Chapter 3

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Marianne is at the clinic for their first OB visit and estimates that she is 5 weeks pregnant by the date of LMP. She is concerned because she attended a party the weekend she become pregnant, and she drank heavily and smoked marijuana but hasn't since. What would be your best response to this couple? "Because the baby was still going through the first stages of fertilization, and organ and brain development weren't taking place, there's a good chance there will be no impact from your actions on the baby." "That amount of substances in your system are probably going to cause your baby to have severe deficits. We'll need to begin testing right away to see how bad the situation is." "The baby was going through significant changes during that time, and exposure to your blood supply may have caused the baby's brain and organ formation to be impaired. We can do testing in a few weeks to see if there

"Because the baby was still going through the first stages of fertilization, and organ and brain development weren't taking place, there's a good chance there will be no impact from your actions on the baby." - brain development and organogenesis does not occur until 3rd week. During zygote formation, the cell is isolated from maternal blood supply.

When assessing for environmental risk, what questions should the nurse ask? Select all that apply. "Tell me more about your work and the kinds of cleaners used there that you might come into contact with." "Tell me more about how much coffee, tea, and/or soda you drink every day." "Does anyone in your family have any genetic diseases?" "I understand gardening is a hobby. What kind of chemicals do you use in your garden for insects and fertilizer?" "I see your address is in an older part of town. Has your home been tested for lead in the paint and/or soil that you know of?"

"Tell me more about your work and the kinds of cleaners used there that you might come into contact with." "I understand gardening is a hobby. What kind of chemicals do you use in your garden for insects and fertilizer?" "I see your address is in an older part of town. Has your home been tested for lead in the paint and/or soil that you know of?" - coffee, tea is lifestyle risk

A woman who is being prepped for preimplantation testing worries because she is unsure of what the procedure entails. Which statement by the nurse best describes preimplantation testing?1. 1. "A cell from the developing fetus will be removed for genetic testing prior to the transferring of the in-vitro embryo into your uterus." 2. "Both you and your partner will be tested to identify who carries one copy of a gene mutation." 3. "Screening will be done to detect genetic disorders that can be treated early in life." 4. "This test allows for the early detection of genetic disorders, such as hemophilia."

1. "A cell from the developing fetus will be removed for genetic testing prior to the transferring of the in-vitro embryo into your uterus." - Preimplantation testing detects genetic changes in embryos that were created using assisted reproductive techniques.

A patient who has just learned that she is pregnant asks the nurse at what point the baby's heart will begin beating. Which of the following should the nurse say? 1. 4th gestational week 2. 8th gestational week 3. 12th gestational 4. 16th gestational week

1. 4th gestational week - The heart forms during the 3rd gestational week and begins to beat and circulate blood during the 4th gestational week.

When assessing the newborn, the nurse notes two vessels in the umbilical cord. What should the nurse do next? 1.Call the pediatrician. 2.Start an IV on the infant. 3.Check the infant's pulse oximetry. 4.Listen to the infant's heart sounds.

1. Call the pediatrician. - Due to the risk of cardiovascular disease, calling the pediatrician is important in order to let the doctor know what is going on.

A newly pregnant client is seen in the clinic for her first prenatal appointment. She states she has a family history of an autosomal recessive disease. Which disease has an autosomal recessive pattern of inheritance? 1. Cystic fibrosis 2. Hemophilia 3. Huntington's disease 4. Sickle-cell anemia 5. Tay-Sachs disease

1. Cystic fibrosis 4. Sickle-cell anemia 5. Tay-Sachs disease - Hemophilia is X-linked. - Sickle-cell anemia has an autosomal recessive pattern of inheritance.

A couple has decided to terminate their pregnancy based on the results of genetic testing, which showed that the fetus has the genetic disorder trisomy 21. Which of the following are appropriate nursing actions? 1. Explain the stages of grief the couple will experience 2. Persuade the couple to reconsider their decision, as a human life is at stake 3. Encourage the couple to communicate with each other and share emotions 4. Refer the couple to a support group available in their community 5. Praise the couple for their decision and explain how difficult it is to raise a child with Down syndrome

1. Explain the stages of grief the couple will experience 3. Encourage the couple to communicate with each other and share emotions 4. Refer the couple to a support group available in their community

Place the following statements in the order they happen during the process of fertilization. Capacitation Nidation Meoisis Fertilization

1. Meiosis 2. Capacitation 3. Fertilization 4. Nidation

A neonate was admitted shortly after birth with a history of the mother who consumed at least six alcoholic beverages per day during pregnancy. For which feature of fetal alcohol syndrome should the nurse expect to assess? Select all that apply. 1. Microcephaly 2. Cardiac defects 3. Cerebral infarction 4. Neural tubal defects 5. Unusual facial features

1. Microcephaly 2. Cardiac defects 5. Unusual facial features

Which umbilical blood vessels carry oxygenated blood from the placenta to the fetus? 1. One umbilical vein 2. One umbilical artery 3. Two umbilical arteries 4. Two umbilical veins

1. One umbilical vein - There is one umbilical vein in the umbilical cord that carries oxygenated blood from the placenta to the fetus.

The nurse is teaching a new nurse about the placenta's oxygen pathway to the newborn. The nurse understands that high levels of oxygenated blood come from what part of the fetal circulation? 1. Placenta and umbilical vein 2. Placenta and umbilical artery 3. Umbilical artery and umbilical vein 4. Ductus arteriosus

1. Placenta and umbilical vein The placenta provides high levels of oxygenated blood from the fetal circulation and the umbilical vein brings it to the fetus.

