Chapter 12, Conception and Fetal Development Test | Exams Nursing

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Chapter 12, Conception and Fetal Development Test Questions and

Answers Graded A

Which fetal lung development finding is

appropriate for a client during the 28th week of

gestation with an amniocentesis lecithin-to-

sphingomyelin (L/S) ratio of 0.4:1? - -Not

completely developed, and the mother has

diabetes mellitus.

Between which time span does human chorionic

gonadotropin (hCG) reach its maximum levels in

a pregnant woman? - -60 to 70 days

The protein hormone hCG can be detected in the

maternal serum by 8 to 10 days after conception,

shortly after implantation. The hCG helps

preserve the function of the ovarian corpus

luteum and ensures the continued supply of

estrogen and progesterone required to maintain

pregnancy. The hCG reaches its maximum level

at 60 to 70 days and then begins to decrease.

The hCG levels are still increasing between 30

and 50 days of pregnancy; hCG levels will

decrease at 70 to 90 days of pregnancy or at 90

to 100 days of pregnancy.

How many days after intercourse do sperm

remain viable in the female reproductive system?

- -2 to 3 days

Which method is appropriate when determining

the expected date of delivery of the client? -

-Ask the client about her last menstrual

period (LMP).

Which hormone produced by the fetus is

believed to initiate labor? - -Cortisol

The adrenal cortex is formed during the 6th week

of the gestational period and produces hormones

by the 8th or 9th week. The fetus produces

higher amounts of cortisol as the due date gets

closer. This is believed to aid in initiating labor by

decreasing maternal progesterone and

stimulating prostaglandin production. Insulin,

which helps regulate glucose in the fetus, is

produced by the islets of Langerhans of the

pancreas. Estriol is a type of estrogen hormone

secreted by the placenta that stimulates

uteroplacental growth. Thyroxine is a thyroid

hormone produced in the fetus; thyroxine does

not easily cross the placenta.

Which risk is appropriate to discuss with a 35-

year-old African-American client who has a

desire to become pregnant? - -Dizygotic

twin pregnancy

In which week of pregnancy can the nurse see

the grossly formed brain on ultrasonography? -

-20 weeks

Which nursing response is appropriate when an

8-month-pregnant woman states she knows her

baby listens to her, but her husband thinks she is

imagining things? - -A baby in utero does

respond to the mother's voice."

Which mechanism aids in providing early passive

immunity to the fetus? - -Pinocytosis

Which response given by the clinical coordinator

indicates effective teaching about when the

gender of the fetus can be determined? - -

12th week of gestation

Which pulmonary surfactant ratio confirms the

maturity of the infant's lungs? - -When the

ratio of lecithin to sphingomyelin is 2:1

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Answers Graded A

Which fetal lung development finding is appropriate for a client during the 28th week of gestation with an amniocentesis lecithin-to- sphingomyelin (L/S) ratio of 0.4:1? - - Not completely developed, and the mother has diabetes mellitus. Between which time span does human chorionic gonadotropin (hCG) reach its maximum levels in a pregnant woman? - - 60 to 70 days The protein hormone hCG can be detected in the maternal serum by 8 to 10 days after conception, shortly after implantation. The hCG helps preserve the function of the ovarian corpus luteum and ensures the continued supply of estrogen and progesterone required to maintain pregnancy. The hCG reaches its maximum level at 60 to 70 days and then begins to decrease. The hCG levels are still increasing between 30 and 50 days of pregnancy; hCG levels will decrease at 70 to 90 days of pregnancy or at 90 to 100 days of pregnancy. How many days after intercourse do sperm remain viable in the female reproductive system?

