Unit 1 NF215
A nurse is teaching a group of adolescent girls about the menstrual cycle. The nurse would integrate information about which hormones as being predominant during the cycle? Select all that apply. LH prolactin FSH testosterone GnRH
LH, FSH, GnRH The predominant hormones involved in the menstrual cycle are gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, and prostaglandins. Testosterone and prolactin do have a role in the female reproductive system are not considered predominant hormones for the menstrual cycle.
When teaching a group of adolescents about the menstrual cycle, the nurse describes the ovarian and endometrial cycles. Which phase(s) would the nurse explain as part of the ovarian cycle? Select all that apply. Ischemic phase Luteal phase Secretory phase Follicular phase Proliferative phase
Luteal phase, Follicular phase The ovarian cycle consists of three phases: the follicular phase, ovulation, and the luteal phase. The four phases of the endometrial cycle are the proliferative phase, secretory phase, ischemic phase, and menstrual phase.
The nurse discusses measures to prevent infection of the reproductive tract with a client. The nurse determines that the client has understood the information when the client identifies which component as helping to protect against vaginal infections? menstrual flow rugae ovulation acidic environment
acidic environment An acidic environment helps protect against ascending infections in the vagina. The client should be cautioned against using douches, hygiene sprays, or deodorants that might upset the acid balance. Rugae allow for extreme dilation of the vaginal canal during labor and birth. Menstrual flow and ovulation play no role in the prevention of vaginal infections.
A young couple is exploring their contraceptive options and are curious about using an intrauterine contraceptive device. The nurse explains that there are two types, one that uses hormones and one that uses: potassium. magnesium. copper. silicone.
copper
A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common? endometriosis multigravida status perimenopause hormonal imbalance
endometriosis Secondary dysmenorrhea is painful menstruation due to pelvic or uterine pathology. Endometriosis is the most common cause of secondary dysmenorrhea. Other recognized causes include adenomyosis, fibroids, pelvic infection, an intrauterine device, cervical stenosis, or congenital uterine or vaginal abnormalities.
The nurse provides client education regarding the uterine corpus. Which part may fluctuate with changes of hormonal levels in the absence of pregnancy? epimetrium myometrium perimetrium endometrium
endometrium The corpus, or main body of the uterus, undergoes cyclic changes as the result of changing levels of hormones secreted by the ovaries, in preparation of a pregnancy. When fertilization does not occur, most of the endometrium is shed, and the monthly period occurs.
Three layers of the uterus
endometrium, myometrium, and serosa
The nurse is planning to speak at a local community center to a group of middle-aged women about osteoporosis. Which measure would the nurse be sure to include as effective in reducing the risk for osteoporosis? engaging in daily weight-bearing exercise drinking at least 1 glass of wine per day limiting intake of cholesterol and saturated fats decreasing vitamin D intake
engaging in daily weight-bearing exercise Engaging in daily weight-bearing exercise such as walking helps to reduce a woman's risk for osteoporosis. To prevent osteoporosis, women should increase their calcium and vitamin D intake. Avoiding excessive alcohol ingestion helps prevent osteoporosis. Limiting intake of cholesterol and saturated fats helps reduce the risk for cardiovascular disease, not osteoporosis.
The ovarian cycle consists of which phases?
follicular phase, ovulation, and the luteal phase
A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs: in the fallopian tubes. in the vagina. in the ovaries. in the uterus.
in the fallopian tubes. Fertilization of the ovum can occur in the distal portion of the fallopian tubes. If the egg is fertilized, it will then be moved through the fallopian tube towards the uterus where it implants in the thick endometrium and begins its development.
The client is interested in using an injectable contraceptive that works by suppressing pituitary secretions. The nurse provides the client with literature and discusses which contraceptive with her? etonogestrel medroxyprogesterone acetate levonorgestrel/ethinyl estradiol norelgestromin/ethinyl estradiol
medroxyprogesterone acetate Medroxyprogesterone acetate is an injectable form of a progesterone-only contraceptive that is given every 12 weeks. It works by suppressing ovulation and the production of FSH and LH by the pituitary gland. Etonogestrel is an implantable form contraceptive. Norelgestromin/ethinyl estradiol is a patch-type contraceptive, and levonorgestrel/ethinyl estradiol is an oral contraceptive that uses a 365-day combination dosing.
