Chapter 52: Introduction to the Reproductive System

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

Facilitate appropriate resources and referrals.

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

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

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

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

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

2 to 6 mL; 60 to 100 million

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

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

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

Asking the client's permission to discuss sexuality

A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The client's need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply.

Breast cancer Cardiovascular disease Venous thromboembolism

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

Cone biopsy (conization)

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

Dilation and curettage

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

Ectopic pregnancy

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

Ensuring that the client has a full bladder

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

History of vascular thrombosis

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

Hormonal disturbances

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

Human chorionic gonadotropin (hCG) testing

The examiner is preparing to perform a pelvic examination. Which of the following would be done first?

Inspection of the external genitalia

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

Lack of ovulation

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

Malignant

After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first:

Menstrual period

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

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

What are the effects of hormones on breast tissue during pregnancy?

Prolactin promotes the production of milk; progesterone stimulates the development of alveoli, which secrete the milk; and estrogen stimulates increased production of tubules and ducts to transport milk to the lactiferous ducts, which drain at the nipple.

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

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

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

Retention of urine

A 55-year-old client has hypertension. She admits to her physician that she stopped taking her regular medications about 3 months ago and started an alternative, new-age therapy. When the client asks about herbal remedies to treat her hot flashes, which natural estrogen is the physician likely to recommend?

Soy milk

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

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

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

The client may have a Candida species infection.

A new client has come to the clinic seeking an appropriate method of birth control. What would the nurse teach this client about a diaphragm?

The diaphragm may be cleaned with soap and water after use.

Nursing students are reviewing information about the various structures of the female reproductive system. The students demonstrate understanding of the material when they identify which of the following about the uterus? Select all that apply.

The uterus is a pear-shaped muscular organ. Ligaments hold the uterus in place. The fundus and cervix comprise the uterus.

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

Trichomonas

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

Vitamin supplements

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

Water-based lubricant

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

age of first ejaculate

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

cervix

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

digital rectal examination

Reproductive systems form during:

embryonic development.

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

estrogen

Which structure is referred to as the vulva?

external female genitalia

Which external reproductive structure is removed by circumcision?

prepuce corpora cavernosa glans

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

scrotum

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

Hysterosalpingography

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

Secondary dysmenorrhea

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

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

An older female client reports pain during intercourse, disrupting the intimacy that she and her husband are accustomed to sharing. What might be the cause of her pain?

atrophy of Bartholin glands

The nurse is discussing nutritional needs for a postmenopausal patient. What dietary increase should the nurse recommend to the patient?

Calcium