Chapter 9 The Reproductive System

The nurse teaching a client describes the effect of a vasectomy on fertilization by saying a man who has had a vasectomy becomes functionally sterile because of which of the following? 1. "Sperm are no longer being produced." 2. "Sperm are no longer motile and fertile." 3. "Sperm sit in the testes where they are formed." 4. "Sperm cannot reach the outside of the body."

4. "Sperm cannot reach the outside of the body." Explanation: 4. Although sperm continue to be produced for the next several years, they can no longer reach the outside of the body.

The OB-GYN nurse knows that the most common shape for the female pelvis is which of the following? 1. Gynecoid type 2. Android type 3. Anthropoid type 4. Platypelloid type

1. Gynecoid type Explanation: 1. The most common female pelvis is the gynecoid type. The inlet is rounded with the anteroposterior diameter a little shorter than the transverse diameter.

The nurse is teaching a woman about her menstrual cycle. Which is the most important change that happens during the follicular phase of the menstrual cycle? 1. Maturation of the primordial follicle 2. Multiplication of the fimbriae 3. Secretion of human chorionic gonadotropin 4. Growth of the endometrium

1. Maturation of the primordial follicle Explanation: 1. Follicle-stimulating hormone is elevated during the follicular phase, and the primordial follicle matures.

the nurse teaching a class on reproductive anatomy knows that no further instruction is needed when a student shows an understanding of the pelvic cavity divisions by making which statement? 1. "The true pelvis is made up of the sacrum, coccyx, and innominate bones." 2. "The false pelvis consists of the inlet, the pelvic cavity, and the outlet." 3. "The true pelvis is the portion above the pelvic brim." 4. "The relationship between the false pelvis and the fetal head is of paramount importance."

1. "The true pelvis is made up of the sacrum, coccyx, and innominate bones." Explanation: 1. The true pelvis is made up of the sacrum, the coccyx, and the two innominate bones.

The external and internal female reproductive organs develop and mature in response to what hormones? 1. Adrenocorticotropic hormones (ACTH) 2. Estrogen and progesterone 3. Steroid hormones 4. Luteinizing hormones (LH)

2. Estrogen and progesterone Explanation: 2. The external and internal female reproductive organs develop and mature in response to estrogen and progesterone.

A nurse teaches newly pregnant clients that if an ovum is fertilized and implants in the endometrium, the hormone the fertilized egg begins to secrete is which of the following? 1. Estrogen 2. Human chorionic gonadotropin (hCG) 3. Progesterone 4. Luteinizing hormone

2. Human chorionic gonadotropin (hCG) Explanation: 2. If the ovum is fertilized and implants in the endometrium, the fertilized egg begins to secrete human chorionic gonadotropin (hCG), which is needed to maintain the corpus luteum.

When planning care for a client who has undergone an episiotomy, it would be important for the nurse to include a goal that addresses the need for pain relief of which part of the body? 1. Mons pubis 2. Perineal body 3. Labia minora 4. Hymen

2. Perineal body Explanation: 2. During the last part of labor, the perineal body thins out until it is just a few centimeters thick. This tissue is often the site of an episiotomy or lacerations during childbirth.

A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. This is most likely due to a lack of which hormone? 1. Estrogen 2. Progesterone 3. FSH 4. LH

2. Progesterone Explanation: 2. Progesterone is often called the hormone of pregnancy because it inhibits uterine contractions and relaxes smooth muscle to cause vasodilation, allowing pregnancy to be maintained.

The nurse teaching a high school class explains that during the menstrual cycle, the endometrial glands begin to enlarge under the influence of estrogen and cervical mucosal changes occur; the changes peak at ovulation. In which phase of the menstrual cycle does this occur? 1. Menstrual 2. Proliferative 3. Secretory 4. Ischemic

2. Proliferative Explanation: 2. The proliferative phase begins when the endometrial glands begin to enlarge under the influence of estrogen and cervical mucosal changes occur; the changes peak at ovulation.

The female and male reproductive organs are homologous, which means what? 1. They are believed to cause vasoconstriction and muscular contraction 2. They are fundamentally similar in function and structure 3. They are rich in sebaceous glands 4. They are target organs for estrogenic hormones

2. They are fundamentally similar in function and structure Explanation: 2. The female and male reproductive organs are homologous; that is, they are fundamentally similar in function and structure.

