Maternal And Child Nursing Care 5th Edition By London – Test Bank

 

 

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Sample Questions

 

Chapter 4   Reproductive Anatomy and Physiology

1)  A nurse is teaching a classroom of teenage girls about the female reproductive system. After teaching, the nurse asks the students to describe the release of an ovum during ovulation. Which response indicates that teaching has been effective?

1.    “Ovulation is when the uterus releases an unfertilized egg or ovum.”

2.    “During ovulation, an egg is released from the ovary and enters the fallopian tube.”

3.    “The endometrium is where the eggs are formed and released into the fallopian tube.”

4.    “Around the middle of the menstrual cycle, one of the fallopian tubes releases an egg.”

Answer:   2

Explanation:

1.    The egg is formed in the ovary and travels by way of the fallopian tube to the uterus.

2.    The egg is formed in the ovary and once released, it enters the fallopian tube.

3.    The uterine endometrium is the site of implantation of a fertilized egg.

4.    The egg is formed in the ovary and then released near the fimbria of the fallopian tube.

Page Ref:   71

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in clients, using developmentally and culturally appropriate approaches | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome:   4.4 Identify the two phases of the ovarian cycle and the changes that occur in each phase.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

2)  A client desiring to become pregnant is concerned because the opening of her spouse’s penis is below the tip. How should the nurse respond to this client?

1.    “This is epispadias and it will cause infertility.”

2.    “This is hypospadias and it will cause infertility.”

3.    “This is epispadias and is not likely to impact fertility.”

4.    “This is hypospadias and is not likely to impact fertility.”

Answer:   4

Explanation:

1.    Epispadias is the condition where the urethral opening is on the upper aspect of the penis. The client is describing hypospadias, when the urethral opening is on the lower side of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility.

2.    The client is describing hypospadias, where the urethral opening is on the lower side of the penis. Mild hypospadias, where the urethral opening is on the glans of the penis, does not impact fertility.

3.    Epispadias is the condition where the urethral opening is on the upper aspect of the penis. The client is describing hypospadias, when the urethral opening is on the lower side of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility.

4.    The client is describing hypospadias, which is the urethral opening on the lower aspect of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility.

Page Ref:   73

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in clients, using developmentally and culturally appropriate approaches | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:   4.6 Identify the structures and functions of the male reproductive system.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

3)  A prenatal client states, “The doctor said he might have to cut my cervix so the baby can get out during delivery.” Based upon this statement, what structure should the nurse define when teaching about an episiotomy?

1.    Mons pubis

2.    Labia majora

3.    Perineal body

4.    Vaginal vestibule

Answer:   3

Explanation:

1.    The mons pubis is a softly rounded mound of subcutaneous fatty tissue that covers the front portion of the symphysis pubis.

2.    The labia majora are longitudinal, raised folds of pigmented skin located on either side of the vulvar cleft.

3.    The perineal body, which is located between the lower part of the vagina and the anus, is often the site of an episiotomy or lacerations during childbirth.

4.    The vaginal vestibule contains the vaginal opening, which is the border between the external and internal genitals.

Page Ref:   60

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.2 Explain the significance of specific female reproductive structures during pregnancy and childbirth.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

4)  A pregnant client asks, “What’s the difference between the true pelvis and the false pelvis?” How should the nurse respond?

1.    “The false pelvis helps support the weight of the pregnant uterus.”

2.    “The false pelvis consists of the inlet, the pelvic cavity, and the outlet.”

3.    “The true pelvis does not affect fetal passage during labor and childbirth.”

4.    “The true pelvis helps direct the presenting fetal part into the false pelvis.”

Answer:   1

Explanation:

1.    The false pelvis helps support the weight of the pregnant uterus.

2.    The true pelvis consists of the inlet, the pelvic cavity, and the outlet.

3.    The size and shape of the true pelvis must be adequate for normal fetal passage during labor and childbirth.

4.    The false pelvis helps direct the presenting fetal part into the true pelvis.

Page Ref:   66

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.2 Explain the significance of specific female reproductive structures during pregnancy and childbirth.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

5)  A pregnant adolescent asks about fundal height. What should the nurse say that incorporates the location of the uterine fundus?

