Chapter 44
The human ovary is fully developed at what age?
By the third month of fetal life
Which physiologic changes result in menopause?
Cessation of ovarian function and decreased estrogen levels
Select the structure primarily responsible for the secretions of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin.
Anterior pituitary gland
The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs:
in the middle to outer portion of the fallopian tube.
The nurse is caring for a female client who asks, "Will taking estrogen increase my chances of developing breast cancer?" Which statement is an appropriate response by the nurse?
"Currently, there is insufficient evidence to support estrogen as the cause of breast cancer."
A postmenopausal client reports painful intercourse. Which information should the nurse provide the client?
"Decreased estrogen levels can lead to vaginal dryness after menopause which can lead to painful intercourse."
The nurse is caring for a 54-year-old female client who reports vaginal dryness and painful intercourse. The nurse expects which prescription will be ordered for this client?
Vaginal estrogen preparation
The nurse suspects which female client may be at risk for infertility?
A long distance runner
The nurse planning care for a menopausal woman should include interventions to decrease risk for:
atherosclerosis.
The nurse is checking the pH of a client's vaginal tissue and finds the pH to be 4.3. The nurse interprets this finding as:
normal.
Which metabolic effects are caused by the action of estrogen? Select all that apply.
Decreased bone resorption Increased production of thyroid globulins
A 51 year-old woman who has been receiving estrogen therapy (ET) for the last 5 years has visited her care provider because her peers have told her about the risks of heart disease, stroke, and breast cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns?
"ET demonstrated no increased risk of heart disease when compared with HT, but there was similar increased risk for stroke."
The nurse is discussing the physical changes related to menopause with a 48-year-old woman. The client asks, "How long will it take before I am through these changes and finally reach menopause?" Which statement is an appropriate response by the nurse?
"Most women experience symptoms for about 4 years."
A female client informs the nurse that she is having hot flashes on occasion, has trouble sleeping, and thinks that she is having some symptoms of menopause. The client asks the nurse how long these symptoms will last prior to experiencing menopause. What is the best response?
"Perimenopause can precede menopause by approximately 4 years."
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why do my hands get puffy and I gain weight right before my periods?" Which statement is an appropriate response by the nurse?
"The level of estrogen increases in your body before your period, and this causes fluid retention."
The hormone progesterone is metabolized in which organ?
Liver
The nurse is teaching a female client who has been prescribed hormone therapy. The client asks, "What does this medication do?" Which statement is an appropriate response by the nurse?
"This medication will help relieve hot flashes and other adverse symptoms of menopause."
The nurse is caring for a 48-year-old female client who asks, "How do you know when you have reached menopause?" Which statement is an appropriate response by the nurse?
"You are considered to be menopausal when you have not menstruated for a full year and the hormone that fluctuates with menstruation no longer fluctuates."
The environment of the vagina is moist with a pH 4.0 to 4.5. The major purpose of the acidic environment is:
Bacteriostatic
What role do Montgomery tubercles play in breast health?
Secrete a lubricant that keeps the nipple soft and elastic
What should the nurse do when a woman who stopped breast-feeding her infant 3 months ago complains of occasional milk leakage from her breasts?
Advise the woman that this is a normal occurrence after stopping breast-feeding
The nurse is administering a phenothiazine derivative with the understanding that this medication puts the client at risk for hyperprolactinemia, which may produce which manifestations? Select all that apply.
Amenorrhea Oligomenorrhea Anovulation
The nurse is explaining ovulation to a female client. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are important hormones needed to ovulate and are secreted by which gland?
Anterior pituitary
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed:
Atrophic vaginitis
A woman of child-bearing age asks the nurse about a natural method to avoid pregnancy. What is an appropriate response?
Avoid sex when cervical mucus is most stretchy.
A 40-year-old woman has been identified to have a deficiency in estrogen. Which physiologic phenomenon is most likely to remain unaffected?
The synthesis and release of adrenal glucocorticoids.
A female client informs the nurse that she had intercourse yesterday evening and is wondering if she could become pregnant. She asks the nurse where the fertilization (implantation) currently would be located if she was indeed pregnant. What should the nurse tell the client?
Fertilization normally occurs in the middle to outer portion of the Fallopian tube.
A woman has gone to her gynecologist complaining of pain during intercourse. The physician orders a maturation index on her vaginal scrapings. The results return an index of 75-25-0. The nurse can interpret this to mean:
The woman is experiencing postmenopausal vaginal dryness.
The fallopian tubes are narrow tubes that attach bilaterally to the uterus. Within the fallopian tube, fertilization of the ovum takes place. The end of the fallopian tube nearest the ovary is funnel-like. What are the fringed, finger-like projections around the funnel-shaped opening of the fallopian tube called?
Fimbriae
A client has just become pregnant and there is a consequent increase in secretions from the columnar epithelium of her endocervix. What effect will this have?
