Pre-Lecture Quiz: Chapter 14 Before Conception (Look at numbers 66-75)

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Postnatally

Occurring after birth

A nurse is discussing menstruation with a female client. The nurse describes a normal amount of blood loss is approximately: 5 to 20 mL. 75 to 100 mL. 120 to 150 mL. 10 to 80 mL.

10 to 80 mL. Menstrual flow usually lasts 2 to 7 days with a normal blood loss between 20 to 80 mL.

The luteal phase is _____ to _____ days for most of a woman's reproductive life.

12 to 14

The maternal mortality rate is _____ out of every 100,000 live births in the United States

Approximately _____% of children are living in a family with a stepsibling, half-sibling, and/or stepparent

_____% of children in the United States are being raised in a blended married family

The nurse is providing education on menstruation to an adolescent client who has just experienced menarche. The nurse will inform the client to contact her health care provider for which situation? if noticing fatigue or bloating while menstruating if the duration of flow lasts between 3 and 7 days if saturating a menstrual pad in 1 hour if cycle length is 30 or more days

22nd To calculate expected ovulation, the nurse should explain to the client to subtract 14 days from the expected start date of the next menstrual cycle.

Today, _____% of children live with only one parent, who is _____ times more likely to be a mother rather than a father

26 6

Organogenesis, the formation of fetal organs, occurs primarily between weeks _____ and _____ of gestation

3 10

Advanced Maternal age

34+

pregnancies in women age _____ are more likely to end in abortion than in any other age group

35 and over

____ to _____of folic acid daily should be taken in advance of conception and through pregnancy, although patients with certain medical conditions may be advised to take more.

400 to 800 μg

Late term:

41 0/7 wk through 41 6/7 wk

Postterm:

42 0/7 wk and beyond

Approximately _____% of women will take illicit drugs in pregnancy

Chadwick's sign

A bluish discoloration of the female genitalia that is an early sign of pregnancy

Acrosome:

A cap on the head of the sperm that aids with the penetration of the ovum

Nuclear family

A family consisting of a married heterosexual couple and their children

Fallopian tubes:

A pair of cilia-lined tubes between the uterus and the ovaries, also referred to as uterine tubes

Ovarian ligaments:

A pair of ligaments attaching the ovaries to the uterus

11. What complication can result from untreated respiratory distress in the newborn? a. Esophageal atresia b. Gastric dilation c. Cold stress d. Reopening of the foramen ovale

ANS: D Respiratory distress can cause increased pressure in the right ventricle, causing reopening of the foramen ovale.

Oocyte

An immature ovum cell

Pregnancy Class C

Animal studies demonstrate harm and there are not sufficient human studies, but benefit may outweigh risk, OR sufficient studies are not available.

Cultural Awareness

Being aware that we all live and function within a culture of our own and that our identity is shaped by it.

Menstrual cycle

Changes to the endometrium during the course of a woman's hormonal cycle

Good ________________ and having an open mind are essential for cultural competence.

Communication

Gravidity (G) is the number of pregnancies a woman has had in her lifetime regardless of outcome.

Communication

Medicaid Eligibility requirements

Determined at the federal level, but individual states may opt to extend coverage to people outside of the mandated federal minimum.

Medicare Eligibility requirements

Determined by age (65 y and over). People with certain disabilities who are not yet age 65 y are also covered, as are people with end-stage kidney disease.

Cultural Blindness

Do not see or believe there are cultural differences among people. Everyone is the same.

Proliferative:

During the proliferative phase, the endometrial glands enlarge and the endometrium thickens in response to estrogen produced by the ovaries. Close to ovulation, the cervical mucus becomes particularly elastic with a consistency akin to egg white.

A pregnancy that is 37 0/7 weeks through 38 6/7 weeks is referred to as a(n) ________________ term pregnancy.

Early

________________ is secreted by the ovaries after ovulation.

Estrogen

Extended family

Family beyond the nuclear family

It is not necessary to seek early prenatal care if a woman is healthy. True or False?

False

It is possible for ova to be fertilized up to 5 days after release into the fallopian tubes. True or False?

False

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history? G2 P1020 G3 P0021 G3 P0020 G2 P0020

G3 P0020 Gravida (G) is the total number of pregnancies she has had, including the present one. Therefore she is G3 and not G2. Para (P), the outcome of her pregnancies, is further classified by the FPAL system as follows: F = Full term: number of babies born at 37 or more weeks of gestation, which is 0 and not 1 in this case. P = Preterm: number of babies born between 20 and 37 weeks of gestation, which is 0 in this case. A = Abortions: total number of spontaneous and elective abortions, which is 2 in this case. L = Living children, as of today. She has no living children; therefore, it is 0 and not 1.

Haploid

Having one set of chromosomes

Diploid

Having two sets of chromosomes, one from each parent

What vaccinations can be given during pregnancy?

Hepatitis B virus, influenza, and the tetanus, diphtheria, and pertussis (Tdap) (27-36 wk) may be given in pregnancy

Pregnancy class A

Human studies have demonstrated fetal safety in the first trimester, and there is no evidence of harm in later trimesters.

Arthralgia

Joint pain

Pregnancy Class B simplified

Mostly safe. Tested on animals with good outcomes, but not enough human testing.

Endometrial

Pertaining to the innermost layer or lining of the uterus, which is shed in part during menstruation

Medicaid source of funding

State and federal funds

Spermatogenesis

The biologic process whereby cells undergo division to create sperm

Organogenesis

The biologic process whereby organs are created

Perineum:

The area between the vulva and the anus

Cervical canal:

The canal between the internal os and outer os

Infundibulum

The distal end of the fallopian tube, near the fibria

Ampulla:

The distal portion of the tube, located between the isthmus and the infundibulum, where fertilization most often occurs

Ampulla:

The distal third of the fallopian tube, furthest from the uterus

Infundibulum:

The funnel-shaped part of the tube, located between the fimbriae and the ampulla

Corpus:

The main body of the uterus, located between the isthmus and the fallopian tubes

Ovarian cycle

The phases of a woman's hormonal cycle specific to the ovaries, including the follicular phase, ovulation, and the luteal phase

Updated criteria Pregnancy Class Lactation

This section includes information on the potential impact of a complication on a breastfeeding infant.

Facilitation:

This technique involves encouraging the patient to continue the narrative by the use of words or body language, such as nodding. For example, "Tell me more about that."

Gravidity (G) is the number of pregnancies a woman has had in her lifetime regardless of outcome. True or False?

True

Luteinizing hormone is the hormone responsible for the release of the mature egg from the follicle. True or Flase?

True

Positive signs of pregnancy

audible fetal heartbeat fetal movement felt by examiner ultrasound visualization of fetus

A nurse _____ _____ that an aspect of a culture is important to a patient simply because they identify with that culture.

cannot assume

Progesterone is produced by the

corpus luteum after rupture of the ovarian follicle.

Medicare Part A is

hospital insurance

The lowering of progesterone and estrogen stimulates the

hypothalamus to produce GnRH, thus cueing the anterior pituitary to produce FSH and LH, thus restarting the cycle.

maternal BMI below 18.5 is correlated with _____ _____ _____ and _____ _____

low birth weight Preterm birth

anterior pituitary secretes

luteinizing hormone (LH) and follicle-stimulating hormone (FSH)

Estrogen is secreted by the

ovaries

Why would a healthcare provider examine a woman's mouth prior to conception?

periodontal disease (oral disease) has been associated with poor pregnancy outcomes, including preterm birth. Conversely, pregnancy can also have a negative impact on periodontal health

Medicare Part D is

prescription drug coverage.

cultural competence is about

recognizing and respecting a person's culture and integrating the aspects important to that individual into their care

Small amounts of estrogen are also secreted from the

renal cortex and from fat cells.

A symptom is _____ and reported by the patient. An example of a symptom would be a patient report of a headache.

subjective

cultural competence

the capacity to work effectively and with people, integrating elements of their culture-vocabulary, value, attitudes, rules, and norms. Translation of knowledge into action.

LH is responsible for

the final maturation and release of the egg from the follicle. Levels of LH peak approximately 12 to 24 hours prior to follicle rupture (ovulation).

Cultural Sensitivity

understanding and accepting different cultural values, attitudes, and behaviors.

Corpus luteum

A hormone-secreting structure that forms from the follicle from which an egg has been released from the ovary

Medicaid

A joint state and federal program of healthcare insurance

Graafian follicle

A mature ovarian follicle from which the secondary oocyte will issue

Clarification:

This technique is requesting clarification of what a patient has said. For example, "When you say that you don't feel well, what do you mean by that?"

Gravidity:

This term refers to any pregnancy, regardless of how it ended. Pregnancies that ended in a birth, miscarriage, and abortion should all be accounted for.

Medicare Part C refers to

a system of private insurance providing the Medicare Part A and Part B coverage

The corpus luteum begins to lose its secretory function approximately

a week after ovulation, lowering levels of both progesterone and estrogen.

Luteinizing hormone (LH)

A hormone originating in the anterior pituitary gland that triggers ovulation

The follicular phase may be as short as _____ days, but may also be considerably longer, with the average follicular phase lasting _____ to _____ days.

8 14 to 21

31. The normal volume of amniotic fluid is approximately _______________ mL at 37 weeks gestation.

ANS: 1000 The volume of amniotic fluid steadily increases from about 30 mL at 10 weeks of pregnancy to 350 mL at 20 weeks. The volume of fluid is about 1000 mL at 37 weeks. In the latter part of pregnancy the fetus may swallow up to 400 mL of amniotic fluid per day and normally excretes urine into the fluid

32. Organize the developmental stages in the correct order. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Fetus b. Zygote c. Embryo d. Blastocyst e. Morula

ANS: B, E, D, C, A The development follows these stages: zygote, morula, blastocyst, embryo, and fetus.

1. What is the total number of chromosomes contained in a mature sperm or ovum? a. 22 b. 23 c. 44 d. 46

ANS: B Gametes (sex chromosomes) contain 23 chromosomes.

Which information provided by a client would be considered a presumptive sign of pregnancy? Reports of increased hunger Weight gain Breast tenderness Ballottement

Breast tenderness Presumptive signs of pregnancy are things reported by the woman to the health care provider and occur early in pregnancy. Breast tenderness is a common sign reported by women in early pregnancy but is not a definitive sign. Reports of increased hunger and weight gain could be caused by any disorder or could be normal responses to eating cycles. Ballottement occurs late in the pregnancy and is a probable sign.