1.    It is the lower third area of the uterus.

2.    It is at the uppermost (dome-shaped top) portion of the uterus.

3.    It is the elongated portion of the uterus where the fallopian tubes enter.

4.    It is the portion of the uterus that lies between the internal cervical os and the endometrial cavity

Answer:   2

Explanation:

1.    The lower third of the uterus is called the cervix or neck.

2.    The rounded, uppermost (dome-shaped top) portion of the uterus that extends above the points of attachment of the fallopian tubes is called the fundus.

3.    The elongated portion where the fallopian tubes enter the uterus is called the cornua.

4.    The portion of the uterus between the internal cervical os and the endometrial cavity is called the isthmus.

Page Ref:   61

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.2 Explain the significance of specific female reproductive structures during pregnancy and childbirth.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

6)  The nurse is teaching a client who recently learned that she is pregnant. Which hormone should the nurse instruct as being secreted by the fertilized egg?

1.    Estrogen

2.    Progesterone

3.    Luteinizing hormone

4.    Human chorionic gonadotropin (hCG)

Answer:   4

Explanation:

1.    Estrogen is an ovarian hormone.

2.    Progesterone is an ovarian hormone.

3.    Luteinizing hormone is excreted by the anterior pituitary.

4.    When the ovum is fertilized and implants in the endometrium, the fertilized egg begins to secrete hCG hormone to maintain the corpus luteum.

Page Ref:   71

Cognitive Level:   Understanding

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.3 Summarize the actions of the hormones estrogen, progesterone, and the prostaglandins that affect reproductive functioning.

MNL Learning Outcome: 1.2.3. Explain the female reproductive cycle.

 

7)  The school nurse is teaching a health class to middle school children. Which structure should the nurse explain as secreting follicle-stimulating hormone (FSH) and luteinizing hormone (LH)?

1.    Hypothalamus

2.    Anterior pituitary

3.    Posterior pituitary

4.    Ovaries and testes

Answer:   2

Explanation:

1.    The hypothalamus secretes gonadotropin-releasing hormone to the pituitary gland in response to signals from the central nervous system.

2.    The anterior pituitary secretes FSH and LH, which are primarily responsible for maturation of the ovarian follicle.

3.    The posterior pituitary gland secretes oxytocin and antidiuretic hormone.

4.    The ovaries secrete the female hormones estrogen and progesterone, and the testes secrete testosterone.

Page Ref:   73

Cognitive Level:   Understanding

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.3 Summarize the actions of the hormones estrogen, progesterone, and the prostaglandins that affect reproductive functioning.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

 

8)  The nurse is presenting a community education session on female hormones. Which participant statement indicates the need for further information?

1.    “Estrogen is what causes females to look female.”

2.    “Prostaglandin is responsible for achieving conception.”

3.    “Progesterone is present at the end of the menstrual cycle.”

4.    “The presence of some hormones causes others to be secreted.”

Answer:   2

Explanation:

1.    Estrogen causes secondary sex characteristics, such as enlarged breasts and widened hips.

2.    Prostaglandin is not related to conception. Prostaglandin is called the hormone of pregnancy because it maintains pregnancy.

3.    Progesterone is present in large quantities during the secretory phase of the menstrual cycle.

4.    An example is that the production of gonadotropin-releasing hormone (GnRH) causes the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Page Ref:   70

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome:   4.3 Summarize the actions of the hormones estrogen, progesterone, and the prostaglandins that affect reproductive functioning.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

9)  A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. Which hormone is most likely causing this client’s issues with pregnancy?

1.    Estrogen

2.    Progesterone

3.    LH (luteinizing hormone)

4.    FSH (follicle-stimulating hormone)

Answer:   2

Explanation:

1.    Estrogen primarily assists in maturation of the ovarian follicles and causes endometrial mucosa to proliferate.

2.    Progesterone is the likely cause because it decreases uterine motility and contractibility caused by estrogens, thereby preparing the uterus for implantation.

