Chapter 3: Structure and Function of the Reproductive System

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

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

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

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

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

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

A woman tells you that both she and her husband like to continue sexual relations during her menstrual period. They have a monogamous relationship. She asks you if this will harm her. Which of the following would be the best response?

"If this is satisfying for you and your partner, then there is no harm in it." Sexual relations may be continued through a menstrual flow if this is satisfying for both partners.

The nursing instructor has completed a teaching session on the female reproductive system. The instructor determines more teaching is necessary when a student indicates which action occurs in the menstrual cycle?

"In the ischemic phase, the uterine lining becomes ischemic because of increased estrogen and progesterone." In the ischemic phase, the uterine lining becomes ischemic because the corpus luteum is no longer producing progesterone and estrogen. The other statements are correct.

The nurse is providing teaching to an adolescent girl on the function of the female reproductive system. Which statement by the client best reflects understanding of the material presented?

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

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

The pediatrician's nurse is educating the mother of a young preadolescent girl. She advises the mother that puberty is marked by the appearance of secondary sexual characteristics and maturation of the reproductive organs. The mother asks the nurse when this will happen. The nurse's reply is based on her knowledge that puberty usually occurs between:

10 and 14 years of age. Puberty usually begins in females between the ages of 10 and 14 years.

A nurse is discussing menstruation with a female client. The nurse describes a normal amount of blood loss is approximately:

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

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

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

A sex education class is being conducted at a local women's center. The attendees ask the nursing instructor about why they experience sensations of increased warmth during sex and redness of the neck and chest. Which information would the nurse provide to explain this experience? Select all that apply.

A person's heart rate increases during sex, making them warmer. The blood pressure will increase, which can cause a feeling of warmth. Vessels in the pelvis are receiving more blood and can cause a warm sensation. During the excitement phase of the sexual response, the body undergoes several physical changes. An increase in the heart rate and blood pressure are two of the normal responses noted; these cause an increase in body warmth. Additionally, the pelvic vessels become congested and this increases blood flow and the area becomes warmer. Reddening of the neck and chest are noted in many people during sex and adds to the sensation of increased warmth. The respiratory rate increases, not decreases, during sex.

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

The nurse is reviewing the process of egg maturation and ovulation with a client. What occurs during ovulation in the ovarian cycle that the nurse should include in the teaching session with the client?

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

The nurse is teaching a preconception class. A participant asks how long after ovulation can the egg be fertilized. What is the best response by the nurse?

An egg can only be fertilized for about 24 hours after release from the ovary. Following ovulation the egg can only be fertilized for about 24 hours. However, sperm have a life cycle of about 5 days. Home ovulation tests can help couples time intercourse with ovulation.

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

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

A nurse is conducting an orientation at a health clinic for newly hired nurses comparing normal and abnormal findings from 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 glands The Bartholin glands are located in the vestibule and secrete a mucus that moistens the vaginal mucosa during sexual intercourse. The introitus is the opening to the vagina. The vulva vestibule is the area between the labia minora. It contains the ureteral meatus, Skene glands, introitus, and Bartholin glands. The labia minora are paired erectile tissue folds that extend anteriorly from the clitoris and join at the perineum.

A sexually active 14-year-old male presents at the local clinic seeking birth control. What reproductive education would the nurse provide for this client at this time? Select all that apply.

Beginning next year, the client should begin monthly testicular self-examinations. It is normal for the left testicle to hang lower that the one on the right. The sperm are formed and matured within the testes. It is recommended that beginning at age 15, men perform a monthly testicular self-examination to detect any changes associated with cancer. The left spermatic cord is longer that the right cord and, thus, the left testicle hangs lower than the right. Sperm are formed and mature in the testes. Constrictive clothing causes a decreased sperm count, not an increased sperm count. The male sex hormone is testosterone, not estrogen.

The time in a woman's life when she loses the capability to reproduce is called menopause. Menopause does not occur all at once, but over a period of time that differs from woman to woman. There is, however, an average age when menopause occurs. What is this average age?

Between 47 and 55 years The average age at which menopause occurs is between 47 and 55 years.

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

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

The nurse is inserting a client's urinary catheter as prescribed. When the nurse begins to introduce the tip of the catheter, the client winces and cries out in pain. What is the nurse's best action?

