DAVIS PEDIATRIC SUCCESS MOTHER BABY

DAVIS PEDIATRIC SUCCESS MOTHER BABY Maternal and Newborn Success A Q&A Review Applying Critical Thinking to Test Taking THIRD EDITION Sexuality, Fertility, 2 Before pregnancy can begin, a sperm and an ovum must unite. This usually occurs as a result of sexual intercourse but can be accomplished via artificial insemination, most com- monly intrauterine insemination (IUI), in-vitro fertilization, and a number of other proce- dures used in attempts to overcome infertility. The nurse must be familiar with the male and female reproductive systems to understand why normal procreation occurs and why, in some instances, a woman fails to become pregnant. This chapter includes questions on three related issues surrounding the process of reproduction: sexuality, infertility, and genetics. Since genetics involves much more than simply parents and their offspring, additional concepts are included in the genetics section. KEYWORDS The following words include English vocabulary, nursing/medical terminology, concepts, principles, or information relevant to content specifically addressed in the chapter or associated with topics presented in it. English dictionaries, your nursing textbooks, and medical dictionaries such as Taber’s Cyclopedic Medical Dictionary are resources that can be used to expand your knowledge and understanding of these words and related information. Allele Amniocentesis Aneuploidy Artificial insemination Autosomal dominant inheritance Autosomal recessive inheritance Autosome Basal body temperature Cell-free DNA Chorionic villus sampling (CVS) Chromosome Corpus cavernosum Corpus luteum Corpus spongiosum Deoxyribonucleic acid (DNA) Diploid Down syndrome Duchenne muscular dystrophy Ejaculatory duct Endometrial biopsy Epididymis Estrogen Expressivity Fallopian tubes Familial adenomatous polyposis (FAP) Ferning capacity Fertilization Fimbriae First trimester screen Follicle-stimulating hormone (FSH) Follicular phase Fragile X syndrome Gametes Gametogenesis Gene Genetics Genome Genotype GIFT (gamete intrafallopian transfer) Glans Gonadotropin-releasing hormone Graafian follicle Haploid Hemophilia A Human chorionic gonadotropin Huntington disease Hysterosalpingogram Hysteroscopy Infertility In-vitro fertilization 12 MATERNAL AND NEWBORN SUCCESS Ischemic phase Karyotype Laparoscopy Luteal phase Luteinizing hormone (LH) Meiosis Menses Menstrual cycle Menstrual phase Mitochondrial inheritance Mitosis Monosomy Oogenesis Ovary Ovulation Ovum Pedigree Penetrance Phenotype Phenylketonuria Polycystic kidney disease (PKD) Prepuce Progesterone Proliferative phase Prostate Ribonucleic acid (RNA) Scrotum Second trimester quad screen Secretory phase Seminal vesicle Sex chromosome Spermatogenesis Spinnbarkeit Surrogate Testes Trisomy Urethra Uterus Vagina Vas deferens X- linked recessive inheritance Y-linked inheritance ZIFT (zygote intrafallopian transfer) QUESTIONS Sexuality 1. A nurse is discussing sexual arousal during a preadolescent boys’ sex education class. Which of the following should the nurse base the reply on when a boy asks, “What exactly happens when my body gets aroused, anyway?” 1. The vas deferens thickens and expands. 2. The sympathetic nerves of the penis are stimulated. 3. The corpora of the penis become engorged. 4. The prepuce of the penis elongates. 2. A woman, whose menstrual cycle is 35 days long, states that she often has a slight pain on one side of her lower abdomen on day 21 of her cycle. She wonders whether she has ovarian cancer. Which of the following is the nurse’s best response? 1. “Women often feel a slight twinge when ovulation occurs.” 2. “You should seek medical attention as soon as possible since ovarian cancer is definitely a possibility.” 3. “Ovarian cancer is unlikely because the pain is not a constant pain.” 4. “It is more likely that such pain indicates an ovarian cyst because pain is more common with that problem.” 3. A nurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, please place the following four hormones in the chronological order in which they elevate during the menstrual cycle. 1. Follicle-stimulating hormone. 2. Gonadotropin-releasing hormone. 3. Luteinizing hormone. 4. Progesterone. CHAPTER 2 SEXUALITY, FERTILITY, AND GENETICS 4. A 54-year-old client calls her healthcare practitioner complaining of frequency and burning when she urinates. Which of the following factors that occurred within the preceding 3 days likely contributed to this client’s problem? 1. She had intercourse with her partner. 2. She returned from a trip abroad. 3. She stopped taking hormone replacement therapy. 4. She started a weight-lifting exercise program. 5. A woman’s temperature has just risen 0.4°F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the change? 1. Estrogen. 2. Progesterone. 3. Luteinizing hormone (LH). 4. Follicle-stimulating hormone (FSH). 6. A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormonal levels would the nurse expect to see? 1. Both estrogen and progesterone are high. 2. Estrogen is high and progesterone is low. 3. Estrogen is low and progesterone is high. 4. Both estrogen and progesterone are low. 7. A nurse teaches a woman who wishes to become pregnant that if she assesses for spinnbarkeit she will be able to closely predict her time of ovulation. Which technique should the client be taught to assess for spinnbarkeit? 1. Take her temperature each morning before rising. 2. Carefully feel her breasts for glandular development. 3. Monitor her nipples for signs of tingling and sensitivity. 4. Assess her vaginal discharge for elasticity and slipperiness. 8. In analyzing the need for teaching regarding sexual health in a client who is sexually active, which of the following questions is the most important for a nurse to ask? 1. “How old are your children?” 2. “Did you have intercourse last evening?” 3. “With whom do you have intercourse?” 4. “Do you use vaginal lubricant?” 9. When a nurse is teaching a woman about her menstrual cycle, which of the following is the most important change that happens during the follicular phase of the menstrual cycle? 1. Maturation of the graafian follicle. 2. Multiplication of the fimbriae. 3. Secretion of human chorionic gonadotropin. 4. Proliferation of the endometrium. 10. It is day 17 of a woman’s menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long. Which of the following is an appropriate reply by the nurse? 1. “You are probably ovulating.” 2. “Your hormone levels should be checked.” 3. “You will probably menstruate early.” 4. “Your breast changes are a worrisome sign.” 14 MATERNAL AND NEWBORN SUCCESS 11. A man asks the nurse where his sperm are produced. On the diagram, please place an “X” on the site of spermatogenesis. 12. The nurse is teaching a class on reproduction. When asked about the development of the ova, the nurse would include which of the following? 1. Meiotic divisions begin during puberty in girls. 2. At the end of meiosis, four ova are created. 3. Each ovum contains the diploid number of chromosomes. 4. Like sperm, ova have the ability to propel themselves. 13. A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the following may have contributed to her problem? 1. At