Chapter 10 Conception and Fetal Development My Nursing Test Banks

Olds Maternal-Newborn Nursing and Womens Health, 10e (Davidson)

Chapter 10 Conception and Fetal Development

1) The nurse is explaining the difference between meiosis and mitosis. Which statements would be best?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Meiosis is the division of a cell into two exact copies of the original cell.

2. Mitosis is splitting one cell into two, each with half the chromosomes of the original cell.

3. Meiosis is a type of cell division by which gametes, or the sperm and ova, reproduce.

4. Mitosis occurs in only a few cells of the body.

5. Meiotic division leads to cells that halve the original genetic material.

Answer: 3, 5

Explanation: 3. Meiosis is a special type of cell division by which diploid cells give rise to gametes (sperm and ova).

5. Meiosis creates two cells that contain half the genetic material of the parent cell.

Page Ref: 170

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: IV. A. 1. Describe the strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | AACN Essentials Competencies: I. 1. Integrate theories and concepts from liberal education into nursing practice. | NLN Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and EBP. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 1 Differentiate between mitotic cellular division and meiotic cellular division.

MNL LO: 1.4.2 Describe the function and structure of chromosomes and genes.

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2) The nurse is preparing a class on reproduction. What is the cell division process that results in two identical cells, each with the same number of chromosomes as the original cell called?

1. Meiosis

2. Mitosis

3. Oogenesis

4. Gametogenesis

Answer: 2

Explanation: 2. Mitosis results in the production of diploid body (somatic) cells, which are exact copies of the original cell.

Page Ref: 170

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: IV. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | AACN Essentials Competencies: I. 1. Integrate theories and concepts from liberal education into nursing practice. | NLN Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and EBP. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 1 Differentiate between mitotic cellular division and meiotic cellular division.

MNL LO: 1.4.2 Describe the function and structure of chromosomes and genes.

3) The nurse educator is discussing human chromosomes with her students, and knows that the teaching has been effective when a student makes which statement?

1. All humans have 48 chromosomes and 2 sex chromosomes.

2. Human chromosomes are shaped like a Y.

3. Humans have 46 chromosomes, 2 of which are the sex chromosomes.

4. Only certain body cells contain the chromosomes.

Answer: 3

Explanation: 3. This is the correct answer. There are 22 pairs of similar cells and 2 sex chromosomes.

Page Ref: 170

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: III. A. 1. Knowledge: Demonstrate knowledge of basic scientific methods and processes. | AACN Essentials Competencies: I. 1. Integrate theories and concepts for liberal education into nursing practice. | NLN Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and EBP. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Differentiate between mitotic cellular division and meiotic cellular division.

MNL LO: 1.4.2 Describe the function and structure of chromosomes and genes.

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4) The nurse is teaching about reproduction, and explains that which of the following are the purposes of meiosis?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Produce gametes

2. Reduce the number of chromosomes

3. Introduce genetic variability

4. Produce cells for growth and development

5. Divide somatic cells into new cells with identical characteristics

Answer: 1, 2, 3

Explanation: 1. Meiosis is a special type of cell division by which diploid cells give rise to gametes (sperm and ova).

2. The cells contain half the genetic material of the parent cellonly 23 chromosomesthe haploid number of chromosomes.

3. During meiosis new combinations of cells are provided by the newly formed chromosomes; these combinations account for the wide variation of traits.

Page Ref: 170

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: IV. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | AACN Essentials Competencies: I. 1. Integrate theories and concepts of liberal education into nursing practice. | NLN Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and EBP. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1 Differentiate between mitotic cellular division and meiotic cellular division.

MNL LO: 1.4.2 Describe the function and structure of chromosomes and genes.

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5) The nurse has completed a presentation on reproduction. Which statement indicates that the teaching has been successful?

1. A male is born with all the sperm he will ever produce.

2. Females create new ova throughout their reproductive life.

3. Ova separate into two unequally sized cells.

4. Each primary spermatocyte divides into four haploid cells.

Answer: 3

Explanation: 3. The first meiotic division produces two cells of unequal size with different amounts of cytoplasm but with the same number of chromosomes.

Page Ref: 171

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2 Compare the processes by which ova and sperm are produced.

MNL LO: 1.4.2 Describe the function and structure of chromosomes and genes.

