OB: Chapter 3 Anatomy and Physiology of the Reproductive Systems

A woman experiencing menopausal symptoms asks the nurse about herbal remedies for managing her symptoms. Which response by the nurse would be most appropriate?

"Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies." Information about the efficacy of herbal therapies is largely anecdotal. Research to validate the efficacy, safety, and potential harmful effects of herbal therapies is lacking. Until recently, hormone replacement therapy was the mainstay of treatment, but in light of the results of the Women's Health Initiative trial, it has become controversial. Telling the woman that her symptoms are not severe enough is demeaning and inappropriate: the woman's symptoms are significant to her, regardless of what the nurse may think. Page 78

A client asks the nurse questions about female hygiene. She wants to know if she should douche to clean her vagina. How should the nurse respond?

"You do not need to douche; the vagina is self-cleaning." The vagina has an acidic environment, and this should not be disturbed. It does not need to be "cleaned" with douching, and douching can change the environment and lead to vaginal infection or irritation. Douching will only cover odor for a short time and may make other issues worse. Itching and burning could be signs of an infection, and the client should contact a health care provider. Page 69

The nurse is working with a young couple who are trying to conceive. The nurse recognizes that the clients understand the basics of the reproductive cycle when they identify that ovulation usually occurs at which day during a 28-day cycle?

14 Ovulation usually occurs at day 14 of a 28-day cycle. Page 74

When a woman is planning pregnancy, what is her window around ovulation to have intercourse?

2 days before to 1 day after ovulation At ovulation, the consistency of the mucus changes so that sperm can swim through it, allowing fertilization. At the same time, the mucus-secreting glands of the cervix actually become able to store live sperm for 2 or 3 days. These sperm can later move up through the corpus and into the fallopian tubes to fertilize the egg; thus, intercourse 1 or 2 days before ovulation can lead to pregnancy. Additionally, since the ovum lives approximately 24 hours, intercourse one day after ovulation may result in pregnancy. Page 74

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?

As ovulation approaches, cervical mucus is abundant and stretchable. 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. Page 74

A nurse is providing information regarding ovulation to a couple who want to have a baby. Which fact should the nurse tell the clients?

At ovulation, a mature follicle ruptures, releasing an ovum. At ovulation, a mature follicle ruptures, releasing a mature oocyte (ovum). Ovulation always takes place 14 days, not 10 days, before menstruation. The lifespan of the ovum is only about 24 hours, not 48 hours; unless it meets a sperm on its journey within that time, it will die. When ovulation occurs, there is a drop, not a rise, in estrogen levels. Page 74

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.

FSH GnRH LH 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. Page 77

A young woman is trying to get pregnant. She asks the nurse to recommend a practical way that she can tell the point in her monthly cycle when she will have the best odds of getting pregnant. Which recommendation by the nurse would be best?

Have sex when the cervical mucus is thin, stretchy, and copious. Women can analyze cervical mucus changes to help plan coitus so it coincides with ovulation if they want to increase their chance of becoming pregnant or plan to avoid coitus at the time of ovulation to prevent pregnancy by analyzing how thick or thin is cervical mucus. At the beginning of each cycle, when estrogen secretion from the ovary is low, cervical mucus is thick and scant. Sperm survival in this type of mucus is poor. At the time of ovulation, when the estrogen level has risen to a high point, cervical mucus becomes thin, stretchy (Spinnbarkeit), and copious. Sperm penetration and survival in this thin mucus are both excellent. Fernlike patterns on a microscope slide of cervical mucus do indicate ovulation, but this method is not nearly as practical as examining the consistency of the cervical mucus. The beginning of the cycle, just after the end of menstruation, is before ovulation, and thus not the best time to have coitus if the goal is conception. Page 75

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of high school students. Which response by a high school student about the function of the clitoris would be accurate?

It is a small erectile structure that responds to sexual stimulation. The clitoris is a small erectile structure that responds to sexual stimulation. 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. Page 72

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. Page 70

A nurse is assessing a female client. When obtaining the client's history, the client tells the nurse that her menstrual cycle is usually 30 days and that she expects her next menstruation on March 20. Based on the client's information and the nurse's understanding of the female reproductive cycle, the nurse would identify ovulation as most likely occurring at which time?

