Chapter 3: Anatomy and Physiology of the Reproductive System

Which client should the nurse flag for the health care provider to assess first?

the male client with three palpable masses in the testes Explanation: The testes should have two nut-like structures present in males. The third mass could indicate a tumor or other anomaly. All the remaining clients have normal, expected findings.

A young male asks the nurse at the clinic about what he can do to maintain his sperm production. The nurse would instruct him to take which action?

It is recommended that men wear boxer-style underwear. Explanation: It is recommended that men wear loose fitting pants and underwear in order to keep the testes cooler than body temperature to best support sperm production. Tight pants and hot baths are counterproductive to sperm production; wearing cotton underwear does not affect it.

With sexual stimulation the penis becomes erect. What is the physiologic cause of an erection?

Penile sinuses fill up with blood. Explanation: The sinuses within the erectile tissue fill up with blood, causing an erection.

Which body structure controls reproductive hormone production and function for both males and females?

Pituitary gland Explanation: The pituitary gland is responsible for governing the reproductive hormone production and reproductive functioning. The other glands have no influence on reproduction hormones.

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. Explanation: 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.

The nurse is assessing a female client who is having difficulty experiencing an orgasm. Which action should the nurse point out as necessary for an orgasm in females?

clitoral stimulation Explanation: The clitoris is highly sensitive and allows the woman to experience sexual pleasure and an orgasm during sexual stimulation. It is thought to be the main stimulus for initiating orgasm in women. Penetration may be pleasurable, but alone it is not enough to stimulate orgasm. Uterine stimulation does not affect orgasm. Sensory arousal plays a major role in attaining female orgasm.

A nurse is teaching a group of young adults about the sexual cycle. The nurse determines that the teaching was successful when the group identifies the five phases as they occur. Place the phases below in the correct order from first to last. All options must be used.

desire excitement plateau orgasm resolution Explanation: The sexual cycle is usually thought of as having five phases: desire, excitement, plateau, orgasm, and resolution.

When describing the process of fertilization, the nurse would explain that it normally occurs in which structure?

fallopian tube Explanation: Fertilization normally occurs in the fallopian tube. Once fertilized, the ovum proceeds down the uterus and attaches itself in the endometrium. The vagina and cervix are not involved in fertilization.

The nurse is teaching a family planning class at a health fair. Which physiologic change during the plateau stage of sexual response will the nurse point out?

retraction of the clitoris Explanation: Retraction of the clitoris occurs during the plateau stage prior to orgasm. Lengthening of the vagina and scrotal elevation occur during excitement. The labia minora deepens in color.

The nurse at a health fair is teaching about the various changes of puberty. Which sequence of events will be best for the nurse to present when illustrating pubertal changes in females?

breast budding, appearance of pubic hair, menarche Explanation: Secondary sexual characteristics develop in an orderly sequence with variance in the timing for individuals. Breast budding in the female is usually the first physical sign noted, and occurs between the ages of 10 and 12 years on average. Appearance of pubic hair usually occurs just before menarche, the first menstrual period. From the onset to the start of menarche is typically 2 years.

An anatomy professor is teaching a class of pre-nursing students about the female reproductive system. One student asks, "Where is the opening to the vagina?" The best answer the professor can give is:

in what is called the vestibule, which is located between the labia minora. Explanation: The vestibule is the area between the labia minora. The urethral meatus (opening to the urethra), paraurethral (Skene) glands, vaginal opening or introitus, and Bartholin glands are located within the vestibule.

Which hormone is called the hormone of pregnancy because it reduces uterine contractions during pregnancy?

progesterone Explanation: Progesterone is called the hormone of pregnancy because it reduces uterine contractions, thus producing a calming effect on the uterus, allowing pregnancy to be maintained. FSH is primarily responsible for the maturation of the ovarian follicle. LH is required for both the final maturation of preovulatory follicles and the luteinization of the ruptured follicle. Estrogen is crucial for the development and maturation of the follicle.

