Chapter 12: Conception and Fetal Development
MULTIPLE CHOICE
1. The nurse knows that teaching about the natural family planning method of contraception
was effective when the couple responds that an ovum is considered fertile for which period
of time?
a. 6 to 8 hours
b. 24 hours
c. 2 to 3 days
d. 1 week
ANS: B
Most ova remain fertile for approximately 24 hours after ovulation, much longer than 6 to 8
hours. However, ova do not remain fertile for 2 to 3 days or are viable for 1 week. If
unfertilized by a sperm after 24 hours, the ovum degenerates and is reabsorbed.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
2. What kind of fetal anomalies are most often associated with oligohydramnios?
a. Renal
b. Cardiac
c. Gastrointestinal NURSINGTB.COM
d. Neurologic
ANS: A
An amniotic fluid volume of less than 300 ml (oligohydramnios) is often associated with
fetal renal anomalies. The amniotic fluid volume has no bearing on the fetal cardiovascular
system. Gastrointestinal anomalies are associated with hydramnios or an amniotic fluid
volume greater than 2 L. The amniotic fluid volume has no bearing on the fetal neurologic
system.
PTS: 1 DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week
and her baby jumped at the noise. Which response by the nurse is most accurate?
a. “That must have been a coincidence; babies can’t respond like that.”
b. “The fetus is demonstrating the aural reflex.”
c. “Babies respond to sound starting at approximately 24 weeks of gestation.”
d. “Let me know if it happens again; we need to report that to your midwife.”
ANS: C
, Babies respond to external sound starting at approximately 24 weeks of gestation. Acoustic
stimulations can evoke a fetal heart rate response. There is no such thing as an aural reflex.
The last statement is inappropriate and may cause undue psychologic alarm to the client.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
4. Which statement regarding the structure and function of the placenta is correct?
a. Produces nutrients for fetal nutrition
b. Secretes both estrogen and progesterone
c. Forms a protective, impenetrable barrier to microorganisms such as bacteria and
viruses
d. Excretes prolactin and insulin
ANS: B
As one of its early functions, the placenta acts as an endocrine gland, producing four
hormones necessary to maintain the pregnancy and to support the embryo or fetus: human
chorionic gonadotropin (hCG), human placental lactogen (hPL), estrogen, and progesterone.
The placenta does not produce nutrients. It functions as a means of metabolic exchange
between the maternal and fetal blood supplies. Many bacteria and viruses can cross the
placental membrane.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
NURSINGTB.COM
5. A woman in labor passes some thick meconium as her amniotic fluid ruptures. The client
asks the nurse where the baby makes the meconium. What is the correct response by the
nurse?
a. Fetal intestines
b. Fetal kidneys
c. Amniotic fluid
d. Placenta
ANS: A
As the fetus nears term, fetal waste products accumulate in the intestines as dark
green-to-black, tarry meconium. Meconium is not produced by the fetal kidneys nor should
it be present in the amniotic fluid, which may be an indication of fetal compromise. The
placenta does not produce meconium.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
6. A woman asks the nurse, “What protects my baby’s umbilical cord from being squashed
while the baby’s inside of me?” What is the nurse’s best response?
a. “Your baby’s umbilical cord is surrounded by connective tissue called Wharton’s
jelly, which prevents compression of the blood vessels.”
b. “Your baby’s umbilical cord floats around in blood and amniotic fluid.”
, c. “You don’t need to be worrying about things like that.”
d. “The umbilical cord is a group of blood vessels that are very well protected by the
placenta.”
ANS: A
Explaining the structure and function of the umbilical cord is the most appropriate response.
Connective tissue called Wharton’s jelly surrounds the umbilical cord, prevents compression
of the blood vessels, and ensures continued nourishment of the embryo or fetus. The
umbilical cord does not float around in blood or fluid. Telling the client not to worry negates
her need for information and discounts her feelings. The placenta does not protect the
umbilical cord.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
7. Which structure is responsible for oxygen and carbon dioxide transport to and from the
maternal bloodstream?
a. Decidua basalis
b. Blastocyst
c. Germ layer
d. Chorionic villi
ANS: D
Chorionic villi are fingerlike projections that develop out of the trophoblast and extend into
the blood-filled spaces of the endometrium. The villi obtain oxygen and nutrients from the
maternal bloodstream and dispose carbon dioxide and waste products into the maternal
blood. The decidua basalis N RSpor
isUthe INtion
GTofB.C
the O M (endometrium) under the blastocyst
decidua
where the villi attach. The blastocyst is the embryonic development stage after the morula;
implantation occurs at this stage. The germ layer is a layer of the blastocyst.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
8. A woman who is 8 months pregnant asks the nurse, “Does my baby have any antibodies to
fight infection?” What is the most appropriate response by the nurse?
a. “Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG),
immunoglobulin M (IgM), and immunoglobulin A (IgA).”
b. “Your baby won’t receive any antibodies until he is born and you breastfeed him.”
c. “Your baby does not have any antibodies to fight infection.”
d. “Your baby has IgG and IgM.”
ANS: D
During the third trimester, IgG is the only immunoglobulin that crosses the placenta; it
provides passive acquired immunity to specific bacterial toxins. However, the fetus
produces IgM by the end of the first trimester. IgA immunoglobulins are not produced by
the baby. Therefore, by the third trimester, the fetus has both IgG and IgM. Breastfeeding
supplies the newborn infant with IgA.
