Preview Extract
Chapter 3
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 student's response suggests she correctly understood the nurse's teaching?
1. “During ovulation, an egg is released from the ovary and enters the fallopian tube.”
2. "Around the middle of the menstrual cycle, one of the fallopian tubes releases an egg."
3. "Ovulation is when the uterus releases an unfertilized egg or ovum."
4. "The endometrium is where the eggs are formed and released into the fallopian tube."
Answer: 1
Rationale 1:
The egg is formed in the ovary and once released, it enters the fallopian tube.
Rationale 2:
The egg is formed in the ovary and then released near the fimbria of the fallopian tube.
Rationale 3:
The egg is formed in the ovary and travels by way of the fallopian tube to the uterus.
Rationale 4:
The uterine endometrium is the site of implantation of a fertilized egg.
2) The clinic nurse is caring for a young woman seeking contraception because she has
recently married and become sexually active. The teen states, “The opening of my husband’s
penis isn’t at the tip; it’s around the corner below the tip. He tells me that he was born that
way. Will that cause problems if we want to have children?” What is the best response for the
nurse to give? “This variation is called:
1. “Epispadias. It is not likely to impact his fertility.”
2. “Epispadias. It will likely cause him to be infertile.”
3. “Hypospadias. It is not likely to impact his fertility.”
4. “Hypospadias. It will likely cause him to be infertile.”
Answer: 3
Rationale 1:
Epispadias is the condition where the urethral opening is on the upper aspect of the penis.
The patient 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.
Rationale 2:
Epispadias is the condition where the urethral opening is on the upper aspect of the penis.
The patient 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.
Rationale 3:
The patient 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.
Rationale 4:
The patient 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) A prenatal patient states, "The doctor said he might have to cut my cervix so the baby can
get out during delivery." Based upon this statement, the nurse should provide teaching related
to episiotomy, which includes defining:
1. The perineal body.
2. The labia majora.
3. The mons pubis.
4. The vaginal vestibule.
Answer: 1
Rationale 1:
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.
Rationale 2:
The labia majora are longitudinal, raised folds of pigmented skin located on either side of the
vulvar cleft.
Rationale 3:
The mons pubis is a softly rounded mound of subcutaneous fatty tissue that covers the front
portion of the symphysis pubis.
Rationale 4:
The vaginal vestibule contains the vaginal opening, which is the border between the external
and internal genitals.
4) A pregnant patient asks, "What's the difference between the true pelvis and the false
pelvis?" The nurse's best response is:
1. "The true pelvis doesn't affect fetal passage during labor and childbirth."
2. "The false pelvis consists of the inlet, the pelvic cavity, and the outlet."
3. "The true pelvis helps direct the presenting fetal part into the false pelvis."
4. "The false pelvis helps support the weight of the pregnant uterus."
Answer: 4
Rationale 1:
The size and shape of the true pelvis must be adequate for normal fetal passage during labor
and childbirth.
Rationale 2:
The true pelvis consists of the inlet, the pelvic cavity, and the outlet.
Rationale 3:
The false pelvis helps direct the presenting fetal part into the true pelvis.
Rationale 4:
The false pelvis helps support the weight of the pregnant uterus.
5) A pregnant adolescent asks the nurse, “Why does the physician call measuring my uterus a
‘fundal height’?” The nurse’s answer is based on the fact that the fundus of the uterus is
located:
1. In the elongated portion where the fallopian tubes enter.
2. In the lower third area.
3. At the uppermost (dome-shaped top) portion.
4. Between the internal cervical os and the endometrial cavity.
Answer: 3
Rationale 1:
The elongated portion where the fallopian tubes enter the uterus is called the cornua.
Rationale 2:
The lower third of the uterus is called the cervix or neck.
Rationale 3:
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.
Rationale 4:
The isthmus is the portion of the uterus between the internal cervical os and the endometrial
cavity.
6) A nurse teaches newly pregnant patients that if an ovum is fertilized and implants in the
endometrium, the hormone the fertilized egg begins to secrete is:
1. Estrogen.
2. Human chorionic gonadotropin (hCG).
3. Progesterone.
4. Luteinizing hormone.
Answer: 2
Rationale 1:
Estrogen is an ovarian hormone.
Rationale 2:
When the ovum is fertilized and implants in the endometrium, the fertilized egg begins to
secrete human chorionic gonadotropin (hCG) hormone to maintain the corpus luteum.
Rationale 3:
Progesterone is an ovarian hormone.
Rationale 4:
Luteinizing hormone is excreted by the anterior pituitary.
7) A school nurse is teaching a health class to middle school children. The nurse explains that
follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are secreted by the:
1. Hypothalamus.
2. Ovaries and testes.
3. Posterior pituitary.
4. Anterior pituitary.
Answer: 4
Rationale 1:
The hypothalamus secretes gonadotropin-releasing hormone to the pituitary gland in response
to signals from the central nervous system.
Rationale 2:
The ovaries secrete the female hormones estrogen and progesterone, and the testes secrete
testosterone.
Rationale 3:
The posterior pituitary gland secretes oxytocin and anti-diuretic hormone.
Rationale 4:
The anterior pituitary secretes FSH and LH, which are primarily responsible for maturation of
the ovarian follicle.
8) The nurse is presenting a community education session on female hormones. Which
statement from a participant indicates the need for further information?
1. “Estrogen is what causes females to look female.”
2. “The presence of some hormones causes other to be secreted.”
3. “Progesterone is present at the end of the menstrual cycle.”
4. “Prostaglandin is responsible for achieving conception.”
Answer: 4
Rationale 1:
This is a true statement. The question is asking for an incorrect statement. Estrogen causes
secondary sex characteristics, such as enlarged breasts and widened hips.