A nurse is teaching a client about the reproductive system and the hormones involved. The nurse would include which structures as the source of these hormones? Select all that apply. uterus placenta ovaries pituitary hypothalamus
ovaries, pituitary, hypothalamus The reproductive cycle is influenced and controlled by hormones secreted by the ovaries, hypothalamus, and pituitary gland. The placenta secretes a temporary hormone that assists with maintaining pregnancy. The uterus does not secrete hormones.
A client is diagnosed with endometriosis. As part of the teaching plan, the nurse is explaining the condition, including the ways that the diagnosis would be confirmed. The nurse determines that the teaching was successful when the client states that which test would confirm the diagnosis? pelvic laparoscopy bimanual exam Papanicolaou test pelvic ultrasound
pelvic laparoscopy A thorough history and pelvic examination may lead the health care practitioner to suspect endometriosis; however, the only certain method of diagnosing it is by visualizing it via a laparoscopy. A tissue biopsy can be obtained at this time and examined microscopically to confirm it. A Papanicolaou test would be done to rule out cervical cancer. A pelvic ultrasound would not be definitive for endometriosis.
After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies which action as the primary function of the ovaries? secreting mucus that supplies lubrication for intercourse secreting estrogen and progesterone implanting a fertilized ovum carrying the ovum to the endometrium
secreting estrogen and progesterone The ovaries have two primary functions: development and release of the ovum and secretion of estrogen and progesterone. The fallopian tubes are responsible for conveying the ovum from the ovary to the uterus and sperm from the uterus toward the ovary. The Bartholin glands when stimulated secrete mucus that supplies lubrication for intercourse. The uterus is the site of implantation of a fertilized ovum.
A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time? five days after the first day of the menstrual cycle three days before and three days after ovulation midway between the normal menstrual cycle six days before the onset of menstruation
three days before and three days after ovulation Typically, the unsafe period during the menstrual cycle is approximately 3 days before and 3 days after ovulation. An ovum is released from the ovary 14 days before the next menstrual period.
When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to: cervical inflammation. pelvic inflammatory disorder. toxic shock syndrome. sexually transmitted infections.
toxic shock syndrome The sponge provides protection for up to 12 hours but should not be left in place for more than 30 hours after insertion to avoid the risk of toxic shock syndrome.
A woman opts to use a diaphragm for contraception. Which instruction would be most important for the nurse to provide? "Keep the diaphragm in place for no more than 4 hours after intercourse." "Wet the diaphragm with water first before inserting it." "Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more." "Replace the diaphragm every 6 months."
"Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more." Diaphragms should be refitted after pregnancy, abdominal or pelvic surgery, or weight loss or gain of 10 pounds (4.5 kilograms) or more. A diaphragm usually is replaced every 1 to 2 years. A diaphragm should remain in place for at least 6 hours after intercourse. A contraceptive sponge, not a diaphragm, should be wetted with water before insertion.
During a routine health visit for an 11-year-old girl, her mother asks the nurse, "My daughter just got her period about 4 months ago, but they haven't been very regular so far. How long might it take until she gets regular?" Which response by the nurse would be most appropriate? "If her periods are not regular now, odds are they will be irregular from now on." "She should start getting regular after about 2 to 3 more months." "That's odd. Her periods should be getting regular by now." "It can take up to 2 years once she starts for the periods to become regular."
"It can take up to 2 years once she starts for the periods to become regular." Once menarche has occurred, cycles may take up to 2 years to become regular, ovulatory cycles. Telling the mother that her daughter's periods would get regular in 2 to 3 months or that she should be having regular periods by now is incorrect. Also, telling the mother that her daughter's periods will continue to be irregular is untrue and inappropriate.
A young adult woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that she suffers from painful cramps during her menses. She states, "It is worse the first couple of days and then it gets better. I take ibuprofen and it helps. Is there anything else I can do?" Which information would the nurse incorporate into the response? Select all that apply. "Use cool compresses to your lower belly." "Limit the amount of salty foods you eat." "Keep your intake of water low." "Try to exercise." "Take warm showers to help relax."
"Limit the amount of salty foods you eat.", "Try to exercise.", "Take warm showers to help relax." Tips for managing dysmenorrhea include: exercising to increase endorphins and suppress prostaglandin release; limiting salty foods to prevent fluid retention; increasing water consumption to serve as a natural diuretic; using heating pads or warm baths to increase comfort; and taking warm showers to promote relaxation.
