Ch 14 | Prep-U Quiz

Which question would be most important for a nurse to ask a G2 P1 client who has a child with sickle cell anemia?

"Did you and your partner get genetic testing?" Explanation: The nurse should assess whether the client has had genetic testing completed. If not, the client should be referred for testing. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233.

When educating parents on recessive genetic disease statistics, the nurse understands that which statement by the parents indicates an accurate understanding of genetic inheritance?

"Each child will have a 25% chance of developing the disease." Explanation: The statistics of inheritance are reset with each pregnancy; therefore, each pregnancy has the same statistical probability of displaying the genetic disease. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

A couple who went through subfertility testing and was told that everything looks normal still has not conceived. They come to the clinic stressed and depressed. The woman tells the nurse that they seem to argue all the time now and she does not know if all this is worth it. What is the nurse's best response?

"Perhaps a support group will help you both work through this stress." Explanation: Fertility does not always instantaneously result in pregnancy, which can cause stress and depression. Participation in a support group may allow a couple to work through the stress that fertility testing places on their lives. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 231-232.

The nurse is teaching a couple about the pros and cons of genetic testing. Which statement by the nurse best describes the limits of genetic testing?

"Some genetic tests can give a probability for developing a disorder." Explanation: The fact that some tests only provide a probability for developing a disorder raises a problem. A serious limitation of these susceptibility tests is that some people who carry a disease-associated mutation never develop the disease. Choosing appropriate treatments, avoiding having children with fatal diseases, and identifying those at high risk affirm the value of genetic tests. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241.

The pregnant client at 6 weeks' gestation asks the nurse if an ultrasound will reveal the sex of the fetus yet. What is the best response by the nurse?

"We will have to wait until the baby is 16 weeks' gestation to determine what the sex is." Explanation: The sex of the baby can be determined by ultrasound at 16 weeks' gestation. An ultrasound at 6 and 8 weeks would be too early to determine the sex. An ultrasound at 20 weeks should confirm what was found at 16 weeks. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 244-246.

A 4-year-old child is recently diagnosed with Wilms tumor. The health care provider suggests that the child's siblings have genetic testing performed. What is the best response by the nurse when explaining this to the parents?

"Wilms tumor is associated with a genetic link to chromosome 11; with early detection and treatment there are better outcomes." Explanation: Genetic testing for siblings of clients with Wilms tumor is suggested for early detection and treatment if necessary. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

Two parents carry the recessive gene for six toes. What is the chance that they will have a child with six toes?

25% Explanation: When two carrier parents have children together, they have a 25% chance of having a child who inherits the gene mutation from both parents and thus will have the condition. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

According to the Family and Medical Leave Act, a woman is guaranteed the right to how many weeks of unpaid, job-protected leave for the birth of a child?

12 Explanation: Passed in 1993, the Family and Medical Leave Act, a federal law, guarantees women the right to 12 weeks of unpaid, job-protected leave for the birth of a child; the adoption of or foster placement of a child; when a woman is needed to care for a parent, spouse, or child with a serious health condition; or because of a serious personal health condition. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 228.

Most cultures have their own beliefs surrounding pregnancy and prenatal care of the woman. A nurse is assigned to a family that is newly immigrated and alone in the community. The patient needs bedrest and help with her activities of daily living. One cultural issue that needs to be assessed is A. The role of the male partner in giving care to his wife B. Traditions surrounding water temperature in health care C. The sleeping arrangement in this family D. The meaning of pregnancy in this family

A. The role of the male partner in giving care to his wife Explanation: Family members will know and can state how their cultural views on water temperature, sleeping arrangements, and pregnancy affect the patient. The nurse must determine whether the male partner is prohibited from giving safe and necessary assistance to his wife. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226.

A 25-year-old woman who recently underwent genetic testing has just learned that she is heterozygous dominant for Huntington disease. Her husband, however, who also underwent the testing, is free from the trait. What are the odds that the couple will have a child who will inherit the disorder?

50% Explanation: If a person who is heterozygous or has a dominant illness gene opposing a recessive healthy gene mates with a person who is free of the trait, the chances are even (50%) a child born to the couple would have the disorder or would be disease and carrier free (that is, carrying no affected gene for the disorder). Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

A woman comes in for her annual gynecological examination and informs the nurse that she is going to try and become pregnant. She asks the nurse when the best time in the month is to become pregnant. What is the best response by the nurse? A. "3 days before until 2 days after ovulation." B. "2 weeks before and 2 weeks after ovulation." C. "5 days after your menstrual cycle is to begin." D. "The day after your menstrual cycle ends."

A. "3 days before until 2 days after ovulation." Explanation: Sperm are able to fertilize the ovum for up to 72 hours after ejaculation, and the ovum remains fertile for a maximum of 48 hours after ovulation. Thus, the window of opportunity for conception is 3 days before until 2 days after ovulation. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 244.

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? A. All the ova a female will ever have are present at birth. B. It contains a small nucleus, within which is a nucleolus called the germinal spot. C. It consists of protoplasm enclosed within a three-layered cell wall. D. The ovum is smaller than the sperm cell.

A. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

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. A. Equal maturation of both sperm and ovum B. Ability of the sperm to reach the ovum C. Ability of the sperm to penetrate the ovum D. Ability of the ovum to ingest the sperm E. Equal motility of both sperm and ovum

A. Equal maturation of both sperm and ovum B. Ability of the sperm to reach the ovum C. Ability of the sperm to penetrate the ovum Explanation: 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 Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 244.

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history? A. G3, T0, P1, A1, L1 B. G3, T1, P0, A2, L1 C. G2, T0, P1, A1, L1 D. G2, T1, P2, A1, L2

A. G3, R0, P1, A1, L1 Gravidity: # of pregnancies (past, current, abortions/miscarriages) Term Births: # of term deliveries @ >37 weeks Preterm births: # of deliveries btwn 20-37 weeks Abortions: pregnancy losses before 20 weeks Living: # of living children Explanation: The woman's obstetric history would be documented as G3, T0, P1, A1, L1. G (gravida) = 3 (past and current pregnancy), T (term pregnancies) = 0, P (number of preterm pregnancies) = 1, A (number of pregnancies ending before 20 weeks viability to include miscarriage) = 1, and L (number of living children) = 1. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233.

A client who is trying not to get pregnant calls the nurse on Saturday at 11 a.m. reporting that she had unprotected sex on Thursday at 10 p.m.. She believes she has just ovulated and wants to verify that she has no risk of pregnancy. What can the nurse tell her? A. If she ovulated on Saturday around 11 a.m., the egg could be fertilized any time before about 11 a.m. on Sunday. B. Because she did not ovulate before the unprotected coitus, she will not get pregnant. C. If she ovulated on Saturday around 11 a.m., the egg could be fertilized any time before about 11 a.m. on Monday. D. If she ovulated on Saturday around 11 a.m., the egg could be fertilized any time before about 10 p.m. on Sunday.

A. If she ovulated on Saturday around 11 a.m., the egg could be fertilized any time before about 11 a.m. on Sunday. Explanation: A single ovum is released from the ovary 14 days before the next menstrual period. It lives approximately 24 hours. The client's fertile period would be from Saturday at 11 a.m. to Monday at 11 a.m. During any other time frame, it would be unlikely that she would become pregnant. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241.

As part of caring for childbearing families, the nurse must be able to educate her families regarding which topic? A. Knowledge of reproductive anatomy and physiology B. Proper selection of a physician C. The best hospital for delivery of their babies D. The cost of obstetrical and neonatal care

A. Knowledge of reproductive anatomy and physiology Explanation: The obstetrical/gynecological nurse must be well versed in pregnancy and childbirth, as well as an understanding of clients of childbearing age. As a gynecological nurse, he or she must also have a good grasp of reproductive anatomy and physiology and the menstrual cycle. Helping select a physician, hospital or providing input on cost factors is not the nurse's job. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 237.

The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client? A. Primigravida B. Multipara C. Primipara D. Nulligravida

A. Primigravida Explanation: Gravida refers to a woman who is or has been pregnant. Primigravida refers to a woman who is pregnant for the first time, which is the case in this scenario. Multigravida refers to a woman who has been pregnant previously. Nulligravida refers to a woman who has never been and is not currently pregnant. Para refers to the number of pregnancies that have reached viability, regardless of whether the infants were born alive. Primipara refers to a woman who has given birth to one child past age of viability. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233. Pg. 284 Box 16.1 Terms Describing Current and Past Pregnancy Status Gravida: A pregnant woman Multigravida: A woman who has had more than one pregnancy Multipara: A woman who has carried a pregnancy past the 20th week of gestation or delivered an infant weighing more than 500 g more than once Nullipara: A woman who has never carried a pregnancy beyond the 20th week of gestation or carried a fetus weighing more than 500 g Para: The number of pregnancies carried to the 20th week of gestation or deliveries of an infant weighing more than 500 g, regardless of the outcome Primigravida: A woman who is pregnant for the first time Primipara: A woman who has been or is currently pregnant for the first time past the 20th week of gestation

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? A. estrogen B. progesterone C. androgens D. follicle-stimulating hormone

A. estrogen Explanation: 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 242.

Which question would be most important for a nurse to ask a G2 P1 client who has a child with sickle cell anemia? A. "Have you done well to control your stress?" B. "When was your last exacerbation?" C. "Do you know the sex of your baby?" D. "Did you and your partner get genetic testing?"

D. "Did you and your partner get genetic testing?" Explanation: The nurse should assess whether the client has had genetic testing completed. If not, the client should be referred for testing. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233.

To assess the sociocultural aspects of the family of an adolescent in an ambulatory clinic, about which of the following would you ask? A. His mother's occupation B. His mother's attitude toward citizenship C. The adolescent's education level D. His family structure

D. His family structure Explanation: Family structure is a characteristic strongly influenced by culture. The mother's occupation and citizenship do not affect the treatment of the adolescent patient. The patient's education also should not be a factor in treatment. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226.

What has served as the model for presymptomatic testing?

Huntington disease Explanation: Huntington disease has served as the model for presymptomatic testing because the presence of the genetic mutation predicts disease onset and progression. The other answers are incorrect because they are not the model for presymptomatic testing. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

A client has been confirmed to be pregnant. She gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history?

