Anatomy and Physiology of the Reproductive System

A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs: a. In the vagina b. In the fallopian tubes c. In the uterus d. In the ovaries - answer-b. In the fallopian tubes (Rationale: Fertilization of the ovum can occur in the distal portion of the fallopian tubes. If the egg is fertilized, it will then be moved through the fallopian tube towards the uterus, where it implants in the thick endometrium and begins its development.) When describing the role of the scrotum as the "climate control system" for the testes, the nurse would include a description of which of the following? a. Testes b. Vas deferens c. Prepuce d. Cremaster muscles - answer-d. Cremaster muscles (Rationale: The cremaster muscles in the scrotal wall relax or contract to allow the testes to hang farther from the body to cool or be pulled close to the body for warmth or protection. The prepuce or foreskin is a circular fold of skin that extends over the glans penis unless it is removed by circumcision. The testes, located in the scrotum, produce sperm and synthesize testosterone. The vas deferens is a cordlike duct that transports sperm from the epididymis.) The client is surprised when the nurse explains how the reproductive cycle involves hormones from the following structures: (Select all that apply.) a. Pituitary b. Ovaries c. Hypothalamus d. Placenta - answer-a. Pituitary b. Ovaries c. Hypothalamus (Rationale: The reproductive cycle is influenced and controlled by hormones secreted by the ovaries, hypothalamus, and pituitary gland. The placenta secretes a temporary hormone that assists with maintaining pregnancy.) It is important that a nurse recognizes there are cultural differences that will have an influence on the care of the client. Some cultures practice female circumcision, which involves the removal of the: a. Hymen b. Clitoris c. Labia minora d. Fourchette - answer-b. Clitoris (Rationale: Some cultures practice female circumcision, which involves the removal of the clitoris. It is important for the nurse to remain open-minded and nonjudgmental with all clients.) The nurse explained to her client that the ____________________ of the uterine corpus can fluctuate with changes of hormonal levels in the absence of pregnancy. a. Myometrium b. Perimetrium c. Endometrium d. Epimetrium - answer-c. Endometrium (Rationale: The corpus, or main body of the uterus, undergoes cyclic changes as the result of changing levels of hormones secreted by the ovaries, in preparation of a pregnancy. When fertilization does not occur, most of the endometrium is shed and the monthly period occurs.) The nurse asks the class to identify the location of sperm production. The class is correct when they identify the: a. Seminiferous tubules b. Seminal vesicles c. Spermatic cord d. Vas deferens - answer-a. Seminiferous tubules (Rationale: Sperm is produced in the seminiferous tubules of the testes. The vas deferens transports sperm from the epididymis. The seminal vesicles produce nutrient seminal fluid. The spermatic cord is formed by the vas deferens, blood vessels, and nerves to act as a passageway for sperm.) It is important that couples who wish to practice natural forms of birth control, understand that the mucus-secreting glands of the cervix can store live sperm for up to: a. 36 hours b. 48 hours c. 12 hours d. 24 hours - answer-b. 48 hours (Rationale: The mucus-secreting glands of the cervix are capable of storing live sperm for 48 to 72 hours [2 to 3 days], enabling pregnancy to occur after intercourse has occurred 1 or 2 days before ovulation.) The nurse is working with a young couple who are trying to conceive. The nurse recognizes that the clients understand the basics of the reproductive cycle when they identify that ovulation usually occurs at day __________ of a 28-day cycle. a. 20 b. 10 c. 14 d. 16 - answer-c. 14 (Rationale: Ovulation usually occurs at day 14 of a 28-day cycle.) When describing the external female reproductive organs, which of the following would the nurse include? (Select all that apply.) a. Vagina b. Labia majora c. Vestibule d. Perineum - answer-b. Labia majora c. Vestibule d. Perineum (Rationale: The external female reproductive organs include the mons pubis, labia majora, labia minora, clitoris, vestibule, and perineum. The vagina, uterus, ovaries and fallopian tubes are internal female reproductive organs.) The nurse describes the components of semen, stating that most of the volume of semen is provided by the seminal vesicles and the: a. Bulbourethral glands b. Penile mucous glands c. Vas deferens d. Prostate gland - answer-d. Prostate gland (Rationale: The seminal vesicles and the prostate gland produce fluid that nourishes the sperm and provide most of the volume of semen. Other fluid that makes up semen comes from the vas deferens and from the mucous glands in the head of the penis. The bulbourethral glands secrete a mucus-like fluid that lubricates the head of the penis in preparation for sexual intercourse.) During an examination of the client, the nurse will question the women concerning their LMP. This indicates: a. The last day of their last menstrual period b. The level of menstrual pain c. The length of their menstrual periods d. The first day of their last menstrual period - answer-d. The first day of their last menstrual period (Rationale: LMP is the abbreviation for last menstrual period. It is used to indicate the first day of the last cycle. This information is used to determine estimated date of delivery, if the client is pregnant. It is also important to establish potential disorders of the reproductive system.) After discussing infection prevention with a client, the nurse