3.    LH is a hormone secreted by the pituitary gland.

4.    FSH is a hormone secreted by the pituitary gland.

Page Ref:   70

Cognitive Level:   Remembering

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in clients, using developmentally and culturally appropriate approaches| NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions │Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:   4.3 Summarize the actions of the hormones estrogen, progesterone, and the prostaglandins that affect reproductive functioning.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

10)  The nurse is explaining the menstrual cycle to a group of women. In which phase should the nurse instruct that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and the blood supply to the endometrium is reduced?

1.    Ischemic phase

2.    Secretory phase

3.    Menstrual phase

4.    Proliferative phase

Answer:   1

Explanation:

1.    The ischemic phase is characterized by ischemia of the endometrium.

2.    The secretory phase involves glycogen secretion by the endometrium after ovulation.

3.    The menstrual phase is the menses.

4.    The proliferative phase is characterized by proliferation of the endometrium.

Page Ref:   71

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.5 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

MNL Learning Outcome: 1.2.3. Explain the female reproductive cycle.

11)  Which statement best indicates that the client understands the differences in the follicular and luteal phases of the ovarian cycle?

1.    “My period will be every 28 days.”

2.    “The follicular phase is when the egg is fertilized.”

3.    “The follicular phase is the second half of my cycle.”

4.    “The first part of my period might vary in length, but not the second.”

Answer:   4

Explanation:

1.    The follicular phase can vary, resulting in cycle length other than 28 days.

2.    The follicular phase comprises days 1 to 14 of the menstrual cycle, not when the egg is fertilized.

3.    The luteal phase is the second half of the cycle.

4.    For a female with a 28-day cycle, the follicular phase comprises days 1 to 14 of the menstrual cycle, and the luteal phase comprises days 15 to 28. The luteal phase does not vary.

Page Ref:   70

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome:   4.4 Identify the two phases of the ovarian cycle and the changes that occur in each phase.

MNL Learning Outcome: 1.2.3. Explain the female reproductive cycle.

12)  The nurse is preparing a handout on the ovarian cycle for a group of middle school girls. Which information should the nurse include?

1.    There are two phases of the ovarian cycle: luteal and follicular.

2.    The hormone human chorionic gonadotropin (hCG) stimulates ovulation.

3.    The ovum travels from the ovary to the tube during the luteal phase.

4.    Irregular menstrual cycles have varying lengths of the follicular phase.

Answer:   1

Explanation:

1.    The two phases of the ovarian cycle are follicular (days 1 to 14 of the menstrual cycle) and luteal (days 15 to 28 of the menstrual cycle).

2.    hCG is secreted by a fertilized ovum and does not stimulate ovulation.

3.    The ovum is released from the graafian follicle of the ovary and travels to the fallopian tube during the follicular phase of the ovarian cycle.

4.    Menstrual cycles that are irregular in length have a consistent follicular phase but a varying luteal phase.

Page Ref:   70

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.4 Identify the two phases of the ovarian cycle and the changes that occur in each phase.

MNL Learning Outcome: 1.2.3. Explain the female reproductive cycle.

13)  The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation?

1.    “One hormone controls the phases of the menstrual cycle.”

2.    “The secretory phase occurs when a woman is most fertile.”

3.    “Menstrual cycle phases vary in order from one woman to another.”

4.    “The menstrual cycle has five distinct phases that occur during the month.”

Answer:   2

Explanation:

1.    Four hormones control ovulation and therefore the menstrual cycle: progesterone, estrogen, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).

2.    During the secretory phase, the endometrium is thickest, and glycogen is produced to nourish a fertilized ovum.

3.    Although the length of the menstrual cycle might vary, the phases of the menstrual cycle always occur in the same order.

4.    There are four phases of the menstrual cycle: menstrual, proliferative, secretory, and ischemic phases.

Page Ref:   71

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning

Learning Outcome:   4.5 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

MNL Learning Outcome: 1.2.3. Explain the female reproductive cycle.

