Maternal Newborn Exam 2

25) The pregnant client who is at 14 weeks gestation asks the nurse why the doctor used to call her baby an embryo, and now calls it a fetus. What is the best answer to this question? 1. A fetus is the term used from the ninth week of gestation and onward. 2. We call a baby a fetus when it is larger than an embryo. 3. An embryo is a baby from conception until the eighth week. 4. The official term for a baby in utero is really zygote.

1. A fetus is the term used from the ninth week of gestation and onward The fetal stage begins in the ninth week.

34) The nurse is teaching a woman about her menstrual cycle. Which is the most important change that happens during the follicular phase of the menstrual cycle? 1. Maturation of the primordial follicle 2. Multiplication of the fimbriae 3. Secretion of human chorionic gonadotropin 4. Growth of the endometrium

1. Maturation of the primordial follicle Follicle-stimulating hormone is elevated during the follicular phase, and the primordial follicle matures.

32) The nurse in the OB-GYN office is explaining the benefits and risks associated with Essure to a client and her husband. What statement made by the client indicates that additional education is needed? 1. A stainless steel microinsert is placed into the distal section of one fallopian tube. 2. The Essure method of permanent sterilization requires no surgical incision. 3. The steel microinserts create a benign tissue response that occludes the fallopian tubes. 4. Women allergic to nickel should consult their physician before placement.

1. A stainless steel microinsert is placed into the distal section of one fallopian tube. The stainless steel microinsert is placed in the proximal section of both fallopian tubes.

19) The nurse is caring for a client pregnant with twins. Which statement indicates that the client needs additional information? 1. Because both of my twins are boys, I know that they are identical. 2. If my twins came from one fertilized egg that split, they are identical. 3. If I have one boy and one girl, I will know they came from two eggs. 4. It is rare for both twins to be within the same amniotic sac.

1. Because both of my twins are boys, I know that they are identical. Not all same-sex twins are identical or monozygotic, because fraternal, or dizygotic, twins can be the same gender or different genders.

13) What type of testing is an inexpensive way to predict the presence of tubal disease and may be more predictive of infertility than an abnormal HSG? 1. Chlamydia trachomatis IgG antibody testing 2. Preimplantation genetic testing 3. Noninvasive prenatal testing (NIPT) 4. DNA testing

1. Chlamydia trachomatis IgG antibody testing Chlamydia trachomatis IgG antibody testing is an inexpensive way to predict the presence of tubal disease and may be more predictive of infertility than an abnormal HSG.

7) A woman is asking the nurse about using the calendar method of contraception. She reports that her last six menstrual cycles were 28, 32, 29, 36, 30, and 27 days long, respectively. Based on this information, when should the nurse tell the client to abstain from intercourse? 1. Days 9-25 2. Days 9-15 3. Days 10-21 4. Days 10-16

1. Days 9-25 To calculate the period of abstinence, the nurse must subtract 18 from the shortest cycle length and 11 from the longest cycle length.

18) A client tells you that her mother was a twin, two of her sisters have twins, and several cousins either are twins or gave birth to twins. The client, too, is expecting twins. Because there is a genetic predisposition to twins in her family, there is a good chance that the client will have what type of twins? 1. Dizygotic twins 2. Monozygotic twins 3. Identical twins 4. Nonzygotic twins

1. Dizygotic twins Studies indicate that dizygotic twins tend to occur in certain families, perhaps because of genetic factors that result in elevated serum gonadotropin levels leading to double ovulation.

6) During a counseling session on natural family planning techniques, the nurse explains that cervical mucus at the time of ovulation should be of what consistency? 1. Egg white appearance and stretchable 2. Opaque and acidic 3. High in leukocytes 4. Lacking in quantity

1. Egg white appearance and stretchable Cervical mucus at the time of ovulation has an egg white appearance and is known as fertile mucus; it is friendly to sperm because it assists passage through the cervix and uterus up into the fallopian tubes.

33) A client using oral contraceptives tells the nurse that her family is complete, and she now desires permanent contraception. Which statement should the nurse include in teaching this client about sterilization options? 1. Essure becomes effective 3 months after insertion. 2. Vasectomy is effective immediately after the procedure. 3. Tubal ligation cannot be performed until the client is age 35. 4. Oral contraception should be taken until menopause.

1. Essure becomes effective 3 months after insertion. The insertion of Essure creates a tissue response that results in tubal occlusion in about 3 months.

19) The OB-GYN nurse knows that the most common shape for the female pelvis is which of the following? 1. Gynecoid type 2. Android type 3. Anthropoid type 4. Platypelloid type

1. Gynecoid type The most common female pelvis is the gynecoid type. The inlet is rounded with the anteroposterior diameter a little shorter than the transverse diameter.

19) The nurse in a fertility clinic is working with a woman who has been undergoing infertility treatment with clomiphene citrate. Which statement would the nurse expect the woman to make? 1. I feel moody so much of the time. 2. If this doesnt work, I think my husband will leave me. 3. This medication will guarantee a pregnancy. 4. My risk of twins or triplets is the same as for the general population.

1. I feel moody so much of the time. Mood swings are a side effect of clomiphene citrate.

30) A pregnant client asks the nurse, What is this knuckle test that is supposed to tell whether my baby has a genetic problem? What does the nurse correctly explain? 1. In the first trimester, the nuchal translucency measurement is added to improve the detection rate for Down syndrome and trisomy 18. 2. You will need to ask the physician for an explanation. 3. It tests for hemophilia A or B. 4. It tests for Duchenne muscular dystrophy.

1. In the first trimester, the nuchal translucency measurement is added to improve the detection rate for Down syndrome and trisomy 18. Screening tests, such as nuchal translucency ultrasound are designed to gather information about the risk that the pregnancy could have chromosome abnormalities or open spina bifida.

9) In evaluating information taught about conception and fetal development, the client verbalizes understanding about transportation time of the zygote through the fallopian tube and into the cavity of the uterus with which statement? 1. It will take at least 3 days for the egg to reach the uterus. 2. It will take 8 days for the egg to reach the uterus. 3. It will only take 12 hours for the egg to go through the fallopian tube. 4. It will take 18 hours for the fertilized egg to implant in the uterus.

1. It will take at least 3 days for the egg to reach the uterus. It will take at least 3 days for the egg to reach the uterus is the correct statement.

12) A client in the womens clinic asks the nurse, How is the cervical mucus method of contraception different from the rhythm method? The appropriate response by the nurse is that the cervical mucus method is which of the following? 1. More effective for women with irregular cycles 2. Not acceptable to women of many different religions 3. Harder to work with than is the rhythm method 4. Requires an artificial substance or device

1. More effective for women with irregular cycles The cervical mucus method (Billings Ovulation Method) can be used by women with irregular cycles.

15) The nurse is planning to teach couples factors that influence fertility. Which factor should not be included in the teaching plan? 1. Sexual intercourse should occur every day of the week. 2. Get up to urinate 1 hour after intercourse. 3. Do not douche. 4. Institute stress-reduction techniques.

1. Sexual intercourse should occur every day of the week. It is optimal if sexual intercourse occurs every other day during the fertile period.

15) When assessing a client asking about birth control, the nurse knows that the client would not be a good candidate for Depo-Provera (DMPA) if which of the following is true? 1. She wishes to get pregnant within 3 months. 2. She is a nursing mother. 3. She has a vaginal prolapse. 4. She weighs 200 pounds.

1. She wishes to get pregnant within 3 months. Return of fertility after use may be delayed for an average of 10 months.

29) The client at 20 weeks gestation thinks she might have been exposed to a toxin at work that could affect fetal development. The client asks the nurse what organs might be affected at this point in pregnancy. What is the nurses best response? 1. The brain is developing now, and could be affected. 2. Because you are in the second trimester, there is no danger. 3. The internal organs like the heart and lungs could be impacted. 4. Its best to not worry about possible problems with your baby.

1. The brain is developing now, and could be affected. Maximum brain growth and myelination are occurring at this point in fetal development.