The nursing instructor is teaching a group of nursing students about the menstrual cycle. The instructor determines the session is successful when the students correctly choose which action as responsible for the increased thickness of the endometrium?

the increasing level of estrogen Explanation: Estrogen levels increase after menstruation. These levels promote a thickening of the endometrial tissue. FSH and LH are responsible for ovarian changes. Progesterone will be increasing not decreasing, and works with estrogen in influencing the menstrual cycle.

A client who is attempting to conceive and menstruates regularly every 30 days asks the nurse what is her probable day of ovulation. The client indicates that her last menses started on the 6th of the month. What is the best response by the nurse?

22nd Explanation: 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.

A couple comes to the clinic asking questions regarding getting pregnant. The nurse explains that fertilization normally occurs in what structure of the woman's body?

Fallopian tube Explanation: The ova mature and are released from the ovary. It then is attracted into the fallopian tube by the fimbriae where the sperm fertilizes it, usually in the ampulla portion of the tube.

The nurse is preparing to assess a new client who has arrived for her initial visit with a gynecologist specializing in menopause issues. The nurse anticipates the client will be in which age group?

47 to 55 Explanation: Menopause refers to the time in a women's life when reproductive capability ends. The average age at which menopause occurs is between 47 and 55 years. Although it is possible to start menopause earlier or later, 47 to 55 is the typical age.

It is important that couples who wish to practice natural forms of birth control understand that the mucus-secreting glands of the cervix can store live sperm for up to:

48 hours. Explanation: The mucus-secreting glands of the cervix are capable of storing live sperm for 48 to 72 hours (2 to 3 days), enabling pregnancy to occur after intercourse has occurred 1 or 2 days before ovulation.

A nurse is providing education to a client with infertility concerns. Which statement by the client indicates appropriate understanding of the Spinnbarkeit Test?

"Halfway in my cycle I will need to check my cervical mucus to see if I can stretch it in to long strands, indicating I am close to ovulating." Explanation: The ability of the cervical mucus to be stretched into long strands indicate an increase in estrogen secretion and impending ovulation. This exam can be conducted at home by the client without the need of additional resources.

A nurse is discussing sexual intercourse during pregnancy with a client. Which statement by the client would indicate that learning has occurred?

"As long as the baby and I both continue to do well, I can have intercourse." Explanation: Barring complications, couples can continue to engage in sexual intercourse to the extent it is comfortable and desired. Oxytocin released during orgasm is not enough to induce preterm labor. The nurse should educate the client about other positions that might be more comfortable to use for intercourse during pregnancy, including the male and pregnant female anatomy during intercourse so the client can understand the lack of risk for injury.

The mother of a 9-year-old girl is concerned because her daughter has already begun menstruating. The daughter is of normal height for her age and weighs 150 lbs (68 kg). The mother is concerned that this is not normal and asks about the factors that could be involved. Which response by the nurse would be best?

"It has become more common for girls to start their periods as early as 9; her weight may be a contributing factor." Explanation: Although it is not proven, the general consensus is a girl must reach a critical weight of approximately 95 lb (43 kg) or develop a critical mass of body fat before the hypothalamus is triggered to send initial stimulation to the anterior pituitary gland to begin the formation of FSH and LH. Probably because of the combination of better nutrition and increased obesity, girls are beginning puberty at earlier ages than ever before (9 to 12 years). Nine is an early age to begin menstruation, but it is within the normal range. Anorexia nervosa is associated with delays or halts in menstruation, not early menstruation. The age of menarche is not governed completely by genetics; other factors are involved.

A woman experiencing menopausal symptoms asks the nurse about herbal remedies for managing her symptoms. Which response by the nurse would be most appropriate?

"Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies." Explanation: Information about the efficacy of herbal therapies is largely anecdotal. Research to validate the efficacy, safety, and potential harmful effects of herbal therapies is lacking. Until recently, hormone replacement therapy was the mainstay of treatment, but in light of the results of the Women's Health Initiative trial, it has become controversial. Telling the woman that her symptoms are not severe enough is demeaning and inappropriate: the woman's symptoms are significant to her, regardless of what the nurse may think.

