Chapter 3: Structure and Function of the Reproductive System
A nurse is providing education to a client with infertility concerns. Which statement by the client indicates appropriate understanding of the Spinnbarkeit Test? "I will need to purchase a microscope and look for a fern-like pattern from a sample of my cervical mucus to indicate when I am ovulating." "I will need to purchase an over-the-counter ovulation kit that will tell me when I am currently ovulating." "Halfway in my cycle I will need to check my cervical mucus to see if I can stretch it into long strands, indicating I am close to ovulating. "At midpoint in my menstrual cycle, I need to come to the clinic for a cervical exam looking for color changes to my cervical mucus."
"At midpoint in my menstrual cycle, I need to come to the clinic for a cervical exam looking for color changes to my cervical mucus."
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? "The damage to your clitoris could cause you to experience incontinence in the future." "Damage to your clitoris may lead to decreased stimulation in future sexual experiences." "The clitoris functions to provide cushioning during intercourse. You might now have increased pain." "There is a chance you will experience increased vaginal discharge due to the injury experienced."
"Damage to your clitoris may lead to decreased stimulation in future sexual experiences."
A woman tells you that both she and her husband like to continue sexual relations during her menstrual period. They have a monogamous relationship. She asks you if this will harm her. Which of the following would be the best response? "Avoid sexual relations because orgasm may be painful for during your menses." "The risk of infection is too great for sexual relations during this time." "You will not be able to achieve orgasm during your menses." "If this is satisfying for you and your partner, then there is no harm in it."
"If this is satisfying for you and your partner, then there is no harm in it."
A 12-year-old girl expresses concern to the nurse because she has not begun her period yet. The nurse notes that the girl has grown 6 in (15 cm) in the past year and a half and is beginning to develop breast buds. Which response by the nurse is appropriate? "It is normal for females to begin menstruating between the ages of 12 and 15." "It is difficult to say when you will get your period, but you should not be concerned at this time." "The average age to begin your period is 12. I will notify the health care provider." "You sound concerned about not having your period. Is there a bigger issue bothering you?"
"It is normal for females to begin menstruating between the ages of 12 and 15."
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? "I will always count from the end of my last menstrual cycle to determine when I will ovulate." "A vaginal discharge that is thick and white in color indicates that I am ovulating." "My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal." "During ovulation, the egg is released directly into my uterus to help with fertilization."
"My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal."
The caregiver of a 10-year-old male client tells the nurse, "He is already showing signs of puberty. He has facial hair and his voice has changed. I want to have his hormone levels tested." Which response by the nurse is appropriate? "I agree. His testosterone levels are probably elevated." "Do you know if his father experienced similar changes early in childhood?" "I will let the health care provider know you are concerned." "This is normal for his age. Puberty can begin as early as 8 years of age."
"This is normal for his age. Puberty can begin as early as 8 years of age." While the average age for puberty to begin in males is 12 years of age, it can occur anytime between the ages of 8 and 14. When the primary androgenic hormone testosterone rises, it influences the following: pubertal changes in the testes, scrotum, penis, prostate, and seminal vesicles; the appearance of male pubic, axillary, and facial hair; laryngeal enlargement with its accompanying voice change; maturation of spermatozoa; and closure of growth plates in long bones (termed adrenarche). Stating the client's hormone levels should be tested is inaccurate and unnecessary as this is an expected developmental change. Determining if the client's father had the same experience or only notifying the primary health care provider does not address the caregiver's concerns.
The nurse is caring for a premenopausal client scheduled for a bilateral oophorectomy. Which education will the nurse provide the client regarding this procedure? "You will need to continue using a contraceptive if you do not desire pregnancy." "You will need to have your hormone level tested monthly for 6 months following surgery." "An oophorectomy will prevent you from having breast cancer in the future." "This procedure will greatly reduce your estrogen and progesterone levels."
"This procedure will greatly reduce your estrogen and progesterone levels."
The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education? "I will ovulate every month on Day 21 of my cycle." "My menstrual cycles are controlled by progesterone production." "When I ovulate, there is a follicle on my uterus that forms showing that an ova was released." "Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)."
"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)."