24) A nurse is providing contraceptive counseling to a perimenopausal client in a monogamous relationship. What comment by the client indicates that further teaching is necessary? 1. The calendar method is the most reliable method for me to use. 2. If I use the IUC, I will be at minimal risk for pelvic inflammatory disease. 3. I should still use birth control, even though I had only three periods last year. 4. The contraceptive skin patch contains both estrogen and progesterone.

1. The calendar method is the most reliable method for me to use. The client who believes the calendar method is the most reliable method requires more teaching. The menstrual cycle of perimenopausal women is irregular, and it is difficult to determine safe and unsafe times.

6) A couple is requesting fertility counseling. The nurse practitioner has identified the factors listed below in the womans health history, and knows which of them could be contributing to the couples infertility? 1. The client is 38 years old. 2. The client was 13 years old when she started her menses. 3. The client works as a dental hygienist 3 days a week. 4. The client jogs 2 miles a day.

1. The client is 38 years old. As the eggs of older women age, their fertility is reduced.

4) A client and her husband have contacted their physician about fertility problems. At the initial visit, the nurse instructs them about the infertility workup. Which statement by the client would indicate that the instructions have been successful? 1. The first test that we need to schedule is a semen analysis. 2. We need to schedule the Pap smear test first. 3. We need to schedule an appointment with the social worker in order to adopt. 4. We need to schedule an appointment with a marriage counselor.

1. The first test that we need to schedule is a semen analysis. A semen analysis is one of the first diagnostic tests, prior to doing invasive procedures.

26) At her first prenatal visit, a woman is discussing fetal development with the nurse. The client asks, When will my baby actually have a heartbeat? The nurse should say the heartbeat of an embryo is distinguishable by what time? 1. The fourth week 2. The sixth week 3. The eighth week 4. The twelfth week

1. The fourth week By the end of the fourth week, embryonic blood is circulating between the embryo and the chorionic villi.

30) The nurse educator is presenting a program to college students about factors that can cause congenital malformations. What should the nurse tell them? 1. The growing embryo is considered most vulnerable to hazardous agents during the first months of pregnancy. 2. Spontaneous abortion always occurs if the fetus is affected by a teratogen. 3. Potential teratogens can cause malformations of the heart, limbs, eyes, and other organ systems only in the second trimester. 4. Teratogen agents are primarily drugs.

1. The growing embryo is considered most vulnerable to hazardous agents during the first months of pregnancy. This is true. Because organs are formed primarily during embryonic development, the growing embryo is considered most vulnerable to hazardous agents during the first months of pregnancy.

34) The nurse teaching the expectant parents about the placenta also talks about the circulation and how the fetus gets its oxygen. She will include in this teaching which important fact? 1. The placenta functions as the lungs for the fetus. 2. The fetus obtains its oxygen from the amniotic fluid. 3. The fetus receives its oxygen by osmosis from the mothers bloodstream. 4. Fetal circulation delivers the highest amount of oxygen to the abdomen and lower body of the fetus.

1. The placenta functions as the lungs for the fetus. Most of the blood supply bypasses the fetal lungs because they do not carry out respiratory gas exchange. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the fetus to excrete carbon dioxide into the maternal bloodstream.

7) After explaining how meiotic division occurs within the ovum, the nurse knows that the pregnant client understands when she makes what statement? 1. The second meiotic division is arrested until and unless the oocyte is fertilized. 2. Meiosis in the oocyte begins at puberty. 3. The first meiotic division continues when the female infant is born. 4. Fertilization does not take place in the secondary oocyte.

1. The second meiotic division is arrested until and unless the oocyte is fertilized. This is true. The secondary oocyte moves into the metaphase stage of cell division, where its meiotic division is arrested until and unless the oocyte is fertilized.

13) The true moment of fertilization occurs when what happens? 1. Cortical reaction occurs 2. Nuclei unite 3. Spermatozoa propel themselves up the female tract 4. Sperm surrounding the ovum release their enzymes

2. Nuclei unite The true moment of fertilization occurs as the nuclei unite. Their individual nuclear membranes disappear, and their chromosomes pair up to produce the diploid zygote.

6) The nurse teaching a class on reproductive anatomy knows that no further instruction is needed when a student shows an understanding of the pelvic cavity divisions by making which statement? 1. The true pelvis is made up of the sacrum, coccyx, and innominate bones. 2. The false pelvis consists of the inlet, the pelvic cavity, and the outlet. 3. The true pelvis is the portion above the pelvic brim. 4. The relationship between the false pelvis and the fetal head is of paramount importance.

1. The true pelvis is made up of the sacrum, coccyx, and innominate bones. The true pelvis is made up of the sacrum, the coccyx, and the two innominate bones.

23) The nurse is working with a client who has experienced a fetal death in utero at 20 weeks. The client asks what her baby will look like when it is delivered. Which statement by the nurse is best? 1. Your baby will be covered in fine hair called lanugo. 2. Your child will have arm and leg buds, not fully formed limbs. 3. A white, cheesy substance called vernix caseosa will be on the skin. 4. The genitals of the baby will be ambiguous.

1. Your baby will be covered in fine hair called lanugo. Downy fine hair called lanugo covers the body of a 20-week fetus.

12) A pregnant woman tells the nurse-midwife, Ive heard that if I eat certain foods during my pregnancy, the baby will be a boy. The nurse-midwifes response should explain that this is a myth, and that the sex of the baby is determined at what time? 1. At the time of ejaculation 2. At fertilization 3. At the time of implantation 4. At the time of differentiation

2. At fertilization Fertilization is the point at which the sex of the zygote is determined.

8) The nurse is teaching the students in their obstetric rotation about fertilization. What processes must the sperm undergo before fertilization can occur? 1. Capacitation and ovulation 2. Capacitation and the acrosomal reaction 3. Oogenesis and the acrosomal reaction 4. Gametogenesis and capacitation

2. Capacitation and the acrosomal reaction The sperm must undergo two processes before fertilization can occur: capacitation and the acrosomal reaction

9) The nurse is reviewing assessment data from several different male clients. Which one should receive information about causes of infertility? 1. Circumcised client 2. Client with a history of premature ejaculation 3. Client with a history of measles at age 12 4. Client employed as an engineer

2. Client with a history of premature ejaculation Premature ejaculation is a possible cause of infertility.

1) The external and internal female reproductive organs develop and mature in response to what hormones? 1. Adrenocorticotropic hormones (ACTH) 2. Estrogen and progesterone 3. Steroid hormones 4. Luteinizing hormones (LH)

2. Estrogen and progesterone The external and internal female reproductive organs develop and mature in response to estrogen and progesterone.

6) During a class on genetics for pregnant families, the nurse is discussing the how the egg and sperm are formed before fertilization takes place. The nurse explains that these cells have only half the number of chromosomes, so when fertilization takes place, there will be the correct number. What is the process by which the egg and sperm are formed called? 1. Oogenesis 2. Gametogenesis 3. Meiosis 4. Spermatogenesis

2. Gametogenesis Gametogenesis is the process by which ovum and sperm are produced.

20) A nurse teaches newly pregnant clients that if an ovum is fertilized and implants in the endometrium, the hormone the fertilized egg begins to secrete is which of the following? 1. Estrogen 2. Human chorionic gonadotropin (hCG) 3. Progesterone 4. Luteinizing hormone

2. Human chorionic gonadotropin (hCG) If the ovum is fertilized and implants in the endometrium, the fertilized egg begins to secrete human chorionic gonadotropin (hCG), which is needed to maintain the corpus luteum.

21) Extended use combined oral contraceptives (COCs) reduce the side effects of COCs such as which of the following? 1. Cramping 2. Hypertension 3. Breast tenderness 4. Bloating

2. Hypertension Complications of COCs include: myocardial infarction, stroke, blood clots, and hypertension.

11) A couple who have sought fertility counseling have been told that the mans sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which condition occurs? 1. The vas deferens is ligated. 2. Male obesity is present. 3. The prostate gland is enlarged. 4. The flagella are segmented.

2. Male obesity is present. Male obesity is associated with poor spermatogenesis and increased amount of time to conception.

