Question 1

A baby is born with several congenital anomalies.The parents are distraught and begin questioning each other about what they did wrong during the pregnancy.What response by the nurse is best?

Accepted Answer

Damage to a developing embryo/fetus can occur from genetic or environmental causes or a combination of both.However,in 50 to 60% of cases,the exact cause may never be known.The nurse should reassure the parents gently.It is incorrect to state that anomalies are usually caused by environmental factors.Telling the family they are lucky and they shouldn't worry is disrespectful and dismissive to the parents.

Question 2

A nurse is assessing a pregnant woman who says she drinks 5 to 7 alcoholic drinks per week.What action by the nurse is best?

Accepted Answer

Alcohol is one of the most potent teratogens known,and a safe level of alcohol during pregnancy has not been established.Therefore,the nurse should advise the woman to stop drinking alcohol altogether while she is pregnant.Caffeine is also considered a teratogen,so this is not a good substitute.

Question 3

A preterm infant is jittery and has an oxygen saturation of 88%.After stabilizing the newborn,what action by the nurse is most important?

Accepted Answer

Maternal opioid use can lead to neonatal withdrawal syndrome,characterized by hyperirritability,gastrointestinal dysfunction,respiratory distress,and autonomic disturbances.After stabilizing the baby,the nurse should first assess the mother for opioid abuse during pregnancy.Caffeine use would not cause these effects.Calling CPS is premature at this point.Questioning the father is not the best way to determine if the mother has abused drugs.

Question 4

A male baby is born with undescended testes.After caring for the newborn,what question by the nurse is most important?

Accepted Answer

One risk factor for undescended testes is intrauterine lead exposure.In this country,the most common source of lead is from lead-based paint in older homes (built prior to 1978),lead-contaminated house dust and soil,and vinyl products.The nurse should assess for sources of lead exposure.The other questions are not relevant.

Question 5

A clinic nurse explains to a pregnant woman that the amount of amniotic fluid present at 7 or 8 months' gestation is approximately what volume?

Accepted Answer

Amniotic fluid first appears at about 3 weeks.There is approximately 30 mL of amniotic fluid present at 10 weeks of gestation,and this amount increases to approximately 800 mL at 24 weeks of gestation.After that time,the total fluid volume remains fairly stable until it begins to decrease slightly as the pregnancy reaches term.

Question 6

A student asks the faculty member to explain why the fetus has such a low PO₂.What explanation by the faculty member is most accurate?

Accepted Answer

The low fetal PO₂ helps to maintain fetal (not maternal)circulation and keeps the ductus arteriosus open.It also helps keep the pulmonary vascular bed constricted.Blood from the mother is oxygenated.It does not support the foramen ovale.

Question 7

A pregnant woman tells the perinatal nurse that she stopped abusing other drugs when she learned that she was pregnant but kept using marijuana because "it is so harmless." What response by the nurse is best?

Accepted Answer

Marijuana use is associated with carbon monoxide levels five times higher than those produced with cigarettes and can lead to intrauterine growth restriction and abnormal neonatal neurobehavior (hyperirritability,tremors,photosensitivity).Marijuana can also lead to and language abnormalities up to 48 months of age.The nurse should not agree that it is less dangerous than other drugs,but should also not tell the mother the child may have withdrawal syndrome,as that information is incorrect.Assessing the mother for a complete history of drug use is important,but is not directly related to the effects of marijuana,and is less important.

Question 8

The prenatal clinic nurse is providing information to a pregnant woman who is at 15 weeks' gestation.The patient asks when she should expect to feel fetal movement.Which of the following is the most appropriate answer by the nurse?

Accepted Answer

In gestational weeks 17 to 20,fetal growth continues,and maternal awareness of fetal movements (termed "quickening")is often first noted.

Question 9

A woman in her 26th week of pregnancy is in preterm labor.What can the nurse conclude about this baby's ability to survive?

Accepted Answer

A baby born at this gestation can survive because the lungs are capable of breathing air,they produce surfactant,and the central nervous system can regulate body temperature and direct rhythmic breathing.Many obstacles remain for a baby born this early,and survival is not guaranteed.The other statements are inaccurate.

Question 10

During preconception counseling,the nurse explains that the fetus is most vulnerable to the effects of teratogens during which time period?

Accepted Answer

The period of organogenesis lasts from approximately the second until the eighth week of gestation,during which time the embryo undergoes rapid growth and differentiation.During organogenesis,the embryo is extremely vulnerable to teratogens,such as medications,alcohol,tobacco,caffeine,illegal drugs,radiation,heavy metals,and maternal (TORCH)infections.Structural fetal defects are most likely to occur during this period because exposure to teratogens,either before or during a critical period of development of an organ,can cause a malformation.