The nurse is reviewing a client's charts before admission for an induction of labor. Which client would have extra assistance at delivery?' 1. The client who was diagnosed with oligohydramnios 2. The client who is having her fifth baby 3. The client who is pregnant with her first baby and had a treated UTI during pregnancy 4. The client who has had hyperemesis gravidarum during the pregnancy

1. The client who was diagnosed with oligohydramnios - This delivery will require an extra person who is trained in neonatal resuscitation to manage an infant in distress due to low amniotic fluid volume.

The nurse is teaching the new pregnant mother about the placenta and its many roles in fetal development. Which statements show an understanding of the hormones the placenta produces? Select all that apply. 1."Progesterone is the hormone that makes you feel bloated." 2."Testosterone is produced only if you are having a boy." 3."Human chorionic gonadotropin doubles or triples the longer you are pregnant." 4."Human placental lactogen helps in the production of breast milk." 5."Estrogen is the reason for my pregnancy glow."

1."Progesterone is the hormone that makes you feel bloated." 3."Human chorionic gonadotropin doubles or triples the longer you are pregnant." 4."Human placental lactogen helps in the production of breast milk." 5."Estrogen is the reason for my pregnancy glow."

A couple was recently diagnosed with a genetic disorder in pregnancy. The couple decided to continue with their pregnancy. They asked the nurse where else they could get more information. Which response by the nurse is most appropriate? 1."The health team is here if you want to talk about how you feel." 2."Avoid using websites as they do not provide accurate information about the disorder." 3."There is no need to worry because I have given you all the information you need to know." 4."There is no support group for parents who have children with the same genetic disorder."

1."The health team is here if you want to talk about how you feel." Option 1:The health team is a source for providing appropriate information on genetic disorders Option 2:Selected websites are appropriate sources of information on genetic disorders. Option 3:The nurse is not the sole provider for information on genetic disorders. Option 4:Support groups provide information for parents who have children with the same genetic disorder.

A couple visited the clinic and wanted to know their likelihood of conceiving a child with a genetic disorder. Which risk factor, identified by the nurse, is correct? Select all that apply. 1.Their first child was born with a genetic disorder. 2.There is a family history of genetic disorders. 3.Both partners are younger than 35 years old. 4.The woman is older than 35 years old. 5. Both parents have a genetic disorder.

1.Their first child was born with a genetic disorder. 2.There is a family history of genetic disorders. 4.The woman is older than 35 years old. 5. Both parents have a genetic disorder. - Being younger than 35 years old minimizes the risk of having a child with a genetic disorder. - Women who are older than 35 years old are at a greater risk of having a baby with a genetic disorder.

A pregnant mother who was exposed to teratogens is now admitted with a diagnosis of fetal growth restriction. In order for this medical diagnosis to be made, the nurse would determine the mother was mostly likely exposed to teratogens during which period? 1. Before getting pregnant 2. After 13 weeks of gestation 3. During the period of organogenesis 4. During the first 8 weeks of gestation

2. After 13 weeks of gestation - Exposure to teratogens after 13 weeks of gestation may cause fetal growth restriction. - Exposure to teratogens during the first 8 weeks of gestation can cause gross structural defects = Exposure to teratogens during the period of organogenesis can cause gross structural defects. - The effects of teratogens depend on when it occurs in pregnancy and not before pregnancy.

The nurse is seeing a woman at 18 weeks gestation for an assessment due to an increased risk for intrauterine growth restriction (IUGR). To which drug or chemical should the nurse be concerned the mother has been exposed? Select all that apply. 1. Alcohol 2. Angiotensin-converting enzyme (ACE) inhibitors 3. Carbamazepine (anticonvulsants) 4. Cocaine 5. Warfarin (coumadin)

2. Angiotensin-converting enzyme (ACE) inhibitors 3. Carbamazepine (anticonvulsants) 4. Cocaine IUGR = Intrauterine growth restriction is when a baby in the womb doesn't grow at the expected rate during the pregnancy. Option 1:Drinking alcohol during pregnancy increases the risk for fetal alcohol syndrome (FAS). With FAS, newborn symptoms include low birth weight, microcephaly, mental retardation, unusual facial features, and cardiac defects. Option 2:Taking ACE inhibitors during pregnancy increases the risk for intrauterine growth restriction, as well as renal tubular dysplasia or neonatal death. Option 3:Taking anticonvulsants while pregnant increases the risk for intrauterine growth restriction, as well as neural tubal and craniofacial defects. Option 4:Taking cocaine while pregnant increases the risk for placental abnormalities, which may also include intrauterine growth restriction. Option 5:Taking coumadin while pregnant increases the risk for spontaneous abortion, fetal demise, fetal or newborn hemorrhage, and central nervous system abnormalities, no intrauterine growth restriction.

The nurse is conducting an investigation on the effects of teratogenic agents on the newborn. The nurse found that exposure to some viruses during pregnancy may result in blindness in the newborn. What are the possible viral infections the nurse would have identified that can cause blindness in newborns? 1. Syphilis, rubella, and Zika 2. Chicken pox, rubella, and Zika 3. Syphilis, cytomegalovirus, and Zika 4. Cytomegalovirus, rubella, and chicken pox

2. Chicken pox, rubella, and Zika - Chicken pox, rubella, and Zika are viruses that may lead to blindness.

A nurse is explaining to a young woman who is trying to become pregnant about the process of conception. Which organ should the nurse mention as the site at which fertilization takes place? 1. Ovaries 2. Fallopian tubes 3. Vagina 4. Uterus

2. Fallopian tubes - Ovaries produce the ovum, or egg. From there, the ovum travels to the fallopian tubes, where fertilization takes place.

