Final Chapter 10: Fetal Development and Structures

Question 1

What is the primary role of the placenta in fetal circulation?

A) To provide nutrition only
B) To support the lungs’ function
C) To produce hormones
D) To act as the oxygen-transfer organ

Answer 1

D) To act as the oxygen-transfer organ

Rationale: In fetal circulation, the placenta serves as the oxygen-transfer organ, facilitating gas exchange because the fetal lungs are not yet fully developed.

Question 2

How does fetal circulation differ from adult circulation?

A) There are no differences between fetal and adult circulation
B) Fetal circulation involves gas exchange in the lungs
C) Fetal circulation includes certain vessels and shunts that close after birth
D) Fetal circulation operates without any blood vessels

Answer 2

C) Fetal circulation includes certain vessels and shunts that close after birth

Rationale: Fetal circulation involves the presence of specialized vessels and shunts that direct blood flow and close after birth, adapting to the different requirements of oxygen and nutrient delivery compared to adult circulation.

Question 3

What are the key functions of shunts in fetal circulation? (SATA)

A) To direct oxygen-rich venous blood to systemic circulation
B) To ensure oxygen-depleted venous blood bypasses pulmonary circulation
C) To facilitate the exchange of oxygen in the fetal lungs
D) To stabilize fetal body temperature

Answer 3

A) To direct oxygen-rich venous blood to systemic circulation
B) To ensure oxygen-depleted venous blood bypasses pulmonary circulation

Rationale: The shunts in fetal circulation are designed to direct oxygen-rich blood to the systemic circulation and bypass the underdeveloped pulmonary circulation, as the lungs are not yet functioning as the primary site for gas exchange.

Question 4

What happens to the fetal shunts after birth?

A) They continue to function as before
B) They close and most become remnants in the adult circulation
C) They open further to increase blood flow
D) They transform into major blood vessels in the lungs

Answer 4

B) They close and most become remnants in the adult circulation

Rationale: After birth, the fetal shunts close and most of these vessels become remnants within the adult circulation, adapting to the changes as the lungs take over the role of gas exchange.

Question 5

Which structure is responsible for gas exchange in the fetus?

A) Lungs
B) Kidneys
C) Placenta
D) Liver

Answer 5

C) Placenta

Rationale: In the fetus, gas exchange occurs at the placenta, which acts as the oxygen-transfer organ since the fetal lungs are not yet fully developed to perform this function.

Question 6

What are the components of fetal circulation that differ from adult circulation? (SATA)

A) Presence of specialized shunts
B) Direct blood flow to the lungs
C) Reliance on maternal circulation for oxygen and nutrients
D) Closure of shunts after birth

Answer 6

A) Presence of specialized shunts
C) Reliance on maternal circulation for oxygen and nutrients
D) Closure of shunts after birth

Rationale: Fetal circulation includes specialized shunts, relies on maternal circulation for oxygen and nutrients, and these shunts close after birth, differentiating it from adult circulation.

Question 7

Which vessels carry oxygen-rich venous blood in fetal circulation?

A) Pulmonary arteries
B) Umbilical arteries
C) Umbilical vein
D) Systemic veins

Answer 7

C) Umbilical vein

Rationale: The umbilical vein carries oxygen-rich venous blood from the placenta to the fetus, playing a critical role in fetal circulation.

Question 8

What functions are taken over by the placenta in fetal life? (SATA)

A) Nutrient supply
B) Gas exchange
C) Waste removal
D) Hormone production

Answer 8

all of the choices are correct

Rationale: The placenta takes over multiple functions in fetal life, including supplying nutrients, facilitating gas exchange, removing waste products, and producing hormones essential for fetal development.

Question 9

What is the purpose of the fetal shunt known as the ductus arteriosus?

A) To direct blood from the left atrium to the right atrium
B) To bypass the liver
C) To shunt blood from the pulmonary artery to the aorta
D) To transport blood from the placenta to the fetus

Answer 9

C) To shunt blood from the pulmonary artery to the aorta

Rationale: The ductus arteriosus is a fetal shunt that directs blood from the pulmonary artery to the aorta, allowing blood to bypass the non-functioning fetal lungs.

Question 10

What are the primary roles of the maternal circulation in fetal development? (SATA)

A) Providing oxygen
B) Supplying nutrients
C) Removing carbon dioxide
D) Maintaining amniotic fluid levels

Answer 10

A) Providing oxygen
B) Supplying nutrients
C) Removing carbon dioxide

Rationale: The maternal circulation plays a crucial role in providing oxygen and nutrients to the fetus and removing carbon dioxide, supporting the fetus’s development and growth.

