NU271 Week 9 PrepU: Reproduction
A student asks the instructor about the origins of different tissues and their cellular origins during the process of development. Which statement by the instructor best describes the process of cell differentiation? "Cells of the hematopoietic system produce the appropriate body cells that are required at each stage of development." "A single stem cell differentiates into approximately 200 different types of cells." "A fertilized ovum undergoes a series of divisions, yielding many different cell types." "Cells differentiate into necessary body cells peaking after conception and ceasing near the time of birth."
"A fertilized ovum undergoes a series of divisions, yielding many different cell types." Cell differentiation and consequent tissue types are the outcome of the series of cell divisions that occur in the fertilized ovum. It originates neither with a single stem cell nor in the hematopoietic system. Stem cells allow for limited differentiation throughout the lifespan, not only antepartum.
A pregnant client's α-fetoprotein (AFP) returns elevated. The couple ask the health care worker to explain what this means. Which is the best response? "This means you need to decrease your protein intake to prevent renal problems in your baby." "Elevated AFP means your baby is at risk of having a neural tube defect like spina bifida (an opening in the spine)." "This means your baby has Down syndrome. We won't know how severe until after you give birth." "This is normal. The problem is if it is low, that means your baby will be born with trisomy 18 and will be intellectually disabled."
"Elevated AFP means your baby is at risk of having a neural tube defect like spina bifida (an opening in the spine)." Maternal and amniotic fluid levels of AFP are elevated in pregnancies where the fetus has a neural tube defect (i.e., anencephaly and open spina bifida) or certain other malformations such as an anterior abdominal wall defect in which the fetal integument is not intact. Screening of maternal blood samples usually is done between weeks 16 and 18 of gestation. Although neural tube defects have been associated with elevated levels of AFP, decreased levels have been associated with Down syndrome.
Cone biopsy describes a procedure in which cervical tissue is removed as result of detection of abnormal cells. Which statements by the client demonstrates that the client undergoing a cone biopsy understands the discharge instructions? "I require a repeat conization in 2 weeks after the edema subsides." "I will avoid having sexual relations until I see the doctor again." "I will use a Sitz bath to relieve pain caused by the sutures." "I will need to use a menstrual pad to capture the moisture as my cervix unfreezes."
"I will avoid having sexual relations until I see the doctor again." Cone biopsy is a procedure done to remove abnormal cervical tissue. The nurse or primary provider provides guidelines regarding postoperative sexual activity, bathing, and other activities. Because open tissue may be potentially exposed to HIV and other pathogens, the client is cautioned to avoid intercourse until healing is complete and verified at follow-up. Routine repeat cone biopsy is not normally indicated. Perineorrhaphy refers to sutural repair of perineal lacerations; sutures are not required with a cone biopsy. Cryotherapy refers to destruction of tissue by freezing; no freezing is involved with a cone biopsy.
The nurse is caring for a client in the first stage of labor who states, "I am scared. The last time I gave birth, I was in labor for 32 hours, it was awful." What is the nurse's best response? "Let me call the anesthesiologist and get you an epidural right away." "Let's talk about options that can keep you more comfortable this time." "Your second labor should be much shorter." "Maybe we can start some oxytocin to speed things up."
"Let's talk about options that can keep you more comfortable this time." A client's ability to cope during labor and childbirth may be hampered by fear of a long, painful or difficult childbirth. A previous negative experience may increase these fears. The client's anxiety stems from her past history of a long labor. Engaging the client in planning options will give more control and let her know that the nurse will support her through this labor. An immediate epidural may lengthen labor time, the nurse cannot know that labor will be shorter. Oxytocin is not an appropriate option at this time.
A 17-year-old girl tells the nurse she uses tampons and asks how she can cut down on odor during her period. What is the nurse's best response? "Tampons are dangerous, and you should not be using them." "The tampon should be changed hourly." "The tampon should be changed frequently." "Use talcum powder on the tampon prior to insertion."
