Exam 4 Test Banks Flashcards
The nurse is teaching a client about side effects and adverse reactions of a PDE5 inhibitor. What information does the nurse include? (Select all that apply.)
a. Refrain from eating citrus fruit within 24 hours of taking the medication.
b. Stop using this drug if your primary health care provider prescribes a nitrate.
c. Do not drink alcohol before having sexual intercourse.
d. Muscle cramps, nausea, and vomiting are possible if you take more than 1 pill a day.
e. Take this medication within 30 to 60 minutes of having sexual intercourse.
f. Change positions slowly especially if you also take an anti-hypertensive drug.
b. Stop using this drug if your primary health care provider prescribes a nitrate.
c. Do not drink alcohol before having sexual intercourse.
d. Muscle cramps, nausea, and vomiting are possible if you take more than 1 pill a day.
f. Change positions slowly especially if you also take an anti-hypertensive drug.
Rationale: A PDE5 inhibitor is used to treat erectile dysfunction. The client should avoid grapefruit or grapefruit juice while taking these drugs.
Taking a PDE5 inhibitor along with a nitrate can cause a profound drop in blood pressure.
Alcohol may interfere with the ability to have an erection. Muscle cramps, nausea, and vomiting are possible side effects if more than 1 pill a day are taken.
Each medication has its own directions for how soon to take it before intercourse, from 15 minutes to 2 hours.
Any PDE5 drug can lower blood pressure so the nurse alerts the client of safety precautions.
A client came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the client during history taking? (Select all that apply.)
a. Recent prostatectomy
b. Long-term hypertension
c. Diabetes mellitus
d. Hour-long exercise sessions
e. Consumption of beer each night
f. Taking long hot baths
a. Recent prostatectomy
b. Long-term hypertension
c. Diabetes mellitus
e. Consumption of beer each night
Rationale: Organic erectile dysfunction can be caused by surgical procedures, vascular diseases such as hypertension and its treatment, diabetes mellitus, and alcohol consumption. There is no evidence that exercise or hot baths are related to this problem.
A nurse is reviewing concepts related to physiological responses that occur during sexual acts. Which statement should the nurse identify as not being accurate?
a. During resolution, ADH and oxytocin are released.
b. Most often in males, orgasm occurs with ejaculation.
c. Genital congestion occurs as part of a reflexive response.
d. Dopamine secretion acts as an inhibitory transmitter.
d. Dopamine secretion acts as an inhibitory transmitter.
Rationale: The general phases of sexual arousal include motivation, arousal, genital congestion, orgasm and resolution. Dopamine secretion is considered to be an excitatory and released during the arousal stage.
Orgasm and ejaculation occur more frequently in males.
Genital congestion is under reflexive autonomic response.
The nurse is obtaining a sexual history from an adolescent patient. Which finding has the greatest implication for this patient’s care?
a. Patient denies any sexual activity.
b. Patient states that he/she uses “safe sex” practices.
c. Patient states that he/she is in a monogamous relationship.
d. Patient has been intimate with more than one person in the last year.
d. Patient has been intimate with more than one person in the last year.
Rationale: The Center for Disease Control (CDC) had identified the 5P’s with regard to obtaining information for a sexual history.
They focus on partners, practices, protection from infection, past history of infection, and prevention of pregnancy.
An individual who has had more than one partner within the time frame should be questioned regarding condom use.
Denial of sexual activity is part of the patient’s self-disclosure. The patient stating that he/she is in a monogamous relationship again represents self-disclosure.
Use of “safe sex” practices may need to be further explored but it does not have the greatest implication at this point.
A 45-year-old female patient, gravida 3 para 3, presents with complaints of decreased desire to engage in sexual activity with her husband as it is becoming more painful. What physical assessment data should the nurse focus on?
a. Urine culture to identify potential STD.
b. Obtain vital signs as a baseline to rule out infection.
c. Prepare for a vaginal exam.
d. Inspection of the abdomen for pelvic mass
c. Prepare for a vaginal exam.
Rationale: Based on the patient’s reported complaint and obstetrical history, it may be likely that the patient has a pelvic prolapse.
Therefore, a vaginal exam would be indicated to help identify possible anatomical changes.
There is no clinical data that supports a potential pelvic mass and inspection alone would not confirm this finding.
Obtaining vital signs as well as a urine culture may
be needed, but the focus should be on determination of physical findings related to the pelvic area.
An adult patient comes for a well-check up to the primary care provider’s office. In completing the office admission form, the
patient does not indicate gender on the form and seems somewhat agitated when providing the form back to the nurse. How should the nurse respond?
a. Ask the patient to complete all of the information at this time.
b. Ask the patient if you can assist with completing the form.
c. The nurse should just indicate which gender she/he thinks is appropriate.
d. Tell the patient that if the form is not completed, then the doctor will not see you.
b. Ask the patient if you can assist with completing the form.
Rationale: Gender identity is defined by the individual patient. The nurse should not designate this description or identity nor should the nurse tell the patient that if the form is not completed, that the patient will not be seen by the healthcare provider.
Asking the patient to complete the information without acknowledging that the patient is exhibiting signs of distress is not therapeutic.
The nurse should offer to provide assistance to the patient.
A nurse is working with a male patient being treated for erectile dysfunction. Which statement indicates that additional teaching is needed?
a. “I like to go walking around my community each night after dinner.”
b. “I have a few drinks during the week when I go out after work.”
c. “I have maintained my weight for the past 5 years after losing 20 pounds.”
d. “I monitor my blood pressure at home using a portable cuff.”
b. “I have a few drinks during the week when I go out after work.”
Rationale: Erectile dysfunction (ED) is a common problem affecting the male population and can be chronic or transient in nature.
Alcohol use can affect ED, so the patient’s reported alcohol intake indicates that additional teaching is warranted.
Exercise, maintaining a healthy weight, and monitoring of blood pressure are examples of appropriate activities.
A nursery nurse performing the first physical assessment of the newborn observes that there is no clear identification of genitalia as being either female or male. How should the nurse identify this newborn?
a. Gender neutral
b. Bisexual
c. Observation of intersex
d. Asexual
c. Observation of intersex
Rationale: Intersex represents a group of conditions where the external genitalia of an infant does not appear as either male or female and/or is not consistent with genetic sex or organs. The nurse cannot attribute sexual preference such as asexual or bisexual.
Gender neutral does not apply to this clinical situation.
A nurse working with a family whose child has recently told them that he identifies with the LGBTQ community asks the nurse to explain how this happened considering the fact that the child was raised as a male and played with appropriate toys. What is the best nursing response to the family’s concerns?
a. Tell them that there is no need for concern for their child has shared this information with them.
b. Ask the parents if they ever noticed something different about their son as he was growing up.
c. Explain that sexual orientation changes can occur over time.
d. Suggest that this behavior may be temporary.
c. Explain that sexual orientation changes can occur over time.