- 2 to 3 days Which method is appropriate when determining the expected date of delivery of the client? -
  - Ask the client about her last menstrual period (LMP). Which hormone produced by the fetus is believed to initiate labor? - - Cortisol The adrenal cortex is formed during the 6th week of the gestational period and produces hormones by the 8th or 9th week. The fetus produces higher amounts of cortisol as the due date gets closer. This is believed to aid in initiating labor by decreasing maternal progesterone and stimulating prostaglandin production. Insulin, which helps regulate glucose in the fetus, is produced by the islets of Langerhans of the pancreas. Estriol is a type of estrogen hormone secreted by the placenta that stimulates uteroplacental growth. Thyroxine is a thyroid hormone produced in the fetus; thyroxine does not easily cross the placenta. Which risk is appropriate to discuss with a 35- year-old African-American client who has a desire to become pregnant? - - Dizygotic twin pregnancy In which week of pregnancy can the nurse see the grossly formed brain on ultrasonography? -
    - 20 weeks Which nursing response is appropriate when an 8 - month-pregnant woman states she knows her baby listens to her, but her husband thinks she is imagining things? - - A baby in utero does respond to the mother's voice." Which mechanism aids in providing early passive immunity to the fetus? - - Pinocytosis Which response given by the clinical coordinator indicates effective teaching about when the gender of the fetus can be determined? - - 12th week of gestation Which pulmonary surfactant ratio confirms the maturity of the infant's lungs? - - When the ratio of lecithin to sphingomyelin is 2:

Answers Graded A

How many days after intercourse do sperm remain viable in the female reproductive system?

- 2 to 3 days Which hormone indicates the client is pregnant from a urine analysis report? - - Human chorionic gonadotropin (hCG) Which fetal physical finding is appropriate in the 20th week of pregnancy? - - Hair on the scalp Which estimation and interpretation information about the recurrence of risk for genetic disorders is appropriate nursing knowledge? - - The risk factor remains the same no matter how many affected children are already in the family. Which finding is appropriate for a woman at 35 weeks of gestation whose amniocentesis revealed surface-active phospholipids in the amniotic fluid? - - The lungs are mature. The detection of the presence of pulmonary surfactants, surface-active phospholipids, in amniotic fluid has been used to determine fetal lung maturity, or the ability of the lungs to function after birth. This occurs at approximately 35 weeks of gestation. This result is unrelated to Down syndrome and in no way indicates risk for preterm labor. Meconium should not be present in the amniotic fluid Which statement by the nurse is appropriate when educating a group of student nurses about when glycogen storage begins in the fetus? -
  - Glycogen storage begins 9 to 10 weeks. Which fetal heart rate indicates that there is normal growth and development? - - 150 beats/minute How many veins and arteries are present between the maternal and the fetal circulatory system by the 5th week of pregnancy? - - One vein and two arteries The fetal heart starts beating by the end of the 5th week. Two arteries carry blood from the embryo to the chorionic villi, and one vein returns the blood to the embryo. Deoxygenated blood leaves the fetus through the umbilical arteries and enters the placenta, where it is oxygenated. Oxygenated blood leaves the placenta through the umbilical vein, which enters the fetus via the umbilical cord. It is rare for there to be one vein and one artery. Approximately 1% of umbilical cords contain only two vessels: one artery and one vein. This occurrence is sometimes associated with congenital malformations. Therefore, the presence of two veins and one artery and two veins and two arteries is inappropriate. The delivery date is calculated 280 days from which day? - - The first day of the last menstrual period Which developmental finding is accurate with regard to fetal growth? - - Blood vessel formation is complete by 8 weeks. The heart starts beating by 4 weeks. Lungs take shape by 12 weeks. Brain configuration is complete by 12 weeks. Which disease risk is increased when caring for a preterm infant with low levels of glucuronyl transferase enzyme? - - Hyperbilirubinemia

Answers Graded A

considering the highest risk for pregnancy- related complications? - - Uncontrolled diabetes mellitus Which presentation would the nurse suspect to find on physical examination of a pregnant woman diagnosed with oligohydramnios? -

