MCN 40items With Ratio

8/6/2019 MCN 40items With Ratio

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1

Marks: 1

What is the endometrium called after implantation?

Choose one answer.

a.Decidua basalis

b.Mesoderm

c.Endoderm

d.Decidua

After implantation, the endometrium is called the decidua. The portiondirectly under the blastocyst, where the chorionic villi tap into the maternalblood vessels, is the decidua basalis. The ectoderm, mesoderm andendoderm refers to the primary germ layers of the embryonic disk.(Lowdermilk & Perry, 2007)

CorrectMarks for this submission: 1/1.

Question2Marks: 1

Premature rupture of membranes is spontaneous rupture of the membranes prior to the onset of labor. Which of the following is a priority nursing diagnosis in the event that PROM occurs?

Choose one answer.

a. Risk for ineffective individual coping

b. Risk for infection

c. Impaired gas exchange in the fetus

Maternal risk of infection increases as does the risk of abruption placentae. Fetal-newborn implications include risk of respiratory distress syndrome, fetal sepsis due toascending pathogens, malpresentation, prolapse of the umbilical cord and increasedperinatal morbidity and mortality. (London et. Al., 2007)

d. Acute pain


Question3Marks: 1

Who is at increased risk f or gestational diabetes mellitus?

Choose one answer.


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a. Beth, 30-year old G1P0 mother, who had a previous history of

GDM

b. Charlene, 28-year old G1P1 mother, who is classified as Obese II

c. Anna, 35-year old G2P2 mother, who has a family history of

diabetes

d. All of the choicesGestational diabetes mellitus is defined as any degree of glucose intolerancethat has its onset or is first diagnosed during pregnancy. Women who aremarkedly obese, have a prior history of GDM, have glycosuria or have astrong family of diabetes are at high risk. The woman may remainasymptomatic or may have a mild form of the disease. Diagnosis of GDM isvery important because even mild diabetes causes increased risk forperinatal morbidity and mortality. (London et. Al., 2007)


Question4Marks: 1

Which of the following statements about the yolk sac is true?

Choose one answer.

a. All of the choices

The yolk sac aids in transferring maternal nutrients and oxygen, whichhave diffused through the chorion, to the embryo. Blood vessels form

to aid transport. The manufacture of blood cells and plasma orhematopoiesis occurs in the yolk sac during the second and thirdweeks. The folding in of the embryo during the fourth week results inincorporation of part of the yolk sac into the embryos body as theprimitive digestive system. Primordial germ cells arise in the yolk sacand move into the embryo. The shrinking remains of the yolk sacdegenerate and by the fifth or sixth week, the remnant has separatedfrom the embryo. (Lowdermilk & Perry, 2007)

b. Part of the yolk sac becomes incorporated into the primitive digestive system

of the embryo by the fourth week

c.Hematopoiesis occurs in the yolk sac.

d. The yolk sac aids in transferring maternal nutrients and oxygen to the

embryo


Question5Marks: 1

Vitamins are organic substances needed for life and growth. These vitamins serve as vital coenzyme factors in many reactions such as cell respiration, glucose oxidation and energy metabolism:


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Choose one answer.

a.Vitamin C

b. B vitamins

The B vitamins include thiamine (B1), riboflavin (B2), niacin, folic acid,pantothenic acid, vitamin B6 and vitamin B12. These vitamins serve asvital coenzyme factors in many reactions such as cell respiration, glucoseoxidation and energy metabolism. The quantities needed increase ascaloric intake increases to meet the metabolic and growth needs of thepregnant woman. (London et. Al., 2007)

c.Vitamins A, D, E, K

d. All of the choices


Question6Marks: 1

Fundal height may be used as an indicator of uterine size. How do you determine the fundal height?

Choose one answer.

a. Place a tape measure from the top of the symphysis pubis to the

umbilical cord.

b. Place a tape measure from the center of the abdomen to the

umbilical cord.

c. Place a tape measure from the umbilical cord to the symphysis

pubis.

d. Place a tape measure from the top of the symphysis pubis to the

top of the uterine fundus.

