Chapter 5: The Nursing Role in Reproductive and Sexual Health

The nurse is teaching an adolescent client about fertility and the various phases of the menstrual cycle. The client has a 28-day menstrual cycle. Which statement is a priority for the nurse to include in the teaching?

"Day 14 of your menstrual cycle is normally when you will ovulate." Explanation: It is a priority for the nurse to teach the client when ovulation will occur to assist in pregnancy prevention at this age. While the other statements are all true, not knowing the specific information for those days does not hold the same consideration or life-altering potential as when pregnancy can occur. The menstrual cycle is based on an average of 28 days and divided into four phases based on the hormones secreted and their actions. Days 1 through 5 are the menstruation phase. Days 6 through 14 are the proliferative phase, ending with ovulation on the 14th day. Days 15 through 26 are the secretory phase. Days 27 and 28 are the ischemic phase when hormonal secretions decline.

A nurse is conducting a sexual health education class about the structures and events of semen production. Which component will the students identify as responsible for semen production if the teaching has been successful?

accessory gland alkaline fluids sperm Explanation: The alkaline fluids from the accessory glands and sperm combine to form a thick, whitish secretion termed semen or seminal fluid. The testes and seminiferous tubules within the testes are where sperm are produced. The vas deferens is the muscular tube in which sperm begin their journey out of the man's body. It connects the epididymis with the ejaculatory duct.

A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity?

administering HPV vaccine Explanation: Primary prevention is aimed at preventing the disease or condition before it occurs, so giving the HPV vaccine would be a primary prevention activity. If the woman does not receive primary prevention with the vaccine, then secondary prevention would focus on education about the importance of receiving regular Papanicolaou tests and, for women over age 30, including an HPV test to determine whether the woman has a latent high-risk virus that could lead to precancerous cervical changes.

A nurse is caring for an adolescent girl experiencing menstruation for the first time. What are the changes that occur in the body at this stage that the nurse should share with the adolescent girl?

breast development Explanation: Breast development is a change that occurs in the body of an adolescent girl. Many changes take place in the body, such as the appearance of feminine contours, development of breast tissue, appearance of unique fatty deposits, and hair in the pubic and axillary areas. Menopausal clients often experience irritability and insomnia, hot flashes, and urinary incontinence.

A school nurse who is teaching a health course at the local high school is presenting information on human development and sexuality. When talking about the role of hormones in sexual development, which hormone does the nurse teach the class is the most important for developing and maintaining the female reproductive organs?

estrogen Explanation: Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.

The nurse is developing a plan of care for a client who is receiving aggressive drug therapy for treatment of HIV. The goal of this therapy is to:

improve survival rates. Explanation: Aggressive anti-retroviral therapy aims to reduce HIV morbidity and mortality, thereby improving survival rates. Drug therapy also aims to decrease the HIV viral load, restore the body's ability to fight off infection, and improve the quality of life. Drug therapy does not promote the progression of the disease. It is started at the time of the first infection, not in late-stage AIDS. Treatment advances have been based on research, but drug therapy is not prescribed to conduct additional research.

An anatomy professor is teaching a class of pre-nursing students about the female reproductive system. One student asks, "Where is the opening to the vagina?" The best answer the professor can give is:

in what is called the vestibule, which is located between the labia minora. Explanation: The vestibule is the area between the labia minora. The urethral meatus (opening to the urethra), paraurethral (Skene) glands, vaginal opening or introitus, and Bartholin glands are located within the vestibule.

The nursing student is preparing to complete the physical inspection of a female client's external reproductive organs. The mentor determines the student has successfully assessed this client based on documentation of which structures? Select all that apply.

perineum labia majora clitoris Explanation: The external female reproductive organs include the mons pubis, labia majora, labia minora, clitoris, vestibule, and perineum. The vagina, uterus, and fallopian tubes are internal female reproductive organs.

