Chapter 5: Fetal Development, Chapter 5: Fetal Development
A woman comes in for her annual gynecological examination and informs the nurse that she is going to try and become pregnant. She asks the nurse when the best time in the month is to become pregnant. What is the best response by the nurse? "The day after your menstrual cycle ends." "5 days after your menstrual cycle is to begin." "3 days before until 2 days after ovulation." "2 weeks before and 2 weeks after ovulation."
"3 days before until 2 days after ovulation."
A pregnant patient scheduled for an amniocentesis asks the nurse how the placenta is not punctured during the procedure. What should the nurse respond to the patient? "A uterus feels soft over the placenta site." "A sonogram to locate it will be done first." "It would not be harmful even if it were punctured." "Placentas always form on the posterior uterine wall."
"A sonogram to locate it will be done first."
The health care provider prescribes 50 mg daily by mouth of clomiphene for a client having fertility problems. The client cannot swallow pills. Available is 200 mg/5 ml elixir. How many milliliters of the medication would the nurse administer? Record your answer using two decimal points.
1.25
When a man ejaculates, his sperm begin a long and arduous journey to fertilize the woman's ovum. What in the semen produces smooth muscle contractions in the uterus to help the sperm along on their journey? Hormones Testosterone Prostaglandins Amino acids
Prostaglandins
When a man ejaculates, his sperm begin a long and arduous journey to fertilize the woman's ovum. What in the semen produces smooth muscle contractions in the uterus to help the sperm along on their journey?
Prostaglandins Prostaglandins in the semen increase smooth muscle contractions of the uterus that facilitate the transport of sperm.
Which hormone(s) is secreted by the placenta during the pregnancy? Select all that apply.
progesterone estrogen human chorionic gonadotropin The placenta secretes hormones that help to sustain the pregnancy. These include progesterone, estrogen, human placental lactogen, and human chorionic gonadotropin. Testosterone is secreted by the male testes. Prolactin is secreted by the anterior pituitary gland.
The placenta is the site where antibodies in the mother's blood pass into the fetal circulation. These antibodies give passive immunity to the fetus for several common childhood diseases. There are some infections for which the mother does not provide antibodies to the fetus. What infection is the fetus not protected from? diphtheria smallpox rubeola rubella
rubella
Implantation generally occurs at which place on the uterus?
the upper posterior surface Implantation occurs most commonly on the upper posterior surface of the uterus. This position allows the fetus to deliver before the placenta.
A client at 20 weeks' gestation is admitted to the hospital birthing center with premature labor. What information regarding fetal lung development at this stage of development makes stopping the labor process beneficial?
Surfactant is not produced until the start of the 21st week of fetal development. The fetal lungs do not produce surfactant at 20 weeks. A preterm neonate without surfactant does not have the fat and protein coating that helps to decrease the surface tension in the alveoli. This lack of surfactant decreases the neonate's ability to exhale.
A pregnant client at 10-weeks' gestation asks the nurse if the developing fetus can get infections. The nurse explains that until about 24 weeks' gestation the cytotrophoblast layer of cells protects the fetus from certain infections. The cytotrophoblast layer will protect against which of these infections? Select all that apply. Syphilis Gonorrhea Group B streptococcus HIV Toxoplasmosis
Syphilis Gonorrhea Group B streptococcus
A woman has just learned that she is pregnant and would like to know how soon she can find out via ultrasound the sex of her fetus. The nurse should respond with which of the following? at about 4 months at about 2 months at about 6 months Fetal gender can only be determined by analysis of maternal serum.
at about 4 months
When preparing a presentation for a group of pregnant women about fetal circulation, the nurse would point out which structure is primarily responsible for ensuring that highly oxygenated blood reaches the fetal brain?
foramen ovale The ductus venosus provides a passageway for oxygenated blood from the umbilical vein to reach the inferior vena cava. The ductus arteriosus is a shunt that receives deoxygenated blood and transports it to the descending aorta. The umbilical vein carries oxygenated blood from the placenta to the fetus. The foramen ovale deflects blood from the vena cava into the left atrium, then left ventricle, into the ascending aorta and into the head and upper body so that the brain receives blood with the highest level of oxygenation.
An expectant mother is on heparin for previous blood clots and voicing concerns about how her medications will affect her baby. The nurse would inform the mother that: heparin does not cross the placenta and is safe for her to take. any medication that an expectant mother takes can cause sequelae for the infant. she should discontinue the heparin and change to another anticoagulant. it is recommended to stop taking the heparin while she is pregnant.
heparin does not cross the placenta and is safe for her to take.
