PN108 PrepU Chapter 5

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 nursing student doing a rotation in obstetrics correctly identifies which of the following structures as the one from which the fetus receives its nutrition and that removes metabolic wastes created by the fetus?

woman's blood

A fertilized ovum is known as which structure?

zygote

Which fetal structure has the highest oxygen concentration?

umbilical vein

The nurse is explaining how fetal sex is determined. Which statements will the nurse include? Select all that apply.

The male gamete is responsible for sex determination. The Y chromosome is smaller and contains genes for maleness.

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?

"5 to 3 days before until 2 days after ovulation."

A woman is to undergo chorionic villus sampling as part of a risk assessment for genetic disorders. What statement would the nurse include when describing this test to the woman?

"A small piece of tissue from the fetal placenta will be removed and analyzed."

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."

A woman at 15 weeks' gestation 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."

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."

A pregnant client in the first trimester asks the nurse about taking medications while she is pregnant. She tells the nurse that she heard that it can be harmful to the fetus if medications are taken at certain times during pregnancy. What is the best response by the nurse?

"Exposure to certain substances during the embryonic phase may be harmful to the developing fetus."

The nurse is teaching a couple about X-linked disorders. They are concerned that they might pass on hemophilia to their children. What response by the couple indicates the need for further teaching?

"If the father doesn't have it, then his kids won't either."

The nurse is teaching a couple about the pros and cons of genetic testing. Which statement by the nurse best describes the limits of genetic testing?

"Some genetic tests can give a probability for developing a disorder."

The nurse is counseling a couple who are concerned that their children might inherit sickle cell disease. Which response from the couple indicates a need for further teaching?

"The father cannot pass the disorder onto his son or the mother to her daughter."

A nursing instructor identifies a further need for 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."

If a woman confuses implantation bleeding with her period, how much older is the pregnancy than she thinks?

1 month

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 ovale

A nursing instructor teaching students about causes of intrauterine growth restriction should include which of the following in the discussion? (Select all that apply.)

chromosomal abnormalities fetal infection pre-eclampsia maternal illegal drug use

A group of nursing students is reviewing information about chromosomal abnormalities. The students demonstrate understanding of this information when they identify what as a common mechanism leading to an abnormal chromosome number?

nondisjunction

A woman just gave birth to a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify which structures as normal? Select all that apply.

one vein two arteries

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

What is the organ with a rich blood supply that supplies the developing organism with food and oxygen and carries away waste for excretion by the mother?

placenta

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.

preembryonic embryonic fetal

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

The pregnant patient at 6 weeks' gestation asks the nurse if 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."

A woman with epilepsy was on phenytoin (Dilantin) when she became pregnant. She is very worried that her baby will have a birth defect. Which reply by the nurse is most therapeutic?

"Yes, Dilantin increases the risk of certain defects in the fetus; however, overall the risk is low that your baby will be affected. Your doctor weighs the risk of untreated epilepsy on the fetus with the risk of the medication when making decisions about your treatment plan."

The nurse is presenting a teaching session for nursing students on cellular division involved in the reproduction of human life. Which statement indicates the students' need for further education?

At ovulation, the gametes unite to form the cell that becomes the developing fetus.

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

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?

46

A nurse is reviewing an article on genotypes. The nurse demonstrates understanding of the information by identifying which designation as homozygous dominant?

BB

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

A young mother delivers twin boys. Each baby had their own amniotic sac and their own placenta. What type of twins are these?

Diamniotic-dichorionic

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

A pregnant woman undergoes a triple/quadruple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's level is decreased?

Down syndrome

Spermatogenesis is the process by which primary spermatocytes become mature sperm. When does spermatogenesis begin?

During puberty

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.

The nurse is explaining fetal circulation to a pregnant woman during an early prenatal visit. The nurse emphasizes the difference in her baby's circulation from the woman's circulation. The nurse determines that the teaching was successful when the woman describes which reason for the difference?

Fetal circulation carries rich, oxygenated blood to vital areas first.

The nurse is explaining to a primigravida how the zygote becomes implanted into the uterus. How would the nurse describe the structure formed in this process known as the blastocyst?

First one, then two layers of cells surround a fluid-filled space.

When describing genetic disorders to a group of couples planning to have children, the nurse would identify which as an example of an autosomal dominant inheritance disorder?