Question 11

Which fetal structure carries deoxygenated blood from the fetus to the placenta?

A) Umbilical arteries
B) Umbilical vein
C) Pulmonary veins
D) Systemic arteries

Answer 11

A) Umbilical arteries

Rationale: The umbilical arteries carry deoxygenated blood from the fetus to the placenta, where gas exchange and nutrient-waste exchange occur.

Question 12

What ensures that oxygen-depleted venous blood bypasses the underdeveloped pulmonary circulation in the fetus?

A) Foramen ovale
B) Ductus arteriosus
C) Pulmonary vein
D) Hepatic portal vein

Answer 12

B) Ductus arteriosus

Rationale: The ductus arteriosus ensures that oxygen-depleted venous blood bypasses the underdeveloped pulmonary circulation by shunting blood from the pulmonary artery to the aorta.

Question 13

What changes occur to the fetal circulatory shunts after birth? (SATA)

A) They remain open
B) They close and form ligaments
C) They transform into adult blood vessels
D) They continue to function as fetal shunt

Answer 13

B) They close and form ligaments
C) They transform into adult blood vessels

Rationale: After birth, the fetal circulatory shunts close and either form ligaments or transform into adult blood vessels, adapting to the new requirements of postnatal circulation.

Question 14

Why is fetal blood circulation adapted differently from adult circulation? (SATA)

A) To accommodate gas exchange at the placenta
B) To ensure proper nutrient and waste exchange with maternal blood
C) To function independently of the maternal circulation
D) To optimize oxygen delivery to underdeveloped fetal lungs

Answer 14

A) To accommodate gas exchange at the placenta
B) To ensure proper nutrient and waste exchange with maternal blood

Rationale: Fetal blood circulation is adapted to accommodate gas exchange at the placenta and ensure proper nutrient and waste exchange with maternal blood. The adaptations allow the fetus to thrive in the uterine environment while the lungs and other organs develop.

Question 15

What is the definition of a teratogen?

A) A substance that enhances fetal development
B) Any substance, organism, physical agent, or deficiency state present during gestation that can induce abnormal postnatal structure or function
C) A nutritional supplement for pregnant women
D) A natural hormone produced during pregnancy

Answer 15

B) Any substance, organism, physical agent, or deficiency state present during gestation that can induce abnormal postnatal structure or function

Rationale: A teratogen is defined as any substance, organism, physical agent, or deficiency state that, when present during gestation, has the potential to interfere with normal embryonic and fetal development, leading to abnormal postnatal structure or function.

Question 16

How can teratogens affect a fetus or embryo? (SATA)

A) Causing physical deformities
B) Improving behavioral development
C) Decreasing intellectual quotient (IQ)
D) Leading to spontaneous abortions

Answer 16

A) Causing physical deformities
C) Decreasing intellectual quotient (IQ)
D) Leading to spontaneous abortions

Rationale: Teratogens can affect a fetus or embryo in multiple ways, including causing physical deformities, behavioral and emotional development problems, decreased intellectual quotient (IQ), and complications such as preterm labor and spontaneous abortions.

Question 17

What factor influences the susceptibility to teratogenic agents?

A) The mother’s diet
B) The genetic makeup of the fetus
C) The type of prenatal vitamins taken
D) The timing of exposure and developmental stage of the embryo or fetus

Answer 17

D) The timing of exposure and developmental stage of the embryo or fetus

Rationale: Susceptibility to teratogenic agents is primarily dependent on the timing of exposure and the developmental stage of the embryo or fetus, as different stages are more vulnerable to specific teratogens.

Question 18

Which teratogen is associated with abnormal brain development, mental impairment, and leukemia?

A) Lead exposure
B) Organic mercury
C) Ionizing radiation
D) Toxoplasma

Answer 18

C) Ionizing radiation

Rationale: Ionizing radiation is associated with abnormal brain development, mental impairment, and an increased risk of leukemia in the developing fetus.

Question 19

What are potential effects of lead exposure on the developing fetus? (SATA)

A) Spontaneous abortions
B) Delayed fetal development
C) Enhanced cognitive function
D) Increased risk of fetal death

Answer 19

A) Spontaneous abortions
B) Delayed fetal development
D) Increased risk of fetal death

Rationale: Lead exposure can cause spontaneous abortions, delayed fetal development, increased risk of fetal death, and abnormal mental or physical development in the fetus.

