Patho Exam ? Ch 44

Avoid sex when cervical mucus is most stretchy

1. A woman of child-bearing age asks the nurse about a natural method to avoid pregnancy. What is an appropriate response? Stand up immediately after intercourse. Take a shower immediately after sex. Use a diluted vinegar douche after intercourse. Avoid sex when cervical mucus is most stretchy.

FSH and LH

9. The endocrine system is highly involved in the female reproductive system. Which hormones are used to stimulate the primordial follicles? FSH and ACTH Estrogen and progesterone FSH and LH Progesterone and testosterone

Normal changes of pregnancy due to increased levels of estrogen and progesterone

10. A newly pregnant woman reports to the nurse that her breasts are excessively tender and that her areolae and nipples are becoming darker and more prominent. The nurse should describe which cause of these changes? Possible pathology due to increased levels of progesterone The effects of increased levels of hCG and follicle-stimulating hormone Normal changes of pregnancy due to increased levels of estrogen and progesterone Hormonal changes that will disappear by the end of the second trimester

b) Alteration of critical body fat-to-muscle ratio needed for menses to occur Pg. 1120 Amenorrhea Female clients with amenorrhea related to anorexia nervosa have decreased adipose tissue, which is required for hormone production. Estrogen and GnRH production is decreased. Sexual activity is not related to amenorrhea.

11. A female client with anorexia nervosa tells the nurse that she has been experiencing amenorrhea. The nurse is aware that this is a result of: a) Increased gonadotropin-releasing hormone (GnRH) production b) Alteration of critical body fat-to-muscle ratio needed for menses to occur c) Increased estrogen production that occurs in the body d) A secondary decrease in sexual activity

d) Cessation of ovarian function and decreased estrogen levels Pg. 1123 Menopause The physiology of menopause involves a gradual cessation of ovarian function and resultant diminished levels of estrogen. The process is not rooted in pituitary or hypothalamic function, and it does not occur because of resistance by ovarian target cells.

12. Which physiologic changes result in menopause? a) Gradual resistance of ovarian target cells to luteinizing hormone (LH) and follicle-stimulating hormone (FSH) stimulation b) Changes in anterior pituitary function that alter ovarian hormone production c) Decreased levels of gonadotropin-releasing hormone (GnRH) d) Cessation of ovarian function and decreased estrogen levels

a) Smoked 1 pack/day for 20 years b) Used hormone therapy for 5 years e) Has hypertension for 15 years Pg. 1123 Hormone Therapy Hormone therapy (HT) has been implicated in coronary heart disease, venous thromboembolism, breast cancer, and cerebral vascular accident (CVA). Hypertension and smoking are also common factors that contribute to coronary heart disease.

13. The nurse is reviewing the history of an older adult female client who was recently diagnosed with coronary heart disease. What factors are known to contribute to this condition? Select all that apply. a) Smoked 1 pack/day for 20 years b) Used hormone therapy for 5 years c) Has two grown children d) No use of alcoholic beverages e) Has hypertension for 15 years

a) Ovaries are responsible for ovulation and hormone production Pg. 1121 Ovarian Follicle Development and Ovulation Ovaries are responsible for ovulation and hormone production.

14. The nurse providing teaching about the female reproductive system includes which principle? a) Ovaries are responsible for ovulation and hormone production b) Continued production of ova takes place monthly in the ovaries c) Ovaries regenerate to form new ovaries each month d) Ovaries physically disintegrate after the childbearing years

c) Anterior pituitary gland Pg. 1120 Hypothalamic and Pituitary Hormones The anterior pituitary gland is responsible for the secretion of LH, FSH, and prolactin. The hypothalamus is stimulated by GnRH to secrete only LH and FSH. The endometrium undergoes proliferative changes and sloughing during the menstrual cycle.

15. Select the structure primarily responsible for the secretions of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin. a) Ovaries b) Endometrium c) Anterior pituitary gland d) Hypothalamus

a) Form a mucous plug during pregnancy b) Alter receptivity to sperm e) Protect the uterus from infection Pg. 1118 Ovaries The opening of the cervix, the os, forms a pathway between the uterus and the vagina. The vaginal opening is called the cervical os. Secretions from the columnar epithelium of the endocervix protect the uterus from infection, alter receptivity to sperm, and form a mucoid "plug" during pregnancy. The endocervical canal provides a route for menstrual discharge and sperm entrance.

