormone that must be present for the genital tubercle to differentiate into male genitalia?

Testosterone Testosterone is necessary for the genital tubercle to differentiate into male genitalia; otherwise, female genitalia develop. Estrogen is the primary female hormone. Progesterone is sometimes called the hormone of pregnancy. Activin stimulates secretion of follicle-stimulating hormone.

A client has a disorder that affects the release of a matured ovum from a follicle. How should the nurse report this finding to the oncoming shift?

The client has a problem with ovulation. Ovulation is marked by the release of a matured ovum from the ovarian follicle. Menarche is the first menstruation in an adolescent girl's life. Ejaculation occurs in men and involves the release of sperm. The gonadostat is operative in the human fetus and responds to high levels of placental estrogens by releasing low levels of gonadotropin-releasing hormone.

A nurse is teaching about the female anatomy. The nurse should include which structure in women of reproductive age that contains rugae?

Vagina In women of reproductive age, the mucosal layer of the vagina is arranged in transverse wrinkles, or folds, called rugae (singular, ruga), which permit stretching during coitus and childbirth. The labia majora and minora do not contain rugae. The labia majora consist of two folds of skin arising at the mons pubis and extending back to the fourchette. The labia minora consist of two smaller, thinner, asymmetric folds of skin within the labia majora. The uterus has three layers (perimetrium, myometrium, and endometrium), which do not contain rugae.

A client is diagnosed with delayed maturation. Which conditions have been linked to this diagnosis? Select all that apply.

low body weight, underweight, intense history of exercise Extreme exercise, low body fat, and being underweight have been linked to delayed maturation. A high level of estrogen has been associated with early puberty. Increased growth hormone has not been linked to delayed maturation.

Which term should the nurse use to describe sperm that is among various glandular fluids?

semen Together the sperm and the glandular fluids compose semen. Emission is when sperm leaves the epididymis. Urine is a fluid of renal excretion from the bladder. Ejaculation, the moment when sexual arousal peaks, occurs immediately after emission.

Which term should the nurse use to identify an elastic, fibromuscular canal that extends from the introitus to the lower portion of a client's uterus?

vagina The vagina is an elastic, fibromuscular canal that is 9 to 10 cm long in a reproductive-age female. It extends up and back from the introitus to the lower portion of the uterus. The cervix is located at the lower end of the uterus. The cul-de-sac is the pouch that separates the posterior fornix from the rectum. The vestibule is an area protected by the labia minora and contains the opening of the vagina and urethra.