2) The nurse is preparing a class on reproduction. What is the cell division process that results in two identical cells, each with the same number of chromosomes as the original cell called? 1. Meiosis 2. Mitosis 3. Oogenesis 4. Gametogenesis

2. Mitosis Mitosis results in the production of diploid body (somatic) cells, which are exact copies of the original cell

36) A client who is currently 12 weeks pregnant is seeking information on pregnancy termination. The nurse is teaching the client about the risks involved if she were to take the medication mifepristone. Which adverse signs would the client need to know and report immediately to a physician? 1. Fatigue, lack of appetite, and inability to concentrate 2. Nausea, diarrhea, vomiting, and stomach pain 3. Increase in heart rate, inability to sit still, and lack of appetite 4. Headache, fatigue, and hunger

2. Nausea, diarrhea, vomiting, and stomach pain Nausea, diarrhea, vomiting, and stomach pain are the symptoms that must be reported immediately to the physician

15) When planning care for a client who has undergone an episiotomy, it would be important for the nurse to include a goal that addresses the need for pain relief of which part of the body? 1. Mons pubis 2. Perineal body 3. Labia minora 4. Hymen

2. Perineal body During the last part of labor, the perineal body thins out until it is just a few centimeters thick. This tissue is often the site of an episiotomy or lacerations during childbirth.

18) Approximately 80% of anovulatory women have which condition? 1. Turner syndrome 2. Polycystic ovary syndrome (PCOS) 3. Klinefelter syndrome 4. Fragile X syndrome

2. Polycystic ovary syndrome (PCOS) Approximately 80% of anovulatory women have polycystic ovary syndrome (PCOS), causing insulin resistance and hyperinsulinemia.

21) A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. This is most likely due to a lack of which hormone? 1. Estrogen 2. Progesterone 3. FSH 4. LH

2. Progesterone Progesterone is often called the hormone of pregnancy because it inhibits uterine contractions and relaxes smooth muscle to cause vasodilation, allowing pregnancy to be maintained.

31) The nurse teaching a high school class explains that during the menstrual cycle, the endometrial glands begin to enlarge under the influence of estrogen and cervical mucosal changes occur; the changes peak at ovulation. In which phase of the menstrual cycle does this occur? 1. Menstrual 2. Proliferative 3. Secretory 4. Ischemic

2. Proliferative The proliferative phase begins when the endometrial glands begin to enlarge under the influence of estrogen and cervical mucosal changes occur; the changes peak at ovulation.

12) An infertile couple confides in the nurse at the infertility clinic that they feel overwhelmed with the decisions facing them. Which nursing strategy would be most appropriate? 1. Refer them to a marriage counselor. 2. Provide them with information and instructions throughout the diagnostic and therapeutic process. 3. Express concern and caring. 4. Inquire about the names they have chosen for their baby.

2. Provide them with information and instructions throughout the diagnostic and therapeutic process. The nurse can provide comfort to couples by offering a sympathetic ear, a nonjudgmental approach, and appropriate information and instruction throughout the diagnostic and therapeutic processes.

9) The nurse educator is planning a class about contraception, and includes information about the effects of various contraceptive methods on sexually transmitted diseases. Which statement will the nurse include concerning spermicides? 1. Spermicides are effective against gonorrhea and chlamydia, but not against HIV. 2. Spermicides are not effective against sexually transmitted diseases, and can increase a womans susceptibility to HIV. 3. Spermicides are effective against HIV, but are not effective against the other sexually transmitted diseases. 4. Whether or not spermicides are effective against sexually transmitted diseases depends on where the woman is in her cycle.

2. Spermicides are not effective against sexually transmitted diseases, and can increase a womans susceptibility to HIV. Spermicides are not effective against any sexually transmitted disease. Spermicides have a negative effect on the integrity of vaginal cells, making them more susceptible.

10) A client is to receive fertility drugs prior to in vitro fertilization. What is the expected action of this medication? 1. Prolonging of the luteal phase 2. Stimulation of ovulation 3. Suppression of menstruation 4. Promotion of cervical mucus production

2. Stimulation of ovulation In IVF, a womans ovaries are stimulated by a combination of medications, one or more oocytes are aspirated from her ovaries and fertilized in the laboratory, and then they are placed into her uterus after normal embryo development has begun.

24) The nurse is presenting a class to pregnant clients. The nurse asks, The fetal brain is developing rapidly, and the nervous system is complete enough to provide some regulation of body function on its own, at which fetal development stage? It is clear that education has been effective when a participant makes which response? 1. The 17th-20th week 2. The 25th-28th week 3. The 29th-32nd week 4. The 33rd-36th week

2. The 25th-28th week Between the 25th and 28th week, the brain is developing rapidly, and the nervous system is complete enough to provide some degree of regulation of body functions.

32) During a prenatal examination, an adolescent client asks, How does my baby get air? What correct information would the nurse give? 1. The lungs of the fetus carry out respiratory gas exchange in utero similar to what an adult experiences. 2. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the excretion of carbon dioxide into your bloodstream. 3. The blood from the placenta is carried through the umbilical artery, which penetrates the abdominal wall of the fetus. 4. The fetus is able to obtain sufficient oxygen due to the fact that your hemoglobin concentration is 50% greater during pregnancy.

2. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the excretion of carbon dioxide into your bloodstream. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the excretion of carbon dioxide into the maternal bloodstream.

3) The female and male reproductive organs are homologous, which means what? 1. They are believed to cause vasoconstriction and muscular contraction 2. They are fundamentally similar in function and structure 3. They are rich in sebaceous glands 4. They are target organs for estrogenic hormones

2. They are fundamentally similar in function and structure The female and male reproductive organs are homologous; that is, they are fundamentally similar in function and structure.

25) A client is using the contraceptive sponge as a birth control method. What action is important in order to maintain the sponges effectiveness? 1. Insert the sponge at least 1 hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Spermicidal jelly must be inserted at the same time the sponge is inserted. 4. A new sponge must be inserted every time a couple has intercourse.

2. Thoroughly moisten the sponge with water before inserting. The sponge is moistened thoroughly with water before use to activate the spermicide.

34) The nurse is developing a teaching plan for a client undergoing a tubal ligation. What information should be included in the plan? 1. The surgical procedure is easily reversible. 2. Laparotomy is performed following a vaginal birth. 3. Minilaparotomy is performed in the postpartum period soon after a vaginal birth. 4. Tubal ligation can be done at any time the woman is either pregnant or not pregnant.

3. Minilaparotomy is performed in the postpartum period soon after a vaginal birth. A tubal ligation minilaparotomy is performed in the postpartum period soon after a vaginal birth.

21) A woman pregnant with twins asks the nurse about differences between identical and fraternal twins. The nurse explains that since it has been determined that she is having a boy and a girl, they are fraternal, and will have with of the following? 1. One placenta, two amnions, and two chorions 2. Two placentas, two amnions, and two chorions 3. Two placentas, one amnion, and two chorions 4. Two placentas, two amnions, one chorion

2. Two placentas, two amnions, and two chorions This is the correct answer. Fraternal twins have two placentas, two amnions, and two chorions, however, the placentas sometimes fuse and look as if they are one.

17) When the nurse is teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size how often? 1. Every five years routinely 2. When weight gain or loss beyond five pounds has occurred 3. After each birth 4. Only after significant weight loss

3. After each birth The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more.

4) The nurse educator is lecturing on the changes that take place during puberty. What is a change that girls experience? 1. Elongation of the hips 2. Deepening of the voice 3. Broadening of the hips and budding of breasts 4. Preparation of the uterus for pregnancy

3. Broadening of the hips and budding of breasts During puberty, girls hips start to broaden and their breasts begin to form.

20) Which statement by a pregnant client to the nurse would indicate that the client understood the nurses teaching? 1. Because of their birth relationship, fraternal twins are more similar to each other than if they had been born singly. 2. Identical twins can be the same or different sex. 3. Congenital abnormalities are more prevalent in identical twins. 4. Identical twins occur more frequently than fraternal twins.

3. Congenital abnormalities are more prevalent in identical twins. Monozygotic twinning is considered a random event and occurs in approximately 3 to 4 per 1000 live births. Congenital anomalies are more prevalent and both twins may have the same malformation.