During a prenatal visit, a pregnant woman tells the nurse, "I have had to buy some new bras because my breasts are getting bigger. I know this is supposed to happen, but what is going on in my body?" Which response by the nurse would be appropriate? "Your breasts are growing because fatty tissue is replacing the gland tissue." "Your hormones are causing the glands in your breasts to grow." "Breast milk is being made already so it will be ready for your newborn." "All the good things in breast milk are collecting in your breasts."
"Your hormones are causing the glands in our breasts to grow."
A nurse is discussing menstruation with a female client. The nurse describes a normal amount of blood loss is approximately: 5 to 20 mL. 10 to 80 mL. 75 to 100 mL. 120 to 150 mL.
10 to 8o mL
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? 17th 31st 10th 22nd
22nd To calculate expected ovulation, the nurse should explain to the client to subtract 14 days from the expected start date of the next menstrual cycle.
A sex education class is being conducted at a local women's center. The attendees ask the nursing instructor about why they experience sensations of increased warmth during sex and redness of the neck and chest. Which information would the nurse provide to explain this experience? Select all that apply. A person's heart rate increases during sex, making them warmer. The blood pressure will increase, which can cause a feeling of warmth. The color change is coincidental and not a part of the sexual response. Vessels in the pelvis are receiving more blood and can cause a warm sensation. Respirations will decrease during sex, which allows the body to warm up faster.
A person's heart rate increases during sex, making them warmer. The blood pressure will increase, which can cause a feeling of warmth. Vessels in the pelvis are receiving more blood and can cause a warm sensation.
A client is at the clinic for her annual pelvic exam and asks the nurse about ovulation and where the eggs come from. What educational information would the nurse share with this client? Ova or eggs are made every month in the ovaries and released for fertilization. The ova begin being produced when the female begins her menstrual cycles. A woman is born with all the ova that she will ever have and they are stored within the ovaries. Ova begin developing around age 9 to 10 in preparation of puberty to begin.
A woman is born with all the ova that she will ever have and they are stored within the ovaries
The vagina is a hostile environment for sperm. What characteristic of semen protects sperm from the vaginal environment? acidic fluid alkaline fluid presence of testosterone secretions from seminiferous tubules
Alkaline fluid (sperm are maintained in an alkaline environment to protect them from the acidic environment of the vagina).
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? It consists of protoplasm enclosed within a three-layered cell wall. It contains a small nucleus, within which is a nucleolus called the germinal spot. All the ova a female will ever have are present at birth. The ovum is smaller than the sperm cell.
All the ova a female will ever have are present at birth
The nurse is examining a pregnant female in her third trimester and measuring to determine if fetal growth has increased. Where would the nurse place the measuring tape? Just below the pubis symphysis At the uterine isthmus At the level of the corpus At the top of the fundus
At the top of the fundus The uterine fundus is located that the uppermost portion of the uterus; that is where the uterus is measured to determine fetal size and gestation. The isthmus is the uterine segment that connects the cervix to the uterus. The corpus, the main body of the uterus, is not the top of the uterus. One end of the measuring tape is placed at the top of the pubic symphysis and extended to the top of the fundus.
A nurse is conducting an orientation at a health clinic for newly hired nurses comparing normal and abnormal findings from a female physical assessment. The nurse determines the session is successful when they correctly point out which structure's secretions assist with sexual intercourse? introitus Bartholin glands vestibule labia minora
Bartholin glands The Bartholin glands are located in the vestibule and secrete a mucus that moistens the vaginal mucosa during sexual intercourse.
The nurse is educating a pregnant woman regarding expectations immediately after the birth of her baby. What information would the nurse include in the teaching plan regarding colostrum? Colostrum is yellow fluid that precedes breast milk and is healthy for the baby. Colostrum is a hormone that promotes breast milk production when the baby is born. Colostrum is a thick, waxy substance covering the baby that helps to protect the skin. Colostrum is the breast milk that comes in after the initial yellow fluid, usually about day 3.
Colostrum is yellow fluid that precedes breast milk and is healthy for the baby. Colostrum is the yellow fluid from the breast that is a precursor to breast milk. It is high in protein and antibodies and is healthy for the baby. The colostrum will last about 1 to 3 days. Vernix is the waxy covering of the baby at birth. Prolactin is the hormone that promotes breast milk production.
