Chapter 14 Before Conception

Which vaccines are contraindicated during pregnancy since they may transmit a viral infection to the fetus? Select all that apply. mumps measles rubella Tdap vaccine (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) influenza

measles mumps rubella Live virus vaccines, such as measles, HPV, mumps, rubella, and poliomyelitis (Sabin type), are contraindicated during pregnancy because they may transmit a viral infection to a fetus. Women are advised to be vaccinated against influenza before/during pregnancy. Tetanus is also treated the same in pregnant women as in others by Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) injection.

A nurse is discussing menstruation with a female client. The nurse describes a normal amount of blood loss is approximately: 5 to 20 mL. 75 to 100 mL. 120 to 150 mL. 10 to 80 mL.

10 to 80 mL. Menstrual flow usually lasts 2 to 7 days with a normal blood loss between 20 to 80 mL.

The nurse is providing education on menstruation to an adolescent client who has just experienced menarche. The nurse will inform the client to contact her health care provider for which situation? if noticing fatigue or bloating while menstruating if the duration of flow lasts between 3 and 7 days if saturating a menstrual pad in 1 hour if cycle length is 30 or more days

22nd To calculate expected ovulation, the nurse should explain to the client to subtract 14 days from the expected start date of the next menstrual cycle.

What instruction should a nurse offer to a pregnant client or a client who wishes to become pregnant to help her avoid exposure to teratogenic substances? Avoid medications. Eat a well-balanced diet. Maintain personal hygiene. Avoid intake of coffee.

Avoid medications. The nurse should instruct a client who is pregnant or one who wants to conceive to avoid medications and thus avoid exposure to any kind of teratogenic substance. Eating a well-balanced diet and maintaining personal hygiene, though important during pregnancy, will not prevent a client's exposure to teratogenic substances. Coffee is not a teratogenic substance, so the client need not avoid coffee. However, coffee is not recommended during pregnancy because it may increase the risk of spontaneous abortion (miscarriage).

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum? Luteinizing hormone Progesterone Estrogen Follicle-stimulating hormone

Follicle-stimulating hormone Explanation: The follicle-stimulating hormone (FSH) is the messenger from the pituitary gland to stimulate the ovum to mature. Luteinizing hormone is the hormone that is released from the pituitary gland once the follicle containing the ovum is mature, but it has no role in maturing the ovum. Estrogen and progesterone are integral parts of the ovulatory cycle but do not mature ovum.

Which statement should be incorporated into the teaching plan developed to present instruction about the female menstrual cycle to nursing students? Progesterone influences the growth of endometrial lining. Estrogen is the dominant hormone during the luteal phase. Menses ensues when the levels of estrogen and progesterone fall. The follicular phase is dominated by progesterone and testosterone.

Menses ensues when the levels of estrogen and progesterone fall. Explanation: Menstruation depends on the interplay of various hormones. The hypothalamus secretes gonadotropin-releasing hormone, which stimulates the pituitary gland to secrete follicle-stimulating hormone and luteinizing hormone. These hormones stimulate the ovaries to produce estrogen and progesterone, which are necessary for stimulation of the target organs (vagina, breast, uterus) in preparing for pregnancy.

A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you to consider? Restricting visitors to reduce the noise level. Organizing nursing care at times other than visiting hours. Asking the hospital's visitor program to call on her to prevent loneliness. Spending increased time with her yourself to prevent loneliness.

Organizing nursing care at times other than visiting hours. Because extended families have many members, support people in time of an illness are usually available. Restricting visitors will leave her without support and will be detrimental to her treatment. Asking the staff to visit will reduce her privacy. You as a practitioner cannot become personally involved.

