REPRODUCTION HESI
Ovulation occurs how many days before the next menstrual period?
14 days
The events of conception occur in which order after fertilization of the ovum? 1. the zygote cells divide and shrink in size 2. Zygote divides in the fallopian tube 3. The blastocyst develops 4. the morula forms
2, 1, 4, 3,
Students are completing a clinical rotation in the prenatal care clinic. Which statements demonstrate understanding of when and how human chorionic gonadotropin (hCG) is secreted? A. the zygote secretes hCG B. A high level of hCG is a pregnancy indicator C. Pregnant women have a higher level of progesterone D. Ovulating women have higher amounts of hCG in their system E. Increased hCG production causes decreased estrogen secretion
A. the zygote secretes hCG B. A high level of hCG is a pregnancy indicator C. Pregnant women have a higher level of progesterone
When does ovulation occur?
Approx. 14 days before the next menstrual period
When are the most fertile days for pregnancy?
Day BEFORE ovulation and the DAY of ovulation
Why do some women not realize they are pregnancy?
They experience implantation bleeding or spotting
When does the fertile period begin and end?
Begins: 4-5 days PRIOR to ovulation Ends: 24-48 hrs AFTER ovulation
Which develops to become part of the placenta and fetal membranes? A. zygote B. morula C. blastocyst D. concepitus
C. bastocyst
Does the menstrual phase vary in length for most women?
YES
State the objective signs that signify ovulation?
-abundant, thin, clear cervical mucus Spinnbarkiet = egg-white stretchiness open cervical os slight drop in basal body temp and than a 0.5-1 degree F rise ferning under the microcope
State 3 ways to identify the chronological age of a pregnancy (gestation)
1.) 10 lunar months 2.) 9 calendar months consisting of 3 months each 3.) 40 weeks- 280 days
How long do eggs live for after being released?
24-38 hrs
A couple presents to the clinic for infertility evaluation. The man states "a low sperm count is the only cause of infertility in men right?" Which statement by the nurse best teaches the couple about male infertility factors? A. Male infertility is usually a matter of sperm count B. Male infertility can also be related to low testosterone levels C. Male infertility can be associated with the structure and function of the sperm or the penis D. Male infertility can be related to obesity
C. Male infertility can be associated with the structure and function of the sperm or the penis
How long can sperm live in the woman's body?
4-5 days
The patient is seeking family planning advice at her annual wellness visit. The nurse provides teaching for the patient about conception and ovulation. Which statement by the patient on the timing of conception indicates that further teaching is necessary? A. I can get pregnant up to seven days after ovulation B. sperm can survive up to two days after sexual intercourse C. when trying to conceive we should plan to have sex when I am ovulating D. even if I'm ovulating my husband still has to produce enough healthy sperm for me to conceive
A. I can get pregnant up to seven days after ovulation Rationale: more teaching is required so that the patient understands that the ovum may have the capacity to be fertilized for 24 hours after ovulation, not for seven days.
A woman has had three lost pregnancies and 18 months. The nurse is discussing possible causes with the patient. What patient statement demonstrates that the woman understands this type of infertility? A. My pregnancy losses could be linked to my age B. My pregnancy losses could be the result of chromosomal errors C. my pregnancy losses could be caused by an incompetent cervix D. my pregnancy losses could be linked to the high stress I feel at my job E. My pregnancy losses could be associated with a hormonal imbalance
A. My pregnancy losses could be linked to my age B. My pregnancy losses could be the result of chromosomal errors C. my pregnancy losses could be caused by an incompetent cervix E. My pregnancy losses could be associated with a hormonal imbalance
Which statements accurately characterize how the female body prepares for conception? A. oocytes remain in the ovary in the Graafian follicle B. the ovum is released on the fallopian tube surface C. an ovum is released 14 days before the menstrual period begins D. the Graafian follicle prepares the uterine lining by producing estrogen and progesterone E. the oval matures as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are released
A. oocytes remain in the ovary in the Graafian follicle C. an ovum is released 14 days before the menstrual period begins D. the Graafian follicle prepares the uterine lining by producing estrogen and progesterone
A patient at the OB/GYN clinic states "once we figure out why I haven't gotten pregnant this past year, then we can fix it." Which response by the nurse best explains the success of identifying infertility causes? A. that is our hope, but there is no guarantee B. Infertility usually resolves with time, not treatment C. Successful treatment typically means you will get pregnant afterward D. Most likely when the cause of infertility is identified a solution can be achieved
A. that is our hope, but there is no guarantee Rationale: many factors contributing to infertility remain unknown. Although treatment does exist for some problems it does not always lead to successful pregnancy
A nurse is reviewing a basal body temperature chart with a couple. Which change would indicate probable ovulation? a) A decrease in temperature followed by an increase for several days b) An increase in temperature followed by a decrease for several days c) A decrease in temperature that remains until menses begins d) A steadily increasing temperature over seven days
Answer: A At ovulation body temperature drops, then rises sharply and remains elevated for several days.