An expectant mother is on heparin for previous blood clots and voicing concerns about how her medications will affect her baby. The nurse would inform the mother that:
heparin does not cross the placenta and is safe for her to take. Heparin is a medication that does not cross the placenta and therefore is safe to use during pregnancy. Not all medications cause fetal sequelae. It is not recommended to abruptly discontinue any medication without consulting the mother's health care provider and heparin is the safest anticoagulant for a pregnant woman to take.
A pregnant woman undergoing amniocentesis asks her nurse why the baby needs this fluid. What would be an accurate response from the nurse? "Amniotic fluid cushions your baby to prevent injury." "Amniotic fluid provides fetal blood circulation." "Amniotic fluid supplies the food your baby needs to grow." "Amniotic fluid keeps the fetus from moving freely inside it to prevent injury."
"Amniotic fluid cushions your baby to prevent injury."
A woman at 15 weeks' gestation who works at a daycare center thinks she may have just been exposed to rubella at work. The client asks how this may affect her fetus. What is the best response the nurse can give?
"By the end of the eighth week all of the organ systems and major structures are present, so exposure to any teratogen can lead to birth defects. More assessments are needed." All organ systems are complete at 8 weeks gestation. During this time of organogenesis the growing structure is most vulnerable to invasion by teratogens.
The school nurse is presenting a lecture to adolescents to teach them how conception occurs. Which statement by the nurse would accurately describe this process? "Human life begins with the union of two cells: the zygote and the sperm." "At the time of conception, the ovum determines the sex of the baby." "Conception usually occurs when the ovum is in the outer third of the fallopian tube." "The ovum carries the Y chromosome, and the sperm carries an X or Y chromosome."
"Conception usually occurs when the ovum is in the outer third of the fallopian tube."
The school nurse is presenting a lecture to adolescents to teach them how conception occurs. Which statement by the nurse would accurately describe this process?
"Conception usually occurs when the ovum is in the outer third of the fallopian tube." Conception usually occurs when the ovum is in the outer third of the fallopian tube (oviduct). Human life (conception) begins with the union of two cells: the ovum (female) and the sperm (male). At the time of conception, the sperm determines the sex. An ovum carries only one type of chromosome to determine sex: the X chromosome. A male sperm cell may carry either an X or Y sex chromosome. If a sperm cell carrying a Y chromosome fertilizes the ovum, a boy (XY) will result; if the sperm cell carries an X chromosome, the result will be a girl (XX).
A nursing instructor teaching a maternity course realizes a student needs more instruction upon overhearing the student make which of the following statements? "Different sexual positions can determine the sex of the fetus." "Ingesting certain foods before intercourse has no bearing on the sex of the fetus." "Some couples mistakenly believe that they can influence the sex of the fetus." "Timing sex at specific times during the menstrual cycle does not influence fetal gender."
"Different sexual positions can determine the sex of the fetus."
A nursing instructor teaching a maternity course realizes a student needs more instruction upon overhearing the student make which of the following statements?
"Different sexual positions can determine the sex of the fetus." Some couples mistakenly believe that they can influence sex determination by using certain sexual positions, ingesting certain foods before intercourse, or timing sex to occur at specific times during the menstrual cycle. These beliefs are often rooted in folklore and not based on scientific principles.
A pregnant patient is concerned that the baby is going to drown in the uterus because of the fluid. What should the nurse respond about fetal respiration?
"Oxygen is provided to the baby through the placenta." Fetal circulation differs from extrauterine circulation because the fetus derives oxygen and excretes carbon dioxide not from gas exchange in the lung but from exchange in the placenta. The baby's lungs are not functioning in utero so the response that the baby's breathing is very minor until delivery and the baby's lungs being able to accommodate the fluid are incorrect. The patient is not "breathing for the baby."
A nursing instructor identifies a need for further instruction in regards to the three stages of fetal development when a nursing student makes which statement?
"The pre-embryonic stage begins approximately 2 weeks after fertilization." The three stages of human development are the pre-embryonic stage, which begins at fertilization and lasts through the end of the second week after fertilization; the embryonic stage, which begins approximately 2 weeks after fertilization and ends at the conclusion of the 8th week after fertilization; and the fetal stage, which begins approximately 9 weeks after fertilization and ends at birth.
During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important, but can you tell me more about it?" When describing amniotic fluid to a pregnant woman, which description would the nurse most likely include?
"This fluid acts as a cushion to help to protect your baby from injury." Amniotic fluid protects the floating embryo and cushions the fetus from trauma. The placenta acts as a transport mechanism for oxygen and nutrients. Amniotic fluid is primarily water with some organic matter. Throughout pregnancy, amniotic fluid volume fluctuates.
