Maternity and Pediatric Nursing 1st (first) Edition by Ricci, Susan Scott – Test Bank

 

 

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Sample Test

Ch. 3: Anatomy and Physiology of the Reproductive System

 

 

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
	Ans:	B
	Response:
	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.

 

 

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
	Ans:	C
	Response:
	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.

 

 

3.	A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the client’s next menses to begin on:
	A)	May 24
	B)	May 26
	C)	May 30
	D)	June 1
	Ans:	A
	Response:
	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.

 

 

4.	Which female reproductive tract structure would the nurse describe to a group of young women as containing rugae that enable it to dilate during labor and birth?
	A)	Cervix
	B)	Fallopian tube
	C)	Vagina
	D)	Vulva
	Ans:	C
	Response:
	The vagina is a tubular, fibromuscular organ lined with mucous membrane that lies in a series of transverse folds called rugae. These rugae allow for extreme dilation of the canal during labor and birth. The cervix, the lower portion of the uterus, is composed of fibrous connective tissue that dilates during labor. The fallopian tube transports the ovum from the ovary to the uterus. The vulva is a collective term used to refer to the external female reproductive organs (mons pubis, labia majora and minora, clitoris, vestibular structures, and perineum).

 

 

5.	After teaching a group of pregnant women about breastfeeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after childbirth?
	A)	Placental estrogen
	B)	Progesterone
	C)	Gonadotropin-releasing hormone
	D)	Prolactin
	Ans:	D
	Response:
	After childbirth and expulsion of the placenta, prolactin stimulates the production of milk. 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.

 

 

6.	The nurse is assessing a 13-year-old girl. Which of the following events 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
	Ans:	B
	Response:
	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.

 

 

7.	When describing the ovarian cycle to a group of students, which phase would the instructor include?
	A)	Luteal phase
	B)	Proliferative phase
	C)	Menstrual phase
	D)	Secretory phase
	Ans:	A
	Response:
	The ovarian cycle consists of three phases: the follicular phase, ovulation, and the luteal phase. The endometrial cycle includes the proliferative phase, menstrual phase, and secretory phase.

 

 

8.	The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation?
	A)	Estrogen
	B)	Progesterone
	C)	Follicle-stimulating hormone
	D)	Luteinizing hormone
	Ans:	D
	Response:
	At ovulation, a mature follicle ruptures in response to a surge of luteinizing hormone. Estrogen is predominant at the end of the follicular phase, directly preceding ovulation. Progesterone peaks 5 to 7 days after ovulation. Follicle-stimulating hormone is highest during the first week of the follicular phase of the cycle.

 

 

9.	The nurse is teaching a health education class on male reproductive anatomy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful?
	A)	Testes
	B)	Seminal vesicles
	C)	Scrotum
	D)	Prostate gland
	Ans:	A
	Response:
	The testes are responsible for sperm production. The seminal vesicles produce nutrient seminal fluid. The scrotum surrounds and protects the testes. The prostate gland and the seminal vesicles produce fluid to nourish the sperm.

 

 

10.	The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would be inappropriate for the nurse to include as an accessory gland?
	A)	Seminal vesicles
	B)	Prostate gland
	C)	Cowper’s glands
	D)	Vas deferens
	Ans:	D
	Response:
	The vas deferens is part of the ductal system of the male reproductive system responsible for transporting sperm from the epididymis. Accessory glands include the seminal vesicles, prostate gland, and Cowper’s or bulbourethral glands.

 

 

11.	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
	Ans:	B
	Response:
	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.

 

 

12.	A woman comes to the clinic complaining 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
	Ans:	D
	Response:
	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.

 

Ch. 4: Common Reproductive Issues

 

1.	After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)?
	A)	Oral contraceptives
	B)	Tubal ligation
	C)	Condoms
	D)	Intrauterine system
	Ans:	C
	Response:
	Condoms are a barrier method of contraception. In addition to providing a physical barrier for sperm, they also protect against STIs. Oral contraceptives, tubal ligation, and intrauterine systems provide no protection against STIs.

