CH 4 OB
19) The nurse is reviewing the male reproductive system with a group of high school students. Using the diagram select the structure that the nurse should identify as a storage area for spermatozoa.
Answer: Explanation: The epididymis provides a reservoir for maturing spermatozoa. Page Ref: 74
20) The nurse is preparing materials to counsel a couple after a consultation visit at an infertility clinic. On the diagram, select the area on the sperm that the nurse should identify as fertilizing the ovum.
Answer: Explanation: The head's main components are the acrosome and nucleus. The head carries the male's haploid number of chromosomes (23), and it is the part that enters the ovum at fertilization. Page Ref: 75
16) A pregnant client is scheduled for a lower-segment cesarean birth. Place an X on the area of the uterine structure where the nurse should instruct that this incision for the procedure will be placed.
Answer: Explanation: The isthmus is that portion of the uterus between the internal cervical os and the endometrial cavity. The isthmus is about 6 mm above the uterine opening of the cervix and takes on importance in pregnancy because it becomes the lower uterine segment. At birth, this thin lower segment, situated behind the bladder, is the site for lower-segment cesarean births.
18) The nurse is reviewing the anatomy and physiology of the reproductive organs during a prenatal class. On the diagram, select the area that the nurse should identify as being the round ligament.
Answer: Explanation: The round ligaments arise from the sides of the uterus near the fallopian tube insertions. They extend outward between the folds of the broad ligament, passing through the inguinal ring and canals and eventually fusing with the connective tissue of the labia majora. The round ligaments are made up of longitudinal muscle and undergo hypertrophy and increase in both length and diameter during pregnancy. Page Ref: 63
17) After delivery, the nurse notes that a client is having considerable vaginal bleeding. On the diagram provided, identify the area of the myometrium that is responsible for stopping bleeding after birth.
Answer: Explanation: The thick middle layer of the myometrium is made up of interlacing muscle fibers in figure-eight patterns that surround large blood vessels. Their contraction produces a tourniquet-like action on blood vessels to stop bleeding after birth.
15) A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0°F) for the past 36 hours. What should these findings indicate to the nurse? 1. Ovulation has occurred. 2. Ovulation will occur soon. 3. Menstruation is about to begin. 4. She is pregnant and will not menstruate.
Answer: 1 Explanation: 1. Signs that ovulation has occurred include: pain associated with rupture of the ovum (mittelschmerz), increased vaginal discharge, and a temperature increase of 0.6°C (1.0°F) over the past 36 hours. 2. A temperature increase does not occur before ovulation has occurred. 3. A temperature increase does not occur when menstruation is about to begin. 4. Pregnancy can be detected only through testing the urine or serum for the presence of human chorionic gonadotropin hormone.
4) A pregnant client asks, "What's the difference between the true pelvis and the false pelvis?" How should the nurse respond? 1. "The false pelvis helps support the weight of the pregnant uterus." 2. "The false pelvis consists of the inlet, the pelvic cavity, and the outlet." 3. "The true pelvis does not affect fetal passage during labor and childbirth." 4. "The true pelvis helps direct the presenting fetal part into the false pelvis."
Answer: 1 Explanation: 1. The false pelvis helps support the weight of the pregnant uterus. 2. The true pelvis consists of the inlet, the pelvic cavity, and the outlet. 3. The size and shape of the true pelvis must be adequate for normal fetal passage during labor and childbirth. 4. The false pelvis helps direct the presenting fetal part into the true pelvis.
10) The nurse is explaining the menstrual cycle to a group of women. In which phase should the nurse instruct that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and the blood supply to the endometrium is reduced? 1. Ischemic phase 2. Secretory phase 3. Menstrual phase 4. Proliferative phase
Answer: 1 Explanation: 1. The ischemic phase is characterized by ischemia of the endometrium. 2. The secretory phase involves glycogen secretion by the endometrium after ovulation. 3. The menstrual phase is the menses. 4. The proliferative phase is characterized by proliferation of the endometrium.
12) The nurse is preparing a handout on the ovarian cycle for a group of middle school girls. Which information should the nurse include? 1. There are two phases of the ovarian cycle: luteal and follicular. 2. The hormone human chorionic gonadotropin (hCG) stimulates ovulation. 3. The ovum travels from the ovary to the tube during the luteal phase. 4. Irregular menstrual cycles have varying lengths of the follicular phase.