A pregnant client is undergoing an amniocentesis in her third trimester and is worried why she is undergoing this procedure. Which statement by the nurse would best alleviate this client's anxieties? "This procedure is not very dangerous and you should not worry about it." "We are concerned that your baby may have some genetic disorder." "The doctor can explain everything to you when we are done with the procedure." "We want to be sure your baby's lungs are mature and this measures the development of the baby's lungs.
"We want to be sure your baby's lungs are mature and this measures the development of the baby's lungs.
A pregnant client is undergoing an amniocentesis in her third trimester and is worried why she is undergoing this procedure. Which statement by the nurse would best alleviate this client's anxieties?
"We want to be sure your baby's lungs are mature and this measures the development of the baby's lungs. The purpose of an amniocentesis is to determine if the lungs of the fetus are mature enough to support respirations outside the womb. Additionally, an amniocentesis is done for genetic testing for a variety of disorders. Telling the client that there might be a genetic disorder would only escalate the mother's concerns, not alleviate them. Telling the client the procedure is not dangerous or that the doctor will explain things after the amniocentesis does not address her concerns; rather, it minimizes them.
The pregnant client at 6 weeks' gestation asks the nurse if an ultrasound will reveal the sex of the fetus yet. What is the best response by the nurse? "We will be able to determine the sex of the baby today with transvaginal ultrasound." "We will have to wait until the baby is 8 weeks' gestation to be able to determine what the sex is." "We will have to wait until the baby is 16 weeks' gestation to determine what the sex is." "We will have to wait until the baby is 20 weeks' gestation to determine the sex of the baby."
"We will have to wait until the baby is 16 weeks' gestation to determine what the sex is."
The pregnant client at 6 weeks' gestation asks the nurse if an ultrasound will reveal the sex of the fetus yet. What is the best response by the nurse?
"We will have to wait until the baby is 16 weeks' gestation to determine what the sex is." The sex of the baby can be determined by ultrasound at 16 weeks' gestation. An ultrasound at 6 and 8 weeks would be too early to determine the sex. An ultrasound at 20 weeks should confirm what was found at 16 weeks.
A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes? 22 23 44 46
46
On what day during pregnancy does the embryo implant on the uterine surface? the 14th day of a "typical" menstrual cycle 8 days after ovulation 10 days after the start of the menstrual flow 4 days after ovulation
8 days after ovulation
On what day during pregnancy does the embryo implant on the uterine surface?
8 days after ovulation After floating free in the uterine cavity for about 4 days, the zygote implants on the uterine surface on about the 22nd day; thereafter it is termed an embryo.
Which body system is most affected throughout the embryonic and fetal period by teratogens?
Central nervous system Whether the teratogen is ingested, injected, occurs through an infectious agent or is environmental, the CNS and brain are the body systems that are most seriously affected during this period.
The nursing instructor is leading a discussion on the process of implantation with a group of nursing students. The instructor determines the session is successful after the students correctly choose which explanation of a blastocyst?
An inner layer of cells that is separated from an outer layer of cells by a fluid-filled cavity The zygote divides rapidly, until it forms a ball of about 16 identical cells, which is then called a morula. The morula is then swept down the fallopian tube and into the uterus, a process that takes approximately 7 to 9 days. The lining of the uterus, or endometrium, has become rich in nutrients in preparation for the pregnancy. Just before the morula reaches the uterus, the cells begin to form layers—first an inner layer, then an outer layer that is around a fluid-filled space. This structure is called a blastocyst. As the structure continues to grow, the outer layer becomes the trophoblast, which will become the structures that nourish (the placenta) and protect the developing conceptus. The inner cell mass will become the embryo which will continue to grow and become the fetus.
A woman has just learned that she is pregnant and would like to know how soon she can find out via ultrasound the sex of her fetus. The nurse should respond with which of the following?
At about 4 months Although fetal gender is usually determined by an ultrasound screen at about 4 months, it can be determined as early as 7 weeks by analysis of maternal serum.
During which stage of fetal development is exposure to teratogens most damaging?
Embryonic stage The most sensitive period of fetal development related to teratogens is during the embryonic period when the different body systems are developing. During the pre-embryonic stage, the fetal stage and the mitosis stage, the risk of teratogenic exposure is not as influential on the fetus.
The nurse is explaining the process of fertilization to a patient who has just learned of being pregnant. On which day during pregnancy should the nurse explain that the embryo implants on the uterine surface?
Eight to 10 days after fertilization Implantation, or contact between the growing structure and the uterine endometrium, occurs approximately 8 to 10 days after fertilization. Four days after fertilization the structure is a zygote. Implantation does not occur on the 14th day of a typical menstrual cycle or 10 days after the start of a menstrual flow.
The nursing instructor is presenting a class on the various classifications of twins. The instructor determines the session is successful after the students correctly choose which classification that indicates twins have separate amniotic sacs and placentas?
