Chapter 5: Fetal Development - ML5 LPN

Prepare the client for an induction of labor. Placental insufficiency is a serious complication where the placenta no longer works properly to provide nutrition and oxygen to the fetus, nor remove waste products from the fetus. Because this client's fetus is at full term, the nurse would anticipate an induction of labor or a cesarean birth. The client is not stable enough to be sent home for monitoring. Hypertension can be a cause of placental insufficiency; however, at this point in the pregnancy, birth is the best option. Betamethasone is a steroid given to clients to hasten preterm fetal lung development. This client is at term and does not need betamethasone.

A client at 38 weeks' gestation is diagnosed with placental insufficiency. Which prescription from the health care provider will the nurse anticipate?

D. 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 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? A. Obtain a detailed 24-hour intake to determine if the pain is related to what she has eaten. B. Encourage her to ambulate since gas pains are common in early pregnancy. C. Reassure the mother that this is normal as the baby is implanting into the uterus. D. Recommend an abdominal ultrasound to the doctor since this may be ectopic pregnancy.

C. The window of opportunity for conception is from 3 days before to 2 days following ovulation. Explanation: 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.

A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information? A. Fertilization can occur only if intercourse occurs on the day of ovulation. B. Since a sperm can only live 12 to 24 hours after ejaculation, fertility is limited to 1 day before to 1 day after ovulation. C. The window of opportunity for conception is from 3 days before to 2 days following ovulation. D. The female fertility period is from Day 12 to Day 21 of her menstrual cycle.

B. 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 tocodynamometer 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.

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? A. stethoscope B. Doppler C. fetoscope D. tocodynometer

C. "The pre-embryonic stage begins approximately 2 weeks after fertilization." Explanation: 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.

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? A. "The fetal stage begins at 9 weeks after fertilization." B. "The fetal stage ends at birth." C. "The pre-embryonic stage begins approximately 2 weeks after fertilization." D. "The embryonic stage begins approximately 2 weeks after fertilization."

D. 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.

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? A. Approximately 6 weeks after fertilization to the end of 8 weeks B. Approximately 9 weeks after fertilization to birth C. Approximately 2 weeks after fertilization to the end of the eighth week D. From fertilization to the end of the second week after fertilization

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 are not based on scientific principles.

A nursing instructor teaching a maternity course realizes a student needs more instruction upon overhearing the student make which of the following statements?

D. 46 With fertilization, the ovum, containing 23 chromosomes, and the sperm, containing 23 chromosomes, join, forming a zygote with a diploid number or 46 chromosomes.

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? A. 22 B. 44 C. 23 D. 46

C. 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.

A fertilized ovum is known as which structure? A. embryo B. fetus C. zygote D. chorion

C. 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.

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? A. The end of the third trimester B. The end of the fourth trimester C. The end of the second trimester D. The end of the first trimester

C. 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 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? A. end of 8 weeks B. end of 4 weeks C. end of 16 weeks D. end of 12 weeks

B. 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 student studying reproduction identifies which of the following statements to be correct? A. The nucleus of each soma cell contains 23 chromosomes. B. Twenty-two of the 23 pairs of chromosomes are autosomes and the remaining pair is the sex chromosomes. C. All 23 pairs of chromosomes are autosomes. D. Not all chromosomes are composed of genes.

D. "Exposure to certain substances during the embryonic phase may be harmful to the developing fetus." Exposure to a teratogen during the embryonic stage produces the greatest damaging effects because cells are rapidly dividing and differentiating into specific body structures.

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? A. "You cannot drink alcohol, but you can take some medications, such as cold preparations and over-the-counter medications." B. "There is no need for you to worry; you are not far enough along in your pregnancy for this to be a problem." C. "As long as you are past 4 weeks of pregnancy, you should be able to take most medications." D. "Exposure to certain substances during the embryonic phase may be harmful to the developing fetus."

C. Oxygen is provided to the baby through the placenta ."Explanation: 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 pregnant client is concerned that the baby is going to drown in the uterus because of the fluid. What should the nurse teach the client about fetal respiration? A. "The baby's lungs can accommodate all of the fluid." B. "You are breathing for the baby." C. "Oxygen is provided to the baby through the placenta." D. "The baby's breathing is very minor until delivery."