A nurse is counseling a patient who has just learned that she is pregnant and who admits to drinking several beers a day about the characteristics of fetal alcohol syndrome. Which of the following should the nurse mention? 1. Increased risk of Down syndrome 2. Low birth weight 3. Microcephaly 4. Mental retardation 5. Increased risk of type I diabetes

2. Low birth weight 3. Microcephaly 4. Mental retardation

A pregnant client in her second trimester is in the provider's office for an ultrasound. Her provider finds that the fetus has a congenital heart defect. Which condition is the client at risk for during pregnancy? Select all that apply. 1. Oligohydramnios (decreased amniotic fluid) 2. Polyhydramnios (excess amniotic fluid) 3. One-vessel umbilical cord 4. Two-vessel umbilical cord 5. Three-vessel umbilical cord

2. Polyhydramnios 4. Two-vessel umbilical cord -A decrease in amniotic fluid is associated with decreased placental function. - An excess amount of amniotic fluid is associated with chromosomal disorders and gastrointestinal, cardiac, and neural tube defects. - An umbilical cord should have three vessels; two arteries and a vein. -When a two-vessel cord is found, it is indicative of cardiac defects. -1 vessel is incompatible with life

The nurse assessing a neonate determines that the neonate was born at 36 weeks gestation because the testes are in the upper portions of the scrotum. which other features of a neonate born at 36 weeks gestation does the nurse expect to find? 1. Weighs 2,100 grams, is 30 cm long, and has an increased amount of adipose tissue 2. Weighs 2,900 grams, is 34 cm long, and lanugo begins to disappear 3. Weighs 820 grams, is 23 cm long, and lungs begins to develop surfactant 4. Weighs 1,300 grams, is 27 cm long, and lungs are not fully mature

2. Weighs 2,900 grams, is 34 cm long, and lanugo begins to disappear A neonate who is born at 36 weeks gestation is expected to weigh around 2,900 grams, be 34 cm long, and their lanugo should begin to disappear.

A couple visiting the clinic voiced their concern that their unborn baby might have Trisomy 21 at birth. Which test would the nurse recommend for this couple? 1.Carrier testing 2.Prenatal testing 3.Newborn screening 4.Preimplantation testing

2.Prenatal testing - Prenatal testing allows for the early detection of genetic disorders such as Trisomy 21.

The Fletchers are expecting their first child, a baby girl, and are at the office for a routine checkup. Mrs. Fletcher states that baby has been moving frequently, and she's no longer having any morning sickness. The app on her phone told her that the baby is about 1,200 g, has eyelashes, and is covered in hair. What gestational week is Mrs. Fletcher's pregnancy? 16 weeks 20 weeks 24 weeks 29 weeks

29 weeks - in the Embryonic and Fetal Growth and Development chart - With physical findings and weight, the baby is at 29 weeks.

A nurse is providing emotional support for a woman experiencing infertility. Which statement would require further assessment from the nurse? 1. "Due to my infertility, I have felt isolated and alone. Thus, my provider suggested therapy for depression." 2. "I feel like I am less of a woman because I am unable to become pregnant." 3. "I am afraid of what my partner will do if I am unable to become pregnant in the next few months." 4. "We are hesitant to spend the money on assisted reproductive technology due to the ethical dilemmas that can occur."

3. "I am afraid of what my partner will do if I am unable to become pregnant in the next few months." - This comment raises a red flag of intimate partner violence. Although infertility can be stressful on a couple, violence should be further assessed and reported.

The nurse is teaching a woman who is 8 weeks pregnant to avoid teratogens. Which client statement indicates the need for further teaching? 1. "I won't change the cat's litter box during the pregnancy." 2. "It's important to exercise during my pregnancy." 3. "I will schedule my next appointment as soon as I leave." 4. "I will not eat sushi during my pregnancy."

3. "I will schedule my next appointment as soon as I leave." -This shows the client understands that prenatal care is important, but does not address understanding of teratogens.

The nurse is reviewing a client's chart and comes across genetic testing results. When answering questions from the family, which statement would prompt the nurse to provide further education? 1. "The human cell has 46 chromosomes." 2. "The human cell has 22 homologous pairs." 3. "The human cell has two pairs of sex chromosomes." 4. "The human cell has XX or YY chromosomes."

3. "The human cell has two pairs of sex chromosomes." - The human cell has one pair of sex chromosomes. It is abnormal to have two pairs. The normal result is one pair of chromosomes, female or male.

After assessing a couple planning to terminate their pregnancy based on the results of the genetic test, the nurse documented "anticipatory grieving". What is the nurse's appropriate plan of care for this couple? 1. Reiterating to the couple that grieving is abnormal 2. Advising the couple to separate from each other for a week 3. Discussing with the couple the stages of grief they will experience 4. Warning the couple that thinking about their "dream child" is of concern

3. Discussing with the couple the stages of grief they will experience The stages of grieving should be included in the plan of care for a couple wanting to terminate a pregnancy.