The nurse is answering questions from a newborn's parents concerning a circumcision. Which structure will the nurse point out is removed during the procedure?

prepuce Explanation: The foreskin or prepuce is a fold of skin which covers the glans of the penis. This fold of skin is removed in a circumcision. The tunica albuginea is connective tissue found inside the penile shaft. The corpus spongiosum is erectile tissue that runs the full length of the penis. Rugae are folds that allow for stretching during an erection

A nurse is teaching a sex education class and is discussing sexual response. She describes a 30-minute period during which external and internal genital organs return to an unaroused state. What is this phase of sexual response known as?

resolution Explanation: Resolution, the fourth and final phase of sexual response, is a 30-minute refractory period during which the external and internal genital organs return to an unaroused state. Excitement, the first phase, occurs with physical and psychological stimulation (sight, sound, emotion, or thought) that causes parasympathetic nerve stimulation. The plateau stage, which is the second phase, is reached just before orgasm. Orgasm, the third phase, occurs when stimulation proceeds through the plateau stage to a point at which a vigorous contraction of muscles in the pelvic area expels or dissipates blood and fluid from the area of congestion.

An adult client currently has low levels of estrogen and progesterone. At this point in the menstrual cycle, the client will likely:

shed her uterine lining. Explanation: Low levels of estrogen and progesterone cause the shedding of the uterine lining (endometrium). Ovulation and subsequent pregnancy result from increased hormone levels. Regeneration follows ovulation during the secretory phase.

The nurse is caring for a female client with subfertility secondary to possible anovulation. The client wants to know what they can do while waiting for an appointment with the health care provider. Which nursing suggestion might the client try while awaiting the appointment?

taking basal body temperature (BBT) each morning before getting out of bed Explanation: The nurse will suggest obtaining the basal body temperature (BBT). This action is the least costly way to determine one's ovulation pattern, if present, as it only requires taking the temperature before getting out of bed in the morning. BBT provides one piece of information for use diagnostically. Typically, the client records the results over a 4-month (4-cycle) time frame to be able to identify when there is a slight decrease in temperature (0.5°F; 0.275°C). Because the client asks about trying something before the appointment to determine if ovulation is occurring, this action may provide some information and begin the documentation if BBT is encouraged by the health care provider. Increasing sex or using menstrual dates will not be helpful if anovulation is the problem. The client may still have a menstrual period with anovulation. Pelvic inflammation most likely will not cause anovulation.

A school nurse is talking to an adolescent who asks about why she has monthly menstrual cycles. The best explanation that the nurse can offer regarding the menstrual phase is to tell her that:

the uterine lining is being shed due to lowering of hormone levels. Explanation: During the menstrual phase of the cycle, the endometrium, or lining of the uterus, is shed because of low estrogen and progesterone levels. The uterus does not fill up with blood monthly, nor do her hormones cause blood accumulation on the uterus. Also, the uterine lining thickens (rather than thins out) each month in preparation of implantation of the fertilized egg

The nurse is assessing a 68-year-old female client. The client presents with mild lower abdominal pain, greenish-yellow vaginal discharge, and pain during urination. Which question is appropriate for the nurse to ask the client next?

"Are you currently sexually active?" Explanation: Nurses should abandon biases that older adults are sexually inactive. Therefore, based on the client's symptoms, the nurse would determine if the client is sexually active. The client has symptoms of gonorrhea. If the client is sexually active, the client should be tested. Vaginal discharge is not a symptom of gallstones or a urinary tract infection. Asking the client if she has checked her temperature today is closed-ended and provides no information for the nurse. Instead of asking about temperature, the nurse would assess the client's temperature.

A client diagnosed with human papillomavirus (HPV) asks the nurse if she will be at risk for developing cervical cancer. The nurse best responds by making which statement?

"Certain strains of the human papillomavirus (HPV) have been associated with causing cervical cancer." Explanation: The human papillomavirus (HPV) is associated with causing both genital warts and cervical cancer. There is not enough information to definitively indicate that this client will or will not contract cancer. The herpes simplex virus is associated with shingles and genital herpes, not cervical cancer. The HPV vaccine prevents certain strains of HPV, but does not decrease the risk for cervical cancer if the person has already been exposed to the virus.

The nurse is caring for a female client who is a victim of intimate partner violence (IPV). The client has experienced traumatic injury to the clitoris. Which statement will the nurse include when providing discharge education to this client?