While caring for a pregnant woman of Middle Eastern descent, a nurse attempts to mold the client's choices to fit what she calls the "American Way." When questioned, she reports it is best and easier to plan and deliver care this way. Based upon your knowledge, you recognize this as: cultural sensitivity. cultural blindness. cultural awareness. cultural destructiveness.

cultural destructiveness. Explanation: Attempts to modify the culture and beliefs of others is a form of cultural destructiveness. Cultural blindness is an unknowing ignorance. Nurses should strive for full cultural understanding and awareness. Cultural sensitivity is the demonstration of awareness.

The nurse is preparing to assess a young woman's external genitalia. The nurse predicts the client is currently in the most fertile phase of the menstrual cycle based on which assessment finding of the vaginal mucus drainage? distensible, stretchable quality clear and oily yellow, tacky, and crumbly raw egg white consistency

distensible, stretchable quality At the peak of fertility (i.e., during ovulation), the mucus has a distensible, stretchable quality called spinnbarkeit. During the proliferative phase, the mucus is yellow, tacky, and crumbly. Close to the time of ovulation, the mucus will appear clear and oily with a raw egg white consistency.

A nurse is preparing a presentation for a group of nurses about genetic discoveries and advances. When discussing this topic, the nurse would most likely include which topic area related to the potential for misuse? greater emphasis on the causes of diseases gene replacement therapy for defective genes slower diagnosis of specific diseases individual risk profiling and confidentiality

individual risk profiling and confidentiality Individual risk profiling based on an individual's genetic makeup can raise issues related to privacy and confidentiality. Gene replacement therapy for defective genes and a greater emphasis on looking at the causes of disease are considered benefits associated with genetic advances. Rapid, more specific diagnosis of diseases would be possible.

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. placenta ovaries hypothalamus pituitary uterus

ovaries hypothalamus 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.

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. pituitary hypothalamus ovaries uterus placenta

ovaries hypothalamus pituitary Explanation: 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.

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 prolactin testosterone luteinizing hormone

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

As part of a 31-year-old client's prenatal care, the nurse is assessing immunization history. Which immunization is most relevant to ensuring a healthy fetus? measles hepatitis A and B rubella diphtheria, tetanus, and pertussis

rubella Maternal exposure to rubella during pregnancy poses a particular fetal risk that supersedes the significance of hepatitis, measles, diphtheria, tetanus, or pertussis.

A woman being assessed by the nurse reports that she is 6 weeks' pregnant. If her report is accurate, when will the nurse predict the client conceived? 4 weeks ago 10 weeks ago 6 weeks ago 8 weeks ago

4 weeks ago The length of a pregnancy is more commonly measured from the first day of the last menstrual period (gestational age). Because ovulation and fertilization take place about 2 weeks after the last menstrual period, the ovulation age of the fetus is always 2 weeks less than the length of the pregnancy or the gestational age. Therefore this client conceived 4 weeks ago.

Which of a client's cells are most likely to reproduce by meiosis? Endometrium Cervix Breast tissue Ova

Ova Ova and other sex cells reproduce by meiosis. All of the other tissues are made up of somatic cells, which reproduce by mitosis.

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother? Social support Early prenatal care Having a planned pregnancy Age at the time of pregnancy

Social support All options are correct and play a role pregnancy, but the most critical for a positive psychological experience is for the woman to have a social support system. Early care, maternal age, and planned pregnancy all affect fetal and maternal health, but are not necessarily linked to positive psychological experiences.

The school nurse is presenting a lecture to adolescents to teach them how conception occurs. Which statement by the nurse would accurately describe this process? "Conception usually occurs when the ovum is in the outer third of the fallopian tube." "Human life begins with the union of two cells: the zygote and the sperm." "The ovum carries the Y chromosome, and the sperm carries an X or Y chromosome." "At the time of conception, the ovum determines the sex of the baby."

"Conception usually occurs when the ovum is in the outer third of the fallopian tube." Conception usually occurs when the ovum is in the outer third of the fallopian tube (oviduct). Human life (conception) begins with the union of two cells: the ovum (female) and the sperm (male). At the time of conception, the sperm determines the sex. An ovum carries only one type of chromosome to determine sex: the X chromosome. A male sperm cell may carry either an X or Y sex chromosome. If a sperm cell carrying a Y chromosome fertilizes the ovum, a boy (XY) will result; if the sperm cell carries an X chromosome, the result will be a girl (XX).

