Chapter 3 Nursing Test Bank Maternal Nursing PDF

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Practice test questions, answers, and rationales to ensure an A on your next test. Practice test questions, answers, and rationales....

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Chapter 3 1. When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle? A. menstrual B. proliferative C. secretory D. ischemic Answer: B Rationale: Estrogen levels are the highest during the proliferative phase of the endometrial cycle, when the endometrial glands enlarge in response to increasing amounts of estrogen. Progesterone is the predominant hormone of the secretory phase. Levels of estrogen and progesterone drop sharply during the ischemic phase and fall during the menstrual phase. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Reference: p. 104 2. 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: A. sexual experience. B. full hormonal cycle. C. menstrual period. D. sign of breast development. Answer: C Rationale: Menarche is defined as the establishment of menstruation. It does not refer to the woman's first sexual experience, full hormonal cycle, or sign of breast development. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 104 3. A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin? A. May 24 B. May 26 C. May 30

D. June 1 Answer: A Rationale: For a woman with a 28-day cycle, ovulation typically occurs on day 14. Therefore, her next menses would begin 14 days later, on May 24. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 102 4. The nurse is assessing a 13-year-old girl. Which event would the nurse expect to have occurred first? A. evidence of pubic hair B. development of breast buds C. onset of menses D. growth spurt Answer: B Rationale: Pubertal events preceding the first menses have an orderly progression beginning with the development of breast buds, followed by the appearance of pubic hair, then axillary hair, then a growth spurt. Menses typically occurs about 2 years after the start of breast development. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 104 5. The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? A. sperm emission B. penile vasodilation C. psychological release D. ejaculation Answer: B Rationale: With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm. Orgasm results in a pleasurable feeling of physiologic and psychological release. Ejaculation results in the discharge of semen from the urethra. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System

Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 109 6. A woman comes to the clinic reporting that she has little sexual desire. As part of the client's evaluation, the nurse would anticipate the need to evaluate which hormone level? A. progesterone B. estrogen C. gonadotropin-releasing hormone D. testosterone Answer: D Rationale: Testosterone is thought to be the hormone of sexual desire in women. Thus, an evaluation of this level would be done. Progesterone is often called the hormone of pregnancy because of its calming effect (reduction in uterine contractions) on the uterus, allowing pregnancy to be maintained. Estrogen is the predominant hormone at the end of the follicular phase. Gonadotropin-releasing hormone induces the release of FSH and LH to assist with ovulation. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Reference: p. 101 7. A school nurse who is teaching a health course at the local high school is presenting information on human development and sexuality. When talking about the role of hormones in sexual development, which hormone does the nurse teach the class is the most important for developing and maintaining the female reproductive organs? A. estrogen B. progesterone C. androgens D. follicle-stimulating hormone Answer: A Rationale: Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 105

8. After explaining the function of the seminal vesicles to a class, the instructor determines the need for additional teaching when the students identify which action as a function of the seminal vesicles? A. nourishes the sperm B. reduces sperm motility C. aids sperm to reach the ovum D. prevents sperm destruction by female antibodies Answer: B Rationale: The seminal vesicles are a pair of glands that produce fluid with various substances that function to (1) nourish sperm, (2) enhance sperm motility by enzymatically liquefying ejaculated semen (3) stimulate contraction of the uterus to help the sperm reach the ovum, and (4) resist sperm destruction by female antibodies. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 108 9. The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during the follicular phase of the ovarian cycle that the nurse should include in the teaching session? A. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature. B. The empty ruptured graafian follicle becomes the corpus luteum, and it begins to secrete progesterone and estrogen. C. About day 14, a surge of hormones cause the ovum to burst through the ovary. D. The uterus prepares for implantation of an ovum. Answer: A Rationale: The follicular phase lasts from about day 4 to about day 14. During this time, under the influence of follicle-stimulating hormone, several follicles begin to ripen and the ovum within each begins to mature. About day 14, a surge of hormones causes the ovum to burst through the ovary; this act is called ovulation. During the luteal phase, the empty, ruptured graafian follicle becomes the corpus luteum, and it begins to secrete progesterone and estrogen. The endometrium of the uterus has a similar cycle. It is called the uterine cycle or endometrial cycle. This process prepares the uterus for implantation of an ovum (egg). Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 102