 

14)  In preparation for teaching a women’s community center class about physiologic changes during menopause, the nurse is preparing a handout for students. Which information should the nurse include in this teaching?

1.    Due to changes in estrogen levels, the labia minora increase in size after menopause.

2.    The ovaries remain small after puberty, but they increase in size following menopause.

3.    After menopause, the endometrium continues to undergo monthly degeneration and renewal.

4.    Ovarian secretion of estrogen decreases between the ages of 45 and 55, after which point ovulatory activity ceases.

Answer:   4

Explanation:

1.    The labia minora decrease in size after menopause because of changes in estrogen levels.

2.    The ovaries of girls are small, but they become larger after puberty and then decrease in size following menopause.

3.    From menarche to menopause, the endometrium undergoes monthly degeneration and renewal in the absence of pregnancy.

4.    Between the ages of 45 and 55, a woman’s ovaries secrete decreasing amounts of estrogen. Eventually, ovulatory activity ceases and menopause occurs.

Page Ref:   65

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning

Learning Outcome:   4.3 Summarize the actions of the hormones estrogen, progesterone, and the prostaglandins that affect reproductive functioning.

MNL Learning Outcome: 1.2.3. Explain the female reproductive cycle.

 

15)  A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0°F) for the past 36 hours. What should these findings indicate to the nurse?

1.    Ovulation has occurred.

2.    Ovulation will occur soon.

3.    Menstruation is about to begin.

4.    She is pregnant and will not menstruate.

Answer:   1

Explanation:

1.    Signs that ovulation has occurred include: pain associated with rupture of the ovum (mittelschmerz), increased vaginal discharge, and a temperature increase of 0.6°C (1.0°F) over the past 36 hours.

2.    A temperature increase does not occur before ovulation has occurred.

3.    A temperature increase does not occur when menstruation is about to begin.

4.    Pregnancy can be detected only through testing the urine or serum for the presence of human chorionic gonadotropin hormone.

Page Ref:   71

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in clients, using developmentally and culturally appropriate approaches | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:   4.5 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

MNL Learning Outcome: 1.2.3. Explain the female reproductive cycle.

 

 

16) A pregnant client is scheduled for a lower-segment cesarean birth. Place an X on the area of the uterine structure where the nurse should instruct that this incision for the procedure will be placed.

Answer:

Explanation: The isthmus is that portion of the uterus between the internal cervical os and the endometrial cavity. The isthmus is about 6 mm above the uterine opening of the cervix and takes on importance in pregnancy because it becomes the lower uterine segment. At birth, this thin lower segment, situated behind the bladder, is the site for lower-segment cesarean births.

Page Ref:   61

Cognitive Level: Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.1 Identify the structures and functions of the female reproductive system.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

 

17) After delivery, the nurse notes that a client is having considerable vaginal bleeding. On the diagram provided, identify the area of the myometrium that is responsible for stopping bleeding after birth.

 

Answer:

Explanation: The thick middle layer of the myometrium is made up of interlacing muscle fibers in figure-eight patterns that surround large blood vessels. Their contraction produces a tourniquet-like action on blood vessels to stop bleeding after birth.

Page Ref:   62

Cognitive Level: Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in clients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions │Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:   4.1 Identify the structures and functions of the female reproductive system.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

 

18) The nurse is reviewing the anatomy and physiology of the reproductive organs during a prenatal class. On the diagram, select the area that the nurse should identify as being the round ligament.

Answer:

Explanation: The round ligaments arise from the sides of the uterus near the fallopian tube insertions. They extend outward between the folds of the broad ligament, passing through the inguinal ring and canals and eventually fusing with the connective tissue of the labia majora. The round ligaments are made up of longitudinal muscle and undergo hypertrophy and increase in both length and diameter during pregnancy.

Page Ref:   63

Cognitive Level: Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Context and Environment; Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.1 Identify the structures and functions of the female reproductive system.