Estrogen, one of the hormones regulating cyclic activities in female reproductive system is responsible for which effect? a. Increases the quantity and pH of cervical mucus, causing it to become thin and watery and can be stretched to a distance of 10-13 cm. b. Inhibits the production of LH c. Increases endometrial tortuosity d. All of the above
Answer: A Effects of estrogen: • Inhibits the production of FSH • Causes hypertrophy of the myometrium • Increases the quantity and pH of cervical mucus, causing it to become thin and watery and can be stretched to a distance of 10-13 cm. Effects of Progesterone • Inhibits the production of LH • Increases endometrial tortuosity • Increased endometrial secretions • Facilitates transport of the fertilized ovum through the fallopian tubes
Which of the following instructions about activities during menstruation would the nurse include when counseling an adolescent who has just begun to menstruate? A) Take a mild analgesic if needed for menstrual pain. B) Avoid cold foods if menstrual pain persists. C) Stop exercise while menstruating. D) Avoid sexual intercourse during menstruation.
Answer: A The nurse should instruct the client to take a mild analgesic, such as ibuprofen, if menstrual pain or "cramps" are present. The client should also eat foods rich in iron and should continue moderate exercise during menstruation, which increases abdominal tone. Avoiding cold foods will not decrease dysmenorrhea. Sexual intercourse is not prohibited during menstruation, but the male partner should wear a condom to prevent exposure to blood.
A 23-year-old nulliparous client visiting the clinic for a routine examination tells the nurse that she desires to use the basal body temperature method for family planning. The nurse should instruct the client to do which of the following? A) Check the cervical mucus to see if it is thick and sparse. B) Take her temperature at the same time every morning. C) Document ovulation when the temperature decreases at least 1°F. D) Avoid coitus for 10 days after a slight rise in temperature.
Answer: B The basal body temperature method requires that the client take her temperature each morning before arising, preferably at the same time each day before eating or any other activity. Just before the day of ovulation, the temperature falls by 0.5°F. At the time of ovulation, the temperature rises 0.4° to 0.8°F because of increased progesterone secretion in response to the luteinizing hormone. The temperature remains higher for the rest of the menstrual cycle. The client should keep a diary of about 6 months of menstrual cycles to calculate "safe" days. There is no mucus for the first 3 or 4 days after menses, and then thick, sticky mucus begins to appear. As estrogen increases, the mucus changes to clear, slippery, and stretchy. This condition, termed spinnbarkeit, is present during ovulation. After ovulation, the mucus decreases in amount and becomes thick and sticky again until menses. Because the ovum typically survives about 24 hours and sperm can survive up to 72 hours, couples must avoid coitus when the cervical mucus is copious and for about 3 to 4 days before and after ovulation to avoid a pregnancy.
Which of the following would the nurse include in the teaching plan for a 32-year-old female client requesting information about using a diaphragm for family planning? A) Douching with an acidic solution after intercourse is recommended. B) Diaphragms should not be used if the client develops acute cervicitis. C) The diaphragm should be washed in a weak solution of bleach and water. D) The diaphragm should be left in place for 2 hours after intercourse.
Answer: B The teaching plan should include a caution that diaphragms should not be used if the client develops acute cervicitis, possibly aggravated by contact with the rubber of the diaphragm. Some studies have also associated diaphragm use with increased incidence of urinary tract infections. Douching after use of a diaphragm and intercourse is not recommended because pregnancy could occur. The diaphragm should be inspected and washed with mild soap and water after each use. A diaphragm should be left in place for at least 6 hours but no longer than 24 hours after intercourse. More spermicidal jelly or cream should be used if intercourse is repeated during this period.
