The Test Bank For Foundations Of Maternal-Newborn And Women’s Health Nursing 7th Edition By Murray

Chapter 03: Reproductive Anatomy and Physiology

Foundations of Maternal-Newborn & Women’s Health Nursing, 7th Edition

MULTIPLE CHOICE

1. A postpartum patient who has had a vaginal birth asks the nurse, “I was wondering if my

cervix will return to its previous shape before I had the baby?” Which is the best response by the

nurse?

a.

The cervix will now have a slit-like shape. b.

The cervix will be round and smooth after healing occurs. c.

The cervix will remain 50% effaced now that you have had a baby.

d.

The cervix will be slightly dilated to 2 cm for about 6 months. ANS: A

After vaginal birth, the external os has an irregular slit-like shape and may have tags of scar

tissue. The external os of a childless woman is round and smooth; however, after a vaginal birth it will be round and smooth. During labor, the cervix effaces (thins) and dilates (opens) to allow

passage of the fetus. Once the baby is born, the cervix will close and return to close to 100%

effacement.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation

MSC: Patient Needs: Health Promotion and Maintenance

2. The school nurse is conducting health education classes for a group of adolescents. Which statement best describes a secondary sexual characteristic?

a.

Maturation of ova b.

Production of sperm

c.

Female breast development d.

Secretion of gonadotropin-releasing hormone

ANS: C

A secondary sexual characteristic is one not directly related to reproduction, such as development of the characteristic female body form. Maturation of ova is directly related to

reproduction and is a primary sexual characteristic. Production of sperm is directly related to reproduction and is a primary sexual characteristic. Secretion of hormones is directly related to

reproduction and is a primary sexual characteristic.

DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Implementation

MSC: Patient Needs: Health Promotion and Maintenance

3. Which 16-year-old female patient is most likely to experience secondary amenorrhea?

a.

5 ft 2 in, 130 lb b.

5 ft 9 in, 180 lb c.

5 ft 7 in, 96 lb

d.

5 ft 4 in, 125 lb

ANS: C

Due to her height and low body weight, this adolescent is at risk of developing secondary amenorrhea. Secondary amenorrhea occurs in women who are thin and have a low percentage

of body fat. Fat is necessary to make the sex hormones that stimulate ovulation and menstruation. The other patients are of sufficient height and weight to promote sex hormone

production.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Physiologic Integrity

4. Which characteristic best describes the levator ani?

a.

Division of the fallopian tube b.

Collection of three pairs of muscles

c.

Imaginary line that divides the true pelvis and false pelvis d.

Basin-shaped structure at the lower end of the spine

ANS: B

The levator ani is a collection of three pairs of muscles that support internal pelvic structures and resist increases in intraabdominal pressure. The fallopian tube divisions are the interstitial portion, isthmus, ampulla, and infundibulum. The linea terminalis is the imaginary line that

divides the false from the true pelvis. The basin-shaped structure at the lower end of the spine is the bony pelvis.

DIF: Cognitive Level: Remembering OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Health Promotion and Maintenance

5. The nurse is describing the size and shape of the nonpregnant uterus to a patient. Which is an accurate description?

a.

The nonpregnant uterus is the size and shape of a pear. b.

The nonpregnant uterus is the size and shape of a cantaloupe. c.

The nonpregnant uterus is the size and shape of a grapefruit. d.

The non-pregnant uterus is the size and shape of a large orange. ANS: A

The nonpregnant uterus is about 7.5  5 2.5 cm, which is close to the size and shape of a pear.

A cantaloupe would be too large and is the wrong shape for the uterus. A grapefruit is too large for the nonpregnant uterus; the uterus is larger at the upper end and tapers down. An orange may be the appropriate size, but it is not the appropriate shape.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation

MSC: Patient Needs: Health Promotion and Maintenance

6. If a woman’s menstrual cycle began on June 2, on which date should ovulation mostly likely

have occurred?

a.

June 10 b.

June 16

c.

June 29 d.

July 5

ANS: B

June 16 would be 18 days into the cycle; ovulation should have occurred at this point. June 10 would just be 8 days into the cycle and too early for ovulation. Ovulation occurs about 12 to 14

days after the beginning of the next menstrual period in a 28-day cycle; ovulation normally

occurs about 14 days before the beginning of the next period. June 29 is at the end of the cycle. July 5 would be 27 days into the cycle and about time for the next period.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Health Promotion and Maintenance

7. A patient states, “My breasts are so small. I don’t think I will be able to breastfeed my baby.” Which is the nurse’s best response?

a.

“It may be difficult but you should try anyway.”

b.

“You can always supplement with formula.”

c.

“All women have about the same amount of glandular tissue necessary to secrete milk.”

d.

“The ability to produce breast milk depends on increased levels of estrogen and progesterone.”

ANS: C

All women have 15 to 20 lobes arranged around and behind the nipple and areola. These lobes, not the size of the breast, are responsible for milk production. The size of the breasts does not ensure success or failure in breastfeeding. Supplementation decreases the production of breast milk by decreasing stimulation. Stimulation of the breast, not the size of the breast, brings about milk production. Increased levels of estrogen decrease the production of milk by affecting prolactin.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation

MSC: Patient Needs: Physiologic Integrity

8. The nurse is explaining the function of the male’s cremaster muscle to a group of nursing

students. Which statement accurately describes the function of the cremaster muscle?

a.

Assists with transporting sperm b.

Aids in temperature control of the testicles

c.

Aids in voluntary control of excretion of urine d.