MNL Learning Outcome: 1.2.2. Describe the structures and functions of the female reproductive system.

 

19) The nurse is reviewing the male reproductive system with a group of high school students. Using the diagram select the structure that the nurse should identify as a storage area for spermatozoa.

 

Answer:

Explanation: The epididymis provides a reservoir for maturing spermatozoa.

Page Ref:   74

Cognitive Level: Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Context and Environment; Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.6 Identify the structures and functions of the male reproductive system.

MNL Learning Outcome: 1.2.4. Describe the structures and functions of the male reproductive system.

 

20) The nurse is preparing materials to counsel a couple after a consultation visit at an infertility clinic. On the diagram, select the area on the sperm that the nurse should identify as fertilizing the ovum.

 

Answer:

Explanation: The head’s main components are the acrosome and nucleus. The head carries the male’s haploid number of chromosomes (23), and it is the part that enters the ovum at fertilization.

Page Ref:   75

Cognitive Level: Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards:   QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care | AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care | NLN Competencies: Context and Environment; Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome:   4.6 Identify the structures and functions of the male reproductive system.

MNL Learning Outcome: 1.2.4. Describe the structures and functions of the male reproductive system.

Chapter 7   Conception and Fetal Development

1)  The nurse is explaining the difference between meiosis and mitosis. Which statements should the nurse include? Select all that apply.

1.    Mitosis occurs in most of the cells of the body.

2.    Meiotic division leads to cells that halve the original genetic material.

3.    Meiosis is the division of a cell into two exact copies of the original cell.

4.    Meiosis is the process by which gametes, or the sperm and ova, are formed.

5.    Mitosis is splitting one cell into two, each with half the chromosomes of the original cell.

Answer:   1, 2, 4

Explanation:

1.    Mitosis is how the majority of cells reproduce so that the new cells have the same structure and function as the original. Meiosis only occurs in gametes.

2.    Meiosis creates two cells that have half of the chromosomes of the original cell.

3.    Meiosis creates two cells that have half of the chromosomes of the original cell.

4.    Both sperm and ova are created through meiosis.

5.    Mitosis creates two cells that are exact copies of the original cell.

Page Ref:   136

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Implementation/Teaching/Learning

Learning Outcome: 7.1 Differentiate between meiotic cellular division and mitotic cellular division.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

2)  The nurse has completed a presentation on reproduction. Which participant’s statement indicates that teaching has been successful?

1.    “Ova separate into two unequally sized cells.”

2.    “A male is born with all the sperm he will ever produce.”

3.    “Females create new ova throughout their reproductive life.”

4.    “Each primary spermatocyte divides into four haploid cells.”

Answer:   1

Explanation:

1.    Each ovum undergoes meiotic division just prior to being released from the graafian follicle. Each cell created by this meiosis has the same number of chromosomes, but the cytoplasm does not split equally. This causes a polar body to be produced along with a secondary oocyte.

2.    Males begin spermatogenesis at puberty and continue throughout their life. Each sperm divides into four haploid cells.

3.    Females are born with all the ova they will ever produce. The ova begin to be formed in early fetal life. One ovum is released each month during the reproductive life of a female, from menarche to menopause.

4.    Primary spermatocytes contain 46 chromosomes (46XY). Each primary spermatocyte undergoes meiotic division into two haploid secondary spermatocytes (22X or 22Y).

Page Ref:   136

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Evaluation/Teaching/Learning

Learning Outcome: 7.2 Compare the processes by which ova and sperm are produced.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

3)  After teaching a class about the female reproductive system, the nurse asks the attendees to describe the process of meiosis. Which student response suggests successful comprehension of the material?

1.    “At the time of ovulation, the first meiotic division begins.”

2.    “At the time of puberty, the second meiotic division begins.”

3.    “Completion of the first meiotic division produces three polar bodies and one primary oocyte.”

4.    “Completion of the second meiotic division results in formation of three polar bodies and one ovum.”