recognizes the client understood by recognizing that an __________________________ helps protect against vaginal infections. a. Rugae b. Menstrual flow c. Acidic environment d. Alkaline environment - answer-c. Acidic environment (Rationale: An acidic environment helps protect against ascending infections in the vagina. The client should be cautioned against using douches, hygiene sprays, or deodorants that might upset the acid balance.) The nurse recognizes that the predominant hormones involved in the menstrual cycle are: (Select all that apply.) a. Prolactin b. LH c. FSH d. GnRH - answer-b. LH c. FSH d. GnRH (Rationale: The predominant hormones involved in the menstrual cycle are gonadotropin-releasing hormone [GnRH], follicle-stimulating hormone [FSH], luteinizing hormone [LH], estrogen, progesterone, and prostaglandins. Testosterone and prolactin do have a role in the female reproductive system but are not considered a predominant hormone for the menstrual cycle.) After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle? a. Ischemic phase b. Follicular phase c. Secretory phase d. Proliferative phase - answer-b. Follicular phase (Rationale: The ovarian cycle consists of the follicular phase, ovulation, and the luteal phase. The proliferative, secretory, and ischemic phases occur in the endometrial cycle.) A woman experiencing menopausal symptoms asks the nurse about herbal remedies for managing her symptoms. Which response by the nurse would be most appropriate? a. "Your symptoms are not severe enough to warrant any treatment or therapy." b. "Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies." c. "Herbal remedies have been proven quite reliable in alleviating the symptoms of menopause." d. "You should avoid herbal remedies and ask your physician for hormone replacement therapy." - answer-b. "Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies." (Rationale: Information about the efficacy of herbal therapies is largely anecdotal. Research to validate efficacy, safety, and potential harmful effects of herbal therapies is lacking. Until recently, hormone replacement therapy was the mainstay of treatment, but in light of the results of the Women's Health Initiative trial, it has become controversial. Telling the woman that her symptoms are not severe enough is demeaning and inappropriate; the woman's symptoms are significant to her regardless of what the nurse may think.) A client is presenting with possible signs of menopause. The nurse recognizes that menopausal symptoms are related to: a. Vasomotor activities b. Autonomic activities c. Psychiatric activities d. Hypersecretion of hormones - answer-a. Vasomotor activities (Rationale: Vasomotor symptoms are the most commonly reported during the menopausal transition. These include hot flashes, irregular menstrual cycles, sleep disruptions, forgetfulness, irritability, mood disturbances, decreased vaginal lubrication, night sweats, fatigue, vaginal atrophy, and depression.) Which hormone would the nurse explain is primarily responsible for maturation of the ovarian follicle? a. Estrogen b. Follicle-stimulating hormone c. Gonadotropin-releasing hormone d. Luteinizing hormone - answer-b. Follicle-stimulating hormone (Rationale: Follicle-stimulating hormone is primarily responsible for the maturation of the ovarian follicle. Luteinizing hormone is required for the final maturation of preovulatory follicles and luteinization of the ruptured follicle. Gonadotropin-releasing hormone induces the release of follicle stimulating hormone and luteinizing hormone to assist with ovulation. Estrogen is crucial for the development and maturation of the follicle and induces proliferation of the endometrial glands.) After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies which of the following as a primary function of the ovaries? a. Secretion of estrogen and progesterone b. Location for implantation of a fertilized ovum c. Carrying the ovum to the endometrium d. Secretion of mucus that supplies lubrication for intercourse - answer-a. Secretion of estrogen and progesterone (Rationale: The ovaries have two primary functions: development and release of the ovum and secretion of estrogen and progesterone. The fallopian tubes are responsible for conveying the ovum from the ovary to the uterus and sperm from the uterus toward the ovary. The Bartholin's glands when stimulated secrete mucus that supplies lubrication for intercourse. The uterus is the site of implantation of a fertilized ovum.) The nurse, while teaching a group of pregnant woman about the production of breast milk, describes colostrum and compares is with mature breast milk. Which of the following would the nurse include in the comparative description? a. Its low mineral content b. High maternal antibody content c. Its high sugar content d. Limited protein content - answer-b. High maternal antibody content (Rationale: Colostrum is rich in maternal antibodies, especially IgA, which protects the newborn against enteric pathogens. Colostrum contains more minerals and protein but less sugar and fat than mature breast milk.) The nurse understands that the endometrium is prepped for egg implantation by the corpus luteum, which secretes: a. Estrogen b. Luteinizing hormone c. Testosterone d. Progesterone - answer-d. Progesterone (Rationale: The corpus luteum secretes increasing amounts of the hormone progesterone, which interacts with the endometrium to prepare it for implantation.) When describing the internal structures, the nurse will identify the neck of the uterus as the: a. Fourchette b. Vagina c. Clitoris d. Cervix - answer-d. Cervix (Rationale: The neck of the uterus is referred to as the cervix. It connects to the vagina.)