G3, P2 Explanation: Gravida (G) is the total number of pregnancies the client has had, including the present one, and para (P) is the number of babies born at 20 or more weeks of gestation. Since she gives a history of two previous normal deliveries, she is P2 and not P0, P1, or P3. Because she has had a total of three pregnancies including the present one, she is G3 and not G2. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233.

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her?

Arrange for prenatal care if the test is positive. Explanation: Home pregnancy testing can be accurate as soon as a period is missed; it should not take the place of prenatal care. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226.

A couple comes to the clinic for subfertility assessment. They are discouraged over their previous attempts to conceive. The nurse overhears the husband say, "I am ready to just give up. Let's go." What can the nurse say to the couple to allow them to express their concerns? A. "I heard you say that you want to give up. If so, this process is very time-consuming, and we need to know if you are committed." B. "How do you feel about what is happening?" C. "Are you blaming each other that you can't conceive? This is a problem with nature." D. "I know just what you are going through. We have a lot of couples in the same boat."

B. "How do you feel about what is happening?" Explanation: Questions such as, "How do you feel about what has happened" or "How do you think your partner feels about not being able to conceive" may be enough to encourage partners to express their concerns. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 231-232.

A couple has just been notified that their unborn child carries a genetic disorder. The couple expresses concern that the insurance company will not cover the costs associated with the medical bills for the child. What is the most appropriate response by the nurse? A. "The insurance company may consider it a preexisting condition since you know." B. "There are laws in place that prohibit that from happening." C. "The insurance company may ask you to change policies once the baby is born." D. "They will charge you a higher premium every month."

B. "There are laws in place that prohibit that from happening." Explanation: The Genetic Information Nondiscrimination Act of 2008 prohibits insurance companies from denying coverage or charging higher premiums based solely on genetic predisposition. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 229.

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

B. Breast tenderness Explanation: 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

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? A. Ask her to complete a written questionnaire concerning her past and present status. B. Conduct an interview in a private room to obtain her health history. C. Ask her some basic questions in the waiting room before taking her to the examining room. D. Wait until she is in the examining room and prepared for her physical examination.

B. Conduct an interview in a private room to obtain her health history. Explanation: Health interviewing is always conducted best in a quiet, private setting before examination procedures begin. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 231.

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? A. Ask her to complete a written questionnaire concerning her past and present status. B. Conduct an interview in a private room to obtain her health history. C. Wait until she is in the examining room and prepared for her physical examination. D. Ask her some basic questions in the waiting room before taking her to the examining room.

B. Conduct an interview in a private room to obtain her health history. Explanation: Health interviewing is always conducted best in a quiet, private setting before examination procedures begin. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 231.

Which disease process would the nurse screen for under potential genetic disorders? A. Asthma B. Cystic fibrosis C. Tuberculosis D. Rheumatic fever

B. Cystic fibrosis Explanation: Screening of genetically linked disorders is important when obtaining a family history. Cystic fibrosis is a genetically linked disorder. Tuberculosis is an infectious disorder. Rheumatic fever stems from a streptococcus infection. Asthma is a hypersensitivity typically from an environmental allergy. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy? A. T4 and GH B. FSH and LH C. FSH and T4 D. LH and MSH

B. FSH and LH Explanation: During pregnancy, FSH and LH are both inhibited as there is no need to develop a follicle and release an ovum. There is an increase in the secretion of T4 and MSH. There is a decrease in the production of GH and MSH but not an inhibition. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 241-242.

A baby is born with what the primary care provider believes is a diagnosis of trisomy 21. This means that the infant has three number 21 chromosomes. What factor describes this genetic change? A. The mother also has genetic mutation of chromosome 21. B. The client has a nondisjunction occurring during meiosis. C. During meiosis, a reduction of chromosomes resulted in 23. D. The client will have a single X chromosome and infertility

B. The client has a nondisjunction occurring during meiosis. Explanation: During meiosis, a pair of chromosomes may fail to separate completely, creating a sperm or oocyte that contains either two copies or no copy of a particular chromosome. This sporadic event, called nondisjunction, can lead to trisomy. Down syndrome is an example of trisomy. The mother does not have a mutation of chromosome 21, which is indicated in the question. Also, trisomy does not produce a single X chromosome and infertility. Genes are packaged and arranged in a linear order within chromosomes, which are located in the cell nucleus. In humans, 46 chromosomes occur in pairs in all body cells except oocytes and sperm, which contain only 23 chromosomes. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

A woman with both heart disease and osteoarthritis has come to the genetics clinic for genetic screening. What would the nurse know about these two diseases? A. They are direct result of the client's lifestyle B. They are multifactorial C. They are caused by a single gene D. They do not have a genetic basis

B. They are multifactorial Explanation: Genomic or multifactorial influences involve interactions among several genes (gene-gene interactions) and between genes and the environment (gene-environment interactions), as well as the individual's lifestyle. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

Genetics-related health care is basic to the holistic practice of nursing. What should nursing practice in genetics include? A. discouraging females to conceive after the age of 40 years B. gathering relevant family and medical history information C. providing advice on termination of pregnancy D. identifying genetic markers

B. gathering relevant family and medical history information Explanation: The nurse's role in genetic counseling is to provide information, collect relevant data, offer support, and coordinate resources. The other answers are incorrect because the nurse does not provide advice or influence the client to make choices. The nurse also does not identify genetic markers. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 231.