10. The nurse is reviewing the process of egg maturation and ovulation with a client. What occurs during ovulation in the ovarian cycle that the nurse should include in the teaching session with the client? A. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature. B. The empty ruptured cavity in the ovary becomes the corpus luteum and begins to secrete progesterone and estrogen. C. About day 14, a surge of hormones cause the ovum to burst through the ovary. D. The uterus is prepared for implantation of an ovum. Answer: C Rationale: The follicular phase lasts from about day 4 to about day 14. During this time, under the influence of FSH, several follicles begin to ripen, and the ovum within each begins to mature. About day 14, a surge of hormones causes the ovum to burst through the ovary. This act is called ovulation. During the luteal phase, the empty, ruptured graafian follicle becomes the corpus luteum and begins to secrete progesterone and estrogen. The endometrium of the uterus has a similar cycle. It is called the uterine cycle or endometrial cycle. This process prepares the uterus for implantation of an ovum (egg). Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 103 11. A nurse is conducting a class for a group of teenage girls about female reproductive anatomy and physiology. Which structures would the nurse include as an external female reproductive organ? Select all that apply. A. mons pubis B. labia C. vagina D. clitoris E. uterus Answer: A, B, D Rationale: The external female reproductive organs collectively are called the vulva (which means "covering" in Latin). The vulva serves to protect the urethral and vaginal openings and is highly sensitive to touch to increase the female's pleasure during sexual arousal (Stables & Rankin, 2010). The structures that make up the vulva include the mons pubis, the labia majora and minora, the clitoris, the structures within the vestibule, and the perineum. The vagina and uterus are internal female reproductive organs. Question format: Multiple Select Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance

Reference: p. 96 12. A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. "I've also been waking up at night feeling really hot and sweating. The nurse interprets these findings as: A. menopause. B. perimenopause. C. climacteric. D. menarche. Answer: B Rationale: Perimenopause is the time period occurring 2 to 8 years prior to menopause during which women may experience physical changes associated with decreasing estrogen levels, which may include vasomotor symptoms of hot flashes, irregular menstrual cycles, sleep disruptions, forgetfulness, irritability, mood disturbances, decreased vaginal lubrication, night sweats, fatigue, vaginal atrophy, and depression (Burbos & Morris, 2011). Vasomotor symptoms (hot flushes and night sweats) are the most common complaints for which women seek treatment. Menopause or climacteric is defined as 1 year without a menstrual period. Menarche refers to the onset of the first menses. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 106 13. A nurse is examining a female client and tests the client's vaginal pH. Which finding would the nurse interpret as normal? A. 4.5 B. 7 C. 8.5 D. 10 Answer: A Rationale: The vagina has an acidic environment; therefore, a pH of 4.5 would indicate an acidic environment. A pH of 7 is considered neutral; a pH above 7 is considered alkaline. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 97-98 14. When describing the male sexual response to a group of students, the instructor determines that the teaching was successful when they identify emission as: A. semen forced through the urethra to the outside.

B. movement of sperm from the testes and fluid into the urethras. C. dilation of the penile arteries with increased blood flow to the tissues. D. body's return to the physiologic nonstimulated state. Answer: B Rationale: Emission refers to the movement of sperm from the testes and fluids from the accessory glands into the urethra, where it is mixed to form semen. As the urethra fills with semen, the base of the erect penis contracts, thus increases pressure. This pressure forces the semen through the urethra to the outside (ejaculation). Dilation of the penile arteries with increased blood flow describes erection. The body's return to the physiologic nonstimulated state describes resolution. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 109 15. A nurse is describing the structure and function of the reproductive system to an adolescent health class. How would the nurse describe the secretion of the seminal vesicles? A. mucus-like B. alkaline C. acidic D. semen Answer: B Rationale: The paired seminal vesicles secrete an alkaline fluid that contains fructose and prostaglandins. The fructose supplies energy to the sperm on its journey to meet the ovum, and the prostaglandins assist in sperm mobility. The Cowper's glands secrete a mucus-like fluid. The vagina is an acidic environment. Semen refers to the sperm-containing fluid. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 108 16. A nurse is completing a continuing education program about the male and female reproductive organs. After reviewing the information, the nurse demonstrates understanding of the information by identifying which structures as male accessory organs? Select all that apply. A. testes B. vas deferens C. bulbourethral glands D. prostate gland E. penis