Insurers are also obligated to pay for_____ _____ and methods for women without a co-pay, even if a woman has not met her insurance deductible.

contraceptive counseling

A nurse is teaching a client about the reproductive system and the hormones involved. The nurse would include which structures as the source of these hormones? Select all that apply. placenta ovaries hypothalamus pituitary uterus

ovaries hypothalamus pituitary The reproductive cycle is influenced and controlled by hormones secreted by the ovaries, hypothalamus, and pituitary gland. The placenta secretes a temporary hormone that assists with maintaining pregnancy. The uterus does not secrete hormones.

17. The nurse is educating a class of expectant parents about fetal development. What is considered fetal age of viability? a. 14 weeks b. 20 weeks c. 25 weeks d. 30 weeks

ANS: B By 20 weeks of gestation, the lungs have matured enough for the fetus to survive outside the uterus (age of viability).

Pregnancy Class X simplified

Harm on fetus, but may be necessary

Urethra meatus:

The opening to the urethra

15. A woman missed her menstrual period 1 week ago and has come to the doctors office for a pregnancy test. Which placental hormone is measured in pregnancy tests? a. Progesterone b. Estrogen c. Human chorionic gonadotropin d. Human placental lactogen

ANS: C Human chorionic gonadotropin is the basis for most pregnancy tests. It is detectable in maternal blood as soon as implantation occurs, usually 7 to 9 days after fertilization.

18. The nurse is presenting a conference on gene dominance. What does the nurse report as the percentage of children carrying the dominant gene if one parent has a dominant gene and the other parent does not? a. 10% b. 25% c. 50% d. 100%

ANS: C If one parent has a dominant trait and the other does not, then 50% of the children will inherit the trait.

True or False? To be a culturally competent nurse, one must understand all aspects of a person's culture.

False

Oogenesis

The biologic process whereby cells undergo division to create ova

Corona radiata

The outermost portion of the ovum

thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. breast changes ultrasound pictures fetal heartbeat amenorrhea hydatidiform mole morning sickness

breast changes amenorrhea morning sickness Presumptive signs are possible signs of pregnancy that appear in the first trimester, often only noted subjectively by the mother (e.g., breast changes, amenorrhea, morning sickness). Probable signs are signs that appear in the first and early second trimesters, seen via objective criteria, but can also be indicators of other conditions (e.g., hydatidiform mole). Positive signs affirm that proof exists that there is a developing fetus in any trimester and are objective criteria seen by a trained observer or diagnostic study, (e.g., ultrasound.)

Estrogen is the dominant hormone in the first half of the menstrual cycle prior to ovulation and causes

proliferation (growth) of the endometrial lining after menstruation as well as the contributing to the maturation of the ovarian follicles.

19. The nurse explains that the birth weight of monozygotic twins is frequently below average. What is the most likely cause? a. Inadequate space in the uterus b. Inadequate blood supply c. Inadequate maternal health d. Inadequate placental nutrition

ANS: D The single placenta may not be able to provide adequate nutrition to two fetuses.

A nurse is reviewing the medical record of a pregnant woman and notes that she is gravida 2. The nurse interprets this to indicate the number of: preterm births. births. spontaneous abortions (miscarriages). pregnancies.

pregnancies Gravida refers to a pregnant woman—gravida 1 (primigravida) during the first pregnancy, gravida 2 (secundigravida) during the second pregnancy, and so on. Para refers to the number of births at 20 weeks or greater that a woman has, regardless of whether the newborn is born alive or dead. "A" would be used to denote the number of abortions and "P" would be used to denote the number of preterm births when using the GTPAL system.

corpus luteum,

produces large amounts of progesterone and a smaller amount of estrogen, which was the dominant hormone prior to ovulation.

The cells lining the follicle are the granulosa cells, which will produce the _____ after ovulation when the empty follicle becomes the corpus luteum.

progesterone

The corpus luteum produces the _____ that creates a hospitable environment within the uterus for a fertilized ovum.

progesterone

In caring for a fully immunized pregnant woman who is a nurse in a family health practice, the obstetric nurse should remind the client that she must not come in contact with clients who have symptoms that could indicate which infection? smallpox Chicken pox diphtheria measles

Chicken pox Chicken pox can be teratogenic to the fetus and exposure may have a significant impact on the fetus and may cause defects. The fetus receives passive immunity from the mother for measles, diphtheria, and smallpox.

A woman has come to the clinic for her first prenatal visit. Which method would be the most effective way for the nurse to initiate data gathering for a health history? Ask her to complete a written questionnaire concerning her past and present status. Conduct an interview in a private room to obtain her health history. Wait until she is in the examining room and prepared for her physical examination. Ask her some basic questions in the waiting room before taking her to the examining room.

Conduct an interview in a private room to obtain her health history. Health interviewing is always conducted best in a quiet, private setting before examination procedures begin.

Ovaries:

Paired reproductive organs that produce ova, estrogen, testosterone, and progesterone and are approximately the size and shape of walnuts

A female client states, "I am concerned because when I have sex with my spouse, I have an area near my vagina that is really sensitive to touch." Which action will the nurse complete? Provide education to the client on the female anatomy. Refer the client for psychological counseling. Determine if the client has a sexually transmitted infection (STI). Have the client provide a urine specimen for testing.

Provide education to the client on the female anatomy. The nurse understands this is a normal, expected experience and would provide education to the client on the clitoris and its function. The clitoris is a small, cylindrical mass of erectile tissue and nerves that is highly sensitive and analogous to the head of the male penis. There is no indication for counseling because no signs of current or past abuse are present. This is not an indication of an STI or urinary tract infection; therefore, no additional testing or specimens are needed.

Pregnancy Class A simplified

Safe

Which question would be most important for a nurse to ask a G2P1 client who has a child with sickle cell anemia? "Have you done well to control your stress?" "Do you know the sex of your baby?" "Did you and your partner get genetic testing?" "When was your last exacerbation?"

"Did you and your partner get genetic testing?" The nurse should assess whether the client has had genetic testing completed. If not, the client should be referred for testing.

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education? "I will ovulate every month on Day 21 of my cycle." "My menstrual cycles are controlled by progesterone production." "When I ovulate, there is a follicle on my uterus that forms showing that an ova was released." "Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)."

"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." Ovulation is controlled by FSH and LH, with the follicle-stimulating hormone encompassing days 1 to 14 of a 28-day cycle and the luteinizing hormone controlling the luteal phase, which is days 15 to 28. The follicle forms only in the ovary, not the uterus. Ovulation should occur on Day 14 of a normal 28-day cycle. Both estrogen and progesterone are necessary to the menstrual cycle, not just progesterone.

The United States Census from 2014 showed that _____% of same-sex households included children.

17.3

The neural tube closes between _____ and _____ days post conception

18 and 26

BMIs of _____ and _____ are ideal

18.5 30

In the United States, the average maternal age at the time of the first birth is

26.3 years

As of 2013, approximately ______% of female same-sex couples and _____% of same-sex male couples in the United States were raising children

27 11

Early term:

37 0/7 wk through 38 6/7 wk

Full term:

39 0/7 wk through 40 6/7 wk

Periodontal disease

A condition caused by bacterial infection of the structures around the teeth, including the gums, periodontal ligament, and alveolar bone

Medicare is broken into four categories:

A, B, C, and D.

29. The component of development that programs the genetic code into the nucleus of the cell is ____________.

ANS: DNA The DNA programs the genetic code to the nucleus of the cell to be replicated.

30. The vessels comprising the umbilical cord are cushioned and protected by a substance called ___________ _____________.

ANS: Whartons jelly Whartons jelly is a substance in the umbilical cord that cushions and protects the vessels.

2. A pregnant woman states, My husband hopes I will give him a boy because we have three girls. What will the nurse explain to this woman? a. The sex chromosome of the fertilized ovum determines the gender of the child. b. When the sperm and ovum are united, there is a 75% chance the child will be a girl. c. When the pH of the female reproductive tract is acidic, the child will be a girl. d. If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.

ANS: D When a Y-bearing sperm fertilizes an ovum, a male child is produced.

Uterus:

Also called the "womb"; the site of implantation of fetal growth and development. The innermost layer of the uterus, the endometrium, sheds with menstruation. When a pregnancy implants in the endometrium, the endometrium is referred to as the decidua. The middle layer, the myometrium, is primarily smooth muscle. The outer layer is called the serosa or perimetrium. A nonpregnant uterus is approximately the size and shape of an upside-down pear.

•Abortion:

Any pregnancy ending prior to 20 weeks should be accounted for as an abortion, regardless of the number of fetuses included in a pregnancy. A twin pregnancy ending prior to 20 weeks would still be counted as one. This category may also be split into spontaneous abortions and elective abortions. If a woman had one spontaneous abortion and one elective abortion, it may be accounted for as 1/1.

The _____ within the fallopian tubes will help move the egg toward the uterus, where it will arrive approximately 72 to 96 hours after ovulation.

cilia

True or False? It is possible for ova to be fertilized up to 5 days after release into the fallopian tubes.

False

Bartholin's glands:

Glands on either side of the vaginal vestibule that secrete mucus for vaginal lubrication

Pregnancy Class D simplified

Harm on Humans, but may be necessary

Pregnancy Class C simplified

Harm on animals, but the bad may outweigh the good

A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take? Contact the health care provider. Immediately stop the nurse. Call the client later and apologize. Tell the unlicensed assistive personnel

Immediately stop the nurse. The nurse should interrupt the nurse and remind him or her that it is important not to impose personal values onto the client.

A nurse is assessing a female client. When obtaining the client's history, the client tells the nurse that her menstrual cycle is usually 30 days and that she expects her next menstruation on March 20. Based on the client's information and the nurse's understanding of the female reproductive cycle, the nurse would identify ovulation as most likely occurring at which time? March 1 March 6 March 13 March 27

March 6 Ovulation usually occurs on day 14 in a 28-day cycle; however, whether a woman's cycle is 28 days or 120 days, ovulation takes place 14 days before menstruation.

Menstrual:

Menstruation occurs when an ovum is not fertilized and the lining of the endometrium is no longer maintained by progesterone released by the corpus luteum. Menstruation typically begins 12 to 14 days after ovulation. Although the loss of blood may seem significant, the menstrual flow consists of blood, vaginal, and cervical secretions, bacteria, and other cellular debris. The loss of actual blood is only 10 to 80 mL over 2 to 7 days.