Answer: 1 Explanation: 1. The two phases of the ovarian cycle are follicular (days 1 to 14 of the menstrual cycle) and luteal (days 15 to 28 of the menstrual cycle). 2. hCG is secreted by a fertilized ovum and does not stimulate ovulation. 3. The ovum is released from the graafian follicle of the ovary and travels to the fallopian tube during the follicular phase of the ovarian cycle. 4. Menstrual cycles that are irregular in length have a consistent follicular phase but a varying luteal phase.
8) The nurse is presenting a community education session on female hormones. Which participant statement indicates the need for further information? 1. "Estrogen is what causes females to look female." 2. "Prostaglandin is responsible for achieving conception." 3. "Progesterone is present at the end of the menstrual cycle." 4. "The presence of some hormones causes others to be secreted."
Answer: 2 Explanation: 1. Estrogen causes secondary sex characteristics, such as enlarged breasts and widened hips. 2. Prostaglandin is not related to conception. Prostaglandin is called the hormone of pregnancy because it maintains pregnancy. 3. Progesterone is present in large quantities during the secretory phase of the menstrual cycle. 4. An example is that the production of gonadotropin-releasing hormone (GnRH) causes the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
9) A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. Which hormone is most likely causing this client's issues with pregnancy? 1. Estrogen 2. Progesterone 3. LH (luteinizing hormone) 4. FSH (follicle-stimulating hormone)
Answer: 2 Explanation: 1. Estrogen primarily assists in maturation of the ovarian follicles and causes endometrial mucosa to proliferate. 2. Progesterone is the likely cause because it decreases uterine motility and contractibility caused by estrogens, thereby preparing the uterus for implantation. 3. LH is a hormone secreted by the pituitary gland. 4. FSH is a hormone secreted by the pituitary gland. Page Ref: 70
13) The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation? 1. "One hormone controls the phases of the menstrual cycle." 2. "The secretory phase occurs when a woman is most fertile." 3. "Menstrual cycle phases vary in order from one woman to another." 4. "The menstrual cycle has five distinct phases that occur during the month."
Answer: 2 Explanation: 1. Four hormones control ovulation and therefore the menstrual cycle: progesterone, estrogen, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). 2. During the secretory phase, the endometrium is thickest, and glycogen is produced to nourish a fertilized ovum. 3. Although the length of the menstrual cycle might vary, the phases of the menstrual cycle always occur in the same order. 4. There are four phases of the menstrual cycle: menstrual, proliferative, secretory, and ischemic phases.
1) A nurse is teaching a classroom of teenage girls about the female reproductive system. After teaching, the nurse asks the students to describe the release of an ovum during ovulation. Which response indicates that teaching has been effective? 1. "Ovulation is when the uterus releases an unfertilized egg or ovum." 2. "During ovulation, an egg is released from the ovary and enters the fallopian tube." 3. "The endometrium is where the eggs are formed and released into the fallopian tube." 4. "Around the middle of the menstrual cycle, one of the fallopian tubes releases an egg."
Answer: 2 Explanation: 1. The egg is formed in the ovary and travels by way of the fallopian tube to the uterus. 2. The egg is formed in the ovary and once released, it enters the fallopian tube. 3. The uterine endometrium is the site of implantation of a fertilized egg. 4. The egg is formed in the ovary and then released near the fimbria of the fallopian tube.
7) The school nurse is teaching a health class to middle school children. Which structure should the nurse explain as secreting follicle-stimulating hormone (FSH) and luteinizing hormone (LH)? 1. Hypothalamus 2. Anterior pituitary 3. Posterior pituitary 4. Ovaries and testes
Answer: 2 Explanation: 1. The hypothalamus secretes gonadotropin-releasing hormone to the pituitary gland in response to signals from the central nervous system. 2. The anterior pituitary secretes FSH and LH, which are primarily responsible for maturation of the ovarian follicle. 3. The posterior pituitary gland secretes oxytocin and antidiuretic hormone. 4. The ovaries secrete the female hormones estrogen and progesterone, and the testes secrete testosterone.
