Maternity/OB

Which functions does the amniotic fluid have? Select all that apply. 1. Nourishes the fetus 2. Provides for fetal circulation 3. Allows for symmetrical growth 4. Maintains an even temperature 5. Allows buoyancy and fetal movement

3, 4, 5 -Allows for symmetrical growth -Maintains an even temperature -Allows buoyancy and fetal movement.

The student nurse is presenting a seminar on developmental milestones of the fetus at 36 weeks of gestation. Which statements made about the fetus need correction? Select all that apply. 1. Skin is smooth and pinkish 2. There is subcutaneous fat 3. Grasp reflexes are present 4. Excessive lung surfactant is produced 5. Head and abdomen circumferences are disproportionate

4 & 5 -Excessive lung surfactant is produced -Head and abdomen circumferences are disproportionate.

While reviewing the ultrasound scan reports of a pregnant patient, the nurse notes that the fetus has a well-developed upper lip, eyelid, nasal pit, and foot plate and the fetal length measures 12 mm. The nurse would conclude this patient is how many weeks pregnant? 1. 3 2. 6 3. 8 4. 12

6 weeks

Which type of multiple birth is associated with the finding of an incompletely divided embryonic disc? 1. Parasitic twins 2. Identical twins 3. Fraternal twins 4. Conjoined twins

Conjoined twins.

Which body parts are formed from the ectodermal germ layer? Select all that apply. 1. Nails and hair 2. Bone and cartilage 3. Lining of digestive tract 4. Blood and blood vessels 5. Mucous membrane of anus

1 & 5 -Nails and hair -Mucous membrane of anus

The nursing instructor is teaching student nurses about the formation of dizygotic and monozygotic twins. Which statement does the nursing instructor include in the teaching? 1. "Monozygotic twins are formed from one egg and two sperm." 2. "Monozygotic twins are formed during the third week of gestation." 3. "Dizygotic twins are formed when a sperm enters the fertilized ovum." 4. "Dizygotic twins are formed as a result of the fusion of two eggs with two sperm."

"Dizygotic twins are formed as a result of the fusion of two eggs with two sperm."

Which response would the nurse give to a patient at her first prenatal visit who reports smoking "only" 10 cigarettes per week and asks if she may continue to smoke? 1. "That is something you should ask the physician." 2. "You should decrease the amount of cigarettes you smoke." 3. "Occasional smoking is not proven to be harmful during pregnancy." 4. "Factors such as smoking and alcohol use may adversely affect your baby's development."

"Factors such as smoking and alcohol use may adversely affect your baby's development."

The nursing instructor is teaching student nurses about the process of fertilization. Which statement by the student nurse indicates effective learning? 1. "The ovum can be fertilized up to 72 hours after ovulation." 2. "The sperm is capable of fertilizing the ovum within 15 days." 3. "Fertilization takes place in the outer third of the fallopian tube." 4. "Another sperm can enter the membrane of the ovum after fertilization."

"Fertilization takes place in the outer third of the fallopian tube."

Which findings on a 4-D ultrasound scan at 29 weeks of gestation are associated with normal growth and development of the fetus? Select all that apply. 1. Fetal length is 38 cm (15 in). 2. There is no subcutaneous fat 3. Position in the uterus is cephalic 4. Head and abdominal circumference are equal. 5. Eyes are closed and leg movements are present.

1 & 3 -Fetal length is 38 cm (15 in). -Position in the uterus is cephalic

The nursing instructor asks a nursing student to describe the process of quickening after teaching about changes that occur in pregnancy. Which statement made by the student nurse indicates effective learning? 1. "It is the thinning of the segment of the lower uterus." 2. It is fetal movement when it is first felt by the mother." 3. "It is the painless contractions that occur throughout pregnancy." 4. "It is the soft blowing sound heard during auscultation of the uterus."

"It is the fetal movement when it is first felt by the mother."