2) The nurse is planning an educational session about contraception. What will the nurse emphasize as being the most significant factor in determining the effectiveness of a specific method of contraception to avoid pregnancy? 1. Reliability 2. Ease of use 3. Consistency of use 4. Cost

3. Consistency of use Consistency of use is the most important factor for determining the effectiveness of a specific type of contraception.

17) The physician has prescribed the medication clomiphene citrate (Clomid) for a client with infertility. What should the nurses instructions to the woman include? 1. Have intercourse every day of 1 week, starting 5 days after completion of medication. 2. This medication is administered intravenously. 3. Contact the doctor if visual disturbances occur. 4. A contraindication is kidney disease.

3. Contact the doctor if visual disturbances occur. Side effects of clomiphene citrate include visual symptoms such as spots and flashes.

12) A school nurse teaching a health class to adolescent boys explains that spermatozoa become motile and fertile during the 2-10 days they are stored in which part of the male body? 1. Prostate gland 2. Vas deferens 3. Epididymis 4. Urethra

3. Epididymis The epididymis provides a reservoir where spermatozoa can survive for a long period and the spermatozoa usually remain in the epididymis for 2 to 10 days.

23) The student nurse encounters a 15-year-old girl who reports that she has no pubic or axillary hair and has not yet experienced growth of her breasts. The student asks the nurse about the physiology of this occurrence. The nurse explains that the client probably lacks which hormone? 1. Testosterone 2. Progesterone 3. Estrogen 4. Prolactin

3. Estrogen Estrogens influence the development of secondary sex characteristics.

7) A client calls the urologists office to receive instructions about semen analysis. What does the nurse instruct the client to do? 1. Avoid sexual intercourse 24 hours prior to obtaining a specimen. 2. Use a latex condom to collect the specimen. 3. Expect that a repeat test might be required. 4. Expect a small sample.

3. Expect that a repeat test might be required. A repeat semen analysis might be required to adequately assess the mans fertility potential.

3) The nurse educator is discussing human chromosomes with her students, and knows that the teaching has been effective when a student makes which statement? 1. All humans have 48 chromosomes and 2 sex chromosomes. 2. Human chromosomes are shaped like a Y. 3. Humans have 46 chromosomes, 2 of which are the sex chromosomes. 4. Only certain body cells contain the chromosomes.

3. Humans have 46 chromosomes, 2 of which are the sex chromosomes. This is the correct answer. There are 22 pairs of similar cells and 2 sex chromosomes.

13) A client who wants to use the vaginal sponge method of contraception shows that she understands the appropriate usage when she makes which statement? 1. I need to use a lubricant prior to insertion. 2. I need to add spermicidal cream prior to intercourse. 3. I need to moisten it with water prior to use. 4. I need to leave it in no longer than 6 hours.

3. I need to moisten it with water prior to use. To activate the spermicide in the vaginal sponge, it must be moistened thoroughly with water.

9) The nurse educator describes the uterus and ovaries as being held in place in the pelvic cavity by what structures? 1. Muscles 2. Tendons 3. Ligaments 4. Peritoneum

3. Ligaments The ovaries and uterus are held in place in the pelvic cavity by a number of ligaments.

16) The nurse is creating a poster for pregnant mothers. Which description of fetal development should the nurse include? 1. Four primary germ layers form from the blastocyst. 2. After fertilization, the cells only become larger for several weeks. 3. Most organs are formed by 8 weeks after fertilization. 4. The embryonic stage is from fertilization until 5 months.

3. Most organs are formed by 8 weeks after fertilization. Most organs are formed during the embryonic stage, which lasts from the 15th day after fertilization until the end of the 8th week after conception.

5) The nurse has completed a presentation on reproduction. Which statement indicates that the teaching has been successful? 1. A male is born with all the sperm he will ever produce. 2. Females create new ova throughout their reproductive life. 3. Ova separate into two unequally sized cells. 4. Each primary spermatocyte divides into four haploid cells.

3. Ova separate into two unequally sized cells. The first meiotic division produces two cells of unequal size with different amounts of cytoplasm but with the same number of chromosomes.

11) The nurse is creating a handout on reproduction for teen clients. Which piece of information should the nurse include in this handout? 1. The fertilized ovum is called a gamete. 2. Prior to fertilization, the sperm are zygotes. 3. Ova survive 12-24 hours in the fallopian tube if not fertilized. 4. Sperm survive in the female reproductive tract up to a week.

3. Ova survive 12-24 hours in the fallopian tube if not fertilized. Ova are considered fertile for about 12 to 24 hours after ovulation.

27) A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6C (1.0F) over the past 36 hours. This most likely indicates what? 1. Menstruation is about to begin. 2. Ovulation will occur soon. 3. Ovulation has occurred. 4. She is pregnant, and will not menstruate.

3. Ovulation has occurred. In some women, ovulation is accompanied by mid-cycle pain, known as mittelschmerz. This pain may be caused by a thick tunica albuginea or by a local peritoneal reaction to the expelling of the follicular contents and body temperature increases about 0.3C to 0.6C (0.5F to 1F) 24 to 48 hours after the time of ovulation.

35) The client who was raped is extremely upset when a pregnancy test confirms that she is pregnant, and requests information regarding pregnancy termination. Which statement is best for the nurse to include? 1. Abortion is morally wrong, and should not be undertaken. 2. Hypertension is a risk with any abortion. 3. Surgical abortion in the first trimester is technically easier and safer than abortion in the second trimester. 4. The most accurate method to determine gestational age are the results of a pregnancy test.

3. Surgical abortion in the first trimester is technically easier and safer than abortion in the second trimester. Second-trimester abortion (greater than 13 weeks gestation up to 24 weeks or as per state law) may be done medically or surgically.

5) A client asks the nurse, Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy? What response by the nurse is best? 1. Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred. 2. Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation. 3. Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur. 4. This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control.

3. Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur. The basal body temperature method is used to detect ovulation by an increase in the basal temperature during the menstrual cycle. It requires that the woman take her temperature every morning upon awakening (before any activity) and record the findings on a temperature graph, and is based on the fact that the temperature almost always rises and remains elevated after ovulation because of the production of progesterone, a thermogenic (heat-producing) hormone.

26) The nurse is preparing educational materials at a family planning clinic. The client who is an appropriate candidate for using emergency contraception would be one who reports which of the following? 1. Forgetting to start her pill pack yesterday 2. Unprotected intercourse during her menses 3. That a condom broke yesterday in the middle of her cycle 4. Increased dysmenorrhea since IUC insertion

3. That a condom broke yesterday in the middle of her cycle Research indicates that oral hormonal EC taken as soon as possible within 72 hours, but up to 5 days, can reduce the risk of pregnancy after a single act of unprotected intercourse by at least 74%.

27) A woman comes into the emergency department stating she was raped the day before, and requests emergency contraception. She states that she is in the middle of her cycle. The nurse knows which of the following about the client? 1. This client has waited too long before coming to the emergency department. 2. The client will have to wait 10 days before she can have emergency contraception. 3. The client can receive emergency contraception up to 72 hours to 5 days after the intercourse. 4. The client will have to wait and see whether she misses a period.

3. The client can receive emergency contraception up to 72 hours to 5 days after the intercourse. This client is within the 72-hour to 5-day timeframe, and is able to receive the medicine.

11) The nurse in the clinic instructs a client using the natural method of contraception to begin counting the first day of her cycle as which day? 1. The day her menstrual period ceases 2. The first day after her menstrual period ceases 3. The first day of her menstrual period 4. The day of ovulation

3. The first day of her menstrual period The first day of menstruation is the first day of the cycle.

13) A nurse teaching a sex education class is asked by a male student, What exactly happens when my body gets aroused? The nurses reply includes which statement? 1. The vas deferens thickens and expands. 2. The sympathetic nerves of the penis are stimulated. 3. The penis elongates, thickens, and stiffens. 4. The prepuce of the penis elongates.

3. The penis elongates, thickens, and stiffens. Sexual stimulation causes the penis to elongate, thicken, and stiffen, a process called erection. The penis becomes erect when its blood vessels become engorged.

