NURSE LICENSURE

EXAMINATION REVIEW CLASS

Prepared by:
ROSELYN SENAS PACARDO, MAN, MM,RN, RM
 I – ANATOMY AND
PHYSIOLOGY
(EXTERNAL AND INTERNAL
FEMALE GENITALIA)
EXTERNAL GENITALIA (CD)
INTERNAL FEMALE GENITALIA
SITUATION A. A group of young couples attended a seminar on reproductive health.

1. Which glands are located on either side of

the female urethra and secrete mucus to
keep the opening moist and lubricated for
urination?
A.Cowper’s gland
B.Bartholin’s glands
C.Skene’s glands
D.Prostate gland
ANSWER AND RATIONALE

A.Cowper’s gland (Bulbourethral glands) – secrete an

alkaline fluid that helps counteract the acid secretion
of the urethra; comprises 5% of semen
B. Bartholin’s glands (vulvovaginal glands/paravaginal) –
located lateral to the vaginal openings; lubricates distal
vagina
C. Skene’s glands ( para or periurethral glands) – located
just lateral to the urinary meatus; ducts open into the
urethra and provides lubrication
D. Prostate gland – secretes a thin, alkaline fluid that
makes up 60% of the semen
* 30% of semen from seminal vesicles; epididymis – 5%
Pillitteri pp. 73 - 74
2. In the woman, the area of the skin,
connective tissue, and the muscle
between the vulva and anus that flattens
and stretches to accommodate the birth
of the baby is the:
A.Perineum
B.Prepuce
C.Hymen
D.Mons Veneris
ANSWER AND RATIONALE

A.Perineum – located posterior to the

fourchette
B.Prepuce – hood that covers the clitoris
C.Hymen – tough but elastic semicircle of
tissue that covers the opening to the vagina
in childhood
D.Mons Veneris (Mons pubis or Mt. of Venus) –
located over the symphisis pubis; protect the
junction of the pubic bone from trauma

Pillitteri pp. 73 - 74
1. Glans of Clitoris

2. Labium Majora

3. Hymen

4. Posterior labial
commissure

5. Prepuce of
clitoris

6. Labium minora

7. External orifice
of urethra

8. Vaginal orifice
9. Perineum
3. Which of the following types of
smooth muscle fibers of the
myometrium contain the “living
ligatures” which will compress
the blood vessels after birth to limit
blood loss?
A. Longitudinal fibers
B. Interlacing fibers
C. Circular fibers
D. Transverse fibers
ANSWER AND RATIONALE

A. Longitudinal fibers (outer layer) - found mostly in the

fundus and are designed to expel the fetus efficiently toward
the pelvic outlet during birth
B. Interlacing fibers (middle layer) – fibers are arranged in
figures of “8”
C. Circular fibers – form constrictions where the fallopian
tubes enter the uterus and surround the internal cervical os.
Circular fibers prevent reflux of menstrual blood and tissue
into the fallopian tubes, promote normal implantation of the
fertilized ovum by controlling its entry into the uterus, and
retain the fetus until the appropriate time of birth
D. Transverse fibers - no such fibers

•Source: McKinney vol 1 2nd ed. 2007 p. 222

4. The site of fertilization is in the:
A. Second division of the fallopian tube
B. Outer third of the fallopian tube
C. At the fundic area of the uterus
D. At the junction between the fundus
and the fallopian tube
ANSWER AND RATIONALE

A. Second division of the fallopian tube – Isthmus; Not the

site of fertilization; cut during bilateral tubal ligation

B. Outer third of the fallopian tube - (Ampulla)

C. At the fundic area of the uterus – Not the site of

fertilization

D. At the junction between the fundus and the fallopian

tube – Interstitial; Not the site of fertilization

Source: Pilliterri vol. 1 5th ed. 2007 p. 76; 183

5. During the reproductive health session one of the
participants asked the nurse, “How many oocytes are
still left in my ovary since I had my menarche at the
age of 12 and I am now 18 years old?” What would
be your expected response from the nurse?

A. “You will have approximately 226 – 426 oocytes.”

B. “You will have approximately 227 – 427 oocytes.”
C. “You will have approximately 228 – 428 oocytes.”
D.“You will have approximately 229 – 429 occytes.”
ANSWER AND RATIONALE

A. “You will have approximately 226 – 426 oocytes.”

B. “You will have approximately 227 – 427 oocytes.”

C. “You will have approximately 228 – 428 oocytes.” (18 yrs -

12 yrs= 6 yrs x 12 eggs released per year = 72; 300 to 500
eggs during the reproductive years – 72 = 228 – 428)

D.“You will have approximately 229 – 429 occytes.”

