L and D Chapter 14 the point

A female client is concerned about the rate of fertility because the client is older than age 35 years. The client states, "Have I given up the chance to be a parent?" Which response from the nurse is accurate?

"A woman's fertility peaks in the 20s, declines gradually until age 35, and then rapidly declines until it ends."

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."

A nursing instructor teaching a maternity course realizes a student needs more instruction upon overhearing the student make which of the following statements?

"Different sexual positions can determine the sex of the fetus."

The nurse is conducting an initial history and assessment on a client at 10 weeks' gestation who is pregnant with her first child. Which question is a priority for the nurse to ask the client at this time?

"Does anyone in your or the father's family have any genetic disorders?"

A 45-year-old man has just been diagnosed with Huntington disease. He and his spouse are concerned about their four children. Based on the knowledge of patterns of inheritance, how will the nurse respond?

"Each of your children will have a 50% chance of inheriting the disease."

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."

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)."

The nurse is caring for several families enrolled in Medicaid in the prenatal setting. Which statement by an expectant mother would alert the nurse to assess the family further?

"We just moved here from another state and I am still getting used to the new town."

When providing preconception care to a client, which instruction will the nurse to provide about medications during pregnancy?

"You need to talk with your health care provider about using all prescription, over-the-counter, and herbal medications."

The nurse is providing a client in the third trimester of pregnancy information on the physiologic advantages of breastfeeding over bottle feeding. Which instruction(s) is included in the teaching session? Select all that apply.

- Breastfeeding aids in uterine involution. -Breastfeeding may reduce your risk of contracting breast and uterine cancer -Breastfeeding provides a delay in the return of menstruation -Breastfeeding will aid in you returning to your prepregnancy weight sooner.

The nurse is teaching a class about conception. The nurse explains to the participant that which factors are necessary for conception to occur? Select all that apply.

-Equal maturation of both sperm and ovum -Ability of the sperm to reach the ovum -Ability of the sperm to penetrate the ovum

A nurse is teaching a group of adolescent girls about the menstrual cycle. The nurse would integrate information about which hormones as being predominant during the cycle? Select all that apply.

-LH -FSH -GnRH

A female client asks the nurse to explain the purpose of the ovaries besides making eggs for pregnancy. The nurse would explain to the client that the ovaries serve what other purpose(s)? Select all that apply.

-Ovaries produce estrogen, which helps in the development of secondary sexual characteristics. -Ovaries help in the regulation of menstrual cycles through hormonal release. -Progesterone produced in the ovaries is necessary for implantation of the fertilized egg and maintenance of the pregnancy.

A client who is attempting to conceive and menstruates regularly every 30 days asks the nurse what is her probable day of ovulation. The client indicates that her last menses started on the 6th of the month. What is the best response by the nurse?

22nd

The nurse is meeting with a young couple who desire to get pregnant to teach them how to determine the best times for intercourse. During which time frame should the nurse encourage them to engage in intercourse to increase their chances of getting pregnant?

3 days before to 2 days after ovulation

How should the nurse document a pregnant client's gestational status using the GTPAL system after collecting the following data? Currently 18 weeks pregnant Client's fourth pregnancy Delivered one nonviable fetus at 26 weeks Experienced one miscarriage Delivered one viable fetus at 38 weeks' gestation

4, 1, 1, 1, 1

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.

4, 1, 1, 1, 1

The nurse cares for multiple clients planning to have children. Which client will the nurse identify as priority for needing a referral for prenatal genetic testing?

A male client with family history of sickle cell disease

Hormone levels of a woman indicate that the corpus luteum stopped functioning and releasing progesterone after 5 weeks. The nurse would recognize that which scenario is the expected outcome?

A spontaneous abortion (miscarriage) would occur.

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.

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her?

Arrange for prenatal care if the test is positive.

A nurse is providing information regarding ovulation to a couple who want to have a baby. Which fact should the nurse tell the clients?

At ovulation, a mature follicle ruptures, releasing an ovum.

What instruction should a nurse offer to a pregnant client or a client who wishes to become pregnant to help her avoid exposure to teratogenic substances?