Answer:   4

Explanation:

1.    The first meiotic division of oocytes begins before the female fetus is born.

2.    The second meiotic division begins at the time of ovulation.

3.    Completion of the first meiotic division produces one polar body and one secondary oocyte.

4.    Completion of the second meiotic division produces three polar bodies and one ovum.

Page Ref:   136

Cognitive Level:   Understanding

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Evaluation/Teaching/Learning

Learning Outcome: 7.2 Compare the processes by which ova and sperm are produced.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

4)  A young woman claims that contraception is not needed because she avoids intercourse on the day of ovulation. How should the nurse instruct this client?

1.    Sperm survive 48 to 72 hours in the female reproductive tract.

2.    After ovulation, ova are considered fertile for about 72 to 96 hours.

3.    Sperm are believed to be healthy and highly fertile for at least 5 days.

4.    Refraining from intercourse on the day of ovulation will effectively prevent pregnancy.

Answer:   1

Explanation:

1.    Sperm survive 48 to 72 hours in the female reproductive tract.

2.    Ova are considered fertile for about 12 to 24 hours after ovulation.

3.    Sperm are believed to be most fertile for the first 24 hours following entry into the female reproductive tract.

4.    Because sperm survive 48 to 72 hours in the female reproductive tract, avoidance of intercourse for 24 hours will not reliably prevent pregnancy from occurring.

Page Ref:   137

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Implementation/Teaching/Learning

Learning Outcome: 7.3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

5)  The nurse instructs a client about conception and fetal development. Which client statement indicates understanding about transportation time of the zygote through the fallopian tube and into the cavity of the uterus?

1.    “It will take 8 days for the egg to reach the uterus.”

2.    “It will take at least 3 days for the egg to reach the uterus.”

3.    “It will take 18 hours for the fertilized egg to implant in the uterus.”

4.    “It will only take 12 hours for the egg to go through the fallopian tube.”

Answer:   2

Explanation:

1.    “It will take 8 days for the egg to reach the uterus” is an incorrect interpretation of the information on conception.

2.    It takes at least 3 days for the egg to reach the uterus.

3.    “It will take 18 hours for the fertilized egg to implant in the uterus” is an incorrect interpretation of the information on conception.

4.    “It will only take 12 hours for the egg to go through the fallopian tube” is an incorrect interpretation of the information on conception.

Page Ref:   139

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Evaluation/Teaching/Learning

Learning Outcome: 7.3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

6)  If only a small volume of sperm is discharged into the vagina, an insufficient amount of enzymes might be released when sperm encounters the ovum. What would be the result for pregnancy?

1.    The block to polyspermy (cortical reaction) would not occur.

2.    The fertilized ovum would be unable to implant in the uterus.

3.    Sperm would be unable to penetrate the zona pellucida of the ovum.

4.    Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus.

Answer:   3

Explanation:

1.    The answer choice of the block to polyspermy (cortical reaction) not occurring is incorrect because it is mediated by release of materials from cortical granules below the ovum’s surface and not the result of low sperm count.

2.    With a low sperm count it is unlikely that the ovum would be fertilized.

3.    Sperm would be unable to penetrate the zona pellucida of the ovum because it takes hundreds of acrosomes (the result of the acrosomal reaction) to rupture and release enough hyaluronic acid to clear the way for a single sperm to penetrate the ovum’s zona pellucida successfully.

4.    “Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus” is an incorrect statement.

Page Ref:   138

Cognitive Level:   Understanding

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in clients, using developmentally and culturally appropriate approaches│ NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention │ Nursing/Integrated Concepts: Assessment

Learning Outcome: 7.3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

7)  The nurse is caring for a client who is pregnant with twins. Which statement indicates the client needs additional information?

1.    “It is rare for twins to both be within the same amniotic sac.”

2.    “Because both of my twins are boys, I know that they are identical.”

3.    “If I have one boy and one girl, I will know they came from two eggs.”

4.    “If my twins came from one fertilized egg that split, they are identical.”

Answer:   2

Explanation:

1.    Monoamnionic-monochorionic twins are very rare and occur as a result of the zygote splitting 7 or more days after fertilization.

