Chapter 44

The nurse is teaching a group of teenage girls about the menstrual cycle, noting that which changes occur during their cycle? Select all that apply.

-Two peaks of estrogen occur during the cycle. -Menstruation occurs with a drop in both progesterone and estrogen. -Ovulation usually occurs around day 14 of the cycle.

A postmenopausal woman mentions experiencing stress incontinence. Which assessments should the nurse perform for this client related to stress incontinence? Select all that apply.

-Urinary tract infection -Vaginitis -Nocturia

The nurse assessing for signs and symptoms of perimenopause in a woman should assess for:

Menstrual irregularity

The Women's Health Initiative results have led the Institute of Medicine (2010) to recommend which guidelines related to hip fractures?

All adults should take 600 IU/day of vitamin D to maintain healthy bones.

Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of:

Crystallization of inorganic salts

Which hormone replacement therapy was traditionally prescribed for a postmenopausal woman diagnosed with an intact uterus?

Estrogen and progesterone therapy

A pregnant client who is taking risperidone, an antipsychotic prescribed for bipolar disorder, is at high risk for developing which hormonal adverse effects?

Excess prolactin secretion.

A nurse is describing the menstrual cycle to a client and is explaining the changes that occur each month. During a normal menstrual cycle, which layer is sloughed off?

Functional layer

A nurse educator is describing the changes in cervical mucus as they related to changes in hormone levels. Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of which hormonal change?

High estrogen levels.

The nurse is caring for a male adolescent who is taking a medication which inhibits dopamine release. What side effect should the nurse inform the client about?

Hyperprolactinemia could contribute to gynecomastia.

The nurse knows that when continuous estrogen-progesterone therapy (CCEPT) is prescribed, the drug is considered effective if which menstrual outcome occurs?

Inhibited endometrial development, resulting in no menses.

The nurse is completing client education on the use of a combination oral contraceptive pill (OCP) to a woman with polycystic ovary syndrome (PCOS). The nurse should include which content in the educational packet?

It contains estrogen and progesterone.

A 12-year-old girl is experiencing an increase in her FSH and LH levels. This rise in hormone levels will have which effect on her reproductive system?

Maturation of her follicles

While explaining milk production and release to a group of expectant parents, the nurse educates the parents that suckling sends feedback to the hypothalamus, which stimulates the release of which hormone responsible for ejection of milk into the ductal system?

Oxytocin

The nurse is caring for a 52-year-old female client who is experiencing hot flashes and night sweats. The nurse anticipates which nonpharmaceutical substance may be prescribed to alleviate these symptoms?

Soy

The nurse is performing urinary catheterization on a 13-year-old girl and notices the girl's hymen is intact. What is the most accurate way to document this finding?

The client exhibits normal findings.

The nurse is discussing changes in the menstrual cycle associated with aging with a 48-eight-year-old female client. The nurse explains that as women age, which bodily effect will occur?

The menstrual cycle shortens.

The nurse is an assessing a female client who suspects she is in menopause. A vaginal pH of 5.6 is obtained. What does this pH indicate for the client?

The pH indicates that the client is deficient in estrogen.

An obstetric nurse is describing the process of follicle development to a recent nurse graduate. Which phenomenon should the nurse describe?

The ripening follicle is accompanied by an increase in estrogen levels.

Which situation would be considered pathological in an otherwise healthy 30-year-old woman?

The woman's ovaries are not producing progesterone.

A woman consults her physician about a study (Women's Health Initiative) discussing an increased risk for breast cancer if taking hormones. The physician can allay her fears by sharing which findings?

This 26% increased risk for developing invasive breast cancer occurred in women taking combined continuous estrogen and progesterone therapy.

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) produce profound effects on the ovaries. What do high levels of estrogen do to FSH and LH?

decrease LH and increase FSH

An adolescent client arrives with her parent reporting all the manifestations of menstruation-like cramping and bloating, however no menstrual flow. Upon examination, the provider states the hymen is intact and rigid. Which procedure will likely be performed to alleviate this problem?

surgical intervention to remove the hymen

Which benefits are found from the secretions of the columnar epithelium of the endocervix? Select all that apply.

-Protect the uterus from infection -Alter receptivity to sperm -Form a mucous plug during pregnancy

Specific actions of estrogen include which actions on the body? Select all that apply.

-Stimulate development of vagina, uterus, and fallopian tubes -Promote growth of ovarian follicles

A 51 year-old woman who has been receiving estrogen therapy (ET) for the last 5 years has visited her care provider because her peers have told her about the risks of heart disease, stroke, and breast cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns?

"ET demonstrated no increased risk of heart disease when compared with HT, but there was similar increased risk for stroke."

A 13 year-old female is undergoing rapid development of her breasts after experiencing menarche several months ago. Which hormones are active in the development of her breasts? Select all that apply.

-Prolactin -Luteinizing hormone -Estrogen -Follicle-stimulating hormone -Progesterone

After hearing daunting reports from her slightly older coworkers and friends, a 44 year-old woman has a number of questions for her physician about what to expect during perimenopause and why. Which teaching point is most accurate?

"Hot flashes are a reality for most women in menopause, and the exact cause of them isn't known yet."