Fundal height in centimeters correlates well with weeks of gestationbetween 22 to 24 weeks and 34 weeks. A centimeter tape is used tomeasure the distance abdominally from the top of the symphysis pubis tothe top of the uterine fundus. (London et. Al., 2007)


Question7Marks: 1

Which of the following statements is incorrect with regards to pregnant women diagnosed with hyperthyroidism?

Choose one answer.


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a.Propylthiouracil is not excreted in breast milk, so mothers may still choose

to breastfeed

Graves disease is the most common cause of hyperthyroidism inpregnant women. The primary treatment of hyperthyroidism duringpregnancy is drug therapy; the medication of choice is propylthiouracil(PTU). Moderate and severe hyperthyroidism must be treated duringpregnancy; untreated or inadequately treated women have an increasedrisk of preterm birth, stillborns, fetal goiter, and fetal hypothyroidism orhyperthyroidism. Women with hyperthyroidism are also at increased risk todevelop severe preeclampsia. Radioactive iodine must not be used in thediagnosis or treatment of hyperthyroidism in pregnancy because it maycompromise the fetal thyroid. Mothers choosing to breastfeed who arealso taking hyperthyroid medication need to be instructed that smallamounts are excreted in breast milk. ( Lowdermilk & Perry, 2007)

b. The primary treatment of hyperthyroidism during pregnancy is drug therapy

c. Women with hyperthyroidism are at increased risk to develop severe

preeclampsia

d. Radioactive iodine must not be used in the diagnosis or treatment of

hyperthyroidism in pregnancy


Question8Marks: 1

Labor that occurs between 20 and 37 completed weeks of pregnancy is called preterm labor. Tocolysis is the use of medications in an attempt to stop l abor. All of the following are tocolytic drugs except:

Choose one answer.

a.Methyldopa

Drugs currently used as tocolytics include beta adrenergic agonists(also called beta mimetics), magnesium sulfate, prostaglandinsynthetase inhibitors, and calcium channel blockers. The betamimetics (ritodrine and terbutaline sulfate) and magnesium sulfate arethe most widely used tocolytics. Nifedipine, a calcium channel blocker,is becoming increasingly popular as a tocolytic because it is easilyadministered orally or sublingually and has few serious maternal sideeffects. Prostaglandin synthesis inhibitors such as indomethacin arebeing used for tocolysis in selected instances. Methyldopa is oftenused for long-term control of mild to moderate hypertension inpregnancy because it is safe and effective. (London et. Al., 2007)

b.Indomethacin

c. Ritodrine

d. Nifedipine



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Question9Marks: 1

The following hormones are produced by the placenta except:

Choose one answer.

a. Human chorionic gonadotropin (hCG)

b.Progesterone

c. Oxytocin

The placenta produces hormones vital to survival of the fetus. Theseinclude human chorionic gonadotropin (hCG), human placentallactogen (hPL), and two steroid hormones, estrogen andprogesterone. (London, et. Al., 2007)

d. Human placental lactogen (hPL)


Question10Marks: 1

Which of the following is not considered as a maternal complication caused by gestational diabetes mellitus?

Choose one answer.

a. Congenital anomalies

The development of congenital anomalies is a fetal-neonatal risk, not amaternal risk. Hydramnios, or an increase in the volume of amniotic fluidis thought to be a result of excessive fetal urination because of fetalhyperglycemia. Premature rupture of membranes and onset of labormay occasionally be a problem with hydramnios. Preeclampsia-eclampsia occurs more often in diabetic pregnancies, especially whenvascular changes already exist. Hyperglycemia can lead to ketoacidosisas a result of the increase in ketone bodies released in the blood fr omthe metabolism of fatty acids. Decreased gastric motility and the anti-insulin effects of hPL also predispose the woman to ketoacidosis.(London et. Al., 2007)

b.Preeclampsia-eclampsia

c.Ketoacidosis

d. Hydramnios


Question11Marks: 1


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Which of the following pairs illustrate a correct pairing of the immunoglobulin and its description?i. IgG lines mucous membranes and protects body surfacesii. IgD assists in the differentiation of B lymphocytesiii. IgE causes symptoms of allergic reactionsiv. IgA is the only immunoglobulin that crosses the placenta and is responsible for the secondary immune responsev. IgM is responsible for the primary immune response

Choose one answer.