B) "A sonogram to locate it will be done first." After the patient is placed in the supine position, a sonogram is done to determine the position of the fetus, the location of a pocket of amniotic fluid, and the placenta. The uterus does not feel soft over the placenta site. It would be harmful if the placenta were punctured during the procedure. Placentas do not always form on the posterior uterine wall.

A pregnant client scheduled for an amniocentesis asks the nurse how the placenta is not punctured during the procedure. How should the nurse respond to the client? A. "A sonogram to locate it will be done first." B. "It would not be harmful even if it were punctured." C. "Placentas always form on the posterior uterine wall." D. "A uterus feels soft over the placenta site."

Some medications cross the placental barrier, so be sure to discuss medications with your Some medications cross the placental barrier, so the nurse will encourage the woman to talk more specifically with her provider. The nurse would be in error to state that all or none cross the placental barrier. Regardless of the route, some medications cross the barrier and are unsafe during pregnancy. The first trimester is the most dangerous time to take a medication that crosses the placental barrier.

A pregnant woman asks the nurse about medications taken during pregnancy and if they cross the placental barrier. What response by the nurse is appropriate?

D. bone development Tetracycline is an antibiotic that may cause dental and osseous concerns for the fetus/infant when taken during pregnancy. Nervous system deficits may be experienced when the fetus is exposed to mercury. When exposed to rubella, deafness and cardiac abnormalities may occur.

A pregnant woman indicates taking prescribed tetracycline during pregnancy, without realizing it was a concern. What infant assessments will the nurse recommend be checked on an ongoing basis? A. hearing acuity B. cardiac function C. nerve conduction D. bone development

C. "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.

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? A. ."We will have to see what gestational age your baby was at exposure." B. "We will need to perform some additional tests." C. "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." D. "Your health care provider will let you know if there are any problems with your baby."

A. 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.

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? A. Recommend that the woman come into the office for a pregnancy test or do a home pregnancy test. B. Explain that irregular cycles and fatigue sometimes occur in women if they are anemic. C. Tell the woman she cannot be pregnant since she had a menstrual cycle three weeks ago. D. Tell the client that she is probably coming down with a virus, making her tired and nauseous.

A. at about 4 months Explanation: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.

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? A. at about 4 months B. at about 6 months C. at about 2 months D. Fetal gender can only be determined by analysis of maternal serum.

D. 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 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? A. not seeking prenatal care in the beginning B. an error in math when calculating C. amount of weight gain of mother in early weeks of pregnancy D. mistaking implantation bleeding for last menstrual period (LMP)

A. "Yes, phenytoin 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." Phenytoin is therapeutic for preventing seizures in the mother but can cause cleft palate and other abnormalities in the fetus. In such a circumstance, the practitioner weighs the risk to the mother against the risk to the developing fetus before prescribing a potential teratogen.

A woman with epilepsy was on phenytoin when she became pregnant. She is very worried that her baby will have a birth defect. Which reply by the nurse is most therapeutic? A. "Yes, phenytoin 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." B. "Yes, there is a very high risk that your fetus will have major birth defects. Your doctor will most likely switch you to a safer medication. Are you on any other medications?" C. "Please don't worry. Phenytoin is a very safe medication and unlikely to cause a birth defect." D. "All substances and medications increase the risk of birth defects when you are pregnant. It is very important for you to discontinue any medications or over-the-counter medications immediately. This is the best way you can protect your baby."

B. fetal C. pre-embryonic D. embryonic The three stages of fetal development are the pre-embryonic, embryonic, and fetal stage. Placental and umbilical are not stages of fetal development.

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. A. placental B. fetal C. pre-embryonic D. embryonic E. umbilical

B. 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.

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? A. Fetal heart rates are rapid and circulation time is double that of adults. B. Fetal circulation carries highly oxygenated blood to vital areas first. C.Fetal blood is thicker than that of adults and needs different pathways. D. Fetal blood has a higher oxygen saturation and circulates more slowly.

D. it is recommended to stop taking the heparin while she is pregnant. Explanation: 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.