"The tampon should be changed frequently." To cut down on odor, and to decrease the risk for toxic shock syndrome, the tampon should be changed frequently, but every hour is too frequent. Nothing should be placed on a tampon prior to insertion as this can cause a serious infection and will not decrease odor. Tampons, if changed frequently, are not dangerous.
A client at 37 weeks gestation is at a prenatal visit and states that she sometimes feels dizzy when lying directly on her back. Which is the nurse's best response? "This is a normal occurrence in the third trimester." "Do you have a family history of cardiac-related illnesses?" "This may be due to the uterus putting pressure on a blood vessel." "This is most likely due to low hemoglobin."
"This may be due to the uterus putting pressure on a blood vessel." During pregnancy, the uterus enlarges, and if the client is lying in a supine position, the uterus may put pressure on the vena cava, causing supine hypotensive syndrome. This pressure on the vena cava causes a decrease in blood flow and a decrease in blood pressure. Often the client will describe symptoms of dizziness, pallor, and clamminess. Instruct the client to lie on her left side to avoid this type of episode. This is not a normal occurrence, but rather a common experience, given the client's description, and warrants discussion. It would be inappropriate to assume that this is due to low hemoglobin. Asking the client of any family cardiac history may imply the nurse's assumption of cardiac complication and may not be the most appropriate response given the client's description of what is being experienced.
By about which day in the menstrual cycle does ovulation occur? 5 14 21 28
14 Ovulation occurs by about day 14 of the menstrual cycle.
The nurse is reviewing the medication administration record (MAR) of a client at 39 weeks' gestation and notes that she is ordered an opioid for pain relief. Which is an assessment priority after administering? Assess maternal blood pressure. Assess for constipation. Assess for dry mouth. Assess fetal heart rate.
Assess fetal heart rate. After administering an opioid to a laboring mother, the priority is to assess the impact on the fetus. Opioid administration can cross the placental barrier and affect fetal heart rate and variability. After birth, there may be a decrease in alertness of the neonate. Maternal factors of decreased blood pressure, constipation, and dry mouth are of a lower priority.
Chromosomes contain all the genetic content of the genome. There are 23 pairs of different chromosomes in each somatic cell, half from the mother and half from the father. One of those chromosomes is the sex chromosome. What are the other 22 pairs of chromosomes called? Ribosomes Helixes Autosomes Haploids
Autosomes Of the 23 pairs of human chromosomes, 22 are called autosomes and are alike in both males and females. The double helix is the shape of the DNA molecule. Ribosomes are areas in a cell that synthesize proteins. Haploid have only one complete set of nonhomologous chromosomes.
A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess. Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy Blood pressure 140/90 and glucose in the urine during the 36th week of pregnancy Blood pressure 130/88 and hyperglycemia occurring during the 22nd week of pregnancy Blood pressure 90/60 and proteinuria in the second trimester
Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy Preeclampsia-eclampsia is defined as an elevation in blood pressure (systolic >140 mm Hg or diastolic >90 mm Hg) and proteinuria (300 or greater in 24 hours) developing after 20 weeks of gestation.
There are many cancers of the female reproductive system. The nursing student knows that the most readily detected and most easily cured cancer—if detected early—is: Cervical Vulvar Ovarian Vaginal
Cervical Cervical cancer is readily detected and, if detected early, is the most easily cured of all the cancers of the female reproductive system.
A client presents to the clinic because she thinks she may be pregnant. On examination, the nurse notes that the client's cervix and vaginal mucosa appear a bluish-purple color. The nurse interprets this finding as which sign? Chadwick sign Hegar sign Goodell sign Braxton sign
Chadwick sign Common probable signs of pregnancy include a bluish-purple coloration of the vaginal mucosa and cervix (Chadwick sign), softening of the lower uterine segment or isthmus (Hegar sign), and softening of the cervix (Goodell sign). There is no such thing as Braxton sign; however, there are the Braxton Hicks contractions, which occur throughout the pregnancy preparing the uterus for delivery.
