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UT Arlington NURS 5315 - Chapter 25 Exam

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Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 25: Alterations of the Female Reproductive SystemMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. In the majority of children experiencing delayed puberty, what is the problem caused by?a. Disruption in the hypothalamusb. Disruption of the pituitaryc. Deficit in estrogen or testosteroned. Physiologic delays in maturationANS: DIn 95% of children with delayed puberty, the delay is physiologic; that is, hormonal levels are normal and the hypothalamic-pituitary-gonadal (HPG) axis is intact, but maturation is happening slowly.PTS: 1 DIF: Cognitive Level: Remembering 2. What is the first sign of puberty in girls?a. Breast enlargementb. Growth of pubic hairc. Menstruationd. Vaginal dischargeANS: AThe first sign of puberty in girls is usually thelarche or breast development. Growth of pubic hair, menstruation, and vaginal discharge are not the usual first sign of puberty in girls.PTS: 1 DIF: Cognitive Level: Remembering 3. Which type of precocious puberty causes the child to develop some secondary sex characteristics of the opposite sex?a. Mixedb. Partialc. Isosexuald. CentralANS: AMixed precocious puberty, which is virilization of a girl or feminization of a boy, causes the child to develop some secondary sex characteristics of the opposite sex. Partial precocious puberty is the partial early development of appropriate secondary sex characteristics alone or in combination. Central precocious puberty is GnRH dependent and occurs when the HPG axis is working normally but prematurely. Central precocious puberty results from failure of central inhibition of the GnRH pulse generator (the gonadostat), often because of CNS abnormality. “Isosexual” is not a description of a type of precocious puberty.PTS: 1 DIF: Cognitive Level: Remembering 4. A person has been diagnosed with primary dysmenorrhea and wants to know why ibuprofen is a good choice for pain control. What response by the health care professional is best?a. “It inhibits the release of leukotrienes in your system.”b. “It reduces the production of prostaglandins in your body.”c. “It enhances the effects of bradykinin release.”d. “It contributes to a higher C reactive protein in your blood.”ANS: BPrimary dysmenorrhea is painful menstruation associated with the release of prostaglandins in ovulatory cycles. Nonsteroidal antiinflammatory medications like ibuprofen reduce the activity of the COX enzyme, which in turn inhibits prostaglandin production. Leukotrienes are part of the inflammatory process. Bradykinin is a vasodilator and also has a role in pain, but is not related to dysmenorrhea. C reactive protein is part of the innate immune system.PTS: 1 DIF: Cognitive Level: Understanding 5. A woman has been diagnosed with compartment II primary amenorrhea. The healthcare professional helps prepare the woman for what type of diagnostic testing?a. Genetic testingb. CT scan of the anterior pituitaryc. Blood work for hypothalamic functiond. Vaginal speculum examANS: ACompartment II disorders involve the ovary and are often linked to genetic disorders. The professional would help prepare the woman for genetic testing. Compartment III disorders result from dysfunction of the anterior pituitary gland. Hypothalamic disorders often cause compartment IV primary amenorrhea. Compartment I disorders are anatomic defects of the outflow tract associated with primary amenorrhea and include congenital absence of the vagina.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 6. Which condition is considered a clinical cause of amenorrhea?a. Disorder in the endometriumb. Obstruction of the fallopian tubesc. Lack of physical exercised. Failure to ovulateANS: DDepressed ovarian hormone levels, which are associated with a variety of clinical disorders, also cause amenorrhea by preventing ovulation. Disorders of the endometrium, obstruction of fallopian tubes, and sedentary lifestyle do not cause amenorrhea.PTS: 1 DIF: Cognitive Level: Remembering 7. Clinical manifestations that include irregular or heavy bleeding, the passage of large clots, and the depletion of iron stores support which diagnosis?a. Premenstrual syndromeb. Abnormal uterine bleedingc. Polycystic ovary syndromed. Primary dysmenorrheaANS: BUnpredictable and variable bleeding, in terms of amount and duration, characterize abnormal uterine bleeding. Especially during perimenopause, dysfunctional bleeding also may involve flooding and the passage of large clots, which often indicate excessive blood loss. Excessive bleeding can lead to iron-deficiency anemia. Premenstrual syndrome involves distressing physical, emotional, or behavioral symptoms. Over 300 symptoms have been ascribed to this condition, but heavy bleeding, passing clots, and iron deficiency anemia are not characteristics of PMS. Polycystic ovary syndrome can include dysfunctional bleeding or amenorrhea. Primary dysmenorrhea is lack of the menstrual period, so heavy bleeding would not be a manifestation of this disorder.PTS: 1 DIF: Cognitive Level: Remembering 8. A woman has been diagnosed with polycystic ovary syndrome but is confused because her pelvic ultrasound (US) was read as “normal” and did not show cysts. What response by the health care professional is most appropriate?a. “We will schedule another US in 3 months to check again.”b. “The cysts may be too small to see right now.”c. “Maybe that diagnosis was incorrect; let’s schedule more testing.”d. “You do not need to have cysts on your ovaries to have this condition.”ANS: DThe three criteria used to diagnose PCOS are androgen excess, chronic anovulation, and sonographic evidence of polycystic ovaries. Two of the three criteria must be present for the diagnosis, so the woman’s ovaries may or may not have cysts and she can still be diagnosed with this condition. If the woman meets the other 2 criteria, there is no need for a follow-up US or testing for other diagnoses.PTS: 1 DIF: Cognitive Level: Understanding 9. A woman reports bloating, anxiety, irritability, and feeling depressed before each of her monthly menstrual cycles. What medication classification does the healthcare professional educate this woman on?a. NSAIDsb. Estrogenc. SSRIsd. ProgesteroneANS: CThis woman is describing premenstrual syndrome (PMS). Selective serotonin


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