What are the probable signs of pregnancy that would be noted in a woman? Select all that apply. Visualization of the gestational sac Positive Goodell sign Ballottement Amenorrhea Breast tenderness

Positive Goodell sign Ballottement Probable signs of pregnancy include objective data such as the Goodell sign, which is cervical softening. Another probable sign is ballottement, which is when the examiner pushes against the uterine wall and it bounces back. Breast tenderness and amenorrhea are presumptive signs and visualization of the gestational sac is a positive sign of pregnancy.

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy? Fatigue Amenorrhea Positive home pregnancy test Nausea and vomiting

Positive home pregnancy test A urine pregnancy test is considered a probable sign of pregnancy as the hCG may be from another source other than pregnancy. Fatigue, amenorrhea, and vomiting are presumptive or possible signs of pregnancy and can also have other causes.

Term:

The T stands for term, indicating all pregnancies that ended at or beyond 37 weeks. It is important to count the number of pregnancies and not the number of infants born. A twin pregnancy is still counted as one. It should be noted that a more current recommendation calls for further dividing term into early term, full term, late term, and postterm. Outcomes and risk factors for a neonate and mother vary widely in the 5 or more weeks accounted for in this category, and this modification is an effort to systematically capture this variation.

Isthmus:

The area of the uterus between the cervix and the corpus, which has thinner, more narrow musculature

Gametogenesis

The biologic process whereby cells undergo division to create gametes

Labia majora:

The exterior skin folds, which are hair-bearing in mature females and extend from the mons pubis to the perineum

Fertilization

The fusion of egg and sperm

Labia minora:

The inner mucosal skin folds, which extend from the mons pubis to the perineum

Ischemic phase:

The ischemic phase begins as the corpus luteum begins to disintegrate, eliminating the source of progesterone. Vascular changes lead to necrosis and the breakdown of the endometrial lining, which sheds during menstruation, leaving behind the tips of the glands from which a new endometrium will grow.

The nurse is teaching a couple trying to conceive about the changes in the cervical mucus near the time of ovulation. The nurse determines the session is successful when the couple correctly choose mucus in which form as indicating ovulation has occurred? Scant amount Thick and tacky Thin and copious Mucus is not visible at ovulation

Thin and copious During ovulation, the mucus will be distensible and stretchable. After ovulation, the mucus will be scant, thick and opaque in nature. During the proliferative phase before ovulation, it is tacky, crumbly, and yellow or white in color. During the menses, there will be no mucus noted.

Capacitation

a biochemical change in the sperm that allows penetration into the egg and increased sperm mobility

Autosomes

a chromosome that is not a sex chromosome

Pregnancies __________________ years are considered high risk because of advanced maternal age and largely because of the higher potential for diminished egg quality and an increased risk for pregnancy-related complications as well as the greater likelihood of preexisting health conditions.

after age 34

There is no known safe amount of _____ _____ in pregnancy and no known safe point in the pregnancy to _____

alcohol consumption drink

A poorly controlled diabetic is at higher risk for a pregnancy with

congenital defects.

During which stage of fetal development is exposure to teratogens most damaging? fetal stage mitosis stage pre-embryonic stage embryonic stage

embryonic stage The most sensitive period of fetal development related to teratogens is during the embryonic period when the different body systems are developing. During the pre-embryonic stage, the fetal stage, and the mitosis stage, the risk of teratogenic exposure is not as influential on the fetus.

Estrogen is the hormone primarily responsible for

female patterns of fat distribution, including the development of breasts.

Variation in the length of a woman's menstrual cycle (the time between the first day of one menses and the first day of the next menses) is typically due to variations in the _____ _____ and not in the _____ _____.

follicular phase luteal phase

The nurse is providing education on menstruation to an adolescent client who has just experienced menarche. The nurse will inform the client to contact her health care provider for which situation? if cycle length is 30 or more days if noticing fatigue or bloating while menstruating if the duration of flow lasts between 3 and 7 days if saturating a menstrual pad in 1 hour

if saturating a menstrual pad in 1 hour The nurse should inform the client to notify the health care provider if she saturates a perineal pad in 1 hour or less. This is an indication of a complication because the client is experiencing too much blood loss. An average cycle length is about 21 to 36 days; therefore, notification is not needed unless the client's length is over 36 days or under 21 days. The duration of the flow averages 3 to 7 days. Feelings of fatigue and bloating are normal physical symptoms of menstruation, along with breast tenderness, headaches, abdominal cramps, acne, and more.

A nurse caring for a 43-year-old client explains to the client that ovarian functions gradually decrease around this age. What is the implication of decreased ovarian function? susceptibility to fractures increases the risk of heart disease changes in sexual response inability to become pregnant

inability to become pregnant Because of the decrease in ovarian functions, the client loses the ability to become pregnant. Loss of estrogen makes the client susceptible to fractures and also increases the risk of heart disease. Changes in sexual response are usually related to physical changes in the vagina.

A nurse is preparing a presentation for a group of nurses about genetic discoveries and advances. When discussing this topic, the nurse would most likely include which topic area related to the potential for misuse? greater emphasis on the causes of diseases gene replacement therapy for defective genes slower diagnosis of specific diseases individual risk profiling and confidentiality

individual risk profiling and confidentiality Individual risk profiling based on an individual's genetic makeup can raise issues related to privacy and confidentiality. Gene replacement therapy for defective genes and a greater emphasis on looking at the causes of disease are considered benefits associated with genetic advances. Rapid, more specific diagnosis of diseases would be possible.

Medicare Part B is

medical insurance

29% of pregnancies to women infected with the zika virus resulted in fetal abnormalities including

microcephaly

Women who are obese in pregnancy are at higher risk for developing all of the following except: macrosomia pregnancy-induced hypertension gestational diabetes neural tube defects cesarean birth.

neural tube defects Folic acid deficiency will increase the risk of neural tube defects.

Optimal replacement of the thyroid hormone is important because uncontrolled hypothyroidism can compromise

neurologic development in the fetus.

The Hyde Amendment,

prohibits spending federal spending on abortion, although individual states may elect to use state dollars to fund abortions for Medicaid patients.

After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies which action as the primary function of the ovaries? carrying the ovum to the endometrium secreting estrogen and progesterone secreting mucus that supplies lubrication for intercourse implanting a fertilized ovum

secreting estrogen and progesterone The ovaries have two primary functions: development and release of the ovum and secretion of estrogen and progesterone. The fallopian tubes are responsible for conveying the ovum from the ovary to the uterus and sperm from the uterus toward the ovary. The Bartholin glands when stimulated secrete mucus that supplies lubrication for intercourse. The uterus is the site of implantation of a fertilized ovum.

In preparing for a preconception class, the nurse plans to include a discussion of potential risk factors. Which risk factor would be most important to include? importance of taking adequate vitamin and mineral supplements the use of OTC drugs with teratogens family history of pregnancy complications the importance of healthy lifestyle

the use of OTC drugs with teratogens Risk factors for adverse pregnancy have been demonstrated by statistics gathered for smoking during pregnancy, consuming alcohol during pregnancy, not taking adequate folic acid supplements during pregnancy, being obese, taking prescription or OTC drugs that are known teratogens, and having a preexisting condition that can negatively affect pregnancy if unmanaged.

The school nurse is presenting a lecture to adolescents to teach them how conception occurs. Which statement by the nurse would accurately describe this process? "Conception usually occurs when the ovum is in the outer third of the fallopian tube." "Human life begins with the union of two cells: the zygote and the sperm." "The ovum carries the Y chromosome, and the sperm carries an X or Y chromosome." "At the time of conception, the ovum determines the sex of the baby."

"Conception usually occurs when the ovum is in the outer third of the fallopian tube." Conception usually occurs when the ovum is in the outer third of the fallopian tube (oviduct). Human life (conception) begins with the union of two cells: the ovum (female) and the sperm (male). At the time of conception, the sperm determines the sex. An ovum carries only one type of chromosome to determine sex: the X chromosome. A male sperm cell may carry either an X or Y sex chromosome. If a sperm cell carrying a Y chromosome fertilizes the ovum, a boy (XY) will result; if the sperm cell carries an X chromosome, the result will be a girl (XX).

The nurse is teaching an adolescent client about fertility and the various phases of the menstrual cycle. The client has a 28-day menstrual cycle. Which statement is a priority for the nurse to include in the teaching? "Days 1 through 5 are the days you will typically experience menstrual flow." "Day 10 is part of the proliferative phase of your menstrual cycle." "Day 14 of your menstrual cycle is normally when you will ovulate." "Days 27 and 28 are when you have declining hormonal secretions."

"Day 14 of your menstrual cycle is normally when you will ovulate." It is a priority for the nurse to teach the client when ovulation will occur to assist in pregnancy prevention at this age. While the other statements are all true, not knowing the specific information for those days does not hold the same consideration or life-altering potential as when pregnancy can occur. The menstrual cycle is based on an average of 28 days and divided into four phases based on the hormones secreted and their actions. Days 1 through 5 are the menstruation phase. Days 6 through 14 are the proliferative phase, ending with ovulation on the 14th day. Days 15 through 26 are the secretory phase. Days 27 and 28 are the ischemic phase when hormonal secretions decline.

The nurse is conducting an initial history and assessment on a client at 10 weeks' gestation who is pregnant with her first child. Which question is a priority for the nurse to ask the client at this time? "Does anyone in your or the father's family have any genetic disorders?" "Do you plan to breastfeed or bottle feed your new baby?" "Are you planning to develop a birth plan for use during the birthing process?" "Was your mother or grandmother diagnosed with gestational diabetes?"

"Does anyone in your or the father's family have any genetic disorders?" Due to the timing of the client's pregnancy, it is a priority for the nurse to assess for potential risk factors for genetic abnormalities. The client is in the appropriate time frame to begin genetic testing if desired. The nurse will determine the client's feeding preference and plans to have a birth plan closer to birth to allow the client time to research these topics and make an informed decision about both. Gestational diabetes is not thought to be genetic in nature. The client will be tested for gestational diabetes regardless of family history during her second trimester.

A 45-year-old man has just been diagnosed with Huntington disease. He and his spouse are concerned about their four children. Based on the knowledge of patterns of inheritance, how will the nurse respond? "This disorder is carried on the X chromosome so only your female children would be affected." "Each of your children will have a 50% chance of inheriting the disease." "Both genes of a pair must be abnormal for the disorder to occur in your children." "Your male children are more likely to be affected than your female children."