6) During a class on genetics for pregnant families, the nurse is discussing the how the egg and sperm are formed before fertilization takes place. The nurse explains that these cells have only half the number of chromosomes, so when fertilization takes place, there will be the correct number. What is the process by which the egg and sperm are formed called?

1. Oogenesis

2. Gametogenesis

3. Meiosis

4. Spermatogenesis

Answer: 2

Explanation: 2. Gametogenesis is the process by which ovum and sperm are produced.

Page Ref: 171

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Teaching and Learning

Learning Outcome: 2 Compare the processes by which ova and sperm are produced.

MNL LO: 1.4.2 Describe the function and structure of chromosomes and genes.

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7) After explaining how meiotic division occurs within the ovum, the nurse knows that the pregnant client understands when she makes what statement?

1. The second meiotic division is arrested until and unless the oocyte is fertilized.

2. Meiosis in the oocyte begins at puberty.

3. The first meiotic division continues when the female infant is born.

4. Fertilization does not take place in the secondary oocyte.

Answer: 1

Explanation: 1. This is true. The secondary oocyte moves into the metaphase stage of cell division, where its meiotic division is arrested until and unless the oocyte is fertilized.

Page Ref: 171

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Teaching and Learning

Learning Outcome: 2 Compare the processes by which ova and sperm are produced.

MNL LO: 1.4.2 Describe the function and structure of chromosomes and genes.

8) The nurse is teaching the students in their obstetric rotation about fertilization. What processes must the sperm undergo before fertilization can occur?

1. Capacitation and ovulation

2. Capacitation and the acrosomal reaction

3. Oogenesis and the acrosomal reaction

4. Gametogenesis and capacitation

Answer: 2

Explanation: 2. The sperm must undergo two processes before fertilization can occur: capacitation and the acrosomal reaction.

Page Ref: 173

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

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9) In evaluating information taught about conception and fetal development, the client verbalizes understanding about transportation time of the zygote through the fallopian tube and into the cavity of the uterus with which statement?

1. It will take at least 3 days for the egg to reach the uterus.

2. It will take 8 days for the egg to reach the uterus.

3. It will only take 12 hours for the egg to go through the fallopian tube.

4. It will take 18 hours for the fertilized egg to implant in the uterus.

Answer: 1

Explanation: 1. It will take at least 3 days for the egg to reach the uterus is the correct statement.

Page Ref: 173

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

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10) The nurse explains to a preconception class that if only a small volume of sperm is discharged into the vagina, an insufficient quantity of enzymes might be released when they encounter the ovum. In that case, pregnancy would probably not result, because of which of the following?

1. Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus.

2. The block to polyspermy (cortical reaction) would not occur.

3. The fertilized ovum would be unable to implant in the uterus.

4. Sperm would be unable to penetrate the zona pellucida of the ovum.

Answer: 4

Explanation: 4. About a thousand acrosomes must rupture to clear enough hyaluronic acid for even a single sperm to penetrate the ovums zona pellucida successfully. If only a small amount of sperm were released, there most likely would be an insufficient quantity of acrosomes to penetrate the zona pellucida of the ovum and allow fertilization.

Page Ref: 173

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

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11) The nurse is creating a handout on reproduction for teen clients. Which piece of information should the nurse include in this handout?

1. The fertilized ovum is called a gamete.

2. Prior to fertilization, the sperm are zygotes.

3. Ova survive 12-24 hours in the fallopian tube if not fertilized.

4. Sperm survive in the female reproductive tract up to a week.

Answer: 3

Explanation: 3. Ova are considered fertile for about 12 to 24 hours after ovulation.

Page Ref: 172

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

12) A pregnant woman tells the nurse-midwife, Ive heard that if I eat certain foods during my pregnancy, the baby will be a boy. The nurse-midwifes response should explain that this is a myth, and that the sex of the baby is determined at what time?

1. At the time of ejaculation

2. At fertilization

3. At the time of implantation

4. At the time of differentiation

Answer: 2

Explanation: 2. Fertilization is the point at which the sex of the zygote is determined.

Page Ref: 173

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

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13) The true moment of fertilization occurs when what happens?

1. Cortical reaction occurs

2. Nuclei unite

3. Spermatozoa propel themselves up the female tract

4. Sperm surrounding the ovum release their enzymes

Answer: 2

Explanation: 2. The true moment of fertilization occurs as the nuclei unite. Their individual nuclear membranes disappear, and their chromosomes pair up to produce the diploid zygote.

