Chapter 02: Maternity Human Reproductive Anatomy and Physiology

The nurse explains to a 12-year-old patient that nocturnal emissions (wet dreams) are characterized by: a. a drop in testosterone level. b. sexual stimulation. c. absence of sperm in ejaculate. d. association with violent dreams.

ANS: C Nocturnal emissions occur without sexual stimulation and contain no sperm. Testosterone levels are constant until midlife.

The nurse outlines the phases of the sexual response. Arrange the phases in order of occurrence. Select all that apply? a. Nipples become erect. b. Involuntary muscle spasms occur. c. Engorgement resolves. d. Heart rate slows. e. Skin flushes.

ANS: A, E, B, C, D

Spermatozoa are produced in the: a. vas deferens. b. seminiferous tubules c. prostate gland d. Leydig cells

Correct answer: B Rationale: Sperm are made in the convoluted seminiferous tubules of the testes. The other answer options are not correct because sperm are produced only in the testes. Page reference: Page 22

A women can keep a diary of her menstrual cycles to help determine her fertile period. She understands that after ovulation she will remain fertile for: a. 2 hours b. 24 hours c. 3 to 5 days d. 7 to 14 days

Correct answer: B Rationale: The egg lives for only 24 hours after ovulation; therefore it is viable for fertilization only for 24 hours. Page reference: Page 29

In males the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH) from the anterior pituitary stimulate testosterone production in the ________ cells of the testes.

ANS: Leydig The Leydig cells in the testes are stimulated by the FSH and LH to produce testosterone.

When the nurse reads in the history and physical of a pregnant patient that she has a platypelloid pelvis, the nurse is aware that this pelvis has a narrow _____________ diameter, making a vaginal birth unlikely.

ANS: anteroposterior The platypelloid pelvis is very narrow from front to back (anteroposterior). The shape of this pelvis makes vaginal delivery unlikely.

The nurse encourages the members of a prenatal class to seriously consider breastfeeding because, in addition to nourishment for the infant, breast milk provides: a. maternal antibodies. b. stimulus for red blood cell production. c. endorphins that soothe the infant. d. hormones that stimulate growth.

ANS: A Breast milk provides maternal antibodies to the infant that give the child acquired immunity from some diseases for several months.

A mother is anxious about her ability to breastfeed after her child is born because of her small breast size. An important point to teach her is that: a. milk is produced in ducts and lobules regardless of breast size. b. supplementing breastfeeding with formula allows the infant to receive adequate nutrition. c. breast size can be increased with exercise. d. drinking extra milk during pregnancy allows breasts to produce adequate amounts of milk.

ANS: A Breast size does not influence the ability to secrete milk.

A group of nursing students plans to teach a class of sixth-grade girls about menstruation. They would teach the girls that: a. menarche usually occurs around 12 years of age. b. ovulation occurs regularly from the very first cycle. c. a regular cycle is established by the third period. d. typically, menstrual flow is heavy and lasts up to 10 days.

ANS: A The beginning of menstruation, called menarche, occurs at about 12 years of age. Early cycles are irregular and anovulatory.

A pregnant woman asks the nurse, "Will I be able to have a vaginal delivery?" The nurse would base a response on the understanding that the pelvic type most favorable for vaginal birth is: a. gynecoid. b. android. c. anthropoid. d. platypelloid.

ANS: A The gynecoid pelvis is the typical female pelvis and is most favorable for vaginal birth.

The nurse who is aware that the diagonal conjugate is 12 centimeters knows that the obstetric conjugate is ________ centimeters. a. 10 to 10.5 b. 11 to 11.5 c. 12.5 to 13 d. 14 to 14.5

ANS: A The obstetric conjugate is approximately 1.5 to 2 centimeters shorter than the diagonal conjugate.

The nurse explains that the production of sperm and secretion of hormones is regulated by the: a. testes. b. vas deferens. c. ejaculatory ducts. d. prostate gland.

ANS: A The testes have two functions: manufacture of spermatozoa and secretion of androgens.

