Chapter 39, 40
A woman who is at 31 weeks' gestation comes to the clinic in labor. The health care provider decides to use terbutaline therapy before transferring the woman to the hospital. The client is upset and confused and asks the nurse why she can't just have the baby, that it's only 5 weeks early. An appropriate response by the nurse should be:
""The drug provides sufficient time for other medications to be given to improve your baby's outcome."
A client asks the nurse about a word they heard from the health care provider. The word was "andropause". The client asks what that is. Which is the nurse's best response?
"A gradual change, related to age, that occurs in the testes."
A new client telephones the clinic requesting a renewal prescription for contraceptives she has been taking for 4 years. It has been more than a year since her last health care visit, but she is unable to come into the clinic until next month. She insists she is "doing fine" on this medication and must have her prescription now. Considering the circumstances and related safety issues, how should the clinic nurse respond?
"Before the drugs are prescribed, a complete medical history, physical examination, Pap test, urinalysis, and weight and blood pressure measurements are recommended."
A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they state:
A primary function of the female breast is to produce milk.
The nurse is describing changes in the male that occur with aging and parallel the changes that occur in women. The nurse is describing:
Andropause
Which are estrogens produced by the ovaries? (Select all that apply.)
Estradiol Estrone Estriol
When describing the process of fertilization, the nurse would explain that it normally occurs in which structure?
Fallopian tube
Damage to what component of the male reproductive system would result in a lack of testosterone?
Leydig cells
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?
Penile vasodilation
The health care provider has ordered oxytocin to be administered via IV pump and titrated until a client's contractions are every 3 minutes. The nurse caring for the client is aware that oxytocin can cause dangerous effects to the CNS, musculoskeletal, and cardiovascular systems of the client. What is the cause of these adverse effects?
Water intoxication
The increase in thickness of the endometrial layer during the first half of the menstrual cycle is controlled by th
increasing level of estrogen.
When teaching an adolescent about ovulation, the nurse would include that ovulation is initiated by a surge in:
luteinizing hormone.
A client prescribed terazosin asks the nurse how the medication works. Which is the nurse's best statement?
"It works by relaxing the smooth muscle of the prostate and the bladder neck."
What statement by the client prescribed a combination contraceptive several months ago indicates a need for health education?
"It's good to know that the pill protects against some sexually transmitted infections (STIs)."
A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this client?
"Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision
A client diagnosed with erectile dysfunction has been advised to take sildenafil. For up to how many hours does the action of the drug persist?
4 hours
What would a nurse attribute to estrogen?
Breast growth
The client is menopausal but refuses to take estrogen because she fears having a stroke. She is currently on hydrochlorothiazide for hypertension. She asks if taking a natural herb, such as cohosh, would be safe. In addition to referring her to her medical care provider for further information, the nurse's best response would be:
It must be used cautiously as the herb may increase the hypotensive effects of antihypertensive drugs.
On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which response by the nurse is most appropriate?
It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke"
A 22-year-old woman is in the clinic to end an early pregnancy. She takes three tablets of mifepristone (Mifeprex). Two days after she takes the medication, she returns to the clinic to see if she is still pregnant or if the medical abortion is complete. It is determined that she is still pregnant. The nurse will administer which drug?
Misoprostol
A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. The nurse should inform the client of which adverse effects of this medication?
Nausea
Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider?
Pain in one leg
When reviewing the history of a patient, which would the nurse identify as a contraindication for the use of progestins?
Pelvic inflammatory disease
A 31-year-old pregnant woman has been prescribed administration of a tocolytic drug. During which period is a tocolytic drug usually administered?
Pre-term labor
A client is started on terbutaline therapy. What would indicate that the therapy has been successful?
Premature birth is avoided for at least 24 hours.
While monitoring a woman who is receiving IV oxytocin for induction of labor, what event would cause the nurse to contact the health care provider immediately?
The uterine contractions are occurring every 90 seconds.
A 37-year-old woman has just experienced the end of a long-term relationship and has expressed a desire to begin using oral contraceptives. What aspect of this woman's current health status would contraindicate this treatment?
The woman takes an antiplatelet medication for coronary artery disease
Medroxyprogesterone acetate is indicated for the treatment of women with what disorder?