March 6 Ovulation usually occurs on day 14 in a 28-day cycle; however, whether a woman's cycle is 28 days or 120 days, ovulation takes place 14 days before menstruation. Page 74

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 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. Page 69

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. Page 79

A nurse is examining a woman's external genitalia. Which area would the nurse identify as the mons pubis?

Picture of External Female Reproductive Organs Page 68

Which statement best expresses the role of the corpus luteum?

The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. 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. Page 75

When teaching a couple trying to conceive about the changes in cervical mucous near the time of ovulation, the nurse should include which information?

The mucous is thin and copious due to the elevated estrogen levels. The estrogen levels are elevated near the time of ovulation. These levels are responsible for the thinning and copious nature of the cervical mucus. Progesterone is not a factor at this time. Page 75

A nurse is caring for a client who has given birth. The client reports that her breast milk is dark yellow. Which information should the nurse give to the client regarding the situation?

The yellow fluid is colostrum and is rich in maternal antibodies. The nurse should inform the client that the yellow fluid is called colostrum, and it contains more minerals and protein, but less sugar and fat, than mature breast milk and is also rich in maternal antibodies. The nurse should inform the client that, gradually, the production of colostrum stops and the production of regular breast milk begins, but there is no need to avoid breastfeeding when colostrum is being produced, if the client's culture allows for it. There is no need to modify diet or to feed formula to the infant. Page 72

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. 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. Page 72

Which client should the nurse assess first?

a nonpregnant client with a cervical mucus pH level of 3.8 Cervical mucus should be alkaline to protect sperm from the acidic environment of the vagina. Colostrum, the dark yellow substance secreted from the breasts following childbirth, is a normal finding in a 1-day postbirth client. The vaginal should have an acidic environment to aid in preventing ascending infections. The shape of the cervical os should be a transverse slit following birth.

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

alkaline fluid The bulbourethral (Cowper's) 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). Page 75

The nurse is leading a seminar for parents on the changes that happen during puberty. Which list of the sequence of pubertal changes is accurate?

breast budding, appearance of pubic hair, menarche in girls Secondary sexual characteristics develop in an orderly sequence with variance in the timing for individuals. Breast budding in the female is usually the first physical sign noted, and occurs between the ages of 10 and 12 years on average. Appearance of pubic hair usually occurs just before menarche, the first menstrual period. From the onset to the start of menarche is typically 2 years. Male puberty occurs simultaneously over a period of years. Page 76

A nurse is caring for an adolescent girl experiencing menstruation for the first time. What are the changes that occur in the body at this stage that the nurse should share with the adolescent girl?

breast development Breast development is a change that occurs in the body of an adolescent girl. Many changes take place in the body, such as the appearance of feminine contours, development of breast tissue, appearance of unique fatty deposits, and hair in the pubic and axillary areas. Menopausal clients often experience irritability and insomnia, hot flashes, and urinary incontinence. Page 76

A nurse is conducting a teaching program for a group of young adult women about the structures of the female reproductive system. After describing the internal structures, the nurse determines that the teaching was successful when the group identifies which structure as the neck of the uterus?

cervix The neck of the uterus is referred to as the cervix. It connects to the vagina. The opening to the vagina is called the introitus, and the half-moon-shaped area behind the opening is called the fourchette. The clitoris is a small, cylindrical mass of erectile tissue and nerves. Most of the components of the clitoris are buried under the skin and connective tissue of the vulva. It is located at the anterior junction of the labia minora.

