5 The Nursing Role in Reproductive and Sexual Health

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Information Field: Client Needs
Information Field: Client Needs 2
Information Field: Cognitive Level
Information Field: Page
Highest Answer Letter: E
Multiple Keywords in Same Paragraph: No
Chapter: 5
Instruction:
Name: __________________________ Date: _____________
Multiple Choice
1. A pregnant woman asks you how the uterine arteries will be able to supply blood to the
uterus after the uterus increases to four times its prepregnant size. You would explain that this
will happen easily because of which of the following?
A) More arteries form during pregnancy.
B) The muscle of the uterus decreases during pregnancy.
C) Venous congestion causes stasis of arterial blood.
D) The normally twisted and coiled uterine vessels uncoil and elongate.
Ans: D
Client Needs: Physiological Integrity: Physiological Adaptation
Cognitive Level: Understand
Page: 89
Feedback: No new arteries form during pregnancy; those already present uncoil and elongate.
2. You help take vaginal cultures on a woman at a prenatal visit. When inserting a culture
applicator for this procedure, it would be important to slant the applicator:
A) parallel with the bed surface.
B) sharply downward.
C) downward and backward.
D) upward for 2 cm, then downward.
Ans: C
Cognitive Level: Apply
Page: 89
Feedback: The slant of the vagina in a supine body position is downward and backward.
3. You care for a patient who has a retroverted uterus. You would explain that this means her:
A) uterus is bent sharply backward at the cervix.
B) cervix is located behind the Douglas cul-de-sac.
C) entire uterus is tipped backward.
D) uterus is anterior to the bladder.
Ans: C
Page: 90
Feedback: Retroverted means to tip backward; retroversion means to bend backward.
4. Following reproductive tract surgery, assessment of urinary status is important because the:
A) ureters pass just behind the uterine arteries.
B) ureters pass in front of the uterus.
C) bladder is supplied by the uterine arteries.
D) bladder and the cervix surfaces touch.
Ans: A
Client Needs: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analyze
Page: 89
Feedback: The proximity of the ureters to the fallopian tubes can cause them to be injured
during uterine or fallopian tube surgery.
5. When reviewing normal menstruation with an early adolescent, the nurse would teach that
during the second half of a typical menstrual cycle, the endometrium of the uterus becomes:
A) thin and transparent because of progesterone stimulation.
B) twisted and ragged because of follicle-stimulating hormone.
C) thick and purple-hued because of estrogen stimulation.
D) corkscrew-like because of progesterone stimulation.
Ans: D
Client Needs: Health Promotion and Maintenance
Page: 95
Feedback: Progesterone is released following ovulation and thus is the dominating hormone of
the second half of the menstrual cycle; its effect is to increase endometrium growth.
6. An adolescent describes her menstrual pattern to you. Which of the following observations is
typical of a usual menstrual pattern?
A) Flow usually lasts 4 to 6 days.
B) The usual cycle is 36 days.
C) The average amount of flow is 500 mL.
D) Menstruation typically begins at 18 years.
Ans: A
Page: 92
Feedback: The average menstrual flow is 4 to 6 days in length; the cycle is 28 days; the average
flow is 25 to 60 mL. Average age of onset is 12 to 14 years.
7. When teaching an adolescent about ovulation, the nurse would include that ovulation is
initiated by a surge in which hormone?
A) luteinizing hormone
B) progesterone
C) follicle-stimulating hormone
D) estrogen
Ans: A
Page: 81
Feedback: Luteinizing hormone is released from the pituitary gland to stimulate ovulation on
approximately the 14th day of a typical cycle.
8. The nurse needs to assess a patient for biologic gender. Which of the following factors would
be most important to assess?
A) Temperament
B) Hair distribution
C) Occupation
D) Ability to love
Ans: B
Page: 86
Feedback: Hair distribution is a biologic factor. Temperament, occupation, and ability to love
are not gender specific.
9. The term gender role refers to:

A) a person's chromosomal inheritance.
B) the gender a woman sees herself as being.
C) a woman's sexual identity.
D) demonstrated sexual behaviors.