Diamniotic-dichorionic Diamniotic-dichorionic twins each develop in their own amniotic sac. Their placentas do not share any vessels. Monoamniotic-monochorionic twins have one amniotic cavity that they both share. "Biplacental" is not a type of twin.
A nurse is asked to auscultate the fetal heart sounds in a pregnant client. Which equipment is most appropriate when auscultating fetal heart sounds at the 12th week? Doppler fetoscope tocodynometer stethoscope
Doppler
A nurse is asked to auscultate the fetal heart sounds in a pregnant client. Which of the following equipment is most appropriate when auscultating fetal heart sounds at the 12th week?
Doppler Fetal heart sounds are best heard with the Doppler from the 10th week onward. They can be heard with the fetoscope by about the 18th to 20th week only. A tocodynometer is used to record uterine contractions and not to auscultate fetal heart tones. Fetal heart tones may not be audible with an ordinary stethoscope at the 12th week.
During the initial assessment of a preterm infant, it is noted that the infant has a heart murmur. Which shunt from fetal life most likely remains open?
Ductus arteriosus There are three shunts in the fetal circulation: the foramen ovale, the ductus venosus and the ductus arteriosus. Additionally, there are two umbilical arteries and one umbilical vein, which close following birth and form ligaments. In a preterm infant, there is a higher likelihood of the ductus arteriosus remaining open, so a murmur heard in a preterm infant shortly after birth would be suspected to be ductal murmur.
Spermatogenesis is the process by which primary spermatocytes become mature sperm. When does spermatogenesis begin? Before birth During puberty When secondary sex characteristics begin to develop Late school age
During puberty
A pregnant client is diagnosed with hydramnios. The nurse explains that further testing will be done to determine if which conditions are present? Select all that apply.
Esophageal atresia Anencephaly Hydramnios or excessive amniotic fluid is found when the fetus has a condition such as esophageal atresia or anencephaly, which inhibit swallowing. Renal atresia or renal conditions that decrease urine production results in oligohydramnios. The volume of amniotic fluid protects the umbilical cord from pressure thus protecting the fetal oxygen supply.
After the nurse describes fetal circulation to a pregnant woman, the woman asks why her fetus has a different circulation pattern than hers. When responding to the client, the nurse integrates understanding of what information? Fetal blood is thicker than that of adults and needs different pathways. Fetal circulation carries highly oxygenated blood to vital areas first. Fetal blood has a higher oxygen saturation and circulates more slowly. Fetal heart rates are rapid and circulation time is double that of adults.
Fetal circulation carries highly oxygenated blood to vital areas first.
After the nurse describes fetal circulation to a pregnant woman, the woman asks why her fetus has a different circulation pattern than hers. When responding to the client, the nurse integrates understanding of what information?
Fetal circulation carries highly oxygenated blood to vital areas first. Fetal circulation carries highly oxygenated blood to vital areas first while shunting it away from less vital ones. Fetal blood is not thicker than that of adults. Large volumes of oxygenated blood are not needed because the placenta essentially takes over the functions of the lung and liver during fetal life. Although fetal heart rates normally range from 120 to 160 beats per minute, circulation time is not doubled.
Fetal circulation differs from the circulatory path of the newborn infant. In utero the fetus has a hole connecting the right and left atria of the heart. This allows oxygenated blood to quickly pass to the major organs of the body. What is this hole called? Foramen venosus Foramen magnum Foramen arteriosus Foramen ovale
Foramen ovale
A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embryonic stage? From fertilization to the end of the second week after fertilization Approximately 2 weeks after fertilization to the end of the eighth week Approximately 9 weeks after fertilization to birth Approximately 6 weeks after fertilization to the end of 8 weeks
From fertilization to the end of the second week after fertilization
A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embryonic stage?
From fertilization to the end of the second week after fertilization The pre-embryonic stage begins at fertilization and lasts through the end of the second week after fertilization. The embryonic stage begins approximately 2 weeks after fertilization and ends at the conclusion of the eighth week after fertilization. The fetal stage begins at 9 weeks after fertilization and ends at birth. There is no distinct stage recognized approximately 6 to 8 weeks after fertilization. This is part of the embryonic stage period.
While in utero, a fetus swallows many substances that are deposited in the fetal intestinal system as meconium. What problem can arise from this occurrence? The fetus can become constipated following birth. If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia. Abdominal distension occurs and infection can set in. Meconium-stained fluids cause an increased risk of jaundice.
If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia.
Amniotic fluid is produced throughout the pregnancy by the fetal membranes. Amniotic fluid has four major functions. What is one of these functions?
