Question 1

Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy, including which of the following? (Select all that apply.)
A) Insulin
B) Estrogen
C) Progesterone
D) Testosterone
E) Human chorionic gonadotropin (hCG)

Accepted Answer

HCG causes the corpus luteum to persist and produce the necessary estrogens and progesterone for the first 6 to 8 weeks. Estrogens cause enlargement of the woman's uterus and breasts and growth of the ductal system in the breasts and, as term approaches, plays a role in the initiation of labor. Progesterone causes the endometrium to change, providing early nourishment. Progesterone also protects against spontaneous abortion by suppressing maternal reactions to fetal antigens and reduces unnecessary uterine contractions. Other hormones produced by the placenta include hCT, hCA, and a number of growth factors. Insulin and testosterone are not secreted by the placenta.

Question 2

An expectant mother, diagnosed with oligohydramnios, asks the nurse what this condition means for the baby. Which statement should the nurse provide for the patient?
A) Oligohydramnios can cause poor fetal lung development.
B) Oligohydramnios means that the fetus is excreting excessive urine.
C) Oligohydramnios could mean that the fetus has a gastrointestinal blockage.
D) Oligohydramnios is associated with fetal central nervous system abnormalities.

Accepted Answer

Because an abnormally small amount of amniotic fluid restricts normal lung development, the fetus may have poor fetal lung development. Oligohydramnios may be caused by a decrease in urine secretion. Excessive amniotic fluid production may occur when the gastrointestinal tract prevents normal ingestion of amniotic fluid. Excessive amniotic fluid production may occur when the fetus has a central nervous system abnormality.

Question 3

Some of the embryo's intestines remain within the umbilical cord during the embryonic period because the
A) intestines need this time to grow until week 15.
B) nutrient content of the blood is higher in this location.
C) abdomen is too small to contain all the organs while they are developing.
D) umbilical cord is much larger at this time than it will be at the end of pregnancy.

Accepted Answer

The abdominal contents grow more rapidly than the abdominal cavity, so part of their development takes place in the umbilical cord. By 10 weeks, the abdomen is large enough to contain them. The intestines remain within the umbilical cord only until about week 10. Blood supply is adequate in all areas; intestines stay in the umbilical cord for about 10 weeks because they are growing faster than the abdomen. Intestines begin their development within the umbilical cord, but only because the liver and kidneys occupy most of the abdominal cavity, not because of the size of the umbilical cord.

Question 4

The nurse is explaining fetal circulation to a group of nursing students. Which information should be included in the teaching session? (Select all that apply.)
A) After birth the ductus venosus remains open, but the other shunts close.
B) The foramen ovale shunts blood from the right atrium to the left atrium.
C) The ductus venosus shunts blood from the liver to the inferior vena cava.
D) The ductus arteriosus shunts blood from the right ventricle to the left ventricle.

Accepted Answer

The foramen ovale shunts oxygenated blood from the right atrium to the left atrium, bypassing the lungs. The ductus venosus shunts oxygenated blood from the liver to the inferior vena cava. All shunts close after birth. The ductus arteriosus shunts blood from the right ventricle to the aorta.

Question 5

What is the purpose of the ovum's zona pellucida?
A) Prevents multiple sperm from fertilizing the ovum
B) Stimulates the ovum to begin mitotic cell division
C) Allows the 46 chromosomes from each gamete to merge
D) Makes a pathway for more than one sperm to reach the ovum

Accepted Answer

Fertilization causes the zona pellucida to change its chemical composition so that multiple sperm cannot fertilize the ovum. Mitotic cell division begins when the nuclei of the sperm and ovum unite. Each gamete (sperm and ovum) has only 23 chromosomes; there will be 46 chromosomes when they merge. Once sperm has entered the ovum, the zona pellucida changes to prevent other sperm from entering.

Question 6

The nurse is assessing a newborn immediately after birth. After assigning the first Apgar score of 9, the nurse notes two vessels in the umbilical cord. What is the nurse's next action?
A) Assess for other abnormalities of the infant.
B) Note the assessment finding in the infant's chart.
C) Notify the health care provider of the assessment finding.
D) Call for the neonatal resuscitation team to attend the infant immediately.

