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A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise.Which response by the nurse is most accurate?


A) "That must have been a coincidence; babies can't respond like that."
B) "The fetus is demonstrating the aural reflex."
C) "Babies respond to sound starting at approximately 24 weeks of gestation."
D) "Let me know if it happens again; we need to report that to your midwife."

E) A) and C)
F) All of the above

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C

A new mother asks the nurse about the "white substance" covering her infant.How should the nurse explain the purpose of vernix caseosa?


A) Vernix caseosa protects the fetal skin from the amniotic fluid.
B) Vernix caseosa promotes the normal development of the peripheral nervous system.
C) Vernix caseosa allows the transport of oxygen and nutrients across the amnion.
D) Vernix caseosa regulates fetal temperature.

E) B) and C)
F) B) and D)

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The maternity nurse is cognizant of what important structure and function of the placenta?


A) As the placenta widens, it gradually thins to allow easier passage of air and nutrients.
B) As one of its early functions, the placenta acts as an endocrine gland.
C) The placenta is able to keep out most potentially toxic substances, such as cigarette smoke, to which the mother is exposed.
D) Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.

E) A) and D)
F) All of the above

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What kind of fetal anomalies are most often associated with oligohydramnios?


A) Renal
B) Cardiac
C) Gastrointestinal
D) Neurologic

E) A) and B)
F) C) and D)

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A woman's cousin gave birth to an infant with a congenital heart anomaly.The woman asks the nurse when such anomalies occur during development.Which response by the nurse is most accurate?


A) "We don't really know when such defects occur."
B) "It depends on what caused the defect."
C) "Defects occur between the third and fifth weeks of development."
D) "They usually occur in the first 2 weeks of development."

E) C) and D)
F) None of the above

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A woman in labor passes some thick meconium as her amniotic fluid ruptures.The client asks the nurse where the baby makes the meconium.What is the correct response by the nurse?


A) Fetal intestines
B) Fetal kidneys
C) Amniotic fluid
D) Placenta

E) All of the above
F) A) and B)

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A newly married couple plans to use the natural family planning method of contraception.Understanding how long an ovum can live after ovulation is important to them.The nurse knows that his or her teaching was effective when the couple responds that an ovum is considered fertile for which period of time?


A) 6 to 8 hours
B) 24 hours
C) 2 to 3 days
D) 1 week

E) A) and B)
F) A) and C)

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The nurse caring for a pregnant client is evaluating his or her health teaching regarding fetal circulation.Which statement from the client reassures the nurse that his or her teaching has been effective?


A) "Optimal fetal circulation is achieved when I am in the side-lying position."
B) "Optimal fetal circulation is achieved when I am on my back with a pillow under my knees."
C) "Optimal fetal circulation is achieved when the head of the bed is elevated."
D) "Optimal fetal circulation is achieved when I am on my abdomen."

E) A) and B)
F) None of the above

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A

The pancreas forms in the foregut during the 5th to 8th week of gestation.A client with poorly controlled gestational diabetes asks the nurse what the effects of her condition will be on the fetus.What is the best response by the nurse? Poorly controlled maternal gestational diabetes will:


A) produce fetal hypoglycemia.
B) result in a macrocosmic fetus.
C) result in a microcosmic fetus.
D) enhance lung maturation.

E) A) and B)
F) A) and D)

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Congenital disorders refer to those conditions that are present at birth.These disorders may be inherited and caused by environmental factors or maternal malnutrition.Toxic exposures have the greatest effect on development between 15 and 60 days of gestation.For the nurse to be able to conduct a complete assessment of the newly pregnant client,he or she should be knowledgeable regarding known human teratogens.Which substances might be considered a teratogen? (Select all that apply) .


A) Cytomegalovirus (CMV)
B) Ionizing radiation
C) Hypothermia
D) Carbamazepine
E) Lead

F) C) and E)
G) A) and E)

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A woman who is 8 months pregnant asks the nurse,"Does my baby have any antibodies to fight infection?" What is the most appropriate response by the nurse?