Page Ref: 173

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: IV. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | AACN Essentials Competencies: I. 1. Integrate theories and concepts from liberal education into nursing practice. | NLN Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and EBP. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

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14) The nurse is teaching a group of adolescents that sperm must undergo the process of capacitation in order to fertilize the ova. The characteristics of sperm that have undergone capacitation include which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Ability to undergo an acrosomal reaction

2. Ability to block polyspermy

3. Ability to bind to the zona pellucida

4. Ability to release norepinephrine

5. Acquisition of hypermotility

Answer: 1, 3, 5

Explanation: 1. Sperm that undergo capacitation take on the ability to undergo the acrosomal reaction.

3. Sperm that undergo capacitation take on the ability to bind to the zona pellucida.

5. Sperm that undergo capacitation have the acquisition of hypermotility.

Page Ref: 173

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

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15) Student nurses in their obstetrical rotation are learning about fertilization and implantation. The process of implantation is characterized by which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The trophoblast attaches itself to the surface of the endometrium.

2. The most frequent site of attachment is the lower part of the anterior uterine wall.

3. Between days 7 and 10 after fertilization, the zona pellucida disappears, and the blastocyst implants itself by burrowing into the uterine lining.

4. The lining of the uterus thins below the implanted blastocyst.

5. The cells of the trophoblast grow down into the uterine lining, forming the chorionic villi.

Answer: 1, 3, 5

Explanation: 1. During implantation, the trophoblast attaches itself to the surface of the endometrium for further nourishment.

3. Between days 7 and 10 after fertilization, the zona pellucida disappears, and the blastocyst implants itself by burrowing into the uterine lining and penetrating down toward the maternal capillaries until it is completely covered.

5. The cells of the trophoblast grow down into the thickened lining, forming the chorionic villi.

Page Ref: 174

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: IV. A. 1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice. | AACN Essentials Competencies: I. 1. Integrate theories and concepts from liberal education into nursing practice. | NLN Competencies: Knowledge and Science: How (a) sciences, (b) the evidence on which practice is based, and (c) informatics are developed, and by whom; the relationships between research and science building, and between research and EBP. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3 Analyze the components of the process of fertilization as to how each may impact fertilization.

MNL LO: 1.4.1 Analyze the components of the fertilization process.

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16) The nurse is creating a poster for pregnant mothers. Which description of fetal development should the nurse include?

1. Four primary germ layers form from the blastocyst.

2. After fertilization, the cells only become larger for several weeks.

3. Most organs are formed by 8 weeks after fertilization.

4. The embryonic stage is from fertilization until 5 months.

Answer: 3

Explanation: 3. Most organs are formed during the embryonic stage, which lasts from the 15th day after fertilization until the end of the 8th week after conception.

Page Ref: 186

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks gestation.

MNL LO: 1.5.1 Compare the different stages and factors influencing embryonic and fetal organ system development.

17) The nurse working with a client describes cellular multiplication and how the zygote moves through the fallopian tube, a movement that takes place via what process?

1. A squeezing motion

2. Pushing from another ovum that has not been fertilized

3. Hormone action

4. A very weak fluid current in the fallopian tube resulting from the beating action of ciliated epithelium

Answer: 4

Explanation: 4. This is correct. There is a very weak fluid current in the fallopian tube resulting from the beating action of the ciliated epithelium that lines the tube.

Page Ref: 173

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Teaching and Learning

Learning Outcome: 4 Summarize the processes that occur during the cellular multiplication and differentiation stages of intrauterine development and their effects on the structures that form.

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MNL LO: 1.4.1 Analyze the components of the fertilization process.

18) A client tells you that her mother was a twin, two of her sisters have twins, and several cousins either are twins or gave birth to twins. The client, too, is expecting twins. Because there is a genetic predisposition to twins in her family, there is a good chance that the client will have what type of twins?

1. Dizygotic twins

2. Monozygotic twins

3. Identical twins

4. Nonzygotic twins

Answer: 1

Explanation: 1. Studies indicate that dizygotic twins tend to occur in certain families, perhaps because of genetic factors that result in elevated serum gonadotropin levels leading to double ovulation.

Page Ref: 179

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: IX. 2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | NLN Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL LO: 1.4.3 Contrast the various genetic inheritance patterns.

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19) The nurse is caring for a client pregnant with twins. Which statement indicates that the client needs additional information?