a. i, iv and v

b. i, ii and iv

c. ii, iv and v

d. ii, iii and v

During the third trimester, albumin and globulin are present in the fetus. The only immunoglobulin thatcrosses the placenta, IgG, provides passive acquired immunity to specific bacterial toxins. The fetusproduces IgM in response to blood group antigens, gram-negative enteric organisms, and some viruses.IgA lines mucous membranes and protects body surfaces. IgD is present on lymphocyte surface andassists in the differentiation of B lymphocytes. IgE causes symptoms of allergic reactions and assists indefense against parasitic infections. (Lowdermilk & Perry, 2007)


Question12Marks: 1

Which of the following is the earliest biochemical marker for pregnancy?

Choose one answer.

a. Estrogen

b. Human chorionic gonadotropin

Human chorionic gonadotropin is the earliest biochemical marker forpregnancy and pregnancy tests are based on the recognition of hCG ora beta subunit of hCG. Production of beta-hCG begins as early as theday of implantation and can be detected as early as 7 to 10 days afterconception. The level of hCG increases until it peaks at about 60 to 70days of gestation and then declines until about 80 days of pregnancy.(Lowdermilk & Perry, 2007)

c. Human placental lactogen

d. Oxytocin


Question13


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Marks: 1

Certain exercises help strengthen muscle tone in preparation for birth and promote more rapid restoration of muscle tone after birth. This type of exercise strengthens the pubococcygeus muscle and increases its elasticity. It is also known as perineatightening.

Choose one answer.

a. Pelvic tilt

b. Inner thigh exercises

c.Abdominal exercises

d. Kegel exercises

Perineal muscle tightening, also called Kegel exercises, strengthens thepubococcygeus muscle and increases its elasticity. The woman can feel thespecific muscle group to be exercised by stopping urination midstream. DoingKegel exercises while urinating is discouraged, however, because this practicehas been associated with urinary stasis and urinary tract infection. (London et.Al., 2007)


Question14Marks: 1

Changes in skin pigmentation commonly occur during pregnancy. Which of the following refers to reddish, wavy streaks that may appear on the abdomen, thighs, buttocks and breasts that result from reduced connective tissue strength due to elevatsteroid levels?

Choose one answer.

a. Spider nevi

b. Striae gravidarum

The linea nigra is a pigmented line in the middle of the abdomen which usuallyextends from the pubic area to the umbilicus or higher. Facial chloasma(melasma gravidarum)is a darkening of the skin over t he forehead and aroundthe eyes. Vascular spider nevi are small, bright red elevations of the skinradiating from a central body which may develop on the chest, neck, face,arms and legs. They may be caused by i ncreased subcutaneous blood flow inresponse to elevated estrogen levels. (London et. Al., 2007)

c. Melasma gravidarum

d. Linea nigra


Question15Marks: 1


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Changes in the endocrine system of a pregnant woman include the following except:

Choose one answer.

a. Serum prolactin is produced in the second trimester

During pregnancy, gland activity and hormone production increase. Parathyroidhormone controls calcium and magnesium metabolism. Pregnancy induces aslight hyperparathyroidism, a reflection of increased fetal requirements forcalcium and vitamin D. There is a moderate enlargement of the thyroid glandcaused by hyperplasia of the glandular tissue and increased vascularity. Theelevated levels of estrogen and progesterone suppress secretion of follicle-stimulating hormone and luteinizing hormone by the anterior pituitary. Serumprolactin produced by the anterior pituitary begins to increase early in the firsttrimester and increases progressively to term. It is responsible for initiallactation. (Lowdermilk & Perry, 2007)

b. There is a moderate enlargement of the thyroid gland

c. The secretion of the follicle-stimulating hormone and the luteinizing

hormone is suppressed

d. Pregnancy induces a slight hyperparathyroidism


Question16Marks: 1

Which of the following correctly describes Goodell sign?