The AAP discourages the use of media, with the exception of video chatting, in children less than
18 months
no more than 1 hour a day of media for children aged
2 - 5 years old
A woman has opted to use medroxyprogesterone injections for birth control. The client receives the first injection today. The nurse instructs the woman to return to the clinic in how many months for the next injection? 1 3 4 2
3
The client has heard of extended-cycle oral contraceptive regimens and desires more information. The nurse explains that these regimens consist of active combination pills, followed by placebo pills. How many days of active combination pills and placebo pills are contained in these regimens? 84 active; 7 placebo 42 active; 4 placebo 56 active; 5 placebo 70 active; 6 placebo
84 active; 7 placebo Research has confirmed that the extended use of active OC pills carries the same safety profile as the conventional 28-day regimens. The extended-cycle regimen consists of 84 consecutive days of active combination pills, followed by 7 days of placebo. The woman has four withdrawal-bleeding episodes a year.
ACDHO stands for
A - anxiety: difficulty sleeping, tenseness, mood swings, and clumsiness; C - cravings: for sweets, salty foods, chocolate; D - depression: feelings of low self-esteem, anger, easily upset; H - hydration: weight gain, abdominal bloating, breast tenderness; and O - other: hot flashes or cold sweats, nausea, change in bowel habits, aches or pains, dysmenorrhea, acne breakout.
The endometrium cycle consists of which phases?
The proliferative, secretory, ischemic and menstrual phases
A nurse is conducting a teaching program for a group of young adult women about the structures of the female reproductive system. After describing the internal structures, the nurse determines that the teaching was successful when the group identifies which structure as the neck of the uterus? introitus cervix clitoris fourchette
cervix The neck of the uterus is referred to as the cervix. It connects to the vagina. The opening to the vagina is called the introitus, and the half-moon-shaped area behind the opening is called the fourchette. The clitoris is a small, cylindrical mass of erectile tissue and nerves. Most of the components of the clitoris are buried under the skin and connective tissue of the vulva. It is located at the anterior junction of the labia minora.
A nurse is conducting a class for a group of young adults at the health clinic about contraceptive options. The nurse determines that the teaching was successful when the group identifies which type as protective against sexually transmitted infections? Contraceptive patch Diaphragm with spermicide Condom Intrauterine system
condom
A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important? weight cultural practices genetics nutrition
genetics Genetics is the most important factor in determining the age at which menarche starts, but geographic location, nutrition, weight, general health, nutrition, cultural and social practices, the girl's educational level, attitude, family environment, and beliefs are also important.
A client is presenting with possible signs of menopause. The nurse recognizes that menopausal symptoms are related to: vasomotor activities. hypersecretion of hormones. autonomic activities. psychiatric activities.
vasomotor activities Vasomotor symptoms are the most commonly reported during the menopausal transition. These include hot flashes, irregular menstrual cycles, sleep disruptions, forgetfulness, irritability, mood disturbances, decreased vaginal lubrication, night sweats, fatigue, vaginal atrophy, and depression.
media should be limited to educational programming with adult interaction during the media viewing in children ages
18 to 24 months
It is important that couples who wish to practice natural forms of birth control understand that the mucus-secreting glands of the cervix can store live sperm for up to: 12 hours. 36 hours. 24 hours. 48 hours.
48 hours The mucus-secreting glands of the cervix are capable of storing live sperm for 48 to 72 hours (2 to 3 days), enabling pregnancy to occur after intercourse has occurred 1 or 2 days before ovulation.
A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because: ECs can induce an abortion of a recently implanted embryo. ECs can help prevent STIs. ECs are more effective than regular birth control. ECs simply prevent embryo creation and uterine implantation from occurring in the first place.
ECs simply prevent embryo creation and uterine implantation from occurring in the first place. ECs prevent the embryo creation and uterine implantation from occurring. There is no evidence that ECs have any effect on an already-implanted ovum or that they induce abortion. They do not protect against STIs and are less effective than regular birth control.
A nurse is conducting a presentation for a group of parents of a local middle school. When describing puberty in girls, which event would the nurse identify as typically occurring last? Breast development Growth spurt Menstruation Pubic hair appearance
Menstruation Pubertal events preceding the first menses have an orderly progression: thelarche, the development of breast buds; adrenarche, the appearance of pubic and then axillary hair followed by a growth spurt; and menarche (occurring about 2 years after the start of breast development).
Prevent swelling in legs during pregnancy
Prolonged sitting (tv, internet) Immobility can increase risk of blood clots Don't cross legs at the knees Rotate feet at the ankles to keep them moving Sit with feet up Change sitting position/get up every hour
The nurse is teaching a group of pregnant females about changes that occur in the uterus during pregnancy. The nurse identifies which area as experiencing marked hypertrophy? Inner endometrium Cervix Lower perimetrium Upper myometrium
Upper myometrium The myometrium makes up the major portion of the uterus and is composed of smooth muscle linked by connective tissue with numerous elastic fibers. During pregnancy, the upper myometrium undergoes marked hypertrophy, but there is limited change in the cervical muscle content. Neither the endometrium (the innermost layer) nor the perimetrium (the outer serosal layer that covers the body of the uterus) undergo such a change.