The male glans penis or glans is equitable to which structure on the female?

clitoris The female clitoris is equitable to the glans; both of these are composed of erectile tissue and are the primary organs responsible for orgasm. The vulva comprises the external female genitalia. The mons pubis is the area just above the vaginal opening. The labia are the lip like structures that are at the opening of the vagina. Page 68

When reviewing normal menstruation with an early adolescent, the nurse would teach that during the second half of a typical menstrual cycle, the endometrium of the uterus becomes:

corkscrew-like because of progesterone stimulation.. Progesterone is released following ovulation and thus is the dominating hormone of the second half of the menstrual cycle; its effect is to increase endometrium growth. Progesterone stimulates a growth of tissue, not a thinning of it. FSH and estrogen are found in the earlier stages of menstruation, not in the second half. Page 77

The ciliated epithelium that lines the inner walls of the cervix serves the purpose of producing mucus. The mucus produced changes during the menstrual cycle. What is the description of the mucus during the height of fertility?

distensible, stretchable quality At the peak of fertility (i.e., during ovulation), the mucus has a distensible, stretchable quality called spinnbarkheit. Page 76

The layer of the uterus that is influenced by hormone changes in preparation for possible conception and pregnancy is:

endometrium. The endometrium is the inner layer of the uterus that builds with hormones during the month in potential preparation for pregnancy. The myometrium is the muscular layer. The perimetrium is a protective layer, and the fundus is the upper area of the uterus. Page 73

The menstrual cycle consists of two main cycles: the ovarian cycle and the uterine cycle. Each of these cycles is regulated by hormonal activity. Which ovarian hormone regulates the proliferative phase of the uterine cycle?

estrogen When estrogen levels are high enough, the endometrium begins to regenerate. Estrogen stimulates blood vessels to develop. Page 77

When educating a client about the four phases of sexual response, the nurse states that one phase of the response cycle is marked by an increase in heart rates, blood pressure, and respiration in both sexes. To which phase is the nurse referring?

excitement During the excitement phase, the physiologic response of both male and females results in increase in heart rate, blood pressure, and respirations. During the plateau, the physiologic changes that occurred during excitement are maintained. In the female, the clitoris retracts and the uterus is fully elevated. In the male, the penis engorges further and the testes remain elevated. Orgasm is marked by muscular contractions. During resolution, the muscles relax and blood pressure, heart rate, and breathing return to normal.

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. Page 77

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 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. Page 75

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. Page 75

The mother of a 10-year-old female brings the girl to the clinic for a routine health visit. During the visit, the mother asks the nurse, "I'm wondering, can you tell me when my daughter might have her first period?" When responding to the mother, the nurse would integrate understanding of which factor as being most important in determining the age at which menstruation would occur?

genetics Although geographic location, nutrition, weight, general health, nutrition, cultural and social practices, the girl's educational level, attitude, family environment, and beliefs are important, genetics is the most important factor in determining the age at which menarche starts. Page 76

A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important?

genetics Genetics is the most important factor in determining the age at which menarche starts, but geographic location, nutrition, weight, general health, nutrition, cultural and social practices, the girl's educational level, attitude, family environment, and beliefs are also important. Page 76

Which hormone is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle?

gonadotropin-releasing hormone (GnRH) GnRH is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle. It induces the release of FSH and LH to assist with ovulation, both of which are secreted by the anterior pituitary gland. Estrogen is secreted by the ovaries and is crucial for the development and maturation of the follicle.

The nurse, while teaching a group of pregnant women about the production of breast milk, describes colostrum and compares it with mature breast milk. Which characteristic would the nurse identify as associated with colostrum?

high mineral content Colostrum is rich in maternal antibodies, especially IgA, which protects the newborn against enteric pathogens. Colostrum contains more minerals and protein but less sugar and fat than mature breast milk. Page 72

A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs:

in the fallopian tubes. Fertilization of the ovum can occur in the distal portion of the fallopian tubes. If the egg is fertilized, it will then be moved through the fallopian tube towards the uterus where it implants in the thick endometrium and begins its development. Page 71

The nurse is reviewing the role of the mammary glands in the reproductive process with a birth class. What should the nurse tell the class is the name of the ducts in the mammary glands that form a small reservoir for milk?

lactiferous Each breast is divided into 15 to 20 lobes of glandular tissue, covered by adipose (fat) tissue, which gives the breast its shape. The lobes are made up of lobules, which consist of milk-secreting cells in glandular alveoli. From the alveoli, small lactiferous ducts converge toward each nipple like the spokes of a wheel. Each lactiferous duct forms a small reservoir for milk. The structures of the breast include the nipple, the areola, and the areolar glands. The nipple is a circular projection containing some erectile tissue. It is surrounded by the pigmented areola. Areolar glands, which are close to the skin's surface, make the areola appear rough. Page 72