Which question would be most important for a nurse to ask a G2P1 client who has a child with sickle cell anemia? "Have you done well to control your stress?" "Do you know the sex of your baby?" "Did you and your partner get genetic testing?" "When was your last exacerbation?"

"Did you and your partner get genetic testing?" The nurse should assess whether the client has had genetic testing completed. If not, the client should be referred for testing.

A 45-year-old man has just been diagnosed with Huntington disease. He and his spouse are concerned about their four children. Based on the knowledge of patterns of inheritance, how will the nurse respond? "This disorder is carried on the X chromosome so only your female children would be affected." "Each of your children will have a 50% chance of inheriting the disease." "Both genes of a pair must be abnormal for the disorder to occur in your children." "Your male children are more likely to be affected than your female children."

"Each of your children will have a 50% chance of inheriting the disease." Huntington disease is an autosomal dominant disorder. A single gene in the heterozygous state is capable of producing the phenotype. In these cases, the abnormal or mutant gene overshadows the normal gene and the individual will demonstrate signs and symptoms of the disorder. The affected person usually has one affected parent. The defect occurs on the autosome not on the X chromosome; therefore, autosomal dominant inherited conditions affect female and male family members equally and follow a vertical pattern of inheritance in families. A person who has an autosomal dominant inherited condition carries a gene mutation for that condition on one chromosome pair. Each of that person's offspring has a 50% chance of inheriting the gene mutation for the condition and a 50% chance of inheriting the normal version of the gene.

The nurse is providing teaching to an adolescent girl on the function of the female reproductive system. Which statement by the client best reflects understanding of the material presented? "I will always count from the end of my last menstrual cycle to determine when I will ovulate." "A vaginal discharge that is thick and white in color indicates that I am ovulating." "My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal." "During ovulation, the egg is released directly into my uterus to help with fertilization."

"My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal." The normal menstrual cycle lasts an average of 28 days, but there is a variance between women and even between cycles in some women, which is normal. Counting to determine ovulation time is based upon the beginning of the menstrual cycle, not the end. The mucus during ovulation is thin, clear and somewhat stretchable. At ovulation, the ova are released into the abdominal cavity and are propelled along by tiny finger-like projections that direct it to the fallopian tube.

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education? "I will ovulate every month on Day 21 of my cycle." "My menstrual cycles are controlled by progesterone production." "When I ovulate, there is a follicle on my uterus that forms showing that an ova was released." "Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)."

"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." Ovulation is controlled by FSH and LH, with the follicle-stimulating hormone encompassing days 1 to 14 of a 28-day cycle and the luteinizing hormone controlling the luteal phase, which is days 15 to 28. The follicle forms only in the ovary, not the uterus. Ovulation should occur on Day 14 of a normal 28-day cycle. Both estrogen and progesterone are necessary to the menstrual cycle, not just progesterone.

The nurse is reviewing hormonal regulation of the female reproductive system with a group of nursing students. A student nurse states, "Progesterone prepares a woman's uterus to receive and welcome a fertilized ovum." Which action will the nurse complete based on the student's response? Ask the student if she has been pregnant in the past. Correct the student's misunderstanding of the hormone's function. Ask the student to stay after class to discuss more in-depth. Applaud the student for understanding the material.

Applaud the student for understanding the material. The nurse would applaud the student's understanding of the material. There is no need for a more in-depth discussion with the student or to clarify material because the student is showing comprehension of the hormone's function. Asking the student about her past medical history is inappropriate in the group setting. This information is irrelevant to the situation as well.