Confirm that the tip of the catheter is not touching the clitoris. The clitoris can be mistaken for the urethra during catheter insertion, causing pain. It would be unsafe and inappropriate to make another attempt without confirming the appropriate landmarking. Palpating the bladder does not address the fact that insertion may be incorrect. Insertion is sometimes uncomfortable, but should not cause pain.

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

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

A nursing instructor is teaching a class on the male reproductive system. The instructor determines the session is successful when the students correctly choose which functions of the bulbourethral glands' (Cowper glands) secretions? Select all that apply.

Enhance sperm motility Nourish sperm Protect sperm The fluids secreted by the bulbourethral glands (Cowper glands) enhance sperm motility, nourish sperm, and protect the sperm. The sperm are not produced in the testes. The fluids secreted by the bulbourethral glands are alkaline.

A nurse is teaching a group of women about the sexual response cycle. The nurse determines that the teaching was successful when the group correctly chooses certain events that occur due to vasocongestion during the sexual response cycle. Select all that apply.

Erection of the penis and the clitoris Enlargement of the labia and testicles Lubricates the vagina Vasocongestion is caused by the arteries dilating faster than the blood can be drained by the venous system. Veins remove blood from the system, not arteries. Vasocongestion can also result in widespread congestion of the pelvic tissues but not necessarily the entire abdomen. The other choices are the result of vasocongestion during the sexual response.

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

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

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

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

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

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

Which actions by a graduate nurse on the postpartum unit would require the nurse manager to intervene? Select all that apply.

Graduate nurse questions how a lesbian couple could have a baby together. Graduate nurse speaks to the surrogate mother about the care of the newborn. Nurses in the obstetric units need to be non-judgmental when caring for clients with a variety of family structures. The nurse manager would need to intervene if a graduate nurse is questioning lifestyle choices of a lesbian couple. It is important for nurses to follow the lead of these parents and acknowledge any same-sex partner of a pregnancy just as you would the father of a heterosexual pregnancy. Also, in the situation with teaching a surrogate mother about care of the newborn, the graduate nurse should be teaching the parents who will be caring for the newborn. Surrogate mothers are used in situations such as two same sex couples or couples unable to conceive. The other situations show respect for clients and their family structures. Blended families are common today, with a possible combination of siblings and half-siblings. Visitation should include siblings and half-siblings, which was handled appropriately by the graduate nurse. Assisting the single mother to complete the birth certificate application is also showing respect, as the single mother may have questions about how to complete the form. Today 26% of children live with only one parent, who is six times more likely to be a mother rather than a father. This is known as a single-parent family. It is important for today's nurses to be aware and non-judgmental when caring for parents in a variety of family structures. Acknowledging family members of the new mother is an important part of demonstrating caring and respect.

An experienced nurse is working with a new graduate on the postpartum unit. Which comment by the new graduate about a client would require the nurse to intervene?

I have ordered a kosher diet for the Jewish client, since that is usually what they prefer. Assuming that a Jewish client would want a kosher diet is incorrect, as the nurse should verify with the client the preferred dietary choices. A nurse cannot assume that an aspect of a culture is important to a client simply because he or she identifies with that culture. It is not essential that nurses understand all aspects of a culture but rather that the nurse respects a client's cultural context and takes the individual client's preferences and beliefs into consideration when providing care. The nurse is showing respect with the other clients by supporting their preferences when possible.

The client is reporting pain when the nurse begins the insertion of a urinary catheter. What measure can the nurse take to facilitate comfort for this client?

Identify the urethral meatus between the labia minora, avoiding the clitoris. It is easy to mistake the clitoris for the urethral meatus so always locate both the clitoris and the meatus prior to beginning the procedure to lessen the pain of the procedure. Rotation of the catheter will likely cause more discomfort. Recleansing the perianal area a second time will not reduce discomfort and will expose the client to more betadine. Bearing down does not reduce pain of catheterization and could interfere with insertion.

The nursing instructor is illustrating the various phases of the uterine cycle to a group of nursing students. The instructor determines the session is successful when the students correctly choose which action occurring during the secretory phase?

If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth 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.

During what phase of the uterine cycle would the uterine lining begin to have a reduced blood supply?