"Each of your children will have a 50% chance of inheriting the disease." Huntington disease is an autosomal dominant disorder. A single gene in the heterozygous state is capable of producing the phenotype. In these cases, the abnormal or mutant gene overshadows the normal gene and the individual will demonstrate signs and symptoms of the disorder. The affected person usually has one affected parent. The defect occurs on the autosome not on the X chromosome; therefore, autosomal dominant inherited conditions affect female and male family members equally and follow a vertical pattern of inheritance in families. A person who has an autosomal dominant inherited condition carries a gene mutation for that condition on one chromosome pair. Each of that person's offspring has a 50% chance of inheriting the gene mutation for the condition and a 50% chance of inheriting the normal version of the gene.

The nurse is providing teaching to an adolescent girl on the function of the female reproductive system. Which statement by the client best reflects understanding of the material presented? "I will always count from the end of my last menstrual cycle to determine when I will ovulate." "A vaginal discharge that is thick and white in color indicates that I am ovulating." "My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal." "During ovulation, the egg is released directly into my uterus to help with fertilization."

"My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal." The normal menstrual cycle lasts an average of 28 days, but there is a variance between women and even between cycles in some women, which is normal. Counting to determine ovulation time is based upon the beginning of the menstrual cycle, not the end. The mucus during ovulation is thin, clear and somewhat stretchable. At ovulation, the ova are released into the abdominal cavity and are propelled along by tiny finger-like projections that direct it to the fallopian tube.

_____% of single-mother families live in poverty. These mothers may report an increased susceptibility to _____ and to _____ and _____ social support

35 illness stress reduced

Approximately _____% to _____% of children were being raised without parents

4 5

A woman being assessed by the nurse reports that she is 6 weeks' pregnant. If her report is accurate, when will the nurse predict the client conceived? 4 weeks ago 10 weeks ago 6 weeks ago 8 weeks ago

4 weeks ago The length of a pregnancy is more commonly measured from the first day of the last menstrual period (gestational age). Because ovulation and fertilization take place about 2 weeks after the last menstrual period, the ovulation age of the fetus is always 2 weeks less than the length of the pregnancy or the gestational age. Therefore this client conceived 4 weeks ago.

How should the nurse document a pregnant client's gestational status using the GTPAL system after collecting the following data? Currently 18 weeks pregnantClient's fourth pregnancyDelivered one nonviable fetus at 26 weeksExperienced one miscarriageDelivered one viable fetus at 38 weeks' gestation 3, 2, 1, 2, 1 4, 2, 2, 1, 1 3, 2, 1, 1, 1 4, 1, 1, 1, 1

4, 1, 1, 1, 1 GTPAL is a more comprehensive system for classifying pregnancy status. By this system, the gravida classification remains the same, but para is broken down into T: the number of full-term infants born (infants born at 37 weeks or after), P: the number of preterm infants born (infants born before 37 weeks), A: the number of spontaneous miscarriages or therapeutic abortions, and L: the number of living children. The client has been pregnant four times. The client delivered one viable infant at 38 weeks. The client delivered one nonviable fetus at 26 weeks. The client had one miscarriage. The client has one living child.

Fimbriae:

A fringe of tissue at the end of the fallopian tube, not attached to the ovary, that gently draws the ovum into the fallopian tube with a sweeping motion

Gonadotropin-releasing hormone (GnRH)

A hormone produced by the hypothalamus that, when secreted, triggers the pituitary gland to secrete the gonadotropin hormones, luteinizing hormone and follicle-stimulating hormone, which are involved in regulating the ovarian cycle

_____% of babies born in the United States were born to women who are not married and were either single or in a partner relationship but unmarried

Higher costs are not associated with superior outcomes. In 2015, the infant mortality rate was _____ out of every 1,000 births in the United States

Follicle-stimulating hormone (FSH)

A hormone produced by the pituitary gland that, in women, regulates the menstrual cycle and recruitment of follicles by the ovaries

Hymen:

A membrane partially covering the opening of the vagina

Vagina:

A muscular tube that extends from the vestibule to the cervix and that accommodates penetrative sex and childbirth

Microcephaly

A congenital defect resulting from abnormal brain development in which the neonate's head is smaller than normal (Think of Micro= Small cephaly= head Therefore Small head)

Cohabitating-parent family

A family in which the parents are partners who live together but are not married

Medicare

A federal program of healthcare insurance

Round ligaments:

A pair of ligaments starting where the fallopian tubes join the uterus (the "uterine horns") and ending deep in the pelvis. Stretching of these ligaments in pregnancy can cause pain.

Hook effect

A phenomenon by which the human chorionic gonadotropin level is so high that it causes a false negative pregnancy test result

Preterm:

A pregnancy should be counted as preterm if it ends between 20 and 36 weeks 6 days. As with term, a twin pregnancy would still be counted as one, not two.

Biochemical pregnancy

A pregnancy that ends shortly after implantation

Cortical reaction

A process by which the ovum prevents penetration from more than one sperm

Mons pubis:

A rounded area, padded with fat, that is anterior to the pubic symphysis; hair-bearing in mature females

Goodell's sign

A softening of the cervix that occurs in pregnancy

Hegar's sign

A softening of the isthmus of the uterus that occurs during pregnancy

Teratogen

A substance with the potential to harm a pregnancy

Broad ligaments:

A wide ligament connecting the uterus to the pelvis

33. Put the embryonic/fetal characteristics in the correct order of occurrence from week 3 to week 36 of gestation. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Subcutaneous fat is present. b. Bone marrow forms blood cells. c. Spinal cord and brain appear. d. Skull and jaw ossify. e. Neural tube closes.

ANS: C, E, D, B, A Primitive spinal cord and brain appear at 3 weeks. Neural tube closes at 4 weeks. Skull and jaw ossify at 6 weeks. Spleen stops forming blood cells and bone marrow takes over at 29 weeks. Subcutaneous fat is present at 36 weeks.

28. The nurse explains that prior to fertilization each cell is reduced from 46 chromosomes to 23 chromosomes. This is referred to as the __________ number.

ANS: haploid When each cell reduces its chromosomes from 46 to 23, it is called the haploid number.

13. A woman who is 25 weeks pregnant asks the nurse what her fetus looks like. What does the nurse explain is one physical characteristic present in a 25-week-old fetus? a. Lanugo covering the body b. Constant motion c. Skin that is pink and smooth d. Eyes that are closed

ANS: A By 25 weeks, the body of the fetus is covered with lanugo, the eyes are open, the skin is wrinkled, and the fetus has definite periods of movement and sleeping.

12. During an ultrasound, two amnions and two placentas are observed. What will be the most likely result of this pregnancy? a. Dizygotic twins b. Monozygotic twins c. Conjoined twins d. High birth-weight twins

ANS: A Dizygotic twins always have two amnions and two chorions (placentas).

10. What organ does the ductus venosus shunt blood away from in fetal circulation? a. Liver b. Heart c. Lungs d. Kidneys

ANS: A Fetal blood bypasses the liver through the ductus venosus by carrying blood directly to the inferior vena cava.

9. A patient asks the nurse when her infants heart will begin to pump blood. What will the nurse reply? a. By the end of week 3 b. Beginning in week 8 c. At the end of week 16 d. Beginning in week 24

ANS: A The fetal heart begins to pump by week 3 of gestation.

5. The nurse is reviewing fetal circulation with a pregnant patient and explains that blood circulates through the placenta to the fetus. What vessel(s) carry blood to the fetus? a. One umbilical vein b. Two umbilical veins c. One umbilical artery d. Two umbilical arteries

ANS: A The umbilical vein transports richly oxygenated blood from the placenta to the fetus.

6. Where is the usual location for implantation of the zygote? a. Upper section of the posterior uterine wall b. Lower portion of the uterus near the cervical os c. Inner third of the fallopian tube near the uterus d. Lateral aspect of the uterine wall

ANS: A The zygote usually implants in the upper section of the posterior uterine wall.

25. A nurse is teaching a lesson on fetal development to a class of high school students and explains the primary germ layers. What are the germ layers? (Select all that apply.) a. Ectoderm b. Endoderm c. Mesoderm d. Plastoderm e. Blastoderm

ANS: A, B, C The zygote transforms its embryonic disc into three layers: the ectoderm, the mesoderm, and the endoderm.

26. What are the functions of amniotic fluid? (Select all that apply.) a. Maintaining an even temperature b. Impeding excessive fetal movement c. Lubricating fetal skin d. Acting as a reservoir for nutrients e. Acting as a cushion for the fetus

ANS: A, E The amniotic fluid provides maintenance of even temperature; prevents amnion from adhering to fetal skin; allows buoyancy, symmetrical growth, and fetal movement; and acts as a cushion for the fetus. Although the fetus does swallow amniotic fluid, it has no nutritional value.

21. What does the nurse explain can affect the survival of the X- and Y-bearing sperm after intercourse? a. Age b. Estrogen level c. Body temperature d. Level of feminine hygiene

ANS: B Estrogen levels and the pH of the female reproductive tract can affect the survival of the X- and Y-bearing sperm as well as their motility.

3. What is the most common site for fertilization? a. Lower segment of the uterus b. Outer third of the fallopian tube near the ovary c. Upper portion of the uterus d. Area of the fallopian tube farthest from the ovary

ANS: B Fertilization takes place in the outer third of the fallopian tube, which is closest to the ovary.

16. When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent? a. Congenital heart defects b. Neural tube defects c. Mental retardation d. Premature birth

ANS: B It is now known that folic acid supplements can prevent neural tube defects such as spina bifida.

20. The school nurse is counseling a group of adolescent girls. What does the nurse explain about sperm ejaculated near the cervix? a. They are destroyed by the acidic pH of the vagina. b. They survive up to 5 days and can cause pregnancy. c. They lose their motility in about 12 hours after intercourse. d. They are usually pushed out of the vagina by the muscular action of the vaginal wall.

ANS: B Sperm ejaculated near the cervix can survive up to 5 days and cause pregnancy even before ovulation

14. At what point in prenatal development do the lungs begin to produce surfactant? a. 17 weeks b. 20 weeks c. 25 weeks d. 30 weeks

ANS: C During week 25, the alveoli begin to produce surfactant, which enables the alveoli to stay open for adequate lung oxygenation to occur.

