D447 Objective Assessment
Women's & Children's Health
200 Questions with Answers and Rationales
2026 Updated Edition
Western Governors University
,Question 1
A nurse teaches about the female reproductive cycle. Which phase begins immediately
after ovulation?
A. Menstrual phase
B. Proliferative phase
C. Secretory (luteal) phase [CORRECT]
Answer: C
D. Ischemic phase
Rationale: The secretory/luteal phase begins after ovulation with progesterone from
the corpus luteum preparing the endometrium for implantation. Proliferative phase is
before ovulation under estrogen. Menstrual and ischemic phases occur at cycle end
without implantation.
Reference: Lowdermilk et al. (2024). Maternity & Women's Health Care, 13th
ed., pp. 112-115.
Question 2
Which hormone triggers ovulation?
A. FSH
B. Luteinizing hormone (LH) [CORRECT]
C. Progesterone
Answer: B
D. Estrogen
Rationale: The LH surge triggers ovulation approximately 24-36 hours later, stimulated
by rising estrogen from the developing follicle. FSH develops follicles, estrogen
thickens endometrium, progesterone maintains it after ovulation.
Reference: Haddock (2025). Maternal & Child Nursing Care, 7th ed., pp. 78-80.
Question 3
Which statement accurately describes the myometrium?
A. Innermost layer that sheds during menstruation
B. Thick middle muscular layer responsible for contractions [CORRECT]
C. Outer serous layer covering the uterus
Answer: B
D. Lining of the cervical canal
Rationale: The myometrium is the thick middle muscular layer composed of smooth
, muscle responsible for uterine contractions during labor and for expelling menstrual
blood. Endometrium is the inner layer; perimetrium is the outer layer.
Reference: Lowdermilk et al. (2024). Maternity & Women's Health Care, 13th
ed., pp. 100-102.
Question 4
Which placental hormone maintains the corpus luteum in early pregnancy?
A. Estrogen
B. Progesterone
C. hCG [CORRECT]
Answer: C
D. hPL
Rationale: hCG from chorionic villi maintains the corpus luteum so it continues
secreting progesterone and estrogen until approximately 10-12 weeks when the
placenta takes over. hCG is detected in pregnancy tests.
Reference: Pillitteri (2024). Maternal & Child Health Nursing, 10th ed., pp. 256-
258.
Question 5
Which structure connects the ovary to the uterus and is the normal site of fertilization?
, A. Round ligament
B. Broad ligament
C. Fallopian tube [CORRECT]
Answer: C
D. Infundibulum
Rationale: Fallopian tubes connect ovaries to the uterus; fertilization occurs in the
ampulla. The infundibulum is the distal end with fimbriae. Round and broad ligaments
support the uterus structurally.
Reference: Haddock (2025). Maternal & Child Nursing Care, 7th ed., pp. 72-74.
Question 6
A drop in estrogen and progesterone at cycle end triggers which event?
A. Ovulation
B. Menstruation [CORRECT]
C. Implantation
Answer: B
D. Fertilization
Rationale: The hormonal drop causes spiral artery constriction, endometrial ischemia,
and necrosis, resulting in menstruation. It also removes negative feedback on the
hypothalamus/pituitary, allowing FSH to rise and start a new cycle.
Reference: Lowdermilk et al. (2024). Maternity & Women's Health Care, 13th
ed., pp. 108-110.
Question 7
A 28-day cycle: on which day would ovulation occur?
A. Day 7
B. Day 14 [CORRECT]
C. Day 21
Answer: B
D. Day 28
Rationale: In a 28-day cycle, ovulation occurs around day 14 (cycle length minus 14
days for the luteal phase). The follicular phase varies; the luteal phase is consistently
about 14 days.
Reference: Pillitteri (2024). Maternal & Child Health Nursing, 10th ed., pp. 252-
254.
Women's & Children's Health
200 Questions with Answers and Rationales
2026 Updated Edition
Western Governors University
,Question 1
A nurse teaches about the female reproductive cycle. Which phase begins immediately
after ovulation?
A. Menstrual phase
B. Proliferative phase
C. Secretory (luteal) phase [CORRECT]
Answer: C
D. Ischemic phase
Rationale: The secretory/luteal phase begins after ovulation with progesterone from
the corpus luteum preparing the endometrium for implantation. Proliferative phase is
before ovulation under estrogen. Menstrual and ischemic phases occur at cycle end
without implantation.
Reference: Lowdermilk et al. (2024). Maternity & Women's Health Care, 13th
ed., pp. 112-115.
Question 2
Which hormone triggers ovulation?
A. FSH
B. Luteinizing hormone (LH) [CORRECT]
C. Progesterone
Answer: B
D. Estrogen
Rationale: The LH surge triggers ovulation approximately 24-36 hours later, stimulated
by rising estrogen from the developing follicle. FSH develops follicles, estrogen
thickens endometrium, progesterone maintains it after ovulation.
Reference: Haddock (2025). Maternal & Child Nursing Care, 7th ed., pp. 78-80.
Question 3
Which statement accurately describes the myometrium?
A. Innermost layer that sheds during menstruation
B. Thick middle muscular layer responsible for contractions [CORRECT]
C. Outer serous layer covering the uterus
Answer: B
D. Lining of the cervical canal
Rationale: The myometrium is the thick middle muscular layer composed of smooth
, muscle responsible for uterine contractions during labor and for expelling menstrual
blood. Endometrium is the inner layer; perimetrium is the outer layer.
Reference: Lowdermilk et al. (2024). Maternity & Women's Health Care, 13th
ed., pp. 100-102.
Question 4
Which placental hormone maintains the corpus luteum in early pregnancy?
A. Estrogen
B. Progesterone
C. hCG [CORRECT]
Answer: C
D. hPL
Rationale: hCG from chorionic villi maintains the corpus luteum so it continues
secreting progesterone and estrogen until approximately 10-12 weeks when the
placenta takes over. hCG is detected in pregnancy tests.
Reference: Pillitteri (2024). Maternal & Child Health Nursing, 10th ed., pp. 256-
258.
Question 5
Which structure connects the ovary to the uterus and is the normal site of fertilization?
, A. Round ligament
B. Broad ligament
C. Fallopian tube [CORRECT]
Answer: C
D. Infundibulum
Rationale: Fallopian tubes connect ovaries to the uterus; fertilization occurs in the
ampulla. The infundibulum is the distal end with fimbriae. Round and broad ligaments
support the uterus structurally.
Reference: Haddock (2025). Maternal & Child Nursing Care, 7th ed., pp. 72-74.
Question 6
A drop in estrogen and progesterone at cycle end triggers which event?
A. Ovulation
B. Menstruation [CORRECT]
C. Implantation
Answer: B
D. Fertilization
Rationale: The hormonal drop causes spiral artery constriction, endometrial ischemia,
and necrosis, resulting in menstruation. It also removes negative feedback on the
hypothalamus/pituitary, allowing FSH to rise and start a new cycle.
Reference: Lowdermilk et al. (2024). Maternity & Women's Health Care, 13th
ed., pp. 108-110.
Question 7
A 28-day cycle: on which day would ovulation occur?
A. Day 7
B. Day 14 [CORRECT]
C. Day 21
Answer: B
D. Day 28
Rationale: In a 28-day cycle, ovulation occurs around day 14 (cycle length minus 14
days for the luteal phase). The follicular phase varies; the luteal phase is consistently
about 14 days.
Reference: Pillitteri (2024). Maternal & Child Health Nursing, 10th ed., pp. 252-
254.