Question 20

Which infectious agent is known to cause fetal death, microcephaly, herpetic pneumonia, and meningoencephalitis?

A) Rubella virus
B) Cytomegalovirus
C) Varicella zoster
D) Herpes virus

Answer 20

D) Herpes virus

Rationale: The herpes virus can cause severe complications in the developing fetus, including fetal death, microcephaly, herpetic pneumonia, and meningoencephalitis.

Question 21

Which teratogen can lead to limb malformations in the developing fetus?

A) Alcohol
B) Cocaine
C) Tetracycline
D) Thalidomide

Answer 21

D) Thalidomide

Rationale: Thalidomide is a drug known to cause limb malformations in the developing fetus when taken by pregnant women.

Question 22

Which maternal conditions can act as teratogens (SATA)

A) Obesity
B) Diabetes
C) Hypothyroidism
D) Hypertension

Answer 22

A) Obesity
B) Diabetes
C) Hypothyroidism

Rationale: Maternal conditions such as obesity, diabetes, and hypothyroidism can act as teratogens, affecting the developing fetus and increasing the risk of complications.

Question 23

A pregnant client at 8 weeks gestation arrives for her prenatal visit. She asks the nurse about the development of her baby’s heart. Which response by the nurse is most appropriate?

A. “The heart begins to develop around week 5, but it is not complete until around week 13.”
B. “Your baby’s heart began forming in week 5 and should now be completely developed.”
C. “Your baby’s heart will begin forming in the next few weeks and be complete by the second trimester.”
D. “The heart does not fully develop until the third trimester, so it is still in early stages now.”

Answer 23

B. “Your baby’s heart began forming in week 5 and should now be completely developed.”

Rationale: The heart begins forming at week 5 and is fully developed by week 8, when the placenta is also functional. This makes option B the most accurate response. Option A is incorrect because the heart is fully developed by week 8, not week 13. Option C incorrectly states that heart formation is yet to begin, and option D incorrectly places heart development in the third trimester.

Question 24

At what gestational age does the placenta become fully functional?

A. 5 weeks
B. 8 weeks
C. 12 weeks
D. 16 weeks

Answer 24

B. 8 weeks

Rationale: The placenta becomes fully functional by week 8. Before this, the embryo relies on diffusion for nutrient and gas exchange. Option A is too early, and options C and D are too late.

Question 25

A nurse is assessing fetal development in a client at 15 weeks gestation. Which finding is expected at this stage?

A. Vernix caseosa covers the fetus
B. Rapid brain development occurs
C. Lanugo is developing
D. Eyelids are opening and closing

Answer 25

C. Lanugo is developing

Rationale: Lanugo begins to develop between weeks 13-16. Vernix (A) and rapid brain growth (B) occur later, around weeks 17-20, while eyelid movement (D) occurs much later at weeks 25-28.

Question 26

A pregnant client at 20 weeks gestation asks the nurse what developments have occurred with her baby. Which responses by the nurse are appropriate? (SATA)

A. “Your baby’s brain has been growing rapidly.”

B. “The kidneys are now secreting urine into the amniotic fluid.”

C. “The lungs have begun to produce surfactant.”

D. “Brown fat has been deposited to help with temperature regulation.”

E. “Your baby’s body fat is rapidly increasing at this stage.”

Answer 26

A. “Your baby’s brain has been growing rapidly.”
B. “The kidneys are now secreting urine into the amniotic fluid.”
D. “Brown fat has been deposited to help with temperature regulation.”

Rationale: Brain growth, kidney function, and brown fat deposits occur between weeks 17-20. Surfactant production (C) starts later, at weeks 21-24, and body fat increases rapidly (E) at weeks 29-32.

Question 27

At which gestational age does surfactant production begin?

A. 17 weeks
B. 21 weeks
C. 25 weeks
D. 29 weeks

Answer 27

B. 21 weeks

Rationale: Surfactant production begins between weeks 21-24, which is crucial for lung maturity. Options A, C, and D are either too early or too late.

Question 28

A nurse is assessing a premature infant born at 30 weeks. Which statement by the nurse correctly explains the infant’s development at this stage?