Rationale: Sexual orientation and gender identification is now thought of as a fluid concept, with the term sexual fluidity being used to convey this meaning for individuals who identify with other than heterosexual relationships.
The nurse should respond to the parent’s concerns and not minimize their reaction but rather let them know that it is the chosen response of their child.
Relating sexual orientation or gender identification to how one was raised indicates an implied bias. Telling the family that the behavior may be temporary is not correct.
A nurse is assessing a client who presents with a scaly rash over the palms and soles of the feet and the feeling of muscle aches and malaise. Which action by the nurse is most appropriate?
a. Reassure the client that these lesions are not infectious.
b. Assess the client for hearing loss and generalized weakness.
c. Don gloves and further assess the client’s lesions.
d. Take a history regarding any cardiovascular symptoms.
c. Don gloves and further assess the client’s lesions.
Rationale: The client is displaying symptoms similar to secondary syphilis, with flu-like symptoms and rash due to the spirochetes circulating throughout the bloodstream. Therefore, the nurse needs to further assess the client’s lesions with gloves since the client is highly contagious at this stage.
Tertiary syphilis may display in the form of cardiovascular or central nervous system symptoms.
Neurosyphilis can appear at any time, in any state, and can include hearing loss.
A male client is diagnosed with primary syphilis. Which question by the nurse is a priority at this time?
a. “Have you been using latex condoms?”
b. “Are you allergic to penicillin?”
c. “When was your last sexual encounter?”
d. “Do you have a history of sexually transmitted infections?”
b. “Are you allergic to penicillin?”
Rationale: Benzathine penicillin G is the evidence-based treatment for primary, secondary, and early latent syphilis.
The client needs to be assessed for allergies before treatment. The other questions would be helpful in the client’s history of sexually transmitted infections but not as important as knowing whether the client is allergic to penicillin.
A client with genital herpes has painful blisters on her vulva. After teaching the client self-care measures, which statement
indicates the need for further education?
a. “Pouring water over my genitals will decrease the pain of urinating.”
b. “I will wash my hands carefully after applying ointment.”
c. “When I don’t have lesions, I am not contagious to my sexual partner.”
d. “I should increase my fluid intake when I have open lesions.”
c. “When I don’t have lesions, I am not contagious to my sexual partner.”
Rationale: A client with genital herpes can still spread the disease when asymptomatic through viral shedding.
The client is taught to use condoms with all sexual activity. Pouring water over the genitals (or urinating in the shower) will help decrease the pain of urine passing over open lesions.
Good handwashing is important.
Open lesions can lead to fluid loss so the client is taught to increase fluid intake.
A 30-year-old male client is asking the nurse about the vaccine for human papilloma virus (HPV). Which statement by the nurse is accurate?
a. “Gardasil protects against all HPV strains.”
b. “You are too old to receive the vaccine.”
c. “Only females can receive the vaccine.”
d. “You will only need 1 dose of the vaccine.”
d. “You will only need 1 dose of the vaccine.”
Rationale: Gardasil is used to provide immunity for HPV types 6, 11, 16, and 18 and Gardasil 9 protects against 5 more strains.
The vaccine is recommended for people aged 9 to 26 years of age, but Gardasil 9 can be given up to age 45.
Both males and females can get the vaccine.
Depending on the timing and type of vaccine, either 2 to 3 doses are required.
A client with multiple sexual partners has been assessed for symptoms of dysuria and green, malodorous vaginal discharge. The nurse administers an injection of ceftriaxone and gives the client a prescription for doxycycline. The client asks why two drugs are needed. What answer by the nurse is best?
a. “It is very common to be infected with both gonorrhea and chlamydia.”
b. “Giving two medications increases the chance of curing the infection.”
c. “Some people are not affected by the injection and need more medication.”
d. “This will prevent you from needing a 3-month follow-up test.”
a. “It is very common to be infected with both gonorrhea and chlamydia.”
Rationale: This client has signs of gonorrhea. Co-infection with gonorrhea and chlamydia is common, so the client being treated for gonorrhea also needs treatment for chlamydia with oral antibiotics.
It is fairly accurate to say two medications increases the chance of cure, but does not really explain the situation.
Giving the client two medications is not because some people are not affected by the injection nor is it to prevent needing a 3-month follow-up test.
Testing for re-infection with chlamydia is recommended by the
CDC.
While evaluating a client for treatment of gonorrhea, which question is the most important for the nurse to ask?
a. “Do you have a history of sexually transmitted infection?”
b. “When was your last sexual encounter?”
c. “When did your symptoms begin?”
d. “Can you remember your partners and contact them to get treated?”
d. “Can you remember your partners and contact them to get treated?”
Rationale: Sexual partners, as well as the client, should be tested and treated for gonorrhea.
Asking about sexually transmitted infection history, last sexual encounter, and onset of symptoms would be helpful with the history taking, but the priority is treating the client’s sexual partners to limit the spread of the infection.
A client has been treated for syphilis with IM penicillin. The next day the client calls the clinic to report fever, chills, achy muscles, and a worsening rash. What statement by the nurse is most appropriate?
a. “You must be allergic to penicillin; over-the-counter antihistamines will help.”
b. “Please go to the nearest emergency department if you develop shortness of breath.”
c. “You can take acetaminophen or ibuprofen for the pain and achiness.”
d. “I think you should come into the clinic either today or tomorrow and be checked.”
c. “You can take acetaminophen or ibuprofen for the pain and achiness.”
Rationale: This client has signs of a Jarisch-Herxheimer reaction which is caused when the organisms’ cell walls are disrupted and cellular contents are released rapidly.
It is usually self-limiting and benign. Antipyretics and mild analgesics treat the symptoms.
The client does not need to monitor for shortness of breath, come into the clinic, or get antihistamines for an allergic reaction.
A 24-year-old female has been diagnosed with genital warts. Which action by the nurse is best?
a. Encourage the client to complete STI screening.
b. Recommend an over-the-counter wart treatment for genital tissue.
c. Report the case to the Centers for Infection Control and Prevention (CDC).
d. Discuss popular options for contraception.
a. Encourage the client to complete STI screening.
Rationale: Clients with HPV should be fully screened for other STIs since co-infection is common.
Over-the-counter treatments should not be applied to genital tissue.
HPV is not reportable.
Contraception is not related.
