Chapter 12: Conception and Prenatal Development My Nursing Test Banks

Chapter 12: Conception and Prenatal Development

Test Bank

MULTIPLE CHOICE

1. Which part of the mature sperm contains the male chromosomes?

a.

The head of the sperm

b.

The middle portion of the sperm

c.

X-bearing sperm

d.

The tail of the sperm

ANS: A

Feedback

A

The head of the sperm contains the male chromosomes that will join the chromosomes of the ovum.

B

The middle portion of the sperm supplies energy for the tails whip-like action.

C

If an X-bearing sperm fertilizes the ovum, the baby will be female.

D

The tail of the sperm helps propel the sperm toward the ovum.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 215

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

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

a.

Two arteries and one vein

b.

Two arteries and two veins

c.

Two veins and one artery

d.

One artery and one vein

ANS: A

Feedback

A

The umbilical cord contains two arteries and one vein to transport blood between the fetus and the placenta.

B

This option is abnormal and may indicate other anomalies.

C

Any option other than two arteries and one vein is considered abnormal and requires further assessment.

D

The presence of one umbilical artery is considered an abnormal finding. This infant would require further assessment for other anomalies.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 229

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. The purpose of the ovums zona pellucida is to

a.

Make a pathway for more than one sperm to reach the ovum.

b.

Allow the 46 chromosomes from each gamete to merge.

c.

Prevent multiple sperm from fertilizing the ovum.

d.

Stimulate the ovum to begin mitotic cell division.

ANS: C

Feedback

A

Once one sperm has entered the ovum, the zona pellucida changes to prevent other sperm from entering.

B

Each gamete (sperm and ovum) has only 23 chromosomes. There will be 46 chromosomes when they merge.

C

Fertilization causes the zona pellucida to change its chemical composition so that multiple sperm cannot fertilize the ovum.

D

Mitotic cell division begins when the nuclei of the sperm and ovum unite.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 216

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

4. While teaching an early pregnancy class, the nurse explains that the morula is a

a.

Fertilized ovum before mitosis begins

b.

Flattened disc-shaped layer of cells within a fluid-filled sphere

c.

Double layer of cells that becomes the placenta

d.

Solid ball composed of the first cells formed after fertilization

ANS: D

Feedback

A

The fertilized ovum is called the zygote.

B

This is the embryonic disc. It will develop into the baby.

C

The placenta is formed from two layers of cells: the trophoblast, which is the other portion of the fertilized ovum, and the deciduas, which is the portion of the uterus where implantation occurs.

D

The morula is so named because it resembles a mulberry. It is a solid ball of 12 to 16 cells that develops after fertilization.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 217

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

5. The upper uterus is the best place for the fertilized ovum to implant because it is here that the

a.

Placenta attaches most firmly

b.

Developing baby is best nourished

c.

Uterine endometrium is softer

d.

Maternal blood flow is lower

ANS: B

Feedback

A

If the placenta attaches too deeply, it does not easily detach after birth.

B

The uterine fundus is richly supplied with blood and has the thickest endometrium, both of which promote optimal nourishment of the fetus.

C

Softness is not a concern with implantation; attachment and nourishment are the major concerns.

D

The blood supply is rich in the fundus, which allows for optimal nourishment of the fetus.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 217

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

6. Some of the embryos intestines remain within the umbilical cord during the embryonic period because the

a.

Umbilical cord is much larger at this time than it will be at the end of pregnancy.

b.

Intestines begin their development within the umbilical cord.

c.

Nutrient content of the blood is higher in this location.

d.

Abdomen is too small to contain all the organs while they are developing.

ANS: D

Feedback

A

The intestines remain within the umbilical cord only until approximately week 10.

B

Intestines begin their development within the umbilical cord, but only because the liver and kidneys occupy most of the abdominal cavity. All the intestines are within the abdominal cavity around week 10.

C

Blood supply is adequate in all areas. Intestines stay in the umbilical cord for approximately 10 weeks because they are growing faster than the abdomen.

D

The abdominal contents grow more rapidly than the abdominal cavity, so part of their development takes place in the umbilical cord. By 10 weeks, the abdomen is large enough to contain them.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 223

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

7. A woman is 16 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is

a.

You should have felt the baby move by now.

b.

Within the next month, you should start to feel fluttering sensations.

c.

The baby is moving, but you cant feel it yet.

d.

Some babies are quiet, and you dont feel them move.

ANS: B

Feedback

A

Because this is her first pregnancy, movement is felt toward the later part of the 17 to 20 weeks. This statement may be alarming to the woman.