Choose one answer.

a. Softening of the uterine isthmus

b. White or slightly gray mucoid discharge with a faint musty odor

c. Softening of the cervical tip

A softening of the cervical t ip called Goodell sign may be observed about thebeginning of the sixth week in a normal, unscarred cervix. At approximately 6weeks of gestation , softening and compressibility of the lower uterine segment(uterine isthmus) may occur and this is known as the Hegar sign. Uterinecontractions felt through the abdominal wall soon after the fourth month ofpregnancy are known as Braxton Hicks contractions. Leucorrhea is a white orslightly gray mucoid discharge with a faint musty odor and it occurs in responseto cervical stimulation by estrogen and progesterone. (Lowdermilk & Perry,2007)

d. Uterine contractions felt through the abdominal wall



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Question17Marks: 1

The following statements regarding the fetal gastrointestinal system are correct except:

Choose one answer.

a. Esophageal atresia is a malformation in the development of the foregut.

b. The hindgut develops into the distal half of the colon, the rectum and

parts of the anal canal, t he urinary bladder and the urethra.

c. The midgut becomes the distal half of the duodenum, the jejunum and

ileum, the cecum and appendix and the proximal half of the colon.

d. The gastrointestinal system matures by 26 weeks.

The foregut produces the pharynx, part of the lower respiratory tract, theesophagus, the stomach, the first half of the duodenum, the liver, thepancreas and the gallbladder. These structures evolve during the fifth andsixth weeks. Malformations that occur in these areas include esophagealatresia, hypertrophic pyloric stenosis, duodenal stenosis or atresia andbiliary atresia. The midgut becomes the distal half of the duodenum, thejejunum and ileum, the cecum and appendix and the proximal half of thecolon. Meckels diverticulum is the most common malformation of themidgut. The hindgut develops into the distal half of the colon, the rectumand parts of the anal canal, the urinary bladder and the urethra. Anorectalmalformations are the most common abnormalities of the digestivesystem. The gastrointestinal system is mature by 36 weeks. (Lowdermilk &Perry, 2007)


Question18Marks: 1

Heartburn is the regurgitation of acidic gastric contents into the esophagus. Which of the following is inappropriate when teaching a pregnant mother about heartburn relief?

Choose one answer.

a. Antacids containing magnesium can cause constipation

b. Sodium bicarbonate should be avoided because it may lead to electrolyte

imbalance

Liquid forms of low-sodium antacids are often most effective inproviding relief from heartburn. The nurse should advise womenthat antacids containing aluminum may cause constipation, andantacids containing magnesium can cause diarrhea. The nurseshould also inform the client that she should avoid sodiumbicarbonate (baking soda) because they may lead to electrolyteimbalance. (London et. Al., 2007)

c. Antacids that contain aluminum may cause diarrhea


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d. None of the choices.


Question19Marks: 1

Many respiratory changes occur to meet the increased oxygen requirements of a pregnant woman. Which of the following changes occur in the respiratory system of a pregnant woman?

Choose one answer.

a. All of the choices

b. Breathing changes from thoracic to abdominal

c. The anteroposterior diameter decreases

d.Progesterone decreases airway resistance

The anteroposterior diameter increases and the chest circumferenceexpands by as much as 6cm. Breathing changes from abdominal tothoracic as pregnancy progresses , and descent of the diaphragm oninspiration becomes less possible. Progesterone decreases airwayresistance, permitting a 15% to 20% increase in oxygen consumption, aswell as increases in carbon dioxide production and in the respiratoryfunctional reserve. (London et. Al., 2007)

Correct

Marks for this submission: 1/1.

Question20Marks: 1

Which of the following illustrates the ideal weight gain pattern during pregnancy?

Choose one answer.

a. 3.5lb to 5lb during the first trimester, 1lb per week during the second and

third trimesters

Maternal weight gain is an important factor in fetal growth andinfant birth weight. For a normal weight woman, the idealpattern of weight gain during pregnancy is a gain of 3.5lb to5lb (1.6kg to 2.3kg) during the first trimester, followed by again of about 1lb (0.5kg) per week during the second and thirdtrimesters. (London et. Al., 2007)

b. 1lb per week during the first trimester and 3.5lb to 5lb in t otal during the

second and third trimesters

c. 1lb during the first trimester, 3lbs per week during the second and third

trimesters

d. 3.5lb to 5lb during the first trimester and 3lbs in total during the second and


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third trimesters


Question21Marks: 1

Which of the following statements about maternal and f etal nutrition is incorrect?