The fetus may have renal problems Which antenatal complication correlates for a client who is at 24 weeks of gestation with dichorionic twins? - - Preterm labor Which information is appropriate when giving a presentation about milestones in embryonic development? - - At 20 weeks of gestation, the vernix caseosa and lanugo appear. Two milestones that occur at 20 weeks are the appearance of the vernix caseosa and lanugo. The primary lung and urethral buds appear at 6 weeks of gestation. The vagina is open or the testes are in position for descent into the scrotum at 16 weeks. The appearance of smooth skin occurs at 28 weeks, and subcutaneous fat begins to collect at 30 to 31 weeks. Which developmental finding is accurate with regard to fetal growth? - - Main blood vessels form by 8 weeks. Which nursing intervention is appropriate to maintain normal blood pressure in the pregnant client? - - Position the client to lie on the left side and rest. Pregnant women often experience hypotension when they lie on their back (in the supine position). The blood that is trying to return to the right atrium is diminished because the uterus is compressing the vena cava. Therefore the nurse would have the client lie on either side to rest. This will reduce uterine pressure on the right atrium and help in optimum circulation. Aerobic exercise would not be helpful in reducing the pressure caused by uterine compression. Making the client stand up and take deep breaths will worsen the symptoms of hypotension. Making the client lie in the supine position will further increase the uterine compression and hypotension. Which factors would limit the survival of a 23- week preterm infant? Select all that apply. -
Lung oxygenation capability Central nervous system (CNS) function Which testing is appropriate to determine if a client is pregnant? - - Biochemical testing Which reason explains why newborns can have milky secretions from the nipples? - - High levels of maternal estrogen Which gestational age is appropriate when the ultrasound reports that the fetal nose and ears are ossified? - - 20 weeks Which birth plan request by the client scheduled for an induction of labor would be most concerning? - - Abstain from administering vitamin K Coagulation factors II, VII, IX, and X cannot be synthesized in the fetal liver because of the lack of vitamin K in the sterile gut. This results in a deficiency in coagulation factors for several days after birth, placing the neonate at risk for bleeding

Answers Graded A

for several days after birth. Vitamin K is administered prophylactically after birth to prevent bleeding. Delayed cord clamping and allowing the amniotic sac to rupture naturally would not be harmful to the newborn unless there is an emergency. Delaying eye ointment for bonding and breastfeeding is not an unreasonable request. Which developmental characteristic is appropriate in a 16-week-pregnant client when observed by ultrasonography? - - Differentiation of the general sense organs Which statements should the clinical coordinator include in teaching about the physiologic process of conception? Select all that apply. - - It is the first phase in the process of a woman becoming pregnant It is the fusion of the sperm cell and egg cell to form a zygote Conception is the very first step and involves fusion of the sperm cell and egg cell to form a zygote. This is considered the beginning of pregnancy. The process of removing a protective coat from the sperm head is called capacitation. It occurs before conception as a result of physiologic changes. The primary germ layer is differentiated into three layers 3 weeks after conception. The process in which the embryo adheres to the wall of the uterus is called implantation. This occurs after conception. Organ systems and external features are developed after differentiation of the primary germ layer. This takes place after conception. Which fetal system is affected by low amniotic fluid volume? - - Renal Which fetal system maturity is at risk of slowing when the client with chronic glomerulonephritis and her fetus are not managed effectively? -

Lung Which immunoglobulin (Ig) is present in colostrum and the rationale behind encouraging postpartum clients to nurse while producing colostrum? - - A (IgA) Which congenital anomalies can be expected in the fetus with a chromosomal defect that has been known to affect mesodermal development?
- Vertebral column Which fetal heart rate is indicative of adequate fetal oxygen supply? - - 130 Which condition is an immediate concern for a client at 8 weeks of gestation? - - Epilepsy Which nurse assessment finding would indicate reduced placental blood flow? - - Prolonged contractions Braxton Hicks contractions generally enhance blood flow to the placenta. However, if the contractions are prolonged, the blood flow to the placenta can become restricted. Increased maternal blood pressure does not affect placental blood flow. Fetal respiratory movements are not associated with placental circulation. Progesterone levels are usually high during pregnancy; they do not affect blood flow to placenta. The nurse is caring for a diabetic pregnant client. Which conditions would the nurse expect to find

Chapter 12, Conception and Fetal Development Test, Exams of Nursing

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