Which hormone causes ovulation to occur?

luteinizing hormone (LH) The hypothalamus releases GnRH at puberty to stimulate the anterior pituitary release of FSH and LH, thus stimulating the production and release of the sex hormones. ACTH targets the adrenal corticosteroid hormone, which helps prepare the body for the "fight or flight" response. Prolactin is responsible for milk production, and FSH in combination with LH stimulates follicles on the outer surface of the uterus to grow and develop and stimulates the release of estrogen and progesterone.

A nurse is obtaining a health history from a female client who reports that she started menstruating at age 11 years. The nurse would document this as:

menarche, age 11. Menarche refers to the start of menstruation, which in this case would be at age 11 years. Thelarche refers to the development of breast buds; adrenarche refers to the appearance of pubic and then axillary hair and subsequent growth spurt. Mensis is a general term referring to menstruation. Page 76

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?

one or two days before ovulation 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. Page 71

After teaching a group of women about reproduction and the structures involved, the nurse determines that the teaching was successful when the group identifies which female reproductive structure as comparable to the male testes?

ovaries The ovaries are a set of paired glands resembling unshelled almonds that are the organs of gamete production in the female. They are homologous to the male testes. The fallopian tubes are the site of fertilization. The clitoris is a small, cylindrical mass of erectile tissue and nerves that is analogous to the male penis. The fundus is the upper portion of the uterus. Page 72

A nurse is teaching a client about the reproductive system and the hormones involved. The nurse would include which structures as the source of these hormones? Select all that apply.

ovaries hypothalmus pituitary The reproductive cycle is influenced and controlled by hormones secreted by the ovaries, hypothalamus, and pituitary gland. The placenta secretes a temporary hormone that assists with maintaining pregnancy. The uterus does not secrete hormones. Page 77

In the female reproductive system, the hormones estrogen and progesterone are produced by the:

ovaries. The ovaries are two almond-shaped bodies lying on either side of the pelvic cavity. They contain ova and female hormones, specifically estrogen and progesterone. Page 77

A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. She states, "I've also been waking up at night feeling really hot and sweating." How should the nurse interpret these findings?

perimenopause Perimenopause is the time period occurring 2 to 8 years prior to menopause during which women may experience physical changes associated with decreasing estrogen levels, which may include vasomotor symptoms of hot flashes, irregular menstrual cycles, sleep disruptions, forgetfulness, irritability, mood disturbances, decreased vaginal lubrication, night sweats, fatigue, vaginal atrophy, and depression (Burbos & Morris, 2011). Vasomotor symptoms (hot flushes and night sweats) are the most common complaints for which women seek treatment. Menopause or climacteric is defined as 1 year without a menstrual period. Menarche refers to the onset of the first menses. Page 77

The nurse is responsible for educating nervous parents about their newborn son's circumcision. In describing the procedure, which part of the penis should the nurse tell them will be removed?

prepuce The foreskin, which covers the glans of the penis, is called the prepuce and parents may elect to have an infant male circumcised, removal of the prepuse. The tunica albuginea is connective tissue found inside the penile shaft. The corpus spongiosum is erectile tissue that runs the full length of the penis. Rugae are folds that allow for stretching during an erection. Page 79

A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation?

progesterone After the follicle ruptures as it releases the egg, it closes and forms a corpus luteum. The corpus luteum secretes increasing amounts of the hormone progesterone, which interacts with the endometrium to prepare it for implantation. The corpus luteum does not secrete estrogen, testosterone, or luteinizing hormone. Page 75

After ovulation the ovary forms a yellow body called the corpus luteum out of the empty egg follicle. What does the corpus luteum produce?

progesterone In addition to producing estrogen, the corpus luteum secretes a hormone called progesterone. Page 77

Which hormone is called the hormone of pregnancy because it reduces uterine contractions during pregnancy?

