Passpoint #3: conception & fetal development

During routine preconception counseling, a client asks how early a pregnancy can be diagnosed. What is the nurse's best response? - "2 to 3 weeks after fertilization." - "When the woman misses a menstrual period." - "As soon as hormone levels decline." - "8 days after conception."

"8 days after conception."

A primigravid client attending parenthood classes tells the nurse that there is a history of twins in her family. What should the nurse tell the client? - Dizygotic twins occur more often in primigravid than in multigravid clients. - Dizygotic twins are usually of the same sex. - Monozygotic twins result from fertilization of one ova. - Monozygotic twins occur by chance regardless of race or heredity.

Monozygotic twins occur by chance regardless of race or heredity.

The nurse is assessing a 16-year-old nulligravida, who asks for information on natural family planning methods of contraception and reports that her menstrual cycle occurs every 28 days. Which information would be important to include in the teaching plan for this client? - Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. - The basal body temperature falls at least 0.2°F (0.1°C) after ovulation has occurred. - The ovum survives for 96 hours after ovulation, making conception possible during this time. - Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus.

Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.

Which instructions should the nurse include in the teaching plan for a 30-year-old multiparous client who will be using an intrauterine device (IUD) for family planning? - Amenorrhea is a common adverse effect of IUDs. - Severe cramping may occur when the IUD is inserted. - IUDs are more costly than other forms of contraception. - Additional conception protection will be needed.

Severe cramping may occur when the IUD is inserted.

When developing a series of parent classes on fetal development, the nurse should include which feature as being developed by the end of the third month (9 to 12 weeks)? - myelinization of nerves - external genitalia - air ducts and alveoli - brown fat stores

external genitalia

A nurse is providing care for a pregnant 16-year-old. The client says that she is concerned she may gain too much weight and wants to start dieting. The nurse should respond by saying: - "Now isn't a good time to begin dieting because you are eating for two." - "The prenatal vitamins should ensure the baby gets all the necessary nutrients." - "Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems." - "Let's explore your feelings further."

"Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems."

A 20-year-old primigravid client tells the nurse that her mother had a friend who died from hemorrhage about 10 years ago during a vaginal birth. Which response would be most helpful? - "Do not concern yourself with things that happened in the past." - "Today's modern technology has resulted in a low maternal mortality rate." - "In North America, mothers seldom die in birth." - "What is it that concerns you about pregnancy, labor, or childbirth?"

"What is it that concerns you about pregnancy, labor, or childbirth?"

A primigravida at 8 weeks' gestation tells the nurse that she wants an amniocentesis because there is a history of hemophilia A in her family. The nurse informs the client that she will need to wait until she is at 15 weeks' gestation for the amniocentesis. Which is the most appropriate rationale for the nurse's statement regarding amniocentesis at 15 weeks' gestation? - Fetal development needs to be complete before testing. - The volume of amniotic fluid needed for testing will be available by 15 weeks. - Performing an amniocentesis prior to 15 weeks' gestation carries a greater infection rate. - Cells indicating hemophilia A are not produced until 15 weeks' gestation.

The volume of amniotic fluid needed for testing will be available by 15 weeks.

A nulliparous client says that she and her husband plan to use a diaphragm with spermicide to prevent conception. Which should the nurse include as the action of spermicides when teaching the client? - slowing of the movement of the migrating spermatozoa - destruction of spermatozoa before they enter the cervix - prevention of spermatozoa from entering the uterus - a change in vaginal pH from acidic to alkaline

destruction of spermatozoa before they enter the cervix

A client in the first trimester of pregnancy joins a childbirth education class. During this trimester, the class is most likely to cover which physiologic aspect of pregnancy? - false labor and true labor - signs and symptoms of labor - quickening and fetal movements - warning signs of complications

warning signs of complications

According to the antenatal record, a newborn is 12 days post-mature. A nurse completes the initial assessment of the newborn and notes increased amounts of vernix. The mother asks why the nurse seems concerned about the presence of the vernix. Which of the following statements by the nurse is most appropriate? - "The presence of vernix affects the newborn's immune system." - "The vernix should be a thicker coating for a newborn." - "The vernix indicates a different gestational age than expected." - "The vernix is difficult and painful to remove from a newborn."