1. Because both of my twins are boys, I know that they are identical.

2. If my twins came from one fertilized egg that split, they are identical.

3. If I have one boy and one girl, I will know they came from two eggs.

4. It is rare for both twins to be within the same amniotic sac.

Answer: 1

Explanation: 1. Not all same-sex twins are identical or monozygotic, because fraternal, or dizygotic, twins can be the same gender or different genders.

Page Ref: 178, 179

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | NLN Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL LO: 1.4.3 Contrast the various genetic inheritance patterns.

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20) Which statement by a pregnant client to the nurse would indicate that the client understood the nurses teaching?

1. Because of their birth relationship, fraternal twins are more similar to each other than if they had been born singly.

2. Identical twins can be the same or different sex.

3. Congenital abnormalities are more prevalent in identical twins.

4. Identical twins occur more frequently than fraternal twins.

Answer: 3

Explanation: 3. Monozygotic twinning is considered a random event and occurs in approximately 3 to 4 per 1000 live births. Congenital anomalies are more prevalent and both twins may have the same malformation.

Page Ref: 179

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL LO: 1.4.3 Contrast the various genetic inheritance patterns.

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21) A woman pregnant with twins asks the nurse about differences between identical and fraternal twins. The nurse explains that since it has been determined that she is having a boy and a girl, they are fraternal, and will have with of the following?

1. One placenta, two amnions, and two chorions

2. Two placentas, two amnions, and two chorions

3. Two placentas, one amnion, and two chorions

4. Two placentas, two amnions, one chorion

Answer: 2

Explanation: 2. This is the correct answer. Fraternal twins have two placentas, two amnions, and two chorions, however, the placentas sometimes fuse and look as if they are one.

Page Ref: 178

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL LO: 1.4.3 Contrast the various genetic inheritance patterns.

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22) The nurse educator is teaching student nurses what a fetus will look like at various weeks of development. Which descriptions would be typical of a fetus at 20 weeks gestation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The fetus has a body weight of 435-465 g.

2. Nipples appear over the mammary glands.

3. The kidneys begin to produce urine.

4. Nails are present on fingers and toes.

5. Lanugo covers the entire body.

Answer: 1, 2, 4, 5

Explanation: 1. A fetus at 20 weeks gestation has a body weight of 435-465 g.

2. A fetus at 20 weeks gestation has nipples appear over the mammary glands.

4. A fetus at 20 weeks gestation nails are present on fingers and toes.

5. A fetus at 20 weeks gestation has lanugo that covers the entire body.

Page Ref: 188, 189

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks gestation.

MNL LO: 1.5.1 Compare the different stages and factors influencing embryonic and fetal organ system development.

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23) The nurse is working with a client who has experienced a fetal death in utero at 20 weeks. The client asks what her baby will look like when it is delivered. Which statement by the nurse is best?

1. Your baby will be covered in fine hair called lanugo.

2. Your child will have arm and leg buds, not fully formed limbs.

3. A white, cheesy substance called vernix caseosa will be on the skin.

4. The genitals of the baby will be ambiguous.

Answer: 1

Explanation: 1. Downy fine hair called lanugo covers the body of a 20-week fetus.

Page Ref: 188, 189

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks gestation.

MNL LO: 1.5.1 Compare the different stages and factors influencing embryonic and fetal organ system development.

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24) The nurse is presenting a class to pregnant clients. The nurse asks, The fetal brain is developing rapidly, and the nervous system is complete enough to provide some regulation of body function on its own, at which fetal development stage? It is clear that education has been effective when a participant makes which response?

1. The 17th-20th week

2. The 25th-28th week

3. The 29th-32nd week

4. The 33rd-36th week

Answer: 2

Explanation: 2. Between the 25th and 28th week, the brain is developing rapidly, and the nervous system is complete enough to provide some degree of regulation of body functions.

Page Ref: 189

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks gestation.

MNL LO: 1.5.1 Compare the different stages and factors influencing embryonic and fetal organ system development.

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25) The pregnant client who is at 14 weeks gestation asks the nurse why the doctor used to call her baby an embryo, and now calls it a fetus. What is the best answer to this question?

1. A fetus is the term used from the ninth week of gestation and onward.

2. We call a baby a fetus when it is larger than an embryo.

3. An embryo is a baby from conception until the eighth week.

4. The official term for a baby in utero is really zygote.

Answer: 1

Explanation: 1. The fetal stage begins in the ninth week.