In caring for a fully immunized pregnant woman who is a nurse in a family health practice, the obstetric nurse should remind the client that she must not come in contact with clients who have symptoms that could indicate which infection? smallpox Chicken pox diphtheria measles

Chicken pox Chicken pox can be teratogenic to the fetus and exposure may have a significant impact on the fetus and may cause defects. The fetus receives passive immunity from the mother for measles, diphtheria, and smallpox.

What should the nurse include when counseling potential parents about genetic disorders? Environmental influences may affect multifactorial inheritance. Genetic disorders primarily follow Mendelian laws of inheritance. The absence of genetic disorders in both families eliminates the possibility of having a child with a genetic disorder. All genetic disorders involve a similar number of abnormal chromosomes.

Environmental influences may affect multifactorial inheritance. Not all genetic disorders follow Mendelian laws of inheritance. Diseases caused by multiple factors do not follow Mendelian laws because more than a single gene or HLA is involved. Environmental influences may be instrumental in determining whether the disorder is expressed. All genetic disorders do not involve a similar number of abnormal chromosomes. A family history may reveal no set pattern so an absence of genetic disorders in both families does not necessarily eliminate the possibility of having a child with a genetic disorder.

The nurse is teaching a class about conception. The nurse explains to the participant that which factors are necessary for conception to occur? Select all that apply. Equal maturation of both sperm and ovum Ability of the sperm to reach the ovum Ability of the sperm to penetrate the ovum Ability of the ovum to ingest the sperm Equal motility of both sperm and ovum

Equal maturation of both sperm and ovum Ability of the sperm to reach the ovum Ability of the sperm to penetrate the ovum For conception to occur three factors must be present: equal maturation of the sperm and ovum, ability to the sperm to reach the ovum, and the ability of the sperm to penetrate the ovum. The ovum does not ingest the sperm; the ovum is passive and the sperm must penetrate the zona pellucida and cell membrane and achieve fertilization. The ovum is not motile. The ovum is propelled through the fallopian tube by the cilia lining the tube. Unlike the motile sperm, an ovum has no independent motility.

A woman in labor has brought a butcher knife with her and insists on putting it under her hospital mattress to "cut the labor pain." Which is the nurse's best response to this situation? Explain the security issue and negotiate with the client asking if a picture or rubber/play knife would honor her values and beliefs. Explain the security issue and educate the client about the cause of labor pain. Explain the security issue and offer to teach the client to use chest breathing with contractions to cut the labor pain. Explain the security issue and inform the client that the hospital will not allow her to keep the knife because it is a lethal weapon.

Explain the security issue and negotiate with the client asking if a picture or rubber/play knife would honor her values and beliefs. This situation highlights the need for nurses to be aware of culturally held beliefs and practices of the clients they see and provide care for. Respect for cultural values is important for developing effective nurse-client relationships. The nurse should allow the client to believe what she wishes is appropriate. An attempt to educate the client or outright restriction of her desires would worsen the situation.

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Positive office pregnancy test Fetal movement felt by examiner Hegar sign Chadwick sign

Fetal movement felt by examiner The positive signs of pregnancy are fetal image on a sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test has 95% accuracy; however, it may come back as a false positive. Hegar sign is a softening of the uterine isthmus. Chadwick sign may have other causes besides pregnancy.

The nurse is assessing a 16-year-old female on a routine well-child visit. Which assessment finding will the nurse predict this healthy female will report concerning her menstrual cycles? Flow usually lasts 4 to 6 days. The usual cycle is 36 days. There's abundant clear mucus at the beginning Menstruation began at age 15.

Flow usually lasts 4 to 6 days. The average menstrual flow is 4 to 6 days in length. The cycle usually lasts 28 days. There should be no mucus during the menstrual cycle, with clear mucus being noted at the time of ovulation or approximately day 14. Menstruation usually begins at the age of 12 to 14 years.

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum? Follicle-stimulating hormone Luteinizing hormone Estrogen Progesterone

Follicle-stimulating hormone The follicle-stimulating hormone (FSH) is the messenger from the pituitary gland to stimulate the ovum to mature. Luteinizing hormone is the hormone that is released from the pituitary gland once the follicle containing the ovum is mature, but it has no role in maturing the ovum. Estrogen and progesterone are integral parts of the ovulatory cycle but do not mature ovum.