A female client returned to the clinic with a yellow vaginal discharge after being treated for a Chlamydia infection 3 weeks ago. Which statement by the client alerts the nurse that there may be a recurrence of the infection?
a. “I did practice abstinence while taking the medication.”
b. “I took doxycycline two times a day for a week.”
c. “I never told my boyfriend about the infection.”
d. “I did drink wine when taking the medication for Chlamydia.”
c. “I never told my boyfriend about the infection.”
Rationale: There is a good possibility that the boyfriend reinfected the client after the medication regimen was finished.
Both the client and the boyfriend need to be treated.
The other statements were in compliance with the recommendations of abstinence and the usual
medication regimen with doxycycline.
Wine should not interfere with the treatment.
A college student seeks information from the school’s nurse about how to avoid sexually transmitted infections (STIs) without abstinence as a choice. Which statement by the nurse is best?
a. “Urinating after intercourse will eliminate the risk of infection.”
b. “A vaccine can prevent genital warts caused by some strains of the human papilloma virus (HPV).”
c. “Oral contraception can prevent pregnancy and STIs.”
d. “Good handwashing helps prevent infection associated with STIs.”
b. “A vaccine can prevent genital warts caused by some strains of the human
Rationale: Gardasil and Gardasil 9 are used to provide immunity for HPV types 6, 11, 16, and 18 and others that are at high risk for cervical cancer and genital warts.
While there is some truth that urination after intercourse may decrease the risk of infection by flushing out organisms, it does not eliminate the risk of contaminating bacteria traveling up the urethra or from skin-to-skin contact.
The other statements are not accurate.
A client has a positive HSV-2 test but is asymptomatic. What action by the nurse is best?
a. Encourage the client to have frequent STI screening.
b. Teach the client ways to prevent getting STIs.
c. Provide the same education as if the client were symptomatic.
d. Inform the client that partner notification is unnecessary.
b. Teach the client ways to prevent getting STIs.
A primary care clinic sees some clients with sexually transmitted infections. Which diseases would the nurse be required to report to the local authority? (Select all that apply.)
a. Chlamydia
b. Gonorrhea
c. Syphilis
d. Human immune deficiency virus
e. Pelvic inflammatory disease
f. Human papilloma virus
a. Chlamydia
b. Gonorrhea
c. Syphilis
d. Human immune deficiency virus
Rationale: Chlamydia, gonorrhea, syphilis, human immune deficiency virus (HIV), and acquired immune deficiency syndrome (AIDS) are all reportable to local authorities in every state.
Pelvic inflammatory disease and HPV do not need to be reported.
A nurse wants to reduce the risk potential for transmission of chlamydia and gonorrhea with a client diagnosed with both
infections. Which items should be included in the client’s teaching plan? (Select all that apply.)
a. Expedited partner therapy
b. Abstinence until therapy is completed
c. Use of intrauterine devices
d. Proper use of condoms
e. Rescreening for infection
f. Use of oral contraception
a. Expedited partner therapy
b. Abstinence until therapy is completed
d. Proper use of condoms
e. Rescreening for infection
Rationale: As part of client/partner education, the nurse should explain expedited partner therapy (the practice of treating both sexual partners by providing medication to the client for the partner).
The nurse should also emphasize the need for abstinence from sexual intercourse until treatment is finished, proper use of condoms, and rescreening.
A client being treated for syphilis visits the office with a possible allergic reaction to benzathine penicillin G. Which abnormal findings would the nurse expect to document? (Select all that apply.)
a. Red rash
b. Shortness of breath
c. Heart irregularity
d. Chest tightness
e. Anxiety
f. Confusion
a. Red rash
b. Shortness of breath
d. Chest tightness
e. Anxiety
Rationale: The nurse should keep all clients at the office for at least 30 minutes after the administration of benzathine penicillin G.
Allergic signs and symptoms consist of rash, shortness of breath, chest tightness, and anxiety.
Heart irregularity and confusion are not seen as allergic manifestation.
The nurse is teaching a client who is taking an oral antibiotic for the treatment of a sexually transmitted infection (STI). Which statements by the client indicate a correct understanding of the treatment? (Select all that apply.)
a. “I need to drink at least eight glasses of fluid each day with my antibiotic.”
b. “I should read the instructions to see if I can take the medication with food.”
c. “Antacids should not interfere with the effectiveness of the antibiotic.”
d. “I need to wait 7 days after this injection to engage in intercourse.”
e. “It should not matter if I skip a couple of doses of the antibiotic.”
a. “I need to drink at least eight glasses of fluid each day with my antibiotic.”
b. “I should read the instructions to see if I can take the medication with food.”
d. “I need to wait 7 days after this injection to engage in intercourse.”
Rationale: When a client is being treated with an oral antibiotic for an STI, 8 to 10 glasses of fluid should be routine, medication instructions should be reviewed, and at least a week break should occur between the antibiotic and sexual intercourse to allow for the medication’s full effects if the medication was given in a single dose.
Use of antacids and missing doses could decrease the
effectiveness of the antibiotic.
A nurse is reviewing the chart of a new client in the family medicine clinic and notes that the client is identified as “George Smith.” The nurse enters the room and finds a woman in a skirt. What action by the nurse is best?
a. Apologize and declare confusion about the client.
b. Ask Mrs. Smith where her husband is right now.
c. Ask the client about preferred forms of address.
d. Explain that the chart must contain an error.
c. Ask the client about preferred forms of address.
Rationale: The nurse may encounter transgender clients whose outward appearance does not match their demographic data. In this case, the nurse should greet the client and ask the client to explain his or her preferred forms of address.
Lengthy apologies can often create embarrassment.
The nurse should not assume that the client is not present in the room.
The chart may or may not contain errors, but that is not related to determining how the client prefers to be addressed.
A nurse is providing health teaching to a middle-aged male-to-female (MtF) client who has undergone gender-reaffirming surgery. What information is most important to this patient?
a. “Be sure to have an annual prostate examination.”
b. “Continue your normal health screenings.”
c. “Try to avoid being around people who are ill.”
d. “You should have an annual flu vaccination.”
a. “Be sure to have an annual prostate examination.”
Rationale: The MtF client retains the prostate, so annual screening examinations for prostate cancer remain important. The other statements are good general health teaching ideas for any patient.
A transgender client is taking transdermal estrogen. What assessment finding does the nurse report immediately to the primary health care provider?
a. Breast tenderness
b. Headaches
c. Red, swollen calf
d. Swollen ankles
c. Red, swollen calf
Rationale: A red, swollen calf could be a sign of a deep-vein thrombosis, a known adverse effect of estrogen.
The nurse reports this finding immediately.
The other signs and symptoms are also side effects of estrogen, but do not need to be reported as a priority.