Page Ref: 188

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks gestation.

MNL LO: 1.5.1 Compare the different stages and factors influencing embryonic and fetal organ system development.

26) At her first prenatal visit, a woman is discussing fetal development with the nurse. The client asks, When will my baby actually have a heartbeat? The nurse should say the heartbeat of an embryo is distinguishable by what time?

1. The fourth week

2. The sixth week

3. The eighth week

4. The twelfth week

Answer: 1

Explanation: 1. By the end of the fourth week, embryonic blood is circulating between the embryo and the chorionic villi.

Page Ref: 184, 186

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks gestation.

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MNL LO: 1.5.1 Compare the different stages and factors influencing embryonic and fetal organ system development.

27) A pregnant client at 28 weeks gestation asks the nurse what her baby is like at this stage of pregnancy. How would the nurse describe the fetus?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. The fetus is developing subcutaneous fat.

2. The fetus is now opening and closing her eyes.

3. The baby could now breathe on her own, if she were born.

4. The fetus has fingernails and toenails.

5. The fetus is forming surfactant needed for lung function.

Answer: 2, 3, 5

Explanation: 2. At 28 weeks, the eyes begin to open and close.

3. At 28 weeks, the delivered baby can breathe.

5. At 28 weeks, the fetus has the surfactant formed needed for breathing.

Page Ref: 185, 189

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7 Summarize the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 32, 36, and 40 weeks gestation.

MNL LO: 1.5.1 Compare the different stages and factors influencing embryonic and fetal organ system development.

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Copyright 2016 Pearson Education, Inc.

28) The nurse is holding a class for newly pregnant couples, and discussing good and bad influences on their developing babies. Prenatal influences on the intrauterine environment include which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The use of saunas or hot tubs

2. The use of drugs

3. The quality of the sperm or ovum

4. Maternal nutrition

5. Vitamins and folic acid

Answer: 1, 2, 4, 5

Explanation: 1. The use of saunas or hot tubs is associated with maternal hyperthermia. Studies of the effects of maternal hyperthermia during the first trimester have raised concern about possible spontaneous abortion, central nervous system (CNS) defects, and failure of neural tube closure.

2. The use of drugs can have teratogenic effects.

4. Maternal nutrition affects brain and neural tube development.

5. Vitamins and folic acid supplements taken before conception can reduce the incidence of neural tube defects.

Page Ref: 190, 191

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 8 Identify the factors that influence congenital malformations of the organ systems and the resulting congenital malformations.

MNL LO: 1.5.4 Compare options for client education of factors affecting embryonic and fetal development.

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29) The client at 20 weeks gestation thinks she might have been exposed to a toxin at work that could affect fetal development. The client asks the nurse what organs might be affected at this point in pregnancy. What is the nurses best response?

1. The brain is developing now, and could be affected.

2. Because you are in the second trimester, there is no danger.

3. The internal organs like the heart and lungs could be impacted.

4. Its best to not worry about possible problems with your baby.

Answer: 1

Explanation: 1. Maximum brain growth and myelination are occurring at this point in fetal development.

Page Ref: 190

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing processes. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8 Identify the factors that influence congenital malformations of the organ systems and the resulting congenital malformations.

MNL LO: 1.5.4 Compare options for client education of factors affecting embryonic and fetal development.

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30) The nurse educator is presenting a program to college students about factors that can cause congenital malformations. What should the nurse tell them?

1. The growing embryo is considered most vulnerable to hazardous agents during the first months of pregnancy.

2. Spontaneous abortion always occurs if the fetus is affected by a teratogen.

3. Potential teratogens can cause malformations of the heart, limbs, eyes, and other organ systems only in the second trimester.

4. Teratogen agents are primarily drugs.

Answer: 1

Explanation: 1. This is true. Because organs are formed primarily during embryonic development, the growing embryo is considered most vulnerable to hazardous agents during the first months of pregnancy.

Page Ref: 190

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: V. B. 2. Demonstrate effectively use of strategies to reduce harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Teaching and Learning

Learning Outcome: 8 Identify the factors that influence congenital malformations of the organ systems and the resulting congenital malformations.

MNL LO: 1.5.4 Compare options for client education of factors affecting embryonic and fetal development.

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Copyright 2016 Pearson Education, Inc.

31) The nurse is teaching the significance of good nutrition on fetal development to a group of young women. What factors will the nurse discuss?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Vitamins and folic acid are important before conception.

