Old's Maternal-Newborn Nursing and Women's Health, 11e (Davidson/London/Ladewig)

Chapter 9 Reproductive Physiology, Conception, and Fetal Development

1. The nurse is preparing a class on reproduction. What is the cell division process called that results in two identical cells, each with the same number of chromosomes as the original cell?
2. Meiosis
3. Mitosis
4. Oogenesis
5. Gametogenesis

Page Ref: 170

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 6 Compare the processes by which ova and sperm are produced.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The female and male reproductive organs are homologous, which means what?
2. They are believed to cause vasoconstriction and muscular contraction
3. They are fundamentally similar in function and structure
4. They are rich in sebaceous glands
5. They are target organs for estrogenic hormones

Page Ref: 169

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Discuss the significance of specific female reproductive structures during pregnancy and childbirth.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse explains to a preconception class that if only a small volume of sperm is discharged into the vagina, an insufficient quantity of enzymes might be released when they encounter the ovum. In that case, pregnancy would probably not result, because of which of the following?
2. Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus.
3. The block to polyspermy (cortical reaction) would not occur.
4. The fertilized ovum would be unable to implant in the uterus.
5. Sperm would be unable to penetrate the zona pellucida of the ovum.

Page Ref: 170

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 7 Analyze the components of the process of fertilization as to how each may affect conception.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is creating a handout on reproduction for teen clients. Which piece of information should the nurse include in this handout?
2. The fertilized ovum is called a gamete.
3. Prior to fertilization, the sperm are zygotes.
4. Ova survive 12-24 hours in the fallopian tube if not fertilized.
5. Sperm survive in the female reproductive tract up to a week.

Page Ref: 172

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Analyze the components of the process of fertilization as to how each may affect conception.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. What are the three functions of the fallopian tubes?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Provide transport for the ovum from the ovary to the uterus
2. Serve as a warm, moist, nourishing environment for the ovum or zygote
3. Secrete large amounts of estrogens
4. Provide a site for fertilization to occur
5. Support and protect the pelvic contents

Page Ref: 161

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts form liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 1 Discuss the significance of specific female reproductive structures during pregnancy and childbirth.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. What are the three functions of cervical mucosa?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Form the relatively fixed axis of the birth passage
2. Provide lubrication for the vaginal canal
3. Provide nourishment and protective maternal antibodies to infants
4. Provide an alkaline environment to shelter deposited sperm from the acidic vaginal secretions
5. Act as a bacteriostatic agent

Page Ref: 161

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Discuss the significance of specific female reproductive structures during pregnancy and childbirth.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. A pregnant woman tells the nurse-midwife, "I've heard that if I eat certain foods during my pregnancy, the baby will be a boy." The nurse-midwife should explain that this is a myth, and that the sex of the baby is determined at what time?
2. At the time of ejaculation
3. At the time of fertilization
4. At the time of implantation
5. At the time of differentiation

Page Ref: 172

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Analyze the components of the process of fertilization as to how each may affect conception.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is explaining the difference between meiosis and mitosis. Which statements would be best?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Meiosis is the division of a cell into two exact copies of the original cell.
2. Mitosis is splitting one cell into two, each with half the chromosomes of the original cell.
3. Meiosis is a type of cell division by which gametes, or the sperm and ova, reproduce.
4. Mitosis occurs in only a few cells of the body.
5. Meiotic division leads to cells that halve the original genetic material.

Page Ref: 170

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe the strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 6 Compare the processes by which ova and sperm are produced.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The true moment of fertilization occurs when what happens?
2. Cortical reaction occurs
3. Nuclei unite
4. Spermatozoa propel themselves up the female tract
5. Sperm surrounding the ovum release their enzymes

Page Ref: 172

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 7 Analyze the components of the process of fertilization as to how each may affect conception.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. Student nurses in their obstetrical rotation are learning about fertilization and implantation. The process of implantation is characterized by which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The trophoblast attaches itself to the surface of the endometrium.
2. The most frequent site of attachment is the lower part of the anterior uterine wall.
3. Between days 7 and 10 after fertilization, the zona pellucida disappears, and the blastocyst implants itself by burrowing into the uterine lining.
4. The lining of the uterus thins below the implanted blastocyst.
5. The cells of the trophoblast grow down into the uterine lining, forming the chorionic villi.

Page Ref: 170—173

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Analyze the components of the process of fertilization as to how each may affect conception.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is creating a poster for pregnant mothers. Which description of fetal development should the nurse include?
2. Four primary germ layers form from the blastocyst.
3. After fertilization, the cells only become larger for several weeks.
4. Most organs are formed by 8 weeks after fertilization.
5. The embryonic stage is from fertilization until 5 months.