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?

"My menstrual cycle lasts about 4 to 6 days each month but varies sometimes, which is normal." Explanation: The normal menstrual cycle lasts an average of 4 to 6 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.

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education?

"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." Explanation: 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.

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which information?

A primary function of the female breast is to produce milk. Explanation: A primary function of the female breast is to produce milk, a process called lactation. The breasts contain an abundant supply of blood vessels and lymphatics. Estrogen is the hormone primarily responsible for the growth and development of breast tissue. Smooth muscle in the nipples contracts, causing them to become erect when cold, touched, or sexually stimulated.

A client is at the clinic for her annual pelvic exam and asks the nurse about ovulation and where the eggs come from. What educational information would the nurse share with this client?

A woman is born with all the ova that she will ever have and they are stored within the ovaries. Explanation: A woman is born with all the ova that she will ever have and they are stored within the ovaries. They are released each month throughout her life until the reproduction years are over.

The nurse is reviewing the structure and function of various organs in the female reproductive system. Which information should the nurse include about the ovum in the review with the client?

All the ova a female will ever have are present at birth. Explanation: It is believed that all the ova a female will ever have are present at birth. The human ovum consists of protoplasm enclosed within a two-layered cell wall. The outer layer is the zona pellucida; the inner layer is the vitelline membrane. The ovum cell contains a large nucleus, within which is a nucleolus called the germinal spot. The ovum is larger than the sperm cell, and it is the only human cell normally visible to the naked eye.

A client asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which statement should the nurse expect to include in the client's teaching plan?

As ovulation approaches, cervical mucus is abundant and stretchable. Explanation: During ovulation, the cervix produces thin, clear, stretchy, slippery mucus that is designed to capture the man's sperm, nourish it, and help the sperm travel up through the cervix to meet the ovum for fertilization.

A nurse is providing information regarding ovulation to a couple who want to have a baby. Which fact should the nurse tell the clients?

At ovulation, a mature follicle ruptures, releasing an ovum. Explanation: At ovulation, a mature follicle ruptures, releasing a mature oocyte (ovum). Ovulation always takes place 14 days, not 10 days, before menstruation. The lifespan of the ovum is only about 24 hours, not 48 hours; unless it meets a sperm on its journey within that time, it will die. When ovulation occurs, there is a drop, not a rise, in estrogen levels.

The nurse is examining a pregnant female in her third trimester and measuring to determine if fetal growth has increased. Where would the nurse place the measuring tape?

At the top of the fundus Explanation: The uterine fundus is located that the topmost portion of the uterus and that is where the uterus is measured to determine fetal size and gestation. The isthmus is the uterine segment that connects the cervix to the uterus. The corpus, the main body of the uterus, is not the top of the uterus. One end of the measuring tape is placed at the top of the pubic symphysis and extended to the top of the fundus.

A nurse is conducting an orientation at a health clinic for newly hired nurses comparing normal and abnormal assessment findings on a female physical assessment. The nurse determines the session is successful when they correctly point out which structure's secretions assist with sexual intercourse?

Bartholin's glands Explanation: The Bartholin glands are located in the vestibule and secrete a mucus which moistens the vaginal mucosa during sexual intercourse. The introitus is the opening to the vagina. The vestibule is the area between the labia minora. It contains the uretheral meatus, Skene glands, introitus, and Bartholin glands. The labia minora is paired erectile tissue folds that extend anteriorly from the clitoris and join at the perineum.

The nurse is educating a pregnant woman regarding expectations immediatley after the birth of her baby. Which would the nurse include in the teaching plan regarding colostrum?

Colostrum is yellow fluid that preceeds breast milk and is healthy for the baby Explanation: Colostrum is the yellow fluid from the breast that is a precourser to breast milk. It is high in protein and antibiodies and is healthy for the baby. The colostrum will last about 1 to 3 days. Vernix is the waxy covering of the baby at birth. Prolactin is the hormone that promotes breast milk production.