Choose one answer.

a. The need for sodium increases during pregnancy

b. There is no increase in the daily recommended intake of calcium duringpregnancy and lactation, in comparison with the recommendation for the

nonpregnant woman

c. Zinc deficiency is associated with malformations of the gastrointestinal

system in infants

Fat-soluble vitamins A, D, E and K are stored in the body tissues. Withchronic overdoses, these vitamins can reach toxic levels. Because of thehigh potential for toxicity, pregnant women are advised to take fat-solublevitamin supplements only as prescribed. During pregnancy, the need forsodium increases slightly, primarily because the body water is expanding.Sodium is essential for maintaining body water balance. There is noincrease in the DRI of calcium during pregnancy and lactation, incomparison with the recommendation for the nonpregnant woman. The DRIappears to provide sufficient calcium for fetal bone and tooth developmentto proceed while maternal bone mass is maintained. Zinc deficiency isassociated with malformations of the central nervous system in infants.

(Lowdermilk & Perry, 2007)

d. Chronic overdoses of the fat-soluble vitamins can lead to toxicity and are

therefore supplemented only as prescribed


Question22Marks: 1

Preeclampsia is the most common hypertensive disorder in pregnancy. Which of the following are important assessment parameters for a client with preeclampsia?i. Vaginal bleeding and uterine rigidityii. Level of consciousnessiii. Fetal heart rateiv. Deep tendon reflexes

Choose one answer.

a. i, ii and iii

b. ii, iii and iv


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c. i and iii only

d. i, ii, iii and iv

Vaginal bleeding and uterine rigidity may indicate placental separation. Observe the womans level ofconsciousness: alertness, mood changes and any signs of impending convulsion. Check the fetal heartrate with the blood pressure, or monitor continuously with the electronic fetal monitor. Assess thewoman for evidence of hyperreflexia in the brachial, wrist, patellar or or Achilles tendons. (London et.Al., 2007)


Question23Marks: 1

Which of the following statements regarding herpes simplex virus infection of the newborn is true?

Choose one answer.

a. After 2 to 12 days, the infant develops jaundice and seizures

b. The infant develops vesicular skin lesions

c. All of the choices

Transmission of herpes simplex infection almost always occurs after themembranes rupture and the virus ascends or during birth through aninfected birth canal. The infected infant is asymptomatic at birth butdevelops symptoms of fever (or hypothermia), jaundice, seizures and poorfeeding after an incubation period of 2 to 12 days. Approximately half ofinfected infants develop the characteristic vesicular skin lesions. Infants

who show signs of neonatal herpes should be evaluated promptly andtreated with intravenous acyclovir. (London et. Al., 2007)

d. The infected infant is asymptomatic at birth


Question24Marks: 1

Ectopic pregnancy is the implantation of the fertilized ovum in a site other than the endometrial lining of the uterus. Which of the following indicate the possibility of an ectopic pregnancy in a woman?

Choose one answer.

a. Nausea

b. Adnexal tendernessAs the pregnancy progresses, the chorionic villi grow into the tubewall or implantation site and establish a blood supply. When theembryo outgrows this space, the tube ruptures and there isbleeding into the abdominal cavity. Physical examination usuallyreveals adnexal tenderness or pain on the area over each ovaryand fallopian tube. An adnexal mass is palpable about half the


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time. Bleeding tends to be slow and chronic, and the abdomengradually becomes rigid and very tender. With bleeding into theabdominal cavity, pelvic examination is very painful, and a mass ofblood may be palpated in the lower abdomen. (London et. Al.,2007)

c. Breast tenderness

d.Amenorrhea


Question25Marks: 1

The following are probable signs of pregnancy except:

Choose one answer.

a. Hegar sign

b.Amenorrhea

Three commonly used signs and symptoms of pregnancy arepresumptive (those felt by the woman: amenorrhea, fatigue, nauseaand vomiting, breast changes); probable ( those changes observed byan examiner: (Hegar sign, ballottement, pregnancy tests); andpositive (those signs that are attributable only to the presence of thefetus: hearing fetal heart tones, visualization of t he fetus, and

palpating fetal movements). (Lowdermilk & Perry, 2007)

c.Pregnancy test

d.Ballottement


Question26Marks: 1

All of the following are implications of iron deficiency anemia on a pregnant woman except:

Choose one answer.