A adult female patient is using the rhythm (calendar-basal body temperature) method of family planning. In this method, the unsafe period for sexual intercourse is indicated by; a. Return preovulatory basal body temperature b. Basal body temperature increase of 0.1 degrees to 0.2 degrees on the 2nd or 3rd day of cycle c. 3 full days of elevated basal body temperature and clear, thin cervical mucus d. Breast tenderness and mittelschmerz
Answer: C Ovulation (the period when pregnancy can occur) is accompanied by a basal body temperature increase of 0.7 degrees F to 0.8 degrees F and clear, thin cervical mucus. A return to the preovulatory body temperature indicates a safe period for sexual intercourse. A slight rise in basal temperature early in the cycle is not significant. Breast tenderness and mittelschmerz are not reliable indicators of ovulation.
. A 19-year-old nulligravid client visiting the clinic for a routine examination asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which of the following statements would the nurse expect to include in the client's teaching plan? a) About midway through the menstrual cycle, cervical mucus is thick and sticky. b) During ovulation, the cervix remains dry without any mucus production. c) As ovulation approaches, cervical mucus is abundant and clear. d) Cervical mucus disappears immediately after ovulation, resuming with menses.
Answer: C As ovulation approaches, cervical mucus is abundant and clear, resembling raw egg white. Ovulation generally occurs 14 days (plus or minus 2 days) before the beginning of menses. During the luteal phase of the cycle, which occurs after ovulation, the cervical mucus is thick and sticky, making it difficult for sperm to pass. Changes in the cervical mucus are related to the influences of estrogen and progesterone. Cervical mucus is always present.
Assessment of a 16-year-old nulligravid client who visits the clinic and asks for information on contraceptives reveals a menstrual cycle of 28 days. The nurse formulates a nursing diagnosis of Deficient Knowledge related to ovulation and fertility management. Which of the following would be important to include in the teaching plan for the client? A) The ovum survives for 96 hours after ovulation, making conception possible during this time. B) The basal body temperature falls at least 0.2°F after ovulation has occurred. C) Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. D) Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus.
Answer: C For a client with a menstrual cycle of 28 days, ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. Stated another way, the menstrual period begins about 2 weeks after ovulation has occurred. Ovulation does not usually occur during the menses component of the cycle when the uterine lining is being shed. In most women, the ovum survives for about 12 to 24 hours after ovulation, during which time conception is possible. The basal body temperature rises 0.5° to 1.0°F when ovulation occurs. Although some women experience some pelvic discomfort during ovulation (mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus is thin and copious.
A multigravid client will be using medroxyprogesterone acetate (Depo-Provera) as a family planning method. After the nurse instructs the client about this method, which of the following client statements indicates effective teaching? a) "This method of family planning requires monthly injections." b) "I should have my first injection during my menstrual cycle." c) "One possible side effect is absence of a menstrual period." d) "This drug will be given by subcutaneous injections."
Answer: C With medroxyprogesterone acetate, irregular menstrual cycles and amenorrhea are common side effects. Other side effects include weight gain, breakthrough bleeding, headaches, and depression. This method requires deep intramuscular injections every 3 months. The first injection should occur within 5 days after menses.
After being examined and fitted for a diaphragm, a 24-year-old client receives instructions about its use. Which of the following client statements indicates a need for further teaching? A) "I can continue to use the diaphragm for about 2 to 3 years if I keep it protected in the case." B) "If I get pregnant, I will have to be refitted for another diaphragm after the delivery." C) "Before inserting the diaphragm I should coat the rim with contraceptive jelly." D) "If I gain or lose 20 pounds, I can still use the same diaphragm."
Answer: D A client would need additional instructions when she says that she can still use the same diaphragm if she gains or loses 20 pounds. Gaining or losing more than 15 pounds can change the pelvic and vaginal contours to such a degree that the diaphragm will no longer protect the client against pregnancy. The diaphragm can be used for 2 to 3 years if it is cared for and well protected in its case. The client should be refitted for another diaphragm after pregnancy and delivery of a newborn because weight changes and physiologic changes of pregnancy can alter the pelvic and vaginal contours, thus affecting the effectiveness of the diaphragm. The client should use a spermicidal jelly or cream before inserting the diaphragm.
