You are taking care of a patient who has had a colporrhaphy. Which option would indicate a priority assessment during the postoperative period?

Correct Answer: B

Rationale: The correct answer is B: Removal of vaginal packing as ordered by the physician. This is a priority assessment because leaving the vaginal packing in place for too long can lead to complications such as infection or tissue damage. It is important to follow the physician's orders for timely removal to prevent these risks. A: Documentation of a pessary in the operative notes is important for accuracy but not a priority assessment in the postoperative period. C: The use of a cell saver for transfusion therapy is not directly related to the immediate postoperative care of a colporrhaphy patient and is not a priority assessment in this context. D: The removal of staples 2 to 3 days post-procedure is important but not as time-sensitive as the removal of vaginal packing. It can be done at a later stage without immediate risk to the patient.

Correct Answer: D

Rationale: The correct answer is D: Gonadotropin-releasing hormone (GnRH). GnRH is the first hormone secreted to initiate puberty. It acts on the pituitary gland to stimulate the release of FSH and LH, which then stimulate the production of sex hormones like estrogen and testosterone. FSH and LH regulate the maturation of ovarian follicles in females and sperm production in males. Estrogen and testosterone are produced in response to FSH and LH, so they are not the first hormones secreted to initiate puberty. Thus, GnRH is the primary hormone that kickstarts the puberty process by signaling the release of FSH and LH.

Correct Answer: A

Rationale: The correct answer is A because the vulva comprises the labia majora, labia minora, clitoris, mons pubis, and vestibular glands. The labia majora and minora are outer and inner folds of skin, the clitoris is a sensitive organ, the mons pubis is a fatty area overlying the pubic bone, and the vestibular glands secrete lubrication. Choices B, C, and D are incorrect because they do not accurately represent the structures of the vulva. B refers to male reproductive structures, C to internal female organs, and D to specific openings rather than the entire vulva.

Correct Answer: A

Rationale: The correct answer, A, is the initial explanation because irregular menstrual periods suggest infrequent ovulation, making it difficult to predict the fertile window for conception. Lack of gonadotropin-releasing hormone (B) would result in no ovulation at all. Blocked fallopian tubes (C) would prevent the egg from reaching the uterus, causing infertility. If only one ovary is functioning (D), the patient would still ovulate regularly from that ovary.

Correct Answer: A,D,C,B

Rationale: The correct order of the female menstrual cycle is: A (Menstrual phase) -> D (Proliferative phase) -> C (Secretory phase) -> B (Premenstrual phase). 1. Menstrual phase (A) involves shedding of the uterine lining. 2. Proliferative phase (D) follows, where the lining thickens in preparation for implantation. 3. Secretory phase (C) occurs next, characterized by further thickening and vascularization of the endometrium. 4. Finally, premenstrual phase (B) occurs, leading to the shedding of the uterine lining if fertilization does not occur. Other choices are incorrect because they do not follow the chronological sequence of events in the menstrual cycle.