a. Easy fatigability

b. Increased susceptibility to infection


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c. Increased risk for pre-eclampsia and eclampsia

d. None of the choices

Iron deficiency anemia is generally defined as a decrease in the oxygen-carrying capacity of the blood. Pregnant women with iron deficiency anemiatires easily, is more susceptible to infection, had increased chance of pre-eclampsia, eclampsia and postpartal hemorrhage, and cannot tolerate evenminimal blood loss during birth. Healing of episiotomy or incision may bedelayed. Fetal implications include risk of low birt h weight, prematurity,stillbirth, and neonatal death increases. Fetus may be hypoxic during labordue to impaired uteroplacental oxygenation. (London et. Al., 2007)


Question27Marks: 1

The following changes can be observed in the vagina during pregnancy except:

Choose one answer.

a. There is a thickening of the vaginal mucosa

b. The connective tissue in the vagina loosens

c. The secretions in the vagina become basic

Estrogen causes a thickening of the vaginal mucosa, a loosening ofthe connective tissue and an increase in vaginal secretions. Thesesecretions are thick, white and acidic (pH 3.5 to 6.0). The acid pH

helps prevent bacterial infection but favors the growth of yeastorganisms. Thus, the pregnant woman is more susceptible to monilialinfection that usual. (London et. Al., 2007)

d. There is an increase in vaginal secretions


Question28Marks: 1

A fetus may be exposed to HIV through which of the following mechanisms?i. Maternal circulation as early as the first trimester of pregnancyii. During labor and birth by inoculation or ingestion of maternal bloodiii. Through breast milk

Choose one answer.

a. ii and iii only


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b. ii only

c. i and ii only

d. i, ii and iii

Pregnancy is not encouraged in HIV-positive women. Exposure may occur to the fetusthrough the maternal circulation as early as the first trimester of pregnancy, to the infantduring labor and birth by inoculation or ingestion of maternal blood and other infected fluids,or to the infant through breast milk. (Lowdermilk & Perry, 2007)

Correct


Question29Marks: 1

Leg cramps are painful muscle spasms in the gastrocnemius muscles. Which of the following is an inappropriate intervention for pregnant women experiencing leg cramps?

Choose one answer.

a. With the woman lying on her back, another person presses thewomans knee down to straighten her leg while pushing her foot

toward her leg

b. Massage and apply a warm compress on the legs

c. Alternate squatting and standing up

Extension of the foot can cause leg cramps. The exact cause of legcramps is unknown but pressure of the enlarged uterus on pelvic

nerves or blood vessels leading to the legs may be a contributingfactor, especially during the third trimester. Stretching providesimmediate relief of the muscle spasm. With the woman lying on herback, another person presses the womans knee down to straightenher leg while pushing her foot toward her leg. The woman may alsostand and put her foot flat on the floor. Massage and warm packs canalleviate the discomfort of leg cramps. A diet that includes dailyportions of both calcium and phosphorus may help prevent leg cramps.(London et. Al., 2007)

d. The woman stands and puts her foot flat on the floor


Question30Marks: 1

The following are functions of the amniotic fluid except:

Choose one answer.

a. It acts as a cushion to protect against mechanical injury.


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b. It permits symmetrical growth and development of the embryo-

fetus.

c. It acts as a wedge during labor.

d. It adheres to the embryo-fetus to restrict movement.

The primary functions of the amniotic fluid are to act as a cushion to protectagainst mechanical injury, help control the embryos temperature, permitsymmetrical growth and development of the embryo-fetus, act as an extension offetal extracellular space, prevent adherence of the amnion to the embryo-fetus toallow freedom of movement so that the embryo-fetus can change position, thusaiding in musculoskeletal development, allow the umbilical cord to be relativelyfree of compression, act as a wedge during labor and provide fluid for analysis todetermine fetal health and maturity. (London, et. Al. 2007)


Question31Marks: 1

Which of the following statements about the umbilical cord is true?

Choose one answer.

a. There is one large vein and one large artery in the umbilical

cord.

b. The umbilical cord has both sensory and motor innervation.

c. All of the choices.

d.Whartons jelly surrounds the blood vessels in the umbilical

cord.