The nurse asks a patient when her last menstrual period began. The patient replies that it began about 10 days ago and ended about 5 days ago. The nurse should recognize that this patient is currently in which phase of her ovarian cycle? 1. Ovulatory 2. Luteal 3. Follicular 4. Secretory

3. Follicular The follicular phase of the ovarian cycle begins on the first day of menstruation and lasts 12 to 14 days. Thus, this patient is currently in the follicular phase.

A parent visits the prenatal clinic wanting to know which genome gives babies their genetic makeup. Which is the appropriate answer by the nurse? 1. Gamete 2. Genetics 3. Genotype 4. Genomics

3. Genotype - A genotype is a person's genetic makeup.

A nurse observes a patient, who has recently given birth, interacting with her mother, who is visiting her and the baby. The patient and her mother both share the same eye and hair color and are about the same height. The nurse knows that these traits are examples of which of the following? 1. Genotypes 2. Genomes 3. Phenotypes 4. Genetics

3. Phenotypes

During a written exam, a nursing student was asked to list the structures derived from the primary germ layers. The student states that the mucosa of the oral and nasal cavities is derived from the ectoderm. Which other statement about the primary germ made by the student is correct? 1.The mucosa of the esophagus, stomach, and intestines are developed from the mesoderm. 2.The bone marrow, blood, and lymphatic tissues are developed from the ectoderm. 3.The epidermis, hair, and nail follicles are developed from the ectoderm. 4.The lens, cornea, and internal ear are developed from the mesoderm.

3. The epidermis, hair, and nail follicles are developed from the ectoderm. - The epidermis, hair, and nail follicles are developed from the ectoderm.

During a teaching session, the nurse had a discussion on the issue of Y-linked inheritance. Which response by the father indicates that learning has taken place? 1."The baby inherited the disease from my wife." 2."My grand-aunt has the same condition." 3."I passed on the condition to my baby." 4. ."We both gave the baby our disease."

3."I passed on the condition to my baby." - The mutation is located only on the Y chromosome and can be passed only from father to son.

A pregnant client states, "I am afraid to have sex with my husband because I don't want the baby to get infected with anything." Which is the nurse's best response to help the client understand the safety of the fetus? 1."If your husband doesn't use a condom, your baby will contract an infection your husband has." 2."Your baby can get sick if you get a yeast infection during the pregnancy." 3."Unless you or your husband has a sexually transmitted disease, your infant is protected with the amniotic sac during the pregnancy." 4."Having intercourse can break the amniotic sac; therefore, couples should not engage in intercourse while pregnant."

3."Unless you or your husband has a sexually transmitted disease, your infant is protected with the amniotic sac during the pregnancy." - This answer is correct because the amniotic sac provides a sterile environment for the fetus that prevents bacteria from entering the amniotic fluid through the vagina.

The nurse is recalling the steps in cell division, beginning at conception and ending with fetal development. List the following steps in order of development: 1. Blastocyst 2. Embryo 3. Fetus 4. Zygote

4, 1, 2, 3 The fertilized oocyte is a zygote from conception/fertilization until day 3. A blastocyst is a result of mitosis and, at day 5, enters the uterus and will begin implantation. The developing human or embryo is from implantation until 8 weeks of gestation. A fetus has all organ systems formed and will continue to grow and mature from 9 weeks of gestation until birth.

A pregnant client presents to the clinic after a prenatal test detected that her baby boy had a Y-linked inheritance disorder. The client indicates an understanding of Y-linked inheritance disorder when she makes which statement? 1. "Both my partner and I carry this trait and passed it along to our baby." 2. "I am a carrier, so I passed this disease to my baby." 3. "I understand that I also present with this trait and need to be tested." 4. "This disease was passed from my male partner to my baby."

4. "This disease was passed from my male partner to my baby." - Y-linked inheritance is a sex-linked inheritance that is located on the Y-chromosome (male = XY). As a result, the disease can only be passed from father to son.

A nurse is working with a woman in labor who has sickle cell anemia. The nurse understands that this patient must have which of the following combinations of genes related to this disorder? 1. Two dominant genes 2. A recessive gene and a dominant gene 3. Only one dominant gene, with the other gene missing 4. Two recessive genes

4. Two recessive genes

The nurse is visiting the home of a woman who recently had a fetal demise. Toxoplasmosis is suspected. Which finding would confirm the possibility of toxoplasmosis exposure? Select all that apply. 1.History of having a sexually transmitted infection 2.History of frequently smoking marijuana 3.Having poor air quality at home 4.Having many cats at home 5.Consuming uncooked beef

4.Having many cats at home 5.Consuming uncooked beef - Getting contaminated with cat feces exposes pregnant women to toxoplasmosis. - Consuming uncooked beef exposes pregnant women to toxoplasmosis.

A zygote will have _____ chromosomes, half from each parent. 23 2 46 42

46 - total = 46

Which of the following couples is most likely to conceive an infant with a chromosomal disorder? A male with no genetic concerns and a female with an X-linked dominant disorder who are having a son. A female with no genetic concerns and a male with an X-linked recessive disorder who are having a daughter. A female and a male who both have the same autosomal recessive inheritance disorder who are having twins. A male with an autosomal dominant inheritance disorder and a female with a cleft lip who are having a daughter.