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history? G2 P1020 G3 P0021 G3 P0020 G2 P0020

G3 P0020 Gravida (G) is the total number of pregnancies she has had, including the present one. Therefore she is G3 and not G2. Para (P), the outcome of her pregnancies, is further classified by the FPAL system as follows: F = Full term: number of babies born at 37 or more weeks of gestation, which is 0 and not 1 in this case. P = Preterm: number of babies born between 20 and 37 weeks of gestation, which is 0 in this case. A = Abortions: total number of spontaneous and elective abortions, which is 2 in this case. L = Living children, as of today. She has no living children; therefore, it is 0 and not 1.

The nurse is documenting a non-pregnant client's obstetric history. The client informed the nurse she has 4 children living at home. She birthed one child at 34 weeks' gestation, one child at 37 weeks' gestation, one at 38 weeks' gestation, and one at 39 weeks' gestation. The client has had one abortion. Using the GTPAL format, how will the nurse document the client's obstetric history? G4, T3, P0, A1, L3 G5, T2, P1, A1, L3 G4, T3, P1, A1, L4 G5, T2, P2, A1, L4

G5, T2, P2, A1, L4 "G" stands for gravida, the total number of pregnancies (5). "T" stands for term, the number of pregnancies that ended at term (at or beyond 38 weeks' gestation)(2). "P" is for preterm, the number of pregnancies that ended after 20 weeks' gestation (2). "A" is for abortions, either spontaneous or elective (1). "L" is for living, the number of children delivered who are alive at the time of history collection (4).

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. LH testosterone FSH prolactin GnRH

GnRH FSH 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.

A 28-year-old client states that she has not had her menstrual period for the past 3 months and suspects she is pregnant. Which should the nurse do next? Have the client take a pregnancy test. Assess the client for a fetal heart tone. Determine at what age the client began menstruating. Ask the client the date her last period ended.

Have the client take a pregnancy test. Absence of menstruation, along with consistent nausea, fatigue, breast tenderness, and urinary frequency, are the presumptive signs of pregnancy. To determine if the client may be pregnant, a pregnancy test is indicated.

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 1 March 6 March 13 March 27

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.

A female client states, "I am concerned because when I have sex with my spouse, I have an area near my vagina that is really sensitive to touch." Which action will the nurse complete? Provide education to the client on the female anatomy. Refer the client for psychological counseling. Determine if the client has a sexually transmitted infection (STI). Have the client provide a urine specimen for testing.

Provide education to the client on the female anatomy. The nurse understands this is a normal, expected experience and would provide education to the client on the clitoris and its function. The clitoris is a small, cylindrical mass of erectile tissue and nerves that is highly sensitive and analogous to the head of the male penis. There is no indication for counseling because no signs of current or past abuse are present. This is not an indication of an STI or urinary tract infection; therefore, no additional testing or specimens are needed.

A newly married female is talking to the nurse about her desire to get pregnant soon. Which suggestion would the nurse make to assist this client? Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle. It is recommended to check her mucus and have intercourse when the mucus is opaque and scant. If she has irregular menstrual cycles, that should not interfere with her conceiving as long as she has intercourse on the same days every month. If ovulation occurs on Day 14 of her menstrual cycle, she should have intercourse one week later on Day 21.

Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle. Fertilization occurs when the woman ovulates and has intercourse within a day either before or after ovulation. The mucus near ovulation is clear, stretchable and thin to facilitate the movement of the sperm. Conception can only occur at the time of ovulation, so having the client engage in intercourse on the same days monthly will not help her conceive. Waiting one week following ovulation will lessen the chance of conception greatly.