16. Which benefits are found from the secretions of the columnar epithelium of the endocervix? Select all that apply. a) Form a mucous plug during pregnancy b) Alter receptivity to sperm c) Prevent the travel of sperm to the uterus d) Help pick up the ovum after its release into the peritoneal cavity following ovulation e) Protect the uterus from infection

a) In the middle to outer portion of the fallopian tube Pg. 1118 Fallopian Tubes Fertilization normally occurs in the middle to outer portion of the fallopian tube.

17. The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs: a) In the middle to outer portion of the fallopian tube b) In the peritoneal cavity c) On the inside wall of the uterus d) On the outside wall of the ovary

c) Bacteriostatic Pg. 1117 Vagina The vagina is lined with mucus-secreting stratified squamous epithelial cells. Vaginal tissue is usually moist, with a pH maintained within the bacteriostatic range of 4.0 to 4.5.

18. The environment of the vagina is moist with a pH 4.0 to 4.5. The major purpose of the acidic environment is: a) Maintains the lining of the vagina b) Helps in times of menses c) Bacteriostatic d) Helps with reproduction

c) Bartholin glands Pg. 1114 External Genitalia The area between labia minora is called the vestibule. Located in the vestibule are the urethral and vaginal openings and Bartholin lubricating glands.

19. The female external genitalia are made up of several components. What is in the vestibule of the female external genitalia? a) Bulbourethral glands b) Skene glands c) Bartholin glands d) Cowper glands

Short term HT can be used to reduce symptoms

2. A female client experiencing hot flashes during perimenopause asks the nurse about hormone therapy (HT). What is the appropriate response by the nurse? SSRIs are a more effective treatment than HT. Short term HT can be used to reduce symptoms. HT can't be used until menses ceases. High-dose HT will be needed.

c) "This medication will promote the continuation of your menstrual periods" Pg. 1123 Hormone Therapy Current recommendations for hormone therapy (HT), in light of the findings of the Women's Health Initiative and other clinical trials, include avoiding HT for primary or secondary prevention of coronary heart disease and using HT only in those women who require relief from menopausal symptoms that affect quality of life. HT is not intended to promote continuation of menstrual periods or increase bone resorption.

20. The nurse is teaching a female client who has been prescribed hormone therapy. The client asks, "What does this medication do?" Which statement is an appropriate response by the nurse? a) "This medication will prevent coronary heart disease" b) "This medication will help relieve hot flashes and other adverse symptoms of menopause" c) "This medication will promote the continuation of your menstrual periods" d) "This medication will increase bone resorption"

d) Fimbriae Pg. 1117 Fallopian Tubes The end of the fallopian tube nearest the ovary forms a funnel-like opening with fringed, finger-like projections called fimbriae, which pick up the ovum after its release into the peritoneal cavity after ovulation.

21. The fallopian tubes are narrow tubes that attach bilaterally to the uterus. Within the fallopian tube, fertilization of the ovum takes place. The end of the fallopian tube nearest the ovary is funnel-like. What are the fringed, finger-like projections around the funnel-shaped opening of the fallopian tube called? a) Oviducts b) Fallopian fingers c) Cilia d) Fimbriae

Progesterone

3. Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation? Progesterone Testosterone Androgen Prolactin

"Perimenopause can precede menopause by approximately 4 years"

4: A female client informs the nurse that she is having hot flashes on occasion, has trouble sleeping, and thinks that she is having some symptoms of menopause. The client asks the nurse how long these symptoms will last prior to experiencing menopause. What is the best response? "Perimenopause can precede menopause by approximately 4 years." "I have had those symptoms myself, it's nothing to worry about." "Those could be symptoms of anything and are not specific to menopause." "Tell the physician, it could be serious."

Advise the woman that this is a normal occurrence after stopping breast-feeding

5. What should the nurse do when a woman who stopped breast-feeding her infant 3 months ago complains of occasional milk leakage from her breasts? Communicate to the physician the woman's symptom of breast cancer Advise the woman that this is a normal occurrence after stopping breast-feeding Encourage the woman to stimulate her nipples with gentle massage Encourage the woman to resume breast-feeding

Anterior pituitary

6. The nurse is explaining ovulation to a female client. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are important hormones needed to ovulate and are secreted by which gland? Thyroid Anterior pituitary Adrenal Posterior pituitary

Normal

7. The nurse is checking the pH of a client's vaginal tissue and finds the pH to be 4.3. The nurse interprets this finding as: too acidic. normal. neutral. too basic.

Soy

8. The nurse is caring for a 52-year-old female client who is experiencing hot flashes and night sweats. The nurse anticipates which nonpharmaceutical substance may be prescribed to alleviate these symptoms? Estriol Progesterone Estrone Grapefruit juice Estradiol Green tea Chocolate Soy