Accepted Answer

The normal finding in the umbilical cord is two arteries and one vein. Two vessels may indicate other fetal anomalies. Notation of the finding is the appropriate next step when the finding is expected. The health care provider will need to be notified; however, the infant is the nurse's primary concern and must be assessed for abnormalities first. The initial Apgar score is 9, indicating no signs of distress or need of resuscitation.

Question 7

An infant is diagnosed with fetal anemia. Which information would support this clinical diagnosis?
A) Presence of excess maternal hormones
B) Maternal blood type O-negative, Rh-negative, and infant blood type O-negative, Rh-negative
C) Passive immunity
D) Rh-negative mother and Rh-positive baby

Accepted Answer

Passive immunity provides temporary protection to the baby based on the transfer of maternal antibodies. Maternal hormones would not lead to a clinical diagnosis of fetal anemia. These blood types and Rh factors are the same; therefore, no antibodies will be created. In this situation, an Rh-negative mother and Rh-positive baby will result in stimulation of antibodies that will stimulate a reaction leading to hemolysis.

Question 8

Which physical characteristics decrease as the fetus nears term? (Select all that apply.)
A) Vernix caseosa
B) Lanugo
C) Port wine stain
D) Brown fat
E) Eyebrows or head hair

Accepted Answer

Both vernix caseosa and lanugo decrease as the fetus reaches term. Port wine stain is a birthmark and, if present, will be exhibited at or shortly after birth. Brown fat in the fetus will be maintained in order to maintain core temperature. Eyebrows and head hair increase as the fetus nears term.

Question 9

An expectant mother says to the nurse, "When my sister's baby was born, it was covered in a cheese-like coating. What is the purpose of this coating?" The correct response by the nurse is to explain that the purpose of vernix caseosa is to
A) regulate fetal temperature.
B) protect the fetal skin from amniotic fluid.
C) promote normal peripheral nervous system development.
D) allow the transport of oxygen and nutrients across the amnion.

Accepted Answer

Prolonged exposure to amniotic fluid during the fetal period could result in breakdown of the skin without the protection of the vernix caseosa. The amniotic fluid aids in maintaining fetal temperature. Normal peripheral nervous system development is dependent on the nutritional intake of the mother. The amnion is the inner membrane that surrounds the fetus. It is not involved in the oxygen and nutrient exchange.

Question 10

An expectant father asks the nurse, "Which part of the mature sperm contains the male chromosome?" What is the correct response by the nurse?
A) X-bearing sperm
B) The tail of the sperm
C) The head of the sperm
D) The middle portion of the sperm

Accepted Answer

The head of the sperm contains the male chromosomes that will join the chromosomes of the ovum. If an X-bearing sperm fertilizes the ovum, the baby will be female. The tail of the sperm helps propel the sperm toward the ovum. The middle portion of the sperm supplies energy for the tail's whip-like action.

Question 11

The nurse is explaining the function of the placenta to a pregnant patient. Which statement indicates to the nurse that further clarification is necessary?
A) "My baby gets oxygen from the placenta."
B) "The placenta functions to help excrete waste products."
C) "The nourishment that I take in passes through the placenta."
D) "The placenta helps maintain a stable temperature for my baby."

Accepted Answer

Amniotic fluid and not the placenta helps with thermoregulation. The remaining statements are correct regarding placental function.

Question 12

The nurse is explaining the process of cell division during the preembryonic period to a group of nursing students. Which statement best describes the characteristics of the morula?
A) Fertilized ovum before mitosis begins
B) Double layer of cells that becomes the placenta
C) Flattened, disk-shaped layer of cells within a fluid-filled sphere
D) Solid ball composed of the first cells formed after fertilization

Accepted Answer

The morula is so named because it resembles a mulberry. It is a solid ball of 12 to 16 cells that develops after fertilization. The fertilized ovum is called the zygote. The placenta is formed from two layers of cells-the trophoblast, which is the other portion of the fertilized ovum, and the decidua, which is the portion of the uterus where implantation occurs. The flattened, disk-shaped layer of cells is the embryonic disk; it will develop into the body.