A transgender client taking spironolactone is in the internal medicine clinic reporting heart palpitations. What action by the nurse takes priority?
a. Draw blood to test serum potassium.
b. Have the client lie down and rest.
c. Obtain a STAT electrocardiogram (ECG).
d. Take a set of vital signs.
c. Obtain a STAT electrocardiogram (ECG).
Rationale: Spironolactone is a potassium-sparing diuretic, and hyperkalemia can cause cardiac dysrhythmias.
The nurse’s priority is to obtain an ECG, and then to facilitate a serum potassium level being drawn.
Having the client lie down and obtaining vital signs are also
important care measures, but are not the most important at this time.
The nurse is teaching a transgender client about taking testosterone. What statement by the client indicates good understanding?
a. “My periods should stop immediately.”
b. “Some effects can take up to a year to see.”
c. “I am glad I don’t have to watch my diet.”
d. “There are very few side effects since it’s a normal hormone.”
b. “Some effects can take up to a year to see.”
Rationale: Testosterone is used as masculinizing drug therapy. Some desired effects may take up to a year to be noticed. Menses should stop within the first few months of therapy. Testosterone increases the risk of heart disease, so clients should follow a heart-healthy diet.
Testosterone has several side effects, including acne, seborrhea, weight gain, edema, headaches, and possible psychosis.
A client is preparing for MtF gender–affirming surgery. The client is worried about the voice not sounding feminine enough. What action by the nurse is best?
a. Ask if the client has considered vocal cord surgery to change the voice.
b. Refer the client for vocal therapy with a speech–language pathologist.
c. Teach the client that there will be no effect on the patient’s voice.
d. Tell the client that the use of hormones will eventually change the voice.
b. Refer the client for vocal therapy with a speech–language pathologist.
Rationale: Male-to-female clients can consult with a speech–language pathologist for vocal training to help with intonation and pitch.
While vocal surgery is possible, it may not be the best first option due to cost and invasiveness.
Telling the client that there will be no change to the voice does not give the client information to address the concern.
While the hormones this client is taking will not affect the voice, simply stating that fact does not help the client manage this issue.
- Which statement made by an adolescent girl indicates an understanding about the prevention of sexually transmitted diseases (STDs)?
a. “I know the only way to prevent STDs is to not be sexually active.”
b. “I practice safe sex because I wash myself right after sex.”
c. “I won’t get any kind of STD because I take the pill.”
d. “I only have sex if my boyfriend wears a condom.”
a. “I know the only way to prevent STDs is to not be sexually active.”
Rationale: Abstinence is the only foolproof way to prevent an STD. STDs are transmitted through body fluids (semen, vaginal fluids, blood).
Perineal hygiene will not prevent an STD.
Oral contraceptives do not protect women from contracting STDs.
A condom can reduce but not eliminate an individual’s chance of acquiring an STD.
However, the nurse should encourage condom use 100% of the time to decrease the risk.
- Which STD should the nurse suspect when an adolescent girl comes to the clinic because she has a vaginal discharge that is white with a fishy smell?
a. Human papillomavirus
b. Bacterial vaginosis
c. Trichomonas
d. Chlamydia
b. Bacterial vaginosis
Rationale: Bacterial vaginosis is characterized by a profuse, white, malodorous (fishy smelling) vaginal discharge that sticks to the vaginal walls.
Manifestations of the human papillomavirus are anogenital warts that begin as small papules and grow into clustered lesions.
Infections with Trichomonas are frequently asymptomatic. Symptoms in females may include dysuria, vaginal itching, burning, and a frothy, yellowish-green, foul-smelling discharge. Many people with chlamydial infection have few or no symptoms.
Urethritis with dysuria, urinary frequency, or mucopurulent discharge may indicate chlamydial infection.
The conscious decision on when to conceive or avoid pregnancy throughout the reproductive years is called
a. family planning.
b. birth control.
c. contraception.
d. assisted reproductive therapy.
a. family planning.
Rationale: Family planning is the process of deciding when and if to have children.
Birth control is the device and/or practice used to reduce the risk of conceiving or bearing children.
Contraception is the intentional prevention of pregnancy during sexual intercourse.
Assisted reproductive therapy is one of several possible treatments for infertility.
While instructing a couple regarding birth control, the nurse should be aware that the method called natural family planning
a. is the same as coitus interruptus, or “pulling out.”
b. uses the calendar method to align the woman’s cycle with sexual activity.
c. is used by 2% of Roman Catholics.
d. relies on barrier methods during fertility phases.
c. is used by 2% of Roman Catholics.
Rationale: Natural family planning is used by about 2% of Roman Catholics.
It is not the same a coitus interruptus. It uses a variety of methods to determine a woman’s fertility.
Those practicing natural family planning do not use barrier methods at any time.
A nurse is providing information about contraceptives to a couple. Which contraceptive method provides protection against sexually transmitted diseases?
a. Oral contraceptives
b. Tubal ligation
c. Male or female condoms
d. Intrauterine device (IUD)
c. Male or female condoms
Rationale: Only the barrier methods provide some protection from sexually transmitted diseases.
Because latex condoms provide the best protection available, they should be used during any potential exposure to a sexually transmitted disease.
Oral contraceptives, tubal ligations, or IUDs do not provide protection against STDs.
A couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). The nurse’s most appropriate reply is
a. “They’re not very effective, and it’s very likely you’ll get pregnant.”
b. “They can be effective for many couples, but they require motivation.”
c. “These methods have a few advantages and several health risks.”
d. “You would be much safer going on the pill and not having to worry.”
b. “They can be effective for many couples, but they require motivation.”
Rationale: FAMs are effective with proper vigilance about ovulatory changes in the body and with adherence to coitus intervals.
However, the typical failure rate is 25%.
This is not the best response, however.
The nurse should provide positive feedback first; otherwise, the couple may become discouraged and think the nurse is negative or biased against a method they are interested in. FAMs have no associated health risks.
The use of birth control has associated health risks.
In addition, taking a pill daily requires compliance on the patient’s part.
A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. The nurse’s most appropriate response is
a. “This is a highly effective method, but it has some side effects.”
b. “Your current medications will reduce the effectiveness of the pill.”
c. “The pill will reduce the effectiveness of your seizure medication.”
d. “This is a good choice for a woman of your age and personal history.”
b. “Your current medications will reduce the effectiveness of the pill.”
Rationale: Because the liver metabolizes oral contraceptives, their effectiveness is reduced when they are taken simultaneously with anticonvulsants.
Telling the woman the pill has some side effects or that it is a good choice for some women is not tailoring teaching to her specific situation.