7. What is the embryonic membrane that contains fingerlike projections on its surface, which attach to the uterine wall? a. Amnion b. Yolk sac c. Chorion d. Decidua basalis

ANS: C The chorion is a thick membrane with fingerlike projections (villi) on its outermost surface.

24. A couple just learned they are expecting their first child and are curious if they are having a boy or a girl. At what point of development can the couple first expect to see the sex of their child on ultrasound? a. 4 weeks gestational age b. 6 weeks gestational age c. 10 weeks gestational age d. 16 weeks gestational age

ANS: C The fetal period begins at the ninth week, and by the tenth week the external genitalia are visible to ultrasound examination

4. The embryo is termed a fetus at which stage of prenatal development? a. 2 weeks b. 4 weeks c. 9 weeks d. 16 weeks

ANS: C The fetus (third stage of prenatal development) begins at the ninth week and continues until the 40th week of gestation or until birth.

23. What part of the fetal body derives from the mesoderm? a. Nails b. Oil glands c. Muscles d. Lining of the bladder

ANS: C The mesoderm is responsible for the development of muscles. Nails and oil glands derive from the ectoderm. The lining of the bladder derives from the endoderm.

22. Of what is the normal umbilical cord comprised? a. 1 artery carrying blood to the fetus and 1 vein carrying blood away from the fetus b. 1 artery carrying blood to the fetus and 2 veins carrying blood away from the fetus c. 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus d. 2 arteries carrying blood to the fetus and 2 veins carrying blood away from the fetus

ANS: C The umbilical cord is comprised of 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus.

27. A patient at the obstetric office has just learned she is pregnant with dizygotic twins. What facts will the nurse include when educating this patient? (Select all that apply.) a. Dizygotic twins are the same sex. b. Dizygotic twins share a placenta. c. Dizygotic pregnancies tend to repeat in families. d. Dizygotic twins have separate chorions. e. Dizygotic twin incidence decreases with maternal age.

ANS: C, D Dizygotic twins tend to repeat in families and have separate chorions. They can be the same sex or different sexes and have their own placenta. Incidence increases with maternal age.

8. Which hormone is responsible for converting the endometrium into decidual cells for implantation? a. Estrogen b. Human chorionic gonadotropin c. Human placental lactogen d. Progesterone

ANS: D At high levels, progesterone maintains the endometrial lining for implantation of the zygote.

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum? Luteinizing hormone Progesterone Estrogen Follicle-stimulating hormone

Follicle-stimulating hormone Explanation: The follicle-stimulating hormone (FSH) is the messenger from the pituitary gland to stimulate the ovum to mature. Luteinizing hormone is the hormone that is released from the pituitary gland once the follicle containing the ovum is mature, but it has no role in maturing the ovum. Estrogen and progesterone are integral parts of the ovulatory cycle but do not mature ovum.

Secretory phase:

After ovulation, the endometrium is maintained by progesterone. Increased blood and secretions to the endometrium, as well as reduced contractility of the uterine, smooth muscles and create a hospitable environment for implantation. If fertilization occurs, this process continues. If it does not occur, the final phase of the menstrual cycle, the ischemic phase, begins.

Hypothalamic-pituitary-ovarian (HPO) axis

An endocrine feedback loop between the hypothalamus, anterior pituitary gland, and ovaries that regulates the ovarian cycle

The nurse is reviewing hormonal regulation of the female reproductive system with a group of nursing students. A student nurse states, "Progesterone prepares a woman's uterus to receive and welcome a fertilized ovum." Which action will the nurse complete based on the student's response? Ask the student if she has been pregnant in the past. Correct the student's misunderstanding of the hormone's function. Ask the student to stay after class to discuss more in-depth. Applaud the student for understanding the material.

Applaud the student for understanding the material. The nurse would applaud the student's understanding of the material. There is no need for a more in-depth discussion with the student or to clarify material because the student is showing comprehension of the hormone's function. Asking the student about her past medical history is inappropriate in the group setting. This information is irrelevant to the situation as well.

A woman from Brazil and her husband are visiting the office for a prenatal checkup. Which of the following would be the best nursing intervention to show respect to the couple and their cultural and individual values related to childbirth? Ask the couple whether there is anything they believe should or should not be done to make the pregnancy successful. Explain to the couple how care for pregnancy has evolved from an illness approach to a view of pregnancy as healthy. Mention to the couple several examples of Brazilian birth practices that you have learned about online. Relate your own personal birth story to the couple.

Ask the couple whether there is anything they believe should or should not be done to make the pregnancy successful. To learn about the beliefs of a particular woman and her partner, ask at prenatal visits if there is anything the couple believes should or should not be done to make the pregnancy successful and keep the fetus healthy. Supporting these beliefs shows respect for the individuality of a woman and her knowledge of good health. The other answers do not allow the couple to speak of their cultural and individual values and therefore do not show respect to them.

What instruction should a nurse offer to a pregnant client or a client who wishes to become pregnant to help her avoid exposure to teratogenic substances? Avoid medications. Eat a well-balanced diet. Maintain personal hygiene. Avoid intake of coffee.

Avoid medications. The nurse should instruct a client who is pregnant or one who wants to conceive to avoid medications and thus avoid exposure to any kind of teratogenic substance. Eating a well-balanced diet and maintaining personal hygiene, though important during pregnancy, will not prevent a client's exposure to teratogenic substances. Coffee is not a teratogenic substance, so the client need not avoid coffee. However, coffee is not recommended during pregnancy because it may increase the risk of spontaneous abortion (miscarriage).

GTPAL

G:The number of pregnancies a woman has had in her lifetime T:The number of pregnancies that have ended at term (37 wk plus) P:The number of pregnancies that have ended preterm (20-37 wk) A:The number of pregnancies that end by spontaneous or elective abortion before 20 wk. This information may also be reported as two separate numbers, with the first representing spontaneous abortions and the second elective abortions. A patient with a pregnancy history including one spontaneous abortion and one elective abortion might have "1/1" following the A or "2," depending on the system used. L:The number of living children

Pregnancy class B

Either animal studies have not demonstrated harm but there are not sufficient human studies OR animal studies have shown harm but human studies have not.

A group of nursing students are preparing a presentation for a health fair illustrating what happens to the body during pregnancy. Which structure will the students point out is influenced the most by hormones to prepare for conception? myometrium endometrium perimetrium fundus

Endometrium The endometrium is the inner layer of the uterus; it builds with hormones during the month in potential preparation for pregnancy. The myometrium is the muscular layer. The perimetrium is a protective layer, and the fundus is the upper area of the uterus.

What should the nurse include when counseling potential parents about genetic disorders? Environmental influences may affect multifactorial inheritance. Genetic disorders primarily follow Mendelian laws of inheritance. All genetic disorders involve a similar number of abnormal chromosomes. The absence of genetic disorders in both families eliminates the possibility of having a child with a genetic disorder.

Environmental influences may affect multifactorial inheritance. Not all genetic disorders follow Mendelian laws of inheritance. Diseases caused by multiple factors do not follow Mendelian laws because more than a single gene or HLA is involved. Environmental influences may be instrumental in determining whether the disorder is expressed. All genetic disorders do not involve a similar number of abnormal chromosomes. A family history may reveal no set pattern so an absence of genetic disorders in both families does not necessarily eliminate the possibility of having a child with a genetic disorder.

What should the nurse include when counseling potential parents about genetic disorders? Environmental influences may affect multifactorial inheritance. Genetic disorders primarily follow Mendelian laws of inheritance. The absence of genetic disorders in both families eliminates the possibility of having a child with a genetic disorder. All genetic disorders involve a similar number of abnormal chromosomes.

The nurse is teaching a class about conception. The nurse explains to the participant that which factors are necessary for conception to occur? Select all that apply. Equal maturation of both sperm and ovum Ability of the sperm to reach the ovum Ability of the sperm to penetrate the ovum Ability of the ovum to ingest the sperm Equal motility of both sperm and ovum

Equal maturation of both sperm and ovum Ability of the sperm to reach the ovum Ability of the sperm to penetrate the ovum For conception to occur three factors must be present: equal maturation of the sperm and ovum, ability to the sperm to reach the ovum, and the ability of the sperm to penetrate the ovum. The ovum does not ingest the sperm; the ovum is passive and the sperm must penetrate the zona pellucida and cell membrane and achieve fertilization. The ovum is not motile. The ovum is propelled through the fallopian tube by the cilia lining the tube. Unlike the motile sperm, an ovum has no independent motility.

A school nurse who is teaching a health course at the local high school is presenting information on human development and sexuality. When talking about the role of hormones in sexual development, which hormone does the nurse teach the class is the most important for developing and maintaining the female reproductive organs? progesterone androgens follicle-stimulating hormone estrogen

Estrogen Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.

A woman in labor has brought a butcher knife with her and insists on putting it under her hospital mattress to "cut the labor pain." Which is the nurse's best response to this situation? Explain the security issue and negotiate with the client asking if a picture or rubber/play knife would honor her values and beliefs. Explain the security issue and educate the client about the cause of labor pain. Explain the security issue and offer to teach the client to use chest breathing with contractions to cut the labor pain. Explain the security issue and inform the client that the hospital will not allow her to keep the knife because it is a lethal weapon.

Explain the security issue and negotiate with the client asking if a picture or rubber/play knife would honor her values and beliefs. This situation highlights the need for nurses to be aware of culturally held beliefs and practices of the clients they see and provide care for. Respect for cultural values is important for developing effective nurse-client relationships. The nurse should allow the client to believe what she wishes is appropriate. An attempt to educate the client or outright restriction of her desires would worsen the situation.

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of spontaneous abortion (miscarriage) within the first trimester. The nurse is correct to document the history as: G = 4, T = 2, P = 0, A = 0, L = 1 G = 3, T = 1, P = 0, A = 1, L = 1 G = 1, T = 1, P = 1, A = 0, L = 1 G = 2, T = 0, P = 0, A = 0, L = 1

G = 3, T = 1, P = 0, A = 1, L = 1 The GTPAL stands for Gravida -- number of pregnancies, which is 3 (current, 4-year-old, and miscarriage); Term -- only one pregnancy thus far carried to term; Preterm deliveries -- 0; Abortions (either elective or miscarriage) -- 1; Living children -- 1. Do not be distracted by the twins. That is still one pregnancy.