A client is attempting to become pregnant and is using varied methods to identify ovulation. What assessment finding would most clearly suggest that the client is ovulating? The client menstruated eight days ago The client has clear, thin cervical mucus Cervical mucus is absent The client's progesterone levels are peaking

The client has clear, thin cervical mucus Cervical mucus is clear and thin near ovulation. Ovulation typically occurs near day 14 of the menstrual cycle. Progesterone levels are low near the time of ovulation.

The student nurse cares for a child from a large extended family. Considering the child's family structure, which way might the child view the student nurse as "poor"? The student is planning to be a nurse. The student owns only one nurse's uniform. The student is unmarried and lives alone. The student stated he or she values honesty.

The student is unmarried and lives alone. Part of the richness of an extended family is the availability of support people in times of family stress. Planning to be a nurse would not be a factor. The child would not know that the student only owns one uniform. The student's views on honesty are unrelated to financial status.

A pregnant woman asks the nurse about using herbal remedies while she is pregnant. The nurse recommends that the woman talk with her health care provider about their use based on which understanding? They are not rated with regard to safety during pregnancy. They have been proven to cause early labor. They can create nutritional deficiencies in the mother and fetus. They are known to cause teratogenic effects in the fetus.

They are not rated with regard to safety during pregnancy. Herbs are not regulated by the FDA in the same way as medications; therefore, they are not rated with regard to their safety in pregnancy. As with medicine, women should not take herbs in pregnancy until they discuss the herbs' safety with their obstetric provider. Herbal supplements do not create nutritional deficiencies in the fetus and are not known that herbal supplements cause teratogenic effects in the fetus. There is no proof that herbal supplements cause early labor.

The nurse is teaching a couple trying to conceive about the changes in the cervical mucus near the time of ovulation. The nurse determines the session is successful when the couple correctly choose mucus in which form as indicating ovulation has occurred? Scant amount Thick and tacky Thin and copious Mucus is not visible at ovulation

Thin and copious During ovulation, the mucus will be distensible and stretchable. After ovulation, the mucus will be scant, thick and opaque in nature. During the proliferative phase before ovulation, it is tacky, crumbly, and yellow or white in color. During the menses, there will be no mucus noted.

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client? An ovum matures and is released. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall.

While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth during the proliferative phase. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall during the secretory phase. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. Maturation of an ovum occurs during the ovarian cycle; growth of the lining (endometrium) of the uterus occurs during the uterine cycle. Together, these cycles are known as the menstrual cycle.

A client makes an appointment at the prenatal clinic because the client thinks the client might be pregnant. Which assessment would the nurse identify as a presumptive sign of pregnancy? amenorrhea vagina violet in color cervical softening positive pregnancy test

amenorrhea Amenorrhea is a presumptive sign of pregnancy. Chadwick sign (vagina changing in color from pink to purple), Goodell sign (softening of the cervix) and a positive pregnancy test are probable signs.

What does the genetic analysis always include? assessment for any other potentially inherited condition evaluation of other potentially inherited conditions interventions for other potentially inherited conditions planning for other potentially inherited conditions

assessment for any other potentially inherited condition The genetic analysis always includes assessment for any other potentially inherited conditions for which testing, prevention, and treatment may be possible. Interventions are not carried out for potential genetic conditions. Evaluation and planning cannot be accomplished if the client does not have the disease.

A group of nursing students are comparing male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure? vulva clitoris labia majora vagina

clitoris The female clitoris is complementary (equitable) to the glans; both of these are composed of erectile tissue and are the primary organs responsible for orgasm. Other comparable structures include the testes and ovaries, and scrotum and labia majora. The vagina does not have a comparable male structure.

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? provides rich blood supply to decidua maintains nutrient-rich decidua continues progesterone production by corpus luteum sustains life of placenta

continues progesterone production by corpus luteum The corpus luteum is responsible for producing progesterone until this function is assumed by the placenta. hCG is a fail-safe mechanism to prolong the life of the corpus luteum and ensure progesterone production. Estrogen is responsible for providing a rich blood supply to the decidua. Progesterone helps maintain a nutrient-rich decidua.

