Chapter 52: Introduction to the Reproductive System

Reproductive systems form during:

embryonic development.

The nurse is scheduling an appointment for Pap test with a client. What information should the nurse provide to the client to ensure the test is accurate? Select all that apply.

"Avoid sexual intercourse for at least 2 days prior to the test." "Use a sanitary pad instead of tampon 2 to 3 days prior to the test."

The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the client's menstrual history? Select all that apply.

"Do you ever experience bleeding after intercourse?" "How long is your typical cycle?" "Do you experience cramps or pain during your cycle?"

A patient who is scheduled for a gynecologic examination and Pap smear informs the nurse that she just began her menstrual cycle. What is the best response by the nurse?

"We will reschedule your examination when you have finished menstruating."

The nurse is taking the sexual history of an adolescent who has come into the free clinic. What question best assesses the client's need for further information?

"What questions or concerns do you have about your sexual health?"

A client has undergone Papanicolaou screening, and the findings show no atypical or abnormal cells. What class would the nurse document these findings?

1

A nurse educator explains to a group of young male students that ejaculation is the discharge of semen, or fluid that contains sperm, from the penis. The normal volume of ejaculate is _______, which contains an average of ________ spermatozoa per milliliter.

2 to 6 mL; 60 to 100 million

A client has undergone Papanicolaou screening, and the findings are strongly suggestive of malignancy. What class would the nurse document these findings? Fill in the blank with a number.

4

The nurse educator is teaching a group of nursing students in a reproductive health class. The students are correct in identifying that a woman is most likely to be unable to become pregnant at what age?

49 years old

The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new client. According to this model, the nurse should begin with what action?

Asking the client's permission to discuss sexuality

A female client who has cognitive and physical disabilities has come into the clinic for a routine check-up. When planning this client's assessment, what action should the nurse take?

Avoid equating the client with her disabilities.

Which term describes a procedure in which cervical tissue is removed because abnormal cells are detected?

Cone biopsy (conization)

The nurse is caring for a client who has been admitted to hospital for uterine bleeding after incomplete miscarriage. The nurse knows what will be included in this client's treatment?

Dilation and curettage

A client is scheduled to undergo a Papanicolaou test. The nurse should advise the client of which preparation?

Do not douche before the procedure

The nurse is preparing a patient for a gynecologic examination when the patient says, "I hope the exam doesn't hurt as much as intercourse with my husband does." What should the nurse document this finding as?

Dyspareunia

A premenopausal client is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this client to be investigated for what health problem?

Ectopic pregnancy

Which diagnostic test is indicated for postmenopausal bleeding?

Endometrial biopsy

A client is scheduled for an abdominal ultrasound as a follow up to her pelvic examination. Which action by the nurse would be most appropriate?

Ensuring that the client has a full bladder

The nurse is caring for a client who is being supplemented with the hormone responsible for developing and maintaining the female reproductive organs. This client is being treated with what hormone?

Estrogen

A couple with a diagnosis of ovarian failure discusses their infertility options with their physician. The nurse should recognize which of the following as the treatment of choice for a client with ovarian failure?

Gamete intrafallopian transfer

A client in her late 50s has expressed to the nurse her desire to explore hormone therapy (HT). Based on what aspect of the client's health history is HT likely contraindicated?

History of vascular thrombosis

The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple?

Hopelessness related to failed IVF

A 21-year-old woman has sought care because of "heavy periods" and has subsequently been diagnosed with menorrhagia. The nurse should recognize which of the following as the most likely cause of the client's health problem?

Hormonal disturbances

A newly pregnant client is being assessed in an obstetric clinic. The client states that she has been experiencing intense abdominal pain and the nurse anticipates that the client will be assessed for ectopic pregnancy. In addition to ultrasonography, what diagnostic test should the nurse anticipate?

Human chorionic gonadotropin (hCG) testing

The nurse is assisting a patient in preparing for a pelvic examination. What position will the nurse place the patient in for the examination?

Lithotomy

An adolescent is brought to the clinic by her mother because of abnormal uterine bleeding. The nurse should understand that the most likely cause of this dysfunctional bleeding pattern is what?

Lack of ovulation

The menstrual cycle is dependent on the interplay among a number of hormones. The hormone(s) responsible for stimulation of progesterone is (are):

Luteinizing hormone.

A Class 5 Pap smear would be interpreted as which of the following?