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records? G2 T2 P1 A0 L2 G2 T1 P1 A1 L1 G3 T0 P1 A1 L2 G3 T2 P2 A0 L1

G3 T0 P1 A1 L2 G indicates the total number of pregnancies (2 prior, now pregnant = 3); T indicates term deliveries at or beyond 38 weeks' gestation (none = 0); P is for preterm deliveries (at 20 to 37 weeks = 1; multiple fetus delivery are scored as 1); A is for abortions or pregnancies ending before 20 weeks' gestation (1); and L refers to living children which is 2. Thus, G3 T0 P1 A1 L2 is what the nurse should note in the client's record.

The nurse is documenting a non-pregnant client's obstetric history. The client informed the nurse she has 4 children living at home. She birthed one child at 34 weeks' gestation, one child at 37 weeks' gestation, one at 38 weeks' gestation, and one at 39 weeks' gestation. The client has had one abortion. Using the GTPAL format, how will the nurse document the client's obstetric history? G4, T3, P0, A1, L3 G5, T2, P1, A1, L3 G4, T3, P1, A1, L4 G5, T2, P2, A1, L4

G5, T2, P2, A1, L4 "G" stands for gravida, the total number of pregnancies (5). "T" stands for term, the number of pregnancies that ended at term (at or beyond 38 weeks' gestation)(2). "P" is for preterm, the number of pregnancies that ended after 20 weeks' gestation (2). "A" is for abortions, either spontaneous or elective (1). "L" is for living, the number of children delivered who are alive at the time of history collection (4).

G:The number of pregnancies a woman has had in her lifetime P:The number of pregnancies carried to viable gestational age (variously defined as 20-24 wk gestation)

The nurse is assessing a 16-year-old female on a routine well-child visit. Which assessment finding will the nurse predict this healthy female will report concerning her menstrual cycles? Flow usually lasts 4 to 6 days. The usual cycle is 36 days. There's abundant clear mucus at the beginning Menstruation began at age 15.

Flow usually lasts 4 to 6 days. The average menstrual flow is 4 to 6 days in length. The cycle usually lasts 28 days. There should be no mucus during the menstrual cycle, with clear mucus being noted at the time of ovulation or approximately day 14. Menstruation usually begins at the age of 12 to 14 years.

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum? Follicle-stimulating hormone Luteinizing hormone Estrogen Progesterone

Follicle-stimulating hormone The follicle-stimulating hormone (FSH) is the messenger from the pituitary gland to stimulate the ovum to mature. Luteinizing hormone is the hormone that is released from the pituitary gland once the follicle containing the ovum is mature, but it has no role in maturing the ovum. Estrogen and progesterone are integral parts of the ovulatory cycle but do not mature ovum.

To be a culturally competent nurse, one must understand all aspects of a person's culture. True or False?

False

True or False? It is not necessary to seek early prenatal care if a woman is healthy.

False

Medicare source of funding

Federal funds

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Fetal movement felt by examiner Hegar sign Chadwick sign Positive office pregnancy test

Fetal movement felt by examiner The positive signs of pregnancy are fetal image on a sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test has 95% accuracy; however, it may come back as a false positive. Hegar sign is a softening of the uterine isthmus. Chadwick sign may have other causes besides pregnancy.

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Positive office pregnancy test Fetal movement felt by examiner Hegar sign Chadwick sign

Skene's glands:

Glands at the anterior of the vulva that drain into the urethra

A nurse is teaching a group of adolescent girls about the menstrual cycle. The nurse would integrate information about which hormones as being predominant during the cycle? Select all that apply. LH testosterone FSH prolactin GnRH

GnRH FSH LH The predominant hormones involved in the menstrual cycle are gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, and prostaglandins. Testosterone and prolactin do have a role in the female reproductive system are not considered predominant hormones for the menstrual cycle.

A 28-year-old client states that she has not had her menstrual period for the past 3 months and suspects she is pregnant. Which should the nurse do next? Have the client take a pregnancy test. Assess the client for a fetal heart tone. Determine at what age the client began menstruating. Ask the client the date her last period ended.

Have the client take a pregnancy test. Absence of menstruation, along with consistent nausea, fatigue, breast tenderness, and urinary frequency, are the presumptive signs of pregnancy. To determine if the client may be pregnant, a pregnancy test is indicated.

Cultural destrutiveness

Making everyone fit the same cultural pattern and excluding those who don't fit-forced assimilation. Emphasis on differences as barriers.

Which statement should be incorporated into the teaching plan developed to present instruction about the female menstrual cycle to nursing students? Progesterone influences the growth of endometrial lining. Estrogen is the dominant hormone during the luteal phase. Menses ensues when the levels of estrogen and progesterone fall. The follicular phase is dominated by progesterone and testosterone.

Menses ensues when the levels of estrogen and progesterone fall. Explanation: Menstruation depends on the interplay of various hormones. The hypothalamus secretes gonadotropin-releasing hormone, which stimulates the pituitary gland to secrete follicle-stimulating hormone and luteinizing hormone. These hormones stimulate the ovaries to produce estrogen and progesterone, which are necessary for stimulation of the target organs (vagina, breast, uterus) in preparing for pregnancy.

A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you to consider? Restricting visitors to reduce the noise level. Organizing nursing care at times other than visiting hours. Asking the hospital's visitor program to call on her to prevent loneliness. Spending increased time with her yourself to prevent loneliness.

Organizing nursing care at times other than visiting hours. Because extended families have many members, support people in time of an illness are usually available. Restricting visitors will leave her without support and will be detrimental to her treatment. Asking the staff to visit will reduce her privacy. You as a practitioner cannot become personally involved.

A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you to consider? Spending increased time with her yourself to prevent loneliness. Organizing nursing care at times other than visiting hours. Restricting visitors to reduce the noise level. Asking the hospital's visitor program to call on her to prevent loneliness.

The formation of fetal organs, or ________________, is a critical period of fetal development that occurs between 3 and 10 weeks of gestation.

Organogenesis

Which of a client's cells are most likely to reproduce by meiosis? Endometrium Cervix Breast tissue Ova

Ova Ova and other sex cells reproduce by meiosis. All of the other tissues are made up of somatic cells, which reproduce by mitosis.

Amenorrhea is a(n) ________________ sign of pregnancy.

Presumptive

Interpretation:

This is the summarizing of a patient's narrative as a means of clarification. For example, "What I'm hearing you say is that you're mostly feeling pain in your right abdomen, but sometimes it's on both sides or in the middle."

Reflection:

Reflection, unlike interpretation, is repeating a patient's own words or phrases. For example, "Okay, so 'more achy than painful.'"

A newly married female is talking to the nurse about her desire to get pregnant soon. Which suggestion would the nurse make to assist this client? Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle. It is recommended to check her mucus and have intercourse when the mucus is opaque and scant. If she has irregular menstrual cycles, that should not interfere with her conceiving as long as she has intercourse on the same days every month. If ovulation occurs on Day 14 of her menstrual cycle, she should have intercourse one week later on Day 21.

Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle. Fertilization occurs when the woman ovulates and has intercourse within a day either before or after ovulation. The mucus near ovulation is clear, stretchable and thin to facilitate the movement of the sperm. Conception can only occur at the time of ovulation, so having the client engage in intercourse on the same days monthly will not help her conceive. Waiting one week following ovulation will lessen the chance of conception greatly.

Updated criteria Pregnancy Class Pregnancy

This section includes information about pregnancy and registries that women taking medications during pregnancy may participate in to further knowledge. It also includes information pertinent to labor and delivery.

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother? Social support Early prenatal care Having a planned pregnancy Age at the time of pregnancy

Social support All options are correct and play a role pregnancy, but the most critical for a positive psychological experience is for the woman to have a social support system. Early care, maternal age, and planned pregnancy all affect fetal and maternal health, but are not necessarily linked to positive psychological experiences.

Updated criteria Pregnancy Class Females and males of reproductive potential

This section includes information on pregnancy testing and contraception considerations, as well as the potential for infertility.

Empathy:

This technique involves making statements that acknowledge a patient's feelings. For example, "That must have been frustrating for you."

True or False? Gravidity (G) is the number of pregnancies a woman has had in her lifetime regardless of outcome.

True

A client is attempting to become pregnant and is using varied methods to identify ovulation. What assessment finding would most clearly suggest that the client is ovulating? The client menstruated eight days ago The client has clear, thin cervical mucus Cervical mucus is absent The client's progesterone levels are peaking

The client has clear, thin cervical mucus Cervical mucus is clear and thin near ovulation. Ovulation typically occurs near day 14 of the menstrual cycle. Progesterone levels are low near the time of ovulation.

True or False? Luteinizing hormone is the hormone responsible for the release of the mature egg from the follicle.

True

Which statement best expresses the role of the corpus luteum? The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. The corpus luteum promotes the increased production of estrogen before ovulation. During the luteal phase, the corpus luteum secretes glycogen. Increasing amounts of cervical mucus are produced as a result of the luteinizing hormone produced by the corpus luteum.

The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. The mature ovum is released from the ovary, resulting in the corpus luteum. Progesterone is produced by the corpus luteum. Estrogen is secreted by the ovaries. Glycogen is secreted by the endometrial glands during the luteal phase. Luteinizing hormone is not a product of the corpus luteum.

Amenorrhea:

The lack of menses

Zona pellucida

The layer of the ovum immediately below the corona radiata

Cervix:

The lowest portion of the uterus, which extends into the vagina. It is approximately an inch in diameter and has a small opening at its center called the os.

Internal os:

The opening between the cervix and the body of the uterus

Outer os:

The opening between the cervix and the vagina

Vaginal vestibule:

The opening into the vagina. When referred to as the vulvar vestibule, the term includes the urethral meatus.

Interstitial part of fallopian tube:

The portion of the fallopian tube that travels through the musculature of the uterus

Isthmus:

The portion of the tube between the interstitial and the ampulla

Conception

The process of becoming pregnant

Fourchette:

The skin at the posterior of the vulva

The student nurse cares for a child from a large extended family. Considering the child's family structure, which way might the child view the student nurse as "poor"? The student is planning to be a nurse. The student owns only one nurse's uniform. The student is unmarried and lives alone. The student stated he or she values honesty.

The student is unmarried and lives alone. Part of the richness of an extended family is the availability of support people in times of family stress. Planning to be a nurse would not be a factor. The child would not know that the student only owns one uniform. The student's views on honesty are unrelated to financial status.

Fundus:

The uppermost, rounded part of the uterus, which contains the greatest volume of smooth muscle

Introitus:

The vaginal orifice

Clitoris glans:

The visible portion of the clitoris and the most sensitive erogenous zone of the female body

Pregnancy Class X

There is evidence of fetal harm, and the risk clearly outweighs benefits in pregnant women.