Huntington disease

A pregnant woman has a ruptured tubal pregnancy. What does the nurse anticipate the treatment will be?

Immediate surgical removal of the pregnancy and affected tube.

A nurse is conducting prenatal classes and is reviewing the stages of fetal development. When discussing the preembryonic stage, the nurse informs the group that this stage begins and ends at which time?

It begins at fertilization and lasts through the end of the second week after fertilization.

The nurse is explaining the procedure for ultrasound to a pregnant client and is discussing the amniotic fluid and how they will determine if there is too much or too little fluid. The client asks about the purpose of the amniotic fluid. What should the nurse tell the client?

It is for the physical protection of the growing fetus. It regulates temperature. It provides unrestricted movement. It provides symmetrical growth.

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 mothers life at risk. Where does the blood hemorrhage into?

Peritoneal cavity

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

Mitosis is the process of cell division for which cells?

Somatic

A pregnant patient at 24 weeks' gestation is admitted to the hospital birthing center with premature labor. She is receiving medications to stop the labor process, which are proving successful. What does the nurse understand about the fetal lung development at this stage of the pregnancy?

Surfactant is not produced until the start of the 28th week .

A nurse is conducting an in-service program for a group of perinatal nurses. After teaching the group about autosomal dominant and recessive inheritance patterns, the nurse determines that the group needs additional teaching when they identify which condition as an example of an autosomal dominant disorder?

Tay-Sachs disease

At what point in the pregnancy is it possible for the fetus to survive outside the womb?

The end of the second trimester

When assisting with the determination of intrauterine growth restriction in a newborn infant, what should the nurse take into consideration?

The ethnicity and stature of both the mother and father.

After teaching a class about conception, the nurse asks the attendees to describe the process of fertilization. Which statements indicate the students' need for further education? Select all that apply.

The ovum is receptive to conception 12 to 23 hours after release. Sperm are viable for 12 to 24 hours after ejaculation. Sperm are able to fertilize the ovum up to 48 hours after ejaculation, and the ovum remains fertile for at least 72 hours after ovulation.

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?

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?

There is additional growth and development of the organs and body systems.

A patient comes to the clinic and tells the nurse that she and her husband are trying to conceive a boy. She says that her grandmother told her to eat a lot of cabbage so that the baby will be a boy. What can the nurse inform the patient about this information?

These beliefs are often rooted in folklore and not based on scientific principles.

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.

What medication can the nurse tell the patient that, when taken as directed, is non-teratogenic and safe during pregnancy?

Tylenol

Pregnancy involves a series of highly complex processes. A few of the key events are listed below. Put them in correct chronological order:

Union of an ovum and sperm Implantation of the zygote Formation of the placenta Heart begins beating Age of viability Fetus kicks actively

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.

The fluid-filled, inner membrane sac surrounding the fetus is which structure?

amnion

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

The nurse is providing prenatal care to a young couple that 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

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 mesoderm?

bones

While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a:

trisomy numeric abnormality.

The nurse explains to the pregnant client that the placenta is important for many reasons, but one function it has is to secrete hormones to sustain the pregnancy. Which hormones does the nurse inform the client that the placenta secretes? Select all that apply.

progesterone estrogen human chorionic gonadotropin human placental lactogen

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

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

The nurse is developing a presentation for a community group of young adults discussing fetal development and pregnancy. The nurse would identify that the sex of offspring is determined at the time of:

fertilization

The clinical nurse specialist is conducting a program for a group of nurses working at the prenatal clinic. When describing the preembryonic stage of fetal development, the nurse describes the events of this stage. Place the events in their proper sequence as the nurse would describe them. All options must be used.

formation of the zygote cleavage formation of the morula formation of blastocyst implantation

Prenatal testing is used to assess for genetic risks and to identify genetic disorders. In explaining to a couple about an elevated alpha-fetoprotein screening test result, the nurse would discuss the need for:

further, more definitive evaluations to conclude anything.

After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests?

human chorionic gonadotropin (hCG)

A nursing student is discussing with a pregnant woman a miscalculation of fetal age. This is mainly attributed to which of the following causes?

implantation bleeding

A woman is undergoing testing which provides a picture-like analysis of the number, form, and size of the woman's chromosomes. The nurse identifies this as:

karyotyping.