The nurse explains that the fallopian tubes have which function(s)? Select all that apply. a. Passage for sperm to meet ova b. Passage for ovum to uterus c. Safe environment for zygote d. Restriction for only one ovum to enter uterus e. Site for fertilization

ANS: A, B, C, E The fallopian tube provides passage for both sperm and ova, offering an optimum place for fertilization and a safe environment for the zygote.

The nurse explains that testosterone is responsible for males exceeding females in which aspect(s)? Select all that apply. a. Strength b. Height c. Mental concentration d. Hematocrit levels e. Agility

ANS: A, B, D

The nurse conducting a sex education class for junior high students describes some cultural rites celebrating the entry to adulthood. Which would be included? Select all that apply. a. Bar mitzvah b. Displays of bravery c. Receiving part of their inheritance d. Ritual circumcision e. Displays of self-defense

ANS: A, B, D, E Some cultures celebrate the entry to adulthood with rites such as displays of strength, bravery, self-reliance, and self-defense. Ritual circumcisions and bar and bat mitzvahs are also entry rites to adulthood. Lack of such rituals can sometimes confuse young people because there is no evidence of acceptance as an adult.

By reading a pregnant patient's history and physical, the nurse recognizes what information that might indicate the need for a cesarean delivery? Select all that apply. a. History of childhood rickets b. Immobile coccyx c. Prepregnant weight of 100 pounds d. Avid horse rider e. Pelvic fracture 3 years ago

ANS: A, B, E Pelvic conditions that might predispose to a cesarean delivery are childhood rickets, pelvic fracture, and immobile coccyx.

Using a diagram, the nurse points out which bones that are part of the pelvis? Select all that apply. a. Two innominates b. Obstetric conjugate c. Sacrum d. Perimetrium e. Coccyx

ANS: A, C, E The bones of the pelvis are two innominates, the sacrum, and the coccyx.

Which statements are true about puberty? (Select all that apply.) a.The first outward change of puberty for a girl is development of breasts. b.Male hormonal changes are complete by age 13. c.Testosterone causes boys to develop secondary sex characteristics. d.Hormonal changes for the male and female begin before age 10. e.The first menstrual period in females occurs 2 to 2½ years after development of breasts.

ANS: A,C,E Breast development is the first outward change of puberty in females. Male hormone changes may not be complete until age 16. Testosterone is the cause of secondary sex characteristics. Both sexes' hormonal changes begin after age 10. The first menstrual period does occur 2 to 2½ years after development of breasts. REF: Pages 20-21

Testosterone has what effects not related to reproduction? (Select all that apply.) a. Increases sebum production b. Decreases hematocrit in males c. Decreases basal metabolic rate d. Promotes growth of long bones e. Increases muscle mass and strength

ANS: A,D,E Testosterone promotes growth of long bones, increases sebum production, and increases muscle mass and strength. Testosterone is responsible for an increase in hematocrit and basal metabolic rate in males. REF: Page 22

Maturation of the ovarian follicle is initiated by which hormone? a. Estrogen b. Follicle-stimulating hormone c. Progesterone d. Luteinizing hormone

ANS: B Follicle-stimulating hormone (FSH) stimulates the maturation of a follicle.

When planning to teach couples about the physiology of the sex act, the nurse would state that: a. "Fertilization of an ovum requires penetration by several sperm." b. "An ovum must be fertilized within 24 hours of ovulation." c. "It takes 4 to 5 days for sperm to reach the fallopian tubes." d. "Sperm live for only 24 hours following ejaculation."

ANS: B Following ovulation, the egg lives for only 24 hours. Sperm must be available during that time if fertilization is to occur.

The statement that indicates a woman has correct information about oogenesis is: a. "Women make fewer ova as they age." b. "Women have all of their ova at the time they are born." c. "Ova production begins at birth and continues until puberty." d. "New ova are made every month from puberty to climacteric."

ANS: B Oogenesis (formation of immature ova) does not occur after fetal development. Females are born with about 2 million immature ova that rapidly reduce by adulthood.

A newly married couple tells the nurse they would like to wait a few years before starting a family. The statement made by the man that indicates an understanding about sexual activity and pregnancy is: a. "My wife can't get pregnant if I withdraw before climax." b. "A man can secrete semen before ejaculation." c. "If we don't have intercourse very often, my wife won't get pregnant." d. "It is safe to ejaculate outside the vagina."