A. “Your baby’s lungs are fully mature, so they should be able to breathe independently.”

B. “Your baby has fully developed reflexes, including the grasp and startle reflex.”

C. “Your baby has well-formed earlobes, which indicate full-term maturity.”

D. “Your baby has started developing surfactant, but the lungs are still immature.”

Answer 28

D. “Your baby has started developing surfactant, but the lungs are still immature.”

Rationale: At 30 weeks, surfactant has started forming, but the lungs are not fully mature.

Question 29

At which gestational age can the fetus open and close its eyelids?

A. 17-20 weeks
B. 21-24 weeks
C. 25-28 weeks
D. 29-32 weeks

Answer 29

C. 25-28 weeks

Rationale: Eyelid movement occurs at weeks 25-28. Earlier stages involve brain growth, kidney function, and surfactant production, while later stages focus on fat accumulation.

Question 30

A nurse is discussing fetal development with a client at 35 weeks gestation. Which statement accurately describes the fetus at this stage?

A. “Your baby’s lungs are fully mature.”
B. “Your baby is considered full term.”
C. “Your baby’s body fat is rapidly increasing.”
D. “Your baby’s external genitalia is now recognizable.”

Answer 30

C. “Your baby’s body fat is rapidly increasing.”

Rationale: Rapid body fat increase occurs at 29-32 weeks and continues until birth. The lungs are still maturing (A). Full-term status is reached at 38 weeks (B). External genitalia becomes recognizable much earlier (D) at 13-16 weeks.

Question 31

Which fetal developments occur between weeks 17-20? (SATA)

A. Brown fat deposits
B. Surfactant production
C. Vernix caseosa covers the fetus
D. Rapid brain growth
E. Eyelid opening and closing

Answer 31

A. Brown fat deposits
C. Vernix caseosa covers the fetus
D. Rapid brain growth

Rationale: Between weeks 17-20, brain growth continues, brown fat deposits form, and vernix caseosa covers the fetus. Surfactant (B) begins later, at 21-24 weeks, and eyelids (E) open at 25-28 weeks.

Question 32

At what gestational age does the grasp reflex first appear?

A. 17-20 weeks
B. 21-24 weeks
C. 25-28 weeks
D. 29-32 weeks

Answer 32

B. 21-24 weeks

Rationale: The grasp reflex first appears at weeks 21-24. Before this, the fetus is developing lanugo and kidneys begin secreting urine.

Question 33

A pregnant client is at 32 weeks gestation. Which statement by the nurse correctly describes the baby’s lung development at this stage?

A. “Your baby’s lungs are fully mature and ready for independent breathing.”
B. “Your baby has begun producing surfactant, but the lungs are not fully mature yet.”
C. “Your baby is still too early to have any lung development.”
D. “Your baby’s lungs will not develop until closer to 38 weeks.”

Answer 33

B. “Your baby has begun producing surfactant, but the lungs are not fully mature yet.”

Rationale: By 32 weeks, surfactant is present, but full lung maturity is still developing. Independent breathing remains a concern for preterm infants.

Question 34

A nurse is caring for a newborn born at 36 weeks gestation. The parents ask if their baby is considered full term. What is the best response?

A. “No, full-term babies are born at 38 weeks or later.”
B. “Yes, your baby is full term because they are past 34 weeks.”
C. “Your baby is full term because their earlobes are fully developed.”
D. “No, full-term status is based on lung maturity, not gestational age.”

Answer 34

A. “No, full-term babies are born at 38 weeks or later.”

Rationale: Full-term status is reached at 38 weeks. While some organs may be well developed, the baby is still considered preterm at 36 weeks.

Question 35

A nurse is assessing a newborn immediately after birth and notes that the umbilical cord has only one artery and one vein. What is the priority nursing action?

A. Document the finding as normal and continue routine newborn care.
B. Notify the healthcare provider for further evaluation of possible congenital abnormalities.
C. Clamp the umbilical cord immediately to prevent further complications.
D. Assess the umbilical cord for Wharton’s jelly to ensure vessel protection.

Answer 35

B. Notify the healthcare provider for further evaluation of possible congenital abnormalities.

Rationale: A normal umbilical cord contains two arteries and one vein. A single umbilical artery can be associated with congenital abnormalities, particularly in the cardiovascular and renal systems. The nurse should notify the provider for further evaluation.

Question 36

What is the function of the two umbilical arteries?