A female with no genetic concerns and a male with an X-linked recessive disorder who are having a daughter. - An X-linked dominant disorder in female only has 50% chance of passing down to any children - An X-linked recessive in male has 100% chance of passing altered gene to child. - A couple with automasal recessive disorder has 50% chance of passing it down to any of their children - An automasal dominant disorder has 50% of being passed to any child.

Which statements below are true about a homozygous gene pair? Select all that apply. A) recessive traits will occur when the gene pair is homozygous B) a homozygous gene pair may have different alleles C) a homozygous gene pair will have identical alleles D) Autosomal dominant inheritance disorders would only occur in homozygous gene pairs

A) recessive traits will occur when the gene pair is homozygous C) a homozygous gene pair will have identical alleles

A woman is a carrier for hemophilia A, an X-linked recessive illness. Her husband has a normal genotype. The nurse can advise the couple that the probability that their daughter will have the disease is: A. 0% probability B. 25% probability C. 50% probability D. 75% probability

A. 0% probability

A student reviewing the anatomy and physiology of fetal circulation learns that fetal blood enters the aorta through which structure? A. Ductus arteriosus B. Ductus venosus C. Foramen ovale D. Portal circulation

A. Ductus arteriosus Most blood enters the aorta through the ductus arteriosus, which is a channel between the pulmonary artery and the descending aorta. The ductus venosus connects the umbilical vein to the inferior vena cava. The foramen ovale is an opening between the atria of the heart. Most blood bypasses the liver (portal circulation).

A nurse teaching a prenatal class instructs the participants that early organ system development occurs during which period of time? A. Embryonic period B. Fetal period C. Pre-embryonic period D. Post-embryonic period

A. Embryonic period The early development of the nervous system, cardiovascular system, and all major internal and external structures occurs during the embryonic period, which is the first 2 weeks beginning at fertilization.

A nurse has completed a family pedigree on a patient with a known autosomal dominant inheritance disorder. No one else in the family has been affected by this disorder. How does the nurse explain this finding to the patient? A. Genetic variation occurred via a mutation. B. Information about the family is incorrect. C. The patient is not biologically related to the family. D. The patient's diagnosis must be incorrect.

A. Genetic variation occurred via a mutation. Most autosomal dominant inheritance disorders are seen in families in which multiple members in different generations have been affected by the disorder. However, the variant allele may arise from a mutation, in which case the affected person will be the first known person in the family to be affected. The other options are incorrect.

The perinatal nurse is explaining blood transport though fetal circulation to the new nurse. How does the perinatal nurse describe the foramen ovale? A. Opening in the heart's septum between the right and left atria B. Vascular channel between the pulmonary artery and the descending aorta C. Vascular channel connecting the umbilical vein to the inferior vena cava D. Vascular route connecting the heart to the extremities

A. Opening in the heart's septum between the right and left atria The foramen ovale is an opening in the heart's septum between the right and left atria. The vascular channel between the pulmonary artery and descending aorta is the ductus arteriosus. The channel connecting the umbilical vein to the inferior vena cava is the ductus venosus. The closest thing to a route connecting the heart to the extremities would be the aorta, which then leads to peripheral and cerebral circulation.

Which of the following are factors that can cause structural anomalies in the growing embryo? Select all that apply. Folic acid Alcohol Coumadin Cat hair Pesticides

Alcohol Coumadin Pesticides

The nurse's role during the preconception and early antepartum phases of pregnancy include which of the following? Select all that apply. Assessing the family for risk factors. Providing information and education when a concern arises. Informing patients of genetic testing diagnosis. Providing therapeutic communication and support when bad news is received. Providing a nonjudgmental atmosphere when patients share information related to their care, even when the information relays something concerning, such as drug use.

Assessing the family for risk factors. Providing information and education when a concern arises. Providing therapeutic communication and support when bad news is received. Providing a nonjudgmental atmosphere when patients share information related to their care, even when the information relays something concerning, such as drug use. - providers should inform pt of test results

Which of the following are true about TORCH infections? Select all that apply. A) only a concern in the first 12 weeks B) a major side effect for many is intrauterine growth restriction C) if pt has TORCH infection, they should refrain from pregnancy for at least 6 months D) HIV + women can be pregnant and deliver without transmitting the inection to the newborn. E) transmission is usually through body fluid

B) a major side effect for many is intrauterine growth restriction D) HIV + women can be pregnant and deliver without transmitting the inection to the newborn.

A pregnant woman is confused about the terms "embryo" and "fetus." How does the nurse explain the difference? A. "The baby can't be called a fetus until the limbs and organs have formed." B. "The baby is an embryo until 8 weeks' gestation; then it is called a fetus." C. "There really isn't any difference between the terms; they are interchangeable." D. "Your baby is a fetus until the kidneys are matured and he makes urine."

B. "The baby is an embryo until 8 weeks' gestation; then it is called a fetus." During the first 8 weeks of gestation, the baby is called an embryo. By the end of the eighth week, the embryo has developed enough to be called a fetus. The other statements are inaccurate.

A nursing faculty member is explaining the process of fertilization to a class of students. One student asks the instructor to clarify the term "secondary oocyte." What description is best? A. An oocyte in the secondary position during transportation B. An oocyte in which the first meiotic division has occurred C. The second egg released by the ovary during ovulation D. The second egg to reach its place in the fallopian tube

B. An oocyte in which the first meiotic division has occurred The secondary oocyte is one in which the first meiotic division has occurred. This is the egg that is expelled from the ovary during ovulation. The other statements are incorrect.