ANS: B Semen may be secreted during sexual intercourse before ejaculation.

When describing the female reproductive tract to a pregnant woman, the nurse would explain that which uterine layer is involved in implantation? a. Perimetrium b. Endometrium c. Myometrium d. Internal os

ANS: B The endometrium is the inner mucosal layer of the uterus that is governed by cyclical hormonal changes. It is functional during menstruation and during the implantation of a fertilized ovum.

A 10-year-old girl asks the nurse, "What is the first sign of puberty?" The correct nursing response is: a. an increase in height. b. breast development. c. appearance of axillary hair. d. the first menstrual period.

ANS: B The first outward change of puberty in girls is the development of breasts at about 10 to 11 years of age.

The nurse assisting with pelvic inlet measurements on a pregnant woman is aware that the measurement that provides information about whether or not the woman can deliver vaginally is: a. diagonal conjugate. b. obstetric conjugate. c. transverse diameter. d. anteroposterior diameter.

ANS: B This measurement determines if the fetus can pass through the birth canal.

Which hormones have a role in the reproductive cycle for the female? (Select all that apply.) a.Testosterone b. Follicle-stimulating hormone c. Luteinizing hormone d. Estrogen e. Progesterone f. Cortisol

ANS: B,C,D,E These hormones are involved in the reproductive cycle for the female. REF: Page 27

The nurse has explained menstruation to a 13-year-old girl. The statement that indicates the girl needs additional education is: a. "Periods last about 5 days." b. "My cycle should get regular in 6 months." c. "I should expect heavy bleeding with clots." d. "Periods come about every 4 weeks."

ANS: C Clots are not normally seen in menstrual discharge. A normal menstrual flow is 30 to 40 mL blood and 30 to 50 mL serous fluid.

The nurse uses a diagram to demonstrate the fimbriae, which: a. are the passageway for the sperm to meet the ovum. b. is the site of fertilization. c. are fingerlike projections that "capture" the ovum. d. propel the egg through the fallopian tube.

ANS: C Fimbriae are the fingerlike projections from the infundibulum that "capture" the ovum at ovulation and conduct it into the fallopian tube.

A 14-year-old boy is at the pediatric clinic for a checkup. The nurse is aware that the production of testosterone is responsible for which physical change in males during puberty? a. Stimulation of production of white cells and platelets b. Promotion of growth of small bones c. Increase in muscle mass and strength d. Decrease in production of sebaceous gland secretions

ANS: C Testosterone increases muscle mass, promotes strength and growth of long bones, and enhances production of red blood cells.

The nurse explains that the sperm are nourished by secretions from the: a. vas deferens. b. epididymis. c. Cowper's glands. d. scrotum.

ANS: C The Cowper's gland secretions nourish the sperm.

At which stage in the monthly cycle does ovulation typically occur? a. 7 days before the end of menstruation b. 7 days after the last day of menstruation c. 14 days after the last day of the menstrual cycle d. 14 days before the onset of the next menstrual cycle

ANS: D Ovulation occurs when a mature ovum is released from the follicle, which is about 14 days before the onset of the next menstrual period. REF: Page 27

What is the most appropriate response from a nurse when a mother reports that her 10-year-old daughter's breasts recently began to develop and asks when her daughter might begin to menstruate? a. "It will be several years before her menstrual cycle begins." b. "Your daughter's menstrual cycle most likely has already started." c. "There is no way to know when to expect her menstrual cycle to begin." d. "The first menstrual period will most likely occur when she is around 12 years old."

ANS: D The first menstrual period (menarche) occurs 2 to 2½ years after breast development. REF: Page 27

What is the function of Montgomery's glands? a. Secrete lubricant into vagina for the purpose of sexual intercourse b. Create an alkaline environment for sperm to progress into the fallopian tubes c. Secrete milk and lubricant when stimulated by the infant when nursing d. Secrete substances to lubricate and protect the breasts during lactation

ANS: D The purpose is to secrete substances to lubricate and protect the breasts during lactation. REF: Page 27

A mother asks the nurse, "When will I know my child has entered puberty?" Based on an understanding of changes associated with puberty, the nurse states: a. "When your daughter has her first period." b. "You'll recognize puberty by the mood swings." c. "The child becomes interested in the opposite sex." d. "Secondary sex characteristics, such as pubic hair, appear."