A nurse teaching a sex education class is asked by a male student, "What exactly happens when my body gets aroused?" The nurse's reply includes which statement? 1. "The vas deferens thickens and expands." 2. "The sympathetic nerves of the penis are stimulated." 3. "The penis elongates, thickens, and stiffens." 4. "The prepuce of the penis elongates."

3. "The penis elongates, thickens, and stiffens." Explanation: 3. Sexual stimulation causes the penis to elongate, thicken, and stiffen, a process called erection. The penis becomes erect when its blood vessels become engorged.

The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation? 1. "The menstrual cycle has five distinct phases that occur during the month." 2. "One hormone controls the phases of the menstrual cycle." 3. "The secretory phase occurs when a woman is most fertile." 4. "Menstrual cycle phases vary in order from one woman to another."

3. "The secretory phase occurs when a woman is most fertile." Explanation: 3. During the secretory phase, the vascularity of the entire uterus increases greatly, providing a nourishing bed for implantation.

A prenatal client asks the nurse how the baby can possibly come out through her vagina, because a vagina is not nearly as big as a baby. How does the nurse best answer this client's question? 1. "The vagina usually tears as it stretches during childbirth." 2. "The vagina is designed to allow a baby come through." 3. "The vagina changes due to pregnancy allow the vagina to stretch more." 4. "The vagina dilates and effaces in labor so the baby can get out."

3. "The vagina changes due to pregnancy allow the vagina to stretch more." Explanation: 3. The walls of the vagina are covered with ridges, or rugae, crisscrossing each other. These rugae allow the vaginal tissues to stretch enough for the fetus to pass through during childbirth.

The nurse educator is lecturing on the changes that take place during puberty. What is a change that girls experience? 1. Elongation of the hips 2. Deepening of the voice 3. Broadening of the hips and budding of breasts 4. Preparation of the uterus for pregnancy

3. Broadening of the hips and budding of breasts Explanation: 3. During puberty, girls' hips start to broaden and their breasts begin to form. Page Ref: 146

A school nurse teaching a health class to adolescent boys explains that spermatozoa become motile and fertile during the 2-10 days they are stored in which part of the male body? 1. Prostate gland 2. Vas deferens 3. Epididymis 4. Urethra

3. Epididymis explanation: 3. The epididymis provides a reservoir where spermatozoa can survive for a long period and the spermatozoa usually remain in the epididymis for 2 to 10 days.

The student nurse encounters a 15-year-old girl who reports that she has no pubic or axillary hair and has not yet experienced growth of her breasts. The student asks the nurse about the physiology of this occurrence. The nurse explains that the client probably lacks which hormone? 1. Testosterone 2. Progesterone 3. Estrogen 4. Prolactin

3. Estrogen Explanation: 3. Estrogens influence the development of secondary sex characteristics.

The nurse educator describes the uterus and ovaries as being held in place in the pelvic cavity by what structures? 1. Muscles 2. Tendons 3. Ligaments 4. Peritoneum

3. Ligaments Explanation: 3. The ovaries and uterus are held in place in the pelvic cavity by a number of ligaments.

A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0°F) over the past 36 hours. This most likely indicates what? 1. Menstruation is about to begin. 2. Ovulation will occur soon. 3. Ovulation has occurred. 4. She is pregnant, and will not menstruate.

3. Ovulation has occurred. Explanation: 3. In some women, ovulation is accompanied by mid-cycle pain, known as mittelschmerz. This pain may be caused by a thick tunica albuginea or by a local peritoneal reaction to the expelling of the follicular contents and body temperature increases about 0.3°C to 0.6°C (0.5°F to 1°F) 24 to 48 hours after the time of ovulation.

The nurse is presenting a community education session on female hormones. Which statement from a participant indicates the need for further information? 1. "Estrogen is what causes females to look female." 2. "The presence of some hormones causes other to be secreted." 3. "Progesterone is present at the end of the menstrual cycle." 4. "Prostaglandin is responsible for achieving conception."

4. "Prostaglandin is responsible for achieving conception." Explanation: 4. Prostaglandin is not related to conception. Prostaglandin production increases during follicular maturation and has basic regulatory functions in cells.