The nurse is caring for a client who has a retroverted uterus. The nurse would explain that this means her: uterus is bent sharply backward at the cervix. cervix is located behind the Douglas cul-de-sac. entire uterus is tipped backward. uterus is anterior to the bladder.
Entire uterus is tipped backward Retroverted means to tip backward; retroversion means to bend backward.
The seminiferous tubules are tiny coils of tissue where spermatogenesis occurs. Where do the sperm mature? vas deferens prostate seminal vesicles epididymis
Epididymis
In the resolution phase of sexual response, which response would be most commonly noted in the male? Testes are elevated against the perineum Scrotal sac thickens Erection is lost Rectal muscles contract
Erection is lost During the resolution phase, which is the final phase of the sexual response cycle, the male will lose his erection, his scrotal sac will thin back out and the testes will descend back down. Rectal contractions occur during the orgasm.
A 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 progesterone androgens follicle-stimulating hormone
Estrogen Estrogens are responsible for developing and maintaining the female reproductive organs.
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? Uterine isthmus Fallopian tube Uterine corpus Ovarian surface
Fallopian tube The ova mature and are released from the ovary. It then is attracted into the fallopian tube by the fimbriae where the sperm fertilizes it, usually in the ampulla portion of the tube.
The nurse is 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 Luteinizing hormone Estrogen Progesterone
Follicle-stimulating hormone The follicle-stimulating hormone (FSH) is the messenger from the pituitary gland to stimulate the ovum to mature.
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 proliferative phase secretory phase ischemic phase
Follicular phase
An experienced nurse is working with a new graduate on the postpartum unit. Which comment by the new graduate about a client would require the nurse to intervene? I have ordered a kosher diet for the Jewish client, since that is usually what they prefer. The Pakistani client has requested no male caretakers so I reassigned the male student to another client. The Hispanic client has many family members, which I have allowed to visit during the day. The Vietnamese client has requested only hot foods, so I contacted dietary to make note of this request. I have given the young high school client information about resources in the community such as WIC (Women, Infants and Children).
I have ordered a kosher diet for the Jewish client, since that is usually what they prefer Assuming that a Jewish client would want a kosher diet is incorrect, as the nurse should verify with the client the preferred dietary choices.
The nursing instructor is illustrating the various phases of the uterine cycle to a group of nursing students. The instructor determines the session is successful when the students correctly choose which action occurring during the secretory phase? While the ovarian follicles are producing increased amounts of estrogen, the endometrium begins to slough off If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. An ovum matures.
If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall.
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: between where you pee and where you poop. in what is called the vestibule, which is located between the labia minora. by the Bartholin glands. between the labia majora and by the paraurethral glands.
In what is called the vestibule, which is located between the labia minora The vestibule is the area between the labia minora. The urethral meatus (opening to the urethra), paraurethral (Skene) glands, vaginal opening or introitus, and Bartholin glands are located within the vestibule.
What changes does the cervix undergo in preparation for childbirth? Select all that apply. It becomes thicker. It produces mucus to lubricate the vaginal canal. It protects the uterus from infection. It has contractions to help expel the infant. It opens up to allow passage of the infant.
It produces mucus to lubricate the vaginal canal. It protects the uterus from infection. It opens up to allow passage of the infant.
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 produces female gametes or ova and secretes female sex hormones. It receives the fertilized ovum and provides housing and nourishment for a fetus. It receives sperm, provides an exit for menstrual flow, and serves as the birth canal. It is a small erectile structure that responds to sexual stimulation.
It receives the fertilized ovum and provides housing and nourishment for a fetus. The uterus's functions are to receive the fertilized ovum and provide housing and nourishment for a fetus. The ovaries' functions are to produce female gametes or ova and secrete female sex hormones. The vagina's functions are to receive sperm, provide an exit for menstrual flow, and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.
A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin? May 24 May 26 May 30 June 1
May 24th For a woman with a 28-day cycle, ovulation typically occurs on day 14. Therefore, her next menses would begin 14 days later, on May 24.
As part of a high school health class, a nurse is teaching the group of students about the male and female reproductive systems. The nurse determines that the teaching was successful when the group states that the prostate gland produces which substance? sperm testosterone nourishment for sperm mucus for lubrication
Nourishment for sperm The prostate and the seminal vesicles above it produce fluid that nourishes the sperm. The testes produce sperm and testosterone. The Cowper's glands secrete a mucus-like fluid that is released during sexual stimulation and lubricates the head of the penis in preparation for sexual intercourse.