Ans: D
Client Needs: Psychosocial Integrity
Page: 78
Feedback: Gender role refers to the actions people take, not necessarily how they feel about
themselves.
10. A woman tells the nurse she has difficulty achieving orgasm. Orgasm in females results
mainly from which stimulus?
A) penile penetration
B) clitoral stimulation
C) uterine stimulation
D) sensory arousal
Ans: B
Cognitive Level: Remember
Page: 84
Feedback: The clitoris is thought to be the main stimulus for initiating orgasm in women.
11. A woman tells you that both she and her husband like to continue sexual relations during
her menstrual period. They have a monogamous relationship. She asks you if this will harm her.
Which of the following would be the best response?
A) “Avoid sexual relations because orgasm may be painful for during your menses.”
B) “The risk of infection is too great for sexual relations during this time.”
C) “You will not be able to achieve orgasm during your menses.”
D) “If this is satisfying for you and your partner, then there is no harm in it.”
Ans: D
Page: 97
Feedback: Sexual relations may be continued through a menstrual flow if this is satisfying for
both partners.
12. A patient asks you if it will be all right to continue sexual relations during her pregnancy.
Which of the following would be the best advice?
A) Sexual relations can be continued safely during a normal pregnancy.
B) Sexual relations are dangerous during pregnancy after 3 months.
C) Sexual relations are dangerous for the first 2 months.
D) Sexual relations can continue, but she must use a diaphragm.
Ans: A
Page: 97
Feedback: Continuing sexual relations is not detrimental to a pregnancy that has no
complications.
13. After an examination, a pregnant patient is diagnosed with a cystocele. How should the
nurse explain this finding to the patient?
A) A fold of peritoneum behind the uterus
B) Pouching of the bladder into the vaginal wall
C) A part of the rectum is pushing into the vaginal wall.
D) Folds of peritoneum that cover the uterus front and back
Ans: B
Client Needs 2: Physiological Integrity: Basic Care and Comfort
Page: 89
Feedback: Pouching of the bladder into the vaginal wall is a cystocele. A fold of peritoneum
behind the uterus is posterior ligament. A part of the rectum pushing into the vaginal wall is a
rectocele. Folds of peritoneum that cover the uterus front and back are the broad ligaments.
14. A pregnant patient is concerned about a sharp pain that is felt in the lower abdomen when
making a quick move. What action should the nurse take to help this patient?
A) Assess when the patient's last bowel movement occurred.
B) Explain that the sharp pain is tension on a uterine ligament.
C) Notify the physician because of manifestations of appendicitis.
D) Instruct that the pain is a pulled muscle and a heating pad will help.
Ans: B
Client Needs: Physiological Integrity: Basic Care and Comfort
Page: 89
Feedback: If a pregnant woman moves quickly, she may pull one of the round or broad
ligaments causing a quick, sharp pain of frightening intensity in one of the lower abdominal
quadrants. This pain is not associated with bowel function. Pain of this type calls for
conscientious assessment or it can be mistaken for labor or appendicitis pain. This pain is not
because of a pulled muscle and application of heat is not indicated.
15. After an assessment, a pregnant patient asks the nurse questions about her changing uterus
and body. Which nursing diagnosis would be appropriate for the patient at this time?
A) Anxiety related to being pregnant
B) Ineffective coping related to being pregnant
C) Health-seeking behaviors related to reproductive functioning
D) Disturbance in body image related to body changes with pregnancy
Ans: C
Client Needs: Safe, Effective Care Environment: Management of Care
Client Needs 2: Health Promotion and Maintenance
Page: 78
Feedback: The patient is asking questions related to reproductive functioning which indicates
health-seeking behaviors. The patient's questions do not indicate that the patient is experiencing
anxiety, ineffective coping, or a disturbance in body image.
16. The nurse is planning expected outcomes for a female patient who will be celebrating her
40th birthday in a few months. Which outcome would be appropriate for this patient?
A) Patient will follow safer sex practices.
B) Patient will explain the process of reproduction.
C) Patient will perform breast self-examination every 2 months.
