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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
Feedback:
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
Feedback:
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
Feedback:
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.
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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
Feedback:
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 breast-feeding, 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
Feedback:
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 who has had her first menses. 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
Feedback:
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.
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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
Feedback:
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
Feedback:
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
Feedback:
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
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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
Feedback:
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
Feedback:
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
Feedback:
Testosterone is needed to stimulate 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.
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13. A nurse is conducting a class for a group of teenage girls about female reproductive
anatomy and physiology. Which of the following 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
Ans: A, B, D
Feedback:
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.
14. 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
Ans: B
Feedback:
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.
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15. A nursing instructor is describing the hormones involved in the menstrual cycle to a
group of nursing students. The instructor determines the teaching was successful when
the students identify follicle-stimulating hormone as being secreted by which of the
following?
A) Hypothalamus
B) Anterior pituitary gland
C) Ovaries
D) Corpus luteum
Ans: B
Feedback:
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.
16. 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 which of the
following?
A) Menopause
B) Perimenopause
C) Climacteric
D) Menarche
Ans: B
Feedback:
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.
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17. After teaching a group of students about female reproductive anatomy, the instructor
determines that the teaching was successful when the students identify which of the
following as the site of fertilization?
A) Vagina
B) Uterus
C) Fallopian tubes
D) Vestibule
Ans: C
Feedback:
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.
18. A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects
that the client has an infection. When gathering additional information, which of the
following would the nurse be least likely to identify as placing the client at risk for an
infection?
A) Recent antibiotic therapy for an upper respiratory infection
B) Last menstrual period about 5 days ago.
C) Weekly douching
D) Frequent use of feminine hygiene sprays.
Ans: B
Feedback:
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.
Menstrual period about 5 days ago is not considered a risk factor.
19. A group of nursing students are reviewing information about the male reproductive
structures. The students demonstrate understanding of the information when they
identify which of the following as accessory organs? (Select all that apply.)
A) Testes
B) Vas deferens
C) Bulbourethral glands
D) Prostate gland
E) Penis
Ans: B, C, D
Feedback:
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).
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20. 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
Ans: A
Feedback:
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.
21. When describing the male sexual response to a group of students, the instructor
determines that the teaching was successful when they identify emission as which of the
following?
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
Ans: B
Feedback:
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.
22. A nurse is describing the structure and function of the reproductive system to an
adolescent health class. The nurse describes the secretion of the seminal vesicles as
which of the following?
A) Mucus-like
B) Alkaline
C) Acidic
D) Semen
Ans: B
Feedback:
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.
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