A group of students are reviewing factors that can affect reproductive ability. The students demonstrate a need for additional teaching when they identify what as decreasing reproductivity? Excessive eating High levels of stress Extreme exercise Emotional problems
Excessive eating A decrease in reproductivity is associated with high stress levels, starvation, extreme exercise, and emotional problems.
Is it true or false that prenatal screening can be used to rule out all possible fetal abnormalities? True False
False Prenatal screening cannot be used to rule out all possible fetal abnormalities. It is limited to determining whether the fetus has (or possibly has) designated conditions indicated by late maternal age, family history, or well-defined risk factors.
Which client in the infertility clinic will likely be able to correct her amenorrhea by diet counseling? Female with a BMI index of 45 who cannot exercise due to knee problems and relies on fast food delivery Extreme marathon runner with a BMI of 13.5 prior to the race but carries protein bars for energy Female with anorexia nervosa who has increased her BMI from 14 to 15 in 2 weeks by weighing food servings Female with chronic kidney disease, stage 4, who has a strict diet of low protein, sodium, and potassium
Female with anorexia nervosa who has increased her BMI from 14 to 15 in 2 weeks by weighing food servings There is evidence that a woman must have a minimum body weight and fat content in order for menarche to occur and for the menstrual cycle to be maintained. Amenorrhea has been seen in women with anorexia nervosa, chronic disease, and malnutrition and in those who are long-distance runners. With resumption of weight gain and attainment of sufficient body mass, the normal hormonal pattern is usually reinstated. Extremely overweight clients with joint problems and lack of desire to change eating patterns will have either amenorrhea or oligomenorrhea along with fertility problems. A BMI of 13.5 is considered extreme malnutrition. The person with chronic kidney disease who is on such a restricted diet plan will likely not be able to correct amenorrhea since she is unable to modify the diet without further impacting her kidney disease.
A client undergoing an amniocentesis asks the nurse how the gender of the fetus will be determined. Which response about chromosome analysis is correct? Females will have XX pairing. Males will have XX pairing. Females will not have a karyotype. Males will have not have a karyotype.
Females will have XX pairing. The nurse should respond that females will have an XX pairing of the sex chromosomes. Males would have an XY pairing. The karyotype is the completed picture of the chromosomes and would be completed during the chromosome studies of both a male and a female fetus.
The fallopian tubes are narrow tubes that attach bilaterally to the uterus. Within the fallopian tube, fertilization of the ovum takes place. The end of the fallopian tube nearest the ovary is funnel-like. What are the fringed, finger-like projections around the funnel-shaped opening of the fallopian tube called? Fallopian fingers Oviducts Cilia Fimbriae
Fimbriae The end of the fallopian tube nearest the ovary forms a funnel-like opening with fringed, finger-like projections called fimbriae, which pick up the ovum after its release into the peritoneal cavity after ovulation.
Which hormone is secreted based on a cyclic rather than a diurnal manner? Follicle-stimulating hormone (FSH) Growth hormone Antidiuretic hormone (ADH) Adrenocorticotropic hormone (ACTH)
Follicle-stimulating hormone (FSH) Hormone secretion varies widely over a 24-hour period. Some hormones, such as GH and adrenocorticotropic hormone (ACTH), have diurnal fluctuations that vary with the sleep-wake cycle. Others, such as the female sex hormones (e.g., follicle-stimulating hormone [FSH]) are secreted in a complicated cyclic manner. The levels of hormones such as insulin and antidiuretic hormone (ADH) are regulated by feedback mechanisms that monitor substances such as glucose (insulin) and water (ADH) in the body. The levels of many of the hormones are regulated by feedback mechanisms that involve the hypothalamic-pituitary-target cell system.