33) The nurse is preparing a handout for female adolescents on the menstrual cycle. What phase of the cycle occurs if fertilization does not take place? 1. Menstrual 2. Proliferative 3. Secretory 4. Ischemic

4. Ischemic The ischemic phase occurs if fertilization does not occur.

32) 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. The menstrual cycle has five distinct phases that occur during the month. 2. One hormone controls the phases of the menstrual cycle. 3. The secretory phase occurs when a woman is most fertile. 4. Menstrual cycle phases vary in order from one woman to another.

3. The secretory phase occurs when a woman is most fertile. During the secretory phase, the vascularity of the entire uterus increases greatly, providing a nourishing bed for implantation.

17) A prenatal client asks the nurse how the baby can possibly come out through her vagina, because a vagina is not nearly as big as a baby. How does the nurse best answer this clients question? 1. The vagina usually tears as it stretches during childbirth. 2. The vagina is designed to allow a baby come through. 3. The vagina changes due to pregnancy allow the vagina to stretch more. 4. The vagina dilates and effaces in labor so the baby can get out.

3. The vagina changes due to pregnancy allow the vagina to stretch more. The walls of the vagina are covered with ridges, or rugae, crisscrossing each other. These rugae allow the vaginal tissues to stretch enough for the fetus to pass through during childbirth.

2) A couple is seeking advice regarding what they can do to increase the chances of becoming pregnant. What recommendation can the nurse give to the couple? 1. The couple could use vaginal lubricants during intercourse. 2. The couple should delay having intercourse until the day of ovulation. 3. The woman should refrain from douching. 4. The woman should be on top during intercourse.

3. The woman should refrain from douching. This is the correct answer, as douching can alter sperm mobility.

20) The nurse is instructing a client in the use of combined oral contraceptives. The nurse knows that additional teaching is required when the client makes which statement about the risks of taking combined oral contraceptives? 1. They will lower my risk for breast cancer. 2. They will increase my risk for cervical cancer. 3. They will lower my risk for ovarian cancer. 4. They will increase my risk for uterine cancer.

3. They will lower my risk for ovarian cancer. This is true. There is a reduction in the incidence of ovarian cancer.

30) The nurse is providing instructions for a woman who has just had intrauterine contraception inserted. What is essential for the nurse to teach the client? 1. To palpate her lower abdomen each month to check the patency of the device 2. To remain on bed rest for 24 hours after insertion of the device 3. To report any pain during intercourse to the physician 4. To insert spermicidal jelly within 4 hours of every sexual encounter

3. To report any pain during intercourse to the physician The client should report any pain during intercourse to the physician. This can be due to an infection.

34) A 58-year-old father and a 45-year-old mother gave birth to a baby boy 2 days ago. The nurse assesses a single palmar crease and low-set ears on the newborn. The nurse plans to counsel the couple about which chromosomal abnormality? 1. Trisomy 13 2. Trisomy 18 3. Trisomy 21 4. Trisomy 26

3. Trisomy 21 A single palmar crease and low-set ears are characteristics of trisomy 21 (Down syndrome).

24) The nurse is reviewing preconception questionnaires in charts. Which couple are the most likely candidates for preconceptual genetic counseling? 1. Wife is 30 years old, husband is 31 years old 2. Wife and husband are both 29 years old, first baby for husband, wife has a normal 4-year-old 3. Wifes family has a history of hemophilia 4. Single 32-year-old woman is using donor sperm

3. Wifes family has a history of hemophilia For families in which the woman is a known or possible carrier of an X-linked disorder, such as hemophilia, the risk of having an affected male fetus is 25%.

29) The nurse in the clinic is seeing four clients. Which one is the best candidate for receiving an IUC? 1. An unmarried, 22-year-old college graduate 2. A married 24-year-old who has never been pregnant 3. An unmarried 25-year-old with a history of chlamydia 4. A married 26-year-old who has two children

4. A married 26-year-old who has two children This client is the best candidate, as she is in a stable relationship, and has children.

17) The nurse working with a client describes cellular multiplication and how the zygote moves through the fallopian tube, a movement that takes place via what process? 1. A squeezing motion 2. Pushing from another ovum that has not been fertilized 3. Hormone action 4. A very weak fluid current in the fallopian tube resulting from the beating action of ciliated epithelium

4. A very weak fluid current in the fallopian tube resulting from the beating action of ciliated epithelium This is correct. There is a very weak fluid current in the fallopian tube resulting from the beating action of the ciliated epithelium that lines the tube.

26) A newborn has been diagnosed with a disorder that occurs through an autosomal recessive inheritance pattern. The parents ask the nurse, Which of us passed on the gene that caused the disorder? Which answer should the nurse tell them? 1. The female 2. The male 3. Neither 4. Both

4. Both An affected individual can have clinically normal parents, but both parents are generally carriers of the abnormal gene.

5) A nurse working in an infertility clinic should include which information in her discussions with the clients? 1. It is important to know the statistics surrounding couples who never learn why they are infertile. 2. Couples should understand the legal controversy concerning therapeutic insemination. 3. Couples should seek marriage counseling before undergoing fertility treatments. 4. Couples should discuss therapeutic insemination and in vitro fertilization as alternatives.

4. Couples should discuss therapeutic insemination and in vitro fertilization as alternatives. This is the correct answer. This information should be presented to clients so that they are aware of all the alternatives and can make an informed decision.

28) The nurse teaching the phases of the menstrual cycle should include the fact that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and extensive vascular changes occur in which phase? 1. Menstrual phase 2. Proliferative phase 3. Secretory phase 4. Ischemic phase

4. Ischemic phase In the ischemic phase, the corpus luteum begins to degenerate, and as a result, both estrogen and progesterone levels fall. Small blood vessels rupture, and the spiral arteries constrict and retract, causing a deficiency of blood in the endometrium, which becomes pale.

8) A client scheduled a laparoscopy. After the procedure, what does the nurse instruct the client to do? 1. Stay on bed rest for 48 hours. 2. Expect to have shoulder and arm pain. 3. Purchase a rectal tube to relieve the gas. 4. Lie on her back to relieve the gas pain after the procedure.

4. Lie on her back to relieve the gas pain after the procedure. Assuming a supine position may help relieve residual shoulder and chest discomfort caused by any remaining gas.

33) The client has read that the placenta produces hormones that are vital to the function of the fetus. It is evident that that the client understands the function of the placenta when she states that which hormone is primarily responsible for the maintenance of pregnancy past the 11th week? 1. Human chorionic gonadotropin (hCG) 2. Human placental lactogen (hPL) 3. Estrogen 4. Progesterone

4. Progesterone Progesterone is a hormone essential for pregnancy. After the 11th week, the placenta produces enough progesterone and estrogen to maintain pregnancy.

22) The nurse is presenting a community education session on female hormones. Which statement from a participant indicates the need for further information? 1. Estrogen is what causes females to look female. 2. The presence of some hormones causes other to be secreted. 3. Progesterone is present at the end of the menstrual cycle. 4. Prostaglandin is responsible for achieving conception.

4. Prostaglandin is responsible for achieving conception. Prostaglandin is not related to conception. Prostaglandin production increases during follicular maturation and has basic regulatory functions in cells.

24) What is the function of the scrotum? 1. Produce testosterone, the primary male sex hormone 2. Deposit sperm in the female vagina during sexual intercourse so that fertilization of the ovum can occur 3. Provide a reservoir where spermatozoa can survive for a long period 4. Protect the testes and the sperm by maintaining a temperature lower than that of the body

4. Protect the testes and the sperm by maintaining a temperature lower than that of the body The function of the scrotum is to protect the testes and the sperm by maintaining a temperature lower than that of the body.

1) During the initial visit with the nurse at the fertility clinic, the client asks what effect cigarette smoking has on the ability to conceive. What is the nurses best response? 1. Smoking has no effect. 2. Only if you smoke more than one pack a day will you experience difficulty. 3. After your first semen analysis, we will determine whether there will be any difficulty. 4. Smoking can affect the quantity of sperm.

4. Smoking can affect the quantity of sperm. The quantity and quality of male sperm are affected by cigarette smoking.

11) The nurse teaching a client describes the effect of a vasectomy on fertilization by saying a man who has had a vasectomy becomes functionally sterile because of which of the following? 1. Sperm are no longer being produced. 2. Sperm are no longer motile and fertile. 3. Sperm sit in the testes where they are formed. 4. Sperm cannot reach the outside of the body.

