NURSE PRACTITIONERS IN PRIMARY CARE I
FOURTH TEST 2026 SUCCESS BLUEPRINT
GUIDE
◉ testes and testosterone pathway. Answer: - hypothalamus >
*GnRH* > anterior pituitary > *FSH/LSH* > testes/seminiferous
tubules/interstitial cells
- testes/interstitial cells > *testosterone*
- hormones are in *bold*
◉ ovaries/estrogen feedback loops. Answer: positive:
- GnRH stimulates pituitary
- FSH/LH stimulates ovaries
- estrogen inhibits hypothalamus and pituitary
◉ female reproductive cycle if not pregnant. Answer: - corpus
luteum breaks down
- progesterone drops
- menstruation begins
- hypothal. releases GnRH; stimulates pituitary
- pituitary releases FSH and LH; stimulates ovaries
,- ovaries release estrogen; stimulates ovulation
- uterine lining builds
- progesterone increases
- chance for pregnancy
◉ female reproductive cycle if pregnant. Answer: - egg is fertilized
- zygote forms
- HCG stimulates corpus luteum to release progesterone
- uterine lining is maintained
◉ reproductive phases of ovaries. Answer: follicular phase:
- follicle matures and ovum develops
- ovulation occurs on day 14
luteal phase:
- released ovum matures into corpus luteum
◉ reproductive phases of endometrium. Answer: - day 1-5; menses
- day 5-13; endometrium proliferates (proliferative phase)
- day 14 - 28; secretory phase
◉ reproductive phases of ovarian hormones. Answer: estrogen:
,- initially low
- increases until ovulation (day 14)
- another smaller peak around day 25 as progesterone levels begin
to decline
progesterone:
- begins to increase just before ovulation
- peaks around day 21
- drops off quickly
◉ reproductive phases of pituitary gonadotropins. Answer: FSH:
- low, plateau
- small spike at day 14
LH:
- low(er), plateau
- large spike at day 14
◉ effect of ovarian estrogen on the follicle and endometrium..
Answer: follicle:
- estrogen peaks as ovulation occurs
, endometrium:
- Proliferation of uterine epithelium
- endocervical mucus production
◉ State the physiologic effects of estrogen. Answer: - Sexual
maturity: Female secondary sex characteristics
- Reproductive cycle: Follicular and luteal phases - Proliferation of
uterine epithelium and endocervical mucus production (among
others)
- Bones: Block the actions of osteoclasts.
- Cholesterol: Favors HDL and nitric oxide - considered
cardioprotective
- Coagulation: Complex, but clinically estrogen considered
thrombogenic.
◉ State the physiologic effects of progesterone.. Answer: -
Reproductive cycle: Luteal phase - secretory phase and hypertrophy
of the endometrium in preparation for implantation of zygote.
- If no pregnancy, corpus luteum breaks down, progesterone
declines, and endometrium sheds (menstruation).
◉ pharmacological uses of estrogen and progesterone. Answer: -
Contraception
- Menopausal hormone therapy
FOURTH TEST 2026 SUCCESS BLUEPRINT
GUIDE
◉ testes and testosterone pathway. Answer: - hypothalamus >
*GnRH* > anterior pituitary > *FSH/LSH* > testes/seminiferous
tubules/interstitial cells
- testes/interstitial cells > *testosterone*
- hormones are in *bold*
◉ ovaries/estrogen feedback loops. Answer: positive:
- GnRH stimulates pituitary
- FSH/LH stimulates ovaries
- estrogen inhibits hypothalamus and pituitary
◉ female reproductive cycle if not pregnant. Answer: - corpus
luteum breaks down
- progesterone drops
- menstruation begins
- hypothal. releases GnRH; stimulates pituitary
- pituitary releases FSH and LH; stimulates ovaries
,- ovaries release estrogen; stimulates ovulation
- uterine lining builds
- progesterone increases
- chance for pregnancy
◉ female reproductive cycle if pregnant. Answer: - egg is fertilized
- zygote forms
- HCG stimulates corpus luteum to release progesterone
- uterine lining is maintained
◉ reproductive phases of ovaries. Answer: follicular phase:
- follicle matures and ovum develops
- ovulation occurs on day 14
luteal phase:
- released ovum matures into corpus luteum
◉ reproductive phases of endometrium. Answer: - day 1-5; menses
- day 5-13; endometrium proliferates (proliferative phase)
- day 14 - 28; secretory phase
◉ reproductive phases of ovarian hormones. Answer: estrogen:
,- initially low
- increases until ovulation (day 14)
- another smaller peak around day 25 as progesterone levels begin
to decline
progesterone:
- begins to increase just before ovulation
- peaks around day 21
- drops off quickly
◉ reproductive phases of pituitary gonadotropins. Answer: FSH:
- low, plateau
- small spike at day 14
LH:
- low(er), plateau
- large spike at day 14
◉ effect of ovarian estrogen on the follicle and endometrium..
Answer: follicle:
- estrogen peaks as ovulation occurs
, endometrium:
- Proliferation of uterine epithelium
- endocervical mucus production
◉ State the physiologic effects of estrogen. Answer: - Sexual
maturity: Female secondary sex characteristics
- Reproductive cycle: Follicular and luteal phases - Proliferation of
uterine epithelium and endocervical mucus production (among
others)
- Bones: Block the actions of osteoclasts.
- Cholesterol: Favors HDL and nitric oxide - considered
cardioprotective
- Coagulation: Complex, but clinically estrogen considered
thrombogenic.
◉ State the physiologic effects of progesterone.. Answer: -
Reproductive cycle: Luteal phase - secretory phase and hypertrophy
of the endometrium in preparation for implantation of zygote.
- If no pregnancy, corpus luteum breaks down, progesterone
declines, and endometrium sheds (menstruation).
◉ pharmacological uses of estrogen and progesterone. Answer: -
Contraception
- Menopausal hormone therapy