A specialized connective tissue, known as Whartons jelly surrounds the bloodvessels in the umbilical cord. This tissue, plus the high blood volume pulsatingthrough the vessels prevents compression of the umbilical cord in utero. Thebody stalk, which contains attaches the embryo to the yolk sac, contains bloodvessels that extend into the chorionic villi. As the body stalk elongates tobecome the umbilical cord, the vessels in the cord decrease to one large veinand two smaller arteries. About 1% of umbilical cords have only two vessels, anartery and a vein; this condition may be associated with congenitalmalformations. The umbilical cord has no sensory or motor innervation.(London, et. Al., 2007)


Question32

Marks: 1Which of the following statements about fertilization and conception is correct?

Choose one answer.


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a. All of the choices.

b.Fertilization is defined as the union of a single egg and sperm.

c.Conception takes place in the ampulla of the uterine tube.

d.Conception marks the beginning of a pregnancy

Conception is defined as the union of a single egg and sperm and itmarks the beginning of a pregnancy. Conception occurs not as anisolated event but as a part of a sequential process. This sequentialprocess includes gamete formation, ovulation, union of the gametesand implantation in the uterus. Fertilization takes place in theampulla (the outer third) of the uterine tube within 24 hours ofovulation. (Lowdermilk & Perry, 2007)


Question33Marks: 1

Which of the following statements is not true regarding the fetal circulatory system?

Choose one answer.

a. The cardiovascular system is the first organ system to function in the

developing human

b. Oxygenated blood that is distributed to the fetus comes from the

placenta

c. The heart develops into a four-chambered organ by the fourth and fifth

week of development

d. The fetal lungs are able to perform respiratory gas exchange

The cardiovascular system is the first organ system to function in thedeveloping human. The maternal-placental-embryonic circulation is inplace by day 17, when the embryonic heart starts beating. In theintervillous spaces, maternal blood supplies oxygen and nutrients to theembryonic capillaries in the villi. The fetal lungs do not function forrespiratory gas exchange, so a special circulatory pathway, the ductusarteriosus, bypasses the lungs. Oxygen-rich blood from the placentaflows rapidly through the umbilical vein into the fetal abdomen. The heartdevelops into a four-chambered organ by the fourth and f ifth week.(Lowdermilk & Perry, 2007)

Correct


Question34Marks: 1


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The effects of rubella on t he fetus and newborn are great because rubella causes a chronic infection that begins in the first tr imester of pregnancy and may persist for months after birth. The following are fetal-neonatal risks involved when the pregnadevelops rubella except:

Choose one answer.

a. Congenital cataracts

b. Patent ductus arteriosus

c. Mental retardation

d.Hydrocephalus

The period of greatest risk for the effects of rubella on the fetus isthe first trimester. The most common clinical signs of congenitalinfection include congenital cataracts, sensorineural deafness andcongenital heart defects, particularly patent ductus arteriosus. Otherabnormalities, such as mental retardation or cerebral palsy, maybecome evident in infancy. (London et. Al., 2007)


Question35Marks: 1

The following cardiovascular changes may be seen in pregnancy except:

Choose one answer.

a. The blood volume starts to increase at about the tenth to twelfth

week.

b. There is slight cardiac hypertrophy

c. Diastolic blood pressure increases in the fi rst trimester

Systolic blood pressure usually remains the same as the prepregnancy levelbut may decrease slightly as pregnancy advances. Diastolic blood pressurebegins to decrease in the first trimester , continues to drop until 24-32 weeks,then gradually increases and returns to prepregnancy levels by term. Theblood volume starts to increase at about the tenth to twelfth week, peaks atabout the thirty-second to thirty-fourth week and then decreases slightly atthe fortieth week. Cardiac output is elevated largely as a result of theincreased stroke volume and heart rate. Slight cardiac hypertrophy isprobably secondary to the increased blood volume and cardiac output thatoccurs. (Lowdermilk & Perry, 2007)

d. The cardiac output is elevated


Question36


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Marks: 1

Which of the following are normal occurrences in the fetal reproductive system?i. Sex differentiation begins in t he seventh weekii. At birth, the ovaries contain the females lifetime supply of ovaiii. Mammary engorgement and secretion of witchs milk upon birth occurs in female newborns onlyiv. Pseudomenstruation