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. A. ultrasound pictures B. morning sickness C. hydatidiform mole D. breast changes E. fetal heartbeat F. amenorrhea

B. morning sickness D. breast changes F. amenorrhea Explanation: 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.) Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

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? A. carrying the ovum to the endometrium B. secreting estrogen and progesterone C. secreting mucus that supplies lubrication for intercourse D. implanting a fertilized ovum

B. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 239.

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? A. endometrial biopsy B. serum progesterone level C. vaginal discharge culture D. clomiphene

B. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 242. Pg. 703 A surge of LH that induces ovulation is expected 5 to 12 days after the completion of the 5-day cycle of clomiphene citrate. Ovulation usually occurs 14 to 26 hours after the LH surge, although it may take up to 48 hours. The LH surge is typically monitored for by testing of the urine. If indicated, a serum progesterone level may be taken a week after the LH surge. A concentration greater than 3 ng/mL indicates that ovulation occurred.

A woman comes to the clinic reporting her period is late and she is wondering if she is pregnant. Which assessment findings by the nurse would indicate she is exhibiting probable signs of pregnancy? Select all that apply. A. absence of menstruation B. softening of the cervix C. ballottement D. positive pregnancy test E. ultrasound visualization of the fetus F. auscultation of a fetal heart beat

B. softening of the cervix C. ballottement D. positive pregnancy test Explanation: Probable signs of pregnancy include a positive pregnancy test, ballottement, and softening of the cervix (Goodell's sign). Ultrasound visualization of the fetus, auscultation of a fetal heart beat, and palpation of fetal movements are considered positive signs of pregnancy. Absence of menstruation is a presumptive sign of pregnancy. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

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: A. her uterus fills up with blood each month and is passed during the menstrual cycle. B. the uterine lining is being shed due to lowering of hormone levels. C. her hormones cause her to accumulate blood in the uterus from ovulation. D. each month, her uterine lining thins out and vessels close to the surface begin to fill with blood.

B. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 237.

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? A. During ovulation, the cervix remains dry with scant mucus secretion. B. Cervical mucus disappears immediately after ovulation, resuming with menses. C. As ovulation approaches, cervical mucus is abundant and stretchable. D. About midway through the menstrual cycle, cervical mucus is clear and sticky.

C. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243. Pg. 85 after menses, vaginal discharge is often thin and slippery, and then at the time nearing ovulation can become thick and stringy like an egg white. This, she explains, is when women are most fertile. Between the egg-white-like mucus, also known as spinnbarkeit, and menses, the discharge can be stickier, even curdy, and white. All of this, says Dr. Janachek, is normal. Pg. 666 It is important for the nurse to know that vaginal discharge is normal, and most women produce 1 to 4 mL of discharge within a 24-hour time period. Normal discharge is white or clear, thin, mucosal, slippery, thick, and/or sticky. It is typically odorless. Normal discharge changes in response to hormones and thus changes throughout the month and throughout the life span. Generally, vaginal discharge is considered normal in the absence of pain, pruritus, abnormal bleeding, irritation, erosions, erythema, or a foul or fishy odor.

A young married woman says that she is planning a tubal ligation because intellectual disability runs in her husband's family and she does not want any children with this problem. Which nursing diagnosis would best apply to this couple? A. Anxiety related to marital issues B. Sexual dysfunction related to the possibility of having a intellectually disabled child C. Deficient knowledge of genetically inherited disorders D. Spiritual distress related to inappropriate approach to the issue of having children

C. Deficient knowledge of genetically inherited disorders Explanation: The young woman is making a decision to not have children without having information about her husband's family and the people who have intellectual disability. This is a knowledge deficit and is the most appropriate diagnosis for this couple. This situation does not support the diagnoses of anxiety, spiritual distress, or sexual dysfunction. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

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: A. Encourage her to start the baby on formula after the first year as recommended by many physicians B. Discuss how painful this will be once the baby has teeth C. Document her report but do nothing as this is a cultural belief that should be respected D. Advise her to be careful who she discusses this with as many will consider that a type of reportable child abuse

C. Document her report but do nothing as this is a cultural belief that should be respected Explanation: 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226.

A client has been confirmed to be pregnant. She gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history? A. G2, P1 B. G3, P0 C. G3, P2 D. G2, P3

C. G3, P2 Gravida (G) is the total number of pregnancies the client has had, including the present one, and para (P) is the number of babies born at 20 or more weeks of gestation. Since she gives a history of two previous normal deliveries, she is P2 and not P0, P1, or P3. Because she has had a total of three pregnancies including the present one, she is G3 and not G2. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233.

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of high school students. What would be the best response by a high school student about the function of the vagina? A. It receives the fertilized ovum and provides housing and nourishment for a fetus. B. It produces female gametes or ova and secretes female sex hormones. C. It receives sperm, provides an exit for menstrual flow, and serves as the birth canal. D. It is a small erectile structure that responds to sexual stimulation.

C. It receives sperm, provides an exit for menstrual flow, and serves as the birth canal. Explanation: The vagina's functions are to receive sperm, provide an exit for menstrual flow, and serve as the birth canal. 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 clitoris is a small erectile structure that responds to sexual stimulation. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 239-240.

Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the sex hormones produced? A. Bulbourethral glands B. Seminal vesicles C. Testes D. Cowper's glands

C. Testes Explanation: The testes serve two important functions: production of androgens (male sex hormones) and formation and maturation of spermatozoa. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241. The testes secrete testosterone and the ovaries secrete estradiol, as directed by the gonadotropins. The sex hormones have diverse effects on the body and also send feedback to the pituitary and hypothalamus glands.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241.

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

C. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241. The follicle, now called the corpus luteum, produces large amounts of progesterone and a smaller amount of estrogen, which was the dominant hormone prior to ovulation.

A student nurse is assigned to care for a woman who is being admitted for delivery of her baby. Where would the nurse expect to find the urethral meatus? A. On the true perineum B. Below the vaginal opening C. Within the vestibule D. Above the clitoris

C. Within the vestibule Explanation: The urethral meatus (opening to the urethra), paraurethral (Skene's) glands, vaginal opening or introitus, and Bartholin glands are located within the vestibule. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238. Vaginal vestibule: The opening into the vagina. When referred to as the vulvar vestibule, the term includes the urethral meatus.

You view a boy from a large extended family as poor because his father is unemployed. Considering his family structure, which way might he view you as "poor"? A. You are planning to be a nurse. B. You own only one student nurse's uniform. C. You are unmarried and live alone. D. You stated you value honesty.

C. You are unmarried and live alone. Explanation: 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. They would not know that you only own one uniform. Your views on honesty are unrelated to your financial status. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 226-227.

A nurse is preparing a presentation on genetic disorders. Which condition would the nurse most likely include as the most common form of male intellectual disability? A. Patau syndrome B. Down syndrome C. fragile X syndrome D. cri du chat syndrome

C. fragile X syndrome Explanation: Fragile X syndrome is the most common form of male retardation. Down syndrome, cri du chat syndrome, and Patau syndrome may also result in retardation, but they are not as common. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

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

C. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241.

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? A. any time during the week before ovulation B. a week after ovulation C. one or two days before ovulation D. any time after ovulation

C. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

The nurse is seeing a client who is going to be married in a month. This client has a history of Huntington disease in her family. The genetic testing has come back, and the client has just been told she carries the gene for Huntington disease and will develop the disease when she gets older. The client asks the nurse if this information is confidential and if it will remain that way. The nurse explains to the client that her family should be told and so should her fiancé. The client forcefully tells the nurse "no." She is not going to tell either her family or her fiancé. What is the nurse's best response? A. "I am ethically bound to tell your family and your fiancé." B. "Your information will remain confidential until the geneticist reviews everything. Then he will have to tell your family." C. "Have you thought about what this disease will do to the person you are going to marry and any children you may have?" D. "I will respect your wishes and keep your information confidential. I do wish you would reconsider though"

D. "I will respect your wishes and keep your information confidential. I do wish you would reconsider though" Explanation: The nurse must honor the client's wishes while explaining to the client the potential benefit this information may have for other family members. The other answers are incorrect because the nurse has to honor the wishes of her client. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 231.

A mother comes to the clinic nurse concerned about whether her adolescent daughter is sexually active. She requests a physical examination of the daughter's hymen. Which statement by the nurse accurately addresses this issue? A. Sexual activity by adolescents is expected and the daughter should not have to undergo the examination. B. The hymen normally stretches to accommodate sexual penetration and is not a good indicator of virginity. C. If the hymen is torn, then this proves that the daughter is sexually active. D. A torn hymen can result from heavy exertion or the use of tampons and is not a reliable method of determining virginity.

D. A torn hymen can result from heavy exertion or the use of tampons and is not a reliable method of determining virginity. Explanation: The hymen of a woman can be torn from a variety of causes not related to sexual activity. The use of tampons and strenuous exercise can tear the hymen. A torn hymen is a poor predictor of sexual activity but it does not stretch during intercourse. Expecting an adolescent to be sexually active does not address the issue raised by the mother. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 238-240.

You see a 3-year-old girl in an ambulatory clinic because she has a bad cold. Her mother tells you the girl's problem was caused by her being affected by "mal ojo." Which of the following would be the best action? A. Teach her mother that colds are caused by viruses B. Explain there is nothing to do for illnesses caused by evil spirits C. Tell her mother this is not a legitimate illness D. Ask her mother what symptoms her daughter is experiencing

D. Ask her mother what symptoms her daughter is experiencing Explanation: Respecting cultural values is important for effective nurse-patient relationships, and can be accomplished without insulting the mother. Telling her that the illness is not legitimate will establish an adversarial relationship. It would insult the mother if you tried to teach her what she believes she knows. Religious views of good and evil in relation to a disease are not to enter the conversation. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226.