A. Carry oxygenated blood from the placenta to the fetus
B. Remove waste products from the fetus to the placenta
C. Supply the amniotic fluid with nutrients
D. Protect the umbilical vessels from compression

Answer 36

B. Remove waste products from the fetus to the placenta

Rationale: The two umbilical arteries remove waste products from the fetus and carry deoxygenated blood to the placenta for elimination. Option A is incorrect because oxygenated blood is delivered to the fetus via the umbilical vein. Option C is incorrect because the amniotic fluid is not supplied with nutrients via the umbilical cord. Option D is incorrect because Wharton’s jelly, not the arteries, provides vessel protection.

Question 37

A nursing student is reviewing the components of the umbilical cord. Which statements indicate a correct understanding? (SATA)

A. “The umbilical cord contains two arteries and one vein.”
B. “The vein carries oxygenated blood and nutrients to the fetus.”
C. “The arteries carry oxygen-rich blood to the fetus.”
D. “Wharton’s jelly protects the umbilical vessels from compression.”
E. “The umbilical cord is derived from the placenta and amniotic fluid.”

Answer 37

A. “The umbilical cord contains two arteries and one vein.”
B. “The vein carries oxygenated blood and nutrients to the fetus.”
D. “Wharton’s jelly protects the umbilical vessels from compression.”

Rationale: The umbilical cord contains two arteries and one vein (A). The vein carries oxygenated blood and nutrients to the fetus (B), while the arteries remove waste away from the fetus (not oxygen-rich blood, so C is incorrect). Wharton’s jelly (D) cushions the vessels and prevents compression. Option E is incorrect because the umbilical cord is derived from the yolk sac and amnion, not the placenta and amniotic fluid.

Question 38

A nurse is explaining umbilical cord function to a group of pregnant clients. Which statement by a client indicates the need for further teaching?

A. “The umbilical cord carries oxygen and nutrients to my baby through the vein.”
B. “The umbilical cord contains two arteries that carry blood away from my baby.”
C. “The umbilical cord helps protect my baby by filtering out harmful substances before they reach the fetus.”
D. “Wharton’s jelly helps prevent the umbilical cord from being compressed during pregnancy.”

Answer 38

C. “The umbilical cord helps protect my baby by filtering out harmful substances before they reach the fetus.”

Rationale: Rationale: The umbilical cord does not filter harmful substances; the placenta serves as the barrier for toxin exchange. The umbilical cord only transports oxygen, nutrients, and waste between the fetus and placenta. Options A, B, and D are all correct statements regarding the function of the umbilical cord.

Question 39

A newborn is born at term with an umbilical cord that is only 12 inches long. Which complication might have occurred during labor?

A. Preterm birth
B. Placental abruption
C. Excessive Wharton’s jelly causing cord compression
D. Fetal distress due to restricted movement

Answer 39

D. Fetal distress due to restricted movement

Rationale: A short umbilical cord (less than 22 inches at term) can restrict fetal movement and lead to fetal distress during labor due to tension on the cord during contractions.

Question 40

A nurse is assessing a client in labor and notes variable decelerations on the fetal monitor. Upon examination, the umbilical cord is wrapped around the fetus’s neck (nuchal cord). Which structure provides protection to the umbilical vessels in this situation?

A. Vernix caseosa
B. Wharton’s jelly
C. Amniotic fluid
D. The placenta

Answer 40

B. Wharton’s jelly

Rationale: Wharton’s jelly is a gelatinous substance in the umbilical cord that cushions the vessels, preventing compression when the cord is wrapped around the fetus. Option A is incorrect because vernix caseosa is a protective coating on the fetus’s skin, not the umbilical cord. Option C is incorrect because amniotic fluid cushions the fetus, not the umbilical vessels specifically. Option D is incorrect because the placenta provides nutrient exchange but does not directly protect the umbilical cord from compression.

Question 41

A nurse is caring for a pregnant client at 32 weeks gestation who is diagnosed with placenta previa. The client asks why she is at risk for complications. What is the best response by the nurse?

A. “Your placenta is implanted too deeply into the uterine wall, which may lead to heavy bleeding.”
B. “Your placenta is covering part or all of your cervix, which can cause bleeding as your cervix begins to thin and dilate.”
C. “Your placenta is aging prematurely, which reduces oxygen and nutrient supply to your baby.”
D. “Your placenta has developed multiple blood clots, which can restrict blood flow to your baby.”

Answer 41

B. “Your placenta is covering part or all of your cervix, which can cause bleeding as your cervix begins to thin and dilate.”

Rationale: Placenta previa occurs when the placenta is implanted over or near the cervical opening. As the cervix thins and dilates, it disrupts the placenta, leading to painless vaginal bleeding.