Ischemic phase On Day 27 and 28 of the uterine cycle, the corpus luteum is no longer producing either estrogen or progesterone. Without these hormones to maintain the blood vessels in the uterus, the uterine lining begins to become ischemic or without blood supply, initiating the ischemic phase.

The nurse is preparing instruction about the menstrual cycle for adolescent patients. What will the nurse include about changes in the uterine endometrium during the second half of the cycle?

It is corkscrew-like because of progesterone stimulation. During the second half of the menstrual cycle, the formation of progesterone in the corpus luteum causes the glands of the uterine endometrium to become corkscrew or twisted in appearance and dilated. The uterine endometrium is thin and transparent immediately after the end of the menstrual cycle. The uterine endometrium does not become thick and purple in color because of estrogen stimulation. The uterine endometrium does not become twisted and ragged because of follicle-stimulating hormone.

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?

It receives sperm, provides an exit for menstrual flow, and serves as the birth canal. 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.

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

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

As part of caring for childbearing families, the nurse must be able to educate families regarding which topic?

Knowledge of reproductive anatomy and physiology 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, a hospital, or providing input on cost factors is not the nurse's job.

The nurse is preparing an educational session about menstruation for a group of adolescents. Which hormone should the nurse instruct as initiating ovulation?

Luteinizing hormone Luteinizing hormone is responsible for ovulation or release of the mature egg cell from the ovary. Estrogen, progesterone, and follicle-stimulating hormone are not hormones responsible for initiating ovulation.

A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin?

May 24 For a woman with a 28-day cycle, ovulation typically occurs on day 14. Therefore, her next menses would begin 14 days later, on May 24.

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

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

The vagina is at risk for infection because of its location and because it opens to the outside of the body. What is a protective mechanism of the vagina to keep it from becoming infected?

Normal vaginal pH is acidic (4 to 5), which protects from infection. Normally, the vagina maintains an acidic pH of 4 to 5, which protects the vagina from infection.

A female client asks the nurse to explain the purpose of the ovaries besides making eggs for pregnancy. The nurse would explain to the client that the ovaries serve what other purpose(s)? Select all that apply.

Ovaries produce estrogen, which helps in the development of secondary sexual characteristics. Ovaries help in the regulation of menstrual cycles through hormonal release. Progesterone produced in the ovaries is necessary for implantation of the fertilized egg and maintenance of the pregnancy. The two female hormones produced by the ovaries are estrogen and progesterone. Estrogen is responsible for development of secondary sex characteristics and progesterone is responsible for implantation of the ova and nourishment of the ova until the placenta takes over the job. Progesterone is secreted by the corpus luteum until around week 12 of the pregnancy, when the placenta takes over production of progesterone.

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

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

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

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

In taking a client history, a client tells the nurse she is having vaginal itching and irritation. Which reported practice could be contributory to this problem?

Previous history of taking clindamycin Antibiotic therapy, use of tampons or deodorant sanitary pads, or douching can all cause vaginal irritation and infection. Wearing cotton underwear is a good habit, allowing air to circulate in the vaginal area. Use of hypoallergenic soaps for bathing is a good idea. Lastly, there is no problem with taking a tub bath as related to vaginal irritation, as long as the person does not remain in the tub for a protracted time frame.

Which physical signs would a parent note in a child who is entering puberty? Select all that apply.

Pubic hair in both genders Breast buds Deepening of voice in males Penile growth The changes noted in individuals entering puberty include growth of external genitalia, growth of body and facial hair, female breast development, possible male breast development (called gynecomastia), and deepening of the male voice. Puberty does not include increased height and weight of the individuals. Increases in both of these are individualized with some adolescents growing faster than others, so these are not good gauges of puberty.

The OB nursing instructor is talking with students about the sexual response cycle. As they are studying the content, they become aware that there are four phases in the sexual response cycle and identify them as which of the following? Select all that apply.

Resolution Excitement Climax Plateau Refraction is not a phase in the sexual response cycle. The other choices are all part of the sexual response cycle.

A nurse is developing a plan of care for a 7-year-old client with precocious puberty. Which would be the priority nursing diagnosis for this client?