A client has just become pregnant and there is a consequent increase in secretions from the columnar epithelium of her endocervix. What effect will this have? A sharp increase in the pH of the vaginal environment Formation of a mucoid plug to protect her uterus Inhibition of FSH synthesis Inhibition of ripening of multiple oocytes
Formation of a mucoid plug to protect her uterus Secretions from the columnar epithelium of the endocervix protect the uterus from infection, alter receptivity to sperm, and form a mucoid "plug" during pregnancy. These secretions do not directly affect pH, FSH levels, or the function of oocytes.
A woman with a regular 28-day menstrual cycle wishes to become pregnant. At which point in the menstrual cycle is the optimal time for intercourse to end in fertilization of the ovum? Third day after menses ceases Fourth day after menses begins Fourteenth day after menses begins Twentieth day after menses ceases
Fourteenth day after menses begins Ovulation usually occurs around the 14th day after menstruation begins. It is the best time to expect the ovum and sperm to join in fertilization.
A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely? Fundal height has dropped since the last recording. Fundal height is at its highest level at the xiphoid process. The fundus is at the level of the umbilicus and measures 20 cm. The lower uterine segment and cervix have softened.
Fundal height has dropped since the last recording. Between 38 and 40 weeks of gestation, the fundal height drops as the fetus begins to descend and engage into the pelvis. Because it pushes against the diaphragm, many women experience shortness of breath. By 40 weeks, the fetal head begins to descend and engage into the pelvis. Although breathing becomes easier because of this descent, the pressure on the urinary bladder now increases, and women experience urinary frequency. The fundus reaches its highest level at the xiphoid process at approximately 36, not 39, weeks. By 20 weeks' gestation, the fundus is at the level of the umbilicus and measures 20 cm. At between 6 and 8 weeks of gestation, the cervix begins to soften (Goodell sign) and the lower uterine segment softens (Hegar's sign).
A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information? Further testing will be required to confirm any diagnosis. The blood tests are definitive. Treatment can be started once the test results are back. A second set of screening tests can be obtained to confirm results.
Further testing will be required to confirm any diagnosis. Nursing management related to marker screening tests consists primarily of providing education about the tests. Remind the couple that a definitive diagnosis is not made without further tests such as an amniocentesis. The blood tests are not definitive but only strongly suggest the possibility of a defect. For some conditions there are no treatments. The couple may request a second set, but the health care provider will probably suggest proceeding with the more definitive methods to confirm the diagnosis.
When an Rh-negative mother gives birth to an Rh-positive infant, the mother usually produces antibodies that will attack any subsequent pregnancies in which the fetus is Rh positive. When subsequent babies are Rh positive, erythroblastosis fetalis occurs. What is another name for erythroblastosis fetalis? Microcytic disease of the newborn Hemolytic iron deficiency anemia Hemolytic disease of the newborn Macrocytic disease of the newborn
Hemolytic disease of the newborn Erythroblastosis fetalis, or hemolytic disease of the newborn, occurs in Rh-positive infants of Rh-negative mothers who have been sensitized. The Rh-negative mother usually becomes sensitized during the first few days after delivery, when fetal Rh-positive red cells from the placental site are released into the maternal circulation. Because the antibodies take several weeks to develop, the first Rh-positive infant of an Rh-negative mother usually is not affected. There is no such thing as microcytic or macrocytic disease of the newborn, nor is there a hemolytic iron deficiency anemia.
Fertilization of the ovum and implantation in the uterine wall result in the production of what hormone? Testosterone Progesterone Human chorionic gonadotropin Estrogen
Human chorionic gonadotropin Fertilization of the ovum and implantation in the uterine wall result in the production of human chorionic gonadotropin. This hormone, in turn, stimulates the corpus luteum to continue producing estrogen and progesterone until the placenta develops and becomes functional.
Which statement best describes the pattern of maternal mortality since World War II? It has steadily decreased. It has remained constant. It has steadily increased. After decreasing until the 1960s, it has increased steadily.