Avoid medications.

A group of nursing students are comparing male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure?

Clitoris

A woman has come to the clinic for her first prenatal visit. Which method would be the mosteffective way for the nurse to initiate data gathering for a health history?

Conduct an interview in a private room to obtain her health history.

What should the nurse include when counseling potential parents about genetic disorders?

Environmental influences may affect multifactorial inheritance.

A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy?

FSH and LH

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

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.

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum?

Follicle-stimulating hormone

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of spontaneous abortion (miscarriage) within the first trimester. The nurse is correct to document the history as:

G = 3, T = 1, P = 0, A = 1, L = 1

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

G3 P0020

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records?

G3 T0 P1 A1 L2

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history?

G3, T0, P1, A1, L1

A 28-year-old client states that she has not had her menstrual period for the past 3 months and suspects she is pregnant. Which should the nurse do next?

Have the client take a pregnancy test.

A pregnant woman needs an update in her immunizations. Which vaccination would the nurse ensure that the woman receives?

Hepatitis B

A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take?

Immediately stop the nurse.

During what phase of the uterine cycle would the uterine lining begin to have a reduced blood supply?

Ischemic phase

The clinic nurse is obtaining baseline information for the medical record which will be sent to the hospital. When asking the client about religious preference, the client says, "Why? What difference does that make?" How will the nurse respond?

It is to identify religious beliefs that may affect you or the fetus during your stay.

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of high school students. What would be the best response by a high school student about the function of the vagina?

It receives sperm, provides an exit for menstrual flow, and serves as the birth canal.

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.

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

Knowledge of reproductive anatomy and physiology

A nurse is assessing a female client. When obtaining the client's history, the client tells the nurse that her menstrual cycle is usually 30 days and that she expects her next menstruation on March 20. Based on the client's information and the nurse's understanding of the female reproductive cycle, the nurse would identify ovulation as most likely occurring at which time?

March 6

A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you to consider?

Organizing nursing care at times other than visiting hours.

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

Ova

A female client states, "I am concerned because when I have sex with my spouse, I have an area near my vagina that is really sensitive to touch." Which action will the nurse complete?

Provide education to the client on the female anatomy.

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.

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother?

Social support

Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the sex hormones produced?

Testes

During a physical exam, the physician notates that the pregnant client has a positive Chadwick sign. What client findings would be noted for this symptom?

The cervix has a bluish, purple discoloration

A client is attempting to become pregnant and is using varied methods to identify ovulation. What assessment finding would most clearly suggest that the client is ovulating?

The client has clear, thin cervical mucus

Which statement best expresses the role of the corpus luteum?

The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation.

The nurse is assessing the past history of a woman at her first prenatal appointment. If the woman has no history of vaccination of the choices listed, which vaccine would the nurse schedule this client to receive?

The flu vaccine, after the first trimester of pregnancy is complete

The nurse is caring for several clients in the prenatal clinic. Which action by the nurse demonstrates cultural competency?

The nurse asks each client about dietary restrictions and preferences during the postpartum period.

The student nurse cares for a child from a large extended family. Considering the child's family structure, which way might the child view the student nurse as "poor"?

The student is unmarried and lives alone.

A client comes to the clinic and tells the nurse that she and her husband are trying to conceive a boy. She says that her grandmother told her to eat a lot of cabbage so that the baby will be a boy. What can the nurse inform the client about this information?

These beliefs are often rooted in folklore and not based on scientific principles.

A pregnant woman asks the nurse about using herbal remedies while she is pregnant. The nurse recommends that the woman talk with her health care provider about their use based on which understanding?

They are not rated with regard to safety during pregnancy.

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of nursing students. What would be the correct response by a nursing student about the function of the ovaries?

They produce female gametes or ova and secrete female sex hormones.

The nurse is teaching a couple trying to conceive about the changes in the cervical mucus near the time of ovulation. The nurse determines the session is successful when the couple correctly choose mucus in which form as indicating ovulation has occurred?

Thin and copious

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client?

While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth.