Uterine bleeding
What would a nurse attribute to the effect of testosterone? (Select all that apply.)
Vocal cord thickening Increased hematocrit Facial hair growth
The pubescent girl exhibits many changes as a result of estrogen production. Her mother asks the nurse what secondary sexual characteristics to look for in her daughter. What is the best information for the nurse to provide to the mother about secondary sexual characteristics? (Select all that apply.)
Wider hip structure Pubic and axillary hair Breast development
A 49-year-old female client is asking the nurse about how her changing hormones relate to menopause. The nurse explains that atrophic vaginitis is a common problem during menopause. The treatment for atrophic vaginitis requires replacing:
estrogen.
The increase in thickness of the endometrial layer during the first half of the menstrual cycle is controlled by the:
increasing level of estrogen.
A client is prescribed oxytocin to stimulate the milk ejection reflex. The nurse would expect this drug to be administered by which route?
intranasally
A female client tells the nurse that she has been experiencing a strong and sudden desire to urinate and often cannot make it to the bathroom. The client also tells the nurse that she has to urinate all day and "many times" at night. The nurse suspects:
overactive bladder.
The nurse monitors a patient receiving oxytocin for water intoxication based on the understanding that this condition is the result of:
release of antidiuretic hormone.
A client with an extensive history of using herbal remedies asks the nurse if there is an herbal supplement for the diagnosis of BPH. Which supplement does the nurse provide information on for the treatment of BPH?
saw palmetto
Which of these terms describes changes in the uterus between days 15-28 of an ideal menstrual cycle?
secretory phase
A client alerts the nurse that they have been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?
"Estrogen and progesterone diminish."
A menopausal client prescribed estrogen asks what the implications of taking the medication are. Which response by the nurse best demonstrates an understanding of the associated implications?
"Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots."
Which statements indicate that a client understands the need for a follow-up after the initial injection of medroxyprogesterone?
"I know that this injection lasts for 3 months."
A nurse is caring for a 25-year-old clinic client who is starting on birth control pills. What statement by the client indicates that she needs further teaching?
"I will exercise more if I experience chest or leg pain."
A client demonstrating signs of being pregnant asks why a blood test for a human chorionic gonadotropin level is needed. Which response would the nurse make?
"This hormone is produced by the implantation of a fertilized ovum in the uterus."
A patient who has come to the emergency department after being raped is given a dose of emergency contraception at 12 AM. The nurse would instruct the patient to take another dose of the drug at which time?
12 PM
The contractions of a client who is receiving tocolytic therapy stop at 4 pm. The nurse would expect to continue to administer the drug infusion for at least which time frame?
12 hours
The "morning after" or emergency contraception dosing regimen must be started within _________ hours after unprotected intercourse, and a follow-up dose of the same number of pills must be taken __________ hours after the first dose.
72 12
Which client who is taking progesterone would a nurse monitor most carefully for potential adverse effects?
A 32-year-old woman with epilepsy
Oral contraceptive use would be contraindicated for which client?
A 40-year-old client who smokes 1 to 1½ packs of cigarettes per day
______________ is the term for drugs that are designed to evacuate the uterus by stimulating intense uterine contractions.
Abortifacient
A boy is learning about his body. Where would this boy learn that androgens are released into the bloodstream?
Adrenal gland
The nurse is reviewing the structure and function of various organs in the female reproductive system. Which information should the nurse include about the ovum?
All the ova a female will ever have are present at birth
Which is analogous to female menopause in men?
Andropause
What occurs during andropause?
Atrophy of the seminiferous tubules
After an injection of oxytocin (Pitocin), during ongoing assessment what should the nurse monitor? (Select all that apply.)
Blood pressure Pulse Respiratory rate
Where does raloxifene (Evista) act as an estrogen agonist?
Bone
The nurse is caring for a client who has cancer and who until recently took estrogen. The nurse knows that estrogen may have increased the risk of development of which types of cancer? (Select all that apply.)
Breast cancer Endometrial cancer
A female client asks the nurse about the use of progestins. The nurse shares with the client that clients who take this medication are at an increased risk for what serious adverse effect?