The anticonvulsant will reduce the effectiveness of the pill, not the other way around
Injectable progestins (DMPA, Depo-Provera) are a good contraceptive choice for women who
a. want menstrual regularity and predictability.
b. have a history of thrombotic problems or breast cancer.
c. have difficulty remembering to take oral contraceptives daily.
d. are homeless or mobile and rarely receive health care.
c. have difficulty remembering to take oral contraceptives daily.
Rationale: Advantages of DMPA include a contraceptive effectiveness comparable to that of combined oral contraceptives with the requirement of only four injections a year.
Disadvantages of injectable progestins are menstrual irregularities.
Use of injectable progestin carries an increased risk of venous thrombosis and thromboembolism.
To be effective, DMPA injections must be administered every 11 to 13 weeks.
Access to health care is necessary to prevent pregnancy or potential complications.
Which woman is the safest candidate for the use of oral contraceptives?
a. 39-year-old with a history of thrombophlebitis
b. 16-year-old with a benign liver tumor
c. 20-year-old who suspects she may be pregnant
d. 43-year-old who does not smoke cigarettes
d. 43-year-old who does not smoke cigarettes
Rationale: Cigarette smoking is a contraindication, especially in women older than 35.
Oral contraceptives are contraindicated with a history of thrombophlebitis, liver tumors, or pregnancy.
The role of the nurse in family planning is to
a. advise couples on which contraceptive to use.
b. educate couples on the various methods of contraception.
c. decide on the best method of contraception for the couple.
d. refer the couple to a reliable physician.
b. educate couples on the various methods of contraception.
Rationale: The nurse’s role is to provide information to the couple so that they can make an informed decision about family planning.
The nurse should not advise the couple or pick the best method for them, nor does he or she need to refer couples for information about contraceptives.
What does the nurse know about postcoital emergency contraception with Ella or Next Choice?
a. Requires that the first dose be taken within 72 hours of unprotected intercourse
b. Requires that the woman take second and third doses at 24 and 36 hours after the first dose
c. Must be taken in conjunction with an IUD insertion
d. Most states require the woman to have a valid prescription
a. Requires that the first dose be taken within 72 hours of unprotected intercourse
Rationale: Emergency contraception is most effective when used within 72 hours of intercourse but may be used with lessened effectiveness up to 120 hours later.
Insertion of the copper IUD within 5 days of intercourse may also be used and is up to 99% effective.
Emergency contraception is available without a prescription for women over 17 and for those younger than 17 with prescription
Informed consent concerning contraceptive use is important because some of the methods
a. are invasive procedures that require hospitalization.
b. require a surgical procedure to insert.
c. may not be reliable.
d. have potentially dangerous side effects.
d. have potentially dangerous side effects.
Rationale: It is important for couples to be aware of potential side effects so they can make an informed decision about the use of contraceptives.
The only contraceptive method that requires hospitalization is sterilization.
The only surgical procedure used would be for permanent sterilization.
Some have more effective rates, and this should be included in the teaching.
Which contraceptive method is contraindicated in a woman with a history of toxic shock syndrome?
a. Condom
b. Spermicide
c. Cervical cap
d. Norplant
c. Cervical cap
Rationale: The cervical cap may increase the risk of toxic shock syndrome because it may be left in the vagina for a prolonged period.
Condoms, spermicides, and Norplant are not contraindicated in women who have had toxic shock syndrome.
What is important in instructing a patient in the use of spermicidal foams or gels?
a. Insert 1 to 2 hours before intercourse.
b. One application is effective for several hours.
c. Avoid douching for at least 6 hours.
d. There are no known side effects.
c. Avoid douching for at least 6 hours.
Rationale: Douching within 6 hours of intercourse removes the spermicide and increases the risk of pregnancy.
Foams or gels should be inserted just before intercourse and are effective for about 1 hour.
Each application is effective for about 1 hour.
Effectiveness is about 74% when used alone.
Vaginal irritation may occur with spermicide use.
A woman currently uses a diaphragm and spermicide for contraception. She asks the nurse what the major differences are between the cervical cap and diaphragm. The nurse’s most appropriate response is
a. “No spermicide is used with the cervical cap, so it’s less messy.”
b. “The diaphragm can be left in place longer after intercourse.”
c. “Repeated intercourse with the diaphragm is more convenient.”
d. “You can have intercourse several times without removing the cap to add more spermicide.”
d. “You can have intercourse several times without removing the cap to add more spermicide.”
Rationale: The cervical cap can be inserted hours before sexual intercourse without the need for additional spermicide later. No additional spermicide is needed inside the cap for repeated acts of intercourse but more is inserted into the vagina. Spermicide should be used inside the cap as an additional chemical barrier.
The cervical cap should remain in place for 6 hours after the last act of intercourse but can stay in place up to 48 hours. Repeated intercourse with the cervical cap is more convenient, because no additional spermicide is needed.
A woman will be taking oral contraceptives using a 28-day pack. The nurse should advise this woman to protect against pregnancy by
a. limiting sexual contact for one cycle after starting the pill.
b. using condoms and foam instead of the pill for as long as she takes an antibiotic.
c. taking one pill at the same time every day.
d. using a backup method if she misses two pills during week 1 of her cycle.
c. taking one pill at the same time every day.
Rationale: To maintain adequate hormone levels for contraception and to enhance compliance, patients should take oral contraceptives at the same time each day.
If contraceptives are to be started at any time other than during normal menses or within 3 weeks after birth or abortion, another method of contraception should be used through the first week to prevent the risk of pregnancy.
Taken exactly as directed, oral contraceptives prevent ovulation, and pregnancy cannot occur.
No strong pharmacokinetic evidence indicates a link between the use of broad-spectrum antibiotics and altered hormonal levels in oral contraceptive users.
If the patient misses two pills during week 1, she should take two pills a day for 2 days and finish the package and use a backup method for the next 7 consecutive days.
With regard to the use of intrauterine devices (IUDs), nurses should be aware that
a. return to fertility can take several weeks after the device is removed.
b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse.
c. IUDs offer the same protection against sexually transmitted diseases as the diaphragm.
d. consent forms are not needed for IUD insertion.
b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse.
Rationale: The woman has up to 5 days to insert the IUD after unprotected sex. Return to fertility is immediate after removal of the IUD.
IUDs offer no protection for sexually transmitted diseases.
A consent form and a negative pregnancy test are required for insertion.
The karyotype of a person is 47, XY, +21. This person is a
a. Normal male
b. Male with Down syndrome
c. Normal female
d. Female with Turner syndrome
b. Male with Down syndrome
Rationale: This person is male because his sex chromosomes are XY.
He has one extra copy of chromosome 21 (for a total of 47 instead of 46), resulting in Down syndrome.
