Unit4: Ch 44- Structure and Function of the Female Reproductive System (Porth's 5th Ed) Flashcards
Which of the following statements most accurately captures a characteristic of the
external female genitalia?
A) Skene and Bartholin glands perform endocrine and exocrine functions.
B) Surgical repair is required in the case of a ruptured hymen in prepubescent
females.
C) The labia majora and clitoris are analogous to the male scrotum and penis,
respectively.
D) The external genitalia facilitate sexual function and hormonal regulation.
Ans: C
Feedback:
Embryonic differentiation results in an anatomical relationship between the labia majora
and the scrotum and between the clitoris and the penis. There is no identified
hormonal/endocrine role of the structures of the external genitalia, and a ruptured
hymen does not necessitate medical intervention
A woman has gone to her gynecologist complaining of pain during intercourse. The
physician orders a maturation index on her vaginal scrapings. The results return an
index of 75-25-0. The nurse can interpret this to mean
A) she is in the beginning of cervical cancer.
B) she is in the prime of her reproductive years.
C) she is in a perimenopausal phase.
D) she is experiencing postmenopausal vaginal dryness.
Ans: D
Feedback:
The vaginal scrapings are used for a test, the maturation index, that examines the
cellular structure and configuration of the vaginal epithelial cells. Typically, this index
is 0-40-60 during the reproductive years. With diminished estrogen levels, there is a
shift to the left, producing an index of 30-40-30 during the perimenopausal period, and
an index of 75-25-0 occurs during the postmenopausal period.
A 20-year-old female has come to the clinic complaining of severe menstrual cramps.
The clinic nurse practitioner knows that dysmenorrhea occurs when which muscle group
contracts?
A) Perimetrium
B) Myometrium
C) Endometrium
D) Fundus
Ans: B
Feedback:
The middle muscle layer, the myometrium, forms the major portion of the uterine wall.
Contractions of these muscle fibers help to expel menstrual flow and the products of
conception during miscarriage or childbirth. When pain accompanies the contractions
associated with menses, it is called dysmenorrheal. The perimetrium is the outer layer of
the uterus. Endometrium, the inner layer of the uterus, is made up of a basal and a
superficial layer. The superficial layer is shed during menstruation and regenerated by
cells of the basal layer. The fundus is the portion of the uterus that lies about the
insertion of the fallopian tubes.
During a group prenatal class, the nurse teaching the course is explaining the thinning of
the cervix that accompanies the stages of labor leading up to delivery. A participant
admits that she is not familiar with either the location or normal role of the cervix.
Which of the following responses by the nurse would be most appropriate?
A) “Your cervix is just the term for the lowest part of your uterus, and it is tightly
shut at all times except in woman who are giving birth.”
B) “The cervix is the opening between the uterus and the vagina, and so it opens
wide during the lead-up to birth.”
C) “Your cervix is the part of your uterus where the fallopian tubes join in and the
baby has to pass through it to the vagina.”
D) “The cervix is the soft lining of your uterus that has to expand greatly to
accommodate your baby during delivery.”
Ans: B
Feedback:
The cervix is best characterized as the neck of the uterus that projects into the vagina. It
opens selectively to accommodate menses. The fallopian tubes enter the uterus far
above the cervix, and the lining of the uterus is known as the endometrium.
Which of the following situations would be considered pathological in an otherwise
healthy, 30-year-old female?
A) The woman’s ovaries are not producing new ova.
B) The woman’s ovaries do not synthesize or secrete luteinizing hormone (LH).
C) The epithelium covering the woman’s ovaries is broken during the time of
ovulation.
D) The woman’s ovaries are not producing progesterone.
Ans: D
Feedback:
As the number of ova within an ovary is fixed at birth and decreases over time, a lack of
production of ova is normal. The epithelial lining is normally broken during ovulation,
and the LH is produced by the pituitary gland. A lack of progesterone would be
considered pathological.
A pregnant client who is taking Risperidone (Risperdal), an antipsychotic prescribed for
her bipolar disorder, is at high risk for developing which of the following hormonal
adverse effects?
A) Increased growth hormone production
B) Decreased human chorionic gonadotropin levels
C) Excess prolactin secretion
D) Decreased follicle-stimulating hormone secretion
Ans: C
Feedback:
Although prolactin does not appear to play a physiologic role in ovarian function,
hyperprolactinemia leads to hypogonadism. Hyperprolactinemia may occur as an
adverse effect of drug treatment using phenothiazine derivatives (i.e., antipsychotic
drugs that block dopamine receptors).
A 40-year-old woman has been identified to have a deficiency in estrogen. Which of the
following physiological phenomena is most likely to remain unaffected?
A) Parathyroid hormone antagonism and the rate of bone resorption
B) The regulation of uterine endothelial development
C) The maintenance of normal skin and blood vessel structure
D) The synthesis and release of adrenal glucocorticoids
Ans: D
Feedback:
Synthesis and release of adrenal glucocorticoids are not directly influenced by estrogen,
unlike the processes of bone resorption, endothelial regulation, and the maintenance of
skin and blood vessel structure.
Which of the following statements best captures an aspect of the role of progesterone?
Progesterone
A) production begins shortly after conception and peaks prior to delivery.
B) is responsible for the stimulation of lactation in the postpartum period.
C) levels peak after ovulation and is present throughout the menstrual cycle.
D) is the primary hormone responsible for the development of female secondary sex
characteristics.
Ans: C
Feedback:
Progesterone is present in varying levels at all times in females, but peaks following
ovulation. It is not responsible for lactation and does not have primary responsibility for
the development of secondary sex characteristics.
