OBGYN: Anatomy and Physiology of the Reproductive Systems

A nurse is examining a female client and tests the client's vaginal pH. Which finding would the nurse interpret as normal?

A) 4.5 B) 7 C) 8.5 D) 10 Ans: A Feedback: The vagina has an acidic environment; therefore a pH of 4.5 would indicate an acidic environment. A pH of 7 is considered neutral; a pH above 7 is considered alkaline.

Which female reproductive tract structure would the nurse describe to a group of young women as containing rugae that enable it to dilate during labor and birth?

A) Cervix B) Fallopian tube C) Vagina D) Vulva Ans: C Feedback: The vagina is a tubular, fibromuscular organ lined with mucous membrane that lies in a series of transverse folds called rugae. These rugae allow for extreme dilation of the canal during labor and birth. The cervix, the lower portion of the uterus, is composed of fibrous connective tissue that dilates during labor. The fallopian tube transports the ovum from the ovary to the uterus. The vulva is a collective term used to refer to the external female reproductive organs (mons pubis, labia majora and minora, clitoris, vestibular structures, and perineum).

When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle?

A) Estrogen B) Luteinizing hormone C) Progesterone D) Prolactin Ans: B Feedback: With the initiation of the menstrual cycle, luteinizing hormone rises and stimulates the follicle to produce estrogen. As this hormone is produced by the follicle, estrogen levels rise inhibiting the output of LH. Ovulation occurs after an LH surge damages the estrogen-producing cells leading to a decline in estrogen. The LH surge results in the corpus luteum, which produces estrogen and progesterone. These two levels rise, suppressing LH. Lack of LH promotes degeneration of the corpus luteum, which then leads to a decline in estrogen and progesterone. The decline of ovarian hormones ends their negative effect on the secretion of LH, which is then secreted and the menstrual cycle begins again. Prolactin is the hormone responsible for breast milk production.

The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation?

A) Estrogen B) Progesterone C) Follicle-stimulating hormone D) Luteinizing hormone Ans: D Feedback: 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 nurse is assessing a 13-year-old girl who has had her first menses. Which of the following events would the nurse expect to have occurred first?

A) Evidence of pubic hair B) Development of breast buds C) Onset of menses D) Growth spurt Ans: B Feedback: 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.

A nursing instructor is describing the hormones involved in the menstrual cycle to a group of nursing students. The instructor determines the teaching was successful when the students identify follicle-stimulating hormone as being secreted by which of the following?

A) Hypothalamus B) Anterior pituitary gland C) Ovaries D) Corpus luteum Ans: B Feedback: Follicle-stimulating hormone and luteinizing hormone are secreted by the anterior pituitary gland. The hypothalamus secretes gonadotropin-releasing hormone. The ovaries secrete estrogen. The corpus luteum secretes progesterone.

When describing the ovarian cycle to a group of students, which phase would the instructor include?

A) Luteal phase B) Proliferative phase C) Menstrual phase D) Secretory phase Ans: A Feedback: The ovarian cycle consists of three phases: the follicular phase, ovulation, and the luteal phase. The endometrial cycle includes the proliferative phase, menstrual phase, and secretory phase.

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

A) May 24 B) May 26 C) May 30 D) June 1 Ans: A Feedback: 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.

A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. "I've also been waking up at night feeling really hot and sweating." The nurse interprets these findings as which of the following?

A) Menopause B) Perimenopause C) Climacteric D) Menarche Ans: B Feedback: 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.

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?

A) Menstrual B) Proliferative C) Secretory D) Ischemic Ans: B Feedback: 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.

A nurse is conducting a class for a group of teenage girls about female reproductive anatomy and physiology. Which of the following would the nurse include as an external female reproductive organ? Select all that apply.

A) Mons pubis B) Labia C) Vagina D) Clitoris E) Uterus Ans: A Feedback: The external female reproductive organs collectively are called the vulva (which means "covering" in Latin). The vulva serves to protect the urethral and vaginal openings and is highly sensitive to touch to increase the female's pleasure during sexual arousal (Stables & Rankin, 2010). The structures that make up the vulva include the mons pubis, the labia majora and minora, the clitoris, the structures within the vestibule, and the perineum. The vagina and uterus are internal female reproductive organs.

A nurse is describing the structure and function of the reproductive system to an adolescent health class. The nurse describes the secretion of the seminal vesicles as which of the following?