It has steadily decreased. Improved prenatal care and early ambulation after birth are factors that have decreased maternal death rates following birth over the past 70 years.
Which statement is true regarding hormonal contraception? It increases risk for benign breast cancer. It increases risk for venous thromboembolism. Fetal anomalies are a concern. It increases risk for uterine cancer.
It increases risk for venous thromboembolism. Clients taking hormonal contraception have an increased risk for venous thromboembolism but a decreased risk for benign breast cancer and uterine cancer. Fetal anomalies are not a concern.
A nurse is giving a prenatal class on teratogens that have an affinity for specific body tissues. Which teratogen is accurately paired with the specific body tissue affected? Lead attacks the joints. Mercury attacks the nervous tissue. Tetracycline attacks the muscles. Thalidomide attacks the lungs.
Mercury attacks the nervous tissue. A factor determining the effects of a teratogen is the teratogen's affinity for specific body tissues. Lead and mercury, for example, attack and disable nervous tissue. Thalidomide, originally used to treat nausea in pregnancy, is now prescribed for cancer therapy, and it may cause limb defects. Tetracycline, a common antibiotic, causes tooth enamel deficiencies, and possibly, long bone deformities.
After teaching a group of students about female reproductive hormones, the instructor determines that the teaching was successful when the students identify which hormone as being primarily responsible for maintaining pregnancy? Estrogen Progesterone Follicle-stimulating hormone Luteinizing hormone
Progesterone Progesterone is the hormone responsible for maintaining pregnancy.
The nurse has been asked to present information to a group of civic leaders concerning women's health issues. In preparing the information, the nurse includes what goal from Healthy People 2030 related to women in labor? Reduce the rate of cesarean births among low-risk women. Encourage women with previous cesareans to always have a cesarean. Ensure care during labor includes immunizations. Ensure all couples receive preconception genetic counseling.
Reduce the rate of cesarean births among low-risk women. Healthy People 2030 includes one goal related to cesarean births in the United States, "Reduce cesarean births among low-risk women with no prior births." Immunizations and genetic counseling are not associated with women in labor.
A 7 months' pregnant woman is experiencing contractions. She is admitted to the hospital in preterm labor. What will be prescribed to stop the labor? Oxytocics Estrogen Tocolytics Prostaglandins
Tocolytics Tocolytics are uterine relaxants that are used to stop labor contractions that occur before the completion of the 37th week of gestation. Oxytocics are uterine stimulants used to initiate or augment a contractile pattern of labor. On the other hand, prostaglandins prepare the uterus for labor and delivery by ripening the cervix. Finally, estrogen may have a role in the creation of additional oxytocin receptors.
Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy? Using a reliable method of contraception for several weeks. Applying warm compresses to the scrotum for the first 24 hours. Taking a prescribed opioid analgesic for pain relief. Resuming sexual activity in 24 to 48 hours.
Using a reliable method of contraception for several weeks. It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed to use a reliable method of contraception until sperm no longer are present. The client should apply ice packs to the scrotum to reduce swelling and use a mild analgesic such as aspirin or acetaminophen for pain relief. The client typically can resume sexual activity when comfortable, usually in 1 week.
While teaching a sex education class to a group of preadolescents, the school nurse explains that human growth and development begins at which of the following events? When intercourse takes place When ovum is fertilized by sperm When ovum implants in the uterus When ovulation occurs in the female
When ovum is fertilized by sperm When ovum and sperm unite, genetic material is combined to begin growth and development. Intercourse is needed for the ovum and sperm to unite. Human growth and development has already occurred before implantation in the uterus. Ovulation is release of the ovum from the ovary.
A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP? elevated lipoproteins hemolysis liver enzyme elevation low platelet count
elevated lipoproteins The acronym HELLP represents hemolysis, elevated liver enzymes, and low platelets. This syndrome is a variant of preeclampsia/eclampsia syndrome that occurs in 10% to 20% of clients whose diseases are labeled as severe.