"The vernix indicates a different gestational age than expected."

A dilatation and curettage (D&C) is scheduled for a primigravid client admitted to the hospital at 10 weeks' gestation with abdominal cramping, bright red vaginal spotting, and passage of some of the products of conception. The nurse should assess the client further for the expression of which feeling? - ambivalence - fear - guilt - anxiety

guilt

During an annual checkup, a client tells the nurse that she and her partner have decided to start a family. Ideally, when should the nurse plan for childbirth education to begin and end? - It should begin at about 5 months' gestation and end at facility discharge. - It should begin before conception and end 3 months after childbirth. - It should begin when the client learns she's pregnant and end after childbirth. - It should begin early in the third trimester and end 1 month after childbirth.

It should begin before conception and end 3 months after childbirth.

A client who's 12 weeks pregnant attends a class on fetal development as part of a childbirth education program. The nurse anticipates that at 16 weeks' gestation, the client's fetus will: - be able to suck and swallow. - have audible heart sounds. - have open nostrils. - open the eyes.

have audible heart sounds.

A nurse is teaching a female client, who is positive for human immunodeficiency virus, about pregnancy. The nurse should know more teaching is necessary when the client says: - "The baby can get the virus from my placenta." - "I'm planning on starting on birth control pills." - "I'll need to have a cesarean birth if I become pregnant and have a baby." - "Not everyone who has the virus gives birth to a baby who has the virus."

"I'll need to have a cesarean birth if I become pregnant and have a baby."

Which statements made by a pregnant woman in the first trimester are consistent with this stage of pregnancy? Select all that apply: - "Oh my, how did this happen? I don't need this now." - "We went to the mall yesterday to buy a crib and dressing table." - "My husband told his friends we'll have to give up the convertible for a minivan." - "I can't wait to see my baby. Do you think it will have my blond hair and blue eyes?" - "I used a princess theme for decorating the room." - "I wonder how it will feel to buy maternity clothes and be fat."

"Oh my, how did this happen? I don't need this now." "My husband told his friends we'll have to give up the convertible for a minivan." "I wonder how it will feel to buy maternity clothes and be fat."

After conducting a class for female adolescents about human reproduction, which student statement indicates that the school nurse's teaching has been effective? - "I won't become pregnant if I abstain from intercourse during the last 14 days of my menstrual cycle." - "Sperm from a healthy male usually remain viable in the female reproductive tract for 96 hours." - "After an ovum is fertilized by a sperm, the ovum then contains 21 pairs of chromosomes." - "Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in pregnancy."

"Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in pregnancy."

When teaching a group of pregnant adolescent clients about reproduction and conception, the nurse is correct when stating that fertilization occurs: - when the ovum is released. - near the fimbriated end. - in the uterus. - in the first third of the fallopian tube.

in the first third of the fallopian tube.

A nurse is doing an assessment of a pregnant client who states that she smokes one pack of cigarettes each day. The nurse should: - insist that the client stop smoking immediately for the health of her baby. - do nothing; smoking is a personal decision. - ask the client to cut down to half a pack a day. - inform the client of the risks to the fetus and ask if she'd like a referral to a smoking cessation support group.

inform the client of the risks to the fetus and ask if she'd like a referral to a smoking cessation support group.

A client has undergone a vasectomy. The nurse instructs the client that he can begin having unprotected intercourse at what time following the surgery? - when the sperm count reflects sterilization - after 6 to 10 ejaculations - when desired because sterilization is immediate - as soon as scrotal edema and tenderness resolve

when the sperm count reflects sterilization