Risk for disturbance in body image related to early development of secondary sex characteristics. As the client will be able to visualize physical differences between other children and herself, it would be a priority for the nurse to recognize in the plan of care that the client may be at risk for disturbances in body image. This would allow for interventions to be put in place for the client to verbalize any concerns she might have and work to enhance body image issues as they develop.

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. 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.

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

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

A nurse is preparing a presentation for a local young adult women's group about reproductive and sexual health. When describing the external female structures, the nurse would include which structure? Select all that apply.

Skene glands labia majora hymen External structures include Skene glands, labia majora, and hymen. The ovaries and fallopian tubes are considered internal structures.

A nurse is performing a physical assessment on a normal male client. Which finding would be considered abnormal in the exam?

Testes measure 6 cm long by 4 cm wide. The normal size of adult male testes are 4 cm x 2.5 cm, so testicular measurements of 6 cm x 4 cm would be considered enlarged and would warrant further diagnostics. Rugae, which are grooves on the scrotal tissue, are normal findings, as is a palpable epididymis and the absence of the prepuce or foreskin if the client has been circumcised.

A client is attempting to become pregnant and is using varied methods to identify ovulation. What assessment finding would most clearly suggest that the client is ovulating?

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

A young male client asks the nurse about circumcision, since he was never circumcised as an infant. Which rationale would be appropriate for exploring circumcision in an adult male?

The client has experienced recurring balanoposthitis and phimosis. If an uncircumcised client is experiencing medical problems such a recurrent infections of the glans and difficulty retracting the foreskin in adulthood, circumcision is a consideration. Having premature ejaculation is not a reason for circumcision. The foreskin covering the glans is a normal finding, as is one side of the scrotum being higher than the other.

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

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

Which of the following occurs in the male during the resolution phase of the sexual response cycle?

The male experiences a period during which he is incapable of sexual response. The resolution phase is characterized by a return to normal body functioning present before the excitement phase. The man experiences a period during which he is incapable of sexual response, called the refractory period. The length of the refractory period is individual; it might be a few minutes or even days before the man's body responds readily to continued sexual stimulation.

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

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

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

They produce female gametes or ova and secrete female sex hormones. 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.

A patient is diagnosed with a uterus that is slightly retroverted. When discussing the implications of this finding, what should the nurse include?

This finding should not cause fertility issues. A retroverted uterus means the uterus tips back. Minor variations of these positions do not tend to cause reproductive problems. A retroverted uterus does not mean that the patient needs surgery. A retroverted uterus does not interfere with fertility. The only way that a retroverted uterus will interfere with conception is if the abnormal position is extreme because the sharp bend can block the deposition or migration of sperm.

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 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 birth.

The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during the follicular phase of the ovarian cycle that the nurse should include in the teaching session?

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

In 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 The fallopian tubes are attached to the uterus but not a part of it. The other selections are all part of the uterus.

What are the primary physiologic responses in the sexual response cycle seen in both males and females?

Vasocongestion and myotonia The two noted physiologic responses to sexual stimulation in both men and women are vasocongestion and myotonia. The pelvic organs undergo widespread congestion due to increased blood flow to the area, leading to erection of the penis, and engorgement of the labia and testes. Myotonia occurs as voluntary and involuntary contractions, resulting in spasmodic contraction of the hands and feet and involuntary muscular contractions during orgasm. The other listed responses are examples of the responses in the sexual response cycle.

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

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

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client?

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

A 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?

Within the vestibule The urethral meatus (opening to the urethra), paraurethral (Skene's) glands, vaginal opening or introitus, and Bartholin glands are located within the vestibule.

The vagina is a hostile environment for sperm. What characteristic of semen protects sperm from the vaginal environment?

alkaline fluid The bulbourethral glands (Cowper glands) secrete an alkaline fluid that coats the last part of the urethra during ejaculation. The alkaline fluids secreted by these glands are nutrient plasmas with several key functions, including the protection of sperm (sperm are maintained in an alkaline environment to protect them from the acidic environment of the vagina).

A nurse is preparing a class for a group of high school adolescents on the topic of the male reproductive system. Which structure will the nurse point out has the function of "climate control system"?

cremaster muscles The cremaster muscles in the scrotal wall relax or contract to allow the testes to hang farther from the body to cool or to be pulled closed to the body for warmth or protection. The prepuce or foreskin is a circular fold of skin that extends over the glans penis unless it is removed by circumcision. The epididymis store the sperm until it is mature enough to be released for potential fertilization of the ovum. The vas deferens is a cordlike duct that transports sperm from the epididymis.