Answer: B, C, D Rationale: The organs of the male reproductive system include the two testes (where sperm cells and testosterone are made), the penis, the scrotum, and the accessory organs (epididymis, vas deferens, seminal vesicles, ejaculatory duct, urethra, bulbourethral glands, and prostate gland). Question format: Multiple Select Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 108 17. A woman is diagnosed with a vaginal infection. After teaching the client about measures to reduce her risk, the nurse determines that the client needs additional teaching when she states which factor as increasing her risk? A. antibiotic therapy B. menstruation C. douching D. use of feminine hygiene sprays Answer: B Rationale: The vagina has an acidic environment, which protects it against ascending infections. Antibiotic therapy, douching, perineal hygiene sprays, and deodorants upset the acid balance within the vaginal environment and can predispose women to infections. Menstruation is not considered a risk factor. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 97-98 18. A nurse is describing the hormones involved in the menstrual cycle to a group of young adult women who are planning to get pregnant. The nurse determines the teaching was successful when the group identifies the follicle-stimulating hormone as being secreted by the: A. hypothalamus. B. anterior pituitary gland. C. ovaries. D. corpus lute. Answer: B Rationale: Follicle-stimulating hormone and luteinizing hormone are secreted by the anterior pituitary gland. The hypothalamus secretes gonadotropin-releasing hormone. The ovaries secrete estrogen. The corpus luteum secretes progesterone. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System

Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 105 19. A nurse has been invited to be a guest speaker for a female high school health class about the menstrual cycle and reproduction. When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle? A. estrogen B. luteinizing hormone C. progesterone D. prolactin Answer: B Rationale: With the initiation of the menstrual cycle, luteinizing hormone rises and stimulates the follicle to produce estrogen. As this hormone is produced by the follicle, estrogen levels rise, inhibiting the output of LH. Ovulation occurs after an LH surge damages the estrogen-producing cells leading to a decline in estrogen. The LH surge results in the corpus luteum, which produces estrogen and progesterone. These two levels rise, suppressing LH. Lack of LH promotes degeneration of the corpus luteum, which then leads to a decline in estrogen and progesterone. The decline of ovarian hormones ends their negative effect on the secretion of LH, which is then secreted and the menstrual cycle begins again. Prolactin is the hormone responsible for breast milk production. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 103 20. After teaching a group of adolescents about female reproductive anatomy, the nurse determines that the teaching was successful when the adolescents identify which structure as the site of fertilization? A. vagina B. uterus C. fallopian tubes D. vestibule Answer: C Rationale: Fertilization occurs in the distal portion of the fallopian tubes. The lining of the uterus is shed with menstruation. The vagina connects the external genitalia to the uterus. The vestibule is an oval area enclosed by the labia minora laterally. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance

Reference: p. 100 21. The nurse is assessing a 12-year-old girl who has had her first menses. When reviewing the client's history, which event would the nurse expect to have most likely occurred last? A. evidence of pubic hair B. breast bud development C. growth spurt D. onset of menses Answer: D Rationale: Pubertal events preceding the first menses have an orderly progression beginning with the development of breast buds, followed by the appearance of pubic hair, then axillary hair, then a growth spurt. Menses typically occurs about 2 years after the start of breast development. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 104 22. After teaching a group of pregnant women about breastfeeding, the nurse determines that the teaching was successful when the group identifies which hormone as being inhibited during pregnancy but is important for the production of breast milk after birth? A. placental estrogen B. progesterone C. gonadotropin-releasing hormone D. prolactin Answer: D Rationale: Following birth and the expulsion of the placenta, levels of placental hormones (progesterone and lactogen) fall rapidly, and the action of prolactin (milk-producing hormone) is no longer inhibited. Prolactin stimulates the production of milk within a few days after birth. Placental estrogen and progesterone stimulate the development of the mammary glands during pregnancy. Gonadotropin-releasing hormone induces the release of follicle-stimulating hormone and luteinizing hormone to assist with ovulation. Question format: Multiple Choice Chapter 3: Anatomy and Physiology of the Reproductive System Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Reference: p. 100 23. A nurse is asked to be a guest speaker for a parents' meeting at the local middle school. Part of the presentation is to focus on the events girls will experience when going through puberty. Place the events in the order that the nurse would address them, from first to last. Use all options. A. Development of the breast

B. ...