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: A. she should discontinue the heparin and change to another anticoagulant. B. heparin does not cross the placenta and is safe for her to take. C. any medication that an expectant mother takes can cause sequelae for the infant. D. it is recommended to stop taking the heparin while she is pregnant.

B. prevent alveoli from collapsing on expiration. Surfactant is a phospholipid that reduces surface tension; it prevents alveoli from collapsing on expiration.

Assessment for surfactant level is a primary estimation of fetal maturity. The purpose of surfactant is to: A. increase lung resistance on inspiration. B. prevent alveoli from collapsing on expiration. C. encourage immunologic competence of lung tissue. D. promote maturation of lung alveoli.

B. when during development the conceptus is exposed to the teratogen E. 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.

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. A. the age of any siblings B. when during development the conceptus is exposed to the teratogen C. the age of the father D. the food preferences of the father E. the particular teratogen to which the fetus is exposed

B. "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.

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? A. "The amount of fluid remains fairly constant throughout the pregnancy." B. "This fluid acts as a cushion to help to protect your baby from injury." C. "The fluid is mostly protein to provide nourishment to your baby." D. "This fluid acts as transport mechanism for oxygen and nutrients."

B. She will miss her menstrual cycle. During the embryonic stage of pregnancy, the mother will miss her menstrual period, which is the first indicator of pregnancy. She will see no increase in her weight this early in the pregnancy. She will have urinary frequency (not constipation) and her heart rate will increase due to the increase in blood volume associated with pregnancy.

During the embryonic stage of pregnancy, what changes would the mother note in her body to signal that she is pregnant? A. She will have a slower heartbeat. B. She will miss her menstrual cycle. C. She will begin to gain weight. D. Constipation often occurs during this time.

A. Foramen ovale The foramen ovale is a hole that connects the right and left atria so the majority of oxygenated blood can quickly pass into the left side of the fetal heart, go to the brain, and move to the rest of the fetal body.

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? A. Foramen ovale B. Foramen magnum C. Foramen arteriosus D. Foramen venosus

A. The umbilical vein carries oxygenated blood, while deoxygenated blood is carried by the umbilical arteries. Explanation: 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.

How does fetal circulation differ from circulation after birth? A. The umbilical vein carries oxygenated blood, while deoxygenated blood is carried by the umbilical arteries. B. Fetal blood flow bypasses the right atrium and goes directly to the right ventricle. C. The ductus arteriosus carries the majority of the blood circulating from the left atrium to the left ventricle directly to the aorta. D. In utero, blood through the pulmonary artery is only 50% of the post-delivery blood flow.

D. There is a 50-50 chance of having a male or a female. Sex determination occurs at the time of fertilization based on the inheritance of X or Y chromosomes. Because the spermatozoon can have either an X or a Y chromosome, the male gamete is responsible for fetal sex determination. Research indicates that there is an approximately 50-50 chance of either occurrence.

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? A. Male gametes carry only Y chromosomes. B. Female gametes can have either X or Y chromosomes. C. The female determines the sex of the conceptus. D. There is a 50-50 chance of having a male or a female.

C. Peritoneal cavity As the embryo grows in the confined space of the fallopian tube, it causes the tube to dilate. The tube will eventually rupture if the condition remains undetected. If the tube ruptures, hemorrhage into the peritoneal cavity can lead to maternal death.

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? A. rectum B. uterus C. peritoneal cavity D. plural cavity

B. during puberty Spermatogenesis begins at puberty in the male.

Spermatogenesis is the process by which primary spermatocytes become mature sperm. When does spermatogenesis begin? A. before birth B. during puberty C. late school age D. when secondary sex characteristics begin to develop

A. 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.

Spermatozoa begin their cellular division in what part of the male reproductive system? A. seminiferous tubules B. vas deferens C. epididymis D. prostate gland

A. 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.

The fluid-filled, inner membrane sac surrounding the fetus is which structure? A. amnion B. chorion C. decidua D. endometrium

1.25 The order is for 50 mg. There are 200 mg in 5 mL. Thus, there are 40 mg per mL. The problem is solved by: 50 mg/X ml = 40 mg/1mL X= 1.25 mL

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.

ectoderm mesoderm endoderm The three germ layers in the embryo are the ectoderm, mesoderm, and endoderm. The others are layers of the skin.