B

Maternal perception of fetal movement usually begins 17 to 20 weeks after conception.

C

This is a true statement. The fetuss movements are not strong enough to be felt until 17 to 20 weeks; however, this statement does not answer the concern of the woman.

D

Fetal movement should be felt by 17 to 20 weeks. If movement is not felt by the end of that time, further assessment will be necessary.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 223

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

8. During a centering pregnancy group meeting, the nurse teaches patients that the fetal period is best described as one of

a.

Development of basic organ systems

b.

Resistance of organs to damage from external agents

c.

Maturation of organ systems

d.

Development of placental oxygencarbon dioxide exchange

ANS: C

Feedback

A

Basic organ systems are developed during the embryonic period.

B

The organs are always at risk for damage from external sources; however, the older the fetus, the more resistant the organs will be. The greatest risk is when the organs are developing.

C

During the fetal period, the body systems grow in size and mature in function to allow independent existence after birth.

D

The placental system is complete by week 12, but that is not the best description of the fetal period.

PTS: 1 DIF: Cognitive Level: Knowledge REF: pp. 223-225

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

9. A new mother asks the nurse about the white substance covering her infant. The nurse explains that the purpose of vernix caseosa is to

a.

Protect the fetal skin from amniotic fluid.

b.

Promote normal peripheral nervous system development.

c.

Allow transport of oxygen and nutrients across the amnion.

d.

Regulate fetal temperature.

ANS: A

Feedback

A

Prolonged exposure to amniotic fluid during the fetal period could result in breakdown of the skin without the protection of the vernix caseosa.

B

Normal peripheral nervous system development is dependent on nutritional intake of the mother.

C

The amnion is the inner membrane that surrounds the fetus. It is not involved in the oxygen and nutrient exchange.

D

The amniotic fluid aids in maintaining fetal temperature.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 223

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

10. A woman who is 16 weeks pregnant asks the nurse, Is it possible to tell by ultrasound if the baby is a boy or girl yet? The best answer is

a.

A babys sex is determined as soon as conception occurs.

b.

The baby has developed enough that we can determine the sex by examining the genitals through ultrasound.

c.

Boys and girls look alike until approximately 20 weeks after conception, and then they begin to look different.

d.

It might be possible to determine your babys sex, but the external organs look very similar right now.

ANS: B

Feedback

A

This is a true statement, but the external genitalia are similar in appearance until approximately the 12th week.

B

Although gender is determined at conception, the external genitalia of males and females look similar through the 9th week. By the 12th week, the external genitalia are distinguishable as male or female.

C

The external genitalia are similar in appearance until approximately 12 weeks, not 20 weeks.

D

The external genitalia are different at approximately week 12.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 223

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

11. The placenta allows exchange of oxygen, nutrients, and waste products between the mother and fetus by

a.

Contact between maternal blood and fetal capillaries within the chorionic villi

b.

Interaction of maternal and fetal pH levels within the endometrial vessels

c.

A mixture of maternal and fetal blood within the intervillous spaces

d.

Passive diffusion of maternal carbon dioxide and oxygen into the fetal capillaries

ANS: A

Feedback

A

Fetal capillaries within the chorionic villi are bathed with oxygen- and nutrient-rich maternal blood within the intervillous spaces.

B

The endometrial vessels are part of the uterus. There is no interaction with the fetal blood at this point.

C

Maternal and fetal blood do not normally mix.

D

Maternal carbon dioxide does not enter into the fetal circulation.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 225

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

12. A patient is sent from the physicians office for assessment because of too little amniotic fluid. The nurse is aware that oligohydramnios can result in

a.

Excessive fetal urine secretion

b.

Newborn respiratory distress

c.

Central nervous system abnormality

d.

Gastrointestinal blockage

ANS: B

Feedback

A

Oligohydramnios may be caused by a decreased in urine secretion.

B

Because an abnormally small amount of amniotic fluid restricts normal lung development, the infant may have inadequate respiratory function after birth, when the placenta no longer performs respiratory function.

C

Excessive amniotic fluid production may occur when the fetus has a central nervous system abnormality.

D

Excessive amniotic fluid production may occur when the gastrointestinal tract prevents normal ingestion of amniotic fluid.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 229

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

13. When explaining twin conception, the nurse points out that dizygotic twins develop from

a.

A single fertilized ovum and are always of the same sex

b.

A single fertilized ovum and may be the same sex or different sexes

c.

Two fertilized ova and are the same sex

d.