The nurse is preparing a handout for female adolescents on the menstrual cycle. What phase of the cycle occurs if fertilization does not take place? 1. Menstrual 2. Proliferative 3. Secretory 4. Ischemic

4. Ischemic Explanation: 4. The ischemic phase occurs if fertilization does not occur.

The nurse teaching the phases of the menstrual cycle should include the fact that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and extensive vascular changes occur in which phase? 1. Menstrual phase 2. Proliferative phase 3. Secretory phase 4. Ischemic phase

4. Ischemic phase Explanation: 4. In the ischemic phase, the corpus luteum begins to degenerate, and as a result, both estrogen and progesterone levels fall. Small blood vessels rupture, and the spiral arteries constrict and retract, causing a deficiency of blood in the endometrium, which becomes pale.

What is the function of the scrotum? 1. Produce testosterone, the primary male sex hormone 2. Deposit sperm in the female vagina during sexual intercourse so that fertilization of the ovum can occur 3. Provide a reservoir where spermatozoa can survive for a long period 4. Protect the testes and the sperm by maintaining a temperature lower than that of the body

4. Protect the testes and the sperm by maintaining a temperature lower than that of the body Explanation: 4. The function of the scrotum is to protect the testes and the sperm by maintaining a temperature lower than that of the body. Page Ref: 165

The nurse teaching a class on the reproductive system is discussing what happens at puberty. Which statement does the nurse make? 1. Boys and girls go through puberty at the same time. 2. Most girls develop breasts and start their menses at about the same time. 3. The nocturnal emissions that adolescent boys have contain a large number of sperm. 4. The onset and progress of puberty varies widely from person to person.

4. The onset and progress of puberty varies widely from person to person. Explanation: 4. The age at onset and progress of puberty vary widely, physical changes overlap, and the sequence of events can vary from person to person.

The nurse explains to the client that the obstetric conjugate measurement is important because of which reason? 1. This measurement determines the tilt of the pelvis. 2. This measurement determines the shape of the inlet. 3. The fetus passes under it during birth. 4. The size of this diameter determines whether the fetus can move down into the birth canal so that engagement can occur.

4. The size of this diameter determines whether the fetus can move down into the birth canal so that engagement can occur. Explanation: 4. The obstetric conjugate extends from the middle of the sacral promontory to an area approximately 1 cm below the pubic crest. The fetus passes through the obstetric conjugate, and the size of this diameter determines whether the fetus can move down into the birth canal in order for engagement to occur.

The nurse is preparing a handout on the ovarian cycle to a group of middle school girls. Which information should the nurse include? 1. The hormone human chorionic gonadotropin stimulates ovulation. 2. Irregular menstrual cycles have varying lengths of the luteal phase. 3. The ovum leaves its follicle during the follicular phase. 4. There are two phases of the ovarian cycle: luteal and follicular.

4. There are two phases of the ovarian cycle: luteal and follicular. Explanation: 4. The ovarian cycle has two phases: the follicular phase (days 1 to 14) and the luteal phase (days 15 to 28 in a 28-day cycle).

The OB-GYN nurse knows that the proliferative phase of the menstrual cycle includes which changes? 1. Thin, clear cervical mucus 2. Estrogen peaks just before ovulation 3. No ferning pattern of cervical mucus 4. A pH change to 7.5 5. Epithelium warps into folds

Answer: 1, 2, 4 Explanation: 1. Cervical mucus at ovulation becomes thin, clear, watery, and more alkaline, making it more favorable to spermatozoa. 2. Estrogen peaks just before ovulation in the proliferative phase of the menstrual cycle. 4. The cervical mucosa pH increases from below 7 to 7.5 at the time of ovulation.

What are the three functions of the fallopian tubes? 1. Provide transport for the ovum from the ovary to the uterus 2. Serve as a warm, moist, nourishing environment for the ovum or zygote 3. Secrete large amounts of estrogens 4. Provide a site for fertilization to occur 5. Support and protect the pelvic contents

Answer: 1, 2, 4 Explanation: 1. The fallopian tubes provide transport for the ovum from the ovary to the uterus. 2. The fallopian tubes serve as a warm, moist, nourishing environment for the ovum or zygote. 4. The fallopian tubes provide a site for fertilization to occur.

Ovarian hormones include which of the following? 1. Estrogens 2. Progesterone 3. Parathyroid hormone 4. Luteinizing hormone 5. Testosterone

Answer: 1, 2, 5 Explanation: 1. Ovarian hormones include the estrogens, progesterone, and testosterone. 2. Ovarian hormones include the estrogens, progesterone, and testosterone. 5. Ovarian hormones include the estrogens, progesterone, and testosterone.