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.

D. "I hear you saying this is a difficult situation. Tell me more about how you are feeling" The nurse will offer emotional support without judgment or blame and will encourage the continued expression of the client's feelings. Acknowledging the situation is difficult for the client and asking the client to tell more will open up communication lines and assist in developing a trusting relationship between the client and nurse. These actions also will help the client sort through her feelings. The nurse would not blame the client by indicating what the client should have done or should not have done. The nurse would not blame the client by implying the client did not tell the health care provider about all of her medications. The nurse would not use a cliche such as "these things happen for a reason and at least you have other children." These statements do not help the client process through her grief and fear of causing the birth defects. The nurse would be hesitant to share her own personal situation during this conversation, because it does not open up the communication for the client and implies that the nurse, like the client, caused her newborn's medical concerns.

The nurse is caring for a client following the birth of the newborn with several birth defects. The client states, "I know the baby has defects because of something I did wrong during my pregnancy. I feel like a horrible mom." How will the nurse respond? A. "That is one reason we always ask pregnant women to tell us all the medication they take." B. "I understand...I have a daughter with medical defects due to the medication I took while pregnant." C. "You should not blame yourself...these things happen for a reason and at least you have other children." D. "I hear you saying this is a difficult situation. Tell me more about how you are feeling"

B. at fertilization Explanation: 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 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? A. when the morula forms B. at fertilization C. during meiosis cell division D. during oogenesis

D. by the tenth day after fertilization Implantation, or contact between the growing structure and the uterine endometrium, occurs between8 and 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 nurse is explaining the process of fertilization to a client who has just learned of being pregnant. On which day during pregnancy should the nurse explain that the embryo implants on the uterine surface? A. on the tenth day after the start of the menstrual flow B. by the fourth day after fertilization C. on the fourteenth day of a "typical" menstrual cycle D. by the tenth day after fertilization

taking "natural" medications receiving immunizations taking over-the-counter herbs The pregnant woman is taught to consider that substances she takes into her body may pass to the fetus. These include immunizations, over-the-counter herbs, and all medications, even the ones labeled as "natural." The woman should verify with her health care provider before any of those things are taken. Eating spicy food and drinking specific brands of bottled water would not need to be cleared with the provider unless the woman experienced gastrointestinal symptoms following ingestion.

The nurse is providing prenatal education in the community. The nurse advises the pregnant women to check with their health care provider before what activity(ies)? Select all that apply.

B. receiving immunizations D. taking "natural" medications E. taking over-the-counter herbs The pregnant woman is taught to consider that substances she takes into her body may pass to the fetus. These include immunizations, over-the-counter herbs, and all medications, even the ones labeled as "natural." The woman should verify with her health care provider before any of those things are taken. Eating spicy food and drinking specific brands of bottled water would not need to be cleared with the provider unless the woman experienced gastrointestinal symptoms following ingestion.

The nurse is providing prenatal education in the community. The nurse advises the pregnant women to check with their health care provider before what activity(ies)? Select all that apply. A. drinking bottled water B. receiving immunizations C. eating spicy foods D. taking "natural" medications E. taking over-the-counter herbs

B. past medical history All of the data obtained in the note is important. The nurse would recognize the client's history of abdominal surgery and tubal ligation reversal as concerning due to the risk of an ectopic pregnancy. The nurse would be aware of the allergies to aspirin and sunscreens would to be need noted but would not be most concerning. Maternal age is not a concern. The family dynamics do not appear to be at risk for violence or increased stress.

The nurse is reviewing the note (above) for a woman hoping to become pregnant in the near future. What concerns the nurse most when reviewing the note? A. allergies B. past medical history C. maternal age D. family dynamics

A. caring for indoor cats The nurse will be most concerned that the mother is caring for indoor cats. The nurse will advise her to avoid caring for the cats' litter boxes to avoid contracting the parasite known to cause toxoplasmosis. The nurse understands that parents may implement folklore techniques to try to influence the sex of the child, but this is not a medical concern. The client indicates that despite being home without her partner, the partner is supportive and she has the help of family members so her emotional health is not at risk. Taking acetaminophen once every 3 to 4 weeks and as directed is not cause for concern.