Two fertilized ova and may be the same sex or different sexes

ANS: D

Feedback

A

A single fertilized ovum that produces twins is called monozygotic.

B

Monozygotic twins are always the same sex.

C

Dizygotic twins are from two fertilized ova and may or may not be the same sex.

D

Dizygotic twins are two different zygotes, each conceived from a single ovum and a single sperm. They may be both male, both female, or one male and one female.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 232

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

14. Oogenesis, the process of egg formation, begins during fetal life in the female. Which statement related to ovum formation is correct?

a.

Two million primary oocytes will mature.

b.

At birth, all ova are contained in the females ovaries.

c.

The oocytes complete their division during fetal life.

d.

Monthly, at least two oocytes mature.

ANS: B

Feedback

A

Only 400 to 500 ova will mature during the approximately 35 years of a womans reproductive life.

B

All of the cells that may undergo meiosis in a womans lifetime are contained in the ovaries at birth.

C

The primary oocytes begin their first meiotic division during fetal life but remain suspended until puberty.

D

Every month, one primary oocyte matures and completes meiotic division yielding two unequal cells.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 213

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

15. Between 6 and 10 days after conception, the trophoblast secretes enzymes that enable it to burrow into the endometrium until the entire blastocyst is covered. This is termed implantation. Tiny projections then develop out of the trophoblast and extend into the endometrium. These projections are referred to as

a.

Decidua basalis

b.

Decidua capsularis

c.

Decidua vera

d.

Chorionic villi

ANS: D

Feedback

A

The deciduas basalis is the portion of the endometrium where the chorionic villi tap into the maternal blood vessels.

B

The deciduas capsularis is the portion of the endometrium that covers the blastocyst.

C

The portion of the endometrium that lines the rest of the uterus is called deciduas vera.

D

These villi are vascular processes that obtain oxygen and nutrients from the maternal bloodstream and dispose of carbon dioxide and waste products into the maternal blood.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 218

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

16. At approximately _____ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and weighs approximately 1110 g.

a.

20

b.

24

c.

28

d.

30

ANS: C

Feedback

A

These milestones would not be completed by 20 weeks of gestation.

B

These milestones in human development will not be completed at 24 weeks of gestation.

C

These are all milestones that occur at 28 weeks.

D

These specific milestones will be reached as early as 28 weeks, not 30 weeks of gestation.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 221 | Table 12-2

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

17. Sally comes in for her first prenatal examination. This is her first child. She asks you (the nurse), How does my baby get air inside my uterus? The correct response is

a.

The babys lungs work in utero to exchange oxygen and carbon dioxide.

b.

The baby absorbs oxygen from your blood system.

c.

The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream.

d.

The placenta delivers oxygen-rich blood through the umbilical artery to the babys abdomen.

ANS: C

Feedback

A

The fetal lungs do not function for respiratory gas exchange in utero.

B

The baby does not simply absorb oxygen from a womans blood system. Blood and gas transport occur through the placenta.

C

The placenta functions by supplying oxygen and excreting carbon dioxide to the maternal bloodstream.

D

The placenta delivers oxygen-rich blood through the umbilical vein, not artery.

PTS: 1 DIF: Cognitive Level: Application REF: p. 225

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

18. The most basic information a maternity nurse should have concerning conception is

a.

Ova are considered fertile 48 to 72 hours after ovulation.

b.

Sperm remain viable in the womans reproductive system for an average of 12 to 24 hours.

c.

Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum.

d.

Implantation in the endometrium occurs 6 to 10 days after conception.

ANS: D

Feedback

A

Ova are considered fertile for approximately 24 hours after ovulation.

B

Sperm remain viable in the womans reproductive system for an average of 2 to 3 days.

C

Penetration of the ovum by the sperm is called fertilization. Conception occurs when the zygote, the first cell of the new individual, is formed.

D

After implantation, the endometrium is called the decidua.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 217

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

19. With regard to the structure and function of the placenta, the maternity nurse should be aware that

a.

As the placenta widens, it gradually thins to allow easier passage of air and nutrients.

b.

As one of its early functions, the placenta acts as an endocrine gland.

c.

The placenta is able to keep out most potentially toxic substances, such as cigarette smoke, to which the mother is exposed.

d.

Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.

ANS: B

Feedback

A

The placenta widens until week 20 and continues to grow thicker.

B

The placenta produces four hormones necessary to maintain the pregnancy.

C

Toxic substances such as nicotine and carbon monoxide readily cross the placenta into the fetus.

D

Optimal circulation occurs when the woman is lying on her side.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 225

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

20. The various systems and organs develop at different stages. Which statement is accurate?

a.

