female reproductive system;

2. Recall the different methods of family planning (natural,

artificial, and surgical methods);
STUDENT ACTIVITY 3. Identify the needs of a family who has difficulty in
SHEET conceiving a child;
4. Learn how to assess a pregnant family;
LESSON TITLE: OBGYN NURSING PART 1 5. Promote fetal and maternal care as well as promoting
LEARNING OUTCOMES: nutritional health during pregnancy

Upon completion of this lesson, the nursing student can:

NUR 099 (Nursing Seminar 1)
MAIN LESSON (60 minutes)
BS NURSING / FOURTH YEAR
Session # 4 I.The male and female reproductive system
Book, pen and notebook, index card/class list

References:
Pillitteri, A. (2009). Maternal & Child Health Nursing: Care
Materials: of the Childbearing & Childrearing Family (6th Edition).
1. Review the anatomy and physiology of the male and Lippincott Williams & Wilkins

II.Nursing care for the family in need of reproductive live planning

III.Nursing care of the family having difficulty conceiving a child
IV.Nursing care related to psychological and physiological changes of pregnancy
V.Nursing care to assessment of a pregnant family
VI.Nursing care to promote fetal and maternal care
VII.The nursing role in promoting nutritional health during pregnancy

CHECK FOR UNDERSTANDING (25 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 25 minutes for this activity:

Multiple Choice

SITUATION : Aling Nena, a 32 year old fish vendor from Barangay Carael came to see you at the prenatal clinic. She
brought with her all her three children. Feliza, 1 year 6 months; Loreta, 3 and Voltaire, 7 years old. She mentioned that
she stopped taking oral contraceptives several months ago and now suspects she is pregnant. She cannot remember
her LMP.

1. Which hormone is necessary for a positive pregnancy test?

a. Progesterone
b. Human chorionic gonadotropin
c. Estrogen
d. Lactogen
ANSWER: B
RATIO: A pregnancy test measures a hormone in the body called human chorionic gonadotropin (HCG). HCG is a
hormone produced during pregnancy. It appears in the blood and urine of pregnant women as early as 10 days after
conception.
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2. With this pregnancy, Aling Nena is a
a. P3 G3
b. Primigravida
c. P3 G4
d. P0 G3

ANSWER: A
RATIO: Aling Nena has 3 children hence has the value of P3. On another note, Aling Nena suspects she is pregnant
yet this concern was never confirmed with the scenario presented and as such the G or gravida value should still be 3
hence option A would be the most appropriate response, the remaining 3 options do not apply.

3. In explaining the development of her baby, you identified in chronological order of growth of the fetus as it occurs in
pregnancy as

a. Ovum, embryo, zygote, fetus, infant

b. Zygote, ovum, embryo, fetus, infant
c. Ovum, zygote, embryo, fetus, infant
d. Zygote, ovum, fetus, embryo, infant

ANSWER: C
RATIO: An egg is released from an ovary into a fallopian tube. After sexual intercourse, sperm move from the vagina
through the cervix and uterus to the fallopian tubes, where one sperm fertilizes the egg. The fertilized egg (zygote)
divides repeatedly as it moves down the fallopian tube to the uterus. At the end of the 8th week after fertilization (10
weeks of pregnancy), the embryo is considered a fetus. During this stage, the structures that have already formed
grow and develop. Once complete, the fetus when release into extrauterine life becomes an infant.

4. When teaching Aling Nena about her pregnancy, you should include personal common discomforts. Which of
the following is an indication for prompt professional supervision?
a. Constipation and hemorrhoids
b. Backache
c. Facial edema
d. Frequency of urination

ANSWER: C.
RATIO:  Swelling in the face, around your eyes, or in your hands accompanied by high blood pressure, call
your doctor immediately. This could be a symptom of preeclampsia, which requires immediate treatment 

5. Which of the following statements would be appropriate for you to include in Aling Nena’s prenatal teaching
plan? a. Exercise is very stressful, it is not recommended
b. Limit your food intake to vegetables only
c. Alcohol has no harmful effects on the fetus
d. Avoid unnecessary fatigue, rest periods should be included in your schedule

ANSWER: D
RATIO: Exercises are still needed during pregnancy, especially pelvic muscle exercises in order to facilitate
easy delivery. The mother should never limit her food intake to vegetables only since she needs other
sources of food that is rich in protein and other nutrients. Alcohol can have a harmful effect on the fetus
which can cause fetal alcohol syndrome. Letter D is the correct answer, unnecessary fatigue can stress the
mother especially if the mother is working, this can sometimes have an effect on pregnancy. Rest periods
should always be included.

SITUATION: Nurse Dina is assigned at the City Health Office to teach contraception to Mang Jess and Aling Sion who
are respectively 35 and 34 years old. The couple has had 4 children and has decided to use contraceptives. The
couple seems interested in both the artificial methods and surgical methods of contraception.
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6. Aling Sion asks Nurse Dina about the details of bilateral tube ligation. Which of the following information is NOT
true with regard to bilateral tube ligation?
a. It is a surgical procedure that can be done through laparoscopy.
b. It is a surgical procedure that creates a temporary contraception or sterilization that can be
easily reversed in the future.
c. There is a risk of ectopic pregnancy albeit a rare occurrence
d. No other contraceptive methods will be used once the female undergoes the minor surgery.