The nurse is assessing a 13-year-old girl. Which event would the nurse expect to have occurred first?

development of breast buds Pubertal events preceding the first menses have an orderly progression beginning with the development of breast buds, followed by the appearance of pubic hair, then axillary hair, then a growth spurt. Menses typically occurs about 2 years after the start of breast development.

The nurse is preparing to assess a young woman's external genitalia. The nurse predicts the client is currently in the most fertile phase of the menstrual cycle based on which assessment finding of the vaginal mucus drainage?

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

You care for a patient who has a retroverted uterus. You would explain that this means her:

entire uterus is tipped backward. Retroverted means to tip backward; retroversion means to bend backward.

The seminiferous tubules are tiny coils of tissue where spermatogenesis occurs. Where do the sperm mature?

epididymis A system of tiny tubes called the rete testis leads from the seminiferous tubules to the epididymis, an intricate network of coiled ducts on the posterior portion of each testis that is approximately 20 feet (6 m) in length. It is here that sperm mature.

The nursing instructor is teaching a session comparing the various phases of the menstrual and uterine cycles. The instructor determines the session is successful when the students correctly choose which hormone that is responsible for regulating the proliferative phase of the uterine cycle?

estrogen Estrogen is the hormone that influences the proliferative phase. During the secretory phase, the corpus luteum produces progesterone. Follicle-stimulating hormone controls the follicular phase and luteinizing hormone controls the luteal phase of the ovarian cycle.

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?

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

Which hormone would the nurse explain as being primarily responsible for maturation of the ovarian follicle?

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

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

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

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

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

The school nurse is teaching a group of adolescent females about the menstrual cycle. The nurse determines the session is successful when the group correctly chooses which phase as part of the ovarian cycle?

luteal The ovarian cycle consists of the follicular phase, ovulation, and the luteal phase. The endometrial or uterine cycle includes the proliferative phase, menstrual phase, secretory phase, and ischemic phase.

A nurse is conducting a routine well-check assessment on an 18-year-old female who is experiencing normal menstrual cycles. When the client questions the nurse concerning the menstrual process, the nurse can point out which hormone is primarily responsible for ovulation?

luteinizing hormone At ovulation, a mature follicle ruptures in response to a surge of luteinizing hormone. Estrogen is predominant at the end of the follicular phase, directly preceding ovulation. Progesterone peaks 5 to 7 days after ovulation. Follicle-stimulating hormone is highest during the first week of the follicular phase of the cycle.

The nursing instructor is teaching a class on the menstrual cycle. The instructor determines the class is successful when the class correctly chooses which hormone that is responsible for imitating ovulation?

luteinizing hormone At the beginning of each menstrual cycle, a follicle on one of the ovaries begins to develop in response to rising levels of FSH from the pituitary gland. The follicle produces estrogen, which causes the ovum contained within the follicle to mature. When the pituitary gland detects high levels of estrogen from the mature follicle, it releases a surge of LH. This sudden release of LH causes the follicle to burst open, releasing the mature ovum into the abdominal cavity in a process called ovulation. This follicle then becomes the corpus luteum, which continues to secrete estrogen and progesterone, preparing the endometrium for possible implantation of a fertilized ovum. If the ovum is not fertilized, the hormone levels subsequently fall and menstruation occurs.

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

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

After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first:

menstrual period. Menarche is defined as the establishment of menstruation. It does not refer to the woman's first sexual experience, full hormonal cycle, or sign of breast development.

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first?

penile vasodilation With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm. Orgasm results in a pleasurable feeling of physiologic and psychological release. Ejaculation results in the discharge of semen from the urethra.

The nursing student is preparing to complete the physical inspection of a female client's external reproductive organs. The mentor determines the student has successfully assessed this client based on documentation of which structures? Select all that apply.

perineum labia majora clitoris The external female reproductive organs include the mons pubis, labia majora, labia minora, clitoris, vestibule, and perineum. The vagina, uterus, and fallopian tubes are internal female reproductive organs.