The nurse recognizes the importance of the interaction between the nervous and endocrine systems in the female reproductive cycle. The interaction involves which of the following? Select all that apply. 1. Hypothalamus 2. Adrenal cortex 3. Ovaries 4. Thyroid 5. Anterior pituitary

Answer: 1, 3, 5 Explanation: 1. The female reproductive cycle is controlled by complex interactions between the nervous and endocrine systems and their target tissues. These interactions involve the hypothalamus. 3. The female reproductive cycle is controlled by complex interactions between the nervous and endocrine systems and their target tissues. These interactions involve the ovaries. 5. The female reproductive cycle is controlled by complex interactions between the nervous and endocrine systems and their target tissues. These interactions involve the anterior pituitary.

The nurse explains the functions of the male reproductive organs to a client. Which correct functions will the nurse include? 1. Ejaculatory ducts move semen and seminal fluid. 2. The adrenal gland is the major source of testosterone. 3. The vas deferens ends before reaching the prostate gland. 4. Sertoli's cells nourish spermatozoa. 5. The testes house seminiferous tubules.

Answer: 1, 5 Explanation: 1. Ejaculatory ducts provide a passageway for semen and seminal fluid into the urethra. 5. The testes house seminiferous tubules and the gonads.

The nurse teaches a client that luteinizing hormone (LH) is important in the ovarian cycle for which purposes? 1. Proliferation of the endometrial mucosa 2. Ovulation 3. Corpus luteum development 4. Maturation of the ovarian follicle 5. Cyclic changes that allow pregnancy not to occur

Answer: 2, 3 Explanation: 2. During the follicular phase, the primordial follicle matures under the influence of FSH and LH until ovulation occurs. 3. The corpus luteum develops under the influence of LH during the luteal phase.

The nurse educator teaching reproductive anatomy wants to make sure the students understand what stabilizes the uterus. Which statements about the individual ligaments would the nurse include? 1. The infundibulopelvic ligaments suspend and support the uterus. 2. The broad ligament keeps the uterus centrally placed. 3. The uterosacral ligaments sweep back around the rectum and insert on the sides of the first and second sacral vertebrae. 4. The ovarian ligaments anchor the ovary to the uterus. 5. The cardinal ligaments prevent uterine prolapse and support the upper vagina.

Answer: 2, 3, 4, 5 Explanation: 2. The broad ligament keeps the uterus centrally placed. 3. The uterosacral ligaments sweep back around the rectum and insert on the sides of the first and second sacral vertebrae. 4. The ovarian ligaments anchor the ovary to the uterus. 5. The cardinal ligaments prevent uterine prolapse and support the upper vagina.

The nurse working with pediatric clients knows that the primary hormone secretions that induce puberty include which of the following? 1. Thyroid hormone 2. Follicle-stimulating hormone 3. Leuteinizing hormone 4. Adrenocorticotropic hormone 5. Gonadotropin-releasing hormones

Answer: 2, 3, 5 Explanation: 2. Follicle-stimulating hormone (FSH) is part of the process that induces puberty. 3. The luteinizing hormone (LH) is a part of the process that induces puberty. 5. The central nervous system releases a neurotransmitter that stimulates the hypothalamus to synthesize and release gonadotropin-releasing hormone (GnRH).

Under the influence of progesterone, which of the following occur? 1. Temperature decreases 2. Cervix secretes thick, viscous mucus 3. Breasts prepare for lactation 4. Breast glandular tissue decreases in size 5. Vaginal epithelium proliferates

Answer: 2, 3, 5 Explanation: 2. Under the influence of progesterone, the cervix secretes thick, viscous mucus. 3. Under the influence of progesterone, breasts prepare for lactation. 5. Under the influence of progesterone, vaginal epithelium proliferates.

What are the three functions of cervical mucosa? 1. Form the relatively fixed axis of the birth passage 2. Provide lubrication for the vaginal canal 3. Provide nourishment and protective maternal antibodies to infants 4. Provide an alkaline environment to shelter deposited sperm from the acidic vaginal secretions 5. Act as a bacteriostatic agent

Answer: 2, 4, 5 Explanation: 2. The cervical mucosa provides lubrication for the vaginal canal. 4. The cervical mucosa provides an alkaline environment to shelter deposited sperm from the acidic vaginal secretions. 5. The cervical mucosa acts as a bacteriostatic agent.