ANSWER: B
RATIO: During tubal ligation, the fallopian  tubes are cut, tied or blocked to permanently prevent pregnancy.
Tubal ligation prevents an egg from traveling from the ovaries through the fallopian  tubes and blocks sperm
from traveling up the fallopian tubes to the egg.

7. Mang Jess on the other hand wants information about vasectomy. Which of the following is NOT true
regarding vasectomy?
a. A vasectomy can be done in an ambulatory setting, such as in a primary health care clinic.
b. The man may experience a small amount of local pain afterward, which can be managed by taking a
mild analgesic and applying ice to the site.
c. The male can have unprotected sex with his spouse immediately after the surgery has been
done. d. The surgical procedure is about 99.5% effective.

ANSWER: D
RATIO: A vasectomy is over 99.99% effective in preventing pregnancies. Like female tubal ligation,  vasectomy is a
one-time procedure that provides permanent contraception
.

8. During the discussion about oral contraceptive pills Aling Sion asked Nurse Dina, “What do I do if I forget to take
an oral contraceptive pill?” Nurse Dina must reply which of the following?
a. “If the pill omitted was one of the placebo ones, ignore it and just take the next pill on time the next
day.” b. “If you forgot to take one of the active pills, take it as soon as you remember. Continue the
following day with your usual pill schedule. Missing one pill this way should not initiate ovulation.”
c. “If you miss two consecutive active pills, take two pills as soon as you remember. Then, continue
the following day with your usual schedule. You may experience some vaginal spotting with two
forgotten pills.”
d. All of the above

ANSWER: D
RATIO: All of the options presented above are correct with regards to pill consumption and therefore must be given
as a patient teaching to the patient.

9. The couple has finally chosen the intrauterine device as a method of contraception. Nurse Dina must inform
Aling Sion of which of the following?
a. Breast tenderness after insertion of the IUD
b. Vaginal discoloration 1 week after insertion of the IUD
c. Amenorrhea for 6 months after the insertion of the IUD
d. Vaginal spotting and uterine cramping during the first 2 or 3 weeks after IUD insertion.

ANSWER: D
RATIO: The most common discomfort the female can have related to IUD is Letter D. Choices B, C, and D are not
related with IUD usage.

10. Aling Sion asks Nurse Dina, “How long should I be having the intrauterine device?” Nurse Dina must tell Aling
Sion that the effectiveness of the Copper T380 IUD is at around
a. 10 years
b. 5 years
c. 3 years
d. 6 months

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ANSWER: A
RATIO: Copper T380 is effective for 10 years. The Levonorgestrel-releasing intrauterine device system 52 mg
(Mirena) IUD is effective for 5-7 years. The Levonorgestrel-releasing intrauterine system 13.5 mg (Skyla) is effective
for 3 years. The Levonorgestrel-releasing intrauterine system 19.5 mg (Kyleena) is effective for 5 years

SITUATION: Rodrigo a 35-year-old male and Leni a 33-year-old female is visiting a fertility clinic. The couple has
mentioned that they have been married for 7 years and have been trying since then to conceive a child. They have
always been unsuccessful. It was found out that the female has obstructed fallopian tubes. The physician has
recommended the couple to undergo in vitro fertilization (IVF).

11. The nurse must know that the process of in vitro fertilization involves which of the following procedures?

a. Oophorectomy
b. Laparoscopy
c. Salpingectomy
d. Drug therapy

ANSWER: D
RATIO: The process involve in the IVF process include the different types of medications needed for the development
or success of the infant.

12. How many hours after fertilization will the laboratory-grown zygotes be inserted into the woman’s uterus?

a. 12 hours
b. 24 hours
c. 48 hours
d. 40 hours

ANSWER: B
RATIO: For patients with at least one normal fallopian tube, GIFT  may be an option. Zygote intrafallopian
transfer (ZIFT), another variation of IVF, involves transferring pre-embryos into the fallopian tubes just
24 hours after in vitro fertilization. 

13. Based from the information above, how many fertilized eggs will be inserted in the woman’s uterus?

a. 1 only
b. 1-2 fertilized ova
c. 3-4 fertilized ova
d. Up to 5 fertilized ova may be transferred

ANSWER: D
RATIO: Women under 38 in IVF programs have acceptable live birth rates even with only  3 – 6 eggs, do better
with more than 6 eggs, and do best with more than 10 eggs.