A woman is to receive methotrexate and misoprostol to terminate a first-trimester pregnancy. When preparing the teaching plan for this client, the nurse understands that misoprostol works by: acting as a toxin to the trophoblastic tissue. blocking the action of progesterone on the endometrium. dilating the cervix. causing uterine contractions to expel the uterine contents.
causing uterine contractions to expel the uterine contents.
A nurse is working with a couple who is dealing with infertility. Which aspect would be most important for the nurse to consider? insurance restrictions emotional limits culture family budget
culture Infertility is not only a physiologic problem but is also one that can initiate a life crisis that is experienced with psychologic, familial, social, and cultural consequences. Although insurance constraints, budget, and emotional aspects are important considerations, the manner in which the various cultures, ethnic groups, and religious groups perceive and manage infertility are very different and must be considered when working with couples who have been unable to conceive. Nurses need to include awareness of these differences in their counseling of the couples as they try to help them achieve their goal of getting pregnant.
The nurse is assessing a couple who have come to the health care facility because they have been unable to conceive a child. When assessing the woman, the nurse would identify which factor as increasing the woman's risk for infertility? age of 25 years endometriosis patent fallopian tubes dysmenorrhea
endometriosis Risk factors for infertility include endometriosis, age older than 27 years, tubal blockages, weight variations, hormonal imbalances, fibroids, reduced oocyte quality, chromosomal abnormalities, congenital anomalies of the cervix and uterus, immune system disorders, chronic illnesses, sexually transmitted infections, history of PID, smoking and alcohol consumption, multiple miscarriages, and psychological stress. Dysmenorrhea is not an associated risk factor.
Which hormone would the nurse explain as being primarily responsible for maturation of the ovarian follicle? follicle-stimulating hormone estrogen luteinizing hormone gonadotropin-releasing hormone
follicle-stimulating hormone Follicle-stimulating hormone is primarily responsible for the maturation of the ovarian follicle. Luteinizing hormone is required for the final maturation of preovulatory follicles and luteinization of the ruptured follicle. Gonadotropin-releasing hormone induces the release of follicle stimulating hormone and luteinizing hormone to assist with ovulation. Estrogen is crucial for the development and maturation of the follicle and induces proliferation of the endometrial glands.
The nurse is providing care to a client with abnormal uterine bleeding. Treatment with medications has been unsuccessful, and surgical intervention is being considered. The nurse identifies which technique as being the last resort? uterine artery embolization hysterectomy dilation and curettage endometrial ablation
hysterectomy
Excessive TV viewing can lead to
obesity, poor cognitive skills, and irregular sleep patterns.
A young mother is expressing frustration of not being able to breastfeed her infant. A potential cause could be the lack of the hormone: oxytocin. estrogen. prolactin. luteinizing hormone.
prolactin
A nurse is preparing a presentation for a client who is considering contraception. When discussing oral contraceptives, the nurse would identify which advantages? Select all that apply. decreased risk of breast cancer lowered risk of migraine headaches reduction in severe cramping shortening of the menstrual period reduction in risk for osteoporosis
reduction in severe cramping shortening of the menstrual period reduction in risk for osteoporosis Oral contraceptives are associated with shortening and regulating the menstrual cycle, reducing severe cramping and bleeding, and reducing the risk for osteoporosis. They are also associated with an increased risk for breast cancer and migraine headaches.
A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize? "Add an aspirin to the regimen if you do not get relief right away." "Take the medication on an empty stomach." "It is normal for your bowel movements to be black." "Start taking the medication when you first get your period."
"Start taking the medication when you first get your period."
A mother presents to the clinic with her 15-year-old daughter who is reporting amenorrhea. The girl's menarche was at age 12. When conducting the health history and physical exam, which findings might the nurse identify as suggesting the underlying cause? Select all that apply. emotional distress hypothyroidism pregnancy lack of exercise extreme rapid weight gain
emotional distress, hypothyroidism, pregnancy, extreme rapid weight gain The girl is experiencing secondary amenorrhea. Risk factors include: recent rapid weight gain or loss, pregnancy, vigorous exercise, hypo- or hyperthyroidism, and chronic prolonged emotional stress.