Events in the ovulatory cycle progress in a similar manner each month. Place the following events in the ovulatory cycle in the correct chronological order. Use all the options. A) Formation of the theca B) Formation of the corpus luteum C) Formation of the antral follicle D) Development of the zona pellucida E) Bursting of the mature follicle
Ans: D, A, C, E, B
Feedback:
The zona pellucida surrounds a primary oocyte as it transitions to a secondary follicle,
after which the theca surrounds the follicle. The antrum is subsequently formed around
the maturing follicle, and it eventually bursts. After ovulation, the corpus luteum is
established marking the beginning of the luteal stage of the ovulatory cycle.
A 29-year-old woman has been trying for many months to become pregnant, and
fertilization has just occurred following her most recent ovulation. What process will
now occur that will differentiate this ovulatory cycle from those prior?
A) Human chorionic gonadotropin will be produced, preventing luteal regression.
B) The remaining primary follicles will provide hormonal support for the first 3
months of pregnancy.
C) The corpus luteum will atrophy and be replaced by corpus albicans.
D) The basal layer of the endometrium will be sloughed in preparation for
implantation
Ans: A
Feedback:
Fertilization is followed by the release of human chorionic gonadotropin. The corpus
luteum, not primary follicles, provides hormonal support for early pregnancy. The
atrophy of corpus luteum and its replacement by corpus albicans only occur when
fertilization does not take place. The endometrium will be preserved following
fertilization.
Long, stretchy cervical mucus that exhibits ferning on a microscope slide is
characteristic of which of the following?
A) Crystallization of inorganic salts
B) Low estrogen levels
C) High progesterone levels
D) Low human chorionic gonadotropin levels
Ans: A
Feedback:
Cervical mucus that exhibits ferning and so-called spinnbarkeit occurs right around the
time of ovulation (midcycle) due to increased water content and alteration in the
concentration of inorganic salts. This is influenced by high serum levels of estrogen,
which lead to the LH spike that promotes ovulation (bursting of the oocyte from the
mature follicle). Progesterone levels increase only after ovulation during the luteal
phase, at which point the cervical mucus “dries up” (becomes more scant).
After hearing daunting reports from her slightly older coworkers and friends, a
44-year-old woman has a number of questions for her physician about what to expect
during perimenopause and why. Which of the following teaching points is most
accurate?
A) “The decrease in estrogen and most other hormones in your body do cause a lot of
instability for most women around menopause.”
B) “Hot flashes are a reality for most women in menopause, and the exact cause of
them isn’t known yet.”
C) “The emotional swings that often accompany menopause result from changes to
the limbic center in the brain, which governs emotion.”
D) “There are a lot of changes to the gastrointestinal and respiratory systems that
exist around menopause that ultimately result from estrogen deficiency.”
Ans: B
Feedback:
Hot flashes are a common accompaniment to menopause, and their exact etiology is not
known. Menopause is caused by a gradual reduction in ovarian estrogen production, but
decreases in other hormones do not commonly occur. Organic brain changes are not a
noted component of menopause, and GI and respiratory symptoms are not prevalent.
The nurse knows that when combined continuous estrogen–progesterone therapy
(CCEPT) is prescribed, the drug is considered effective if which of the following
occurs?
A) More regular periods for women with irregular menses
B) Inhibited endometrial development resulting in no menses
C) Relaxation of the myometrium, thereby limited painful cramps
D) Shedding of the endometrial build-up on a more regular basis
Ans: B
Feedback:
Thus, continuous exposure to progesterone inhibits endometrial development.
Eventually, the combined continuous estrogen–progesterone therapy (CCEPT) results in
no bleeding. It can be associated with irregular bleeding and spotting until the lining
becomes atrophic. It relieves cramps rather than generating them.
A 51-year-old woman who has been receiving estrogen and progesterone therapy (EPT)
for the last 5 years has visited her care provider because her peers have told her about
the risks of heart disease, stroke, and breast cancer that could accompany hormone
therapy (HT). How should her care provider respond to her concerns?
A) “There is a demonstrable increase in breast cancer risk with HT, but the risk of
stroke or heart disease actually go down slightly.”
B) “All considered, the benefits of HT outweigh the slightly increased risks of heart
disease, stroke, or breast cancer.”
C) “HT is actually associated with a decrease in heart disease risk, but there is an
increase in stroke risk; the breast cancer connection is still unclear.”
D) “There’s in fact a slight protective effect against stroke associated with HT, but
this is partially offset by increased rates of heart disease and breast cancer.”
Ans: C
Feedback:
Current evidence shows a decrease in coronary heart disease (CHD) risk with HT but an
increase in CVA risk; the evidence regarding breast cancer is still indefinite.
A woman consults her physician about a study (Women’s Health Initiative) discussing
an increased risk for breast cancer if taking hormones. The physician can allay her fears
by sharing which of the following findings?
A) Only women with a family history of breast cancer had an increased risk for
developing breast cancer while on birth control pills.
B) This 26% increased risk for developing invasive breast cancer occurred in women
taking combined continuous estrogen–progesterone therapy.
C) The increased risk for developing inflammatory breast cancer occurred in women
taking hormone replacement therapy when they were over the age of 45.
D) Follow-up studies demonstrated that there was only a 3% increase in risk for
developing breast cancer if hormones were discontinued immediately.
Ans: B
Feedback:
The WHI added to the breast cancer concern by reporting a 26% increased risk of
invasive breast cancer in the women using CCEPT. Results from a 3-year WHI
follow-up study revealed that the breast cancer risk of women who stopped taking
CCEPT continued at a rate similar to that observed during the intervention.