Page Ref: 182—183

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 11 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks' gestation.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. A client tells you that her mother was a twin, two of her sisters have twins, and several cousins either are twins or gave birth to twins. The client, too, is expecting twins. Because there is a genetic predisposition to twins in her family, there is a good chance that the client will have what type of twins?
2. Dizygotic twins
3. Monozygotic twins
4. Identical twins
5. Nonzygotic twins

Page Ref: 176

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | N L N Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 9 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is caring for a client pregnant with twins. Which statement indicates that the client needs additional information?
2. "Because both of my twins are boys, I know that they are identical."
3. "If my twins came from one fertilized egg that split, they are identical."
4. "If I have one boy and one girl, I will know they came from two eggs."
5. "It is rare for both twins to be within the same amniotic sac."

Page Ref: 176—177

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | N L N Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 9 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. A nurse teaches newly pregnant clients that if an ovum is fertilized and implants in the endometrium, the hormone the fertilized egg begins to secrete is which of the following?
2. Estrogen
3. Human chorionic gonadotropin (h C G)
4. Progesterone
5. Luteinizing hormone

Page Ref: 180

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Summarize the actions of the hormones that affect reproductive functioning.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. This is most likely due to a lack of which hormone?
2. Estrogen
3. Progesterone
4. F S H
5. L H

Page Ref: 163

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 2 Summarize the actions of the hormones that affect reproductive functioning.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is presenting a community education session on female hormones. Which statement from a participant indicates the need for further information?
2. "Estrogen is what causes females to look female."
3. "The presence of some hormones causes other to be secreted."
4. "Progesterone is present at the end of the menstrual cycle."
5. "Prostaglandin is responsible for achieving conception."

Page Ref: 163

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 2 Summarize the actions of the hormones that affect reproductive functioning.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The student nurse encounters a 15-year-old girl who reports that she has no pubic or axillary hair and has not yet experienced growth of her breasts. The student asks the nurse about the physiology of this occurrence. The nurse explains that the client probably lacks which hormone?
2. Testosterone
3. Progesterone
4. Estrogen
5. Prolactin

Page Ref: 163

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Summarize the actions of the hormones that affect reproductive functioning.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. What is the function of the scrotum?
2. Produce testosterone, the primary male sex hormone
3. Deposit sperm in the female vagina during sexual intercourse so that fertilization of the ovum can occur
4. Provide a reservoir where spermatozoa can survive for a long period
5. Protect the testes and the sperm by maintaining a temperature lower than that of the body

Page Ref: 167

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes for care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 5 Identify the structures and functions of the male reproductive system.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. Ovarian hormones include which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Estrogens
2. Progesterone
3. Parathyroid hormone
4. Luteinizing hormone
5. Testosterone

Page Ref: 162

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 2 Summarize the actions of the hormones that affect reproductive functioning.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0°F) over the past 36 hours. This most likely indicates what?
2. Menstruation is about to begin.
3. Ovulation will occur soon.
4. Ovulation has occurred.
5. She is pregnant, and will not menstruate.

Page Ref: 165

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅳ. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: How (a) science, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and E B P. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 4 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse teaching the phases of the menstrual cycle should include that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and extensive vascular changes occur in which phase?
2. Menstrual phase
3. Proliferative phase
4. Secretory phase
5. Ischemic phase

Page Ref: 160

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 4 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is preparing a handout on the ovarian cycle to a group of middle school girls. Which information should the nurse include?
2. The hormone human chorionic gonadotropin stimulates ovulation.
3. Irregular menstrual cycles have varying lengths of the luteal phase.
4. The ovum leaves its follicle during the follicular phase.
5. There are two phases of the ovarian cycle: luteal and follicular.

Page Ref: 164

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 3 Identify the two phases of the ovarian cycle and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse teaching a high school class explains that during the menstrual cycle, the endometrial glands begin to enlarge under the influence of estrogen and cervical mucosal changes occur; the changes peak at ovulation. In which phase of the menstrual cycle does this occur?
2. Menstrual
3. Proliferative
4. Secretory
5. Ischemic

Page Ref: 163—164

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 4 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation?
2. "The menstrual cycle has five distinct phases that occur during the month."
3. "One hormone controls the phases of the menstrual cycle."
4. "The secretory phase occurs when a woman is most fertile."
5. "Menstrual cycle phases vary in order from one woman to another."