What does the genetic analysis always include? A. Interventions for other potentially inherited conditions B. Evaluation of other potentially inherited conditions C. Planning for other potentially inherited conditions D. Assessment for any other potentially inherited condition

D. Assessment for any other potentially inherited condition Explanation: 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 patient does not have the disease. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

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? A. Just below the pubis symphysis B. At the uterine isthmus C. At the level of the corpus D. At the top of the fundus

D. 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 239-240.

Cystic fibrosis is an example of which type of inheritance? A. multifactorial B. autosomal dominant C. X-linked recessive D. autosomal recessive

D. Autosomal Recessive pg 33 "About one in twenty-seven people who are of European descent carry a cystic fibrosis mutation. Cystic fibrosis is autosomal recessive, which means that to actually get the disease, you need two copies of the mutation, one from each parent. Explanation: Cystic fibrosis is an autosomal recessive inherited condition. Huntington disease would be an example of an autosomal dominant inherited condition. Hemophilia is an X-linked recessive inherited condition. Cleft lip is a multifactorial inherited condition. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

A boy tells you that his family celebrates the Fourth of July by eating out at a local restaurant. He tells you this is a better way to celebrate the holiday than having a picnic like his neighbors. This statement represents which of the following? A. Stereotyping B. A taboo C. Cultural assimilation D. Ethnocentrism

D. Ethnocentrism Explanation: Ethnocentrism is a belief that one's own culture or customs are superior to others. A stereotype is often used with a negative connotation when referring to an oversimplified, exaggerated, or demeaning assumption that a particular individual possesses the characteristics associated with the class due to his or her membership in it. A taboo is forbidden. Assimilation is the fusion of a person into a culture. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226.

A Spanish-speaking couple comes in for genetic testing. They are planning to start a family and are concerned because the wife's sister has a genetic disorder. The clinic's consent form is in English and the husband is speaks only Spanish. The nurse does not speak Spanish. What should the nurse do? A. Explain the form to the patient in English and have them sign it B. Let the wife translate for her husband C. Inform the couple they just needed to sign so the testing could be done D. Informing the geneticist that the couple cannot give informed consent

D. Informing the geneticist that the couple cannot give informed consent Explanation: Nurses assess the patient's capacity and ability to give voluntary consent. This includes assessment of factors that may interfere with informed consent, such as hearing loss, language differences, cognitive impairment, and the effects of medication. The nurse's best action is to inform the geneticist that the couple cannot give informed consent until a translator is available. The other answers are incorrect because just having the couple sign the form or explaining it in English and then having them sign the form does not allow you to know that the husband understands what he is signing. The wife cannot translate for her husband because you do not know it she is translating the document correctly. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

A woman is 10 weeks pregnant and tells the nurse that this pregnancy was unplanned and she has no real family support. The nurse's most therapeutic response would be to: A. remind her that she is still early in the pregnancy and she will feel better about it as the pregnancy progresses. B. tell her to move home so her family will be nearby to help her. C. offer to meet with the client on a regular basis to provide her someone to talk to about her concerns. D. encourage her to identify someone that she can talk to and share the pregnancy experience.

D. encourage her to identify someone that she can talk to and share the pregnancy experience. Explanation: A pregnant woman without social support needs to identify someone with whom she can share the experience of pregnancy because social support is a crucial part of adapting to parenthood. Telling her to move home and telling her that she will feel better as the pregnancy progresses do not address the issue of isolation. Also, moving home my not be a possibility for this woman. The nurse should maintain a professional relationship and not commit to a long-term relationship with a client. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 231-232.

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

D. hepatitis B Pg 236, chart of vaccinations that can be administered during pregnancy Explanation: Hepatitis B vaccine should be considered during pregnancy. Immunizations for measles, mumps, and rubella are contraindicated during pregnancy. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 236.

A nurse is interviewing the family members of a pregnant client to obtain a genetic history. While asking questions, which information would be most important? A. socioeconomic status of the family members B. avoidance of questions on race or ethnic background C. specific physical characteristics of family members D. if couples are related to each other or have blood ties

D. if couples are related to each other or have blood ties Explanation: While obtaining the genetic history of the client, the nurse should find out if the members of the couple are related to each other or have blood ties, as this increases the risk of many genetic disorders. The socioeconomic status or the physical characteristics of family members do not have any significant bearing on the risk of genetic disorders. The nurse should ask questions about race or ethnic background because some races are more susceptible to certain disorders than others. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

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? A. changes in sexual response B. increases the risk of heart disease C. susceptibility to fractures D. inability to become pregnant

D. inability to become pregnant 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 242.

While conducting the first prenatal health history visit, the nurse learns that a pregnant patient 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 patient at this time?

Deficient knowledge regarding exposure to teratogens during pregnancy xplanation: The patient 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 no enough information to determine if the fetus is at risk because of the patient's lifestyle choices. The patient has not asked for specific information so health-seeking behavior diagnoses would not be appropriate for the patient at this time. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 234.

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?

G3 T0 P1 A1 L2 Explanation: 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; mulitple 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233.

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 Explanation: 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226.

During which stage of fetal development is exposure to teratogens most damaging?

Embryonic stage Explanation: 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 234-236.

What suggestions can the nurse make to the subfertile couple trying to work through the the stress that fertility testing is placing on their lives?

Encourage them to join a support group for subfertile couples. Explanation: Participation in a support group may allow a couple to work through the stress that fertility testing places on their lives. Resolve (http://www.resolve.org), a national support group for couples with subfertility, can be helpful in offering referral sources and support that a couple can use in planning. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 226, 232.

A female patient is willing to alter nutrition and activity status in an attempt to conceive. What teaching should the nurse provide to support this patient's desire? Select all that apply.