People who have two copies of the same abnormal autosomal dominant gene will usually be
a. More severely affected by the disorder than will people with one copy of the gene
b. Infertile and unable to transmit the gene
c. Carriers of the trait but not affected with the disorder
d. Mildly affected with the disorder
a. More severely affected by the disorder than will people with one copy of the gene
Rationale: People who have two copies of an abnormal gene are usually more severely affected by the disorder because they have no normal gene to maintain normal function.
A baby is born with blood type AB. The father is type A, and the mother is type B. The father asks why the baby has a blood type different from those of his parents. The nurses answer should be based on the knowledge that
a. Both A and B blood types are dominant.
b. The baby has a mutation of the parents blood types.
c. Type A is recessive and links more easily with type B.
d. Types A and B are recessive when linked together.
a. Both A and B blood types are dominant.
Rationale: Rationale: Types A and B are equally dominant, and the baby can thus inherit one from each parent.
Which statement is true of multifactorial disorders?
a. They may not be evident until later in life.
b. They are usually present and detectable at birth.
c. The disorders are characterized by multiple defects.
d. Secondary defects are rarely associated with multifactorial disease.
b. They are usually present and detectable at birth.
Rationale: Multifactorial disorders result from an interaction between a persons genetic susceptibility and environmental conditions that favor development of the defect.
They are characteristically present and detectable at birth.
Both members of an expectant couple are carriers for phenylketonuria (PKU), an autosomal recessive disorder. In counseling them about the risk to their unborn child, the nurse should tell them that
a. The child has a 25% chance of being affected.
b. The child will be a carrier, like the parents.
c. The child has a 50% chance of being affected.
d. One of four of their children will be affected.
a. The child has a 25% chance of being affected.
Rationale: Each child born to a couple who carries an autosomal recessive trait has a 25% chance of having the disorder, because the child receives either a normal or an abnormal gene from each parent.
Which statement should a counselor make when telling a couple about the prenatal diagnosis of genetic disorders?
a. Diagnosis can be obtained promptly through most hospital laboratories.
b. Common disorders can quickly be diagnosed through blood tests.
c. A comprehensive evaluation will result in an accurate diagnosis.
d. Diagnosis may be slow and could be inconclusive.
d. Diagnosis may be slow and could be inconclusive.
Rationale: Even the best efforts at diagnosis do not always yield the information needed to counsel patients.
They may require many visits over several weeks.
A woman tells the nurse at a prenatal interview that she has quit smoking, only has a glass of wine with dinner, and has cut down on coffee to four cups a day. What response by the nurse will be most helpful in promoting a lifestyle change?
a. You have made some good progress toward having a healthy baby. Lets talk about the changes you have made.
b. You need to do a lot better than that. You are still hurting your baby.
c. Here are some pamphlets for you to study. They will help you find more ways to improve.
d. Those few things wont cause any trouble. Good for you.
a. You have made some good progress toward having a healthy baby. Lets talk about the changes you have made.
Rationale: Praising her for making positive changes is an effective technique for motivating a patient.
She still has to identify the risk factors to optimize the results.
A 35-year-old woman has an amniocentesis performed to find out whether her baby has a chromosome defect. Which statement by this patient indicates that she understands her situation?
a. The doctor will tell me if I should have an abortion when the test results come back.
b. I know support groups exist for parents who have a baby with birth defects, but we have plenty of insurance to cover what we need.
c. When all the lab results come back, my husband and I will make a decision about the pregnancy.
d. My mother must not find out about all this testing. If she does, she will think Im having an abortion.
c. When all the lab results come back, my husband and I will make a decision about the pregnancy.
Rationale: The final decision about genetic testing and the future of the pregnancy lies with the patient.
She will involve only those people whom she chooses in her decisions.
Which question by the nurse will most likely promote sharing of sensitive information during a genetic counseling interview?
a. How many people in your family are mentally retarded or handicapped?
b. What kinds of defects or diseases seem to run in the family?
c. Did you know that you can always have an abortion if the fetus is abnormal?
d. Are there any family members who have learning or developmental problems?
d. Are there any family members who have learning or developmental problems?
Rationale: The nurse should probe gently by using lay-oriented terminology rather than direct questions or statements.
You are a maternal-newborn nurse caring for a mother who just delivered a baby born with Down syndrome. What nursing diagnosis is the most essential in caring for the mother of this infant?
a. Disturbed body image
b. Interrupted family processes
c. Anxiety
d. Risk for injury
b. Interrupted family processes
Rationale: This mother likely will experience a disruption in the family process related to the birth of a baby with an inherited disorder.
Family disruption is common, and the strain of having a child with a serious birth defect may lead to divorce.
Siblings may feel neglected because the child with a disorder requires more of their parents time and attention.
A couple has been counseled for genetic anomalies. They ask you, What is karyotyping? Your best response is
a. Karyotyping will reveal if the babys lungs are mature.
b. Karyotyping will reveal if your baby will develop normally.
c. Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes.
d. Karyotyping will detect any physical deformities the baby has.
c. Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes.
Rationale: Karyotyping provides genetic information, such as gender and chromosomal structure.
Karyotyping is completed by photographing or using computer imaging to arrange chromosomes in pairs from largest to smallest.
The karyotype can then be analyzed.
In practical terms regarding genetic health care, nurses should be aware that
a. Genetic disorders equally affect people of all socioeconomic backgrounds, races, and ethnic groups.
b. Genetic health care is more concerned with populations than individuals.
c. The most important of all nursing functions is providing emotional support to the family during counseling.
d. Taking genetic histories is the province of large universities and medical centers.
c. The most important of all nursing functions is providing emotional support to the family during counseling.
Rationale: Nurses should be prepared to help with a variety of stress reactions from a couple facing the possibility of a genetic disorder.
The nurse is working in an OB/GYN office, where part of her duties include obtaining a patient’s history and performing an initial assessment. Which woman is likely to be referred for genetic counseling after her first visit?
a. A pregnant woman who will be 40 years or older when her infant is born
b. A woman whose partner is 38 years of age
c. A patient who carries a Y-linked disorder
d. An anxious woman with a normal quadruple screening result
b. A woman whose partner is 38 years of age
Rationale: Men who father children after the age of 40 should also be sent for referral.
Men who father children in their 5th decade or later are more likely to have offspring with a new autosomal dominant mutation.
Chromosomes are composed of genes, which are composed of DNA. Abnormalities are either numerical or structural in nature. Which abnormalities are structural? Select all that apply.
a. Part of a chromosome is missing.
b. The material within a chromosome is rearranged.
c. One or more sets of chromosomes are added.
d. Entire single chromosome is added.
e.Two chromosomes adhere to each other.
a. Part of a chromosome is missing.
b. The material within a chromosome is rearranged.
e.Two chromosomes adhere to each other.