When caring for a woman in her sixth month of pregnancy, she reports her plans to nurse for at least two to three years like the rest of the women in her family. Based upon your knowledge, you: advise her to be careful who she discusses this with, as many will consider that a type of reportable child abuse. document her report but do nothing, as this is a cultural belief that should be respected. encourage her to start the baby on formula after the first year as recommended by many physicians. discuss how painful this will be once the baby has teeth.

document her report but do nothing, as this is a cultural belief that should be respected. Culturally specific decisions should be respected and incorporated into the plan of care. Options other than following the mother's wishes (insomuch as these wishes do not put the child in danger), are inconsequential and may be viewed as intrusive and inappropriate.

During which stage of fetal development is exposure to teratogens most damaging? fetal stage mitosis stage pre-embryonic stage embryonic stage

embryonic stage The most sensitive period of fetal development related to teratogens is during the embryonic period when the different body systems are developing. During the pre-embryonic stage, the fetal stage, and the mitosis stage, the risk of teratogenic exposure is not as influential on the fetus.

The nurse is conducting an annual examination on a young female who reports her last menses was 2 months ago. The client insists she is not pregnant due to a negative home pregnancy test. Which assessment should the nurse use to assess confirm the pregnancy? positive urine human chorionic gonadotropin (hCG) uterine size and shape changes fetal heartbeat Chadwick sign

fetal heartbeat The only positive sign of pregnancy is a sign or symptom that could only be attributable to the fetus; thus, fetal heartbeat can have no other origin. Chadwick sign is a color change in the cervix, vagina, and perineum; these could all be the result of other causes. A positive urine hCG is a probable sign as it can be related to causes other than pregnancy. A change in the size and shape of the uterus can occur due to other causes.

Which of the following is a positive sign of pregnancy? positive pregnancy test fetal movement felt by examiner Hegar's sign uterine contractions TAKE ANOTHER QUIZ

fetal movement felt by examiner The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and examiner feeling fetal movement.

Which hormone would the nurse explain as being primarily responsible for maturation of the ovarian follicle? luteinizing hormone follicle-stimulating hormone estrogen gonadotropin-releasing hormone

follicle-stimulating hormone Explanation: 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.

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 proliferative phase secretory phase ischemic phase

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.

A nurse is preparing a program for a group of parents of prepubertal children about the changes to expect with puberty. When describing the sequence of events that occur, the nurse would identify which hormone as initiating the cycle? follicle-stimulating hormone luteinizing hormone testosterone gonadotropin-releasing hormone

gonadotropin-releasing hormone Puberty is the stage of life at which secondary sex changes begin. In most girls, these changes are stimulated when the hypothalamus synthesizes and releases gonadotropin-releasing hormone (GnRH), which then triggers the anterior pituitary to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH are termed gonadotropin (gonad = "ovary"; tropin = "growth") hormones because they begin the production of androgen and estrogen, which in turn initiate secondary sex characteristics.

Which hormone is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle? follicle-stimulating hormone (FSH) gonadotropin-releasing hormone (GnRH) luteinizing hormone (LH) estrogen

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.

Which hormone stimulates the release of the follicle-stimulating hormone (FSH) from both male and female glands? growth hormone-releasing hormone (GHRH) thyrotropin-releasing hormone (TRH) gonadotropin-releasing hormone (GnRH) prolactin-releasing hormone (PRH)

gonadotropin-releasing hormone (GnRH) The male and female glands respond to LH and FSH, which are released from the anterior pituitary in response to stimulation from gonadotropin-releasing hormone that is released from the hypothalamus. GHRH stimulates the release of the growth hormone, which targets cell growth. THR stimulates the thyroid stimulating hormone, which targets the thyroid gland. PRH stimulates the release of prolactin, which is necessary for milk production.