The cardiovascular system is the first organ system to function in the developing human.

b.

Hematopoiesis originating in the yolk sac begins in the liver at 10 weeks.

c.

The body changes from straight to C-shaped at 8 weeks.

d.

The gastrointestinal system is mature at 32 weeks.

ANS: A

Feedback

A

The heart is developmentally complete by the end of the embryonic stage.

B

Hematopoiesis begins in the liver during the 6th week.

C

The body becomes C-shaped at 21 weeks.

D

The gastrointestinal system is complete at 36 weeks.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 218

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

1. Congenital disorders refer to those conditions that are present at birth. These disorders may be inherited and caused by environmental factors or maternal malnutrition. Toxic exposures have the greatest effect on development between 15 and 60 days of gestation. For the nurse to be able to conduct a complete assessment of the newly pregnant client, she should be knowledgeable regarding known human teratogens, which include (select all that apply)

a.

Infections

b.

Radiation

c.

Maternal conditions

d.

Drugs

e.

Chemicals

ANS: A, B, C, D

Feedback

Correct

Exposure to radiation and a number of infections may result in profound congenital deformities. These include varicella, rubella, syphilis, parvovirus, CMV, and toxoplasmosis. Certain maternal conditions such as diabetes and PKU may also affect organs and other parts of the embryo during this developmental period. Drugs such as antiseizure medication and some antibiotics, as well as chemicals including lead, mercury, tobacco, and alcohol, also may result in structural and functional abnormalities.

Incorrect

Coffee is not considered a teratogen.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 218

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy. These include (select all that apply)

a.

Human chorionic gonadotropin (hCG)

b.

Insulin

c.

Estrogen

d.

Progesterone

e.

Testosterone

ANS: A, C, D

Feedback

Correct

hCG causes the corpus luteum to persist and produce the necessary estrogens and progesterone for the first 6 to 8 weeks. Estrogens cause enlargement of the womans uterus and breasts; cause growth of the ductal system in the breasts; and, as term approaches, play a role in the initiation of labor. Progesterone causes the endometrium to change, providing early nourishment. Progesterone also protects against spontaneous abortion by suppressing maternal reactions to fetal antigens and reduces unnecessary uterine contractions. Other hormones produced by the placenta include hCT, hCA, and a number of growth factors.

Incorrect

Human placental lactogen promotes normal nutrition and growth of the fetus and maternal breast development for lactation. This hormone decreases maternal insulin sensitivity and utilization of glucose, making more glucose available for fetal growth. If a Y chromosome is present in the male fetus, hCG causes the fetal testes to secrete testosterone necessary for the normal development of male reproductive structures.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 228

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

COMPLETION

1. The ability of the fetus to survive outside the uterus is called ___________.

ANS:

viability

In the past, the earliest age at which fetal survival could be expected was 28 weeks after conception. With modern technology and advancements in maternal and neonatal care, viability is now possible at 20 weeks after conception (22 weeks after last menstrual period [LMP], fetal weight of 500 g or more).

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 223

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

2. Very fine hairs, called __________, appear first on the fetuss eyebrows and upper lip at 12 weeks of gestation. By 20 weeks, they cover the entire body. By 28 weeks, the scalp hair is longer than these fine hairs, which thin and may disappear by term gestation.

ANS:

lanugo

By 20 weeks of gestation, the eyelashes, eyebrows, and scalp hair also begin to grow.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 223

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

TRUE/FALSE

1. When teaching contraception, the nurse must be able to effectively communicate the nuances of conception. An ovum has the capacity to be fertilized for only 24 hours, whereas a sperm may remain fertile for up to 80 hours. Is this statement true or false?

ANS: T

Most sperm survive for no more than 1 or 2 days, although a few will remain fertile in the female reproductive tract for up to 80 hours. Conception requires correct timing for fertilization to occur. This information is important whether the patient is seeking to become pregnant or prevent pregnancy.

PTS: 1 DIF: Cognitive Level: Application REF: p. 215

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

2. The nurse is precepting a student who asks about fetal circulation. The nurse explains that the fetal circulatory shunts are still required after birth. Is this statement true or false?

ANS: F

Fetal circulatory shunts are not needed after birth because the infant oxygenates blood in the lungs, metabolizes substances in the liver, and stops circulating blood to the placenta. As the infant breathes, blood flow to the lungs increases, pressure in the right-sided heart falls, and the foramen ovale closes.

PTS: 1 DIF: Cognitive Level: Comprehension REF: pp. 230-231

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

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