Which teaching would the nurse provide to the parents of a 4-month-old infant who has been diagnosed with an unclosed foramen ovale? 1. "The baby will have difficulty in swallowing as a result of this defect." 2. "The baby's heart has impaired function and will pump out less blood." 3. "The baby will have less blood reaching the heart from the extremities." 4. "Oxygenated and deoxygenated blood will get mixed in the baby's heart."

"Oxygenated and deoxygenated blood will get mixed in the baby's heart."

Which response from the nurse is accurate when a pregnant woman having ultrasound examination at 8 weeks of gestation asks if she may learn her expectant child's sex? 1. "Yes, we will be able to tell the sex of your child." 2. "No, the sex organs have not yet started to develop." 3. "We will have to wait until the birth of your child to know for sure." 4. "The 10th week is when the external genitalia are visible on ultrasound."

"The 10th week is when the external genitalia are visible on ultrasound."

A pregnant patient asks the nurse, "Do you think I'll have a boy? If I don't have a boy this time, my husband will probably divorce me." Which response would the nurse make? 1. "The heartbeat of the baby is fast, which means it's a boy." 2. "The father's sperm determines if the baby is a male or female." 3. "Don't worry; you are carrying this baby low, which means it's a boy." 4. "Implantation of the embryo in the uterus determines the sex of the fetus."

"The father's sperm determines if the baby is a male or female."

The nursing instructor asks a student nurse, "How does the circulation of the blood from the placenta to the fetus take place after the fourth week of gestation?" Which response given by the student indicates effective learning? 1. "Through fully developed blood vessels." 2. "Through chorionic villi and blood vessels." 3. "Through two veins and one umbilical artery." 4. "Through three temporary circulatory shunts."

"Through three temporary circulatory shunts."

Which additional features would the nurse expect in a fetus showing leg movements and a crown-rump measurement of 150 mm? Select all that apply. 1. Eye movements 2. Presence of nails 3. Presence of the tail 4. Sucking and swallowing 5. Lanugo covering the fetal body

1 & 4 -Eye movements -Sucking and swallowing

A patient wishing to become pregnant and with a positive ovulation test informs the nurse that she had intercourse 3 days previously. Which guidance would the nurse provide to the patient? 1. "You should take a home pregnancy test after a month." 2. "You should take progesterone pills today to get pregnant." 3. "You should engage in intercourse 5 days from now to get pregnant." 4. "You should get an abdominal ultrasound scan today to detect pregnancy."

"You should take a home pregnancy test after a month."

Which are the functions of the amniotic fluid? Select all that apply. 1. Allows symmetrical growth 2. Acts as cushion for the fetus 3. Acts as a reservoir for nutrients 4. Maintains an even temperature 5. Prevents compression of blood vessels

1, 2, 4 -Allows symmetrical growth -Acts as cushion for the fetus -Maintains an even temperature

The nursing instructor is teaching student nurses about the hormones produced by the placenta. Which statements by the student nurse indicate effective learning? Select all that apply. 1. "Estrogen and progesterone prepare the breasts for lactation." 2. "Estrogen plays an important role in preventing spontaneous abortion." 3. "Human placental lactogen increases insulin sensitivity in the fetus." 4. "Progesterone and estrogen decrease the blood flow to uterine blood vessels." 5. "Human chorionic gonadotropin (hCG) levels are determined to confirm pregnancy."

1, 3, 5 -"Estrogen and progesterone prepare the breasts for lactation." -"Human placental lactogen increases insulin sensitivity in the fetus." -"Human chorionic gonadotropin (hCG) levels are determined to confirm pregnancy.

Which statements are true about the placenta? Select all that apply. 1. It functions as an endocrine gland during the pregnancy 2. It is much larger than the fetus during the entire pregnancy 3. It serves as an organ for fetal respiration, nutrition, and excretion. 4. It is always present in the uterus; it just grows in size during pregnancy. 5. It produces estrogen, which stimulates the development of breasts for lactation.

1, 3, 5 -It functions as an endocrine gland during the pregnancy. -It serves as an organ for fetal respiration, nutrition, and excretion. -It produces estrogen, which stimulates the development of breasts for lactation.