D) Patient will schedule a mammogram shortly after 40th birthday.
Ans: D
Page: 78
Feedback: To help patients better understand reproductive functioning and sexual health
throughout their life, an expected outcome might include encouraging women over 40 to have
mammograms. The process of reproduction would be appropriate for younger patients. Teaching
on safer sex practices would be appropriate for an adolescent. Breast self-examinations should be
conducted every month.
17. A patient is diagnosed with a uterus that is slightly retroverted. When discussing the
implications of this finding, what should the nurse include?
A) This finding indicates the need for surgery.
B) This finding will render the patient infertile.
C) This finding should not cause fertility issues.
D) This finding could interfere with conception.
Ans: C
Page: 90
Feedback: A retroverted uterus means the uterus tips back. Minor variations of these positions
do not tend to cause reproductive problems. A retroverted uterus does not mean that the patient
needs surgery. A retroverted uterus does not interfere with fertility. The only way that a
retroverted uterus will interfere with conception is if the abnormal position is extreme because
the sharp bend can block the deposition or migration of sperm.
18. A patient sustains a vaginal tear during the labor and delivery process and is experiencing
profuse vaginal bleeding. What should the nurse instruct the patient about this injury?
A) This injury will heal rapidly.
B) Surgery is needed to repair the tear.
C) Future vaginal deliveries will be compromised.
D) Bleeding will continue for several weeks to months.
Ans: A
Client Needs 2: Physiological Integrity: Reduction of Risk Potential
Page: 91
Feedback: The blood supply to the vagina is furnished by the vaginal artery, a branch of the
internal iliac artery. Vaginal tears at childbirth tend to bleed profusely because of this rich blood
supply. The same rich blood supply is the reason any vaginal trauma at birth heals rapidly.
Surgery is not needed to repair the tear. Future vaginal deliveries will not be compromised.
Bleeding will not continue for several weeks to months.
19. An adolescent female patient asks the nurse questions about menstruation. What should the
nurse include when instructing the patient?
A) Keeping active increases discomfort.
B) A prostaglandin inhibitor best relieves pain.
C) Eating sour foods contributes to discomfort.
D) Hair permanents do not take during a menstrual flow.
Ans: B
Page: 93
Feedback: Prostaglandin inhibitors such as ibuprofen are most effective for menstrual pain
because they reduce inflammation as well as relieve pain. Activity reduces the discomfort of
menstrual pain. Eating sour foods does not influence menstruation. Menstruation does not affect
hair care needs.
20. The nurse is preparing instruction about the menstrual cycle for adolescent patients. What
will the nurse include about changes in the uterine endometrium during the second half of the
cycle?
A) It is corkscrew-like because of progesterone stimulation.
B) It is thick and purple-hued because of estrogen stimulation.
C) It is thin and transparent because of progesterone stimulation.
D) It is twisted and ragged because of follicle-stimulating hormone.
Ans: A
Page: 95
Feedback: During the second half of the menstrual cycle, the formation of progesterone in the
corpus luteum causes the glands of the uterine endometrium to become corkscrew or twisted in
appearance and dilated. The uterine endometrium is thin and transparent immediately after the
end of the menstrual cycle. The uterine endometrium does not become thick and purple in color
because of estrogen stimulation. The uterine endometrium does not become twisted and ragged
because of follicle-stimulating hormone.
21. The nurse completes an assessment of an adolescent patient's menstrual pattern. Which
finding should the nurse identify as being within normal limits?
A) The usual cycle is 19 days.
B) Flow usually lasts 4 to 6 days.
C) Menstruation started at age 10 years.
D) The average amount of flow is 500 ml.
Ans: B
Page: 92-93
Feedback: The duration of menstrual flow averages between 4 and 6 days. The average
menstrual cycle is 28 days. The average age at onset of menstruation is 12.4 years. The average
amount of flow is 30 to 80 ml per menstrual period.
22. The nurse is preparing an educational session about menstruation for a group of
adolescents. Which hormone should the nurse instruct as initiating ovulation?