A) Mucus-like B) Alkaline C) Acidic D) Semen Ans: B Feedback: The paired seminal vesicles secrete an alkaline fluid that contains fructose and prostaglandins. The fructose supplies energy to the sperm on its journey to meet the ovum, and the prostaglandins assist in sperm mobility. The Cowper's glands secrete a mucus-like fluid. The vagina is an acidic environment. Semen refers to the sperm-containing fluid.

After teaching a group of pregnant women about breast-feeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after childbirth?

A) Placental estrogen B) Progesterone C) Gonadotropin-releasing hormone D) Prolactin Ans: D Feedback: After childbirth and expulsion of the placenta, prolactin stimulates the production of milk. Placental estrogen and progesterone stimulate the development of the mammary glands during pregnancy. Gonadotropin-releasing hormone induces the release of follicle-stimulating hormone and luteinizing hormone to assist with ovulation.

A woman comes to the clinic complaining that she has little sexual desire. As part of the client's evaluation, the nurse would anticipate the need to evaluate which hormone level?

A) Progesterone B) Estrogen C) Gonadotropin-releasing hormone D) Testosterone Ans: D Feedback: Testosterone is needed to stimulate sexual desire in women. Thus, an evaluation of this level would be done. Progesterone is often called the hormone of pregnancy because of its calming effect (reduction in uterine contractions) on the uterus, allowing pregnancy to be maintained. Estrogen is the predominant hormone at the end of the follicular phase. Gonadotropin-releasing hormone induces the release of FSH and LH to assist with ovulation.

A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects that the client has an infection. When gathering additional information, which of the following would the nurse be least likely to identify as placing the client at risk for an infection?

A) Recent antibiotic therapy for an upper respiratory infection B) Last menstrual period about 5 days ago. C) Weekly douching D) Frequent use of feminine hygiene sprays. Ans: B Feedback: The vagina has an acidic environment, which protects it against ascending infections. Antibiotic therapy, douching, perineal hygiene sprays, and deodorants upset the acid balance within the vaginal environment and can predispose women to infections. Menstrual period about 5 days ago is not considered a risk factor.

When describing the male sexual response to a group of students, the instructor determines that the teaching was successful when they identify emission as which of the following?

A) Semen forced through the urethra to the outside B) Movement of sperm from the testes and fluid into the urethra C) Dilation of the penile arteries with increased blood flow to the tissues. D) Body's return to the physiologic nonstimulated state Ans: B Feedback: Emission refers to the movement of sperm from the testes and fluids from the accessory glands into the urethra, where it is mixed to form semen. As the urethra fills with semen, the base of the erect penis contracts, thus increasing pressure. This pressure forces the semen through the urethra to the outside (ejaculation). Dilation of the penile arteries with increased blood flow describes erection. The body's return to the physiologic nonstimulated state describes resolution.

The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would be inappropriate for the nurse to include as an accessory gland?

A) Seminal vesicles B) Prostate gland C) Cowper's glands D) Vas deferens Ans: D Feedback: The vas deferens is part of the ductal system of the male reproductive system responsible for transporting sperm from the epididymis. Accessory glands include the seminal vesicles, prostate gland, and Cowper's or bulbourethral glands.

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:

A) Sexual experience B) Full hormonal cycle C) Menstrual period D) Sign of breast development Ans: C Feedback: 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?

A) Sperm emission B) Penile vasodilation C) Psychological release D) Ejaculation Ans: B Feedback: 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 nurse is teaching a health education class on male reproductive anatomy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful?

A) Testes B) Seminal vesicles C) Scrotum D) Prostate gland Ans: A Feedback: 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 group of nursing students are reviewing information about the male reproductive structures. The students demonstrate understanding of the information when they identify which of the following as accessory organs? (Select all that apply.)

A) Testes B) Vas deferens C) Bulbourethral glands D) Prostate gland E) Penis Ans: B, C, D Feedback: 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).

After teaching a group of students about female reproductive anatomy, the instructor determines that the teaching was successful when the students identify which of the following as the site of fertilization?

A) Vagina B) Uterus C) Fallopian tubes D) Vestibule Ans: C Feedback: Fertilization occurs in the distal portion of the fallopian tubes. The lining of the uterus is shed with menstruation. The vagina connects the external genitalia to the uterus. The vestibule is an oval area enclosed by the labia minora laterally.