"Damage to your clitoris may lead to decreased stimulation in future sexual experiences." Explanation: At the superior junction of the labia, there is a fleshy protrusion of tissue called the clitoris. The clitoris is an erectile tissue that enlarges and becomes sensitive when stimulated by the penis or touching that accompanies sexual foreplay. Depending on the severity of the damage, the clitoris may have decreased ability to function with future sexual experiences. The clitoris does not affect bladder function or provide cushioning during intercourse. The mons pubis is responsible for providing a cushion. Vaginal discharge should not increase. There may be a decrease in vaginal secretions related to sexual arousal if permanent damage to the clitoris occurs due to decreased sexual stimulation.

A parent is worried about her 14-year-old child's recent interest, and possible participation, in sexual activities. Which response by the nurse is appropriate?

"I can help you and your child develop strategies that will be in the child's best interests." Explanation: The nurse should help the client's child identify information necessary to make an informed decision about sexual activity. Advising or forcing the child to delay sexual gratification is not a realistic course of action and may lead to rebellion. The best approach includes the child and not just the parent. Questioning how the parent knows the child's activities relays doubt. Stating that sexually transmitted infections are the biggest concern is worrisome and inappropriate. It is unrealistic to monitor a 14-year-old child's activity at all times

The nurse is speaking to a client regarding sexual history. The client states, "I was born with a penis but I should have had a vagina." Which question would the nurse ask next?

"I understand what you are saying. Tell me how you are feeling." Explanation: A man who states feeling like they should have a vagina may be identifying being in the incorrect body related to how they identify. To physically change sexual orientation would make the client a transgender woman. Stating that the nurse understands and seeks to further explore feelings would be the next statement offered. Offerring acceptance is important in the communication with the client. Further relevant questions may include when the client first felt that way and if the client would consider transitioning. Stating what the nurse knows of others is not as important.

The mother of a 9-year-old girl is concerned because her daughter has already begun menstruating. The daughter is of normal height for her age and weighs 150 lbs (68 kg). The mother is concerned that this is not normal and asks about the factors that could be involved. Which response by the nurse would be best?

"It has become more common for girls to start their periods as early as 9; her weight may be a contributing factor." Explanation: Although it is not proven, the general consensus is a girl must reach a critical weight of approximately 95 lb (43 kg) or develop a critical mass of body fat before the hypothalamus is triggered to send initial stimulation to the anterior pituitary gland to begin the formation of FSH and LH. Probably because of the combination of better nutrition and increased obesity, girls are beginning puberty at earlier ages than ever before (9 to 12 years). Nine is an early age to begin menstruation, but it is within the normal range. Anorexia nervosa is associated with delays or halts in menstruation, not early menstruation. The age of menarche is not governed completely by genetics; other factors are involved.

A 12-year-old girl expresses concern to the nurse because she has not begun her period yet. The nurse notes that the girl has grown 6 in (15 cm) in the past year and a half and is beginning to develop breast buds. Which response by the nurse is appropriate?

"It is normal for females to begin menstruating between the ages of 12 and 15." Explanation: There is wide variation in the time required for adolescents to move through sexual developmental stages; however, the sequential order is fairly constant. In girls, pubertal changes typically occur in the following order: growth spurt, increase in transverse diameter of the pelvis, breast development, growth of pubic hair, onset of menstruation, growth of axillary hair, and vaginal secretions. Thelarche, which is the beginning of breast development, usually starts 1 to 2 years before menstruation. Given the signs of development that this client has already exhibited, it seems likely that she will begin her period in the coming year. Her development is completely normal, so the nurse should not suggest something is wrong by stating she will notify the health care provider. The client does not indicate another issue is concerning her; therefore, the nurse would address the client's current statement. The nurse would not tell the client to not be concerned as this statement is not therapeutic and does not address the client's concern.

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?

"My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal." Explanation: 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.

A male adolescent male tells the nurse that the parent said their penis will be damaged because the adolescent masturbates so much. The adolescent asks if this is true. Which response by the nurse is best?

"Self-stimulation is a normal activity causing no detrimental effects." Explanation: Masturbation is a technique of sexual expression in which an individual practices self-stimulation. People masturbate regardless of age, sex, or marital status. It is a normal activity that has no detrimental effects. Once the adolescent understands this point, a good follow-up question is if the adolescent has any further questions. Asking a follow-up question of why the adolescent is masturbating sounds accusatory. Masturbation does not do any damage to the penis

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education?

"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." Explanation: 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.

A 14-year-old male client voices concern that the testes seem to have enlarged over the past few months and, of most concern, one testicle seems to be larger than the other. How will the nurse respond?