Entraps blood in the penis to produce an erection

ANS: B

One cremaster muscle is attached to each testicle. Its function is to bring the testicle closer to the body to warm it or allow it to fall away from the body to cool it, thus promoting normal sperm production. Seminal fluid assists with transporting sperm. The urinary meatus aids in controlling the excretion of urine. Entrapment of the blood in the penis is a result of the spongy tissue.

DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Physiologic Integrity

9. A newly pregnant patient asks the nurse, “What is a false pelvis?” Which statement by the

nurse will best explain this anatomy to the patient?

a.

It is the total anterior portion of the pelvis. b.

It is considered to be the lower portion of the pelvis.

c.

It provides support for the internal organs and the upper part of the body. d.

It is the narrowest part of the pelvis through which a fetus will pass during birth. ANS: C

The linea terminalis, also called the pelvic brim or iliopectineal line, is an imaginary line that divides the upper, or false, pelvis from the lower, or true, pelvis. The false pelvis provides support for the internal organs and upper part of the body. The false pelvis is the upper portion,

not the total anterior portion. The lower portion of the pelvis is the true pelvis, which is most important during childbirth because it has the narrowest portion through which the fetus will

pass during childbirth.

DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Health Promotion and Maintenance

10. The clinic nurse is reviewing breastfeeding with a pregnant patient. Which hormone will the nurse explain is responsible for milk production after the birth of the placenta?

a. Pitocin b.

Prolactin c.

Estrogen d.

Progesterone

ANS: B

During pregnancy, high levels of estrogen and progesterone produced by the placenta stimulate growth of the alveoli and ductal system to prepare them for lactation. Prolactin secretion by the

anterior pituitary gland stimulates milk production during pregnancy; however, this effect is

inhibited by estrogen and progesterone produced by the placenta. Inhibiting effects of estrogen and progesterone stop when the placenta is expelled after birth, and active milk production

occurs in response to the infant’s suckling while breastfeeding. Pitocin is the hormone that

causes the let-down reflex during breastfeeding.

DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Health Promotion and Maintenance

11. Which hormonal effect is noted during the menstrual cycle?

a.

Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion rise during the ovulatory phase.

b.

A negative feedback mechanism is exhibited by the anterior pituitary gland and ovaries. c.

The posterior pituitary gland secretes LH.

d.

Estrogen secretion enhances FSH secretion. ANS: A

Levels of LH and FSH rise dramatically during the ovulatory phase and are known as the LH

surge prior to ovulation. A positive feedback mechanism occurs with regard to the menstrual cycle. The anterior pituitary gland secretes LH. Estrogen secretion minimizes FSH secretion. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Physiologic Integrity: Reduction of Risk Potential/System-Specific

Assessments

12. A female patient who has gone through puberty and started menstruating without any problems has developed cessation of periods after 2 years of normal cycles. Which finding would indicate a possible cause for this occurrence?

a.

Lag in development of secondary sexual characteristics b.

Overproduction of androgenic hormones

c.

Negative pregnancy test d.

Clinical diagnosis of primary amenorrhea

ANS: B

An overproduction of androgenic hormones may cause the development of secondary amenorrhea. This patient has progressed through puberty, which would indicate that there is no

problem with the development of secondary sexual characteristics. If the patient had a positive

pregnancy test, then menstruation would stop. These signs and symptoms indicate the occurrence of secondary amenorrhea.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Health Promotion and Maintenance

13. On speculum examination of the cervix, it is found to be round and smooth. These findings suggest that the patient

a.

is a multipara. b.

has had previous vaginal deliveries.

c.

is nulliparous. d.

is a gravida 1, para 0.

ANS: C

These findings indicate that the patient has never been pregnant and she would be classified as nulliparous. The other findings indicate that the patient is a multipara, has had vaginal

deliveries, or is a gravida 1, para 0. These all refer to a patient with a positive history of pregnancy.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Health Promotion and Maintenance: Techniques of Physical Assessment

14. Which statement with regard to reproductive anatomy and physiology is inaccurate?

a.

Female patients who are past puberty and sexually active can become pregnant even if they have not had a menstrual cycle.

b.

Puberty symptoms are more prominent in males than females. c.

Females enter puberty earlier than their male counterparts.

d.

Secondary sexual characteristics develop during puberty. ANS: B

Puberty symptoms are less prominent in developing males than females. The other statements

are correct.

DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment

MSC: Patient Needs: Health Promotion and Maintenance

15. The nurse is reviewing normal female development with a mother of a 10-year-old daughter. The mother states, “I noticed that my daughter developed breast buds about a year ago. When do you think she will start her menstrual cycle?” What is the nurse’s best response?

a.

“In about a year.”

b.

“Likely any time now.”

c.

“Does your daughter know what to expect?”

d.

“It is impossible to predict when she will start her cycle.”

ANS: A

Menarche occurs about 2 to 2.5 years after breast development. Asking the mother if her

daughter knows what to expect is a vague response that does not answer the mother’s

question.

DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Implementation

MSC: Patient Needs: Health Promotion and Maintenance

16. The middle school nurse is reviewing the phases of the endometrial cycle with a group of female students. Which statement by a student will the nurse need to correct?

a.

“The proliferative phase occurs when the ovum is maturing.”

b.

“The expulsion phase occurs when the ovum is discharged from the ovary.”

c.

“The secretory phase occurs during the second half of the menstrual cycle.”

d.

“The menstrual phase occurs after the levels of estrogen and progesterone fall.”

ANS: B