Maternal-Newborn Nursing The Critical Components of Nursing Care, 3rd Edition, Roberta Durham, Linda Chapman

Maternal-Newborn Nursing The Critical Components of Nursing Care, 3rd Edition, Roberta Durham, Linda Chapman A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 week s’ gestation is approximately: a. 500 mLb. 750 mLc. 800 mLd. 1000 mL ANS: c Amniotic fluid first appears at about 3 week s. There are approximately 30 mL of amniotic fluid present at 10 week s’ gestation, and this amount increases to approximately 800 mL at 24 week s’ gestation. After that time, the total fluid volume remains fairly stable until it begins to decrease slightly as the pregnancy reaches term. KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy 13. Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also: a. Facilitates asymmetrical growth of the fetal limbsb. Cushions the fetus from mechanical injuryc. Promotes development of muscle toned. Promotes adherence of fetal lung tissue ANS: b Feedback a. Amniotic fluid allows for symmetrical fetal growth.b. Amniotic fluid cushions the fetus from mechanical injury.c. Amniotic fluid does not promote muscle tone.d. Amniotic fluid prevents adherence of the amnion to the fetus. KEY: Integrated Process: Teaching and Learning | Cognitive Level: Comprehension | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate 14. During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from: a. 2 to 8 week sb. 4 to12 week sc. 5 to 10 week sd. 6 to 15 week s ANS: a The period of organogenesis lasts from approximately the second until the eighth week of gestation during which time the embryo undergoes rapid growth and differentiation. During organogenesis, the embryo is extremely vulnerable to teratogens such as medications, alcohol, tobacco, caffeine, illegal drugs, radiation, heavy metals, and maternal (TORCH) infections. Structural fetal defects are most lik ely to occur during this period because exposure to teratogens either before or during a critical period of development of an organ can cause a malformation. KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Physiological Integrity | Difficulty Level: Easy 15. A major fetal development characteristic at 16 week s’ gestation is: a. The average fetal weight is 450 gramsb. Lanugo covers entire bodyc. Brown fat begins to developd. Teeth begin to form ANS: d Feedback a. The average fetal weight at 16 week s is 200 grams.b. Lanugo is present on the head.c. Brown fat begins to develop at 20 week s.d. This is the correct answer. KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Physiological Integrity | Difficulty Level: Moderate 16. Karen, a 26-year-old woman, has come for preconception counseling and ask s about caring for her cat as she has heard that she ―should not touch the cat during pregnancy.‖ The clinic nurse’s best response is: a. It is best if someone other than you changes the cat’s litter pan during pregnancy so that you have no risk of toxoplasmosis during pregnancy.b. It is important to have someone else change the litter pan during pregnancy and also avoid consuming raw vegetables.c. Have you had any ―flu-lik e‖ symptoms since you got your cat? If so, you may have already had toxoplasmosis and there is nothing to worry about.d. Toxoplasmosis is a concern during pregnancy, so it is important to have someone else change the cat’s litter pan and also to avoid consuming uncook ed meat. ANS: d Feedback a. The nurse should also explain that the patient should not eat uncook ed meat as it is a potential source for toxoplasmosis.b. Raw vegetables are not a source for toxoplasmosis.c. This is not an accurate way to diagnose if the woman has had toxoplasmosis.d. Women need to be aware that Toxoplasma gondii, a single-celled parasite, is responsible for the infection toxoplasmosis. The majority of individuals who become infected with toxoplasmosis are asymptomatic, although when present, symptoms are described as ―flu lik e‖ and include glandular pain and enlargement and myalgia. Severe toxoplasmosis infection may cause damage to the fetal brain, eyes, or other organs. Toxoplasmosis is usually acquired by consuming raw or poorly cook ed meat that has been contaminated with T. gondii. Toxoplasmosis may also be acquired through close contact with feces from an infected animal (usually cats) or soil that has been contaminated with T. gondii. KEY: Integrated Processes: Caring | Cognitive Level: Application | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate 17. A couple who has sought infertility counseling has been told that the man’s sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur? a. The testes are overheated.b. The vas deferens is ligated.c. The prostate gland is enlarged.d. The flagella are segmented. ANS: a