The nurse is caring for a patient at 3 weeks of gestation. The patient tells the nurse, "I really want to know the sex of my baby. When can I find out?" Which response does the nurse give to the patient? 1. 17 weeks 2. 5 weeks 3. 9 weeks 4. 36 weeks

17 weeks.

The nurse is caring for a patient who is 8 weeks pregnant. After how many weeks total would the nurse teach the patient to expect to feel fetal movement? 1. 10 weeks 2. 13 weeks 3. 17 weeks 4. 23 weeks

17 weeks.

Which conditions would the nurse associate with changes in the levels of intrauterine amniotic fluid? Select all that apply. 1. Decrease due to fetal movements. 2. Increase due to fetal urine excretion. 3. Increase due to increased estrogen levels. 4. Decrease due to the fetus swallowing the fluid. 5. Increase due to increased progesterone levels.

2 & 4 -Increase due to fetal urine excretion. -Decrease due to the fetus swallowing the fluid.

The nursing instructor is teaching a student nurse about postfertilization events. Which statements by the student nurse indicate effective learning? Select all that apply. 1. The morula is a multicellular structure formed in the uterus. 2. The zygote undergoes rapid mitotic divisions after fertilization. 3. The zygote increases in its size as it travels through the fallopian tube. 4. The blastomere is an eight-celled structure resulting from mitosis. 5. The cells fuse to form larger cells to form the solid ball-like morula.

2 & 4 -The zygote undergoes rapid mitotic divisions after fertilization. -The blastomere is an eight-celled structure resulting from mitosis. P. 37

The nursing instructor is teaching student nurses about the umbilical cord. Which statement by the student nurse indicates effective learning? Select all that apply. 1. "The umbilical cord protrudes from the edge of the placenta." 2. "The umbilical cord contains one vein carrying blood toward the fetus." 3. "The umbilical cord contains one artery carrying blood toward the fetus." 4. "The umbilical cord contains two veins carrying blood away from the fetus." 5. "The umbilical cord contains two arteries carrying blood away from the fetus."

2 & 5 -"The umbilical cord contains one vein carrying blood toward the fetus." -"The umbilical cord contains two arteries carrying blood away from the fetus."

The nursing instructor is teaching student nurses about the factors affecting the sex of a fetus. Which statements should the nursing instructor include in the teaching? Select all that apply. 1. "Female hormones do not influence sperm fertilization of the mature ovum." 2. "The male partner determines the sex of the fetus but not the female partner." 3. "A male fetus results when a sperm carrying a Y chromosome fertilizes the ovum." 4. "A female fetus results when a sperm carrying an X chromosome fertilizes the ovum." 5. "The estrogen level in the female partner during fertilization determines the sex of the fetus."

2, 3, 4 -"The male partner determines the sex of the fetus but not the female partner." -"A male fetus results when a sperm carrying a Y chromosome fertilizes the ovum." -"A female fetus results when a sperm carrying an X chromosome fertilizes the ovum."

Which ultrasound findings indicate that a 25-week-old fetus has normal growth and development? Select all that apply. 1. Fetal weight is 260 g. 2. Fetal crown-heel length is 28 cm. 3. The fetus shows respiratory movements. 4. The fetus exhibits minimal leg movements. 5. The fetus has wrinkled skin and a lean body.

2, 3, 5 -Fetal crown-heel length is 28 cm. -The fetus shows respiratory movements. -The fetus has wrinkled skin and a lean body.

A patient asks the nurse at what age could her baby survive if it is born. Which gestational age would the nurse inform the patient is considered viable? 1. 17 weeks 2. 20 weeks 3. 23 weeks 4. 25 weeks

20 weeks.