ANS: D Puberty begins when the secondary sex characteristics appear. Puberty ends when mature sperm are formed in the male and when regular menstrual cycles occur in the female.

The nurse clarifies that puberty ends for a male when: a. facial hair is evident. b. erections can be sustained. c. ejaculate is greater than 5 mL. d. mature sperm form

ANS: D Puberty ends for a male when mature sperm are formed by the testes.

The nurse explains that sperm can remain viable in the female reproductive tract for as long as: a. 12 hours. b. 1 day. c. 2 days. d. 4 days.

ANS: D Sperm can remain viable in the reproductive tract of the female for as long as 4 to 5 days

The nurse explains to a pregnant patient who expects to breastfeed that the portions of the breast that secrete milk are the: a. lactiferous sinuses. b. lobes. c. Montgomery's glands. d. alveoli.

ANS: D The alveoli secrete milk.

The nurse explains that the decrease in estrogen and progesterone during the menstrual cycle is responsible for: a. degeneration of the corpus luteum. b. ovulation. c. follicle maturation. d. shedding of the endometrium.

ANS: D The fall in estrogen and progesterone causes the endometrium to break down, resulting in menstruation.

The nurse, speaking with a couple trying to conceive a child, reminds the patients that a factor that can decrease sperm production is: a. infrequent sexual intercourse. b. the man not being circumcised. c. the penis and testes being small. d. the testes being too warm.

ANS: D The scrotum is suspended away from the perineum to lower the temperature of the testes for sperm production.

The tissue between the vaginal orifice and the anus is known as the ____________.

ANS: perineum The perineum is a strong, muscular area between the vaginal opening and the anus. REF: Page 23

Which data indicates that the women may have pelvic dimensions that would be inadequate for a normal vaginal delivery? A women with a(n): a. anthropoid-shaped pelvis with a history of pelvic inflammatory disease b. gynecoid - shaped pelvis with a history of rickets c. anthropoid-shaped that oreviously delivered a 9lbs infant d. gynecoid-shaped pelvis with a history of poor nutrition

Correct answer: B Rationale: Although the gynecoid-shaped pelvis is considered most favorable for a vaginal delivery, a woman with a history of rickets (a disease in which normal bone formation is disturbed when bone fails to mineralize and becomes soft and distorted) would be the most likely of the choices for inadequate normal vaginal delivery. An anthropoid-shaped pelvis with a history of PID, although not most favorable, allows for possible vaginal delivery, and history of PID might interfere with conception but not delivery. Previous delivery of a large infant is evidence of adequate pelvic dimensions for a normal vaginal delivery. Although poor maternal nutrition can affect the health of the newborn, delivery is not necessarily affected. Page reference: Pages 25-27

The muscular layer of the uterus that is the functional unit in pregnancy and labor is the: a. perimetrium b. myometrium c. endometrium d. cervix

Correct answer: B Rationale: The myometrium is the middle muscular uterine layer and is functional in pregnancy and labor. The perimetrium is the outermost, or serosal, layer that envelops the uterus. The endometrium is the inner, or mucosal, layer that is functional during menstruation and implantation of the fertilized ovum. The cervix is the lower part of the uterus that lubricates the vagina, acts as a bacteriostatic agent, provides an alkaline environment, and produces a mucous plug. Page reference: Page 24

During a prenatal clinic visit, a women states that she probably will not plan to breastfeed her infant because she has a very small breasts and believes she cannot provide adequate milk for a full-term infant. The best response of the nurse would be: a. "Ask the physician if he or she will prescribe hormones to build up the breasts." b. "I can provide you with exercises that will build up your breast tissue." c. The fluid intake of the mother will determine the milk output." d. "The size of the breast has no relationship to the ability to produce adequate milk."

Correct answer: D Rationale: Breast size is primarily determined by the amount of fatty tissue and is unrelated to a woman's ability to produce milk. The other answer options are inaccurate. Page reference: Page 27