Pregnancy Class D

There is evidence of harm in humans, but therapeutic benefits may outweigh this harm.

A pregnant woman asks the nurse about using herbal remedies while she is pregnant. The nurse recommends that the woman talk with her health care provider about their use based on which understanding? They are not rated with regard to safety during pregnancy. They have been proven to cause early labor. They can create nutritional deficiencies in the mother and fetus. They are known to cause teratogenic effects in the fetus.

They are not rated with regard to safety during pregnancy. Herbs are not regulated by the FDA in the same way as medications; therefore, they are not rated with regard to their safety in pregnancy. As with medicine, women should not take herbs in pregnancy until they discuss the herbs' safety with their obstetric provider. Herbal supplements do not create nutritional deficiencies in the fetus and are not known that herbal supplements cause teratogenic effects in the fetus. There is no proof that herbal supplements cause early labor.

•Living Children:

This category accounts for children alive at the time of the recording

Confrontation:

This is the process of pointing out an inconsistency in what a patient is expressing or how she is behaving. For example, "You're telling me that you feel confident about when your last period was, but you'd like a dating ultrasound. Tell me what you're hoping to learn from this ultrasound today."

The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during the follicular phase of the ovarian cycle that the nurse should include in the teaching session? The uterus prepares for implantation of an ovum. The empty ruptured graafian follicle becomes the corpus luteum, and it begins to secrete progesterone and estrogen. About day 14, a surge of hormones cause the ovum to burst through the ovary. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature.

Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature. The follicular phase lasts from about day 4 to about day 14. During this time, under the influence of follicle-stimulating hormone, several follicles begin to ripen and the ovum within each begins to mature. About day 14, a surge of hormones causes the ovum to burst through the ovary; this act is called ovulation. During the luteal phase, the empty, ruptured graafian follicle becomes the corpus luteum, and it begins to secrete progesterone and estrogen. The endometrium of the uterus has a similar cycle. It is called the uterine cycle or endometrial cycle. This process prepares the uterus for implantation of an ovum (egg).

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client? An ovum matures and is released. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall.

While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth during the proliferative phase. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall during the secretory phase. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. Maturation of an ovum occurs during the ovarian cycle; growth of the lining (endometrium) of the uterus occurs during the uterine cycle. Together, these cycles are known as the menstrual cycle.

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client? If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. An ovum matures and is released.

How long should a woman with a confirmed zika exposure wait before she should attempt to conceive?

Women with confirmed exposure should wait for at least 8 weeks after the onset of symptoms or last possible exposure to attempt to conceive.

Which body system is most affected throughout the embryonic and fetal period by teratogens? gastrointestinal system genitourinary system central nervous system musculoskeletal system

central nervous system Whether the teratogen is ingested, injected, occurs through an infectious agent, or is environmental, the CNS and brain are the body systems most seriously affected during this period.

Cultural Humility

a lifelong process of self-reflection and self-critique that begins, not with an assessment of a client's beliefs, but rather an assessment of your own.

Employers may elect to provide _____ coverage as part of their policies for employees, although the law does not require it.

abortion

A client makes an appointment at the prenatal clinic because the client thinks the client might be pregnant. Which assessment would the nurse identify as a presumptive sign of pregnancy? amenorrhea vagina violet in color cervical softening positive pregnancy test

amenorrhea Amenorrhea is a presumptive sign of pregnancy. Chadwick sign (vagina changing in color from pink to purple), Goodell sign (softening of the cervix) and a positive pregnancy test are probable signs.

Presumptive signs of pregnancy

amenorrhea nausea breast tenderness deepening pigmentation urinary frequency quickening Fatigue

What does the genetic analysis always include? assessment for any other potentially inherited condition evaluation of other potentially inherited conditions interventions for other potentially inherited conditions planning for other potentially inherited conditions

assessment for any other potentially inherited condition The genetic analysis always includes assessment for any other potentially inherited conditions for which testing, prevention, and treatment may be possible. Interventions are not carried out for potential genetic conditions. Evaluation and planning cannot be accomplished if the client does not have the disease.

What does the genetic analysis always include? assessment for any other potentially inherited condition interventions for other potentially inherited conditions evaluation of other potentially inherited conditions planning for other potentially inherited conditions

Probable signs of pregnancy

blood and urine tests Chadwick's sign Goodell's sign Hegar's sign Positive pregnancy test

What elements of an exam should occur before a woman plans to conceive?

blood pressure and BMI assessment, auscultation of heart and lungs, a thyroid exam, an abdominal and genital exam, and an exam of the mouth.

Women are still considered to have the potential for pregnancy until:

they are deemed menopausal a year after their last period.

A group of nursing students are comparing male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure? vulva clitoris labia majora vagina

clitoris The female clitoris is complementary (equitable) to the glans; both of these are composed of erectile tissue and are the primary organs responsible for orgasm. Other comparable structures include the testes and ovaries, and scrotum and labia majora. The vagina does not have a comparable male structure.

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? maintains nutrient-rich decidua sustains life of placenta continues progesterone production by corpus luteum provides rich blood supply to decidua

continues progesterone production by corpus luteum The corpus luteum is responsible for producing progesterone until this function is assumed by the placenta. hCG is a fail-safe mechanism to prolong the life of the corpus luteum and ensure progesterone production. Estrogen is responsible for providing a rich blood supply to the decidua. Progesterone helps maintain a nutrient-rich decidua.

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? provides rich blood supply to decidua maintains nutrient-rich decidua continues progesterone production by corpus luteum sustains life of placenta

If conception occurs the pregnancy cues the continuation of the _____ _____ and the maintenance of the endometrium (called the _____ in pregnancy) by producing _____ _____ _____, thus inhibiting GnRH and the response of the anterior pituitary.

corpus luteum decidua human chorionic gonadotropin (hCG)

While caring for a pregnant woman of Middle Eastern descent, a nurse attempts to mold the client's choices to fit what she calls the "American Way." When questioned, she reports it is best and easier to plan and deliver care this way. Based upon your knowledge, you recognize this as: cultural sensitivity. cultural blindness. cultural awareness. cultural destructiveness.

cultural destructiveness. Explanation: Attempts to modify the culture and beliefs of others is a form of cultural destructiveness. Cultural blindness is an unknowing ignorance. Nurses should strive for full cultural understanding and awareness. Cultural sensitivity is the demonstration of awareness.

Vaccines That Should Be Administered Preconception or Postpartum if Indicated

•Measles, mumps, and rubella virus •Varicella virus •Hepatitis A virus •Pneumococcal virus •Polio virus •Human papillomavirus

While conducting the first prenatal health history visit, the nurse learns that a pregnant client is taking various herbal remedies and over-the-counter medications for minor ailments. Which nursing diagnosis should the nurse identify as being appropriate for the client at this time? health-seeking behaviors related to guidelines for nutrition and activity during pregnancy risk for injury to fetus related to lifestyle choices health-seeking behaviors related to strong cultural desire to have a healthy child deficient knowledge regarding exposure to teratogens during pregnancy

deficient knowledge regarding exposure to teratogens during pregnancy The client is taking herbal remedies and over-the-counter medications, many of which can be teratogenic to the developing fetus. This is the most appropriate nursing diagnosis for the nurse to select for this assessment finding. There is not enough information to determine if the fetus is at risk because of the client's lifestyle choices. The client has not asked for specific information so health-seeking behavior diagnoses would not be appropriate for the client at this time.

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to: detect fetal heart sounds with a Doppler. feel fetal movements. hear the fetal heartbeat with a stethoscope. palpate the fetal outline.

detect fetal heart sounds with a Doppler. Fetal heart sounds are audible with a Doppler at 10 to 12 weeks' gestation but cannot be heard through a stethoscope until 18 to 20 weeks' gestation. Fetal movements can be felt by a woman as early as 16 weeks of pregnancy and felt by the examiner around 20 weeks' gestation. The fetal outline is also palpable around 20 weeks' gestation.

The nurse is preparing to assess a young woman's external genitalia. The nurse predicts the client is currently in the most fertile phase of the menstrual cycle based on which assessment finding of the vaginal mucus drainage? distensible, stretchable quality clear and oily yellow, tacky, and crumbly raw egg white consistency

distensible, stretchable quality At the peak of fertility (i.e., during ovulation), the mucus has a distensible, stretchable quality called spinnbarkeit. During the proliferative phase, the mucus is yellow, tacky, and crumbly. Close to the time of ovulation, the mucus will appear clear and oily with a raw egg white consistency.

When caring for a woman in her sixth month of pregnancy, she reports her plans to nurse for at least two to three years like the rest of the women in her family. Based upon your knowledge, you: advise her to be careful who she discusses this with, as many will consider that a type of reportable child abuse. document her report but do nothing, as this is a cultural belief that should be respected. encourage her to start the baby on formula after the first year as recommended by many physicians. discuss how painful this will be once the baby has teeth.

document her report but do nothing, as this is a cultural belief that should be respected. Culturally specific decisions should be respected and incorporated into the plan of care. Options other than following the mother's wishes (insomuch as these wishes do not put the child in danger), are inconsequential and may be viewed as intrusive and inappropriate.

When caring for a woman in her sixth month of pregnancy, she reports her plans to nurse for at least two to three years like the rest of the women in her family. Based upon your knowledge, you: document her report but do nothing, as this is a cultural belief that should be respected. discuss how painful this will be once the baby has teeth. advise her to be careful who she discusses this with, as many will consider that a type of reportable child abuse. encourage her to start the baby on formula after the first year as recommended by many physicians.

ovaries secrete

estradiol, as directed by the gonadotropins.

The nurse is conducting an annual examination on a young female who reports her last menses was 2 months ago. The client insists she is not pregnant due to a negative home pregnancy test. Which assessment should the nurse use to assess confirm the pregnancy? positive urine human chorionic gonadotropin (hCG) uterine size and shape changes fetal heartbeat Chadwick sign

fetal heartbeat The only positive sign of pregnancy is a sign or symptom that could only be attributable to the fetus; thus, fetal heartbeat can have no other origin. Chadwick sign is a color change in the cervix, vagina, and perineum; these could all be the result of other causes. A positive urine hCG is a probable sign as it can be related to causes other than pregnancy. A change in the size and shape of the uterus can occur due to other causes.