A) "Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG) , immunoglobulin M (IgM) , and immunoglobulin A (IgA) ."
B) "Your baby won't receive any antibodies until he is born and you breastfeed him."
C) "Your baby does not have any antibodies to fight infection."
D) "Your baby has IgG and IgM."

E) None of the above
F) A) and B)

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An expectant couple attending childbirth classes have questions regarding multiple births since twins "run in the family." What information regarding multiple births is important for the nurse to share?


A) Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing.
B) Dizygotic twins (two fertilized ova) have the potential to be conjoined twins.
C) Identical twins are more common in Caucasian families.
D) Fraternal twins are the same gender, usually male.

E) None of the above
F) A) and D)

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The various systems and organs of the fetus develop at different stages.Which statement is most accurate?


A) Cardiovascular system is the first organ system to function in the developing human.
B) Hematopoiesis originating in the yolk sac begins in the liver at 10 weeks of gestation.
C) Body changes from straight to C-shape occurs at 8 weeks of gestation.
D) Gastrointestinal system is mature at 32 weeks of gestation.

E) None of the above
F) B) and C)

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Some of the embryo's intestines remain within the umbilical cord during the embryonic period.What is the rationale for this development of the gastrointestinal system?


A) Umbilical cord is much larger at this time than it will be at the end of pregnancy.
B) Intestines begin their development within the umbilical cord.
C) Nutrient content of the blood is higher in this location.
D) Abdomen is too small to contain all the organs while they are developing.

E) B) and C)
F) C) and D)

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Which statement concerning neurologic and sensory development in the fetus is correct?


A) Brain waves have been recorded on an electroencephalogram as early as the end of the first trimester (12 weeks of gestation) .
B) Fetuses respond to sound by 24 weeks of gestation and can be soothed by the sound of the mother's voice.
C) Eyes are first receptive to light at 34 to 36 weeks of gestation.
D) At term, the fetal brain is at least one third the size of an adult brain.

E) A) and B)
F) All of the above

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B

The measurement of lecithin in relation to sphingomyelin (lecithin/sphingomyelin [L/S] ratio) is used to determine fetal lung maturity.Which ratio reflects fetal maturity of the lungs?


A) 1.4:1
B) 1.8:1
C) 2:1
D) 1:1

E) A) and C)
F) None of the above

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Which development related to the integumentary system is correct?


A) Very fine hairs called lanugo appear at 12 weeks of gestation.
B) Eyelashes, eyebrows, and scalp hair appear at 28 weeks of gestation.
C) Fingernails and toenails develop at 28 weeks of gestation.
D) By 32 weeks, scalp hair becomes apparent.

E) C) and D)
F) B) and C)

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At a routine prenatal visit,the nurse explains the development of the fetus to her client.At approximately ____ weeks of gestation,lecithin is forming on the alveolar surfaces,the eyelids open,and the fetus measures approximately 27 cm crown to rump and weighs approximately 1110g The client is how many weeks of gestation at today's visit?


A) 20
B) 24
C) 28
D) 30

E) B) and C)
F) B) and D)

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Which statement regarding the structure and function of the placenta is correct?


A) Produces nutrients for fetal nutrition
B) Secretes both estrogen and progesterone
C) Forms a protective, impenetrable barrier to microorganisms such as bacteria and viruses
D) Excretes prolactin and insulin

E) C) and D)
F) B) and D)

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Relating to the fetal circulatory system,which special characteristics allow the fetus to obtain sufficient oxygen from the maternal blood? (Select all that apply) .


A) Fetal hemoglobin (Hb) carries 20% to 30% more oxygen than maternal Hb.
B) Fetal Hb carries 40% to 50% more oxygen than maternal Hb.
C) Hb concentration is 50% higher than that of the mother.
D) Fetal heart rate is 110 to 160 beats per minute.
E) Fetal heart rate is 160 to 200 beats per minute.

F) All of the above
G) A) and D)

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