A) Estrogen
B) Progesterone
C) Luteinizing hormone
D) Follicle-stimulating hormone
Ans: C
Page: 93
Feedback: Luteinizing hormone is responsible for ovulation or release of the mature egg cell
from the ovary. Estrogen, progesterone, and follicle-stimulating hormone are not hormones
responsible for initiating ovulation.
Multiple Selection
23. The nurse is determining the topics to include in an educational program to meet the 2020
National Health Goals for sexuality and reproductive health. What should the nurse include when
planning this program? Select all that apply.
A) Outline safer sex practices.
B) Discuss the disadvantages of annual mammography.
C) Review skills to use to negate unwanted sexual advances.
D) Stress the importance of abstinence when teaching adolescent patients.
E) Explain the advantages of obtaining the human papillomavirus vaccination.
Ans: A, C, D, E
Page: 78
Feedback: The nurse can help the nation achieve the 2020 National Health Goals for sexuality
and reproductive health by outlining safer sex practices, reviewing refusal skills, teaching about
abstinence, and explaining the advantages of obtaining the human papillomavirus vaccination.
Annual mammography is not a disadvantage for women of a specific age range.
Multiple Choice
24. The nurse is determining a patient's gender role. What is the nurse doing to make this
determination?
A) Assessing the patient's sexual preferences
B) Asking what gender the patient identifies with
C) Analyzing the patient's chromosomal inheritance
D) Analyzing the patient's demonstrated sexual behaviors
Ans: D
Client Needs 2: Safe, Effective Care Environment: Management of Care
Page: 79
Feedback: Gender role is the male or female behavior a person exhibits, which may or may not
be the same as biologic gender or gender identity. Assessing the patient's sexual preferences,
asking what gender the patient identifies, and analyzing the patient's chromosomal inheritance
will not determine the patient's gender role.
25. A patient with vaginismus has attended counseling to treat the disorder. Which patient
statement indicates that treatment has been effective?
A) “Lacking an interest in sex is a normal part of aging.”
B) “I can learn to tolerate sex if I want to have a family.”
C) “I can use lubricants to help with the pain of having sex.”
D) “Sex is not a bad thing but can be enjoyed with my husband.”
Ans: D
Client Needs 2: Safe, Effective Care Environment: Management of Care
Page: 79
Feedback: Vaginismus is involuntary contraction of the muscles at the outlet of the vagina
when coitus is attempted that prohibits penile penetration and may occur in women who have
been raped. Other causes are unknown, but it could also be the result of early learning patterns in
which sexual relations were viewed as bad or sinful. As with other sexual problems, sexual or
psychological counseling to reduce this response may be necessary. A lack of interest in sex is
not a normal part of aging. Learning to tolerate sex and using lubricants does not help with the
problem of vaginismus.
Multiple Selection
26. The nurse is planning an education seminar on safer sexual practices for a group of young
adults. Which information should the nurse include in this teaching? Select all that apply.
A) Use a latex condom for intercourse.
B) Void immediately after having sex.
C) Avoid sex with intravenous drug users.
D) Hand-to-genital sex is the safest sexual practice.
E) Inspect your sexual partner for lesions in the genital area.
Ans: A, B, C, E
Page: 79
Feedback: Safer sexual practices include using a latex condom for intercourse, voiding
immediately after having sex, avoiding sex with intravenous drug users, and inspecting the
sexual partner for genital lesions. Hand-to-genital sex is not the safest sexual practice.
Abstinence is the only 100% guarantee against not contracting a sexually transmitted infection.
Multiple Choice
27. The nurse is teaching a client about sildenafil citrate prescribed for erectile dysfunction.
Which client statement indicates that teaching has been effective?
A) “A change in vision is to be expected.”
B) “This medication is birth control for men.”
C) “I can take this medication several times a day.”
D) “I should report to my health care provider an erection that lasts longer than 4 hours.”
Ans: D
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Page: 78
Feedback: An erection lasting more than 4 hours can occur when taking sildenafil citrate. This
condition can lead to penile tissue damage and should be reported to a health care provider. A
change in vision should be reported to the health care provider. Sildenafil citrate is not birth
control. This medication should be taken up to one dose per day.

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