Maternity Nursing An Introductory Text 11th Edition By Gloria Leifer -Test Bank
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Leifer: Maternity Nursing: An Introductory Text, 11th Edition
Chapter 03: Fetal Development
Test Bank
MULTIPLE CHOICE
1. The
nucleus of each somatic (body) cell contains _____ chromosomes.
|
a. |
23 |
|
b. |
28 |
|
c. |
46 |
|
d. |
48 |
ANS: C
Each somatic cell contains 22 pairs of autosomes and two sex
chromosomes for a total of 46.
DIF: Cognitive Level:
Knowledge
REF: 30
OBJ: 2
TOP:
Genetics KEY: Nursing
Process Step:
N/A
MSC: NCLEX: N/A
2. Which
statement best describes the relationship between genes and chromosomes?
|
a. |
Chromosomes and genes are
completely independent of each other. |
|
b. |
Genes are involved in
meiosis only, and chromosomes are involved in mitosis only. |
|
c. |
Chromosomes are composed of
genes, which are DNA segments controlling heredity. |
|
d. |
Absence of a single gene is
unimportant; absence of a chromosome results in cell death. |
ANS: C
A gene can be described as a single bead and a chromosome as a
string of beads. Chromosomes are made up of chains of genes.
DIF: Cognitive Level:
Comprehension REF: 29-30 | Figure 3-1
OBJ:
3
TOP: Genetics
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
3. During
a prenatal visit, a patient asks what determines the sex of the baby. The
correct explanation is that:
|
a. |
The mother determines the
sex by the number of Y chromosomes she contributes. |
|
b. |
Females have X chromosomes
only, and males have Y chromosomes only, so there are equal chances of each
child being male or female. |
|
c. |
Two X chromosomes produce a
female child, whereas two Y chromosomes produce a male child. |
|
d. |
If the father contributes
an X chromosome, the baby will be a girl; if he contributes a Y chromosome,
the baby will be a boy. |
ANS: D
The ovum has two X chromosomes; the sperm has one X and one Y
chromosome. If the sperm contributes the X chromosome, the zygote will have two
X chromosomes and will be female. If the sperm contributes the Y chromosome,
the zygote will have one X and one Y chromosome and will be male.
DIF: Cognitive Level:
Application
REF:
31
OBJ: 4
TOP:
Genetics KEY: Nursing
Process Step: Implementation
MSC: NCLEX: N/A
4. Fertilization
normally occurs in the:
|
a. |
Abdominal cavity |
|
b. |
Fallopian tube |
|
c. |
Ovary |
|
d. |
Uterus |
ANS: B
Fertilization normally occurs in the outer one-third of a
fallopian tube.
DIF: Cognitive Level:
Knowledge
REF:
31
OBJ: 5
TOP: Fertilization KEY:
Nursing Process Step:
N/A
MSC: NCLEX: N/A
5. What
is the correct sequence in the development of the fertilized ovum?
|
a. |
Zygote, morula, blastocyst,
embryo, fetus |
|
b. |
Blastocyst, trophoblast,
morula, fetus, embryo |
|
c. |
Zygote, morula,
trophoblast, blastocyst, fetus |
|
d. |
Trophoblast, morula,
zygote, embryo, fetus |
ANS: A
The stages of development of the fertilized ovum are zygote,
morula, blastocyst, embryo, and fetus.
DIF: Cognitive Level:
Comprehension REF: 31-32 | Box 3-1
OBJ:
6
TOP: Implantation KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
6. From
the third week to the eighth week of gestation, the product of conception
(conceptus) is referred to as the:
|
a. |
Zygote |
|
b. |
Embryo |
|
c. |
Fetus |
|
d. |
Infant |
ANS: B
The embryonic period of development extends from the third to
the eighth week after conception. At fertilization, a zygote is formed from the
nucleus of the sperm and the nucleus of the ovum. The fetal period begins with
the ninth week after conception and extends until the infant is born at
delivery.