Physical protection Amniotic fluid serves four main functions for the fetus: physical protection, temperature regulation, provision of unrestricted movement, and symmetrical growth.
A client asks the nurse to describe the difference between menstruation and implantation bleeding. Which statements should the nurse include in the description? Select all that apply.
Menstruation occurs when the ovum is not fertilized. Implantation bleeding occurs when the blastocyst burrows into the endometrium. Menstruation occurs 14 days after ovulation. Implantation bleeding occurs 7 to 10 days after fertilization. Menstruation is a cyclic bleeding that occurs when the ovum is not fertilized and begins about 14 days after ovulation. Implantation bleeding occurs 7 to 10 days after fertilization when the blastocyst burrows into the endometrium. Menstruation occurs in the ischemic phase, not the follicular phase of the uterine cycle. Menstruation occurs every 29 days, not every 8 days and varies from 21 to 35 days, not 1 to 14 days. Implantation bleeding is not as heavy as a menstrual period.
Often, an ectopic pregnancy occurs in one of the woman's fallopian tubes. If undetected, the growing embryo puts extreme pressure on the tube, dilating it until it finally ruptures. Hemorrhage then occurs, putting the mother's life at risk. Where does the blood hemorrhage into? Uterus Peritoneal cavity Rectum Plural cavity
Peritoneal cavity
Amniotic fluid is produced throughout the pregnancy by the fetal membranes. Amniotic fluid has four major functions. What is one of these functions? Medium in which to test organ maturity Physical protection Provide fluid to keep the fetus hydrated Restriction of movement
Physical protection
A client comes to the clinic with concerns about her pregnancy. She is in her first trimester and is now experiencing moderate abdominal pain on the right side. What would be the nurse's first action? Recommend an abdominal ultrasound to the doctor since this may be ectopic pregnancy. Reassure the mother that this is normal as the baby is implanting into the uterus. Obtain a detailed 24-hour intake to determine if the pain is related to what she has eaten. Encourage her to ambulate since gas pains are common in early pregnancy.
Recommend an abdominal ultrasound to the doctor since this may be ectopic pregnancy.
A client comes to the clinic with concerns about her pregnancy. She is in her first trimester and is now experiencing moderate abdominal pain on the right side. What would be the nurse's first action?
Recommend an abdominal ultrasound to the doctor since this may be ectopic pregnancy. The nurse should recognize that abdominal pain is not normal during pregnancy and warrants investigation since ectopic pregnancy is a distinct possibility. An abdominal ultrasound would be best practice for this complaint. Dismissing her reports as normal is not a wise choice.
A woman calls the obstetrician's office and states that she is feeling nauseated and tired and suspects she may be pregnant. The nurse asks the woman when her last menstrual cycle was and is told that the woman had a light cycle three weeks ago. How would the nurse respond to this client?
Recommend that the woman come into the office for a pregnancy test or do a home pregnancy test. Women may experience a small amount of bleeding during the time of implantation and this scanty bleeding can be mistaken for a menstrual cycle and lead to miscalculation of the fetal dates. By doing a pregnancy test, the woman can determine if she is pregnant or not.
Spermatozoa begin their cellular division in what part of the male reproductive system?
Seminiferous tubules The male spermatozoa undergo the initial division in the seminiferous tubules within the testes. The other areas listed have no bearing on the development of spermatocytes.
During the embryonic stage of pregnancy, what changes would the mother note in her body to signal that she is pregnant? She will miss her menstrual cycle. She will begin to gain weight. Constipation often occurs during this time. She will have a slower heartbeat.
She will miss her menstrual cycle.
A multigravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? The end of the second trimester The end of the first trimester The end of the third trimester The end of the fourth trimester
The end of the second trimester
A multigravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out?
The end of the second trimester During the second trimester, fetal growth is significant. The fetus begins this trimester 3 inches long and weighing less than 1 oz (0.8 gm). By the end of the second trimester, the fetus is about 15 inches long and weighs more than 2 lbs (1000 gm). Major organs develop to the point that the fetus may survive (with help) outside the womb. The fetus would not be able to survive at the end of the first trimester. The end of the third trimester is the expected time of deliver. The fourth trimester involves the time after delivery.
The nurse is assessing a newborn infant for possible intrauterine growth restriction (IUGR). Which factor should the nurse analyze first to help determine if this diagnosis is accurate?
The ethnicity and stature of both the mother and father The nurse should first ensure it is truly IUGR and not related to other issues such as the ethnicity and stature of both the mother and father, as some ethnic groups commonly produce offspring that are smaller than others. The diet, certain teratogenic medications, and incorrect due dates may contribute to the correct diagnosis of IUGR.