 

 

2.	When discussing contraceptive options, which method would the nurse recommend as being the most reliable?
	A)	Coitus interruptus
	B)	Lactational amenorrheal method (LAM)
	C)	Natural family planning
	D)	Intrauterine system
	Ans:	D
	Response:
	An intrauterine system is the most reliable method because users have to consciously discontinue using them to become pregnant rather than making a proactive decision to avoid conception. Coitus interruptus, LAM, and natural family planning are behavioral methods of contraception and require active participation of the couple to prevent pregnancy. These behavioral methods must be followed exactly as prescribed; otherwise, they are associated with a 27% failure rate.

 

 

3.	A client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. The nurse expects to prepare the client for which of the following to confirm this suspicion?
	A)	Pelvic examination
	B)	Transvaginal ultrasound
	C)	Laparoscopy
	D)	Hysterosalpingogram
	Ans:	C
	Response:
	The only certain method of diagnosing endometriosis is by seeing it. Therefore, the nurse would expect to prepare the client for a laparoscopy to confirm the diagnosis. A pelvic examination and transvaginal ultrasound are done to assess for endometriosis but do not confirm its presence. Hysterosalpingography aids in identifying tubal problems resulting in infertility.

 

 

4.	A client is to receive an implantable contraceptive. The nurse describes this contraceptive as containing:
	A)	Synthetic progestin
	B)	Combined estrogen and progestin
	C)	Concentrated spermicide
	D)	Concentrated estrogen
	Ans:	A
	Response:
	Implantable contraceptives deliver synthetic progestin that act by inhibiting ovulation and thickening cervical mucus so sperm cannot penetrate. Implantable contraceptives do not contain combined estrogen and progestin, concentrated spermicide, or concentrated estrogen.

 

 

5.	The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription?
	A)	Condom
	B)	Spermicide
	C)	Diaphragm
	D)	Basal body temperature
	Ans:	C
	Response:
	The diaphragm is available only by prescription and must be professionally fitted by a health care provider. Condoms and spermicides are available over the counter. Basal body temperature requires the use of a special thermometer that is available over the counter.

 

 

6.	When developing a teaching plan for a couple who are considering contraception options, which of the following statements would the nurse include?
	A)	“You should select one that is considered to be 100% effective.”
	B)	“The best one is the one that is the least expensive and most convenient.”
	C)	“A good contraceptive doesn’t require a physician’s prescription.”
	D)	“The best contraceptive is one that you will use correctly and consistently.”
	Ans:	D
	Response:
	For a contraceptive to be most effective, the client must be able to use it correctly and consistently. Even if a method is considered 100% effective, it is not the best choice if the couple does not use it correctly or consistently. Cost is a consideration, but the least expensive method is not necessarily the best choice. The need for a prescription is not relevant to the couple’s choice.

 

 

7.	Which of the following measures would the nurse include in the teaching plan for a woman to reduce the risk of osteoporosis after menopause?
	A)	Taking vitamin supplements
	B)	Eating high-fiber, high-calorie foods
	C)	Restricting fluid to 1,000 mL daily
	D)	Participating in regular daily exercise
	Ans:	D
	Response:
	Measures to reduce osteoporosis after menopause include daily weight-bearing exercise, increasing calcium and vitamin D intake, and avoiding smoking and excessive alcohol intake. General vitamin supplements may be helpful overall, but they are not specific to reducing the risk of osteoporosis. A diet high in calcium and vitamin D, not fiber and calories, would be appropriate. Restricting fluids would have no effect on preventing osteoporosis.

 

 

8.	When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which of the following as the primary cause?
	A)	Poor dietary intake
	B)	Estrogen deficiency
	C)	Active lifestyle
	D)	Changes in vaginal pH
	Ans:	B
	Response:
	Hot flashes and night sweats are classic signs of estrogen deficiency. They are unrelated to dietary intake or active lifestyle. Changes in vaginal pH are associated with genitourinary changes of menopause.

 

 

9.	A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for:
	A)	DEXA scan
	B)	Ultrasound
	C)	MRI
	D)	Pelvic x-ray
	Ans:	A
	Response:
	The client most likely will be having a DEXA scan, which is a screening test that calculates the mineral content of the bone at the spine and hip. Ultrasound, MRI, and a pelvic x-ray would be of little help in determining bone mass.