Question 11

A neonate whose mother is a drug addict is listless and sweating.What action by the nurse takes priority?

Accepted Answer

Babies born of mothers who have used amphetamines during pregnancy may exhibit hypoglycemia,sweating,poor visual tracking,lethargy,and difficulty feeding.The nurse would conclude that the baby may be at risk for hypoglycemia because he or she has other manifestations of this syndrome and should check the blood sugar.If low,the blood glucose can be treated quickly.The other options may be valuable,but do not take priority over this assessment.

Question 12

During prenatal classes for expectant parents,the perinatal nurse explains that fetal brain development is most critical during which gestational weeks?

Accepted Answer

The most critical time for brain development is between 3 and 16 weeks of gestation.However,the fetal brain continues to differentiate and grow rapidly until at least the first 2 years of life.

Question 13

A pregnant woman is confused about the terms "embryo" and "fetus." How does the nurse explain the difference?

Accepted Answer

During the first 8 weeks of gestation,the baby is called an embryo.By the end of the eighth week,the embryo has developed enough to be called a fetus.The other statements are inaccurate.

Question 14

A nurse teaching a prenatal class instructs the participants that early organ system development occurs during which period of time?

Accepted Answer

The early development of the nervous system,cardiovascular system,and all major internal and external structures occurs during the embryonic period,which is the first 2 weeks beginning at fertilization.

Question 15

The birthing center nurse is assisting with pain management for a laboring woman at 18 weeks' gestation.The fetus is born and the weight is 450 gm.The nurse would document this birth as which of the following?

Accepted Answer

The loss of a fetus before 20 to 22 weeks of gestation is referred to as an abortion because the fetus is considered too immature to survive outside the uterus.Fetal loss and neonatal death are not medical terms.Stillbirth is the intrauterine death of a fetus old enough to survive outside the womb.

Question 16

The birthing center nurse caring for a 21-year-old laboring woman is given a report about the patient's cocaine use throughout pregnancy.This history prompts the labor nurse to assess for which condition?

Accepted Answer

Cocaine and crack use during pregnancy causes vasoconstriction of the uterine vessels and adversely affects blood flow to the fetus.Cocaine use in pregnancy is associated with spontaneous abortion,abruptio placentae,stillbirth,intrauterine growth restriction (IUGR),fetal distress,meconium staining,and preterm birth.

Question 17

The nurse discussing fetal development describes the hormone responsible for suppressing the maternal immunological response to the fetus,thereby facilitating physiological acceptance of the pregnancy.Which hormone is the nurse describing?

Accepted Answer

Progesterone helps to suppress maternal immunological responses to fetal antigens,thereby preventing maternal rejection of the fetus.Estrogen enhances myometrial activity,promotes myometrial vasodilation,increases maternal respiratory center sensitivity to carbon dioxide,softens fibers in the cervical collagen tissue,increases the pituitary secretion of prolactin,increases serum-binding proteins and fibrinogen,decreases plasma proteins,and increases sensitivity of the uterus to progesterone in late pregnancy.Human placental lactogen regulates glucose availability for the fetus and promotes fetal growth by altering maternal protein,carbohydrate,and fat metabolism.Human chorionic gonadotropin maintains the corpus luteum during early pregnancy until the placenta has sufficiently developed to produce adequate amounts of progesterone.

Question 18

A woman is starting on birth control,but tells the nurse she wants to become pregnant next year.What action by the nurse is most important?

Accepted Answer

Neural tube defects occur during the fourth week of pregnancy,which is often before women know they are pregnant.Any woman considering pregnancy should take folic acid supplements well in advance of trying to conceive.The other options are not helpful interventions.

Question 19

A student reviewing the anatomy and physiology of the fetal circulatory system learns that the highest concentration of oxygen in fetal blood is measured at what level?

Accepted Answer

The highest concentration of oxygen (PO₂)in fetal circulation is found in the blood returning from the placenta via the umbilical vein and is measured at 30-35 mm Hg.

Question 20

A newborn has rachischisis.What action by the nurse takes priority?

Accepted Answer

Rachischisis is spina bifida,a type of neural tube defect that often requires immediate surgery.The priority of the nurse is to obtain signatures on the informed consent form and place it on the chart.There is no need for palliative care or parenteral nutrition.The nurse would not discourage the family from seeing the baby.

Quiz 7: Conception and Development of the Embryo and Fetus