Maternal-Child Nursing McKinney Ch 11 Reproductive Anatomy and Physiology

1. 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

ANS: A 20-year-old man with undescended testicles

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.

2. 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

ANS: A To assist in becoming pregnant or preventing pregnancy

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.

3. 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

ANS: A Female breast development

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.

4. 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

ANS: B Ampulla

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.

5. 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

ANS: C A girl who is 5 ft 7 in, 96 lb

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.

6. 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.

ANS: C collection of three pairs of muscle

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.

7. 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.

ANS: C pear.

The nonpregnant uterus is approximately 7.5 × 5.0 × 2.5 cm, which is close to the size and shape of a pear.

8. 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

ANS: B 16

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.

9. 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."

ANS: C "Breast size is not related to the ability to breastfeed."

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.

10. 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.

ANS: D aid in temperature control of the testicles.

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.

11. 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.

ANS: A a longer period of skeletal growth.

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.

12. 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.

ANS: C Few sperm reach the fallopian tube and ova.

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.

13. The student nurse learns that follicle stimulating hormone is produced in which gland?

a. Anterior pituitary

b. Posterior pituitary

c. Hypothalamus

d. Adrenal glands

ANS: A Anterior pituitary

Follicle stimulating hormone is produced in the anterior pituitary gland.

1. A young female patient comes to the school nurse to discuss her irregular periods. In providing education regarding the female reproductive cycle, which phases of the ovarian cycle does the nurse include? (Select all that apply.)

a. Follicular

b. Ovulatory

c. Luteal

d. Proliferative

e. Secretory

ANS: A, B, C

The follicular phase is the period during which the ovum matures. It begins on day 1 and ends around day 14. The ovulatory phase occurs near the middle of the cycle, approximately 2 days before ovulation. After ovulation and under the influence of the luteinizing hormone, the luteal phase corresponds with the last 12 days of the menstrual cycle. The proliferative and secretory phases are part of the endometrial cycle. The proliferative phase takes place during the first half of the ovarian cycle when the ovum matures. The secretory phase occurs during the second half of the cycle when the uterus is prepared to accept the fertilized ovum. These are followed by the menstrual phase if fertilization does not occur.

2. The anterior pituitary gland is responsible for producing which hormones? (Select all that apply.)

a. Follicle-stimulating hormone (FSH)

b. Luteinizing hormone (LH)

c. Gonadotropin-releasing hormone (GnRH)

d. Oxytocin

e. Prolactin

ANS: A, B, E

FSH and LH are both produced by the anterior pituitary gland. Both of these hormones assist in the stimulation and maturation of the ovarian follicle. Prolactin is also produced by the anterior pituitary and is required for milk production (lactogenesis) to occur. GnRH is produced by the hypothalamus and stimulates the release of FSH and LH. Oxytocin is produced by the posterior pituitary gland and is responsible for stimulating uterine contractions during birth