Source: Pilliterri vol. 1 5th ed. 2007 p. 183

 ANATOMY AND
PHYSIOLOGY
(PELVIS AND MENSTRUAL
CYCLE)
PARTS OF THE PELVIS (CD)
TYPES OF PELVIS
 MENSTRUAL CYCLE
On the third day of the menstrual cycle

Estrogen level

hypothalamus

GnRH
 APG

FSH

Maturation of immature oocyte inside a

primordial follicle (ovum)

ovary
Produces
Estrogen
 Primordial follicle becomes Graafian
follicle ; continues to secrete high level of
estrogen
Endometrium thickens

13th day of menstrual cycle

Low level of progesterone

 Hypothalamus
GnRH

APG

Luteinizing Hormone

Ovary

Progesterone
Increased estrogen and progesterone
pushes the ovum to the surface of ovary

LH surge and release of prostaglandins

Graafian follicle ruptures then matured

ovum released - OVULATION
GF becomes corpus luteum; contains
high amount of progesterone
 Causes
Glands of endometrium – corkscrew,
twisted, highly vascular, velvety soft,and spongy

No fertilization (until 24th day of MC)

CL becomes corpus albicans

Decrease estrogen and progesterone

Thickened lining of uterus degenerates,

sloughs off, capillaries rupture - MENSES
FACTS TO REMEMBER
CHARACTERISTIC DESCRIPTION
MENARCHE Average Onset: 11 – 13 years
Average Range: 9 – 17 years
INTERVAL Average: 28 days
Range: 15 to 45 days
DURATION Average: 2 to 7 days
Range: 1 to 9 days
AMOUNT 20 to 80 mL per flow

COLOR Dark Red

ODOR Marigold
TERMS TO REMEMBER
AMENORRHEA Temporary cessation of menses
OLIGOMENORRHEA Markedly diminished menstrual flow

MENORRHAGIA
Excessive bleeding during menses

METRORRHAGIA
Bleeding at irregular intervals
POLYMENORRHEA Frequent menses occurring
at less than 3 weeks interval
MITTELSCHMERZ
“Middle pain” during ovulation

ARBORIZATION
TEST “Fern-like” pattern of cervical
mucus during ovulation as seen
under the slide

SPINNBARKEIT
TEST Cervical mucus can be stretched
into long strands
SITUATION B: A nurse is
conducting a health teaching
class, reviewing the functions of
the pelvis and the importance of
the menstrual cycle.
6. Three of the bones below
unite to form the innominate
bone. Which of the following
bones is not included?
A.Pubis
B.Ilium
C.Coccyx
D.Ischium
ANSWER AND RATIONALE

A.Pubis – anterior portion of the

innominate bone
B.Ilium – forms the upper and lateral part of
the hip bone
C.Coccyx – just below the sacrum,
composed of five very small bones fused
together
D.Ischium – inferior portion of the hip bone
Pillitteri p. 82
7. One of the participants asks, “What is a gynecoid
pelvis?”. The nurse replies that this type of pelvis:
A.Has an inlet that is oval, smoothly curved, but
the anteroposterior diameter is shallow.
B.Has a narrow pubic arch.
C.Has a narrow transverse diameter and the
anteposterior diameter of the inlet is larger than
normal.
D.Has an inlet that is well-rounded forward and
backward and the pubic arch is wide
ANSWER AND RATIONALE

A.Has an inlet that is oval, smoothly curved, but the

anteroposterior diameter is shallow. (Platypelloid; “flat”
pelvis)
B. Has a narrow pubic arch. (Android; heart-shaped;
“male” pelvis)
C.Has a narrow transverse diameter and the anteposterior
diameter of the inlet is larger than normal. (Anthropoid;
“ape-like” pelvis; oblong)
D.Has an inlet that is well-rounded forward and backward
and the pubic arch is wide

Pillitteri p. 264
8. A couple trying to conceive asks the nurse,
“When does ovulation occur?”. The woman reports
a 28-day cycle. Which of the following response of
the nurse is correct?

A. On the 14th day prior to the next menstrual cycle.

B. On the 15th day prior to the next menstrual cycle.
C. On the 16th day prior to the next menstrual cycle.
D. On the 17th day prior to the next menstrual cycle.
ANSWER AND RATIONALE

A. On the 14th day prior to the next

menstrual cycle. – Deduct 14 days from the
given menstrual cycle
B. On the 15th day prior to the next
menstrual cycle.
C. On the 16th day prior to the next
menstrual cycle.
D. On the 17th day prior to the next
menstrual cycle.
Pillitteri p. 84
14th day
9. A lady asks the nurse to describe the follicle
stimulating hormone (FSH) and the
luteinizing hormone (LH). The nurse accurately
responds by stating that?
A.FSH and LH are released by the anterior pituitary
gland.
B.FSH and LH are secreted by the corpus luteum of
the ovary.
C.FSH and LH are secreted by the adrenal glands.
D.FSH and LH stimulate the formation of milk
during pregnancy.
ANSWER AND RATIONALE
9. A lady asks the nurse to describe the follicle
stimulating hormone (FSH) and the
luteinizing hormone (LH). The nurse accurately
responds by stating that?
A.FSH and LH are released by the anterior
pituitary gland.
B.FSH and LH are secreted by the corpus luteum
of the ovary. (progesterone)
C.FSH and LH are secreted by the adrenal glands.
D.FSH and LH stimulate the formation of milk
during pregnancy. Estrogen and progesterone stimulates APG to
Pillitteri pp. 83 – 84; 632 produce prolactin
10. The hormone that is secreted by
the corpus luteum and prepares the
endometrium for implantation is:
A.Estrogen
B.Luteinizing hormone
C.Progesterone
D.Gonadotropin-releasing
hormone
10. The hormone that is secreted by
the corpus luteum and prepares the
endometrium for implantation is:
A.Estrogen – from ovary
B.Luteinizing hormone – from APG
C.Progesterone
D.Gonadotropin-releasing hormone
– released by hypothalamus
Pillitteri pp. 83 - 84