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?

Explanation: 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.

The nurse is explaining the menstrual cycle to a group of older adolescents. Which factor should the nurse point out will lead to menstruation?

Decreasing production of progesterone by the corpus luteum Explanation: If the ovum is not fertilized, the production of progesterone and estrogen by the corpus luteum begins to decrease. Without the high levels of progesterone and estrogen, the endometrium degenerates and sheds, a process referred to as menstruation. The follicle becomes the corpus luteum after ovulation and continues to secrete estrogen and progesterone. The production of another ovum is not the factor that causes endometrium degeneration. Production of follicle stimulating hormone by the anterior pituitary initiates ovulation.

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. Explanation: 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.

A nursing student is preparing an exhibit for a school health fair on the male reproductive system. The student should point out which pituitary hormone as being necessary in the process of sperm production?

Follicle-stimulating hormone. Explanation: Follicle-stimulating hormone is produced by the anterior pituitary gland and is responsible for stimulation of sperm production. Other hormones secreted by the anterior pituitary include interstitial cell stimulating hormone (which stimulates the testes to secrete testosterone) and leutinizing hormone (which causes ovulation and stimulates the ovaries to produce progesterone in women). The testes are responsible for producing testosterone, which is necessary for the maturation of sperm as well as secondary sexual characteristics.

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.

GnRH, FSH, LH Explanation: 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 young woman is trying to get pregnant. She asks the nurse to recommend a practical way that she can tell the point in her monthly cycle when she will have the best odds of getting pregnant. Which recommendation by the nurse would be best?

Have sex when the cervical mucus is thin, stretchy, and copious. Explanation: Women can analyze cervical mucus changes to help plan coitus so it coincides with ovulation if they want to increase their chance of becoming pregnant or plan to avoid coitus at the time of ovulation to prevent pregnancy by analyzing how thick or thin is cervical mucus. At the beginning of each cycle, when estrogen secretion from the ovary is low, cervical mucus is thick and scant. Sperm survival in this type of mucus is poor. At the time of ovulation, when the estrogen level has risen to a high point, cervical mucus becomes thin, stretchy (Spinnbarkeit), and copious. Sperm penetration and survival in this thin mucus are both excellent. Fernlike patterns on a microscope slide of cervical mucus do indicate ovulation, but this method is not nearly as practical as examining the consistency of the cervical mucus. The beginning of the cycle, just after the end of menstruation, is before ovulation, and thus not the best time to have coitus if the goal is conception.

When assessing an adolescent for the use of safer sex practices, which should be the nurse's first question?

Have you engaged in oral, vaginal, or anal sex?" Explanation: The nurse should first assess the client for sexual activity. All other responses assume that the client is already engaged in sexual activity and therefore not appropriate first responses.

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of nursing students. What would be the best response by a nursing student about the function of the uterus?

It receives the fertilized ovum and provides housing and nourishment for a fetus. Explanation: The uterus's functions are to receive the fertilized ovum and provide housing and nourishment for a fetus. The ovaries' functions are to produce female gametes or ova and secrete female sex hormones. The vagina's functions are to receive sperm, provide an exit for menstrual flow, and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.

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 6 Explanation: 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.

Which statement should be incorporated into the teaching plan developed to present instruction about the female menstrual cycle to nursing students?

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.

There are two major functions of the reproductive system, continuation of the species and sexual pleasure. In the male, the reproductive system has a third function. What is this third function?

Urinary elimination Explanation: Some of the structures in the reproductive tract serve dual purposes. Most often these alternate functions have to do with urinary elimination because the urinary and reproductive systems are closely connected.

A client is at the clinic for her yearly physical and is found to be anemic. What information from her history would most likely be a contributory factor to this finding?

She reports that her menstrual cycle is irregular and often lasts 7 to 10 days. Explanation: Prolonged menstrual cycles can cause anemia and iron deficiency due to the blood loss. The other factors will not make the client anemic.

Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the sex hormones produced?

Testes Explanation: The testes serve two important functions: production of androgens (male sex hormones) and formation and maturation of spermatozoa.

The school nurse is preparing a teaching session for a group of adolescent girls explaining the menstrual cycle. The nurse determines the session is successful when the young students correctly choose which fact?

The average menstrual flow lasts 4 to 6 days. Explanation: The average flow last 4 to 6 days and is caused by casting away of blood, tissue and debris from the uterus. The average age for menarche is from 12 to 14 years. Menarche is the end of puberty, which follows breast budding and the appearance of pubic hair. The total blood loss each month is 25 to 60 mL.

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 has clear, thin cervical mucus Explanation: 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.

Which statement best expresses the role of the corpus luteum?

The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. Explanation: 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.

A woman is going through the luteal phase of her ovarian cycle. What changes are taking place during this period of time?

The follicle develops into the corpus luteum. Explanation: In the luteinizing phase, ovulation has already occurred and if the egg is fertilized, progesterone and estrogen levels increase. The follicle remnants become the corpus luteum, a yellow body on the ovary. LH levels remain elevated after ovulation. FSH levels increase during the follicular stage.

A client asks the nurse about how the testes function in reproduction. Which is the nurse's best reply?

The testes serve as the production center for sperm. Explanation: The testes serve two purposes: production of testosterone and formation and maturation of sperm. Seminal fluid is located in prostate and seminal vesicles. The testes produce testosterone, not estrogen, which is a female hormone. The testes have no connection to sexual stimulation.

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of nursing students. What would be the best response by a nursing student about the function of the ovaries?

They produce female gametes or ova and secrete female sex hormones. Explanation: The ovaries' functions are to produce female gametes or ova and secrete female sex hormones. The uterus's functions are to receive the fertilized ovum and provide housing and nourishment for a fetus. The vagina's functions are to receive sperm, provide an exit for menstrual flow, and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.

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?

Thin and copious Explanation: 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.

The nurse is explaining about the function of the mons pubis to a client. Which explanation describes the function of the mons pubis?

To protect the pelvic bones during sexual intercourse Explanation: The mons pubis is a fatty pad that lies over the pubic symphysis and serves to protect the pelvic bones during intercourse. The vagina is the receptacle for sperm, the clitoris is the body that enhances sexual pleasure in the female and the perineum and pelvic floor are the structures that stretch during childbirth.

The nurse at the fertility clinic is counseling two women in a relationship about their decision to start a family. Which decision would the nurse discuss that is unique to their situation?

Which partner carries the pregnancy Explanation: A unique decision that needs to be made by two women who decide to seek pregnancy is who will carry the pregnancy. The other decisions such as selection of a sperm donor, the methods of insemination, and the cost of the attempts to conceive are decisions made by all couples seeking fertility services.

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?

While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. Explanation: 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.

A group of nursing students are comparing the 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?

clitoris Explanation: The female clitoris is 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.

A nurse is conducting a health education program about pubertal changes at a local all-girls school for the parents who have daughters in the 4th and 5th grades. The nurse is describing the events that occur prior to the first menses. Place the events in the order in which the nurse would describe them from first to last. All options must be used.

development of breast buds appearance of pubic hair appearance of axillary hair growth spurt menstruation Explanation: Pubertal events preceding the first menses have an orderly progression: thelarche, the development of breast buds; adrenarche, the appearance of pubic and then axillary hair, followed by a growth spurt; and menarche, occurring about 2 years after the start of breast development.

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?

endometrium Explanation: 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.

The nurse is teaching a group of college students about the four phases of the sexual response. Which phase will the nurse point out as producing an elevation in heart rate, blood pressure, and respirations?

excitement Explanation: During the excitement phase, the physiologic response of both male and females results in an increase in heart rate, blood pressure, and respirations. During the plateau phase, the physiologic changes that occurred during excitement are maintained. In the female, the clitoris retracts and the uterus is fully elevated. In the male, the penis engorges further and the testes remain elevated. Orgasm is marked by muscular contractions. During resolution, the muscles relax and blood pressure, heart rate, and breathing return to normal.