4. Sperm cannot reach the outside of the body. Although sperm continue to be produced for the next several years, they can no longer reach the outside of the body.

10) The nurse explains to a preconception class that if only a small volume of sperm is discharged into the vagina, an insufficient quantity of enzymes might be released when they encounter the ovum. In that case, pregnancy would probably not result, because of which of the following? 1. Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus. 2. The block to polyspermy (cortical reaction) would not occur. 3. The fertilized ovum would be unable to implant in the uterus. 4. Sperm would be unable to penetrate the zona pellucida of the ovum.

4. Sperm would be unable to penetrate the zona pellucida of the ovum. About a thousand acrosomes must rupture to clear enough hyaluronic acid for even a single sperm to penetrate the ovums zona pellucida successfully. If only a small amount of sperm were released, there most likely would be an insufficient quantity of acrosomes to penetrate the zona pellucida of the ovum and allow f

29) The couple at 12 weeks gestation has been told that their fetus has sickle cell disease. Which statement by the couple indicates that they are adequately coping? 1. We knew we were both carriers of sickle cell. We shouldnt have tried to have a baby. 2. If we had been healthier when we conceived, our baby wouldnt have this disease now. 3. Taking vitamins before we got pregnant would have prevented this from happening. 4. The doctor told us there was a 25% chance that our baby would have sickle disease.

4. The doctor told us there was a 25% chance that our baby would have sickle disease. A true statement indicates coping. When both parents are carriers of an autosomal recessive disease, there is a 25% risk for each pregnancy that the fetus will be affected.

2) The nurse teaching a class on the reproductive system is discussing what happens at puberty. Which statement does the nurse make? 1. Boys and girls go through puberty at the same time. 2. Most girls develop breasts and start their menses at about the same time. 3. The nocturnal emissions that adolescent boys have contain a large number of sperm. 4. The onset and progress of puberty varies widely from person to person.

4. The onset and progress of puberty varies widely from person to person. The age at onset and progress of puberty vary widely, physical changes overlap, and the sequence of events can vary from person to person.

21) A client has been diagnosed with fallopian tube obstruction and told that her best option for becoming pregnant is with in vitro fertilization. The client asks the nurse about the procedure. What is the nurses best explanation of this procedure? 1. In vitro fertilization (IVF) occurs over a full menstrual cycle. 2. In IVF, a womans ovaries are stimulated by a combination of egg and sperm donations. 3. After ovarian stimulation, you will be inseminated with your partners sperm. 4. The oocytes are aspirated from the ovaries and fertilized in the laboratory.

4. The oocytes are aspirated from the ovaries and fertilized in the laboratory. This is true. The oocytes are aspirated from the clients ovaries and fertilized in the laboratory.

16) The nurse explains to the client that the obstetric conjugate measurement is important because of which reason? 1. This measurement determines the tilt of the pelvis. 2. This measurement determines the shape of the inlet. 3. The fetus passes under it during birth. 4. The size of this diameter determines whether the fetus can move down into the birth canal so that engagement can occur.

4. The size of this diameter determines whether the fetus can move down into the birth canal so that engagement can occur. The obstetric conjugate extends from the middle of the sacral promontory to an area approximately 1 cm below the pubic crest. The fetus passes through the obstetric conjugate, and the size of this diameter determines whether the fetus can move down into the birth canal in order for engagement to occur.

29) The nurse is preparing a handout on the ovarian cycle to a group of middle school girls. Which information should the nurse include? 1. The hormone human chorionic gonadotropin stimulates ovulation. 2. Irregular menstrual cycles have varying lengths of the luteal phase. 3. The ovum leaves its follicle during the follicular phase. 4. There are two phases of the ovarian cycle: luteal and follicular.

4. There are two phases of the ovarian cycle: luteal and follicular. The ovarian cycle has two phases: the follicular phase (days 1 to 14) and the luteal phase (days 15 to 28 in a 28-day cycle).

33) A nurse counsels a couple on sex-linked disorders. Both the man and the woman are carriers of the disorder. They ask the nurse how this disorder will affect any children they might have. What is the nurses best response? 1. If you have a daughter, she will not be affected. 2. Your son will be affected because the father has the disorder. 3. There is a 25% chance that your son will have the disorder because the mother has the disorder. 4. There is a 50% chance that your son will be a carrier only.

4. There is a 50% chance that your son will be a carrier only. There is a 50% chance that a carrier mother will pass the normal gene to each of her sons, who will be unaffected.

14) A female client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this client? 1. Intrauterine device 2. Vaginal sponge 3. Combined oral contraceptives 4. Transdermal hormonal contraception

4. Transdermal hormonal contraception Transdermal hormonal contraception is contraindicated because of the clients obesity.

16) A couple asks the nurse what is the safest method of sterilization. What should the nurse reply? 1. Laparotomy tubal ligation. 2. Laparoscopy tubal ligation. 3. Minilaparotomy. 4. Vasectomy.

4. Vasectomy. Vasectomy (male sterilization) is a relatively minor procedure.

4) The nurse is teaching about reproduction, and explains that which of the following are the purposes of meiosis? Select all that apply. 1. Produce gametes 2. Reduce the number of chromosomes 3. Introduce genetic variability 4. Produce cells for growth and development 5. Divide somatic cells into new cells with identical characteristics

Answer: 1, 2, 3 1. Meiosis is a special type of cell division by which diploid cells give rise to gametes (sperm and ova). 2. The cells contain half the genetic material of the parent cellonly 23 chromosomesthe haploid number of chromosomes. 3. During meiosis new combinations of cells are provided by the newly formed chromosomes; these combinations account for the wide variation of traits.

18) What issues should the nurse consider when counseling a client on contraceptive methods? Select all that apply. 1. Cultural perspectives on menstruation and pregnancy 2. Effectiveness of the method 3. Future childbearing plans 4. Whether the client is a vegetarian 5. Age at menarche

Answer: 1, 2, 3 Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem.

31) The nurse is educating a client on intrauterine contraception (IUC). Which advantages of IUC will the nurse include? Select all that apply. 1. It is effective, continuous contraception. 2. It is relatively inexpensive over time. 3. It does not need to be inserted immediately prior to coitus. 4. Small amounts of estrogen are released daily. 5. It slightly increases the risk of ectopic pregnancy.

Answer: 1, 2, 3 Three advantages of IUC is it's high rate of effectiveness, it is inexpensive over time, it is non-coitus-related contraception.

1) A nurse is teaching contraception to a group of college students during a health class. What reason will the nurse include as to why couples might choose to use contraception? Select all that apply. 1. Couples use contraception to avoid pregnancy. 2. Couples use contraception to space future pregnancies. 3. Couples use contraception to gain control over the number of children conceived. 4. Couples use contraception to avoid decisions about the number of children to have. 5. Couples use contraception to avoid contracting sexually transmitted diseases.

Answer: 1, 2, 3, 5

19) The nurse teaching a group of new mothers and explains that barrier methods of contraception are appropriate if which of the following conditions exist? Select all that apply. 1. Just started an oral contraceptive 2. Is opposed to systemic medications 3. Is lactating 4. Is unconcerned about using contraception 5. Does not smoke and is perimenopausal

Answer: 1, 2, 3, 5

3) The culturally sensitive nurse will assess cultural attitudes and beliefs about contraception, which can include which of the following? Select all that apply. 1. Gender inequities 2. Religion 3. Deference to authority figures 4. Devaluation of large families 5. Attitudes about bleeding

Answer: 1, 2, 3, 5

31) The nurse is teaching the significance of good nutrition on fetal development to a group of young women. What factors will the nurse discuss? Select all that apply. 1. Vitamins and folic acid are important before conception. 2. Maternal nutrition may predispose to the development of adult coronary heart disease, hypertension, and diabetes. 3. Glucose, amino acids, and fatty acids are of high importance. 4. Nutrition is important only during the first trimester. 5. Maternal nutrition can affect brain and neural tube development.