Question 42

Which function of the placenta is most critical for fetal survival in utero?

A. Filtering maternal blood to remove toxins before reaching the fetus
B. Producing hormones to maintain pregnancy
C. Facilitating gas exchange between the mother and fetus
D. Preventing maternal antibodies from attacking the fetus

Answer 42

C. Facilitating gas exchange between the mother and fetus

Rationale: The placenta plays a vital role in fetal circulation by facilitating gas exchange—bringing oxygen to the fetus and removing carbon dioxide. This is crucial because the fetal lungs remain collapsed in utero. Option A is incorrect because while the placenta does act as a barrier, it does not filter all toxins. Option B is important, but hormone production is not the most critical function for immediate survival. Option D is correct in preventing some immune attacks, but it is not as essential as oxygen exchange.

Question 43

A nurse is educating a group of prenatal clients about placental function. Which statements should the nurse include? (SATA)

A. “The placenta produces hormones that support fetal growth and maternal adaptation to pregnancy.”

B. “The placenta allows maternal and fetal blood to mix so that oxygen can be delivered efficiently.”

C. “The placenta removes waste products from the fetus and transfers them to the maternal circulation for elimination.”

D. “The placenta helps protect the fetus from some maternal immune responses.”

E. “The placenta directly controls fetal heart rate and circulation.”

Answer 43

A. “The placenta produces hormones that support fetal growth and maternal adaptation to pregnancy.”
C. “The placenta removes waste products from the fetus and transfers them to the maternal circulation for elimination.”
D. “The placenta helps protect the fetus from some maternal immune responses.”

Rationale: (A) The placenta produces essential hormones like hCG, progesterone, and estrogen to maintain pregnancy. (C) It also plays a crucial role in removing fetal waste via maternal circulation. (D) The placenta acts as an immune barrier, preventing maternal antibodies from attacking fetal tissue. (B) is incorrect because maternal and fetal blood do not mix; exchange occurs through the placental membrane. (E) is incorrect because fetal circulation is controlled by the fetal heart, not the placenta.

Question 44

A nurse is reviewing the placental circulation of a fetus in utero. Which statement correctly explains why the placenta is vital for fetal oxygenation?

A. The placenta serves as the fetal respiratory organ because the fetal lungs are nonfunctional.
B. The placenta delivers oxygen to the fetal lungs for gas exchange.
C. The placenta directs blood to bypass the fetal heart and circulate through the maternal system.
D. The placenta increases fetal red blood cell production to compensate for lower oxygen levels.

Answer 44

A. The placenta serves as the fetal respiratory organ because the fetal lungs are nonfunctional.

Rationale: The fetal lungs remain collapsed and filled with fluid during pregnancy, so the placenta serves as the organ for gas exchange, providing oxygen and removing carbon dioxide.

Question 45

A nurse is monitoring a 40-week pregnant client in labor and notes late decelerations on the fetal heart monitor. The nurse suspects placental insufficiency. Which nursing intervention is priority?

A. Reposition the client to the left lateral position and administer oxygen.
B. Prepare the client for an immediate cesarean section.
C. Encourage the client to bear down and push harder.
D. Reduce IV fluids to prevent excess placental perfusion.

Answer 45

A. Reposition the client to the left lateral position and administer oxygen.

Rationale: Late decelerations indicate placental insufficiency, meaning the fetus is not receiving enough oxygen. The priority is to increase blood flow to the placenta, which can be done by repositioning the client to improve circulation and administering oxygen to maximize fetal oxygenation.

Question 46

A nurse is caring for a pregnant client with preeclampsia. Why is this condition concerning for placental function?

A. It can lead to premature rupture of membranes due to excess amniotic fluid.
B. It increases the risk of fetal infection through the placental barrier.
C. It results in an overproduction of hormones, causing preterm labor.
D. It can cause placental abruption due to decreased blood flow to the placenta.

Answer 46

D. It can cause placental abruption due to decreased blood flow to the placenta.

Rationale: Preeclampsia is associated with reduced placental blood flow, which can lead to placental abruption (separation of the placenta from the uterine wall), endangering the fetus.

Question 47

A pregnant client at 28 weeks asks how the placenta protects her baby from harmful substances. The nurse should explain that the placenta:

A. Acts as a complete barrier, preventing all harmful substances from reaching the fetus.
B. Allows only maternal oxygen and nutrients to pass through while filtering out toxins.
C. Provides some protection but allows certain substances like alcohol and nicotine to cross into fetal circulation.
D. Uses Wharton’s jelly to block harmful chemicals from reaching the fetus.

