Ultimate OB

It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long. Which of the following is an appropriate reply by the nurse? 1. "You are probably ovulating." 2. "Your hormone levels should be checked." 3. "You will probably menstruate early." 4. "Your breast changes are a worrisome sign."

1. "You are probably ovulating." There are two hints to the answer in this question. First, the woman has a 31-day cycle and it is day 17. It is, therefore, 14 days before the woman usually menstruates. Women usually ovulate 14 days before their menstrual periods begin. The one-sided lower quadrant pain is also a clue. Women often feel a twinge, called mittelschmerz, near the site of the ovary at the time of ovulation.

A client has just had an amniocentesis to determine whether her baby has an inheritable genetic disease. Which of the following interventions is highest priority at this time? 1. Assess the fetal heart rate. 2. Check the client's temperature. 3. Acknowledge the client's anxiety about the possible findings. 4. Answer questions regarding the genetic abnormality.

1. Assess the fetal heart rate. The test taker should remember Maslow's Hierarchy of Needs and established procedures for providing first aid and CPR when answering prioritizing questions.

When a nurse is teaching a woman about her menstrual cycle, which of the following is the most important change that happens during the follicular phase of the menstrual cycle? 1. Maturation of the graafian follicle. 2. Multiplication of the fimbriae. 3. Secretion of human chorionic gonadotropin. 4. Proliferation of the endometrium.

1. Maturation of the graafian follicle.

A woman, whose menstrual cycle is 35 days long, states that she often has a slight pain on one side of her lower abdomen on day 21 of her cycle. She wonders whether she has ovarian cancer. Which of the following is the nurse's best response? 1. "Women often feel a slight twinge when ovulation occurs." 2. "You should seek medical attention as soon as possible since ovarian cancer is definitely a possibility." 3. "Ovarian cancer is unlikely because the pain is not a constant pain." 4. "It is more likely that such pain indicates an ovarian cyst because pain is more common with that problem."

1. This statement is true and the discomfort, at the location of the ovary where ovulation occurs, is called mittelschmerz. Ovulation usually occurs 14 days before the first day of the menses.

Which of the following client responses indicates that the nurse's teaching about care following chorionic villus sampling (CVS) has been successful? 1. If the baby stops moving, the woman should immediately go to the hospital. 2. The woman should take oral terbutaline every 2 hours for the next day. 3. If the woman starts to bleed or to contract, she should call her physician. 4. The woman should stay on complete bed rest for the next 48 hours.

3. If the woman starts to bleed or to contract, she should call her physician.

A nurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, please place the following four hormones in the chronological order in which they elevate during the menstrual cycle. Good Fellas Love Pepperoni 1. Follicle-stimulating hormone. 2. Gonadotropin-releasing hormone. 3. Luteinizing hormone. 4. Progesterone.

2, 1, 3, 4. Gonadotropin-releasing hormone stimulates the production of follicle stimulating hormone (FSH) and lutenizing hormone (LH). FSH rises first and LH follows. After ovulation, progesterone rises. To remember the hormones of the female menstrual cycle, it is important to know definitions, especially of prefixes and suffixes. Gonadotropin is a hormone that stimulates the gonads—that is, the ovaries or the testes. Follicle-stimulating hormone stimulates the follicle, or ovum sac, to mature, while luteinizing hormone stimulates the release of the ovum from the ovary and heralds the luteal phase of the menstrual cycle (when the corpus luteum is functioning). Finally, progesterone, which is produced by the corpus luteum, rises in the woman's bloodstream.

6. A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormonal levels would the nurse expect to see? 1. Both estrogen and progesterone are high. 2. Estrogen is high and progesterone is low. 3. Estrogen is low and progesterone is high. 4. Both estrogen and progesterone are low.

4. Both estrogen and progesterone are low.