What physiologic changes occur after birth when the cord is cut and clamped? The infant takes its first breath and the lungs expand to increase blood oxygen levels. The ductus ovale closes over the next 2 to 3 days. The oxygenated blood coming from the placenta is diverted around the liver through the ductus venosus. The placenta is immediately expelled.
The infant takes its first breath and the lungs expand to increase blood oxygen levels.
What physiologic changes occur after birth when the cord is cut and clamped?
The infant takes its first breath and the lungs expand to increase blood oxygen levels. As the infant takes its first breath, the pulmonary resistance decreases and blood flow increases to the lungs, resulting in increased oxygenation of the infant's blood. The ductus venosus and the ductus arteriosus close, not the ductus ovale. The foramen ovale normally closes when the pressure gradient in the heart shift from higher pressure on the right side to higher pressure on the left side of the heart. The placenta is not immediately expelled once the infant takes its first breath.
While conducting a class for a group of pregnant women in their first trimester, one of the woman asks, "How is my baby's sex determined?" Which factors should the nurse include in the response? Select all that apply. The male gamete is responsible for sex determination. Sex determination occurs at the time of ovulation by the combination of the sex chromosomes of the sperm and ovum. Certain sexual positions and foods influence sex determination. The Y chromosome contains the genes for maleness. The 22 autosomes from the ovum and sperm combine to determine the sex of the fetus.
The male gamete is responsible for sex determination. The Y chromosome contains the genes for maleness.
How does fetal circulation differ from circulation after birth?
The umbilical vein carries oxygenated blood, while deoxygenated blood is carried by the umbilical arteries. The umbilical vein carries oxygenated blood from the placenta to the fetus and the deoxygenated blood is returned to the placenta by the two umbilical arteries, whereby in circulation after delivery, oxygenated blood is carried by arteries and deoxygenated blood is carried by veins. The blood flow through the pulmonary artery is approximately 10% of the post-delivery blood flow due to high pulmonary vascular resistance in utero. The ductus arteriosus carries blood from the pulmonary artery to the aorta, not the blood coming from the left ventricle.
A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information? The female fertility period is from Day 12 to Day 21 of her menstrual cycle. Fertilization can occur only if intercourse occurs on the day of ovulation. The window of opportunity for conception is from 3 days before to 2 days following ovulation. Since a sperm can only live 12 to 24 hours after ejaculation, fertility is limited to 1 day before to 1 day after ovulation.
The window of opportunity for conception is from 3 days before to 2 days following ovulation.
A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information?
The window of opportunity for conception is from 3 days before to 2 days following ovulation. Since sperm are viable for 24 to 72 hours after ejaculation and the ovum remains fertile for a maximum of 48 hours after ovulation, the window is from 3 days before to 2 days after ovulation.
Assessment for surfactant level is a primary estimation of fetal maturity. The purpose of surfactant is to:
prevent alveoli from collapsing on expiration. Surfactant is a phospholipid that reduces surface tension; it prevents alveoli from collapsing on expiration.
Many couples attempt to influence the gender of the child they are trying to conceive by using special sexual positions, eating special food, or having intercourse at specific times. None of these are factors in the determination of the gender of the conceptus. What has research shown about gender determination? Female determines the sex of the conceptus. There is a 50-50 chance of having a male or a female. Male gametes carry only Y chromosomes. Female gametes can have either X or Y chromosomes.
There is a 50-50 chance of having a male or a female.
What should the nurse explain to the pregnant client about the importance of the fetal stage of development? The fetus is ready to be born. There can be no damage to the fetus if the mother drinks alcohol at this stage. Cellular division and implantation occur during this stage of development. There is additional growth and development of the organs and body systems.
There is additional growth and development of the organs and body systems.
What should the nurse explain to the pregnant client about the importance of the fetal stage of development?
There is additional growth and development of the organs and body systems. The fetal stage is from the beginning of the ninth week after fertilization and continues until birth. At this time, the developing human is called a fetus. During the fetal stage, there is additional growth and maturation of the organs and body systems.
A nursing student studying reproduction identifies which of the following statements to be correct?
Twenty-two of the 23 pairs of chromosomes are autosomes and the remaining pair is the sex chromosomes. The nucleus of each soma cell contains 46 chromosomes, arranged in 23 pairs. Each parent donates one chromosome of every pair. Each chromosome is composed of genes, which are segments of DNA that control hereditary traits. Twenty-two of the 23 pairs of chromosomes are autosomes, and the remaining pair, the sex chromosomes, determines an individual gender.