A woman is starting on birth control, but tells the nurse she wants to become pregnant next year. What action by the nurse is most important? A. Ask the woman to describe how her life will be different in the next year. B. Educate the woman about the need for folic acid supplementation before conceiving. C. Have the woman make a pre-pregnancy appointment for next year before she leaves. D. Tell the woman that it is difficult to get pregnant right after stopping birth control

B. Educate the woman about the need for folic acid supplementation before conceiving. Neural tube defects occur during the fourth week of pregnancy, which is often before women know they are pregnant. Any woman considering pregnancy should take folic acid supplements well in advance of trying to conceive. The other options are not helpful interventions.

A student asks the faculty member to explain why the fetus has such a low PO2. What explanation by the faculty member is most accurate? A. Blood from the mother is deoxygenated. B. It keeps the ductus arteriosus open. C. It maintains the maternal circulation. D. It supports the foramen ovale.

B. It keeps the ductus arteriosus open. The low fetal PO2 helps to maintain fetal (not maternal) circulation and keeps the ductus arteriosus open. It also helps keep the pulmonary vascular bed constricted. Blood from the mother is oxygenated. It does not support the foramen ovale.

The developing human is most vulnerable to teratogens during A. The first 4 weeks of gestation B. The first 8 weeks of gestation C. The first 12 weeks of gestation D. The first 16 weeks of gestation

B. The first 8 weeks of gestation

What is the umbilical cord formed from during placental development? Yolk sac Wharton's jelly Amnion Body stalk

Body stalk

A couple wishes to know the chances of passing on an X-linked dominant heritable disorder to their four sons. The father's family has the disorder. The sons appear healthy, but the couple wants to be prepared for possible future events related to the disease. What information does the nurse give them? A. "All of them will be affected." B. "Half of them will be affected." C. "None of your sons will be affected." D. "One of the four will be affected."

C. "None of your sons will be affected." An X-linked dominant inheritance disorder is the result of an alteration in a gene located on an X chromosome. None of this couple's sons can be affected because boys get a Y chromosome from the father, whereas all of a man's daughters will have it.

A student has read that hematopoiesis occurring in the wall of the yolk sac declines after the eighth week of gestation and asks the instructor for clarification. What statement by the faculty member is most accurate? A. "All of the blood needed is transported across the placenta." B. "Bone marrow production of blood begins in week 8." C. "The fetal liver takes over that function then." D. "You must have misread that information."

C. "The fetal liver takes over that function then." Formation and development of red blood cells (hematopoiesis) occurs in the wall of the yolk sac beginning in the third week. The function gradually declines after the eighth gestational week when the fetal liver begins to take over this process.

A couple wishes to determine the chances of having a blue-eyed baby. Both parents have brown eyes, but have heterozygous gene pairs for eye color. Calculate the odds of their having a child with blue eyes. A. 10% B. 20% C. 25% D. 50%

C. 25%

You are a nurse working in a prenatal clinic. Yourpatient, an 18-year-old woman, is in her 10th gesta-tional week. She wants to know when her baby's heartwill start to beat. You inform her that it usually begins to beat around: A. The 2nd week of gestation B. The 3rd week of gestation C. The 4th week of gestation D. The 5th week of gestation

C. The 4th week of gestation

Celia is 38 and 11 weeks pregnant. The doctor has recommended she have an alpha-fetoprotein (AFP) level check. Why would this be recommended? Celia is over 35 and has an increased risk of a chromosomal disorder. Celia is 11 weeks pregnant. An AFP check should be performed on every patient at this gestational age. Celia may not be taking proper care of herself during her pregnancy, and the doctor is looking for nutritional deficits. Celia has a family history of hemophilia, and the AFP will let the doctor know if her baby has the disease.

Celia is over 35 and has an increased risk of a chromosomal disorder. - Celia is of advanced maternal age thus her risk of having child with chromosomal disorder is increased.

The fetus receives nutrients and oxygen, and passes waste products and carbon dioxide through which structure in the placenta? Amnion Chorionic villi Amniotic fluid Intervillous spaces

Chorionic villi - The chorion contains fingerlike projections (chorionic villi) that may be used for genetic testing (chorionic villus sampling) during the first trimester. ----> The villi beneath the embryo grow and branch out into depressions in the wall of the uterus, and from this structure, the fetal portion of the placenta is formed.

Identical twins will occur during which stage of development? Cleavage Nidation Fertilization After the formation of the placenta

Cleavage - aka mitotic cell division

What is the most common viral infection found in the fetus? Herpes Simplex Virus (HSV) Cytomegalovirus (CMV) Rubella Treponema pallidum

Cytomegalovirus (CMV)

A nurse is counseling a couple whose child has been diagnosed with cystic fibrosis. They understand that this is an inherited disease, but don't know how the child got it, as neither of them is affected. What response by the nurse is best? A. "Are you certain that you (points to man) are the biological father?" B. "Maybe each of you has a mild case that hasn't been diagnosed yet." C. "Something in your environment must have altered one of the genes." D. "This is a recessive disorder, meaning that each of you is just a carrier."