"What you are describing is very common but it is important to have the health care provider assess." Explanation: When a client verbalizes a concern, it is important to address the concern by both discussing common changes of puberty and physically assessing the concern. The nurse should inform the client that enlargement of the testes is one of the normal pubescent physical changes and the occurrence of one testicle that is larger than the other (usually the right testicle) and one testicle is lower than the other (usually the left testicle) are common as well. Telling the client not to worry is nontherapeutic. In addition, stating that a specialist is needed provides the client with misinformation and most likely will increase the already elevated anxiety level. It would be inappropriate for the nurse to suggest that the size will decrease.

During a prenatal visit, a pregnant woman tells the nurse, "I have had to buy some new bras because my breasts are getting bigger. I know this is supposed to happen, but what is going on in my body?" Which response by the nurse would be appropriate?

"Your hormones are causing the glands in your breasts to grow." Explanation: During pregnancy, placental estrogen and progesterone stimulate the development of the mammary glands. Because of this hormonal activity, the breasts may double in size during pregnancy in preparation for milk production. At the same time, glandular tissue replaces the adipose tissue of the breasts. Following childbirth and the expulsion of the placenta, levels of placental hormones (progesterone and lactogen) fall rapidly, and the action of prolactin (milk-producing hormone) is no longer inhibited. Prolactin stimulates the production of milk within a few days after child birth, but in the interim, dark yellow fluid called colostrum is secreted. The substances in breast milk are not present until breast milk is produced.

A mother comes to the clinic nurse concerned about whether her adolescent daughter is sexually active. She requests a physical examination of the daughter's hymen. Which statement by the nurse accurately addresses this issue?

A torn hymen can result from heavy exertion or the use of tampons and is not a reliable method of determining virginity. Explanation: The hymen of a woman can be torn from a variety of causes not related to sexual activity. The use of tampons and strenuous exercise can tear the hymen. A torn hymen is a poor predictor of sexual activity but it does not stretch during intercourse. Expecting an adolescent to be sexually active does not address the issue raised by the mother.

A client is at the clinic for her annual pelvic exam and asks the nurse about ovulation and where the eggs come from. What educational information would the nurse share with this client?

A woman is born with all the ova that she will ever have and they are stored within the ovaries. Explanation: A woman is born with all the ova that she will ever have and they are stored within the ovaries. They are released each month throughout her life until the reproduction years are over.

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 in the review with the client?

All the ova a female will ever have are present at birth. Explanation: It is believed that all the ova a female will ever have are present at birth. The human ovum consists of protoplasm enclosed within a two-layered cell wall. The outer layer is the zona pellucida; the inner layer is the vitelline membrane. The ovum cell contains a large nucleus, within which is a nucleolus called the germinal spot. The ovum is larger than the sperm cell, and it is the only human cell normally visible to the naked eye.

The nurse is examining a pregnant female in her third trimester and measuring to determine if fetal growth has increased. Where would the nurse place the measuring tape?

At the top of the fundus Explanation: The uterine fundus is located that the uppermost portion of the uterus; that is where the uterus is measured to determine fetal size and gestation. The isthmus is the uterine segment that connects the cervix to the uterus. The corpus, the main body of the uterus, is not the top of the uterus. One end of the measuring tape is placed at the top of the pubic symphysis and extended to the top of the fundus.

A nurse is conducting an orientation at a health clinic for newly hired nurses comparing normal and abnormal findings from a female physical assessment. The nurse determines the session is successful when they correctly point out which structure's secretions assist with sexual intercourse?

Bartholin glands Explanation: The Bartholin glands are located in the vestibule and secrete a mucus that moistens the vaginal mucosa during sexual intercourse. The introitus is the opening to the vagina. The vulva vestibule is the area between the labia minora. It contains the ureteral meatus, Skene glands, introitus, and Bartholin glands. The labia minora are paired erectile tissue folds that extend anteriorly from the clitoris and join at the perineum.

The nurse is caring for a client beginning the second trimester of pregnancy. The client asks if there are any concerns if the couple continue to have sex. Which response by the nurse is best?