Answer 47

C. Provides some protection but allows certain substances like alcohol and nicotine to cross into fetal circulation.

Rationale: The placenta does provide a protective barrier, but some harmful substances, such as alcohol, nicotine, and certain medications, can still cross into fetal circulation. Option A is incorrect because the placenta is not an absolute barrier. Option B is incorrect because while the placenta facilitates nutrient exchange, it cannot fully filter out all toxins. Option D is incorrect because Wharton’s jelly is located in the umbilical cord, not the placenta.

Question 48

A nurse is caring for a pregnant client at 28 weeks who has been diagnosed with gestational diabetes mellitus (GDM). The nurse explains that a placental hormone is responsible for increasing insulin resistance, contributing to the development of GDM. Which hormone is the primary cause of this change?

A. Estrogen
B. Progesterone
C. Human placental lactogen (hPL)
D. Relaxin

Answer 48

C. Human placental lactogen (hPL)

Rationale: Human placental lactogen (hPL) decreases maternal glucose utilization, increasing glucose availability to the fetus. This leads to maternal insulin resistance, which can contribute to gestational diabetes mellitus.

Question 49

Which hormone is most responsible for maintaining the endometrial lining and preventing uterine contractions during pregnancy?

A. Estrogen
B. Progesterone
C. Relaxin
D. Human placental lactogen (hPL)

Answer 49

B. Progesterone

Rationale: Progesterone maintains the endometrium and decreases uterine contractility, preventing preterm labor.

Question 50

A nurse is educating a prenatal class about pregnancy hormones. Which functions of estrogen should the nurse include? (SATA)

A. Stimulates uterine contractions
B. Enlarges maternal organs
C. Relaxes pelvic ligaments
D. Stimulates breast development
E. Modulates glucose metabolism

Answer 50

A. Stimulates uterine contractions
B. Enlarges maternal organs
D. Stimulates breast development

Rationale: (A) Estrogen stimulates uterine contractions, particularly in late pregnancy. (B) It enlarges maternal organs, including the uterus and breasts. (D) It plays a role in breast tissue development in preparation for lactation. (C) is incorrect because relaxin, not estrogen, relaxes pelvic ligaments. (E) is incorrect because glucose metabolism is primarily influenced by hPL.

Question 51

A pregnant client at 34 weeks reports pelvic pain and increased flexibility in her joints. The nurse explains that this is due to the hormone responsible for loosening pelvic ligaments in preparation for labor. Which hormone is responsible for these changes?

A. Estrogen
B. Progesterone
C. Relaxin
D. Human placental lactogen (hPL)

Answer 51

C. Relaxin

Rationale: Relaxin relaxes the pelvic ligaments and softens the cervix in preparation for childbirth.

Question 52

Which hormone is primarily responsible for breast development and preparation for lactation during pregnancy?

A. Progesterone
B. Human placental lactogen (hPL)
C. Relaxin
D. Estrogen

Answer 52

A. Progesterone

Rationale: Progesterone stimulates breast tissue development and maternal metabolism, preparing the body for lactation.

Question 53

Which statement made by a pregnant client requires further teaching regarding progesterone’s role in pregnancy?

A. “Progesterone helps maintain my pregnancy by keeping the uterine lining thick.”
B. “Progesterone causes my joints to become loose for childbirth.”
C. “Progesterone keeps my uterus relaxed and prevents contractions.”
D. “Progesterone helps my breasts develop in preparation for breastfeeding.”

Answer 53

B. “Progesterone causes my joints to become loose for childbirth.”

Rationale: Relaxin, not progesterone, is responsible for loosening joints and ligaments in preparation for childbirth.

Question 54

A nurse is caring for a pregnant client who is at 39 weeks gestation and is experiencing mild contractions. The client asks which hormone is responsible for initiating labor. The nurse should respond by explaining the role of:

A. Estrogen
B. Progesterone
C. Relaxin
D. Human placental lactogen (hPL)

Answer 54

A. Estrogen

Rationale: Estrogen stimulates uterine contractions, contributing to labor initiation.

Question 55

Which hormone is responsible for increasing available glucose for the fetus by decreasing maternal glucose utilization?

A. Progesterone
B. Estrogen
C. Relaxin
D. Human placental lactogen (hPL)

Answer 55

D. Human placental lactogen (hPL)

Rationale: hPL modulates maternal metabolism by decreasing glucose utilization in the mother, ensuring an increased glucose supply to the fetus.