Cardiovascular complications
A group of students are reviewing the various fertility drugs that are available. The students demonstrate understanding when they identify which drug as being administered orally?
Clomiphene
The client informs the nurse that she had unprotected intercourse last night. The client is considering requesting emergency postcoital contraception. The nurse's best response is:
Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure.
The nurse is aware that older men are more prone to urinary tract infections because of what physiologic change related to aging?
Enlargement of the prostate
Estrogen receptor modulators are designed to produce the positive effects of _______________ replacement while limiting the _______________ effects.
Estrogen adverse
During anatomy class, the students learn that what structure in the body is a muscular tube with a ciliated lining that is constantly moving?
Fallopian tube
Dinoprostone can be used to terminate a pregnancy after 20 weeks.
False
Which are normal physiological changes in the urinary system that occur with age? Select all that apply.
Filtration changes and the urine becomes more dilute. Urethra shortens and the lining becomes thinner, resulting in increasing susceptibility to infection.
Gonadotropin-releasing hormone (GnRH) stimulates the anterior pituitary to release which hormones? (Select all that apply.)
Follicle-stimulating hormone (FSH) Luteinizing hormone (LH)
Which hormones are not released during childhood
Gonadotropin-releasing hormone (GnRH)
A patient is receiving a progestin as a vaginal gel formulation. The nurse would instruct the patient about what possible adverse effect? (Select all that ap
Headache Constipation Perineal pain
What happens with the hormones associated with pregnancy once the fetus and the placenta have been expelled from the uterus?
Hormone levels decrease significantly.
Fertilization of the ovum and implantation in the uterine wall result in the production of what hormone?
Human chorionic gonadotropin
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?
Inability to become pregnant
In describing the effects of progesterone, which would be appropriate to include?
Increased body temperature
A nurse is caring for a pregnant patient receiving oxytocin. Via which route should oxytocin be administered during the third stage of labor?
Intramuscular
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:
May 24.
A group of students are reviewing information about the menstrual cycle. The students demonstrate understanding when they identify what as the onset of the menstrual cycle?
Menarche
When the nurse is interviewing an adolescent, the patient states that she experienced her first menstrual cycle at age 11. The nurse documents this as:
Menarche
A 38-year-old female client has just visited the health care provider and has received a prescription for birth control pills. The client calls the nurse and states that she doesn't need birth control pills because she had voluntary sterilization after her third child. The nurse explains that birth control pills may be used for what other reason?
Menstrual disorders
The nurse is preparing a teaching plan for a group of high school girls about the female reproductive system. Which would the nurse incorporate into the teaching?
One-half of the genetic material is contained in a single ovum.
Insufficient levels of oxytocin would affect what event related to pregnancy?
Onset of labor contractions
A postmenopausal woman is receiving raloxifene as part of a treatment plan for osteoporosis. The nurse would instruct the patient that this drug is administered by which route?
Oral
A postmenopausal woman is administered estradiol for the purpose of preventing which condition?
Osteoporosis
Drugs that are used to stimulate contraction of the uterus are called ______________.
Oxytocic
Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider
Pain in one leg
During pregnancy, what becomes a massive endocrine gland?
Placenta
When stimulation levels off during the human sexual response, the person is said to be in which of the following phases?
Plateau
Progestin medications can cause a variety of adverse effects. When assessing for adverse medication effects of drospirenone, what would the nurse assess?
Potassium
After describing the events of the menstrual cycle to a group of students, the instructor determines that the students have understood the information when they identify what as the initial event that occurs following fertilization and implantation?
Production of human chorionic gonadotropin
After teaching a group of students about female reproductive hormones, the instructor determines that the teaching was successful when the students identify which hormone as being primarily responsible for maintaining pregnancy?
Progesterone
Which hormone is involved if a couple engages in the rhythm method of birth control?
Progesterone
The nurse knows that for a client who still has her ovaries intact, estrogen must be paired with what other drug when used to treat menopausal symptoms?
Progestins
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?
Receives the fertilized ovum and provides housing and nourishment for a fetus
The nurse is aware that progestins will be prescribed with extreme caution in a client with which condition? (Select all that apply.)