DIF: Cognitive Level: Knowledge
REF: 32 | Box 3-1 OBJ: 6
TOP: Implantation KEY: Nursing
Process Step:
N/A
MSC: NCLEX: N/A
7. The
functions of amniotic fluid include:
|
a. |
Restricting fetal movement |
|
b. |
Maintaining a constant
temperature for the fetus |
|
c. |
Preventing adherence of the
amnion to the chorion |
|
d. |
Exchanging materials
between the blood of the mother and the fetus |
ANS: B
The amniotic fluid maintains a constant temperature for the
fetus. It also permits fetal movement and prevents adherence of the amnion to
the fetus. Exchanges between the blood of the mother and the fetus occur
through the placenta.
DIF: Cognitive Level:
Knowledge
REF: 33 | Box 3-3 OBJ: 8
TOP: Fetal Membranes and Amniotic
Fluid
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
8. An
example of the endocrine function of the placenta is:
|
a. |
The production of human
chorionic gonadotropin (hCG) to stimulate uterine contractions |
|
b. |
Suppression of the corpus luteum
to prevent spontaneous abortion |
|
c. |
The production of human
placental lactogen (hPL) to suppress the mother’s metabolism |
|
d. |
Stimulation of the corpus
luteum to produce estrogen and progesterone |
ANS: D
The placenta produces hCG, which stimulates the corpus luteum to
secrete the continuous supply of estrogen and progesterone needed to maintain
pregnancy.
DIF: Cognitive Level:
Comprehension REF:
34-35
OBJ: 7
TOP:
Placenta KEY: Nursing
Process Step: N/A
MSC: NCLEX: N/A
9. Which
sequence of events accurately describes circulation in the umbilical cord?
|
a. |
Oxygenated blood flows from
the fetus to the placenta through the umbilical vein. |
|
b. |
Deoxygenated blood flows
from the fetus to the placenta through the umbilical arteries. |
|
c. |
Deoxygenated blood flows
from the placenta to the fetus through the umbilical artery. |
|
d. |
Oxygenated blood flows from
the placenta to the fetus through the umbilical artery. |
ANS: B
From the fetus, deoxygenated blood flows through the two
umbilical arteries to the placenta, where carbon dioxide and waste products are
passed into the maternal blood for elimination. Oxygenated blood passes from
the mother, through the placenta, into the umbilical vein, and to the fetus.
DIF: Cognitive Level:
Comprehension REF: 35-36 | Figure 3-6
OBJ:
9
TOP: Umbilical
Cord
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
10. Which
action accurately describes the shunts in fetal circulation?
|
a. |
The foramen ovale bypasses
the left ventricle. |
|
b. |
The ductus venosus bypasses
the liver. |
|
c. |
The umbilical artery
bypasses the stomach. |
|
d. |
The ductus arteriosus
bypasses the aorta. |
ANS: B
The ductus venosus bypasses the liver, the foramen ovale
bypasses the right ventricle, and the ductus arteriosus bypasses the lungs.
DIF: Cognitive Level:
Comprehension REF: 36 | Figure 3-7 | Table 3-1
OBJ:
9
TOP: Fetal Circulation
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. The
foramen ovale closes after birth because of:
|
a. |
Increased pressure in the
left atrium |
|
b. |
High oxygen content of the
blood |
|
c. |
Constriction of umbilical vessels |
|
d. |
Decreased pressure in the
right ventricle |
ANS: A
The increase in pulmonary blood flow after birth causes the
pressure in the left atrium to exceed that of the right atrium. This
functionally closes the foramen ovale. Permanent closure occurs as adhesions
develop.
DIF: Cognitive Level:
Comprehension REF: 36 | Table 3-2
OBJ:
9
TOP: Circulatory Changes After Birth
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
12. The
beginnings of all major organs are present in the fetus by the end of _____
weeks.
|
a. |
4 |
|
b. |
7 |
|
c. |
9 |
|
d. |
12 |
ANS: B
The beginnings of all major organs are present by the end of the
seventh week. Therefore, it is important that the mother avoid substances that
could disrupt organ development in early pregnancy.
DIF: Cognitive Level:
Knowledge
REF:
37
OBJ: 6
TOP: Fetal
Development
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
13. A
mother who had no prenatal care delivers in the emergency department. She did
not know her due date. The infant looks rather thin and has long nails,
abundant hair, little vernix caseosa, and dry skin. The nurse would estimate
the infant’s gestational age as _____ weeks.
|
a. |
Less than 34 |
|
b. |
Approximately 36 |
|
c. |
Approximately 40 |
|
d. |
More than 42 |
ANS: D
The characteristics described are typical of a postterm
(postmature) infant, that is, one born past 42 weeks’ gestation.