Choose one answer.

a. i and iii only

b. i, ii and iii only

c. i, ii and iv only

Sex differentiation begins in the seventh week. Distinguishing characteristics appear around the ninth week and arefully differentiated by the twelfth week. At birth the ovaries contain the females lifetime supply of ova. The fetalendometrium responds to maternal hormones, and withdrawal bleeding or vaginal discharge (pseudomenstruation)may occur at birth when these hormones are lost. The high level of maternal estrogen also stimulates mammaryengorgement and secretion of fluid (witchs milk) in newborn infants of both sexes. (Lowdermilk & Perry, 2007)

d. ii and iii only


Question37Marks: 1

Which of the following terms is correctly defined?

Choose one answer.

a. Gravidity refers to the number of pregnancies in which the fetus or fetuses

have reached viability when they are born

b. Primigravida refers to a woman who has completed one pregnancy with a

fetus or fetuses who have reached the stage of fetal viability

c. Nulligravida refers to a woman who is pregnant for the first time

d. Viability refers to the capacity to live outside the uterus; about 22 to 24 weeks

since LMP or fetal weight greater than 500g

Viability refers to the capacity to live outside the uterus; about 22to 24 weeks since LMP or fetal weight greater than 500g.Gravidity refers to pregnancy. Parity refers to the number ofpregnancies in which the fetus or fetuses have reached viabilitywhen they are born. A nullipara is a woman who has never been

pregnant. A primigravida refers to a woman who is pregnant forthe first time. A primipara refers to a woman who has completedone pregnancy with a fetus or fetuses who have reached thestage of fetal viability. (Lowdermilk & Perry, 2007)

Correct


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Question38Marks: 1

All of the following are actions of progesterone on pregnancy except:

Choose one answer.

a. Together with estrogen, it causes fats to deposit in subcutaneous

tissues over the maternal abdomen, back and upper thighs

b. It promotes the enlargement of the genitals, uterus and breastsProgesterone is essential for maintaining pregnancy by relaxing smoothmuscles, resulting in decreased uterine contractility and prevention ofmiscarriage. Progesterone and estrogen cause fat to deposit insubcutaneous tissues over the maternal abdomen, back and upperthighs. This fat serves as an energy reserve for both pregnancy andlactation. The enlargement of the genitals, uterus and breasts is causedby estrogen and this occurs through the increase in vascularity, therebycausing vasodilation. (Lowdermilk & Perry, 2007)

c. None of the choices

d. It relaxes smooth muscles


Question39

Marks: 1Which of the following discomforts is normally experienced by a pregnant woman on her first trimester:

Choose one answer.

a.Heartburn

b. Supine hypotension

c. Nausea and vomiting

Nausea and vomiting occur during the first tr imester and this may resultfrom hormonal changes. Heartburns and supine hypotension occur duringthe second trimester. Heartburns are present because progesterone slowsGI tract motility and digestion, reverses peristalsis, relaxes cardiacsphincter and delays emptying time of stomach. The stomach is alsodisplaced upward as it is compressed by the enlarging uterus. Supinehypotension is induced by the pressure of the gravid uterus on the

ascending vena cava when the woman is supine and this reduces utero-placental and renal perfusion. (Lowdermilk & Perry, 2007)

d. Ankle edema


21/21


Question40Marks: 1

The Estimated Date of Birth (EDB) is calculated using Nageles Rule. Which of the following correctly describes Nageles Rule?

Choose one answer.

a. Subtract 7 calendar months from the LMP, add 3 days and 1 year

b. Determine the first day of LMP, subtract 3 calendar months, add 7

days and 1 year

Nageles Rule is as follows: after determining the first day of LMP,subtract 3 calendar months, add 7 days and 1 year; or alternatively,add 7 days to the LMP and count forward 9 calendar months. Nagelesrule assumes that the woman has a 28-day menstrual cycle and thatpregnancy occurred on the fourteenth day. Most women give birthduring the period extending from 7 days before to 7 days after theEDB. (Lowdermilk & Perry, 2007)

c. Add 7 days to the LMP and count forward 8 calendar months

d. Add 11 days to the LMP and count forward 9 calendar months

SOURCE: CARL BALITA ONLINE REVIEW

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