Which of the following would the nurse expect to include in the teaching plan for a 30-year-old multiparous client who will be using an intrauterine device (IUD) for family planning? a) Amenorrhea is a common side effect of IUDs. b) The client needs to use additional protection for conception. c) IUDs are more costly than other forms of contraception. d) Severe cramping may occur when the IUD is inserted.
Answer: D Severe cramping and pain may occur as the device is passed through the internal cervical os. The insertion of the device is generally done when the client is having her menses, because it is unlikely that she is pregnant at that time. Common side effects of IUDs are heavy menstrual bleeding and subsequent anemia, not amenorrhea. Uterine infection or ectopic pregnancy may occur. The IUD has an effectiveness rate of 98%. Therefore, additional protection is not necessary to prevent pregnancy. IUDs generally are less costly than other forms of contraception because they do not require additional expense. Only one insertion is necessary, in comparison to daily doses of oral contraceptives or the need for spermicides in conjunction with diaphragm use.
A patient has diagnosed endometriosis. Which statement by the patient demonstrates an understanding of the relationship between infertility and endometriosis? A. Endometriosis can affect the patency of the ovaries B. Endometriosis can scar and block the fallopian tube's C. Endometriosis can increase the frequency of shedding of the endometrium D. Endometriosis can cause the uterine lining to overproduce in the uterus
B. Endometriosis can scar and block the fallopian tube's
A student nurse is reviewing the conception process with a classmate. Which statement demonstrates an understanding of the fertilization process? A. fertilization causes the ovum to undergo mitosis B. fertilization causes changes to the zona pellucida C. it only takes one day for fertilization to be complete D. cell division occurs after sperm and ovum merge E. fertilization describes the union between the ovum and the sperm F. sperm penetrate the overnight by enlarging and lengthening the tail
B. Fertilization causes changes to the zona pellucida Rationale: the zona pellucida is a mechanical protection of the egg as it travels from the ovary to the uterus. Once the egg is fertilized, the Zona Pellucida keeps the other sperm from entering C. it only takes one day for fertilization to be complete D. Cell division occurs after the sperm and ovum merge E. fertilization describes the union between the ovum and the sperm
Which statements explain what occurs during the fusion of the sperm and the ovum? A. the sperm into is that ovum B. both of the sperm head and tail change C. fertilization is complete within 12 hours D. nuclei of the gametes cluster at the center of the ovum E. changes in the ovum prevent other sperm from entering
B. both of the sperm head and tail change D. nuclei of the gametes cluster at the center of the ovum
Which statement describes how the fertilization process in humans results and 46 chromosomes? A. the 23 chromosomes from the sperm end of them are doubled B. the nuclei of the gametes touch and dissolve producing 46 chromosomes C. The zona pellucida prevents sperm from entering after 46 chromosomes are restored D. the fertilized ova and contains 23 unpaired chromosomes, 22 autosomes, and a Y chromosome
B. the nuclei of the gametes touch and dissolve producing 46 chromosomes
A couple that is in fertile has just been made aware that they're in fertility is related to hypospadias. Which statements by the couple demonstrate that more teaching is needed? A. Sperm cannot reach the cervix B. Hypospadias affects ejaculation C. Hypospadias affects sperm structure D. hypospadias is an anatomic problem E. hypospadias is possible in both partners
C. Hypospadias affects sperm structure E. hypospadias is possible in both partners
Which statement, made by the nurse, demonstrates appropriate patient teaching regarding the effect of cervical mucus abnormalities on conception? A. Cervical mucus may cause an obstruction, preventing sperm from entering the uterus B. Cervical mucus abnormalities can be caused by sexually transmitted diseases C. Cervical mucus deficiency keep sperm from penetrating the uterus D. Cervical mucus deficiency causes painful periods and painful intercourse
D. Cervical mucus deficiency causes painful periods and painful intercourse
A couple returns to the clinic for premarital counseling. The woman states "if we don't get pregnant in the next year can we assume the problem is with one of our reproductive organs?" Which statement by the nurse explains the infertility doctors for men and women? A. infertility is typically only associated with one of the partners B. Let's not worry about that now. I am sure you will conceive before then C. let's not assume so soon. Infertility cannot be determined after one year D. Infertility can be influenced by factors including social behaviors and your environment
D. Infertility can be influenced by factors including social behaviors and your environment
To avoid pregnancy, when should the woman avoid having unprotected sex?
During her fertile days
What are the 4 phases of the menstrual cycle?