DIF: Cognitive Level:
Application
REF: 37
OBJ: 6
TOP: Fetal
Development
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiologic Integrity
14. Oxygen
content is highest in which of the following fetal structures?
|
a. |
Ductus venosus |
|
b. |
Foramen ovale |
|
c. |
Umbilical artery |
|
d. |
Umbilical vein |
ANS: D
Because oxygenated blood from the mother passes through the
placenta to the fetus through the umbilical vein, blood in the umbilical vein
has the highest oxygen content of the listed structures.
DIF: Cognitive Level:
Comprehension REF:
35
OBJ: 9
TOP: Fetal
Circulation
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
15. Twins
who originate from a single ovum and sperm are:
|
a. |
Identical or monozygotic |
|
b. |
Nonidentical or monozygotic |
|
c. |
Fraternal or dizygotic |
|
d. |
Fraternal or monozygotic |
ANS: A
Twins who originate from a single ovum and sperm share the same
genetic makeup and will be identical. The term monozygotic means “of one zygote,”
whereas dizygotic refers to two zygotes.
DIF: Cognitive Level:
Knowledge
REF: 37 | 40 | Figure 3-9
OBJ:
10
TOP: Multifetal
Pregnancy
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
16. A
woman who is 39 weeks’ pregnant has been diagnosed with oligohydramnios. The
nurse recognizes that following birth her newborn must be assessed for which
type of fetal abnormality?
|
a. |
Cardiac |
|
b. |
Gastrointestinal |
|
c. |
Renal |
|
d. |
Neurologic |
ANS: C
Although most amniotic fluid appears to be derived from maternal
blood, the fetus also adds to the fluid by excreting urine into it.
Oligohydramnios, or decreased amniotic fluid, is therefore associated with
renal anomalies.
DIF: Cognitive Level:
Analysis
REF:
33
OBJ: 8
TOP: Fetal Membranes and Amniotic Fluid
KEY: Nursing Process Step: Assessment MSC:
NCLEX: Health Promotion and Maintenance
17. A
pregnant woman at 30 weeks’ gestation tells the nurse that she dropped a pan
last week and her baby jumped at the noise. Which of the following responses by
the nurse is most accurate?
|
a. |
“Let me know if it happens
again, since we need to report that to your health care provider.” |
|
b. |
“Babies respond to sound
starting at about the twenty-fourth week of gestation.” |
|
c. |
“The fetus is demonstrating
the aural reflex.” |
|
d. |
“That movement was just a
coincidence; unborn babies can’t respond to sound like that.” |
ANS: B
By about the twenty-fourth week of gestation, a fetus is able to
hear and respond to sounds, including voices.
DIF: Cognitive Level:
Analysis
REF: 39 | Table 3-3
OBJ:
6
TOP: Fetal Development
KEY: Nursing Process Step:
Implementation
MSC: NCLEX: N/A
18. During
an ultrasound, a patient at 41 weeks’ gestation is found to have an amniotic
fluid level between 800 mL and 1000 mL. The nurse understands that this
indicates:
|
a. |
Hydramnios |
|
b. |
Oligohydramnios |
|
c. |
A normal amniotic fluid
level |
|
d. |
That the baby has a fetal
abnormality |
ANS: C
The amount of amniotic fluid present at term varies from 800 to
1000 mL. Levels less than 300 mL are known as oligohydramnios. Levels greater
than 2 L are known as hydramnios. Both hydramnios and oligohydramnios are
associated with fetal abnormalities.
DIF: Cognitive Level:
Application
REF:
33
OBJ: 8
TOP: Fetal Membranes and Amniotic
Fluid
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
19. During
a prenatal class, a participant asks when the most critical period of fetal
development occurs. Which of the following is the most appropriate response?
|
a. |
“The embryonic period, from
the second to eighth week after conception.” |
|
b. |
“Immediately following
implantation.” |
|
c. |
“During the zygotic phase
after fertilization.” |
|
d. |
“From twenty to thirty
weeks of gestation, when the organs are formed.” |
ANS: A
The embryonic period of development is when the basic organ
structures are formed. During this time, teratogenic agents have the most
damaging effects on the developing embryo.