D. "This is a recessive disorder, meaning that each of you is just a carrier."

The perinatal nurse understands that 4 days after fertilization, the morula now contains how many cells? A. 2 B. 4 C. 8 D. 16

D. 16 By 3-4 days after fertilization, there are approximately 16 cells in the zygote, which is now termed a morula.

The perinatal nurse understands that maternal antibodies pass through the placenta by which mechanism? A. Active transport B. Facilitated diffusion C. Osmosis D. Pinocytosis

D. Pinocytosis Maternal antibodies pass through the placenta via pinocytosis, not by active transport, facilitated diffusion, or osmosis.

The nurse discussing fetal development describes the hormone responsible for suppressing the maternal immunological response to the fetus, thereby facilitating physiological acceptance of the pregnancy. Which hormone is the nurse describing? A. Estrogen B. Human chorionic gonadotropin C. Human placental lactogen D. Progesterone

D. Progesterone Progesterone helps to suppress maternal immunological responses to fetal antigens, thereby preventing maternal rejection of the fetus.

The perinatal nurse explains the function of Wharton's jelly to a class of expectant parents. What description is most accurate? A. Collection of blood from the maternal circulation B. Gooey uterine substance that cushions the fetus C. Precursor cells from which blood cells originate D. Protects the umbilical cord from compression

D. Protects the umbilical cord from compression Wharton's jelly is a specialized type of connective tissue surrounding the vessels within the umbilical cord that protects the cord from compression.

A couple has been told that there is a problem with their pregnancy. They only remember the term "ductus venosus." The nurse explains that there is a problem in the circulation between which two structures? A. Pulmonary artery and descending aorta B. Pulmonary vein and pulmonary artery C. Right and left atria in the heart D. Umbilical cord and inferior vena cava

D. Umbilical cord and inferior vena cava The ductus venosus is a vascular channel connecting the umbilical vein to the inferior vena cava. The ductus arteriosus connects the pulmonary artery and descending aorta. The foramen ovale is an opening in the septum between the right and left atria of the heart.

Which placental hormone is responsible for regulating glucose availability to the fetus? A. Progesterone B. Estrogen C. hCG D. hPL

D. hPL

Which of the following processes carries oxygen across the placenta? Pinocytosis Active transport Diffusion Independent movement

Diffusion

Solvent drag is used to transport _________ across the placenta. Intact blood cells Viruses Antibiotics Electrolytes

Electrolytes

Margie, a new patient at her first OB visit, asks where fertilization occurs. What is your best answer as her nurse? Fertilization of the egg usually occurs in the uterus, and then the fertilized egg, or zygote, implants into the uterine lining. Fertilization of the egg occurs at the cervix immediately after the male ejaculates, then the ovum and sperm go through nidation on the uterine wall. Fertilization of the egg takes place in the ampulla of the fallopian tube after sperm have traveled through the uterus to the ovum. Fertilization takes place in the fundibulum at the distal end of the fallopian tube, and then cilia move the fertilized ovum, or zygote, down to the uterus.

Fertilization of the egg takes place in the ampulla of the fallopian tube after sperm have traveled through the uterus to the ovum.

Pati is at the OB office where you work for a new patient visit, and she just found out that she's having twins. She asks you what it means to have fraternal twins. What's your best answer? Fraternal, or dizygotic twins are no more alike than any other siblings. They could each be either gender and look similar or dissimilar Fraternal, or monozygotic twins develop from a single zygote that then divides. The twins look the same and are same gender Fraternal, or dizygotic twins form after embryonic disk has fused Fraternal, or dizygotic twins will have same amniotic sack and share a placenta

Fraternal, or dizygotic twins are no more alike than any other siblings. They could each be either gender and look similar or dissimilar

Low fetal PO2 is compensated by which of the following that differentiates fetal circulation from maternal circulation? An increased alveoli surface area in lings increased arterial pressure Hemoglobin Vesseles of the umbilical cord

Hemoglobin

Which of the following is a genetic test, in which cells from a sample of venous blood or buccal membrane tissue is grown, stained, and photographed in the lab and then compared to normal chromosomes? Karyotyping Pedigree Alpha-fetoprotein Chorionic villus sampling

Karyotyping

What are the two main organs fetal blood supply mostly bypasses until delivery? Heart and lungs Brain and placenta Lungs and liver Liver and yolk sac

Lungs and liver - bypassed by fetal circulation bc they are not needed at this time.

Which of the following state the difference between a malformation and a disruption?

Malformation = is the alteration in embryonic development caused by genetic transmission, chromosomal anomalies, environmental factors, and multifactorial/unknown causes. -----> present from begining of development Disruption = caused by force outside the body that laters previously normal tissue - are not inherited although an individual may be predisposed to the development of a disruption.

Which of the following teratogens is most commonly found in fish? Retinol Lead Methylmercury Thalidomide

Methylmercury

Implantation of the fertilized ovum into the endometrium is called _________________. Nidation Cleavage Gluconeogenesis endocytosis

Nidation

Blood flows from the ___________ to the fetus in the ____________. Fetal liver, ductus arteriosus Foramen ovale, umbilical arteries Placenta, umbilical vein Placenta, umbilical arteries

Placenta, umbilical vein - blood travels from the placenta to the fetus through the umbilical vein

During pregnancy, progesterone is responsible for which of the following functions? Select all the apply. Maintaining corpus luteum Preventing maternal rejection of fetus Relaxes myometrium to inhibit contractions Increases myometrial vasodilation increases basal body temperature

Preventing maternal rejection of fetus Relaxes myometrium to inhibit contractions increases basal body temperature

Satina and Joe are interested in starting a family, but Joe's family has a history of Marfan's syndrome. What simple tool can be used to determine the likelihood of inheritance to Sally and Joe's offspring? Punnett square blood sample for dna testing genomics mendelian

Punnett square

Which of the following statements are true about brown eyes? Select all that apply. Someone with brown eyes could have parents who are both heterozygous for eye color. The person only needs one allele for brown eyes. Eye color is determined during organogenesis. Eye color is an X-linked phenotype. Eye color is determined during mitosis.