2. Maternal nutrition may predispose to the development of adult coronary heart disease, hypertension, and diabetes.

3. Glucose, amino acids, and fatty acids are of high importance.

4. Nutrition is important only during the first trimester.

5. Maternal nutrition can affect brain and neural tube development.

Answer: 1, 2, 3, 5

Explanation: 1. Vitamins and folic acid supplements taken before conception can reduce the incidence of neural tube defects.

2. This is true. Maternal nutrition may predispose to the development of adult coronary heart disease, hypertension, and diabetes.

3. Amino acids, glucose, and fatty acids are considered to be the primary dietary factors in brain growth.

5. Adequacy of the maternal environment is also important during the periods of rapid embryonic and fetal development. Maternal nutrition can affect brain and neural tube development.

Page Ref: 190, 191

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Lifestyle Choices

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8 Identify the factors that influence congenital malformations of the organ systems and the resulting congenital malformations.

MNL LO: 1.5.4 Compare options for client education of factors affecting embryonic and fetal development.

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Copyright 2016 Pearson Education, Inc.

32) During a prenatal examination, an adolescent client asks, How does my baby get air? What correct information would the nurse give?

1. The lungs of the fetus carry out respiratory gas exchange in utero similar to what an adult experiences.

2. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the excretion of carbon dioxide into your bloodstream.

3. The blood from the placenta is carried through the umbilical artery, which penetrates the abdominal wall of the fetus.

4. The fetus is able to obtain sufficient oxygen due to the fact that your hemoglobin concentration is 50% greater during pregnancy.

Answer: 2

Explanation: 2. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the excretion of carbon dioxide into the maternal bloodstream.

Page Ref: 182

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6 Describe the development, structure, and functions of the placenta and umbilical cord during intrauterine life (embryonic and fetal development).

MNL LO: 1.5.2 Describe the development and functions of the placenta and amniotic fluid.

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33) The client has read that the placenta produces hormones that are vital to the function of the fetus. It is evident that that the client understands the function of the placenta when she states that which hormone is primarily responsible for the maintenance of pregnancy past the 11th week?

1. Human chorionic gonadotropin (hCG)

2. Human placental lactogen (hPL)

3. Estrogen

4. Progesterone

Answer: 4

Explanation: 4. Progesterone is a hormone essential for pregnancy. After the 11th week, the placenta produces enough progesterone and estrogen to maintain pregnancy.

Page Ref: 182

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, cultural, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6 Describe the development, structure, and functions of the placenta and umbilical cord during intrauterine life (embryonic and fetal development).

MNL LO: 1.5.2 Describe the development and functions of the placenta and amniotic fluid.

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34) The nurse teaching the expectant parents about the placenta also talks about the circulation and how the fetus gets its oxygen. She will include in this teaching which important fact?

1. The placenta functions as the lungs for the fetus.

2. The fetus obtains its oxygen from the amniotic fluid.

3. The fetus receives its oxygen by osmosis from the mothers bloodstream.

4. Fetal circulation delivers the highest amount of oxygen to the abdomen and lower body of the fetus.

Answer: 1

Explanation: 1. Most of the blood supply bypasses the fetal lungs because they do not carry out respiratory gas exchange. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the fetus to excrete carbon dioxide into the maternal bloodstream.

Page Ref: 182

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Teaching and Learning

Learning Outcome: 6 Describe the development, structure, and functions of the placenta and umbilical cord during intrauterine life (embryonic and fetal development).

MNL LO: 1.5.2 Describe the development and functions of the placenta and amniotic fluid.

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35) The OB-GYN nurse teaches a first-time pregnant client that functions of the amniotic fluid include which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Allowing fetal freedom of movement

2. Releasing heat to control fetal temperature

3. Acting as an extension of fetal extracellular space

4. Providing a water source for the fetus to swallow

5. Acting as a wedge during labor

Answer: 1, 3, 5

Explanation: 1. Amniotic fluid permits fetal freedom of movement.

3. A primary function of amniotic fluid is to act as an extension of fetal extracellular space.

5. A primary function of amniotic fluid is to act as a wedge during labor.

Page Ref: 175

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4 Summarize the processes that occur during the cellular multiplication and differentiation stages of intrauterine development and their effects on the structures that form.

MNL LO: 1.5.2 Describe the development and functions of the placenta and amniotic fluid.

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