MULTIPLE CHOICE
1. The nurse knows that teaching about the natural family planning method of contraception
was effective when the couple responds that an ovum is considered fertile for which period
of time?
a. 6 to 8 hours
b. 24 hours
c. 2 to 3 days
d. 1 week
ANS: B
Most ova remain fertile for approximately 24 hours after ovulation, much longer than 6 to 8
hours. However, ova do not remain fertile for 2 to 3 days or are viable for 1 week. If
unfertilized by a sperm after 24 hours, the ovum degenerates and is reabsorbed.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
2. What kind of fetal anomalies are most often associated with oligohydramnios?
a. Renal
b. Cardiac
c. Gastrointestinal NURSINGTB.COM
d. Neurologic
ANS: A
An amniotic fluid volume of less than 300 ml (oligohydramnios) is often associated with
fetal renal anomalies. The amniotic fluid volume has no bearing on the fetal cardiovascular
system. Gastrointestinal anomalies are associated with hydramnios or an amniotic fluid
volume greater than 2 L. The amniotic fluid volume has no bearing on the fetal neurologic
system.
PTS: 1 DIF: Cognitive Level: Understanding
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week
and her baby jumped at the noise. Which response by the nurse is most accurate?
a. “That must have been a coincidence; babies can’t respond like that.”
b. “The fetus is demonstrating the aural reflex.”
c. “Babies respond to sound starting at approximately 24 weeks of gestation.”
d. “Let me know if it happens again; we need to report that to your midwife.”
ANS: C
, Babies respond to external sound starting at approximately 24 weeks of gestation. Acoustic
stimulations can evoke a fetal heart rate response. There is no such thing as an aural reflex.
The last statement is inappropriate and may cause undue psychologic alarm to the client.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
4. Which statement regarding the structure and function of the placenta is correct?
a. Produces nutrients for fetal nutrition
b. Secretes both estrogen and progesterone
c. Forms a protective, impenetrable barrier to microorganisms such as bacteria and
viruses
d. Excretes prolactin and insulin
ANS: B
As one of its early functions, the placenta acts as an endocrine gland, producing four
hormones necessary to maintain the pregnancy and to support the embryo or fetus: human
chorionic gonadotropin (hCG), human placental lactogen (hPL), estrogen, and progesterone.
The placenta does not produce nutrients. It functions as a means of metabolic exchange
between the maternal and fetal blood supplies. Many bacteria and viruses can cross the
placental membrane.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
NURSINGTB.COM
5. A woman in labor passes some thick meconium as her amniotic fluid ruptures. The client
asks the nurse where the baby makes the meconium. What is the correct response by the
nurse?
a. Fetal intestines
b. Fetal kidneys
c. Amniotic fluid
d. Placenta
ANS: A
As the fetus nears term, fetal waste products accumulate in the intestines as dark
green-to-black, tarry meconium. Meconium is not produced by the fetal kidneys nor should
it be present in the amniotic fluid, which may be an indication of fetal compromise. The
placenta does not produce meconium.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
6. A woman asks the nurse, “What protects my baby’s umbilical cord from being squashed
while the baby’s inside of me?” What is the nurse’s best response?
a. “Your baby’s umbilical cord is surrounded by connective tissue called Wharton’s
jelly, which prevents compression of the blood vessels.”
b. “Your baby’s umbilical cord floats around in blood and amniotic fluid.”
, c. “You don’t need to be worrying about things like that.”
d. “The umbilical cord is a group of blood vessels that are very well protected by the
placenta.”
ANS: A
Explaining the structure and function of the umbilical cord is the most appropriate response.
Connective tissue called Wharton’s jelly surrounds the umbilical cord, prevents compression
of the blood vessels, and ensures continued nourishment of the embryo or fetus. The
umbilical cord does not float around in blood or fluid. Telling the client not to worry negates
her need for information and discounts her feelings. The placenta does not protect the
umbilical cord.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
7. Which structure is responsible for oxygen and carbon dioxide transport to and from the
maternal bloodstream?
a. Decidua basalis
b. Blastocyst
c. Germ layer
d. Chorionic villi
ANS: D
Chorionic villi are fingerlike projections that develop out of the trophoblast and extend into
the blood-filled spaces of the endometrium. The villi obtain oxygen and nutrients from the
maternal bloodstream and dispose carbon dioxide and waste products into the maternal
blood. The decidua basalis N RSpor
isUthe INtion
GTofB.C
the O M (endometrium) under the blastocyst
decidua
where the villi attach. The blastocyst is the embryonic development stage after the morula;
implantation occurs at this stage. The germ layer is a layer of the blastocyst.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
8. A woman who is 8 months pregnant asks the nurse, “Does my baby have any antibodies to
fight infection?” What is the most appropriate response by the nurse?
a. “Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG),
immunoglobulin M (IgM), and immunoglobulin A (IgA).”
b. “Your baby won’t receive any antibodies until he is born and you breastfeed him.”
c. “Your baby does not have any antibodies to fight infection.”
d. “Your baby has IgG and IgM.”
ANS: D
During the third trimester, IgG is the only immunoglobulin that crosses the placenta; it
provides passive acquired immunity to specific bacterial toxins. However, the fetus
produces IgM by the end of the first trimester. IgA immunoglobulins are not produced by
the baby. Therefore, by the third trimester, the fetus has both IgG and IgM. Breastfeeding
supplies the newborn infant with IgA.