Question 13

A pregnant patient asks the nurse how her baby gets oxygen to breathe. What is the nurse's best response?
A) "Oxygen-rich blood is delivered through the umbilical vein to the baby."
B) "Take lots of deep breaths because the baby gets all of its oxygen from you."
C) "You don't need to be concerned about your baby getting enough oxygen."
D) "The baby's lungs are not mature enough to actually breathe, so don't worry."

Accepted Answer

Oxygen-rich blood travels from the mother's circulatory system to the placenta and from the placenta to the umbilical vein (veins carry blood to the heart). From the vein, most of the oxygenated blood travels to the fetal liver or the inferior vena cava. Taking deep breaths can temporarily increase oxygenation but can also lead to increased carbon dioxide retention and dizziness. The patient is asking a normal fetal developmental question often asked by pregnant women. Fetal lungs reach maturity by 37 weeks of gestation, but fetal breathing movements are common. Oxygen transport across lung tissue occurs with the first breath.

Question 14

The upper uterus is the best place for the fertilized ovum to implant due to which anatomical adaptation?
A) Maternal blood flow is lower.
B) Placenta attaches most firmly.
C) Uterine endometrium is softer.
D) Developing baby is best nourished.

Accepted Answer

The uterine fundus is richly supplied with blood and has the thickest endometrium, both of which promote optimum nourishment of the fetus. The blood supply is rich in the fundus, which allows for optimal nourishment of the fetus. If the placenta attaches too deeply, it does not easily detach. Softness is not a concern with implantation; attachment and nourishment are the major concerns.

Question 15

The nurse is planning a prenatal class on fetal development. Which characteristics of prenatal development should the nurse include for a fetus of 24 weeks, based on fertilization age? (Select all that apply.)
A) Ear cartilage firm
B) Skin wrinkled and red
C) Testes descending toward the inguinal rings
D) Surfactant production nears mature levels
E) Fetal movement becoming progressively more noticeable

Accepted Answer

A fetus of 24 weeks, based on fertilization age, will have wrinkled and red skin, testes descending toward inguinal rings, and the fetal movement becoming progressively more noticeable. Surfactant production nearing the mature levels does not occur until 32 weeks and ear cartilage is not firm until 38 weeks.

Question 16

Which statement best describes the changes that occur during the fetal period of development?
A) Maturation of organ systems
B) Development of basic organ systems
C) Resistance of organs to damage from external agents
D) Development of placental oxygen-carbon dioxide exchange

Accepted Answer

During the fetal period, the body systems grow in size and mature in function to allow independent existence after birth. Basic organ systems are developed during the embryonic period. The organs are always at risk for damage from external sources; however, the older the fetus, the more resistant will be the organs. The greatest risk is when the organs are developing. The placental system is complete by week 12, but that is not the best description of the fetal period.

Question 17

A patient who is 16 weeks pregnant with her first baby asks how long it will be before she feels the baby move. Which is the nurse's best answer?
A) "You should have felt the baby move by now."
B) "The baby is moving, but you can't feel it yet."
C) "Some babies are quiet and you don't feel them move."
D) "Within the next month you should start to feel fluttering sensations."

Accepted Answer

Maternal perception of fetal movement (quickening) usually begins between 17 and 20 weeks after conception. Because this is her first pregnancy, movement is felt toward the later part of the 17 to 20 weeks. "The baby is moving, but you can't feel it yet" may be alarming to the woman. "Some babies are quiet and you don't feel them move" is a true statement; the fetus' movements are not strong enough to be felt until 17 to 20 weeks; however, this statement does not ans the woman's concern. Fetal movement should be felt between 17 and 20 weeks; if movement is not perceptible by the end of that time, further assessment will be necessary.