2.    Not all same-sex twins are identical or monozygotic, because fraternal, or dizygotic, twins can be the same gender or different genders.

3.    The only way to have twins of different genders is if they came from two separate fertilized ova. Monozygotic twins are identical and are the same gender.

4.    When the zygote splits, identical twins share the same genotype result.

Page Ref:   143

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Evaluation/Teaching/Learning

Learning Outcome: 7.5 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

8)  A pregnant client asks about the differences between monozygotic and dizygotic twins. Which should the nurse include during this teaching?

1.    Dizygotic twins share one placenta and one chorion.

2.    Monozygotic twins are also referred to as “fraternal” twins.

3.    Dizygotic twinning occurs less frequently than does monozygotic twinning.

4.    Monozygotic twins originate from division of the fertilized ovum at different stages.

Answer:   4

Explanation:

1.    Dizygotic twins each have a separate chorion and amnion.

2.    Monozygotic twins are also referred to as “identical” twins.

3.    Dizygotic twinning occurs more frequently than does monozygotic twinning.

4.    Monozygotic twins originate from division of the fertilized ovum at different stages of early development.

Page Ref:   143

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Implementation/Teaching/Learning

Learning Outcome: 7.5 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

9)  Which statement by a client pregnant with twins would indicate that teaching was effective?

1.    “Identical twins can be the same or different sex.”

2.    “Identical twins occur more frequently than fraternal twins.”

3.    “Congenital abnormalities are more prevalent in identical twins.”

4.    “Because of their birth relationship, fraternal twins are more similar to each other than if they had been born singly.”

Answer:   3

Explanation:

1.    Identical or monozygotic twins have identical chromosomal structures and therefore are always the same sex.

2.    Dizygotic, or fraternal, twins occur more frequently than do monozygotic twins.

3.    Due to variations in the timing of the splitting of the embryo, congenital abnormalities are more common in monozygotic twins.

4.    Fraternal twins are not more similar to each other than if they had been born singly.

Page Ref:   143

Cognitive Level:   Analyzing

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Evaluation/Teaching/Learning

Learning Outcome: 7.5 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

10)  The nurse is creating a teaching poster for pregnant mothers. Which description of fetal development should the nurse include?

1.    Most organs are formed by 8 weeks after fertilization.

2.    The embryonic stage is from fertilization until 5 months.

3.    Four layers of cells form after the embryo is at the ball stage.

4.    After fertilization, the cells only become larger for several weeks.

Answer:   1

Explanation:

1.    Most organs are formed during the embryonic stage, which lasts from the 15th day after fertilization until the end of the 8th week after fertilization. This is also a critical period because major organs are being developed and teratogens introduced during this time can increase the risk of congenital abnormalities.

2.    The embryonic stage begins on the 15th day after fertilization and ends at the completion of the 8th week after fertilization.

3.    Three primary germ layers form from the ball of undifferentiated cells, the blastocyst: ectoderm, mesoderm, and endoderm.

4.    After fertilization, the cells reproduce by mitosis, resulting in more cells, not larger cells.

Page Ref:   151

Cognitive Level:   Applying

Client Need/Sub:   Health Promotion and Maintenance

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that reflects developmental stage, age, culture, spirituality, client preferences, and health literacy considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts: Implementation/Teaching/Learning

Learning Outcome: 7.4 Summarize the processes that occur during the cellular multiplication and differentiation stages of intrauterine development and their effects on the structures that form.

MNL Learning Outcome: 1.4.1. Analyze the components of the fertilization process.

 

11)  The nurse is conducting an early pregnancy class for a group of pregnant women. Which statement indicates a need for further education about the placenta?

1.    “It develops and grows larger until about 20 weeks’ gestation.”

2.    “It floats in the amniotic sac and filters waste products from the fetus.”

3.    “It creates hormones and enzymes that are necessary during pregnancy.”

4.    “It ages and becomes less permeable during the last month of pregnancy.”

Answer:   2

Explanation: