The Reproductive System Review Questions

1. The Reproductive SystemReview Questions Ana H. Corona, MSN, FNP-C Nursing Instructor February 2009 NCLEX-PN/RN license practice tests database system DGH 2007

2. Approximately how much blood does a woman lose during her menstruation? • 20 to 80 ML • 1 cup • 1 pint • 1 gallon

3. Answer is 20 to 80 ml • Though it may often feel like gallons, in actuality a women typically loses 20 to 80 ml of blood during her menstrual period.

4. During what phase of the menstrual cycle is an ovum released? • Ovulation • Gestation • Luteal • Mittelschmerz • Incubation

5. Answer is Ovulation • During Ovulation, a mature egg is released from one of the two ovaries into the Fallopian tube, where it is available for fertilization.

6. What does Mittelschmerz mean? • Menstrual cramps • Ovulation pain • Laboratory tests run on a pap smear • Archaic reference to menstruation

7. Answer is Ovulation Pain • From the German word which literally means middle pain, Mittelschmerz refers to pain occurring during ovulation on one side of the lower abdomen. • The location (left or right side) is based on which ovary produces the ovum that month. • It is estimated that about 20% of women experience mittelschmerz, which typically lasts several hours.

8. Only two female mammals menstruate. Humans and… • Dogs • Cats • Apes • Mice • Aardvarks

9. Answer is #3 Apes • Humans and apes are the only two mammals that menstruate. • Other mammals, such as dogs, cats, and even mice, have estrous cycles. When they’re in “heat”

10. What causes menstrual cramps? • Excessive menstrual flow • Prostaglandins • Water weight gain • Estrogen

11. Answer is Prostaglandins • Prostaglandins are a hormone-like substance that cause uterine contractions, which, in turn, assist in the shedding of the endometrium during menstruation. • It is believed that excessive production of Prostaglandins cause menstrual cramps.

12. What does amenorrhea mean? • Painful menstruation • Menstrual cycle where ovulation does not occur • Absence of menstrual period • Heavy bleeding during menstruation

13. Answer is absence of menstrual period • Primary amenorrhea is defined as the absence of menstruation at puberty: the menstrual cycle never starts. • Secondary amenorrhea is defined as a condition whereby a woman's menstrual period stops due to an underlying medical cause.

14. What is Menorrhagia? • Menstrual cramps • Periods with abnormally heavy flow or longer than usual • Periods with abnormally light flow or shorter than usual • Water retention during menstruation

15. Answer is Periods of abnormally heavy flow or longer than usual • Menorrhagia refers to menstrual periods that are abnormally heavy in flow, or that are prolonged and last much longer than usual.

16. Which is the first phase of the menstrual cycle? • Luteal • Ovulation • Follicular

17. Answer is follicular phase • The first phase of the menstrual cycle is the follicular phase. • During this phase, a follicle containing an egg develops in the ovary.

18. A nurse is conducting a prenatal teaching class and is reviewing the functions of the female reproductive system. A client in the class asks the nurse about the function of the fallopian tubes. The nurse tells the client that: a. estrogen and progesterone are secreted from the fallopian tubes. b. the fallopian tubes are the passageway for the fetus c. the fetus develops in the fallopian tubes d. Fertilization occurs in the fallopian tubes.

19. Answer is D • Fertilization occurs in the fallopian tubes.

20. A nursing instructor is reviewing the menstrual cycle with a nursing student who will be conducting a prenatal teaching session. The instructor asks the student to describe the follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The student accurately responds by stating that: a. FSH and LH are released from the anterior pituitary gland. b. FSH and LH are secreted by the corpus luteum of the ovary. c. FSH and LH are secreted by the adrenal glands D. FSH and LH stimulate the formation of milk during pregnancy.

21. Answer is A • FSH and LH are released from the anterior pituitary gland

22. A pregnant adolescent client ask the nurse about the menstrual cycle. The nurse describes the cycle and tells the adolescent that its normal duration is about: a. 14 days b. 28 days c. 30 days 4. 45 days

23. Answer is B • 28 days

24. A 28-year-old married woman seeks advice from the nurse in her company health office about oral contraceptives. The nurse should advise her that if she smokes: • Oral contraceptives can cause thrombophlebitis • Some oral contraceptives are safe, and others are not safe • Oral contraceptives can be used with other methods • Some oral contraceptives can be used without concern

25. Answer is #1 • Studies have shown that women who smoke at least a pack of cigarettes a day are more prone to cardiovascular problems such as thrombophlebitis.

26. The school nurse is teaching a group of 16-year-old girls about the female reproductive system. One student asks how long after ovulation it is possible for conception to occur. The nurse's most accurate response is based on the knowledge that an ovum is no longer viable after: • 12 hours • 24 hours • 48 hours • 72 hours

27. Answer is #2 • The ovum is viable for about 24 hours after ovulation and if not fertilized before this time it degenerates.

