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Fewer fetal movements than expected suggest possible:
- A. Intrauterine fetal growth restriction.
- B. Inaccurate gestational age dating.
- C. Rapid intrauterine fetal maturation.
- D. Reduced placental perfusion with fetal hypoxia.
Correct Answer: D
Rationale: Reduced placental perfusion or fetal hypoxia can lead to fewer fetal movements.
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What routine lab tests should a pregnant person have in the first trimester? Select all that apply.
- A. complete blood count (CBC)
- B. blood type and Rh factor
- C. urinalysis
- D. thyroid function tests
Correct Answer: D
Rationale: The correct answer is D: thyroid function tests. During pregnancy, thyroid function is crucial for the health of the mother and baby. Thyroid disorders can lead to complications. Testing thyroid function in the first trimester helps detect any abnormalities early.
A, B, and C are commonly performed tests in pregnancy, but they are not specific to the first trimester. A CBC helps assess overall health, blood type and Rh factor are important for identifying potential blood type incompatibilities, and urinalysis can indicate urinary tract infections or other issues. However, these tests are not unique to the first trimester and are typically done throughout pregnancy.
At which point in the pregnancy are alveoli formed and fetal breathing movements noted?
- A. 12 weeks
- B. 6 weeks
- C. 20 weeks
- D. 24 weeks
Correct Answer: D
Rationale: The correct answer is D (24 weeks) because alveoli formation and fetal breathing movements are typically observed during the late second trimester, around 24 weeks. At this stage, the lungs have developed sufficiently to support breathing outside the womb. Choices A (12 weeks), B (6 weeks), and C (20 weeks) are incorrect because alveoli formation and breathing movements do not occur as early as these time points in the pregnancy. Fetal breathing movements are a crucial sign of lung maturation and readiness for extrauterine life, which is why the correct answer is 24 weeks.
A patient at 37 weeks gestation arrives at the labor and delivery unit and reports a rupture of her membranes. Which factor causes the nurse to anticipate the HCP will prescribe a medical method of labor induction?
- A. The fetus is viable and the barrier for a sterile uterine environment is breached.
- B. The fetus is at risk for “drying out” and causing the mother to have a dry birth.
- C. The mother must be maintained on complete bedrest until contractions begin.
- D. The mother is at risk for developing an infection and passing it to the fetus.
Correct Answer: A
Rationale: The correct answer is A: The fetus is viable and the barrier for a sterile uterine environment is breached. At 37 weeks gestation, the fetus is considered full-term and capable of surviving outside the womb. Rupture of membranes increases the risk of infection as it exposes the fetus to the vaginal flora. Therefore, a medical method of labor induction may be prescribed to prevent complications such as intrauterine infection.
Choices B, C, and D are incorrect:
B: The fetus "drying out" and causing a dry birth is not a valid reason for labor induction.
C: Bedrest until contractions begin is not a standard approach for managing ruptured membranes.
D: While infection risk is a concern with ruptured membranes, the primary reason for induction is to prevent harm to the fetus due to the breach in the sterile uterine environment, not just maternal infection.
Upon receiving report on a 36-week G1P0 patient, the nurse has been informed that the pregnancy is at high risk because the umbilical cords may become entangled. Which does the nurse understand about this pregnancy?
- A. It is a diamnionic, monochorionic twin gestation.
- B. It is a monoamnionic, monochorionic twin gestation.
- C. It is a monoamnionic, dichorionic twin gestation.
- D. It is a diamnionic, dichorionic twin gestation.
Correct Answer: B
Rationale: The correct answer is B: It is a monoamnionic, monochorionic twin gestation. In this type of pregnancy, twins share the same amniotic sac (monoamnionic) and placenta (monochorionic). This situation increases the risk of cord entanglement, leading to potential complications. The other choices are incorrect because they do not describe a pregnancy with the same level of risk for cord entanglement. Choice A, diamnionic, monochorionic, implies two amniotic sacs, reducing the risk of cord entanglement. Choice C, monoamnionic, dichorionic, describes a less risky scenario with two separate placentas. Choice D, diamnionic, dichorionic, indicates two separate sacs and placentas, also reducing the risk of cord entanglement.
A woman who is assessing fetal movements each day should notify her health care provider if:
- A. More than six movements are felt during a 30- to 60-minute period.
- B. Fetal movements are fewer than the minimum set by the provider.
- C. The movement pattern remains about the same from day to day.
- D. Fetal movements are more frequent during the evening than in the morning.
Correct Answer: B
Rationale: Decreased fetal movement may indicate a potential issue and requires further evaluation.