CARE MANAGEMENT 3 FINAL REVIEW OB 4,8,16, peds 33-55 Q&A

CM3 FINAL EXAM – OB 4,8,16, peds 33-55 Chapter 4 Reproductive Anatomy and Physiology 1) A nurse is teaching a classroom of teenage girls about the female reproductive system. After teaching, the nurse asks the students to describe the release of an ovum during ovulation. Which response indicates that teaching has been effective? 1. “Ovulation is when the uterus releases an unfertilized egg or ovum.” 2. “During ovulation, an egg is released from the ovary and enters the fallopian tube.” 3. “The endometrium is where the eggs are formed and released into the fallopian tube.” 4. “Around the middle of the menstrual cycle, one of the fallopian tubes releases an egg.” Answer: 2 2) A client desiring to become pregnant is concerned because the opening of her spouse’s penis is below the tip. How should the nurse respond to this client? 1. “This is epispadias and it will cause infertility.” 2. “This is hypospadias and it will cause infertility.” 3. “This is epispadias and is not likely to impact fertility.” 4. “This is hypospadias and is not likely to impact fertility.” Answer: 4 3) A prenatal client states, “The doctor said he might have to cut my cervix so the baby can get out during delivery.” Based upon this statement, what structure should the nurse define when teaching about an episiotomy? 1. Mons pubis 2. Labia majora 3. Perineal body 4. Vaginal vestibule Answer: 3 4) A pregnant client asks, “What’s the difference between the true pelvis and the false pelvis?” How should the nurse respond? 1. “The false pelvis helps support the weight of the pregnant uterus.” 2. “The false pelvis consists of the inlet, the pelvic cavity, and the outlet.” 3. “The true pelvis does not affect fetal passage during labor and childbirth.” 4. “The true pelvis helps direct the presenting fetal part into the false pelvis.” Answer: 1 5) A pregnant adolescent asks about fundal height. What should the nurse say that incorporates the location of the uterine fundus? 1. It is the lower third area of the uterus. 2. It is at the uppermost (dome-shaped top) portion of the uterus. 3. It is the elongated portion of the uterus where the fallopian tubes enter. 4. It is the portion of the uterus that lies between the internal cervical os and the endometrial cavity CM3 FINAL EXAM – OB 4,8,16, peds 33-55 Answer: 2 6) The nurse is teaching a client who recently learned that she is pregnant. Which hormone should the nurse instruct as being secreted by the fertilized egg? 1. Estrogen 2. Progesterone 3. Luteinizing hormone 4. Human chorionic gonadotropin (hCG) Answer: 4 7) The school nurse is teaching a health class to middle school children. Which structure should the nurse explain as secreting follicle-stimulating hormone (FSH) and luteinizing hormone (LH)? 1. Hypothalamus 2. Anterior pituitary 3. Posterior pituitary 4. Ovaries and testes Answer: 2 8) The nurse is presenting a community education session on female hormones. Which participant statement indicates the need for further information? 1. “Estrogen is what causes females to look female.” 2. “Prostaglandin is responsible for achieving conception.” 3. “Progesterone is present at the end of the menstrual cycle.” 4. “The presence of some hormones causes others to be secreted.” Answer: 2 9) A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. Which hormone is most likely causing this client’s issues with pregnancy? 1. Estrogen 2. Progesterone 3. LH (luteinizing hormone) 4. FSH (follicle-stimulating hormone) Answer: 2 10) The nurse is explaining the menstrual cycle to a group of women. In which phase should the nurse instruct that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and the blood supply to the endometrium is reduced? 1. Ischemic phase 2. Secretory phase 3. Menstrual phase 4. Proliferative phase Answer: 1 CM3 FINAL EXAM – OB 4,8,16, peds 33-55 11) Which statement best indicates that the client understands the differences in the follicular and luteal phases of the ovarian cycle? 1. “My period will be every 28 days.” 2. “The follicular phase is when the egg is fertilized.” 3. “The follicular phase is the second half of my cycle.” 4. “The first part of my period might vary in length, but not the second.” Answer: 4 12) The nurse is preparing a handout on the ovarian cycle for a group of middle school girls. Which information should the nurse include? 1. There are two phases of the ovarian cycle: luteal and follicular. 2. The hormone human chorionic gonadotropin (hCG) stimulates ovulation. 3. The ovum travels from the ovary to the tube during the luteal phase. 4. Irregular menstrual cycles have varying lengths of the follicular phase. Answer: 1 13) The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation? 1. “One hormone controls the phases of the menstrual cycle.” 2. “The secretory phase occurs when a woman is most fertile.” 3. “Menstrual cycle phases vary in order from one woman to another.” 4. “The menstrual cycle has five distinct phases that occur during the month.” Answer: 2 14) In preparation for teaching a women’s community center class about physiologic changes during menopause, the nurse is preparing a handout for students. Which information should the nurse include in this teaching? 1. Due to changes in estrogen levels, the labia minora increase in size after menopause. 2. The ovaries remain small after puberty, but they increase in size following menopause. 3. After menopause, the endometrium continues to undergo monthly degeneration and renewal. 4. Ovarian secretion of estrogen decreases between the ages of 45 and 55, after which point ovulatory activity ceases. Answer: 4 15) A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0°F) for the past 36 hours. What should these findings indicate to the nurse? 1. Ovulation has occurred. 2. Ovulation will occur soon. 3. Menstruation is about to begin. 4. She is pregnant and will not menstruate. Answer: 1 16) A pregnant client is scheduled for a lower-segment cesarean birth. Place an X on the area of the uterine structure where the nurse should instruct that this incision for the procedure will be placed. CM3 FINAL EXAM – OB 4,8,16, peds 33-55 Answer: Explanation: The isthmus is that portion of the uterus between the internal cervical os and the endometrial cavity. The isthmus is about 6 mm above the uterine opening of the cervix and takes on importance in pregnancy because it becomes the lower uterine segment. At birth, this thin lower segment, situated behind the bladder, is the site for lower-segment cesarean births. 17) After delivery, the nurse notes that a client is having considerable vaginal bleeding. On the diagram provided, identify the area of the myometrium that is responsible for stopping bleeding after birth. CM3 FINAL EXAM – OB 4,8,16, peds 33-55 Answer: Explanation: The thick middle layer of the myometrium is made up of interlacing muscle fibers in figure-eight patterns that surround large blood vessels. Their contraction produces a tourniquet-like action on blood vessels to stop bleeding after birth. 18) The nurse is reviewing the anatomy and physiology of the reproductive organs during a prenatal class. On the diagram, select the area that the nurse should identify as being the round ligament