Formation of a mucoid plug to protect her uterus
A woman with a regular 28-day menstrual cycle wishes to become pregnant. At which point in the menstrual cycle is the optimal time for intercourse to end in fertilization of the ovum?
Fourteenth day after menses begins
Which structure supports the breasts while dividing the breast into 15 to 25 lobes?
Cooper ligaments
An older adult female client had an oophorectomy before menopause. Which current symptoms could result from early loss of estrogen? Select all that apply.
Cognitive decline Hyperlipidemia
The nurse is reviewing the history of an older adult female client who was recently diagnosed with coronary heart disease. What factors are known to contribute to this condition? Select all that apply.
Has hypertension for 15 years Used hormone therapy for 5 years Smoked 1 pack/day for 20 years
A female client is experiencing infertility. Which laboratory result would indicate the problem originates in the ovaries?
Elevated FSH
The ovarian follicle becomes luteinized once ovulation has taken place. As the corpus luteum, the now empty follicle produces what?
Estrogen and progesterone
The nurse is reviewing findings from the maturation index with an understanding that the test indicates:
Estrogen levels
How often do most women in the middle reproductive years menstruate?
Every 28 to 30 days
The endocrine system is highly involved in the female reproductive system. Which hormones are used to stimulate the primordial follicles?
FSH and LH
A nurse educator is explaining the process of sexual intercourse, fertilization, and fetal development to a high school biology class. What process should the nurse describe?
Fertilization in the outer portion of the fallopian tube
A nurse educator is describing the changes in cervical mucus as they related to changes in hormone levels. Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of which hormonal change?
High estrogen levels.
The nurse is completing client education on the use of a combination oral contraceptive pill (OCP) to a woman with polycystic ovary syndrome (PCOS). The nurse should include which content in the educational packet?
It contains estrogen and progesterone.
The nurse is taking the history of a 30-year-old female client with amenorrhea. What factors does the nurse identify as contributing to the condition? Select all that apply.
Long-distance running Anorexia nervosa Pituitary tumor
The nurse is reviewing laboratory values of a 70-year-old female client and observes the client's low-density lipoprotein (LDL) level is elevated. The nurse understands a possible reason for this is:
Long-term estrogen deprivation
What are the small bumps or projections on the areolar surface called?
Montgomery tubercles or glands
A 13-year-old client undergoing puberty is alarmed to find small, white bumps surrounding her areolae. The nurse reassures her that these are a normal sign of her sexual maturation and tells her that they are:
Montgomery tubercles.
A 20-year-old female has come to the clinic complaining of severe menstrual cramps. The clinic nurse practitioner knows that dysmenorrhea occurs when which muscle group contracts?
Myometrium
A newly pregnant woman reports to the nurse that her breasts are excessively tender and that her areolae and nipples are becoming darker and more prominent. The nurse should describe which cause of these changes?
Normal changes of pregnancy due to increased levels of estrogen and progesterone
A client is complaining to the health care provider about several vague signs/symptoms. Which sign/symptom raises a "red flag" indicating the client may have developed endometrial cancer?
Painless abnormal bleeding
The nurse is caring for a pregnant client who is experiencing morning sickness. The nurse understands that which of the following is responsible for many of the common discomforts of pregnancy?
Progesterone
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone
Which physiologic process is caused by estrogens?
Promotion of ovarian follicle growth
The lactating mother of a 3-month-old infant reports to the nurse that she experiences milk leakage if she hears the child cry when it has been more than 2 hours since the last feeding. How should the nurse respond?
Reassure her that this is a normal physiologic response.
A female client experiencing hot flashes during perimenopause asks the nurse about hormone therapy (HT). What is the appropriate response by the nurse?
Short term HT can be used to reduce symptoms.
The nurse is assessing a female client who is being seen at the clinic for a yearly pelvic and Pap smear. Upon assessment, which sign is consistent with the facilitation of movement of intravascular fluid into the extracellular space related to estrogen levels before menstruation?
Slight edema of the feet and ankles
Specific actions of estrogen include which actions on the body? Select all that apply.
Stimulate development of vagina, uterus, and fallopian tubes Promote growth of ovarian follicles
The gonads of the female have a dual function. Which of the following is a function of the female gonads?
Storing female germ cells
The nurse is performing urinary catheterization on a 13-year-old girl and notices the girl's hymen is intact. What is the most accurate way to document this finding?
The client exhibits normal findings.
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why does my side hurt halfway through my monthly cycle almost every month? The nurse suspects the cause of the pain may be:
The client has a leakage of blood onto the peritoneal surface after ovulation has occurred.
The nurse is assessing the genitalia of a 42-year-old female client diagnosed with a genitourinary disorder. The nurse recognizes that which finding does not describe the normal anatomy of the female genitalia.
The clitoris is located posterior to the urethra.
The nurse is discussing ovulation with a female client and notes an indication of ovulation is spinnbarkeit. What is an accurate description of spinnbarkeit?
The stretchy consistency of cervical mucus during ovulation
The connecting tube between the cervix and the vestibule is referred to as:
Vagina