Page Ref: 165, 167

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is preparing a handout for female adolescents on the menstrual cycle. What phase of the cycle occurs if fertilization does not take place?
2. Menstrual
3. Proliferative
4. Secretory
5. Ischemic

Page Ref: 160

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. Which statement by a pregnant client to the nurse would indicate that the client understood the nurse's teaching?
2. "Because of their birth relationship, fraternal twins are more similar to each other than if they had been born singly."
3. "Identical twins can be the same or different sex."
4. "Congenital abnormalities are more prevalent in identical twins."
5. "Identical twins occur more frequently than fraternal twins."

Page Ref: 177

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 12 Identify the factors that influence congenital malformations of the organ systems and the resulting congenital malformations.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is reviewing the process of fertilization with a group of high school students. Which structure should the nurse identify as the location where fertilization of the ovum occurs?

1. A
2. B
3. C
4. D

Page Ref: 161

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 7 Analyze the components of the process of fertilization as to how each may affect conception.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse educator is teaching student nurses what a fetus will look like at various weeks of development. Which descriptions would be typical of a fetus at 20 weeks' gestation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The fetus has a body weight of 435-465 g.
2. Nipples appear over the mammary glands.
3. The kidneys begin to produce urine.
4. Nails are present on fingers and toes.
5. Lanugo covers the entire body.

Page Ref: 183

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 11 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks' gestation.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is reviewing the female reproductive cycle with a group of high school students. Which part of the following diagram identifies the menstrual phase of this cycle?

1. A
2. B
3. C
4. D

Page Ref: 164

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 4 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. During health class the school nurse is reviewing the anatomy of the male reproductive system. Which structure should be identified as the location of sperm production?

1. A
2. B
3. C
4. D

Page Ref: 167—168

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 5 Identify the structures and functions of the male reproductive system.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. Where in the illustration below is the isthmus of the fallopian tube located?

1. A
2. B
3. C
4. D

Page Ref: 159

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 1 Discuss the significance of specific female reproductive structures during pregnancy and childbirth.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is working with a client who has experienced a fetal death in utero at 20 weeks. The client asks what her baby will look like when it is delivered. Which statement by the nurse is best?
2. "Your baby will be covered in fine hair called lanugo."
3. "Your child will have arm and leg buds, not fully formed limbs."
4. "A white, cheesy substance called vernix caseosa will be on the skin."
5. "The genitals of the baby will be ambiguous."

Page Ref: 183

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Relationship-Centered Care: Respect the patient's dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 11 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks' gestation.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. The nurse is presenting a class to pregnant clients. The nurse asks, "The fetal brain is developing rapidly, and the nervous system is complete enough to provide some regulation of body function on its own, at which fetal development stage?" It is clear that education has been effective when a participant makes which response?
2. "The 17th-20th week"
3. "The 25th-28th week"
4. "The 29th-32nd week"
5. "The 33rd-36th week"

Page Ref: 183

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 11 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks' gestation.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. A pregnant client who is at 14 weeks' gestation asks the nurse why the doctor used to call her baby an embryo, and now calls it a fetus. What is the best answer to this question?
2. "Fetus is the term used from the ninth week of gestation onward."
3. "We call a baby a fetus when it is larger than an embryo."
4. "An embryo is a baby from conception until the eighth week."
5. "The official term for a baby in utero is really zygote."

Page Ref: 185

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 11 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks' gestation.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. Which term will the nurse use when teaching a client information regarding the entire female external genitalia?
2. Vulva
3. Clitoris
4. Mons pubis
5. Perineal body

Page Ref: 158

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅲ. A. 1. Demonstrate knowledge of basic scientific methods and processes. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines. |

Nursing/Integrated Concepts: Teaching and Learning.

Learning Outcome: 1 Discuss the significance of specific female reproductive structures during pregnancy and childbirth.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.

1. Which statement regarding cervical mucus is accurate during ovulation and appropriate to include in an educational session with the client?
2. Cervical mucus is thicker during ovulation.
3. Cervical mucus is opaque during ovulation.
4. Cervical mucus is clearer during ovulation.
5. Cervical mucus is acidic during ovulation.

Page Ref: 161

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅲ. A. 1. Demonstrate knowledge of basic scientific methods and processes. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Knowledge and Science: Knowledge: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Teaching and Learning.

Learning Outcome: 4 Describe the phases of the uterine (menstrual) cycle, their dominant hormones, and the changes that occur in each phase.

M N L L O: Demonstrate understanding of reproductive physiology, conception, and fetal development.