Deck 50: Disorders of Musculoskeletal Function: Rheumatic Disorders

Question 1

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.

Answer 1

The labia majora and clitoris are analogous to the male scrotum and penis, respectively.

Question 2

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.

Answer 2

she is experiencing postmenopausal vaginal dryness.

Question 3

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

Answer 3

Myometrium

Question 4

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."

Question 5

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.

Question 6

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

Question 7

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

Question 8

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.

Question 9

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

Question 10

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.

Question 11

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

Question 12

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."

Question 13

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

Question 14

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."

Question 15

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.

Question 16

The Women's Health Initiative results have led the Institute of Medicine (2010) to recommend which of the following guidelines related to hip fractures in women?

A) All postmenopausal women should take 1200 mg of calcium per day to prevent osteoporosis.
B) The standard daily recommended amount of vitamin D was increased to 400 IU/day.
C) All adults should take 600 IU/day of vitamin D to maintain healthy bones.
D) A combination of calcium and vitamin D does not appear to prevent hip fractures.

Question 17

Having heard positive reports of the benefits of hormone therapy (HT) from her sister-in-law and friends, a 49-year-old woman has presented to her family physician asking to start HT. Her uterus is intact, and previous bone scans have indicated low bone density. The client also has a family history of heart disease. She characterizes her symptoms of menopause as "noticeable, but not debilitating by any means." Based on the most current research, what is her physician's best course of action?

A) Begin estrogen-progesterone HT (EPT) to prevent future menopausal symptoms and coronary heart disease (CHD).
B) Forego HT in light of her preexisting low bone density and consequent risk of osteoporosis.
C) Forego HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life.
D) Begin low-dose HT but perform regular breast cancer screening and heart health checks.

Question 18

A 13-year-old female is undergoing rapid development of her breasts after experiencing menarche several months ago. Which of the following hormones are active in the development of her breasts? Select all that apply.

A) Prolactin
B) Human growth hormone
C) Luteinizing hormone
D) Estrogen
E) Follicle-stimulating hormone
F) Progesterone

Question 19

A 13-year-old patient undergoing puberty is alarmed to find small, white bumps surrounding the areolae on her nipples. You reassure her that these are a normal sign of her sexual maturation and tell her that they are which of the following?

A) Skene glands
B) Bartholin glands
C) Montgomery tubercles
D) Cooper ligaments

Question 20

While explaining milk production and release to a group of expectant parents, the nurse educates the parents on the fact that suckling by the infant provides the stimulus for milk ejection. This suckling sends feedback to the hypothalamus, which stimulates the release of which hormone from the pituitary gland responsible for the ejection of milk into the ductal system?

A) Oxytocin
B) Prolactin
C) Progesterone
D) Follicle-stimulating hormone