With sexual stimulation the penis becomes erect. What is the physiologic cause of an erection? Penile sinuses fill up with blood. The fascia becomes firm. Veins in the shaft of the penis vasoconstrict. The corpus cavernous vasodilates.
Penile sinuses fill up with blood.
The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? sperm emission penile vasodilation psychological release ejaculation
Penile vasodilation With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm. Orgasm results in a pleasurable feeling of physiologic and psychological release. Ejaculation results in the discharge of semen from the urethra.
Which body structure controls reproductive hormone production and function for both males and females? Hypothalamus Adrenal glands Pancreas Pituitary gland
Pituitary gland
What is the intended purpose of the alkaline environment of prostatic fluids found in ejaculation? Select all that apply. Enhancement of sperm longevity Protection of sperm Nourishment of sperm Reducing prostatic infections Increasing fertility of the female
Protection of sperm Nourishment of sperm
The nurse is caring for a 16-year-old female client. The client states, "I recently had sex for the first time and I had some bleeding afterward. It was not time for my period. Could something bad have happened?" Which action will the nurse complete next? Provide education to the client on sexual intercourse. Determine if the client is pregnant. Test the client for sexually transmitted infections. Ask the health care provider to prescribe an oral contraceptive.
Provide education to the client on sexual intercourse.
The OB nursing instructor is talking with students about the sexual response cycle. As they are studying the content, they become aware that there are four phases in the sexual response cycle and identify them as which of the following? Select all that apply. Resolution Refraction Excitement Climax Plateau
Resolution Excitement Climax Plateau
A nurse is developing a plan of care for a 7-year-old client with precocious puberty. Which would be the priority nursing diagnosis for this client? Risk for high-risk sexual behaviors related to early development of secondary sex characteristics. Risk for disturbance in body image related to early development of secondary sex characteristics. Risk for back pain related to early breast tissue development. Risk for anxiety related to bullying activities from development of secondary sex characteristics.
Risk for disturbance in body image related to early development of secondary sex characteristics.
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. It is recommended to check her mucus and have intercourse when the mucus is opaque and scant. If she has irregular menstrual cycles, that should not interfere with her conceiving as long as she has intercourse on the same days every month. If ovulation occurs on Day 14 of her menstrual cycle, she should have intercourse one week later on Day 21.
Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle.
A client is at the clinic for her yearly physical and is found to be anemic. What information from her history would most likely be a contributory factor to this finding? She eats chicken and spinach salads three times a week. She has been on a weight loss plan, counting calories. She reports that her menstrual cycle is irregular and often lasts 7 to 10 days. She exercises 1 hour every day at the gym.
She reports that her menstrual cycle is irregular and often lasts 7 to 10 days. Prolonged menstrual cycles can cause anemia and iron deficiency due to the blood loss. The other factors will not make the client anemic.
An adult client currently has low levels of estrogen and progesterone. At this point in the menstrual cycle, the client will likely: shed her uterine lining. ovulate. become pregnant. experience endometrial regeneration.
Shed her uterine lining.
Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the sex hormones produced? Cowper glands Testes Seminal vesicles Bulbourethral glands
Testes The testes serve two important functions: production of androgens (male sex hormones) and formation and maturation of spermatozoa.
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 Cervical mucus is absent The client menstruated eight days ago The client's progesterone levels are peaking
The client has clear, thin cervical mucus
A young male client asks the nurse about circumcision, since he was never circumcised as an infant. Which rationale would be appropriate for exploring circumcision in an adult male? The client is experiencing premature ejaculation. The client has experienced recurring infections of the glans. The foreskin appears to cover the glans of the penis. His scrotum appears uneven with one testicle higher than the other.
The client has experienced recurring infections of the glans.
The nurse is caring for a couple trying to conceive their first child. The couple state they have been attempting to become pregnant for the past year. Which finding in the couple's history most concerns the nurse? The male client drinks 4 to 5 beers per week. The female client's mother had breast cancer. The male client's sister experienced infertility. The female client has a history of pelvic inflammatory disease (PID).