How long does the ovum survive after ovulation? 1. 2 hours 2. 5 days 3. 12 days 4. 24 hours

24 hours

. The nurse is caring for a pregnant patient. Based on the ultrasound report, at which fetal age is there an indication of reduced fetal growth? -Fetal age: 8 Weeks, Fetal weight (g): 6, Fetal length: 30 mm -Fetal age: 17 Weeks, Fetal weight (g): 260, Fetal length: 150 mm -Fetal age: 25 Weeks, Fetal weight (g): 550, Fetal length: 28 cm -Fetal age: 29 Weeks, Fetal weight (g): 1260, Fetal length: 38 cm 1. 8th Week 2. 17th Week 3. 25th Week 4. 29th Week

25th Week. --The fetus should weigh about 780 g at 25 weeks of gestation.

Which is the most likely outcome in a patient with multifetal gestation and each fetus has a separate amnion but a common chorion and placenta. 1. Post-term delivery 2. Birth of identical twins 3. Birth of conjoined twins 4. Delivery of normal weight babies

Birth of identical twins.

Which characteristics does a fetus display at 25 weeks of gestation? 1. Eyes are closed. 2. Constant motion. 3. Skin is pink and smooth. 4. Body is covered by lanugo.

Body is covered by lanugo.

Which body system in the newborn is at risk in the setting of maternal malnutrition and changes in the renal and vascular structures on ultrasound? 1. Renal 2. Neurological 3. Cardiovascular 4. Gastrointestinal

Cardiovascular

Which would the nurse use to describe fetal circulation through the foramen ovale? 1. Diverts some blood from the mitral into the tricuspid valve. 2. Diverts most blood from the right atrium to the left atrium. 3. Diverts most blood through the pulmonary artery into the aorta. 4. Diverts some blood away from the liver as it returns from the placenta.

Diverts most blood from the right atrium to the left atrium.

At which stage of delivery would the nurse expect complications in a fetus as the result of a difference between the maternal and fetal blood groups? 1. After dilation of the cervix during labor. 2. During stretching and thinning of the cervix. 3. During separation of the placental membranes. 4. After the expulsion of the fetus from the uterus.

During separation of the placental membranes.

Which germ layer forms the fetal nervous system? 1. Ectoderm 2. Endoderm 3. Ectocervix 4. Endocervix

Ectoderm P. 38

Which hormone is produced by the placenta? 1. Estrogen 2. Aldosterone 3. Testosterone 4. Luteinizing hormone

Estrogen

A postpartum Asian patient tells the nurse that her family members are disappointed in her, as she failed to give birth to a baby of their desired sex. Which is the most important nursing intervention in this situation? 1. Console and motivate the patient to take proper care of the baby. 2. Divert the disturbed patient by frequently talking about the baby. 3. Stop frequent visits of the family members to meet the patient. 4. Explain to the family members that the father contributes to the actual sex of the baby.

Explain to the family members that the father contributes to the actual sex of the baby.

The nurse is caring for a patient at 25 weeks of gestation and observes increased skin pigmentation, increased skin temperature, salivation and reddening of both upper and lower lips. Changes in which hormone levels have caused these symptoms in the patient? 1. Fetal placental estrogen 2. Human placental lactogen 3. Fetal placental progesterone 4. Human chorionic gonadotropin

Fetal placental estrogen

The nurse is caring for a patient who delivered a preterm male neonate at 28 weeks of gestation. Which findings would the nurse expect during the physical examination of the neonate? 1. Soft skin 2. Fingernails 3. Normal weight 4. Absence of testicles

Fingernails

Deficiency of which nutrient in the mother is associated with a neural tube defect in the fetus? 1. Calcium 2. Folic acid 3. Vitamin A 4. Vitamin C

Folic Acid.

The nurse is collecting data on a newborn immediately following birth and finds that the newborn has reduced abdominal circumference. The infant may have impaired function of which system? 1. Hepatic 2. Renal 3. Respiratory 4. Neurological

Hepatic --Reduced abdominal circumference indicates reduced liver size and impaired liver growth.