A female college student is planning to become sexually active. She is considering birth control options and desires a method in which ovulation will be prevented. To prevent ovulation while reaching 99% effectiveness in preventing pregnancy, which option should be given the strongest consideration?
a. Intrauterine device
b. Coitus interruptus
c. Natural family planning
d. Oral contraceptive pills
d. Oral contraceptive pills
Rationale: Oral contraceptive pills prevent ovulation and are 99% effective in preventing pregnancy when taken as directed. Intrauterine devices, coitus interruptus, and natural family planning will not prevent ovulation while reaching 99% effectiveness in preventing pregnancy, so they are not recommended for this college student.
The nurse at the family planning clinic conducts a male history for infertility evaluation. Which finding has the greatest
implication for this patient’s care?
a. Practice of nightly masturbation
b. Primary anovulation
c. High testosterone levels
d. Impotence due to alcohol ingestion
d. Impotence due to alcohol ingestion
Rationale: Factors affecting male infertility include impotence due to alcohol.
Nightly masturbation and high testosterone levels do not have
the greatest implication on male infertility in a patient with admitted alcohol issues.
Primary anovulation refers to female infertility, so it is not a consideration for male infertility.
The emergency department nursing assessment of a pregnant female at 35 weeks gestation reveals back pain, blood pressure 150/92, and leaking of clear fluid from the vagina. Which complication of pregnancy does the nurse suspect?
a. Ectopic pregnancy
b. Spontaneous abortion
c. Premature rupture of membranes
d. Supine hypotension
c. Premature rupture of membranes
Rationale: Leaking of clear fluid from the vagina with back pain and elevated BP is associated with premature rupture of membranes, a complication of pregnancy.
An ectopic pregnancy usually manifests as unilateral pain early in the pregnancy.
Vaginal bleeding is a classic sign of miscarriage, or spontaneous abortion, not leaking of clear fluid.
This patient’s blood pressure is elevated.
Supine hypotension occurs when the woman is lying supine; then low blood pressure occurs due to the decrease in venous return from the gravid uterus placing pressure on the vena cava.
The nurse is admitting a prenatal patient for diagnostic testing. While eliciting the psychosocial history, the nurse learns the patient smokes a pack of cigarettes daily, drinks a cup of cappuccino with breakfast, has smoked marijuana in the remote past, and is a social drinker. Which action should the nurse first take?
a. Strongly advise immediate tobacco cessation
b. Elimination of all caffeinated beverages
c. Serum and urine testing for drug use and alcohol use
d. Referral to a 12-step program
a. Strongly advise immediate tobacco cessation
Rationale: There are numerous risk factors for women and men affecting reproductive health and pregnancy outcomes. These can be categorized into biophysical, psychosocial, sociodemographic, and environmental factors.
Some of the risk factors for human reproduction fit into multiple categories.
Psychosocial factors cover smoking, excessive caffeine, alcohol and drug abuse, psychological status including impaired mental health, addictive lifestyles, spouse abuse, and noncompliance with cultural norms.
Drinking a cup of a caffeinated beverage a day is not associated with adverse fetal outcomes usually.
Serum and urine testing for drug/alcohol use is not required for stated marijuana use in the remote past.
Patient referral to a 12-step program is usually advisable for current alcohol and/or drug use.
A female infertility patient is found to be hypoestrogenic at the preconceptual clinic visit. She asks the nurse why she has never been able to get pregnant. Which is the best nursing response?
a. Circulating estrogen contributes to secondary sex characteristics.
b. Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.
c. Hyperestrogen may be preventing the zona pellucida from forming an ovum protective layer.
d. The corona radiata is preventing fertilization of the ovum.
b. Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.
Rationale: The cilia in the tubes are stimulated by high estrogen levels, which propel the ovum toward the uterus. Without estrogen, the ovum won’t reach the uterus.
The results of a series of events occurring in the ovary cause an expulsion of the oocyte from the ovarian follicle known as ovulation.
The ovarian cycle is driven by multiple important hormones: (1) gonadotropic hormone, (2) follicle-stimulating hormone (FSH), and (3) luteinizing hormone (LH).
The zona pellucida (inner layer) and corona radiata (outer layer) form protective layers around the ovum.
If an ovum is not fertilized within 24 hours of ovulation by a sperm, it is usually reabsorbed into a woman’s body.
A patient who is hypoestrogenic would not have excess circulating estrogen.
A patient with low estrogen would not be classified as hyperestrogenic.
Without sufficient estrogen, there can be no fertilization of the ovum.
An obstetric multipara with triplets is placed on bed rest at 24 weeks’ gestation. Her perinatologist is managing intrauterine
growth restriction with serial ultrasounds. This prescribed treatment is an example of which type of care?
a. Antenatal diagnostics
b. Primary prevention
c. Secondary prevention
d. Tertiary prevention
c. Secondary prevention
Rationale: An example of secondary prevention relating to reproductive health would be managing fetal intrauterine growth restriction by serial ultrasounds.
This type of diagnostic maternal/fetal monitoring is performed to determine the best time for delivery due to
potential fetal nutritional, circulatory, or pulmonary compromise.
A cesarean section (operative delivery) may be performed if
maternal or fetal conditions indicate that delivery is necessary. Antenatal diagnostics refers to prior to pregnancy.
An example of primary prevention is teaching a high school class about reproductive health.
An example of tertiary prevention would be aimed at improving health following an illness and/or rehabilitation.
A female patient comes to the clinic after missing one menstrual period. She lives in a house beneath electrical power lines which is located near an oil field. She drinks two caffeinated beverages a day, is a daily beer drinker, and has not stopped eating sweets. She takes a multivitamin and exercises daily. She denies drug use. Which finding in the history has the greatest implication for this patient’s plan of care?
a. Electrical power lines are a potential hazard to the woman and her fetus.
b. Living near an oil field may mean the water supply is polluted.
c. Alcohol exposure should be avoided during pregnancy due to teratogenicity.
d. Eating sweets may cause gestational diabetes or miscarriage.
c. Alcohol exposure should be avoided during pregnancy due to teratogenicity.
Rationale: Stages of development include ovum, embryonic, and fetal.
The beginning of the fourth week to the end of the eighth week
comprise the embryonic period.
Teratogenicity is a major concern because all external and internal structures are developing in the embryonic period.
A pregnant woman should avoid exposure to all potential toxins during pregnancy, especially alcohol, tobacco, radiation, and infections during embryonic development.
Living in a house beneath power lines is not the greatest
implication in this patient’s plan of care as there are no definite risks to the developing fetus.