A nursing instructor is discussing the various events that occur during a pregnancy. The instructor determines the session is successful after the students put the following events in the correct chronological order. Use all the options. Formation of the placenta Union of an ovum and sperm Implantation of the zygote Heart begins beating Fetus kicks actively Fetus ready to be born
Union of an ovum and sperm Implantation of the zygote Formation of the placenta Heart begins beating Fetus kicks actively Fetus ready to be born
A nursing instructor is discussing the various events that occur during a pregnancy. The instructor determines the session is successful after the students put the following events in the correct chronological order. Use all the options.
Union of an ovum and sperm Implantation of the zygote Formation of the placenta Heart begins beating Fetus kicks actively Fetus ready to be born The correct order is as follows: 1) union of an ovum and sperm (fertilization); 2) implantation of the zygote; 3) formation of the placenta; 4) heart begins beating; 5) fetus kicks actively; 6) fetus ready for birth.
During a clinical rotation at a prenatal clinic, a client asks a nurse what causes certain birth defects. The nurse replies that they can be caused by teratogens. What does the severity of the defects depend on? Select all that apply.
When during development the conceptus is exposed to the teratogen The particular teratogen to which the fetus is exposed A teratogen is a substance that causes birth defects. The severity of the defect depends on when during development the conceptus is exposed to the teratogen and the particular teratogenic agent to which the fetus is exposed.
A patient is to have an amniocentesis with ultrasound. What does the nurse explain to the patient that amniocentesis can determine? Select all that apply.
Whether the fetal lungs are mature enough to support respiration outside of the womb. For genetic testing. Amniotic fluid provides a great deal of information. During pregnancy, a procedure called an amniocentesis can obtain a sample of amniotic fluid. The practitioner can analyze the fluid to determine whether the fetal lungs are mature enough to support respiration outside of the womb. The fluid can also be used for genetic testing because the fluid contains fetal cells with fetal DNA.
The fluid-filled, inner membrane sac surrounding the fetus is which structure?
amnion The fluid-filled, inner membrane sac surrounding the fetus is the amnion. The chorion is the outer membrane surrounding the fetus. The endometrium is the inner lining of the uterus. The decidua is the name used for the endometrium during pregnancy.
Amniotic fluid does not grow stagnant because:
amniotic fluid is constantly formed by the amnion. Amniotic fluid is formed by the amnion; a main portion of it is swallowed by the fetus.
What medication can the nurse tell the client that, when taken as directed, is nonteratogenic and safe during pregnancy? acetaminophen warfarin phenytoin tetracycline
acetaminophen
The nurse is conducting a presentation for a young adult community group about fetal development and pregnancy. The nurse determines that the teaching was successful when the group identifies that the sex of offspring is determined at which time?
at fertilization Sex determination occurs at the time of fertilization. Meiosis refers to cell division resulting in the formation of an ovum or sperm with half the number of chromosomes. The morula develops after a series of four cleavages following the formation of the zygote. Oogenesis refers to the development of a mature ovum, which has half the number of chromosomes.
The nursing instructor is presenting a class on the various classifications of twins. The instructor determines the session is successful after the students correctly choose which classification that indicates twins have separate amniotic sacs and placentas? diamniotic-dichorionic biplacental monoamniotic-monochorionic monozygotic
diamniotic-dichorionic
After teaching a class on the various structures formed by the embryonic membranes, the nurse determines that the teaching was successful when the class identifies which structure as being formed by the ectoderm?
ears The ectoderm forms the structures of the special senses. The endoderm forms the structures of the respiratory and digestive systems. The mesoderm forms the structures of the skeletal system.
The nurse explains to a pregnant woman that the germ layers that develop in the embryo and become different organs and tissues consist of which layers? Select all that apply. ectoderm epithelium mesoderm endoderm subcutaneous
ectoderm mesoderm endoderm
The nurse explains to a pregnant woman that the germ layers that develop in the embryo and become different organs and tissues consist of which layers? Select all that apply.
ectoderm mesoderm endoderm The three germ layers in the embryo are the ectoderm, mesoderm, and endoderm. The others are layers of the skin.
The nursing student is preparing a presentation that will illustrate the various stages of fetal development. The student will label which stage as the time when the various tissues of the growing embryo begin to assume specific functions? pre-embryonic embryonic fetal post-embryonic
embryonic
The nursing student is preparing a presentation that will illustrate the various stages of fetal development. The student will label which stage as the time when the various tissues of the growing embryo begin to assume specific functions?
embryonic During the embryonic period, the cells multiply and tissues begin to assume specific functions, a process known as differentiation. This stage lasts from the end of the second week after fertilization until the end of the eighth week. The pre-embryonic stage begins with fertilization and lasts for 2 weeks. Cellular division and implantation occur during this stage of development. The fetal stage is from the beginning of the ninth week after fertilization and continues until birth. There is additional growth and maturation of the organs and body systems during this time. There is no post-embryonic stage.