Menstrual phase: Days 1-5 Proliferation (Follicular) phase: Day 5-ovulation Ovulatory phase Luteal phase: Begins immediately after ovulation an ends with menstruation
When must a couple avoid unprotected sex to prevent pregnancy?
Several days before ovulation and 3 days after ovulation
A 22-year-old nulligravid client tells the nurse that she and her husband have been considering using condoms for family planning. Which of the following instructions would the nurse include about the use of condoms as a method for family planning? A) Using a spermicide with the condom offers added protection against pregnancy. B) Natural skin condoms protect against sexually transmitted diseases. C) The typical failure rate for couples using condoms is about 25%. D) Condom users frequently report penile gland sensitivity
Answer: A The typical failure rate of a condom is approximately 12% to 14%. Adding a spermicide can decrease this potential failure rate because it offers additional protection against pregnancy. Natural skin condoms do not offer the same protection against sexually transmitted diseases caused by viruses as latex condoms do. Unlike latex condoms, natural skin (membrane) condoms do not prevent the passage of viruses. Most condom users report decreased penile gland sensitivity. However, some users do report an increased sensitivity or allergic reaction (such as a rash) to latex, necessitating the use of another method of family planning or a switch to a natural skin condom.
Jessa, 17 years old, is bleeding between periods of less than two weeks. This condition is an abnormality in the menstrual cycle known as: a. Metrorrhagia b. Menorrhagia c. Amenorrhea d. Dysmenorrheal
Answer: A Abnormalities of Menstruation 1. Amenorrhea - absence of menstrual flow 2. Dysmenorrhea - painful menstruation 3. Oligomenorrhea - scanty menstruation 4. Menorrhagia -excessive menstrual bleeding 5. Metrorrhagia - bleeding between periods of less than 2 weeks
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for signs and symptoms of which of the following? A) Anemia. B) Hypertension. C) Dysmenorrhea. D) Acne vulgaris.
Answer: B Before advising a client about oral contraceptives, the nurse needs to assess the client for signs and symptoms of hypertension. Clients who have hypertension, thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident are poor candidates for oral contraceptives. In addition, women who smoke, are older than 40 years of age, or have a history of pulmonary disease should be advised to use a different method. Iron-deficiency anemia, dysmenorrhea, and acne are not contraindications for the use of oral contraceptives. Iron-deficiency anemia is a common disorder in young women. Oral contraceptives decrease the amount of menstrual flow and thus decrease the amount of iron lost through menses, thereby providing a beneficial effect when used by clients with anemia. Low-dose oral contraceptives to prevent ovulation may be effective in decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to be caused by the release of prostaglandins in response to tissue destruction during the ischemic phase of the menstrual cycle. Use of oral contraceptives often improves facial acne
Which of the following instructions should be included in the nurse's teaching regarding oral contraceptives? a. Weight gain should be reported to the physician. b. An alternate method of birth control is needed when taking antibiotics. c. If the client misses one or more pills, two pills should be taken per day for 1 week. d. Changes in the menstrual flow should be reported to the physician.
Answer: B When the client is taking oral contraceptives and begins antibiotics, another method of birth control should be used. Antibiotics decrease the effectiveness of oral contraceptives. Approximately 5-10 pounds of weight gain is not unusual, so answer A is incorrect. If the client misses a birth control pill, she should be instructed to take the pill as soon as she remembers the pill. Answer C is incorrect. If she misses two, she should take two; if she misses more than two, she should take the missed pills but use another method of birth control for the remainder of the cycle. Answer D is incorrect because changes in menstrual flow are expected in clients using oral contraceptives. Often these clients have lighter menses.
A 20-year-old woman desiring to use a cervical cap for family planning is instructed on its use. Which of the following client statements would indicate to the nurse that the client needs further instruction? A) "Cervical caps can be left in place longer than a diaphragm." B) "Using a cervical cap may increase the risk of irritation." C) "Cervical caps usually fit better than a diaphragm." D) "Many women are unable to use cervical caps."
Answer: C The client needs further instruction when she says that cervical caps fit better than the diaphragm. Many women are unable to use cervical caps because their cervix is too short for the cap to fit the cervix properly. A cervical cap may remain in place for up to 48 hours after intercourse, whereas it is recommended that a diaphragm be left in place for only 24 hours. The cervical cap is associated with cervical irritation.