The nurse is assessing a client who has recently become pregnant. What hormone activity is most likely to maintain the pregnancy until birth of the fetus? high levels of estrogen for the first trimester, gradually declining throughout pregnancy temporary cessation of gonadotropin-releasing hormone (GnRH) high levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) high levels of estrogen and progesterone throughout pregnancy
high levels of estrogen and progesterone throughout pregnancy In a pregnant woman, both estrogen and progesterone hormones have specific functions. High levels of both hormones are needed for the maintenance of pregnancy. Pregnancy is not maintained through the actions of GnRH, FSH, or LH.
Nausea and vomiting are common reports during pregnancy. What nutritional action can be used to lessen nausea and vomiting? drinking liquids with meals limiting intake of heavy, greasy foods increasing fluid intake limiting carbohydrate intake
limiting intake of heavy, greasy foods Nausea and vomiting can be lessened by limiting intake of fatty and greasy foods and eating small frequent meals every 2 to 3 hours. Other interventions include eating carbohydrate foods such as dry crackers, Melba toast, dry cereal, or hard candy before getting out of bed in the morning. Avoid drinking liquids with meals; avoid coffee, tea, and spicy foods; and eliminate individual food intolerances. Drinking liquids, increasing fluid intake, and limiting carbohydrate intake does not lessen nausea and vomiting.
A nurse is reviewing the medical record of a woman who has given birth vaginally. The record reveals that the client required a right mediolateral episiotomy during birth. When assessing the client, the nurse would inspect which area to evaluate the status of the episiotomy? perineum clitoris vestibule labia
perineum The perineum is the most posterior part of the external female reproductive organs. This external region is located between the vulva and the anus. It is made up of skin, muscle, and fascia. Incising the perineum area to provide more space for the presenting part is called an episiotomy. An episiotomy does not involve the clitoris, vestibule, or labia.
Which hormone is called the hormone of pregnancy because it reduces uterine contractions during pregnancy? luteinizing hormone (LH) estrogen follicle-stimulating hormone (FSH) progesterone
progesterone Progesterone is called the hormone of pregnancy because it reduces uterine contractions, thus producing a calming effect on the uterus, allowing pregnancy to be maintained. FSH is primarily responsible for the maturation of the ovarian follicle. LH is required for both the final maturation of preovulatory follicles and the luteinization of the ruptured follicle. Estrogen is crucial for the development and maturation of the follicle.
When assessing a client, a nurse determines that the client has a rectocele based on which finding? protrusion of the bladder wall through the anterior vaginal wall bulging of the small intestine through the posterior vaginal wall sagging of the rectum, which pushes against or into the posterior vaginal wall downward movement of the uterus through the pelvic floor and into the vagina
sagging of the rectum, which pushes against or into the posterior vaginal wall A rectocele occurs when the rectum sags and pushes into or against the posterior vaginal wall. A cystocele occurs when the posterior bladder wall protrudes downward through the anterior vaginal wall. An enterocele occurs when the small intestine bulges through the posterior vaginal wall. Uterine prolapse occurs when the uterus descends through the pelvic floor and into the vaginal canal.
A client who has just given a blood sample for pregnancy testing in the health care provider's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy? visualization of the fetus by ultrasound laboratory test of a urine specimen for hCG laboratory test of a blood serum specimen for hCG absence of a period
visualization of the fetus by ultrasound There are only three documented or positive signs of pregnancy: 1) demonstration of a fetal heart separate from the mother's, 2) fetal movements felt by an examiner, and 3) visualization of the fetus by ultrasound. The absence of a period is an example of a presumptive symptom, which is a symptom that, when taken as a single entity, could easily indicate other conditions. Laboratory tests of either urine or blood serum for human chorionic gonadotropin (hCG) are examples of probable signs of pregnancy, which are objective and so can be verified by an examiner.