A nursing student is explaining to a newly pregnant woman what happens during each stage of fetal development. At which stage does the nurse inform the woman that the lungs are fully shaped? end of 4 weeks end of 8 weeks end of 12 weeks end of 16 weeks
end of 16 weeks
A nursing student is explaining to a newly pregnant woman what happens during each stage of fetal development. At which stage does the nurse inform the woman that the lungs are fully shaped?
end of 16 weeks At the end of 16 weeks, the lungs are fully shaped, fetus swallows amniotic fluid, skeletal structure is identifiable, downy lanugo hair is present on the body, and sex can be determined using ultrasound.
A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age? an error in math when calculating mistaking implantation bleeding for last menstrual period (LMP) amount of weight gain of mother in early weeks of pregnancy not seeking prenatal care in the beginning
mistaking implantation bleeding for last menstrual period (LMP)
A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age?
mistaking implantation bleeding for last menstrual period (LMP) The most common cause is implantation bleeding, which can occur as the blastocyst implants itself into the endometrium. This bleeding can be mistaken for a scanty menstrual period and can lead to miscalculation of fetal age by 2 weeks. The other choices might also contribute, especially the math miscalculation, but are not the primary reason.
A woman has just given birth to a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify what findings as normal? Select all that apply.
one vein two arteries The normal umbilical cord contains one large vein and two small arteries.
The purpose of a circulatory shunt, such as the ductus arteriosus, is to:
permit oxygenated blood to supply the most important fetal organs. The ductus arteriosus helps propel oxygenated blood quickly to the coronary arteries, brain, and kidneys.
After teaching a class on the stages of fetal development, the nurse determines that the teaching was successful when the group identifies which stages? Select all that apply.
pre-embryonic embryonic fetal The three stages of fetal development are the pre-embryonic, embryonic, and fetal stage. Placental and umbilical are not stages of fetal development.
The placenta is the site where antibodies in the mother's blood pass into the fetal circulation. These antibodies give passive immunity to the fetus for several common childhood diseases. There are some infections for which the mother does not provide antibodies to the fetus. What infection is the fetus not protected from?
rubella The fetus does not receive immunity to rubella, cytomegalovirus (CMV), varicella, or measles. If the woman encounters these pathogens during her pregnancy, fetal infection may ensue.
What medication should the nurse advise a woman to discontinue prior to becoming pregnant because it will damage the developing dental and osseous tissue in the fetus? chemotherapy agents tetracycline acetaminophen ibuprofen
tetracycline
What medication should the nurse advise a woman to discontinue prior to becoming pregnant because it will damage the developing dental and osseous tissue in the fetus?
tetracycline Tetracycline may damage the developing dental and osseous tissue in the fetus.
A pregnant client asks the nurse how the fetus breathes if it is floating in the amniotic fluid. The best explanation by the nurse is:
the fetus receives oxygen through the umbilical vein. The fetal lungs are non-functional and are an organ of oxygenation during intrauterine life. There is no gas exchange occurring in the lungs. The fetus receives oxygenated blood through the umbilical vein. The umbilical artery removes carbon dioxide from the fetus. Oxygen from the maternal system diffuses across the placenta, but the maternal circulation is not responsible for fetal breathing.
The nurse is providing prenatal care to a young couple who is pregnant with their first child. In what period of development would the nurse explain to the couple that most congenital defects would occur? the period of the zygote the period of the embryo the period of the fetus all periods are equally vulnerable
the period of the embryo
The nurse is providing prenatal care to a young couple who is pregnant with their first child. In what period of development would the nurse explain to the couple that most congenital defects would occur?
the period of the embryo During the period of the embryo, which lasts until the eighth week after conception, the embryo is in what is called the critical phase of human development. During these weeks, all the organs and structures of the human are formed and are most susceptible to damage.
A client is to have an amniocentesis with ultrasound. What does the nurse explain to the client that amniocentesis can determine? Select all that apply. what type of facial features the fetus will have how much the fetus will weigh at birth whether the fetal lungs are mature enough to support respiration outside of the womb the amniotic fluid can be used for genetic testing what the eye color of the baby will be
whether the fetal lungs are mature enough to support respiration outside of the womb the amniotic fluid can be used for genetic testing
A fertilized ovum is known as which structure? fetus zygote embryo chorion
zygote
A fertilized ovum is known as which structure?
zygote A fertilized ovum is known as a zygote and is the beginning of potential individual human development. The developing human organism is known as an embryo from the time it implants on the uterine wall until the eighth week after inception and as a fetus from the beginning of the ninth week after fertilization through birth. The chorion is the outermost cell layer that surrounds the embryo and fluid cavity.