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."

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."

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."

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 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.

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 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

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

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.

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

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

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.

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 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 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

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.

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.

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.

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.

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

What medication can the nurse tell the client that, when taken as directed, is nonteratogenic and safe during pregnancy? acetaminophen warfarin phenytoin tetracycline

acetaminophen

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

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

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 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

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 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

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

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.

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

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.

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)

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

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

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

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