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

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

When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?

proliferative Estrogen levels are the highest during the proliferative phase of the endometrial cycle, when the endometrial glands enlarge in response to increasing amounts of estrogen. Progesterone is the predominant hormone of the secretory phase. Levels of estrogen and progesterone drop sharply during the ischemic phase and fall during the menstrual phase.

After explaining the function of the seminal vesicles to a class, the instructor determines the need for additional teaching when the students identify which action as a function of the seminal vesicles?

reduces sperm motility The seminal vesicles are a pair of glands that produce fluid with various substances that function to (1) nourish sperm, (2) enhance sperm motility by enzymatically liquefying ejaculated semen (3) stimulate contraction of the uterus to help the sperm reach the ovum, and (4) resist sperm destruction by female antibodies.

A nurse is teaching a sex education class and is discussing sexual response. She describes a 30-minute period during which external and internal genital organs return to an unaroused state. What is this phase of sexual response known as?

resolution Resolution, the fourth and final phase of sexual response, is a 30-minute refractory period during which the external and internal genital organs return to an unaroused state. Excitement, the first phase, occurs with physical and psychological stimulation (sight, sound, emotion, or thought) that causes parasympathetic nerve stimulation. The plateau stage, which is the second phase, is reached just before orgasm. Orgasm, the third phase, occurs when stimulation proceeds through the plateau stage to a point at which a vigorous contraction of muscles in the pelvic area expels or dissipates blood and fluid from the area of congestion.

The nurse has been teaching a community class for couples planning a pregnancy and is illustrating the male reproductive system and function in this session. The nurse should point out which structure's secretions provide nourishment for the sperm during ejaculation?

seminal vesicles The seminal vesicles secrete an alkaline, fructose-rich fluid into the ejaculatory ducts during ejaculation which provides nourishment for the sperm. The vas deferens carries the sperm from the epididymis to the urethra. The bulbourethral glands secrete an alkaline fluid that coats the last part of the urethra during ejaculation. The prostate gland secretes an alkaline fluid which helps with sperm mobility and protects the sperm from the acidic environment of the vagina.

The nurse is explaining the various male internal reproductive structures in a high school health class. The nurse determines the class is successful when the class correctly chooses which structure as responsible for sperm production?

seminiferous tubules Sperm is produced in the seminiferous tubules of the testes. The vas deferens transports sperm from the epididymis. The seminal vesicles produce nutrient seminal fluid. The spermatic cord is formed by the vas deferens, blood vessels, and nerves to act as a passageway for sperm.

An adult client currently has low levels of estrogen and progesterone. At this point in the menstrual cycle, the client will likely:

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

The school nurse is teaching a health education class on the male reproductive system. The nurse determines the class is successful when the students correctly point out which structure produces sperm?

testes The testes are responsible for sperm production. The seminal vesicles produce nutrient seminal fluid. The scrotum surrounds and protects the testes. The prostate gland and the seminal vesicles produce fluid to nourish the sperm.

A 13-year-old boy has begun showing signs of puberty, including appearance of axillary and facial hair, as well as a change in his voice. He asks the nurse what exactly is causing these changes in his body. The nurse should mention which primary hormone that is responsible for these changes?

testosterone The level of the primary androgenic hormone, testosterone, is low in males until puberty (between ages 12 and 14 years) when it rises to influence pubertal changes in the testes, scrotum, penis, prostate, and seminal vesicles; the appearance of male pubic, axillary, and facial hair; laryngeal enlargement with its accompanying voice change; maturation of spermatozoa; and closure of growth plates in long bones (termed adrenarche). Estrogen, luteinizing hormone, and follicle-stimulating hormone are not the primary hormone associated with secondary sex changes in males.

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

the uterine lining is being shed due to lowering of hormone levels. 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 do 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.

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

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

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

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

A group of student nurses are comparing the various events which take place during the sexual arousal of both males and females. The students are able to correctly point out which event is one of the underlying physiologic responses after the session?

vasocongestion There two underlying physiologic responses to sexual stimulation in both men and women: vasocongestion and myotonia (muscular tension). Myospasm is the spasmodic muscular contraction that is most often a sign of a muscular disorder. Ovulation occurs during the follicular phase of the menstrual cycle. Climacteric phase occurs during menopause when the various changes gradually take place.