Answer: 1, 2, 3, 5

3) The nurse is teaching an infertile couple about the causes of infertility. The nurse tells them that infertility can be caused by which of the following? Select all that apply. 1. Immunological responses 2. Congenital anomalies 3. Patent fallopian tubes 4. Hypothyroidism 5. Favorable cervical mucus

Answer: 1, 2, 4

35) The OB-GYN nurse knows that the proliferative phase of the menstrual cycle includes which changes? Select all that apply. 1. Thin, clear cervical mucus 2. Estrogen peaks just before ovulation 3. No ferning pattern of cervical mucus 4. A pH change to 7.5 5. Epithelium warps into folds

Answer: 1, 2, 4 1. Cervical mucus at ovulation becomes thin, clear, watery, and more alkaline, making it more favorable to spermatozoa. 2. Estrogen peaks just before ovulation in the proliferative phase of the menstrual cycle. 4. The cervical mucosa pH increases from below 7 to 7.5 at the time of ovulation.

8) What are the three functions of the fallopian tubes? Select all that apply. 1. Provide transport for the ovum from the ovary to the uterus 2. Serve as a warm, moist, nourishing environment for the ovum or zygote 3. Secrete large amounts of estrogens 4. Provide a site for fertilization to occur 5. Support and protect the pelvic contents

Answer: 1, 2, 4 The fallopian tubes provide transport for the ovum from the ovary to the uterus, serve as a warm, moist, nourishing environment for the ovum or zygote, and provide a site for fertilization to occur.

14) The nurse is talking with a couple who have been trying to get pregnant for 5 years. They are now at the fertility clinic seeking help. The nurse assesses their emotional responses as part of the workup. Which responses would the nurse expect to hear? Select all that apply. 1. Experiencing a sense of loss of status 2. Feelings of failure because they cannot make a baby 3. Healthy relationship with healthcare partners 4. Stress on the marital and sexual relationship 5. Feelings of frustration

Answer: 1, 2, 4, 5

23) The nurse is discussing the use of contraception with a client who has just become sexually active. What factors should the nurse include when educating the client on contraceptive methods? Select all that apply. 1. Contraindications in the clients health history 2. Religious or moral beliefs 3. Partners belief in the effectiveness of the choice 4. Personal preferences to use method 5. Future childbearing plans

Answer: 1, 2, 4, 5

28) The nurse is holding a class for newly pregnant couples, and discussing good and bad influences on their developing babies. Prenatal influences on the intrauterine environment include which of the following? Select all that apply. 1. The use of saunas or hot tubs 2. The use of drugs 3. The quality of the sperm or ovum 4. Maternal nutrition 5. Vitamins and folic acid

Answer: 1, 2, 4, 5

22) The nurse educator is teaching student nurses what a fetus will look like at various weeks of development. Which descriptions would be typical of a fetus at 20 weeks gestation? Select all that apply. 1. The fetus has a body weight of 435-465 g. 2. Nipples appear over the mammary glands. 3. The kidneys begin to produce urine. 4. Nails are present on fingers and toes. 5. Lanugo covers the entire body.

Answer: 1, 2, 4, 5 A fetus at 20 weeks gestation has a body weight of 435-465, has nipples appear over the mammary glands, nails are present on fingers and toes, and has lanugo that covers the entire body.

25) Ovarian hormones include which of the following? Select all that apply. 1. Estrogens 2. Progesterone 3. Parathyroid hormone 4. Luteinizing hormone 5. Testosterone

Answer: 1, 2, 5 Ovarian hormones include the estrogens, progesterone, and testosterone.

28) The nurse in the OB-GYN clinic counsels a couple that in autosomal dominant inheritance, which of the following occur? Select all that apply. 1. An affected individual might have an affected parent. 2. The affected individual has a 75% chance of passing on the abnormality. 3. Males and females are equally affected by the gene. 4. A father can pass the defective gene to a son. 5. There are no variances in the genetic pattern for autosomal dominant disorders.

Answer: 1, 3, 4

8) A nurse is teaching a group of college students at a Catholic university about natural family planning (NFP). Teaching was successful if the students say natural family planning is which of the following? Select all that apply. 1. It is free, safe, and acceptable according to our religion. 2. It includes breastfeeding for 1 year. 3. It is useful in helping us plan pregnancies. 4. It allows us to safely have intercourse during our fertile days. 5. It does not involve the use of artificial substances or devices.

Answer: 1, 3, 5

15) Student nurses in their obstetrical rotation are learning about fertilization and implantation. The process of implantation is characterized by which statements? Select all that apply. 1. The trophoblast attaches itself to the surface of the endometrium. 2. The most frequent site of attachment is the lower part of the anterior uterine wall. 3. Between days 7 and 10 after fertilization, the zona pellucida disappears, and the blastocyst implants itself by burrowing into the uterine lining. 4. The lining of the uterus thins below the implanted blastocyst. 5. The cells of the trophoblast grow down into the uterine lining, forming the chorionic villi.

Answer: 1, 3, 5 1. During implantation, the trophoblast attaches itself to the surface of the endometrium for further nourishment. 3. Between days 7 and 10 after fertilization, the zona pellucida disappears, and the blastocyst implants itself by burrowing into the uterine lining and penetrating down toward the maternal capillaries until it is completely covered. 5. The cells of the trophoblast grow down into the thickened lining, forming the chorionic villi.

35) The OB-GYN nurse teaches a first-time pregnant client that functions of the amniotic fluid include which of the following? Select all that apply. 1. Allowing fetal freedom of movement 2. Releasing heat to control fetal temperature 3. Acting as an extension of fetal extracellular space 4. Providing a water source for the fetus to swallow 5. Acting as a wedge during labor

Answer: 1, 3, 5 Amniotic fluid permits fetal freedom of movement, acts as an extension of fetal extracellular space and acts as a wedge during labor.

14) The nurse is teaching a group of adolescents that sperm must undergo the process of capacitation in order to fertilize the ova. The characteristics of sperm that have undergone capacitation include which of the following? Select all that apply. 1. Ability to undergo an acrosomal reaction 2. Ability to block polyspermy 3. Ability to bind to the zona pellucida 4. Ability to release norepinephrine 5. Acquisition of hypermotility

Answer: 1, 3, 5 Sperm that undergo capacitation take on the ability to undergo the acrosomal reaction.

26) The nurse recognizes the importance of the interaction between the nervous and endocrine systems in the female reproductive cycle. The interaction involves which of the following? Select all that apply. 1. Hypothalamus 2. Adrenal cortex 3. Ovaries 4. Thyroid 5. Anterior pituitary

Answer: 1, 3, 5 The female reproductive cycle is controlled by complex interactions between the nervous and endocrine systems and their target tissues. These interactions involve the hypothalamus.

28) A client who was raped is in the emergency department. She asks the nurse what her alternatives are for emergency contraception. The nurse tells her she can receive which of the following treatments? Select all that apply. 1. Take levonorgestrel and ethinyl estradiol. 2. Have Essure implanted. 3. Have a laparoscopic tubal ligation. 4. Take levonorgestrel alone, but in a high dose. 5. Take high doses of male hormones.

Answer: 1, 4 1. Preparations for EC include high doses of levonorgestrel and ethinyl estradiol (Yuzpe regimen). 4. Preparations for EC include high doses of levonorgestrel (Plan B).

20) The nurse is planning a group session for clients who are beginning infertility evaluation. Which statements should be included in this session? Select all that apply. 1. Infertility can be stressful for a marriage. 2. The doctor will be able to tell why you have not conceived. 3. Your insurance will pay for the infertility treatments. 4. Keep communicating with one another through this process. 5. Support organizations can be helpful to deal with the emotional issues associated with infertility.