Rationale 2:
This is a true statement. The question is asking for an incorrect statement. One example is
that the production of gonadotropin-releasing hormone (GnRH) causes the secretion of
luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
Rationale 3:
This is a true statement. The question is asking for an incorrect statement. Progesterone is
present in large quantities during the secretory phase of the menstrual cycle.
Rationale 4:
Prostaglandin is not related to conception. Prostaglandin is called the hormone of pregnancy
because it maintains pregnancy.
9) A woman has been unable to complete a full-term pregnancy because the fertilized ovum
failed to implant in the uterus. This is most likely due to a lack of which hormone?
1. Estrogen
2. Progesterone
3. FSH (follicle-stimulating hormone)
4. LH (luteinizing hormone)
Answer: 2
Rationale 1:
Estrogen primarily assists in maturation of the ovarian follicles and causes endometrial
mucosa to proliferate.
Rationale 2:
Progesterone is the likely cause because it decreases uterine motility and contractibility
caused by estrogens, thereby preparing the uterus for implantation.
Rationale 3:
FSH is a hormone secreted by the pituitary gland.
Rationale 4:
LH is a hormone secreted by the pituitary gland.
10) The nurse is explaining the menstrual cycle to a group of women. The teaching on phases
of the menstrual cycle should include the fact that the corpus luteum begins to degenerate,
estrogen and progesterone levels fall, and the blood supply to the endometrium is reduced in
which phase?
1. Menstrual phase
2. Proliferative phase
3. Secretory phase
4. Ischemic phase
Answer: 4
Rationale 1:
The menstrual phase is the menses.
Rationale 2:
The proliferative phase is characterized by proliferation of the endometrium.
Rationale 3:
The secretory phase involves glycogen secretion by the endometrium after ovulation.
Rationale 4:
The ischemic phase is characterized by ischemia of the endometrium.
11) Which statement best indicates that the patient understands the differences in the
follicular and luteal phases of the ovarian cycle?
1. “My period will be every 28 days.”
2. “The first part of my period might vary in length, but not the second.”
3. “The follicular phase is the second half of my cycle.”
4. “The follicular phase is when the egg is fertilized.”
Answer: 2
Rationale 1:
The follicular phase can vary, resulting in cycle length other than 28 days.
Rationale 2:
For a female with a 28-day cycle, the follicular phase comprises days 1–14 of the menstrual
cycle, and the luteal phase comprises days 15–28. The luteal phase does not vary.
Rationale 3:
The luteal phase is the second half of the cycle.
Rationale 4:
The follicular phase comprises days 1–14 of the menstrual cycle, not when the egg is
fertilized.
12) The nurse is preparing a handout on the ovarian cycle to 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. Irregular menstrual cycles have varying lengths of the follicular phase.
3. The ovum travels from the ovary to the tube during the luteal phase.
4. The hormone human chorionic gonadotropin stimulates ovulation.
Answer: 1
Rationale 1:
The two phases of the ovarian cycle are follicular (days 1–14 of the menstrual cycle) and
luteal (days 15–28 of the menstrual cycle).
Rationale 2:
Menstrual cycles that are irregular in length have a consistent follicular phase but a varying
luteal phase.
Rationale 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.
Rationale 4:
Human chorionic gonadotropin (hCG) is secreted by a fertilized ovum and does not stimulate
ovulation.
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. “The menstrual cycle has five distinct phases that occur during the month.”
2. “One hormone controls the phases of the menstrual cycle.”
3. “The secretory phase occurs when a woman is most fertile.”
4. “Menstrual cycle phases vary in order from one woman to another.”
Answer: 3
Rationale 1:
There are four phases of the menstrual cycle: menstrual, proliferative, secretory, and ischemic
phases.
Rationale 2:
Four hormones control ovulation and therefore the menstrual cycle: progesterone, estrogen,
follicle-stimulating hormone (FSH), and luteinizing hormone (LH).
Rationale 3:
During the secretory phase, the endometrium is thickest, and glycogen is produced to nourish
a fertilized ovum.
Rationale 4:
Although the length of the menstrual cycle might vary, the phases of the menstrual cycle
always occur in the same order.
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 her teaching?
1. The ovaries remain small after puberty, but they increase in size following menopause.
2. Ovarian secretion of estrogen decreases between the ages of 45 to 55, after which point
ovulatory activity ceases.
3. Due to changes in estrogen levels, the labia minora increase in size after menopause.
4. After menopause, the endometrium continues to undergo monthly degeneration and
renewal.
Answer: 2
Rationale 1:
The ovaries of girls are small, but they become larger after puberty and then decrease in size
following menopause.
Rationale 2:
Between the ages of 45 and 55, a woman’s ovaries secrete decreasing amounts of estrogen.
Eventually, ovulatory activity ceases and menopause occurs.
Rationale 3:
The labia minora decrease in size after menopause because of changes in estrogen levels.
Rationale 4:
From menarche to menopause, the endometrium undergoes monthly degeneration and
renewal in the absence of pregnancy.
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. This most likely indicates
that:
1. Menstruation is about to begin.
2. Ovulation will occur soon.
3. Ovulation has occurred.
4. She is pregnant and will not menstruate.
Answer: 3
Rationale 1:
A temperature increase does not occur when menstruation is about to begin.
Rationale 2:
A temperature increase does not occur before ovulation has occurred.
Rationale 3:
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 over the
past 36 hours.
Rationale 4:
Pregnancy can be detected only through testing the urine or serum for the presence of human
chorionic gonadotropin hormone.
Test Bank for Contemporary Maternal-Newborn Nursing
Patricia W Ladewig, Marcia L London, Michele Davidson
9780133429862, 9780134257020