Which complication is associated with the finding of reduced abdominal circumference on ultrasound? 1. Reduced ossification 2. Reduced blood pressure 3. Impaired lipid metabolism 4. Increased insulin secretion

Impaired lipid metabolism

Alteration in which blood level is associated with intrauterine growth restriction resulting in a reduced number of pancreatic beta cells? 1. Insulin 2. Bile acid 3. Thyroxine 4. Aldosterone

Insulin

From which structure is blood diverted by the ductus venosus in fetal circulation? 1. Lungs 2. Heart 3. Liver 4. Kidneys

Liver

Which disorder does the intake of folic acid help prevent in the fetus? 1. Hepatic 2. Cardiac 3. Respiratory 4. Neural tube

Neural tube

Which maternal hormone reduces uterine contractions as a means of preventing spontaneous abortion? 1. Estrogen 2. Progesterone 3. Luteinizing hormone 4. Follicle-stimulating hormone

Progesterone

Which condition is associated with spontaneous abortion? 1. Increased estrogen levels 2. Reduced progesterone levels 3. Reduced human placental lactogen levels 4. Increased human chorionic gonadotropin levels

Reduced progesterone levels

Which complication would the nurse assess for in an infant diagnosed with respiratory distress syndrome? 1. Reduced lipid metabolism 2. Impaired hepatic functioning 3. Closure of the ductus venosus 4. Reopening of the foramen ovale

Reopening of the foramen ovale.

An opened foramen ovale in a 2-week old infant that was previously closed 2 hours following birth is associated with a disorder of which system? 1. Hepatic 2. Respiratory 3. Neurological 4. Gastrointestinal

Respiratory

The nurse is caring for a pregnant patient who had a fall and sustained a mild injury to the abdomen. Examination revealed no injury to the fetus. Which factor could have prevented fetal injury in this case? 1. The placenta protects the fetus by immediately wrapping around it. 2. The amniotic fluid acts as a cushion and protects the fetus from injury. 3. The thick membranous villi of the chorion protect the fetus from injury. 4. Vernix and lanugo protect the fetus from injury by covering the skin.

The amniotic fluid acts as a cushion and protects the fetus from injury.

Which condition results from failure of the corpus luteum to persist following the conception? 1. The pregnancy would abort. 2. The fetus will have slow growth. 3. The estrogen levels would increase. 4. The progesterone levels would increase.

The pregnancy would abort. --Corpus Luteum produces estrogen and progesterone.

Which statement is correct with regards to the tubal transport of the zygote? 1. The size of the zygote increases as it undergoes rapid meiotic division or cleavage. 2. The zygote undergoes meiotic division during transport through the fallopian tube. 3. The zygote undergoes cleavage to form a four-celled structure called a blastomere. 4. The zygote gets implanted in the lining of the tube, causing tubal ectopic pregnancy.

The zygote gets implanted in the lining of the tube, causing tubal ectopic pregnancy.

Reduced levels of human placental lactogen at 29 weeks of gestation is associated with which condition in the fetus? 1. There is reduced growth and development in the fetus. 2. There is less wrinkled skin as a result of subcutaneous fat. 3. The fetus has assumed the cephalic position in utero. 4. There is a reduction in the formation of erythrocytes by the spleen.

There is reduced growth and development in the fetus.

Which statement is true of monozygotic twins? 1. They will not be identical to each other. 2. They may or may not be of the same sex. 3. They share a common placenta for growth. 4. They share a common amnion and chorion.

They share a common placenta for growth.

Which information would the nursing instructor give to the students regarding fetal blood supply? 1. Two umbilical blood vessels carry blood away from the fetus. 2. Three umbilical blood vessels carry blood away from the fetus. 3. Three umbilical blood vessels are coiled and are not separated. 4. One vein is covered by Wharton's jelly and two arteries are uncovered.

Two umbilical blood vessels carry blood away from the fetus.

Which anatomic location is the usual site of zygote implantation in the female reproductive system? 1. Edge of the inner cervical os 2. Outer third of the fallopian (uterine) tube 3. Lower section of the posterior uterine wall 4. Upper section of the posterior uterine wall

Upper section of the posterior uterine wall.