Which of the following is a positive sign of pregnancy? positive pregnancy test fetal movement felt by examiner Hegar's sign uterine contractions TAKE ANOTHER QUIZ

fetal movement felt by examiner The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and examiner feeling fetal movement.

Which hormone would the nurse explain as being primarily responsible for maturation of the ovarian follicle? luteinizing hormone follicle-stimulating hormone estrogen gonadotropin-releasing hormone

follicle-stimulating hormone Explanation: Follicle-stimulating hormone is primarily responsible for the maturation of the ovarian follicle. Luteinizing hormone is required for the final maturation of preovulatory follicles and luteinization of the ruptured follicle. Gonadotropin-releasing hormone induces the release of follicle stimulating hormone and luteinizing hormone to assist with ovulation. Estrogen is crucial for the development and maturation of the follicle and induces proliferation of the endometrial glands.

After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle? follicular phase proliferative phase secretory phase ischemic phase

follicular phase The ovarian cycle consists of the follicular phase, ovulation, and the luteal phase. The proliferative, secretory, and ischemic phases occur in the endometrial cycle.

Same-sex couples are approximately _____ times as likely to be raising an adopted child and they are six times more likely than heterosexual parents to be raising foster children

four

A nurse is preparing a program for a group of parents of prepubertal children about the changes to expect with puberty. When describing the sequence of events that occur, the nurse would identify which hormone as initiating the cycle? follicle-stimulating hormone luteinizing hormone testosterone gonadotropin-releasing hormone

gonadotropin-releasing hormone Puberty is the stage of life at which secondary sex changes begin. In most girls, these changes are stimulated when the hypothalamus synthesizes and releases gonadotropin-releasing hormone (GnRH), which then triggers the anterior pituitary to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH are termed gonadotropin (gonad = "ovary"; tropin = "growth") hormones because they begin the production of androgen and estrogen, which in turn initiate secondary sex characteristics.

The hypothalamus, a region of the forebrain, releases

gonadotropin-releasing hormone (GnRH)

Which hormone is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle? follicle-stimulating hormone (FSH) gonadotropin-releasing hormone (GnRH) luteinizing hormone (LH) estrogen

gonadotropin-releasing hormone (GnRH) GnRH is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle. It induces the release of FSH and LH to assist with ovulation, both of which are secreted by the anterior pituitary gland. Estrogen is secreted by the ovaries and is crucial for the development and maturation of the follicle.

Which hormone stimulates the release of the follicle-stimulating hormone (FSH) from both male and female glands? growth hormone-releasing hormone (GHRH) thyrotropin-releasing hormone (TRH) gonadotropin-releasing hormone (GnRH) prolactin-releasing hormone (PRH)

gonadotropin-releasing hormone (GnRH) The male and female glands respond to LH and FSH, which are released from the anterior pituitary in response to stimulation from gonadotropin-releasing hormone that is released from the hypothalamus. GHRH stimulates the release of the growth hormone, which targets cell growth. THR stimulates the thyroid stimulating hormone, which targets the thyroid gland. PRH stimulates the release of prolactin, which is necessary for milk production.

At the end of the follicular phase, the now mature follicle is called the _____ _____ and measures about 5 to 10 mm, about the size of a pencil eraser or a dime.

graafian follicle

A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse? gravida 2, para 1 gravida 4, para 2 gravida 3, para 4 gravida 2, para 4

gravida 4, para 2 Gravida (G) indicates the number of pregnancies. When a nurse calculates the GP of a pregnant client, the current pregnancy counts as one, the twin pregnancy counts as one, and the previous pregnancies count as two for a gravida of 4. Para (P) indicates the number of pregnancies that result in birth at a viable gestational age. The birth of multiples count as one. Thus, this client has a 2-year-old and one set of twins, for a para of 2.

A pregnant woman needs an update in her immunizations. Which vaccination would the nurse ensure that the woman receives? hepatitis B measles mumps rubella

hepatitis B Hepatitis B vaccine should be considered during pregnancy. Immunizations for measles, mumps, and rubella are contraindicated during pregnancy.

With advanced maternal age (35+) and very advanced maternal age (45+) there is a higher risk of complications including:

higher risks for fetal abnormalities spontaneous abortion hypertension neonatal morbidity complications in labor and delivery

To assess the sociocultural aspects of the family of an adolescent in an ambulatory clinic, which of the following would you ask? his mother's occupation his mother's attitude toward citizenship the adolescent's education level his family structure

his family structure Family structure is a characteristic strongly influenced by culture. The mother's occupation and citizenship do not affect the treatment of the adolescent client. The client's education also should not be a factor in treatment.

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client? options for birth control in the future whether sex was consensual knowledge of child development sexual development of the client

knowledge of child development The nurse should address the client's knowledge of child development during assessment of the pregnant adolescent client. The nurse need not address the sexual development of the client or whether sex was consensual. This would not be an opportune time to discuss birth control methods to be used after the pregnancy.

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client? sexual development of the client whether sex was consensual options for birth control in the future knowledge of child development

After follicle rupture, LH stimulates the ruptured follicle, free of its ovum, in a process called .

luteinization

When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle? estrogen prolactin progesterone luteinizing hormone

luteinizing hormone With the initiation of the menstrual cycle, luteinizing hormone rises and stimulates the follicle to produce estrogen. As this hormone is produced by the follicle, estrogen levels rise, inhibiting the output of LH. Ovulation occurs after an LH surge damages the estrogen-producing cells leading to a decline in estrogen. The LH surge results in the corpus luteum, which produces estrogen and progesterone. These two levels rise, suppressing LH. Lack of LH promotes degeneration of the corpus luteum, which then leads to a decline in estrogen and progesterone. The decline of ovarian hormones ends their negative effect on the secretion of LH, which is then secreted and the menstrual cycle begins again. Prolactin is the hormone responsible for breast milk production.

When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle? estrogen luteinizing hormone prolactin progesterone

luteinizing hormone Explanation: With the initiation of the menstrual cycle, luteinizing hormone rises and stimulates the follicle to produce estrogen. As this hormone is produced by the follicle, estrogen levels rise, inhibiting the output of LH. Ovulation occurs after an LH surge damages the estrogen-producing cells leading to a decline in estrogen. The LH surge results in the corpus luteum, which produces estrogen and progesterone. These two levels rise, suppressing LH. Lack of LH promotes degeneration of the corpus luteum, which then leads to a decline in estrogen and progesterone. The decline of ovarian hormones ends their negative effect on the secretion of LH, which is then secreted and the menstrual cycle begins again. Prolactin is the hormone responsible for breast milk production.

insurance companies may no longer charge women more for coverage, and they are required to cover ___________________________________.

maternity and newborn care.

FSH is the primary hormone responsible for

maturation of the follicles of the ovary that will subsequently release eggs for fertilization.

Which vaccines are contraindicated during pregnancy since they may transmit a viral infection to the fetus? Select all that apply. mumps measles rubella Tdap vaccine (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) influenza

measles mumps rubella Live virus vaccines, such as measles, HPV, mumps, rubella, and poliomyelitis (Sabin type), are contraindicated during pregnancy because they may transmit a viral infection to a fetus. Women are advised to be vaccinated against influenza before/during pregnancy. Tetanus is also treated the same in pregnant women as in others by Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) injection.

Women who are obese in pregnancy are at higher risk for developing all of the following except: pregnancy-induced hypertension macrosomia neural tube defects gestational diabetes cesarean birth.

neural tube defects Folic acid deficiency will increase the risk of neural tube defects.

A sign is _____ and may be witnessed by an observer. Blood pressure would be an example of a sign.

objective

ovaries hypothalamus pituitary Explanation: The reproductive cycle is influenced and controlled by hormones secreted by the ovaries, hypothalamus, and pituitary gland. The placenta secretes a temporary hormone that assists with maintaining pregnancy. The uterus does not secrete hormones.

A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation? progesterone prolactin testosterone luteinizing hormone

progesterone After the follicle ruptures as it releases the egg, it closes and forms a corpus luteum. The corpus luteum secretes increasing amounts of progesterone and estrogen, which interact with the endometrium to prepare it for implantation. The corpus luteum does not secrete prolactin, testosterone, or luteinizing hormone.

A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation? testosterone progesterone prolactin luteinizing hormone

The nurse is preparing to teach a client and her partner about the hormones involved in menstruation. Which hormone will the nurse point out is secreted by the corpus luteum? progesterone androgen luteinizing hormone follicle stimulating hormone

progesterone The corpus luteum secretes estrogen and progesterone. The anterior pituitary secretes the luteinizing hormone and follicle-stimulating hormone. The testes secrete androgen.

In the second half of the menstrual cycle after ovulation, _____ helps maintain the_____ _____ as well as relaxing the smooth muscle of the uterus and causing vasodilation, all of which would support implantation of a pregnancy.

progesterone uterine lining

As part of a 31-year-old client's prenatal care, the nurse is assessing immunization history. Which immunization is most relevant to ensuring a healthy fetus? measles hepatitis A and B rubella diphtheria, tetanus, and pertussis

rubella Maternal exposure to rubella during pregnancy poses a particular fetal risk that supersedes the significance of hepatitis, measles, diphtheria, tetanus, or pertussis.

An adult client currently has low levels of estrogen and progesterone. At this point in the menstrual cycle, the client will likely: shed her uterine lining. ovulate. become pregnant. experience endometrial regeneration.

shed her uterine lining. Low levels of estrogen and progesterone cause the shedding of the uterine lining (endometrium). Ovulation and subsequent pregnancy result from increased hormone levels. Regeneration follows ovulation during the secretory phase.

Progesterone is also the hormone that creates the

small rise in body temperature (about 0.3°C to 0.6°C) we see after ovulation.

Which vaccine is safe to give in pregnancy? the flu vaccine after the first trimester the measles vaccine in the second trimester the varicella vaccine before 36 weeks the HPV vaccine if the woman is younger than 26 years of age

the flu vaccine after the first trimester Live viruses vaccines such as MMR, varicella, and HPV are contraindicated in pregnancy.

The ovarian cycle is broken into two phases,

the follicular phase prior to ovulation and the luteal phase after ovulation.

The sex hormones have diverse effects on the body and also send feedback to

the pituitary and hypothalamus glands.

progesterone is responsible for

the secretory phase of the endometrial cycle, during which the lining of the uterus is nourished and maintained in the event of a fertilized embryo and implantation.

Pre-Lecture Quiz: Chapter 14 Before Conception (Look at numbers 66-75)

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