Exercise 30 minutes each day. Ingest vegetables that are high in fiber. Consciously reduce every day stressors. Add brown rice and dark bread to the diet. Explanation: Nutrition, body weight, and exercise are all important for adequate ova production because they all influence the blood glucose/insulin balance. The patient should be instructed to exercise 30 minutes each day, ingest vegetables that are high in fiber, and reduce every day stressors. In addition, eating slowly digested carbohydrate foods such as brown rice and dark bread rather than food such as white bread, which has easily digested carbohydrates, cannot only increase fertility by keeping insulin levels balanced. Decreased body weight or a body/fat ratio of less than 10% can reduce pituitary hormones such as FSH and LH and halt ovulation. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 236.

A client arrives to the clinic very excited and reporting a postive 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 Explanation: The positive signs of pregnancy are fetal image on 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's sign is a softening of the uterine isthmus. Chadwick's sign may have other causes besides pregnancy. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

A child is diagnosed with an X-linked dominant inheritance disorder. What should the nurse explain to the parents about this disorder?

It appears in every generation. Explanation: X-linked dominant inheritance disorders appear in every generation. The pattern of inheritance is through the X chromosome and affects female offspring. All children will not be affected. It is unclear if the diseases caused by this disorder are life threatening. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 229.

A couple has just learned that their unborn son has a chromosome disorder that results in an extra X chromosome. The primary care provider explains that secondary sex characteristics will not develop in this child at puberty and that his testes will remain small and produce ineffective sperm. The nurse recognizes that this child likely has:

Klinefelter syndrome. Explanation: Infants with Klinefelter syndrome are males with an extra X chromosome. At puberty, secondary sex characteristics do not develop; the child's testes remain small and produce ineffective sperm. Turner syndrome occurs in females and is characterized by only one functional X chromosome. Fragile X syndrome is an X-linked disorder in which one long arm of an X chromosome is defective, which results in inadequate protein synaptic responses; it results in intellectual disability in males. Down syndrome (trisomy 21) is characterized by an extra chromosome at chromosome 21. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 244.

A nurse is describing X-linked recessive disorders to a group of women undergoing genetic testing. The nurse determines that the teaching was successful when the group states which information?

No male-to-male transmission occurs. Explanation: Most X-linked disorders demonstrate a recessive pattern of inheritance. Males are more affected than females. A male has only one X chromosome, and all the genes on his X chromosome will be expressed whereas a female will usually need both X chromosomes to carry the disease. There is no male-to-male transmission (since no X chromosome from the male is transmitted to male offspring), but any man who is affected will have carrier daughters. If a woman is a carrier, there is a 50% chance that her sons will be affected and a 50% chance that her daughters will be carriers. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 246.

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?

Organizing nursing care at times other than visiting hours. Explanation: 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 226-227.

Which of a client's cells are most likely to reproduce by meiosis?

Ova Explanation: Ova and other sex cells reproduce by meiosis. All of the other tissues are made up of somatic cells, which reproduce by mitosis. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

A nurse is present when a health care provider tells a couple that the results of their genetic testing came back normal. Later, the nurse notes that the completed genetic report identifies the couple positive for a genetic disorder. What is the most appropriate action by the nurse?

Report it to the nursing supervisor. Explanation: The nurse has an obligation to report unethical behavior and should report the discrepancy to the nursing supervisor. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 242.

A female patient had a diagnostic laparoscopy and is now reporting a sharp pain in her shoulder. What response is a priority by the nurse?

Some of the carbon dioxide that was used to insufflate the abdomen has likely escaped under the diaphragm and this will resolve on its own. Explanation: Women may feel bloating of the abdomen from the infusion of CO2 after such a procedure. If some CO2 escapes under the diaphragm, there may be extremely sharp should pain from pressure. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 232.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241.

A nurse is caring for a 32-year-old Jewish client who is pregnant with a female baby. The parents are not directly related by blood. The mother reports that her husband's cousin had an infant born with Tay-Sachs disease that died two years ago and she is concerned about her baby. Which information does the nurse need to give the client to help alleviate her concerns regarding her baby having the same disease?

There is a risk to the baby based upon the Jewish background, so genetic testing would be Explanation: Tay-Sachs disease affects both male and female babies. The age of the client does not significantly increase the risk of Tay-Sachs disease. Even though the client and her husband are not related by blood, their background places their baby at a greater risk. There is a chance that the offspring may have Tay-Sachs disease even if both parents don't have it because they could be carriers, so genetic testing would be advisable. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 239.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

A mother has come to the clinic with her 13-year-old daughter to find out why she has not started her menses. After a thorough examination and history, genetic testing is prescribed to rule out which abnormality?

Turner syndrome Explanation: Turner syndrome is a common abnormality of the sex chromosome in which a portion or all of the X chromosome is missing. Only about one third of the cases are diagnosed as newborns; the remaining two thirds are diagnosed in early adolescence when they experience primary amenorrhea. No cure exists for this syndrome. Hormone replacement therapy may be used to induce puberty. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

A nurse is reviewing the obstetric history of a pregnant woman who has come to the clinic for a visit. The history reveals that the woman is "gravida 3, para 2". Which interpretation by the nurse would be appropriate?