Someone with brown eyes could have parents who are both heterozygous for eye color. The person only needs one allele for brown eyes. Eye color is determined during mitosis. - the process of mitosis creates the human genome - brown eyes are considered dominant so only 1 allele is needed. - eye color is determinded during mitosis not organogenesis

By the 10th week of gestation, which of the following statements are true? Select all that apply. The placenta has implanted in the lower anterior of the uterus. The formation of all four limbs can be seen. Organogenesis has occurred. The heart has been beating for a few weeks. The foramen ovale has closed.

The formation of all four limbs can be seen. Organogenesis has occurred. The heart has been beating for a few weeks.

If an alpha-fetoprotein test or a cell-free fetal DNA is ordered and shows concern, what is the next step for the patient? The patient should be offered a therapeutic abortion. The patient should be offered DNA testing. A family pedigree should be made to determine if any of the areas of concern could be genetic. The patient should be offered percutaneous umbilical sampling (PUBS).

The patient should be offered DNA testing. - both tests indicate need for further testing

Amniotic fluid does all of the following except? The volume of amniotic fluid is directly related to age of infant, increasing continuously until delivery Acts as thermoregulator for fetus throughout pregnancy Aids in symmetrical growth and muscle development Has similar substances as those found in breast milk including antibacterials, Immunoglobulins, and fatty acids

The volume of amniotic fluid is directly related to age of infant, increasing continuously until delivery

Which of the following statements are true about a gamete? Select all that apply. There are two types of gamete cells. Gamete cells are considered to be diploid cells. Meiosis occurs when gametes are produced. Each gamete contains 46 chromosomes It takes one haploid cell to make four diploid cells.

There are two types of gamete cells. Meiosis occurs when gametes are produced. -gametes are haploids and each contain 23 chromosomes. - it takes 1 diploid to make 4 haploid.

Which of the following statements about trisomy 21 (down) are true? Select all that apply. Trisomy 21 is the most common trisomy. Trisomy 21 is not compatible with life. Those born with trisomy 21 have significant and severe mental deficits. Hypotonia at birth is a common neonatal finding in trisomy 21. Between the ages of 35 and 46, a women's chances of having an infant with a trisomy disorder increases by 7%.

Trisomy 21 is the most common trisomy. Hypotonia at birth is a common neonatal finding in trisomy 21. Between the ages of 35 and 46, a women's chances of having an infant with a trisomy disorder increases by 7%. - Trisomy 21 is compatible with life - do not necessarily have mental deficit (they have intellectual defects)

Alex is a new OB patient who just found out she's pregnant and has questions about what she should avoid during pregnancy. Which of the following should you counsel her to avoid? Select all that apply. Unvaccinated children Gardening Trout Vitamin C A cup of morning coffee

Unvaccinated children Gardening - lead and pesticides can be found in soil - trout is small freshwater fish --> pregnant women avoid large ocean fish such as tuna and shark. - morning coffee (1 cup) is not considered high caffeine consumption.

The thick, white substance that covers the fetus to protect it from amniotic fluid starting in the 20th week is called ______________. Vernix Lanugo Sphingomyelin Germ layer

Vernix

Anna is pregnant and asking about her baby's appearance and weight. You tell her the baby's skin is red, the eyes are still fused closed, the uterus has formed, the baby has fingernails, the lungs are secreting surfactant, and the fetus is over 300 gms. What week of gestation is the baby? Week 18 Week 21 Week 24 Week 28

Week 24

Which week of gestation would the embryo be most at risk for abnormalities from teratogenic exposure? Week 1 Week 4 Week 12 Week 18

Week 4

Ana is at the office you work in for a routine visit. Discussing the pregnancy with Ana, you let her know that her baby's weight has gone from 3 g to 20 g, and the baby's bones would now be seen on ultrasound. What period is Ana's pregnancy in? Pre-embyronic period Embryonic period fetal period preconception period

fetal period

From 9 weeks' gestation until delivery, the growing human is referred to as a(n) ______________. embryo fetus baby zygote

fetus

The difference between a genotype and a phenotype is which of the following?

genotype = genetic makeup of indivudal phenotype = observable expression of genotype

Cleft palate and neural tube defects could be a result of what kind of inheritance? multifactoral inheritance unifactorical inheritance Autosomal Dominant X-Linked recessive

multifactoral inheritance

Conception ______________. Select all that apply. occurs in the upper posterior of the uterus results in a zygote is also known as ovulation occurs in the outer third of the fallopian tube can only occur on day 14 of the menstrual cycle

results in a zygote occurs in the outer third of the fallopian tube

From implantation until 8 weeks' gestation, ___________ will have the most profound negative impact on the embryo. organogenesis conception teratogens infertility

teratogens

The most important information when calculating risk from teratogen exposure is ___________, _______________, and ________________ . Maternal age, timing, and karyotype timing of exposure, substance, and dose Ethnicity, substance, and prenantal care graivida, mental health, and genotype

timing of exposure, substance, and dose


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