28. While the nurse is discussing methods of contraception with a client during her first visit to the well-woman clinic, the client expresses a desire to postpone pregnancy for at least 5 years. Her health history reveals that she currently smokes 1 1/2 packs of cigarettes a day, has never been pregnant, and does not want to use a barrier method of contraception. The most appropriate method for the nurse to recommend is: • A vaginal ring (NuvaRing) • An intrauterine device (IUD) • Medroxyprogesterone (Depo-Provera) • Combined oral contraceptive pills (COCs)

29. Answer is #3 • Depo-Provera is a long acting, progestin-only contraceptive that is less likely to cause cardiovascular problems in women who smoke than contraceptives containing estrogen.

30. After the nurse instructs a 20-year-old nulligravid client on how to perform a breast self-examination (BSE) which of the following client statements indicates that the teaching has been successful? • "I should perform breast self-examination on the day my menstrual flow begins." • "It's important that I perform breast self-examination on the same day each month." • "If I notice that one of my breasts is much smaller than the other, I shouldn't worry." • "If there is some discharge from my nipples, I should avoid squeezing them."

31. Answer is #4 • The nurse determines that the client has understood the instructions when the client says that she should not squeeze her nipples if there is a discharge present. • If the client notices a discharge or bleeding, she should notify her health care provider, because this may be symptomatic of underlying disease. • BSE should be performed about 1 week after the onset of menses because hormonal influences on breast tissue are at a low at this time. • The client's breasts should mirror each other. If one breast is significantly larger than the other, or if there is "pitting" disease, a tumor may be present.

32. Assessment of a 16-year-old nulligravid client who visits the clinic and asks for information on contraceptives reveals a menstrual cycle of 28 days. The nurse formulates a nursing diagnosis of Deficient Knowledge related to ovulation and fertility management. Which of the following would be important to include in the teaching plan for the client? • The ovum survives for 96 hours after ovulation, making conception possible during this time. • The basal body temperature falls at least 0.2°F after ovulation has occurred. • Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. • Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus.

33. Answer is #3 • For a client with a menstrual cycle of 28 days, ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. • The menstrual period begins about 2 weeks after ovulation has occurred. • Ovulation does not usually occur during the menses component of the cycle when the uterine lining is being shed. In most women, the ovum survives for about 12 to 24 hours after ovulation, during which time conception is possible. • The basal body temperature rises 0.5° to 1.0°F when ovulation occurs. • Although some women experience some pelvic discomfort during ovulation (mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus is thin and copious.

34. When describing a vasectomy to a couple inquiring about this procedure, the nurse would explain that which of the following is clamped or excised? • Ejaculatory duct. • Seminiferous tubules. • Seminal vesicles. • Vas deferens.

35. Answer is #4 • In vasectomy, a common procedure for male sterilization, the vas deferens (ductus deferens) is cut and tied. Coagulation may also be used to create an obstruction in the vas deferens and block the passage of sperm.

36. A 39-year-old multigravid client asks the nurse for information about female sterilization with a tubal ligation. Which of the following client statements indicates effective teaching? • My fallopian tubes will be tied off through a small abdominal incision." • "Reversal of a tubal ligation is easily done, with a pregnancy success rate of 80%." • "After this procedure, I must abstain from intercourse for at least 3 weeks." • "Both of my ovaries will be removed during the tubal ligation procedure."

37. Answer is #1 • Tubal ligation involves ligation (tying off) or cauterization of the fallopian tubes through a small abdominal incision (laparotomy). • Reversal of a tubal ligation is not easily done. • After a tubal ligation, the client may engage in intercourse 2 to 3 days after the procedure. • The ovaries are not removed during a tubal ligation. • An oophorectomy involves removal of one or both ovaries.

38. A couple visiting the infertility clinic for the first time asks the nurse, "What causes infertility in a woman?" Which of the following would the nurse include in the response as one of the most common factors? • Absence of an ovary. • Overproduction of prolactin. • Anovulation. • Immunologic factors.

39. Answer is #3 • The most common factor in female infertility is ovarian dysfunction, particularly anovulation. • The causes of infertility can be determined in about 80% to 90% of couples investigated, but in about 10% to 20% of the cases no cause can be found. • Immunologic factors do play a role in female infertility; however, they are less common than anovulation. • Overproduction of prolactin is also a less frequent cause of infertility in women. • Absence of an ovary is an extremely rare cause of infertility.

40. The nurse is aware that the patient understands how to perform a BSE when the patient makes which of the following statements: • I will perform my breast exam once every 2 months • It is not necessary to examine my breasts because I have a mammogram every year • Dimpling of the breast tissue is a normal finding that occurs with age. • I will examine my breasts one week after my period ends.

41. Answer is #4 • Breast self exam needs to be done every month. • Mammogram does not substitute for monthly BSE. • Dimpling of the breast is one of the warning signs of breast cancer • BSE should be done one week after menstruation because of the decreased presence of benign cysts in the breast.