You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a probable sign of pregnancy?

a positive pregnancy test

It is important that nurses include a discussion about teratogens in their prenatal discussions to help prevent deformities or abnormalities. Which substance(s) would the nurse include as a teratogen(s)? Select all that apply.

alcohol certain medications caustic chemicals

A client makes an appointment at the prenatal clinic because the client thinks the client might be pregnant. Which assessment would the nurse identify as a presumptive sign of pregnancy?

amenorrhea

A client asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which statement should the nurse expect to include in the client's teaching plan?

as ovulation approaches, cervical mucus is abundant and stretchable.

When a woman is admitted to the labor and delivery unit, her husband says he is going to work and asks you to call when the baby is born. Your best response to this husband would be to:

ask him if he knows that he can stay with his wife during labor.

What does the genetic analysis always include?

assessment for any other potentially inherited condition

Which body system is most affected throughout the embryonic and fetal period by teratogens?

central nervous system

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG?

continues progesterone production by corpus luteum

While conducting the first prenatal health history visit, the nurse learns that a pregnant client is taking various herbal remedies and over-the-counter medications for minor ailments. Which nursing diagnosis should the nurse identify as being appropriate for the client at this time?

deficient knowledge regarding exposure to teratogens during pregnancy

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to:

detect fetal heart sounds with a Doppler.

When caring for a woman in her sixth month of pregnancy, she reports her plans to nurse for at least two to three years like the rest of the women in her family. Based upon your knowledge, you:

document her report but do nothing, as this is a cultural belief that should be respected.

During which stage of fetal development is exposure to teratogens most damaging?

embryonic stage

A woman is 10 weeks' pregnant and tells the nurse that this pregnancy was unplanned and she has no real family support. The nurse's most therapeutic response would be to:

encourage her to identify someone that she can talk to and share the pregnancy experience.

After a reproductive class at the local school, the public health nurse realizes more training is needed when the class identifies the layers of the uterus to include:

epimetrium.

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

The nurse is conducting an annual examination on a young female who reports her last menses was 2 months ago. The client insists she is not pregnant due to a negative home pregnancy test. Which assessment should the nurse use to assess confirm the pregnancy?

fetal heartbeat

What is a positive sign of pregnancy?

fetal movement felt by examiner

A nurse is conducting an in-service education program about the female reproductive cycle for a group of nurses working at a women's health clinic. When describing the phases of the endometrial cycle, the nurse would explain that the proliferative phase of the endometrial cycle corresponds to which phase in the ovarian cycle?

follicular

After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle?

follicular phase

Which hormone is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle?

gonadotropin-releasing hormone (GnRH)

A nurse is documenting the obstetric history for a pregnant woman who has previously given birth to two infants at term and had one abortion at 12 weeks' gestation. How would the nurse document this information?

gravida 4, para 2

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.

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

A nurse is preparing a presentation for a group of nurses about genetic discoveries and advances. When discussing this topic, the nurse would most likely include which topic area related to the potential for misuse?

individual risk profiling and confidentiality

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client?

knowledge of child development

The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client?

primigravida

A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation?

progesterone

The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence?

quickening

Which client immunization titer is most important to assess and document in the prenatal record of the pregnant woman?

rubella

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

The nurse is assessing a pregnant client's family history at the first prenatal visit. The client states that heart disease, diabetes and breast cancer are in the family and that a niece has spinal bifida. Which instruction is most important at this time?

taking a folic acid supplement

Most cultures have their own beliefs surrounding pregnancy and prenatal care of the woman. A nurse is assigned to a family that is newly immigrated and alone in the community. The client needs bed rest and help with her activities of daily living. One cultural issue that needs to be assessed is:

the role of the male partner in giving care to his wife.

In preparing for a preconception class, the nurse plans to include a discussion of potential risk factors. Which risk factor would be most important to include?

the use of OTC drugs with teratogens

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.

A nurse is teaching a group of women at the local health clinic about reproduction. After describing the various internal structures involved, the nurse determines that the teaching was successful when the group identifies which structure as connecting the external structures with the cervix?

vagina

A student nurse is assigned to care for a woman who is being admitted for delivery of her baby. Where would the nurse expect to find the urethral meatus?

within the vestibule