Nokea
The nurse is explaining fetal circulation to a group of nursing students. Which information should be included in the teaching session? (Select all that apply.)
- A. After birth the ductus venosus remains open, but the other shunts close
- B. The foramen ovale shunts blood from the right atrium to the left atrium.
- C. The ductus venosus shunts blood from the liver to the inferior vena cava
- D. The ductus venosus shunts blood from the liver to the inferior vena cav
Correct Answer: C
Rationale: The correct answer is C: The ductus venosus shunts blood from the liver to the inferior vena cava. During fetal circulation, the ductus venosus allows oxygenated blood from the placenta to bypass the liver and flow directly into the inferior vena cava. This is important for fetal circulation as the liver is not fully functional in the fetus. After birth, the ductus venosus closes as the liver becomes fully operational.
Rationale for incorrect choices:
A: After birth, the ductus venosus closes, not remains open.
B: The foramen ovale shunts blood from the right atrium to the left atrium, not related to the ductus venosus.
D: This choice is a repetition of the correct information but incorrectly states the destination of the shunted blood.
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The nurse is assessing the knowledge of new parents with a child born with maple syrup urine disease (MSUD). This is an autosomal recessive inherited disorder, which means that:
- A. Both genes of a pair must be abnormal for the disorder to be expressed.
- B. Only one copy of the abnormal gene is required for the disorder to be expressed.
- C. The disorder occurs in males and heterozygous females.
- D. The disorder is carried on the X chromosome.
Correct Answer: A
Rationale: MSUD is a type of autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed.
The nurse is reviewing the schedule for the OB/GYN she works for. In reviewing a patient’s chart, the nurse notes the patient is 32 weeks pregnant, has hypertension, and had a previous fetal death. What test does the nurse anticipate the provider will order?
- A. a contraction stress test
- B. amniotic fluid index
- C. nonstress test
- D. fetal movement count
Correct Answer: C
Rationale: The correct answer is C: nonstress test. A nonstress test is used to assess fetal well-being by monitoring the baby's heart rate in response to its own movements. In this case, the patient's history of hypertension and previous fetal death indicate a higher risk pregnancy, making it important to monitor the baby's well-being. A contraction stress test (choice A) is not suitable for a patient with hypertension as it can induce contractions and potentially harm the baby. An amniotic fluid index (choice B) is used to evaluate amniotic fluid levels and is not specific to this patient's situation. Fetal movement count (choice D) assesses the baby's movements but does not provide real-time information on fetal well-being like a nonstress test does.
A 37-year-old patient is being seen for her first OB appointment after having a positive pregnancy test at home. She thinks she is about 6 weeks pregnant. She and her husband have been trying to conceive for 7 years, and she has a history of three spontaneous abortions. What antepartum testing do you anticipate the provider ordering at today’s visit?
- A. a vaginal ultrasound to confirm gestation age, due date, and pregnancy viability
- B. maternal assay blood tests to screen for genetic and chromosomal disorders
- C. a nuchal translucency ultrasound
- D. an integrated screen blood test
Correct Answer: A
Rationale: The correct answer is A: a vaginal ultrasound to confirm gestation age, due date, and pregnancy viability. At the first OB appointment, confirming gestational age and viability is crucial, especially for a patient with a history of spontaneous abortions. This ultrasound will help determine the accurate due date and assess the viability of the pregnancy. Maternal assay blood tests for genetic and chromosomal disorders (choice B) are usually done later in the pregnancy, around 10-13 weeks. Nuchal translucency ultrasound (choice C) and integrated screen blood test (choice D) are typically done between 11-14 weeks and are not usually ordered at the first OB appointment.
A woman is 15 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; however, you can't feel it yet.
- D. Some babies are quiet, and you don't feel them move.
Correct Answer: B
Rationale: Maternal perception of fetal movement usually begins 16 to 20 weeks after conception.
Fetal circulation includes 3 shunts. Match each shunt to its physiologic action. Ductus venosus
- A. Connects the pulmonary artery and the aorta, bypassing the lungs.
- B. Connects the right and left atria.
- C. Connects the right and left ventricles.
- D. Allows the umbilical vein to bypass the liver to flow into the inferior vena cava.
Correct Answer: D
Rationale: Ductus venosus allows the umbilical vein to bypass the liver.