progesterone Progesterone is called the hormone of pregnancy because it reduces uterine contractions, thus producing a calming effect on the uterus, allowing pregnancy to be maintained. FSH is primarily responsible for the maturation of the ovarian follicle. LH is required for both the final maturation of preovulatory follicles and the luteinization of the ruptured follicle. Estrogen is crucial for the development and maturation of the follicle. page 77

The uterine cycle refers to changes that occur in the endometrial lining of the uterus. In which phase of this cycle does the corpus luteum begin to produce progesterone?

secretory After ovulation, the corpus luteum begins to produce progesterone; this hormone causes the uterine lining to become rich in nutrients in preparation for pregnancy. During the menstrual phase of the uterine cycle, the uterine lining is shed because of low levels of progesterone and estrogen. When estrogen levels are high enough, the endometrium begins to regenerate. Estrogen stimulates blood vessels to develop. The blood vessels, in turn, bring nutrients and oxygen to the uterine lining, which begins to grow and become thicker. The proliferative phase ends with ovulation on day 14. Without estrogen and progesterone to maintain the blood vessel network, the uterine lining becomes ischemic. Page 75

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?

serum progesterone level 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. Page 77

A nurse is assisting with the pelvic examination of a female client. The client has given birth to two living children, ages 5 and 2 years. The nurse would expect the client's cervical os to appear as which shape on examination?

slit-like Before birth, the external cervical os is a small, regular, oval opening. After birth, the opening is converted into a transverse slit that resembles lips. Page 71

Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the male sex hormones produced?

testes The testes serve two important functions: production of male sex hormones, androgens, and formation and maturation of spermatozoa. Page 78

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. Page 78

A nurse is conducting a health class for a group of adolescents about male and female reproduction. When describing the testes, the nurse would explain that these organs are important for manufacturing which hormone?

testosterone The testes serve two functions: production of sperm and synthesis of testosterone, the primary male sex hormone. Estrogen is secreted by the ovaries; progesterone is secreted by the corpus luteum. Luteinizing hormone is secreted by the anterior pituitary gland and is responsible for both the final maturation of the preovulatory follicles and luteinization of the ruptured follicle.

The increase in thickness of the endometrial layer during the first half of the menstrual cycle is controlled by:

the increasing level of estrogen. Estrogen levels increase after menstruation. These levels promote a thickening of the endometrial tissue. FSH and LH are responsible for ovarian changes. HcG is the hormone present during pregnancy. Page 75

Which client should the nurse flag for the health care provider to assess first?

the male client with three palpable masses in the testes The testes should have two nut-like structures present in males. The third mass could indicate a tumor or other anomaly. All the remaining clients have normal, expected findings. Page 79

A nurse is inspecting the external genitalia of a female client. When inspecting the vestibule, the nurse would expect to note openings for which structures? Select all that apply.

urethra vagina Bartholin glands Skene glands The vestibule is an oval area enclosed by the labia minora laterally. It is inside the labia minora and outside of the hymen and is perforated by six openings. Opening into the vestibule are the urethra from the urinary bladder, the vagina, and two sets of glands, the Bartholin and Skene glands. The anus opens posteriorly to the perineum.

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. Page 79

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 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. Page 69

A nurse is conducting a class and is describing the spermatic cord. Which structures would the nurse identify as being involved? Select all that apply.

vas deferens blood vessels nerves The vas deferens is a cord-like duct that transports sperm from the epididymis. One such duct travels from each testis up to the back of the prostate and enters the urethra to form the ejaculatory ducts. Other structures, such as blood vessels and nerves, also travel along with each vas deferens and together form the spermatic cord. The urethra is the terminal duct of the reproductive and urinary systems. The seminal vesicles produce nutrient seminal fluid and with the prostate are connected to the ejaculatory duct leading into the urethra.

A nurse is completing a continuing education program about the male and female reproductive organs. After reviewing the information, the nurse demonstrates understanding of the information by identifying which structures as male accessory organs? Select all that apply

vas deferens bulbourethral glands prostate gland The organs of the male reproductive system include the two testes (where sperm cells and testosterone are made), the penis, the scrotum, and the accessory organs (epididymis, vas deferens, seminal vesicles, ejaculatory duct, urethra, bulbourethral glands, and prostate gland).