Be aware that foreplay with the breasts may cause a release of oxytocin. Explanation: It is most important to state, especially for those with history of preterm labor, foreplay with the breasts may cause a release of oxytocin causing cramping and the onset of preterm labor. It is important to recognize if cramping occurs. Pelvic vasocongestion causes an increased blood flow and possibly an increased sexual interest in the pregnant client. Sexual contact can be fulfilling at this time. It is true that a couple may need to use other positions when the abdomen expands. This is a normal part of the sexual experience in pregnancy but not as important to address. It is a myth that an orgasm can cause a spontaneous abortion (miscarriage). It is important to address that this is untrue.

In the resolution phase of sexual response, which response would be most commonly noted in the male?

Erection is lost Explanation: During the resolution phase, which is the final phase of the sexual response cycle, the male will lose his erection, his scrotal sac will thin back out and the testes will descend back down. Rectal contractions occur during the orgasm.

A couple comes to the clinic asking questions regarding getting pregnant. The nurse explains that fertilization normally occurs in what structure of the woman's body?

Fallopian tube Explanation: The ova mature and are released from the ovary. It then is attracted into the fallopian tube by the fimbriae where the sperm fertilizes it, usually in the ampulla portion of the tube.

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. Explanation: 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.

A client comes to the clinic because she suspects she has syphilis. The nurse teaches the woman she will also need additional testing for:

HIV. Explanation: According to CDC guidelines, any clients seeking treatment for an STI should also be tested for HIV. Any clients with risky sexual behaviors, men who have sex with men, and all people 13 to 64 years old should also be tested. Trichomoniasis testing should be completed if the HIV-positive woman is pregnant and should be done annually if the woman is HIV positive.

A young male asks the nurse at the clinic about what he can do to maintain his sperm production. The nurse would instruct him to take which action?

It is recommended that men wear boxer-style underwear. Explanation: It is recommended that men wear loose fitting pants and underwear in order to keep the testes cooler than body temperature to best support sperm production. Tight pants and hot baths are counterproductive to sperm production; wearing cotton underwear does not affect it.

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?

It receives the fertilized ovum and provides housing and nourishment for a fetus. Explanation: The uterus's functions are to receive the fertilized ovum and provide housing and nourishment for a fetus. The ovaries' functions are to produce female gametes or ova and secrete female sex hormones. The vagina's functions are to receive sperm, provide an exit for menstrual flow, and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.

As part of caring for childbearing families, the nurse must be able to educate families regarding which topic?

Knowledge of reproductive anatomy and physiology Explanation: The obstetrical/gynecological nurse must be well versed in pregnancy and childbirth, as well as an understanding of clients of childbearing age. As a gynecological nurse, he or she must also have a good grasp of reproductive anatomy and physiology and the menstrual cycle. Helping select a physician, a hospital, or providing input on cost factors is not the nurse's job.

A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin?

May 24 Explanation: For a woman with a 28-day cycle, ovulation typically occurs on day 14. Therefore, her next menses would begin 14 days later, on May 24.

The vagina is at risk for infection because of its location and because it opens to the outside of the body. What is a protective mechanism of the vagina to keep it from becoming infected?

Normal vaginal pH is acidic (4 to 5), which protects from infection. Explanation: Normally, the vagina maintains an acidic pH of 4 to 5, which protects the vagina from infection.

Which of a client's cells are most likely to reproduce by meiosis?

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

The nurse is educating a pregnant woman who is planning to breast feed her newborn about the events associated with it. Which hormone would the nurse explain as being reponsible for the let-down reflex?

Oxytocin Explanation: The nipple, on stimulation, transmits sensations to the posterior pituitary gland to release oxytocin, which then acts to constrict milk glands and push milk forward into the ducts that lead to the nipple (a let-down reflex). Estrogen is responsible for the increase in size of the breasts at puberty. Progesterone and testosterone are not involved with the breasts or the let-down reflex.

Which body structure controls reproductive hormone production and function for both males and females?

Pituitary gland Explanation: The pituitary gland is responsible for governing the reproductive hormone production and reproductive functioning. The other glands have no influence on reproduction hormones.

A nurse is developing a plan of care for a 7-year-old client who has experienced early development of secondary sex characteristics. Which would be the priority nursing diagnosis for this client?

Risk for disturbance in body image related to early development of secondary sex characteristics. Explanation: As the client will be able to visualize physical differences between other children and herself, it would be a priority for the nurse to recognize in the plan of care that the client may be at risk for disturbances in body image. This would allow for interventions to be put in place for the client to verbalize any concerns she might have and work to enhance body image issues as they develop.

