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At 16 weeks of gestation a pregnant person states, 'The most dangerous time is the first 3 months, so I shouldn’t have to worry from now on about any dangers to the baby.' What is the nurse's most appropriate response?
- A. There are teratogens with the potential to harm your baby at any time during the pregnancy.
- B. We really won’t be able to say for sure before you have an ultrasound.
- C. You are correct. You are past the critical point.
- D. You don’t seem very concerned about your baby’s welfare.
Correct Answer: A
Rationale: The correct answer is A because teratogens, substances that can harm the developing fetus, can have negative effects on the baby at any point during pregnancy, not just in the first trimester. The nurse's response should educate the pregnant person about the ongoing risks and the importance of avoiding harmful substances throughout pregnancy.
Option B is incorrect because an ultrasound is not used to assess the risk of teratogens. Option C is incorrect as it provides incorrect information that the risk is past, which is not true. Option D is incorrect as it is judgmental and does not address the pregnant person's misconception about the risks throughout pregnancy.
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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.
The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy?
- A. Determine whether termination is still a consideration.
- B. Explain they will experience grief, which is normal.
- C. Provide additional information about the disorder.
- D. Refer them to a disorder-specific support group.
Correct Answer: A
Rationale: The correct answer is A because it respects the couple's decision-making autonomy. The nurse should support their choice to continue the pregnancy without suggesting termination. Providing information, emotional support, and connecting them with a support group are appropriate actions. It is crucial to respect the couple's decision and provide compassionate care regardless of their choice. The other choices are incorrect because they may undermine the couple's autonomy and may not be aligned with their wishes.
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.
The measurement of lecithin in relation to sphingomyelin (L/S ratio) is used to determine fetal lung maturity. Which ratio reflects maturity of the lungs?
- A. 1.4:1
- B. 1.8:1
- C. 2:01
- D. 1:01
Correct Answer: C
Rationale: A ratio of 2:1 indicates lung maturity.