Renal disease Epilepsy Asthma
During fetal development, the descent of the testes into what structure helps prevent injury to the sperm-producing cells?
Scrotum
After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies what as a primary function of the ovaries?
Secretion of estrogen and progesterone
What would castration prior to puberty result in? (Select all that apply.)
Sterility Failure to develop normal male characteristics
The anatomy and physiology instructor is discussing the action of endogenous estrogen on the body. What effect would the instructor tell the students estrogen has on breast tissue in the body?
Stimulates construction of milk ducts
When caring for a postpartum patient who is receiving oxytocin intranasally, the nurse understands what is the action of oxytocin?
Stimulates the milk ejection reflex
The nurse is discussing the human response to sexual stimulation with a client experiencing an arousal problem. In which phase of sexual response should the client begin to feel the effects of the sympathetic nervous system?
Stimulation
What factor might influence the release of the hormones necessary for the human reproductive cycle?
Stress
The human sexual response involves the activation of which system?
Sympathetic nervous system
Castration involves the removal of what structure of the male reproductive system?
Testes
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 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?
Testes
What is the most plausible rationale for a female client being prescribed danazol?
The client has endometriosis.
The nurse reviews the physiologic changes that occur during puberty with the parent of a 10-year-old female client. Which statement indicates to the nurse that the parent understands the teaching?
The hypothalamus releases a hormone that starts sexual development."
When caring for a patient receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis related to impaired tissue perfusion. Which condition is the nurse referring to in the diagnosis?
Thromboembolism
The nurse anticipates the health care provider will order methylergonovine for which purpose?
To contract the uterus after delivery of the placenta
The nurse anticipates that the health care provider will order carboprost to treat which condition related to labor and delivery?
Uterine atony
The nurse is on the phone with a woman who is taking an antispasmodic for overactive bladder syndrome. The woman states that her mouth is very dry, but she is afraid to drink because she does not want the urge to urinate to increase. What is the nurse's best response to this client?
You shouldn't restrict your fluid intake because it will only make your bladder problems worse."
After puberty, secondary male sexual characteristics can be maintained by:
androgens.
If pregnancy does not occur during the menstrual cycle, the corpus luteum involutes and becomes the:
corpus albicans.
A group of nursing students are reviewing information about hormonal therapy for cancer. The students demonstrate understanding of the information when they identify which medication as a gonadotropin-releasing hormone analog? Select all that apply.
degarelix leuprolide
A monophasic oral contraceptives composition is described as having which characteristic?
fixed amounts of both estrogen and progestin components
The nurse suspects that a female client is experiencing a decline in estrogen. Which assessment finding caused the nurse to make this clinical determination?
hot flashes
A client is prescribed methylergonovine. The nurse reviews the client's medical record for possible contraindications to the use of this drug. Which, if found, would the nurse identify as being a contraindication to the prescribed drug
hypertension
A client is prescribed methylergonovine. The nurse reviews the client's medical record for possible contraindications to the use of this drug. Which, if found, would the nurse identify as being a contraindication to the prescribed drug?
hypertension
Regular monthly menstrual cycles cease at the time of:
menopause.
If a released egg is not fertilized, the lining of the uterus breaks down in the process called:
menstruation.
Oral contraceptives are available as _______________, _______________, and ____________ preparations.
monophasic, biphasic, triphasic
A nurse is reading a journal article about female hormones. Which would the nurse identify as a progestin?
norethindrone
A nurse is obtaining a history from an older adult woman. During the interview, the woman states, "When I feel like I have to urinate, the urge is really strong and I go to the bathroom really frequently, often waking up several times during the night to go." The nurse would likely identify this as which condition?
overactive bladder syndrome
A nurse is explaining the drug oxytocin to a client. When describing this drug, the nurse notes that oxytocin is an endogenous hormone produced by which?
posterior pituitary gland
Pitocin is given to prevent what condition?
postpartum bleeding
A patient reports menstrual cramps. The nurse understands that this is due to:
prostaglandins.
The nurse would be alert for signs and symptoms of which if methylergonovine is prescribed for a client who is a heavy smoker?
vasoconstriction
Which is an adverse effect caused by all uterine stimulants because of their antidiuretic effect?
water intoxication