A woman calls the clinic because she is having an unusually heavy menstrual flow. She tells the nurse that she has saturated three tampons in the past 2 hours. The nurse estimates that the amount of blood loss over the past 2 hours is _____ mL.

Correct Answer: B

Rationale: The correct answer is B (40 to 60 mL) because a typical tampon can absorb around 20 mL of blood. If the woman has saturated three tampons in 2 hours, that would be 3 tampons x 20 mL each = 60 mL. This indicates a significant blood loss. The other choices are incorrect because they do not account for the volume of blood absorbed by the tampons and underestimate the amount of blood loss. Choice A is too low, choices C and D are too high. The correct estimation of 40 to 60 mL aligns with the information provided and reflects the severity of the situation.

Correct Answer: C

Rationale: The correct answer is C (Day 14). On day 14 of a typical 28-day female reproductive cycle, the level of luteinizing hormone (LH) is most likely to be highest. This is because day 14 corresponds to ovulation, which is triggered by a surge in LH. Ovulation occurs when the mature egg is released from the ovary, and LH surge is crucial in this process. Therefore, the peak level of LH is expected on day 14. Incorrect Choices: A: Day 5 - Too early in the cycle for LH surge. B: Day 7 - Still early in the cycle for LH surge. D: Day 21 - LH surge typically occurs around day 14, not day 21.

Correct Answer: B

Rationale: The correct answer is B: Stratum functionalis is shed during menstrual phase. The endometrium is composed of two layers - the stratum functionalis and the stratum basalis. The stratum functionalis is the layer that undergoes cyclic changes during the menstrual cycle, thickening and then shedding during menstruation. This process is essential for preparing the endometrium for potential implantation of a fertilized egg. Choice A is incorrect because the endometrium is actually lined by simple columnar epithelium with ciliated cells. Choice C is incorrect because the decidua is the name for the endometrium during pregnancy, but it is not specific to forming the decidua of the placenta. Choice D is incorrect because the arcuate artery is a branch of the uterine artery that runs along the myometrium, not penetrating the endometrium directly.

Correct Answer: A

Rationale: The correct answer is A: Cervical cancer. Cervical cancer can cause abnormal vaginal bleeding due to the presence of cancerous cells in the cervix. This can lead to spotting or bleeding between periods. Endometrial cancer (choice B) and endometrial carcinoma (choice D) specifically involve the endometrium, not the cervix. Leiomyoma (choice C) refers to uterine fibroids, which can cause heavy menstrual bleeding but are not typically associated with vaginal bleeding outside of menstruation. Therefore, the correct choice is A as it directly relates to per vaginal bleeding, while the other choices are not directly linked to this symptom.

Correct Answer: D

Rationale: The correct answer is D: in the fifth month of pregnancy. The testes begin to descend from the abdomen into the scrotum during the fifth month of pregnancy. This process is crucial for proper development and function of the testes. Descending at this stage allows for the testes to be positioned outside the body, which is essential for sperm production as it requires a slightly lower temperature than the internal body temperature. Summary: A: at birth - Incorrect, as the descent of the testes occurs during fetal development, not at birth. B: two months after birth - Incorrect, as the descent happens during pregnancy, not after birth. C: two months prior to birth - Incorrect, as the descent occurs during pregnancy, not prior to birth.