Living near an oil field has no definite risks to the fetus.
Eating sweets may contribute to maternal obesity, large for gestational age fetus, and maternal gestational diabetes but does not have the immediate implication of a daily beer drinker which can cause fetal alcohol syndrome.
Which man is most likely to have abnormal sperm formation resulting in infertility?
a. A 20-year-old man with undescended testicles
b. An uncircumcised 40-year-old man
c. A 35-year-old man with previously treated sexually transmitted disease
d. A 16-year-old adolescent who is experiencing nocturnal emissions
a. A 20-year-old man with undescended testicles
Rationale: For normal sperm formation, a man’s testes must be cooler than his core body temperature.
The cremaster muscle attached to each testicle causes the testes to rise closer to the body and become warmer or allow the testes to fall away from the body to become cooler. Circumcision does not prevent fertility.
Scar tissue in the fallopian tubes as a result of a sexually transmitted disease can be a cause of infertility in women. Nocturnal emissions of seminal fluid are normal and expected in teenagers.
A nurse is teaching a woman about spinnbarkeit. The student nurse asks why the woman would need this information. What response by the nurse is most appropriate?
a. To assist in becoming pregnant or preventing pregnancy
b. To determine if she can breastfeed
c. To assess risk for genetic defects in the fetus
d. To find out if her ova are suitable for fertilization
a. To assist in becoming pregnant or preventing pregnancy
Rationale: Spinnbarkeit refers to the elasticity of cervical mucosa.
The woman can assess this to avoid or promote pregnancy.
It does not refer to breastfeeding, genetics, or her ova status.
Which of these is a secondary sexual characteristic?
a. Female breast development
b. Production of sperm
c. Maturation of ova
d. Secretion of gonadotropin-releasing hormone
a. Female breast development
Rationale: A secondary sexual characteristic is one not directly related to reproduction, such as development of the characteristic female body form.
Production of sperm, maturation of ova, and secretion of hormones are all directly related to reproduction and not secondary sexual characteristics.
The nursing students learn that fertilization of the ovum takes place in which part of the fallopian tube?
a. Interstitial portion
b. Ampulla
c. Isthmus
d. Infundibulum
b. Ampulla
Rationale: The ampulla is the wider middle part of the tube lateral to the isthmus and is where fertilization occurs.
It does not occur in the interstitial portion, isthmus, or infundibulum.
Which 16-year-old female is most likely to experience secondary amenorrhea?
a. A girl who is 5 ft 2 in, 130 lb
b. A girl who is 5 ft 9 in, 150 lb
c. A girl who is 5 ft 7 in, 96 lb
d. A girl who is 5 ft 4 in, 120 lb
c. A girl who is 5 ft 7 in, 96 lb
Rationale: Low body fat is a risk factor for secondary amenorrhea.
The girl who is 5 ft 7 inches tall and only weighs 96 pounds has less body fat that the other girls and a higher likelihood of secondary amenorrhea.
It is important for the nurse to understand that the levator ani is a(n)
a. imaginary line that divides the true and false pelvis.
b. basin-shaped structure at the lower end of the spine.
c. collection of three pairs of muscles.
d. division of the fallopian tube.
c. collection of three pairs of muscles.
Rationale: The levator ani is a collection of three pairs of muscles that support internal pelvic structures and resist increases in intra-abdominal pressure.
The linea terminalis is the imaginary line that divides the false pelvis from the true pelvis.
The basin-shaped structure at the lower end of the spine is the bony pelvis.
The fallopian tube divisions are the interstitial portion, isthmus, ampulla, and infundibulum.
In describing the size and shape of the nonpregnant uterus to a patient, the nurse would say it is approximately the size and shape of a
a. cantaloupe.
b. grapefruit.
c. pear.
d. large orange.
c. pear.
Rationale: The nonpregnant uterus is approximately 7.5 × 5.0 × 2.5 cm, which is close to the size and shape of a pear.
If a woman’s menstrual cycle began on June 2 and normally lasts 28 days, ovulation would mostly likely occur on June
a. 10
b. 16
c. 21
d. 29
b. 16
Rationale: Ovulation occurs approximately 12 to 14 days after the beginning of the menstrual period in a 28-day cycle.
In this woman, ovulation would most likely occur on June 16. June 10 would just be 8 days into the cycle and too early for ovulation.
June 21 would be 18 days into the cycle.
Ovulation should have already occurred at this point.
June 29 would be 27 days into the cycle and almost time for the next period.
A patient states, “My breasts are so small, I don’t think I will be able to breastfeed.” The nurse’s best response is
a. “It may be difficult, but you should try anyway.”
b. “You can always supplement with formula.”
c. “Breast size is not related to the ability to breastfeed.”
d. “The ability to breastfeed depends on secretion of estrogen and progesterone.”
c. “Breast size is not related to the ability to breastfeed.”
Rationale: All women have approximately the same amount of glandular tissue to secrete milk, despite breast size.
Saying that nursing will be difficult or that the woman can use formula does not provide the woman with accurate information.
Increased estrogen decreases the production of milk.
The function of the cremaster muscle in men is to
a. aid in voluntary control of excretion of urine.
b. entrap blood in the penis to produce an erection.
c. assist with transporting sperm.
d. aid in temperature control of the testicles.
d. aid in temperature control of the testicles.
Rationale: A 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.
It is not involved in urination, causing an erection or assist in transporting sperm.
The average man is taller than the average woman at maturity because of
a. a longer period of skeletal growth.
b. earlier development of secondary sexual characteristics.
c. earlier onset of growth spurt.
d. starting puberty at an earlier age.
a. a longer period of skeletal growth.
Rationale: The man’s greater height at maturity is the combined result of beginning the growth spurt at a later age and continuing it for a longer period.
Girls develop earlier than boys.
Boys’ growth spurts start at a later age.
Girls start puberty approximately 6 months to 1 year earlier than boys.
A student nurse just read that up to 200 million sperm are deposited in the vagina with each ejaculation and asks the faculty why so many are needed. What response by the faculty is most accurate?
a. Competition results in fewer genetic defects.
b. Sperm are weak and die off quickly.
c. Few sperm reach the fallopian tube and ova.
d. Most sperm are not the correct shape.
c. Few sperm reach the fallopian tube and ova.
Rationale: Although a huge quantity of sperm are released with each ejaculation, very few make it to the fallopian tube where an ovum may be waiting to be fertilized.
The student nurse learns that follicle-stimulating hormone is produced in which gland?
a. Anterior pituitary
b. Posterior pituitary
c. Hypothalamus
d. Adrenal glands
a. Anterior pituitary
Rationale: Follicle stimulating hormone is produced in the anterior pituitary gland.