Parents of a toddler express concern because the toddler is touching their genitals. The parents state that they do not know where the toddler learned this behavior and are concerned. What is most important for the nurse teach the parents?

Self-manipulation of genitals is normal behavior for this age. Explanation: It is most important for the parents to understand that toddlers enjoy touching their genitals. This is normal behavior for a toddler with no counseling recommended. Punishment of genital fondling may lead to guilt and shame regarding sexual behavior later in life. If the toddler demonstrates sexual behaviors or activities that should be unknown to a toddler, sexual abuse may be occurring. This behavior would be reported.

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. Explanation: 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 in the first trimester of pregnancy asked if they can continue to have sexual relations throughout pregnancy. How will the nurse respond?

Sexual relations can be safely continued during a normal pregnancy. Explanation: It is important for the client to understand if there are any sexual restrictions during pregnancy. Continuing sexual relations is not detrimental to a pregnancy that has no complications. Sexual relations can be continued throughout the full length of pregnancy with the couple determining which positions are best.

A client is at the clinic for her yearly physical and is found to be anemic. What information from her history would most likely be a contributory factor to this finding?

She reports that her menstrual cycle is irregular and often lasts 7 to 10 days. Explanation: Prolonged menstrual cycles can cause anemia and iron deficiency due to the blood loss. The other factors will not make the client anemic.

The nurse is caring for a couple trying to conceive their first child. The couple state they have been attempting to become pregnant for the past year. Which finding in the couple's history most concerns the nurse?

The female client has a history of pelvic inflammatory disease (PID). Explanation: The nurse would be most concerned learning the female client has a history of PID, because this can cause scarring and lead to subfertility. Consuming 4 to 5 alcoholic drinks per week is not concerning. Excessive alcohol consumption can interfere with fertility and would be addressed. The female client's mother having breast cancer does place the client at increased risk; however, this is not the primary concern at this time. The male client's sister having infertility does not indicate a genetic complication because one sibling is male and the other female

The nurse is explaining about the function of the mons pubis to a client. Which explanation describes the function of the mons pubis?

To protect the pelvic bones during sexual intercourse Explanation: The mons pubis is a fatty pad that lies over the pubic symphysis and serves to protect the pelvic bones during intercourse. The vagina is the receptacle for sperm, the clitoris is the body that enhances sexual pleasure in the female, and the perineum and pelvic floor are the structures that stretch during birth.

When developing a program for STI prevention, which action would need to be done first?

educating on how to promote sexual health Explanation: The key to successful treatment and prevention of STIs is education to promote sexual health. Behavior changes, increasing the availability of resources, and interfering with modes of transmission are important, but all of these require education.

A group of nursing students are preparing a presentation for a health fair illustrating what happens to the body during pregnancy. Which structure will the students point out is influenced the most by hormones to prepare for conception?

endometrium Explanation: The endometrium is the inner layer of the uterus; it builds with hormones during the month in potential preparation for pregnancy. The myometrium is the muscular layer. The perimetrium is a protective layer, and the fundus is the upper area of the uterus.

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 Explanation: With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm. Orgasm results in a pleasurable feeling of physiologic and psychological release. Ejaculation results in the discharge of semen from the urethra

After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies which action as the primary function of the ovaries?

secreting estrogen and progesterone Explanation: The ovaries have two primary functions: development and release of the ovum and secretion of estrogen and progesterone. The fallopian tubes are responsible for conveying the ovum from the ovary to the uterus and sperm from the uterus toward the ovary. The Bartholin glands when stimulated secrete mucus that supplies lubrication for intercourse. The uterus is the site of implantation of a fertilized ovum.

A group of student nurses are comparing the various events which take place during the sexual arousal of both males and females. The students are able to correctly point out which event is one of the underlying physiologic responses after the session?

vasocongestion Explanation: There two underlying physiologic responses to sexual stimulation in both men and women: vasocongestion and myotonia (muscular tension). Myospasm is the spasmodic muscular contraction that is most often a sign of a muscular disorder. Ovulation occurs during the follicular phase of the menstrual cycle. Climacteric phase occurs during menopause when the various changes gradually take place