Malignant

A patient asks the nurse if there are any available nonsurgical options to terminate a pregnancy if she is only 2 weeks pregnant. What information should the nurse provide to the patient about a medication that blocks progesterone

Mifepristone (RU-486, Mifeprex) is used only in early pregnancy to terminate a pregnancy nonsurgically.

A 15-year-old girl is brought to the clinic by her mother to see her primary provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the client has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect?

Primary amenorrhea

When the nurse places the patient in the stirrups for a pelvic exam she observes a bulge caused by rectal cavity protrusion. What does the nurse know this protrusion is called?

Rectocele

A 51-year-old woman is experiencing perimenopausal symptoms and expresses confusion around the possible use of hormone therapy (HT). She explains that her mother and aunts used HT and she is unsure why few of her peers have been prescribed this treatment. What should the nurse explain to the client?

Research has shown that significant health risks are associated with HT.

A client is scheduled to undergo an abdominal ultrasonography. The technician instructs the client to drink at least 1 quart of water 45 minutes to 1 hour before the test and not to void until after the test is completed. What other instruction is given to the client for the test?

Restrict solid food for 6 to 8 hours before the test.

A client has been diagnosed with an enlarged prostate. What information should the nurse explain to the client about the effects of an enlarged prostate?

Retention of urine

A couple has come to the infertility clinic because they have been unable to get pregnant even though they have been trying for over a year. Diagnostic tests are planned for the woman to ascertain if ovulation is regular and whether her endometrium is adequately supported for implantation. What test would the nurse expect to have ordered for this woman?

Serum progesterone

By initiating an assessment about sexual concerns what information should the nurse convey to the client? Select all that apply.

That sexual issues are valid health issues That it is safe to talk about sexual issues That changes or problems in sexual functioning should be discussed

The nurse is assessing a client who believes that she has recently begun menopause. What principle should inform the nurse's interactions with this client?

The nurse must carefully assess the client's feelings and beliefs surrounding menopause.

During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. What bacteria does the practitioner suspect is causing this disorder?

Trichomonas

A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but that she is reluctant to begin hormone therapy (HT). What potential solution should the nurse discuss with the client?

Vitamin supplements

A postmenopausal patient is experiencing dyspareunia. What methods can the nurse recommend she use to diminish the discomfort?

Water-based lubricant

During physical examination of the male reproductive system, which method would best provide the nurse information about the prostate's size as well as evidence of tumor?

digital rectal examination

Which structure is referred to as the vulva?

external female genitalia

A couple that has been married for 5 years is unable to conceive a child. Diagnostic test results indicate that the husband has a low sperm count. What sperm count indicates infertility?

less than 20 million sperm per milliliter

Which external reproductive structure is removed by circumcision?

prepuce

Which structure is involved in keeping the testes at the necessary temperature to ensure sperm production?

scrotum

After a physical examination, a client is informed that his prostate gland is enlarged. An enlarged prostate might cause compromised:

urination.

The nurse is caring for a couple trying to get pregnant and have not been able to for over a year. The couple asks what kind of problems a man can have that can cause infertility. What should be the nurse's response?

"Men can have problems that increase the temperature around their testicles and decrease the quality of their semen."

The nurse is providing information at the local YMCA about screenings for breast and cervical cancer. The nurse should inform young women that they should begin their screenings at what time?

Annual breast and pelvic examinations are important for all women 21 years of age or older and for those who are sexually active, regardless of age.

During the nurse's assessment of a female client, the client reveals that she experienced sexual abuse when she was a young woman. What is the nurse's most appropriate response to this disclosure?

Facilitate appropriate resources and referrals.

While examining the introitus, the nurse practitioner asks the client to "bear down." The nursing student observing the examination knows that the nurse practitioner is assessing the client for which condition?

Uterine prolapse

A nurse is obtaining a male client's health history before performing a physical examination. Which information would most likely not be obtained?

age of first ejaculate

A client is scheduled to have her first Pap test and asks the nurse why this test is necessary. The nurse should tell the client that this test is used to detect early cancer of the _____.

cervix

Which test is an x-ray study of the uterus and the fallopian tubes after injection of a contrast agent?

Hysterosalpingography

The nurse is planning the sexual assessment of a new adolescent client. The nurse should include what assessment components? Select all that apply.

Physical examination findings Laboratory results Health history

A client calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?

The client may have a Candida species infection.