Question 56

Which statements about relaxin are accurate? (SATA)

A. It decreases uterine contractility.
B. It enlarges maternal organs.
C. It relaxes the pelvic ligaments.
D. It softens the cervix in preparation for birth.
E. It decreases maternal insulin resistance.

Answer 56

A. It decreases uterine contractility.
C. It relaxes the pelvic ligaments.
D. It softens the cervix in preparation for birth.

Rationale: (A) Relaxin works with progesterone to maintain pregnancy by reducing uterine contractions. (C) It relaxes pelvic ligaments to prepare for birth. (D) It softens the cervix for labor. (B) is incorrect because estrogen is responsible for maternal organ enlargement. (E) is incorrect because hPL, not relaxin, affects maternal insulin resistance.

Question 57

A pregnant client is admitted with preterm labor at 30 weeks. The provider orders progesterone therapy. The nurse explains that this treatment is used because progesterone:

A. Stimulates uterine contractions to speed up labor.
B. Prevents uterine contractions and helps maintain pregnancy.
C. Increases maternal metabolism to enhance fetal growth.
D. Strengthens the cervix to prevent dilation.

Answer 57

B. Prevents uterine contractions and helps maintain pregnancy.

Rationale: Progesterone decreases uterine contractility, which helps prevent preterm labor.

Question 58

A nurse is teaching a prenatal class about hormonal changes in pregnancy. Which statement indicates a need for further teaching?

A. “Relaxin will help my pelvis loosen for labor.”
B. “hPL will help my baby get more glucose by making my body use less.”
C. “Progesterone will keep my uterus from contracting.”
D. “Estrogen is what maintains my pregnancy in the first trimester.”

Answer 58

D. “Estrogen is what maintains my pregnancy in the first trimester.”

Rationale: Progesterone, not estrogen, is the key hormone that maintains pregnancy in the first trimester. Estrogen plays a role in pregnancy but does not maintain it early on. The other statements are correct.

Question 59

After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests?

A) Human placental lactogen (hPL)

B) Estrogen (estriol)

C) Progesterone (progestin)

D) Human chorionic gonadotropin (hCG)

Answer 59

D) Human chorionic gonadotropin (hCG)

Question 60

After the nurse describes fetal circulation to a pregnant woman, the woman asks why her fetus has a different circulation pattern than hers. In planning a response, the nurse integrates understanding of which of the following?

A) Fetal blood is thicker than that of adults and needs different pathways.

B) Fetal circulation carries highly oxygenated blood to vital areas first.

C) Fetal blood has a higher oxygen saturation and circulates more slowly.

D) Fetal heart rates are rapid and circulation time is double that of adults.

Answer 60

B) Fetal circulation carries highly oxygenated blood to vital areas first.

Question 61

After teaching a class on the stages of fetal development, the instructor determines that the teaching was successful when the students identify which of the following as a stage? (Select all that apply.)

A) Placental
B) Preembryonic
C) Umbilical
D) Embryonic
E) Fetal

Answer 61

B) Preembryonic
C) Umbilical
E) Fetal

Question 62

A nurse is discussing fetal development with a pregnant woman. The woman is 12 weeks pregnant and asks, Whats happening with my baby? Which of the following would the nurse integrate into the response? (Select all that apply.)

A) Continued sexual differentiation

B) Eyebrows forming

C) Startle reflex present

D) Digestive system becoming active

E) Lanugo present on the head

Answer 62

A) Continued sexual differentiation
D) Digestive system becoming active

Question 63

After teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as essential for fetal lung development?

A) Umbilical cord

B) Amniotic fluid

C) Placenta

D) Trophoblasts

Answer 63

B) Amniotic fluid

Question 64

During a prenatal class for a group of new mothers, the nurse is describing the hormones produced by the placenta. Which of the following would the nurse include? (Select all that apply.)

A) Prolactin
B) Estriol
C) Relaxin
D) Progestin
E) Human chorionic somatomammotropin

Answer 64

B) Estriol
C) Relaxin
D) Progestin
E) Human chorionic somatomammotropin

Question 65

When describing the structures involved in fetal circulation, the nursing instructor describes which structure as the opening between the right and left atrium?

A) Ductus venosus

B) Foramen ovale

C) Ductus arteriosus

D) Umbilical artery

Answer 65

B) Foramen ovale