Deck 12: Conception and Fetal Development

Question 1

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

Answer 1

2:1

Question 2

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

Answer 2

28

Question 3

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.

Answer 3

Cardiovascular system is the first organ system to function in the developing human.

Question 4

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."

Question 5

Which statement regarding the development of the respiratory system is a high priority for the nurse to understand?

A) The respiratory system does not begin developing until after the embryonic stage.
B) The infant's lungs are considered mature when the L/S ratio is 1:1, at approximately 32 weeks of gestation.
C) Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity.
D) Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks of gestation.

Question 6

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

Question 7

What is the most basic information that a nurse should be able to share with a client who asks about the process of conception?

A) Ova are considered fertile 48 to 72 hours after ovulation.
B) Sperm remain viable in the woman's reproductive system for an average of 12 to 24 hours.
C) Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum.
D) Implantation in the endometrium occurs 6 to 10 days after conception.

Question 8

Which information regarding amniotic fluid is important for the nurse to understand?

A) Amniotic fluid serves as a source of oral fluid and a repository for waste from the fetus.
B) Volume of the amniotic fluid remains approximately the same throughout the term of a healthy pregnancy.
C) The study of fetal cells in amniotic fluid yields little information.
D) A volume of more than 2 L of amniotic fluid is associated with fetal renal abnormalities.

Question 9

A client arrives for her initial prenatal examination.This is her first child.She asks the nurse,"How does my baby get air inside my uterus?" What is the correct response by the nurse?

A) "The baby's lungs work in utero to exchange oxygen and carbon dioxide."
B) "The baby absorbs oxygen from your blood system."
C) "The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream."
D) "The placenta delivers oxygen-rich blood through the umbilical artery to the baby's abdomen."

Question 10

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."

Question 11

Which structure is responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream?

A) Decidua basalis
B) Blastocyst
C) Germ layer
D) Chorionic villi

Question 12

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.

Question 13

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

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

Question 14

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

Question 15

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.

Question 16

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.

Question 17

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

Question 18

A woman asks the nurse,"What protects my baby's umbilical cord from being squashed while the baby's inside of me?" What is the nurse's best response?

A) "Your baby's umbilical cord is surrounded by connective tissue called Wharton's jelly, which prevents compression of the blood vessels."
B) "Your baby's umbilical cord floats around in blood and amniotic fluid."
C) "You don't need to be worrying about things like that."
D) "The umbilical cord is a group of blood vessels that are very well protected by the placenta."

Question 19

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."

Question 20

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."

Question 21

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.

Question 22

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.

Question 23

Relating to the fetal circulatory system,which special characteristics allow the fetus to obtain sufficient oxygen from the maternal blood?

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.

Question 24

A woman who is 16 weeks pregnant asks the nurse,"Is it possible to tell by ultrasound if the baby is a boy or girl yet?" What is the best answer?

A) "A baby's sex is determined as soon as conception occurs."
B) "The baby has developed enough to enable us to determine the sex by examining the genitals through an ultrasound scan."
C) "Boys and girls look alike until approximately 20 weeks after conception, and then they begin to look different."
D) "It might be possible to determine your baby's sex, but the external organs look very similar right now."

Question 25

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.

Question 26

A woman is 15 weeks pregnant with her first baby.She asks how long it will be before she feels the baby move.What is the nurse's best answer?

A) "You should have felt the baby move by now."
B) "Within the next month, you should start to feel fluttering sensations."
C) "The baby is moving; however, you can't feel it yet."
D) "Some babies are quiet, and you don't feel them move."

Question 27

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?

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

Question 28

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.