14. Why is progesterone or luteinizing hormone prescribed a woman after undergoing IVF?
a. Due to the blockage of the fallopian tubes
b. Hormonal imbalances brought about by the procedure
c. The corpus luteum can be injured by the aspiration of the follicle
d. Due to cysts growing on the mother’s ovaries

ANSWER: B.
RATIO: Intramuscular or vaginal progesterone administration is critical to support the luteal phase following in-
vitro fertilization and is widely employed in intrauterine insemination cycles . Progesterone is used to help prevent
changes in the uterus (womb) in women and helps transition the endometrial lining into a receptive phase,
allowing a chance for the fertilized egg to implant into the uterine wall.

15. Prior to aspiration of ova from the female which of the following hormones will be given to the woman 1 month
prior to the procedure?

a. Follicle-stimulating hormone
b. Luteinizing hormone
c. Estrogen
d. Human chorionic gonadotropin hormone

ANSWER: A
RATIO: In IVF treatment a large dose of synthetic  follicle stimulating hormone (FSH) is used to induce the
growth of multiple follicles in the ovary.

SITUATION: Aling Leni, a 33-year old mother came to the health center for her prenatal check-up. She is currently in
her second trimester of her pregnancy, at about 22 age of gestation with a score of P2G4.

16. Upon interview, Aling Leni told Nurse Kristine that she can feel fetal movements. Nurse Kristine that the
fetal movements can be felt by the mother as early as

a. 12-15 weeks AOG

b. 16-20 weeks AOG
c. 21-25 weeks AOG
d. 8-11 weeks AOG

ANSWER: B.
RATIO: You should feel your  baby's first movements, called "quickening," between weeks 16 and 25 of your
pregnancy. If this is your first pregnancy, you may not feel your  baby move until closer to 25 weeks. By the
second pregnancy, some women start to feel  movements as early as 13 weeks.

17. Nurse Kristine began assessing Aling Leni’s pregnancy. Which of the following findings would indicate for a
positive pregnancy?

a. Linea nigra that has formed on the mother’s abdomen

b. Goodell’s sign
c. Fetal movements felt by the mother
d. Fetal heart tone heard by the nurse through the stethoscope

ANSWER: D
RATIO: Positive signs of pregnancy are those signs that are definitely confirmed as a  pregnancy.
They include fetal heart sounds, ultrasound scanning of the fetus, palpation of the entire fetus, palpation of
fetal movements, x-ray, and actual delivery of an infant.

18. Nurse Kristine has told Aling Leni about the importance of taking folic acid supplements. Aling Leni asks
the significance of taking these supplements. Nurse Kristine must state that

a. Folic acid prevents the occurrence of mental retardation in the fetus

b. Folic acid prevents iron deficiency anemia in the pregnant mother
c. Folic acid prevents neural tube defects from developing in the fetus
d. Folic acid prevents gestational diabetes in the mother

ANSWER: C
RATIO: Pregnant women need to get enough  folic acid. The vitamin is important to the growth of the fetus's
spinal cord and brain. Folic acid deficiency can cause severe birth defects known as neural tube defects.

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19. Aling Leni has observed that there was a change in the color of her vagina which went from pink to violet. Which of
the following statements by Nurse Kristine is correct with this finding?

a. “It is a normal occurrence during pregnancy known as Chadwick’s sign.”

b. “It is a normal occurrence during pregnancy known as Goodell’s sign.”
c. “It is a normal occurrence during pregnancy known as Hegar’s sign.”
d. “It is a normal occurrence during pregnancy known as Braxton-Hicks’ sign.”

ANSWER: A
RATIO: Chadwick sign is a bluish discoloration of the cervix, vagina, and labia resulting from increased blood
flow. It can be observed as early as 6 to 8 weeks after conception, and its presence is an early  sign of
pregnancy.
20. Which of the following is TRUE with regard to Aling Nena’s psychological change during her second trimester of
her pregnancy?

a. The woman and her partner both spend time recovering from the surprise of learning that they are pregnant
and concentrate on what it feels like to be pregnant.
b. The woman and her partner move through emotions such as narcissism and introversion as they concentrate
on what it feels like to be a parent.
c. The woman and her partner prepare clothing and sleeping arrangements for the baby but also grow impatient
as they ready themselves for birth.
d. The woman has a common reaction of ambivalence, or feeling both pleased and not pleased about
the pregnancy.

ANSWER: D
RATIO: Psychological changes during pregnancy: Pregnancy is always associated
with changes in psychological functioning of pregnant women. It is usually associated with ambivalence,
frequent mood changes, varying from anxiety, fatigue, exhaustion, sleepiness, depressive reactions to
excitement.

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION) The instructor will
now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write the correct
answer and correct/additional ratio in the space provided.
1. ANSWER: ________
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LESSON WRAP-UP (10 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Strategy: CAT 3-2-1

(To develop habits on thinking about learning, teacher writes a question or two that may ask students about their learning
experience, if they met the learning target, what they found difficult / easy about the topic or experience, what strategies
worked for them or not, etc. You can use AL strategy like CAT 3-2-1, Muddiest point and the like.)

(For next session, review Chapter 14, 15, 16, 17, and 18 of your Adele Pilliteri book)

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