The nurse reviews the notes (above) of a pregnant client. What would concern the nurse the most? A. caring for indoor cats B. medications taken during pregnancy C. client's emotional health D. client's belief in determining the sex of the child

D. 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.

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? A. smallpox B. diphtheria C. rubeola D. rubella

D. "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.

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? A. "We will be able to determine the sex of the baby today with transvaginal ultrasound." B. "We will have to wait until the baby is 20 weeks' gestation to determine the sex of the baby." C. "We will have to wait until the baby is 8 weeks' gestation to be able to determine what the sex is." D. "We will have to wait until the baby is 16 weeks' gestation to determine what the sex is."

A. "Conception usually occurs when the ovum is in the outer third of the fallopian tube." Explanation: 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).

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? A. "Conception usually occurs when the ovum is in the outer third of the fallopian tube." B. "At the time of conception, the ovum determines the sex of the baby." C "The ovum carries the Y chromosome, and the sperm carries an X or Y chromosome." D. "Human life begins with the union of two cells: the zygote and the sperm."

B. tetracycline Tetracycline may damage the developing dental and osseous tissue in the fetus.

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? A. ibuprofen B. tetracycline C. chemotherapy agents D. acetaminophen

B. 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? A. The infant takes its first breath and the lungs expand to increase blood oxygen levels. B. The placenta is immediately expelled. C. The oxygenated blood coming from the placenta is diverted around the liver through the ductus venosus. D. The ductus ovale closes over the next 2 to 3 days.

B. prostaglandins Prostaglandins in the semen increase smooth muscle contractions of the uterus that facilitate the transport of sperm.

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? A. hormones B. prostaglandins C. amino acids D. testosterone

B. Use gloves when handling any chemicals. Environmental teratogens include X-rays and exposure to chemicals, so wearing gloves when coming in contact with any chemicals is advised. Cleaning cat litter boxes causes exposure to infectious agents. Alcohol consumption is never advised and a pregnant woman needs to seek approval for any medication she takes, but these are ingested teratogens.

Which actions would protect a fetus from exposure to environmental teratogens? A. Ask the doctor before taking any medications. B. Use gloves when handling any chemicals. C. Avoid cleaning cat litter boxes while pregnant. D. Limit alcohol consumption to one glass of wine per day.

B. 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 most seriously affected during this period.

Which body system is most affected throughout the embryonic and fetal period by teratogens? A. genitourinary system B. central nervous system C. musculoskeletal system D. gastrointestinal system

B. The male gamete is responsible for sex determination. C. The Y chromosome contains the genes for maleness. The female gamete has two X chromosomes. Because the sperm can have either an X or a Y chromosome, the male gamete is responsible for fetal sex determination. If the sperm Y chromosome combines with the female X chromosome, then the fetus will be a male. If both X chromosomes combined, then the fetus will be a female. Sex determination occurs at the time of fertilization not ovulation. The use of certain sexual positions and foods are old myths which are not true and do not effect the outcome. There are actually 23 total autosomes from the ovum and sperm which combine but only one from each which will determine the sex; the remaining chromosomes combine to determine other genetic qualities of the fetus.

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. A. Certain sexual positions and foods influence sex determination. B. The male gamete is responsible for sex determination. C. The Y chromosome contains the genes for maleness. D. Sex determination occurs at the time of ovulation by the combination of the sex chromosomes of the sperm and ovum. E. The 22 autosomes from the ovum and sperm combine to determine the sex of the fetus.

A. If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia. Infants develop meconium in their intestines; if they are stressed or hypoxic, the anal sphincter relaxes and meconium is passed into the amniotic fluid. This poses a danger to the fetus since they breathe in this fluid and swallow it. The meconium lines the lungs and respiratory passages, making it difficult for the infant to breathe once it is born.

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? A. Abdominal distension occurs and infection can set in. B. If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia. C. The fetus can become constipated following birth. D. Meconium-stained fluids cause an increased risk of jaundice.