Answer: 1, 4, 5

32) The clinic nurse assesses a newborn that is not progressing as expected. Genetic tests are ordered. The nurse explains to the parents that the laboratory tests to be done include which of the following? Select all that apply. 1. Chromosome analysis 2. Complete blood count 3. Phenylketonuria 4. Enzyme assay 5. Antibody titers

Answer: 1, 4, 5

23) Methods to increase fertility awareness include which of the following? Select all that apply. 1. Home assessment of cervical mucus 2. Pharmacologic agents 3. Therapeutic insemination 4. IVF 5. Basal body temperature (BBT) recordings

Answer: 1, 5

14) The nurse explains the functions of the male reproductive organs to a client. Which correct functions will the nurse include? Select all that apply. 1. Ejaculatory ducts move semen and seminal fluid. 2. The adrenal gland is the major source of testosterone. 3. The vas deferens ends before reaching the prostate gland. 4. Sertolis cells nourish spermatozoa. 5. The testes house seminiferous tubules.

Answer: 1, 5 1. Ejaculatory ducts provide a passageway for semen and seminal fluid into the urethra. 5. The testes house seminiferous tubules and the gonads.

27) Couples at risk for having a detectable single gene or chromosomal anomaly may wish to undergo which procedure? 1. Preimplantation genetic screening (PGS) 2. Preimplantation genetic diagnosis (PGD) 3. Intracytoplasmic sperm injection (ICSI) 4. Gamete intrafallopian transfer (GIFT)

Answer: 2 Preimplantation genetic diagnosis (PGD) is a term used when one or both genetic parents carry a gene mutation and testing is performed to determine whether that mutation or unbalanced chromosomal compliment has been passed to the oocyte or embryo.

30) The nurse teaches a client that luteinizing hormone (LH) is important in the ovarian cycle for which purposes? Select all that apply. 1. Proliferation of the endometrial mucosa 2. Ovulation 3. Corpus luteum development 4. Maturation of the ovarian follicle 5. Cyclic changes that allow pregnancy not to occur

Answer: 2, 3 2. During the follicular phase, the primordial follicle matures under the influence of FSH and LH until ovulation occurs. 3. The corpus luteum develops under the influence of LH during the luteal phase.

7) The nurse educator teaching reproductive anatomy wants to make sure the students understand what stabilizes the uterus. Which statements about the individual ligaments would the nurse include? Select all that apply. 1. The infundibulopelvic ligaments suspend and support the uterus. 2. The broad ligament keeps the uterus centrally placed. 3. The uterosacral ligaments sweep back around the rectum and insert on the sides of the first and second sacral vertebrae. 4. The ovarian ligaments anchor the ovary to the uterus. 5. The cardinal ligaments prevent uterine prolapse and support the upper vagina.

Answer: 2, 3, 4, 5

10) The OB-GYN nurse is teaching a client at the clinic that use of a spermicide has an increased effectiveness if used with which other items? Select all that apply. 1. A non-water-based lubricant 2. A diaphragm 3. A contraceptive sponge 4. Prophylactic antibiotics 5. A condom

Answer: 2, 3, 5

4) A client in the clinic asks the nurse about available contraceptives. Before responding, the nurse must assess which of the following factors? Select all that apply. 1. When menarche occurred 2. How frequently the client has intercourse 3. Whether the client has a history of thrombophlebitis 4. What the clients partner prefers 5. Whether the client is in a monogamous relationship

Answer: 2, 3, 5

5) The nurse working with pediatric clients knows that the primary hormone secretions that induce puberty include which of the following? Select all that apply. 1. Thyroid hormone 2. Follicle-stimulating hormone 3. Leuteinizing hormone 4. Adrenocorticotropic hormone 5. Gonadotropin-releasing hormones

Answer: 2, 3, 5

18) Under the influence of progesterone, which of the following occur? Select all that apply. 1. Temperature decreases 2. Cervix secretes thick, viscous mucus 3. Breasts prepare for lactation 4. Breast glandular tissue decreases in size 5. Vaginal epithelium proliferates

Answer: 2, 3, 5 2. Under the influence of progesterone, the cervix secretes thick, viscous mucus. 3. Under the influence of progesterone, breasts prepare for lactation. 5. Under the influence of progesterone, vaginal epithelium proliferates.

27) A pregnant client at 28 weeks gestation asks the nurse what her baby is like at this stage of pregnancy. How would the nurse describe the fetus? Select all that apply. 1. The fetus is developing subcutaneous fat. 2. The fetus is now opening and closing her eyes. 3. The baby could now breathe on her own, if she were born. 4. The fetus has fingernails and toenails. 5. The fetus is forming surfactant needed for lung function.

Answer: 2, 3, 5 At 28 weeks, the eyes begin to open and close. the delivered baby can breathe. the fetus has the surfactant formed needed for breathing.

25) A couple is at the clinic for preconceptual counseling. Both parents are 40 years old. The nurse knows that the education session has been successful when the wife makes which statement? Select all that apply. 1. We are at low risk for having a baby with Down syndrome. 2. Our children are more likely to have genetic defects. 3. Children born to parents this age have sex-linked disorders. 4. The tests for genetic defects can be done early in pregnancy. 5. It will be almost impossible for us to conceive a child.

Answer: 2, 4

16) A male client visits the infertility clinic for the results of his comprehensive exam. The exam indicated oligospermia. The client asks the nurse which procedure would assist him and his wife to conceive. The nurses best response would include which of the following? Select all that apply. 1. You might want to consider adoption. 2. An option you might consider is in vitro fertilization. 3. Surrogacy might be your best option. 4. Many couples utilize therapeutic husband insemination. 5. The GIFT procedure has had much success.

Answer: 2, 4 2. An option you might consider is in vitro fertilization. 4. Many couples utilize therapeutic husband insemination.

10) What are the three functions of cervical mucosa? Select all that apply. 1. Form the relatively fixed axis of the birth passage 2. Provide lubrication for the vaginal canal 3. Provide nourishment and protective maternal antibodies to infants 4. Provide an alkaline environment to shelter deposited sperm from the acidic vaginal secretions 5. Act as a bacteriostatic agent

Answer: 2, 4, 5 The cervical mucosa provides lubrication for the vaginal canal, provides an alkaline environment to shelter deposited sperm from the acidic vaginal secretions, and acts as a bacteriostatic agent.

22) The nurse in the community clinic instructs a client starting on a combined oral contraceptive that she must immediately report which of the following symptoms? Select all that apply. 1. Only four withdrawal bleeds per year 2. Speech problems 3. Unscheduled bleeding 4. Blood pressure of 126/84 5. New lumps in her breast

Answer: 2, 5 2. The woman using combined oral contraceptives should contact her healthcare provider if she develops speech problems. 5. The woman using combined oral contraceptives should contact her healthcare provider if she develops a breast lump.

22) A nurse working with couples undergoing genetic testing recognizes which of the following as nursing responsibilities? Select all that apply. 1. Allowing the family to interact with the genetic counselor without interference 2. Giving information about support groups when asked 3. Identifying families at risk for genetic problems 4. Aiding families in coping with the crisis 5. Ensuring continuity of nursing care to the family

Answer: 3, 4, 5

31) The OB-GYN nurse is assessing a pregnant client, and recognizes genetic amniocentesis will be indicated. The nurse makes this conclusion because the indications for genetic amniocentesis include which of the following? Select all that apply. 1. Maternal age under 35 2. Fetus with no abnormalities on ultrasound 3. One child with a chromosome abnormality 4. A family history of neural tube defects 5. Both parents with an abnormal chromosome

Answer: 3, 4, 5

35) Which couples may benefit from prenatal diagnosis? Select all that apply. 1. Couples including women under the age of 35 2. Couples with an unbalanced translocation 3. Couples with a family history of known or suspected single-gene disorder 4. Couples including women with a teratogenic risk secondary to an exposure or maternal health condition 5. Family history of birth defects and/or intellectual disability

Answer: 3, 4, 5

1) The nurse is explaining the difference between meiosis and mitosis. Which statements would be best? Select all that apply. 1. Meiosis is the division of a cell into two exact copies of the original cell. 2. Mitosis is splitting one cell into two, each with half the chromosomes of the original cell. 3. Meiosis is a type of cell division by which gametes, or the sperm and ova, reproduce. 4. Mitosis occurs in only a few cells of the body. 5. Meiotic division leads to cells that halve the original genetic material.

Answer: 3, 5 3. Meiosis is a special type of cell division by which diploid cells give rise to gametes (sperm and ova). 5. Meiosis creates two cells that contain half the genetic material of the parent cell.