A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse? gravida 2, para 1 gravida 4, para 2 gravida 3, para 4 gravida 2, para 4

gravida 4, para 2 Gravida (G) indicates the number of pregnancies. When a nurse calculates the GP of a pregnant client, the current pregnancy counts as one, the twin pregnancy counts as one, and the previous pregnancies count as two for a gravida of 4. Para (P) indicates the number of pregnancies that result in birth at a viable gestational age. The birth of multiples count as one. Thus, this client has a 2-year-old and one set of twins, for a para of 2.

The nurse is providing education on menstruation to an adolescent client who has just experienced menarche. The nurse will inform the client to contact her health care provider for which situation? if cycle length is 30 or more days if noticing fatigue or bloating while menstruating if the duration of flow lasts between 3 and 7 days if saturating a menstrual pad in 1 hour

if saturating a menstrual pad in 1 hour The nurse should inform the client to notify the health care provider if she saturates a perineal pad in 1 hour or less. This is an indication of a complication because the client is experiencing too much blood loss. An average cycle length is about 21 to 36 days; therefore, notification is not needed unless the client's length is over 36 days or under 21 days. The duration of the flow averages 3 to 7 days. Feelings of fatigue and bloating are normal physical symptoms of menstruation, along with breast tenderness, headaches, abdominal cramps, acne, and more.

A nurse caring for a 43-year-old client explains to the client that ovarian functions gradually decrease around this age. What is the implication of decreased ovarian function? susceptibility to fractures increases the risk of heart disease changes in sexual response inability to become pregnant

inability to become pregnant Because of the decrease in ovarian functions, the client loses the ability to become pregnant. Loss of estrogen makes the client susceptible to fractures and also increases the risk of heart disease. Changes in sexual response are usually related to physical changes in the vagina.

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client? options for birth control in the future whether sex was consensual knowledge of child development sexual development of the client

knowledge of child development The nurse should address the client's knowledge of child development during assessment of the pregnant adolescent client. The nurse need not address the sexual development of the client or whether sex was consensual. This would not be an opportune time to discuss birth control methods to be used after the pregnancy.

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

luteinizing hormone 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.

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

luteinizing hormone Explanation: 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.

Women who are obese in pregnancy are at higher risk for developing all of the following except: pregnancy-induced hypertension macrosomia neural tube defects gestational diabetes cesarean birth.

neural tube defects Folic acid deficiency will increase the risk of neural tube defects.

A nurse is reviewing the medical record of a pregnant woman and notes that she is gravida 2. The nurse interprets this to indicate the number of: preterm births. births. spontaneous abortions (miscarriages). pregnancies.

pregnancies Gravida refers to a pregnant woman—gravida 1 (primigravida) during the first pregnancy, gravida 2 (secundigravida) during the second pregnancy, and so on. Para refers to the number of births at 20 weeks or greater that a woman has, regardless of whether the newborn is born alive or dead. "A" would be used to denote the number of abortions and "P" would be used to denote the number of preterm births when using the GTPAL system.

The nurse is preparing to teach a client and her partner about the hormones involved in menstruation. Which hormone will the nurse point out is secreted by the corpus luteum? progesterone androgen luteinizing hormone follicle stimulating hormone

progesterone The corpus luteum secretes estrogen and progesterone. The anterior pituitary secretes the luteinizing hormone and follicle-stimulating hormone. The testes secrete androgen.

In preparing for a preconception class, the nurse plans to include a discussion of potential risk factors. Which risk factor would be most important to include? importance of taking adequate vitamin and mineral supplements the use of OTC drugs with teratogens family history of pregnancy complications the importance of healthy lifestyle

the use of OTC drugs with teratogens Risk factors for adverse pregnancy have been demonstrated by statistics gathered for smoking during pregnancy, consuming alcohol during pregnancy, not taking adequate folic acid supplements during pregnancy, being obese, taking prescription or OTC drugs that are known teratogens, and having a preexisting condition that can negatively affect pregnancy if unmanaged.