A nurse is conducting an in-service education program about the female reproductive cycle for a group of nurses working at a women's health clinic. When describing the phases of the endometrial cycle, the nurse would explain that the proliferative phase of the endometrial cycle corresponds to which phase in the ovarian cycle?

follicular Explanation: The endometrial cycle consists of four phases: proliferative, secretory, ischemic, and menstrual. The proliferative phase of the endometrial cycle corresponds to the follicular phase of the ovarian cycle.

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

A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important?

genetics Explanation: Genetics is the most important factor in determining the age at which menarche starts, but geographic location, nutrition, weight, general health, nutrition, cultural and social practices, the girl's educational level, attitude, family environment, and beliefs are also important.

Which hormone is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle?

gonadotropin-releasing hormone (GnRH) Explanation: 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?

gonadotropin-releasing hormone (GnRH) Explanation: 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.

The nurse, while teaching a group of pregnant women about the production of breast milk, describes colostrum and compares it with mature breast milk. Which characteristic would the nurse identify as associated with colostrum?

high mineral content Explanation: Colostrum is rich in maternal antibodies, especially IgA, which protects the newborn against enteric pathogens. Colostrum contains more minerals and protein but less sugar and fat than mature breast milk.

A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs:

in the fallopian tubes. Explanation: Fertilization of the ovum can occur in the distal portion of the fallopian tubes. If the egg is fertilized, it will then be moved through the fallopian tube towards the uterus where it implants in the thick endometrium and begins its development.

A nurse is conducting a class for a group of female adolescents about the structures of the female reproductive tract. The nurse determines that the teaching was successful when the class identifies which structure as containing sweat and sebaceous glands?

labia majora Explanation: The labia majora contain sweat and sebaceous glands. The mons pubis is the elevated, rounded, fleshy prominence made up of fatty tissue that overlays the symphysis pubis. The clitoris is a small, cylindrical mass of erectile tissue and nerves. The joining of the folds above and below the clitoris form the prepuce, a hood-like covering over the clitoris.

The nurse is reviewing the role of the mammary glands in the reproductive process with a birth class. What should the nurse tell the class is the name of the ducts in the mammary glands that form a small reservoir for milk?

lactiferous Explanation: Each breast is divided into 15 to 20 lobes of glandular tissue, covered by adipose (fat) tissue, which gives the breast its shape. The lobes are made up of lobules, which consist of milk-secreting cells in glandular alveoli. From the alveoli, small lactiferous ducts converge toward each nipple like the spokes of a wheel. Each lactiferous duct forms a small reservoir for milk. The structures of the breast include the nipple, the areola, and the areolar glands. The nipple is a circular projection containing some erectile tissue. It is surrounded by the pigmented areola. Areolar glands, which are close to the skin's surface, make the areola appear rough.

A 47-year-old woman is being seen at the local clinic reporting irregular menstrual cycles. The nurse would explain to the client that the irregularity is most likely due to:

menopause. Explanation: As a woman's reproductive capabilities end, her menstrual cycles will become irregular and finally cease. The average age for menopause is 47 to 55 years. This client meets these criteria. Pregnancy would cause absence of menstrual cycles. Hormonal fluctuations and underlying endocrine problems would not be the anticipated causality.

A client is trying to have a baby and wants to know the best time to have intercourse to increase the chances of pregnancy. Which time for intercourse is ideal to help her chances of conceiving?

one or two days before ovulation Explanation: To increase the chances of conceiving, the best time for intercourse is 1 or 2 days before ovulation. This ensures that the sperm meets the ovum at the right time. The average life of a sperm cell is 2 to 3 days, and the sperm cells will not be able to survive until ovulation if intercourse occurs a week before ovulation. The chances of conception are minimal for intercourse after ovulation.