DIF: Cognitive Level:
Application
REF:
37
OBJ: 6
TOP: Embryonic
Development
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
20. The
patient asks, “When will my baby be able to live outside my body?” The most
appropriate response is:
|
a. |
“You don’t need to worry.
Your baby will be fine.” |
|
b. |
“The age of fetal viability
is twenty weeks’ gestation.” |
|
c. |
“The best chance of
survival is at thirty weeks’ gestation.” |
|
d. |
“Doctors don’t know because
every pregnancy is different.” |
ANS: B
The age of fetal viability is 20 weeks’ gestation.
DIF: Cognitive Level: Application
REF:
37
OBJ: 6
TOP: Fetal
Development
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
21. What
must occur for a recessive trait to be expressed in a child?
|
a. |
Both parents must carry the
recessive trait. |
|
b. |
One parent must carry the
recessive trait. |
|
c. |
Neither parent can carry
the recessive trait. |
|
d. |
A sibling must carry the
recessive trait. |
ANS: A
Each parent must carry a recessive trait for there to be a
chance of the offspring to display the trait.
DIF: Cognitive Level:
Comprehension REF:
30
OBJ: 3
TOP:
Genes
KEY: Nursing Process Step:
N/A
MSC: NCLEX: N/A
22. Where
are estrogen and progesterone produced during pregnancy until the placenta
begins functioning as an exocrine gland?
|
a. |
Umbilical cord |
|
b. |
Corpus luteum |
|
c. |
Thymus gland |
|
d. |
Breast tissue |
ANS: B
The corpus luteum produces estrogen and progesterone until the
placenta is mature enough to act as an exocrine gland.
DIF: Cognitive Level:
Comprehension REF:
34
OBJ: 7
TOP: Placental
Hormones
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
MULTIPLE RESPONSE
23. The
pregnant patient is being monitored for low progesterone levels. She asks the
nurse why progesterone is important. Which response(s) by the nurse would be
appropriate? (Select all that apply.)
|
a. |
“It maintains the uterine
lining for implantation of the zygote.” |
|
b. |
“It reduces uterine
contractions to help prevent spontaneous abortions.” |
|
c. |
“It prepares the glands of
the breasts for lactation.” |
|
d. |
“It increases blood flow to
the uterine vessels.” |
|
e. |
“It stimulates the testes
of the male fetus to produce testosterone, which aids in the development of
the reproductive tract.” |
ANS: A, B, C, E
The hormone progesterone is important for the preparation and
maintenance of pregnancy.
DIF: Cognitive Level:
Application
REF:
34
OBJ: 7
TOP: Placental
Functions
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
24. The
patient asks the nurse why estrogen is important to pregnancy. Which
statement(s) by the nurse would be accurate? (Select all that apply.)
|
a. |
“Estrogen increases blood
flow to uterine vessels.” |
|
b. |
“Estrogen stimulates
uterine growth.” |
|
c. |
“Estrogen stimulates the
release of prostaglandins.” |
|
d. |
“Estrogen stimulates the
production of testosterone.” |
|
e. |
“Estrogen stimulates
development of the breast ducts to prepare for lactation.” |
ANS: A, B, E
The hormone estrogen is necessary for the preparation and
maintenance of pregnancy.
DIF: Cognitive Level:
Application
REF:
34-35
OBJ: 7
TOP: Placental
Functions
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
25. The
patient asks whether something she did could have contributed to her conceiving
twins. Which response(s) would be appropriate? (Select all that apply.)
|
a. |
“Fertility drugs have increased
the incidence in multifetal pregnancies.” |
|
b. |
“Women who are older have
an increased probability of having twins.” |
|
c. |
“Decreased maternal folate
levels have been shown to cause multifetal pregnancies.” |
|
d. |
“In vitro fertilization has
increased the incidence of multifetal pregnancies.” |
|
e. |
“Increased vitamin C levels
have been linked to multifetal pregnancies.” |
ANS: A, B, D
The use of fertility drugs and in vitro fertilization has
increased the incidence of multifetal pregnancies. Women who are older have an
increased probability of having multifetal pregnancies.
DIF: Cognitive Level:
Application
REF:
37
OBJ: 10
TOP: Multifetal
Pregnancy
KEY:
Nursing Process Step: N/A
MSC: NCLEX: N/A
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