5) A pregnant adolescent asks about fundal height. What should the nurse say that incorporates the location of the uterine fundus? 1. It is the lower third area of the uterus. 2. It is at the uppermost (dome-shaped top) portion of the uterus. 3. It is the elongated portion of the uterus where the fallopian tubes enter. 4. It is the portion of the uterus that lies between the internal cervical os and the endometrial cavity
Answer: 2 Explanation: 1. The lower third of the uterus is called the cervix or neck. 2. The rounded, uppermost (dome-shaped top) portion of the uterus that extends above the points of attachment of the fallopian tubes is called the fundus. 3. The elongated portion where the fallopian tubes enter the uterus is called the cornua. 4. The portion of the uterus between the internal cervical os and the endometrial cavity is called the isthmus.
3) A prenatal client states, "The doctor said he might have to cut my cervix so the baby can get out during delivery." Based upon this statement, what structure should the nurse define when teaching about an episiotomy? 1. Mons pubis 2. Labia majora 3. Perineal body 4. Vaginal vestibule
Answer: 3 Explanation: 1. The mons pubis is a softly rounded mound of subcutaneous fatty tissue that covers the front portion of the symphysis pubis. 2. The labia majora are longitudinal, raised folds of pigmented skin located on either side of the vulvar cleft. 3. The perineal body, which is located between the lower part of the vagina and the anus, is often the site of an episiotomy or lacerations during childbirth. 4. The vaginal vestibule contains the vaginal opening, which is the border between the external and internal genitals.
2) A client desiring to become pregnant is concerned because the opening of her spouse's penis is below the tip. How should the nurse respond to this client? 1. "This is epispadias and it will cause infertility." 2. "This is hypospadias and it will cause infertility." 3. "This is epispadias and is not likely to impact fertility." 4. "This is hypospadias and is not likely to impact fertility."
Answer: 4 Explanation: 1. Epispadias is the condition where the urethral opening is on the upper aspect of the penis. The client is describing hypospadias, when the urethral opening is on the lower side of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility. 2. The client is describing hypospadias, where the urethral opening is on the lower side of the penis. Mild hypospadias, where the urethral opening is on the glans of the penis, does not impact fertility. 3. Epispadias is the condition where the urethral opening is on the upper aspect of the penis. The client is describing hypospadias, when the urethral opening is on the lower side of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility. 4. The client is describing hypospadias, which is the urethral opening on the lower aspect of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility.
6) The nurse is teaching a client who recently learned that she is pregnant. Which hormone should the nurse instruct as being secreted by the fertilized egg? 1. Estrogen 2. Progesterone 3. Luteinizing hormone 4. Human chorionic gonadotropin (hCG)
Answer: 4 Explanation: 1. Estrogen is an ovarian hormone. 2. Progesterone is an ovarian hormone. 3. Luteinizing hormone is excreted by the anterior pituitary. 4. When the ovum is fertilized and implants in the endometrium, the fertilized egg begins to secrete hCG hormone to maintain the corpus luteum.
11) Which statement best indicates that the client understands the differences in the follicular and luteal phases of the ovarian cycle? 1. "My period will be every 28 days." 2. "The follicular phase is when the egg is fertilized." 3. "The follicular phase is the second half of my cycle." 4. "The first part of my period might vary in length, but not the second."
Answer: 4 Explanation: 1. The follicular phase can vary, resulting in cycle length other than 28 days. 2. The follicular phase comprises days 1 to 14 of the menstrual cycle, not when the egg is fertilized. 3. The luteal phase is the second half of the cycle. 4. For a female with a 28-day cycle, the follicular phase comprises days 1 to 14 of the menstrual cycle, and the luteal phase comprises days 15 to 28. The luteal phase does not vary.
14) In preparation for teaching a women's community center class about physiologic changes during menopause, the nurse is preparing a handout for students. Which information should the nurse include in this teaching? 1. Due to changes in estrogen levels, the labia minora increase in size after menopause. 2. The ovaries remain small after puberty, but they increase in size following menopause. 3. After menopause, the endometrium continues to undergo monthly degeneration and renewal. 4. Ovarian secretion of estrogen decreases between the ages of 45 and 55, after which point ovulatory activity ceases.
Answer: 4 Explanation: 1. The labia minora decrease in size after menopause because of changes in estrogen levels. 2. The ovaries of girls are small, but they become larger after puberty and then decrease in size following menopause. 3. From menarche to menopause, the endometrium undergoes monthly degeneration and renewal in the absence of pregnancy. 4. Between the ages of 45 and 55, a woman's ovaries secrete decreasing amounts of estrogen. Eventually, ovulatory activity ceases and menopause occurs.