After teaching a group of women about reproduction and the structures involved, the nurse determines that the teaching was successful when the group identifies which female reproductive structure as comparable to the male testes?

ovaries Explanation: The ovaries are a set of paired glands resembling unshelled almonds that are the organs of gamete production in the female. They are homologous to the male testes. The fallopian tubes are the site of fertilization. The clitoris is a small, cylindrical mass of erectile tissue and nerves that is analogous to the male penis. The fundus is the upper portion of the uterus.

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

A young mother is expressing frustration of not being able to breastfeed her infant. A potential cause could be the lack of the hormone:

prolactin. Explanation: The hormone prolactin is responsible for the stimulation of milk production. Oxytocin is responsible for uterine contractions during labor. Luteinizing hormone and estrogen are important hormones responsible for the monthly cycles.

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?

secreting estrogen and progesterone Explanation: 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's glands when stimulated secrete mucus that supplies lubrication for intercourse. The uterus is the site of implantation of a fertilized ovum.

A woman has been assessing her basal body temperature for 4 months. Upon reviewing her temperature history log, the nurse notes no change in her daily temperatures. Which should the nurse expect the health care provider to prescribe first?

serum progesterone level Explanation: There should be a significant increase in temperature, usually 0.5° to 1° F, within a day or two after ovulation has occurred. The temperature remains elevated for 12 to 16 days, until menstruation begins. The cause of this rise in temperature is the hormone progesterone. If there is no change in the woman's monthly temperature, the progesterone level should be assessed.

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. Explanation: 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.

A nurse is assisting with the pelvic examination of a female client. The client has given birth to two living children, ages 5 and 2 years. The nurse would expect the client's cervical os to appear as which shape on examination?

slit-like Explanation: Before birth, the external cervical os is a small, regular, oval opening. After birth, the opening is converted into a transverse slit that resembles lips.

A nurse is conducting a health class for a group of adolescents about male and female reproduction. When describing the testes, the nurse would explain that these organs are important for manufacturing which hormone?

testosterone Explanation: The testes serve two functions: production of sperm and synthesis of testosterone, the primary male sex hormone. Estrogen is secreted by the ovaries; progesterone is secreted by the corpus luteum. Luteinizing hormone is secreted by the anterior pituitary gland and is responsible for both the final maturation of the preovulatory follicles and luteinization of the ruptured follicle.

A school nurse is talking to an adolescent, who asks her about why she has monthly menstrual cycles. The best explanation that the nurse can offer the adolescent regarding the menstrual phase is to tell her that:

the uterine lining is being shed due to lowering of hormone levels. Explanation: During the menstrual phase of the cycle, the endometrium, or lining of the uterus, is shed because of low estrogen and progesterone levels. The uterus does not fill up with blood monthly, nor does her hormones cause blood accumulation on the uterus. Also, the uterine lining thickens (rather than thins out) each month in preparation of implantation of the fertilized egg.

The nurse is preparing to teach a birthing class and intends to alert the couples to potential difficulites, ensuring they have as much accurate information as possible. Which area of the uterus will the nurse explain has the highest risk of rupture during labor?

uterine isthmus Explanation: The uterine isthmus is the lower uterine segment and is the thinnest portion of the uterus; it does not participate in the muscular contractions of labor. The cervix is the tubular structure that connects the vagina and the uterus. The corpus is the main body of the uterus. The fundus is the top portion of the uterus. The cervix, corpus, and fundus will all stretch and contract due to the muscular action.

The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would the nurse include as a major structure to help ensure fertilization of the ovum?

vas deferens Explanation: The vas deferens is part of the ductal system of the male reproductive system responsible for transporting sperm from the epididymis to the outside. Accessory glands include the seminal vesicles, prostate gland, and Cowper or bulbourethral glands, and they each play an important role in assisting with the transportation process by adding to the semen and protecting the sperm, but without the passageway, the sperm would not be able to exit the body.