Two previous pregnancies, two children born at term, and currently pregnant Explanation: A woman who has had two previous pregnancies, given birth to two term children, and is pregnant again is gravida 3, para 2. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 233.

n OB class, the nursing instructor is discussing the female reproductive anatomy. In order to understand the anatomy and function of the uterus, the instructor explains that there are four sections in the uterus. Which of the following are sections of the uterus? Select all that apply.

Uterine isthmus Fundus Cervix Corpus Explanation: The fallopian tubes are attached to the uterus but not a part of it. The other selections are all part of the uterus. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 239-240.

A nurse is teaching a group of women at the local health clinic about reproduction. After describing the various internal structures involved, the nurse determines that the teaching was successful when the group identifies which structure as connecting the external structures with the cervix?

Vagina Explanation: The vagina is a canal that connects the external genitals to the cervix. The uterus is an inverted, pear-shaped muscular organ at the top of the vagina and is subdivided into the convex portion above the uterine tubes, called the fundus, the central portion or corpus between the fundus and the cervix, and the cervix, or neck which opens into the vagina. Rugae are transverse folds in the vagina that allow it to dilate during labor and birth. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 239-240.

The nursing instructor is explaining the nursing care that is given to a client during her pregnancy. The instructor determines the session is successful when the students correctly choose which method will be used to evaluate the effectiveness of the nursing care they will provide?

Verify that desired outcomes for identified goals have been met. Evaluating the effectiveness of nursing care given during pregnancy is to look at the nursing diagnosis for the specific client, identify the goals and their desired outcomes for each diagnosis, and see if the desired outcomes are achieved. This may involve using a preprinted survey and interviewing the client. The nursing diagnoses should be established at the beginning to help guide the care for each individual client. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 231.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

What suggestions can the nurse make to the subfertile couple trying to work through the the stress that fertility testing is placing on their lives? a) Encourage them to join a support group for subfertile couples. b) Inform them that results are not instantaneous and they will have to deal with the stresses and disappointments. c) Encourage them to see a psychiatrist. d) Inform them that other people are going through the same thing

a) Participation in a support group may allow a couple to work through the stress that fertility testing places on their lives. Resolve (http://www.resolve.org), a national support group for couples with subfertility, can be helpful in offering referral sources and support that a couple can use in planning

A woman comes to the women's health clinic for a routine follow-up visit. While discussing the client's sexual history, the client tells the nurse, "When I have intercourse, I notice that there's an area near my vagina that is really sensitive when it is touched." The nurse identifies this area as the:

clitoris Explanation: 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. The prepuce is the hood-like covering over the clitoris. The vulva is a term used to collectively refer to the external genitalia. The vestibule is an oval area enclosed by the labia minora laterally. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 237.

When providing preconception care to a client, the nurse would identify which medication as being safe to continue during pregnancy?

famotidine Explanation: Famotidine is a category B drug that has been used frequently during pregnancy and does not appear to cause major birth defects or other fetal problems. Isotretinoin and warfarin are category X drugs and should never be taken during pregnancy. Lithium is a category D drug with clear health risks for the fetus and should be avoided during pregnancy. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, pp. 234-245.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

An expectant mother is on heparin for previous blood clots and voicing concerns about how her medications will affect her baby. The nurse would inform the mother that:

heparin does not cross the placenta and is safe for her to take. Explanation: Heparin is a medication that does not cross the placenta and therefore is safe to use during pregnancy. Not all medications cause fetal sequelae. It is not recommended to abruptly discontinue any medication without consulting the mother's health care provider and heparin is the safest anticoagulant for a pregnant woman to take. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 235.

When genetics and genomics were incorporated into nursing, the decision was made to include them in what part of the nursing process?

interventions that support identification of the genetics-related health needs of people xplanation: The incorporation of genetics and genomics into nursing means including genetics and genomics in health assessments, planning, and interventions that support identification of and response to the changing genetics-related health needs of people. The other answers are incorrect because the responses measured in genomic nursing care are not to generalized nursing care, nurses do not plan medical interventions, and interventions are not planned in the assessment phase of nursing care. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

When teaching an adolescent about ovulation, the nurse would include that ovulation is initiated by a surge in which hormone?

luteinizing hormone Explanation: Luteinizing hormone is released from the pituitary gland to stimulate ovulation on approximately the 14th day of a typical cycle. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 241

A nurse teaching a couple says that when X-linked recessive inheritance is present in a family, the genogram will reveal that:

only males in the family have the disorder. Explanation: When X-linked recessive inheritance is in a family, a genogram will reveal only males in the family with the disorder, a history of girls dying at birth for unknown reasons, unaffected sons of affected men, and parents of affected children not having the disorder. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 244.

The ethics of genetic screening encourage you to:

relay findings to individuals as soon as possible. Explanation: Promptly relating findings increases patient satisfaction. Genetic analysis information should be shared only with the person requesting the analysis. Analysis should be conducted voluntarily. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 238.

Genetic testing has revealed that a couple's unborn child shows the possibility of mosaicism. When counseling this couple, the nurse explains this means that:

the genetic abnormality occurred after fertilization and during the mitotic cell division. Explanation: Mosaicism refers to when the chromosomal abnormalities do not show up in every cell and only some cells or tissues carry the abnormality. It occurs after fertilization and during the mitotic cell division. The symptoms are usually less severe. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.

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 xplanation: 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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 242.

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. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 14: Before Conception, p. 243.