The nurse is discussing menstruation with a group of teenaged girls. One girl asks, "Do I ovulate every month that I have a period?" Which response by the nurse is most accurate?

"It is not necessary for a woman to ovulate to menstruate."

A 50-year-old woman experiencing hot flashes and other menopausal symptoms asks the nurse about the benefits of the traditional Chinese use of dong quai. What is the nurse's best response?

"More research is needed on herbal remedies. Neither safety nor efficacy is guaranteed."

During an annual examination, the health care provider tells the client that the vaginal epithelial cells have shifted to the left. The client asks, "What does that mean?" Which response by the nurse is most accurate?

"With decreased estrogen levels, your secretions are primarily made up of immature cells."

A client experiencing infertility problems has learned that the prolactin levels are elevated. The client asks, "What does that mean in terms of us getting pregnant?" Which response is most accurate?

"Your sex glands will produce little or no sex hormones."

A client is beginning menopause and asks, "What do you mean by vasomotor instability now that my estrogen levels are decreasing?" Which manifestation(s) will the nurse share with this client related to this instability? Select all that apply.

-"hot flashes" -headaches -dizziness

The nurse is administering a phenothiazine derivative with the understanding that this medication puts the client at risk for hyperprolactinemia, which may produce which manifestations? Select all that apply.

-Anovulation -Amenorrhea -Oligomenorrhea

What changes in the breasts would the nurse assessing a 12-year-old girl expect to find, indicating the onset of puberty? Select all that apply.

-Areola and nipples become darker -Nipples are more prominent

The nurse is discussing hormonal replacement therapy (HRT) with a postmenopausal woman. The nurse points out that concerns relating to their use include increased risk for which disease processes? Select all that apply.

-Atherosclerosis -Breast cancer

The nurse is planning a staff education program on current recommendations for hormone replacement therapy (HT) during menopause. Which content should the nurse include in the educational program? Select all that apply.

-Avoid HT for secondary prevention of coronary heart disease -Consider alternative therapy for asymptomatic women -Limit HT to the shortest duration possible

An older adult female client had an oophorectomy before menopause. Which current symptoms could result from early loss of estrogen? Select all that apply.

-Cognitive decline -Hyperlipidemia

Which metabolic effects are caused by the action of estrogen? Select all that apply.

-Decreased bone resorption -Increased production of thyroid globulins

A clinician in a fertility clinic is describing the role of the fallopian tubes in response to a question from the client. Which physiologic processes should be explained to the client about the role of the fallopian tubes? Select all that apply.

-Facilitating drainage of secretions into the uterus -Providing a passageway for ova -Acting as a passage for sperm after coitus

What clinical manifestations would the nurse caring for a female client taking a gonadotropic hormone (GnRH) inhibitor expect the client to exhibit? Select all that apply

-Hot flashes -Absent menstrual cycle

Progesterone maintains pregnancy but also has which local effects on the body? Select all that apply.

-Increase in basal body temperature -Increase in secretion of aldosterone by the adrenal cortex -Relaxation of smooth muscle

A new mother asks the nurse what she can do to prevent her breasts from drooping. What should the nurse recommend? Select all that apply.

-Maintain good posture -Use bras that provide good support

Menopause signals the end of the menstrual cycle. It is caused by the end of ovarian function and the decreased levels of estrogen this brings to the body. What problems can arise from the onset of menopause? Select all that apply.

-Nocturia -Urinary stress incontinence -Vaginitis

The nurse is caring for a client who has inflammation of the vagina. The nurse is aware that which bodily disturbance may change the vaginal ecology? Select all that apply.

-Oral contraceptive use -Diabetes -Systemic antibiotic use

Long-term effects of estrogen deprivation include which of the following? Select all that apply.

-Osteoporosis -Increased risk for cardiovascular disease -Bone resorption at a faster rate than bone formation

The nurse is teaching a class to adolescent girls about puberty. Which health information is accurate for inclusion in the class? Select all that apply.

-Ovaries produce hormones that cause growth of reproductive organs. -Estrogen stimulates bone growth and closure of growth plates. -Ovulation usually occurs in the middle of the monthly cycle.

During rounds at an infertility clinic, the provider suspects a new client has anovulation caused by polycystic ovarian syndrome (PCOS) based on which finding(s)? Select all that apply.

-able to palpate many "lumps" in uterus during examination -testosterone levels are elevated -noticeable acne and male-pattern hair growth -cannot remember date of last menstrual period

A perimenopausal client is discussing the role estrogen plays in the body. Which function(s) would be considered extragenital metabolic effects that the nurse will share with this client? Select all that apply.

-anti-atherosclerotic effects on the arterial wall -decrease the rate of bone resorption -production of an increase in high-density lipoproteins -increase memory by enhancing presynaptic signal transmission

The nurse is discussing prenatal care with a female who is pregnant with her first child. The mother would like to know what milestones the fetus will have in utero. The nurse explains that if it is a girl, the ovaries will have fully developed and descended at what point?

3 months

The nurse is counseling a group of perimenopausal and postmenopausal women about the pros and cons of hormone therapy (HT). Which member of the group should the nurse identify as likely to benefit most from HT while incurring the least risk?

A 49-year-old who is experiencing many menopausal symptoms