The female client has a history of pelvic inflammatory disease (PID) The nurse would be most concerned learning the female client has a history of PID, because this can cause scarring and lead to subfertility.
Which of the following occurs in the male during the resolution phase of the sexual response cycle? The penis becomes erect due to increased pelvic congestion of blood. Involuntary spasmodic contractions occur in the penis. The male orgasm occurs usually with ejaculation of semen from the penis. The male experiences a period during which he is incapable of sexual response.
The male experiences a period during which he is incapable of sexual response.
The school nurse is teaching a health education class on the male reproductive system. The nurse determines the class is successful when the students correctly point out which structure produces sperm? testes seminal vesicles scrotum prostate gland
The testes The testes are responsible for sperm production. The seminal vesicles produce nutrient seminal fluid. The scrotum surrounds and protects the testes. The prostate gland and the seminal vesicles produce fluid to nourish the sperm.
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: her uterus fills up with blood each month and is passed during the menstrual cycle. the uterine lining is being shed due to lowering of hormone levels. her hormones cause her to accumulate blood in the uterus from ovulation. each month, her uterine lining thins out and vessels close to the surface begin to fill with blood.
The uterine lining is being shed due to lowering of hormone levels. During the menstrual phase of the cycle, the endometrium, or lining of the uterus, is shed because of low estrogen and progesterone levels.
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. They receive the fertilized ovum and provide housing and nourishment for a fetus. They receive sperm, provide an exit for menstrual flow, and serve as the birth canal. They are a small erectile structure that responds to sexual stimulation.
They produce female gametes or ova and secrete female sex hormones. The ovaries' functions are to produce female gametes or ova and secrete female sex hormones. The uterus's functions are to receive the fertilized ovum and provide housing and nourishment for a fetus. The vagina's functions are to receive sperm, provide an exit for menstrual flow, and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.
The nurse is explaining about the function of the mons pubis to a client. Which explanation describes the function of the mons pubis? To enhance sexual pleasure To serve as the receptacle for sperm To allow for stretching during birth To protect the pelvic bones during sexual intercourse
To protect the pelvic bones during sexual intercourse The mons pubis is a fatty pad that lies over the pubic symphysis and serves to protect the pelvic bones during intercourse. The vagina is the receptacle for sperm, the clitoris is the body that enhances sexual pleasure in the female, and the perineum and pelvic floor are the structures that stretch during birth.
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. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. An ovum matures and is released.
While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth.
A nurse is preparing a class for a group of high school adolescents on the topic of the male reproductive system. Which structure will the nurse point out has the function of "climate control system"? prepuce epididymis vas deferens cremaster muscles
cremaster muscles
A nurse is preparing a presentation for a group of young adults about the sexual response cycle. Place the events in the sequence that they would occur. Use all options. excitement desire plateau orgasm resolution
desire excitement plateau orgasm resolution
A 47-year-old woman is being seen at the local clinic reporting irregular menstrual cycles. The nurse would explain to the client that the irregularity is most likely due to: pregnancy. menopause. hormonal fluctuations. an underlying endocrine problem.
menopause As a woman's reproductive capabilities end, her menstrual cycles will become irregular and finally cease. The average age for menopause is 47 to 55 years. This client meets these criteria. Pregnancy would cause absence of menstrual cycles. Hormonal fluctuations and underlying endocrine problems would not be the anticipated causality.
There are two major functions of the reproductive system, continuation of the species and sexual pleasure. In the male, the reproductive system has a third function. What is this third function? urinary elimination elimination of solid wastes production of sex hormones stimulation of sexual maturation
urinary elimination
The nurse is answering questions of a young pregnant woman concerning the birthing process. Which structure is able to dilate during labor and birth because it contains rugae? cervix uterus vagina vulva
vagina
The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would the nurse include as a major structure to help ensure fertilization of the ovum? seminal vesicles prostate gland Cowper glands vas deferens
vas deferens
A nurse is discussing sexual intercourse during pregnancy with a client. Which statement by the client would indicate that learning has occurred? "If I have an orgasm, I might go into labor." "My belly will get in the way, so we will not be able to have intercourse." "The placenta might get a tear if I engaged in intercourse during the third trimester." "As long as the baby and I both continue to do well, I can have intercourse."
"As long as the baby and I both continue to do well, I can have intercourse."