Question 18

A nurse is conducting prenatal education classes for a group of expectant parents. Which information should the nurse include in her discussion of the purpose of amniotic fluid? (Select all that apply.)
A) Cushions the fetus
B) Protects the skin of the fetus
C) Provides nourishment for the fetus
D) Allows for buoyancy for fetal movement
E) Maintains a stable temperature for the fetus

Accepted Answer

The amniotic fluid provides cushioning for the fetus against impacts to the maternal abdomen. It provides a stable temperature and allows room and buoyancy for fetal movement. Vernix caseosa, the cheeselike coating on the fetus, provides skin protection. The placenta provides nourishment for the fetus.

Question 19

One of the assessments performed in the birth room is checking the umbilical cord for blood vessels. Which finding is considered to be within normal limits?
A) One artery and one vein
B) Two veins and one artery
C) Two arteries and one vein
D) Two arteries and two veins

Accepted Answer

The umbilical cord contains two arteries and one vein to transport blood between the fetus and the placenta. Any option other than two arteries and one vein is considered abnormal and requires further assessment. Two veins and one artery is abnormal and may indicate an anomaly. Two arteries instead is a normal finding; this infant would require further assessment for anomalies due to the finding of two veins.

Question 20

The nurse is conducting a staff in-service on multifetal pregnancy. Which statement regarding dizygotic twin development should the nurse include in the teaching session?
A) Dizygotic twins arise from two fertilized ova and are the same sex.
B) Dizygotic twins arise from a single fertilized ovum and are always of the same sex.
C) Dizygotic twins arise from two fertilized ova and may be the same sex or different sexes.
D) Dizygotic twins arise from a single fertilized ovum and may be the same sex or different sexes.

Accepted Answer

Dizygotic twins arise from two ova that are fertilized by different sperm. They may be the same or different gender, and they may not have similar physical traits. Monozygotic twins are always the same sex. A single fertilized ovum that produces twins is called monozygotic. Dizygotic twins are from two fertilized ova and may or may not be the same sex.

Quiz 5: Conception and Prenatal Development

Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy, including which of the following? (Select all that apply.)

An expectant mother, diagnosed with oligohydramnios, asks the nurse what this condition means for the baby. Which statement should the nurse provide for the patient?

Some of the embryo's intestines remain within the umbilical cord during the embryonic period because the

The nurse is explaining fetal circulation to a group of nursing students. Which information should be included in the teaching session? (Select all that apply.)

What is the purpose of the ovum's zona pellucida?

The nurse is assessing a newborn immediately after birth. After assigning the first Apgar score of 9, the nurse notes two vessels in the umbilical cord. What is the nurse's next action?

An infant is diagnosed with fetal anemia. Which information would support this clinical diagnosis?

Which physical characteristics decrease as the fetus nears term? (Select all that apply.)

An expectant mother says to the nurse, "When my sister's baby was born, it was covered in a cheese-like coating. What is the purpose of this coating?" The correct response by the nurse is to explain that the purpose of vernix caseosa is to

An expectant father asks the nurse, "Which part of the mature sperm contains the male chromosome?" What is the correct response by the nurse?

The nurse is explaining the function of the placenta to a pregnant patient. Which statement indicates to the nurse that further clarification is necessary?

The nurse is explaining the process of cell division during the preembryonic period to a group of nursing students. Which statement best describes the characteristics of the morula?

A pregnant patient asks the nurse how her baby gets oxygen to breathe. What is the nurse's best response?

The upper uterus is the best place for the fertilized ovum to implant due to which anatomical adaptation?

The nurse is planning a prenatal class on fetal development. Which characteristics of prenatal development should the nurse include for a fetus of 24 weeks, based on fertilization age? (Select all that apply.)

Which statement best describes the changes that occur during the fetal period of development?

A patient who is 16 weeks pregnant with her first baby asks how long it will be before she feels the baby move. Which is the nurse's best answer?

A nurse is conducting prenatal education classes for a group of expectant parents. Which information should the nurse include in her discussion of the purpose of amniotic fluid? (Select all that apply.)

One of the assessments performed in the birth room is checking the umbilical cord for blood vessels. Which finding is considered to be within normal limits?

The nurse is conducting a staff in-service on multifetal pregnancy. Which statement regarding dizygotic twin development should the nurse include in the teaching session?