 

 

10.	The nurse is reviewing the medical records of several clients. Which client would the nurse expect to have an increased risk for developing osteoporosis?
	A)	A woman of African American descent
	B)	A woman who plays tennis twice a week
	C)	A thin woman with small bones
	D)	A woman who drinks one cup of coffee a day
	Ans:	C
	Response:
	A woman with a small frame and thin bones is at a higher risk for osteoporosis. Caucasian or Asian women, not African American women, are at higher risk for the condition. A woman who plays tennis twice a week is active and thus would be at low risk for osteoporosis. Women who ingest excessive amounts of caffeine are at increased risk.

 

 

11.	Which of the following would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis?
	A)	Swimming daily
	B)	Taking vitamin A
	C)	Using hormone replacements
	D)	Taking calcium supplements
	Ans:	D
	Response:
	Osteoporosis is a condition in which bone mass declines to such an extent that fractures occur with minimal trauma. Increasing calcium and vitamin D intake is a major preventive measure. Other measures to reduce the risk include engaging in weightbearing exercise such as walking. Swimming, although a beneficial exercise, is not a weightbearing exercise. Taking vitamin A supplements would have no effect on preventing bone loss. Recent studies have shown that the overall health risks associated with hormone replacement therapy exceed the benefits, increasing the woman’s risk for heart attacks, strokes, and breast cancer.

 

 

12.	Which finding would the nurse expect to find in a client with endometriosis?
	A)	Hot flashes
	B)	Dysuria
	C)	Fluid retention
	D)	Fever
	Ans:	B
	Response:
	The client with endometriosis is often asymptomatic, but clinical manifestations include painful urination, pain before and during menstrual periods, pain during or after sexual intercourse, infertility, depression, fatigue, painful bowel movements, chronic pelvic pain, hypermenorrhea, pelvic adhesions, irregular and more frequent menses, and premenstrual spotting. Hot flashes may be associated with premenstrual syndrome or menopause. Fluid retention is associated with premenstrual syndrome. Fever would suggest an infection.

 

 

13.	After the nurse teaches a client about ways to reduce the symptoms of premenstrual syndrome, which client statement indicates a need for additional teaching?
	A)	“I will make sure to take my estrogen supplements a week before my period.”
	B)	“I’ve signed up for an aerobic exercise class three times a week.”
	C)	“I’ll cut down on the amount of coffee and colas I drink.”
	D)	“I quit smoking about a month ago, so that should help.”
	Ans:	A
	Response:
	Lifestyle changes such as exercising, avoiding caffeine, and smoking cessation are a key component for managing the signs and symptoms of premenstrual syndrome. Estrogen supplements are not used. If medication is necessary, NSAIDs may be used for painful physical symptoms; spironolactone may help with bloating and water retention.

 

 

14.	A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which of the following?
	A)	Onset of menses
	B)	Ovulation
	C)	Pregnancy
	D)	Safe period for intercourse
	Ans:	B
	Response:
	Basal body temperatures typically rise within a day or two after ovulation and remain elevated for approximately 2 weeks, at which point bleeding usually begins. Basal body temperature is not a means for determining pregnancy. Having intercourse while the temperature is elevated would increase the risk of pregnancy.

 

 

15.	A woman using the cervical mucus ovulation method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which of the following?
	A)	Spinnbarkeit mucus
	B)	Purulent mucus
	C)	Post-ovulatory mucus
	D)	Normal pre-ovulation mucus
	Ans:	A
	Response:
	The client is describing spinnbarkeit mucus, the copious, clear, slippery, smooth, and stretchable mucus that occurs as ovulation approaches. Purulent mucus would be yellow or green and malodorous. Pre-ovulation mucus is clear but not as copious, slippery, and stretchable.

 

 

16.	The nurse is reviewing the laboratory test results of a client with dysfunctional uterine bleeding (DUB). Which finding would be of concern?
	A)	Negative pregnancy test
	B)	Hemoglobin level of 10.1 g/dL
	C)	Prothrombin time of 60 seconds
	D)	Serum cholesterol of 140 mg/dL
	Ans:	B
	Response:
	A hemoglobin level of 10.1 g/dL suggests anemia, which might occur secondary to prolonged or heavy menses. A negative pregnancy test, a prothrombin time of 60 seconds, and a serum cholesterol level of 140 mg/dL are within normal parameters.