31. Ans. C Heart development occurs between the second and eighth weeks of gestation.
A. This is a neural tube defect not asstd with Rubella.
B. Asstd with intake of teratogenic drugs not rubella; Rubella may cause nerve deafness from 8th cranial nerve or hearing center involvement.
32. Ans. B Increased pulmonary blood flow raises the pressure on the left atrium and functionally forces the septum to close the foramen ovale.
A. There is an increased aortic blood flow
C. Caused by increased pressure in the left atrium
D. There is decreased pressure in the right atrium.
33. Ans. C There is anatomic obliteration of the lumen by fibrous proliferation, leading to the term “ligamentum arteriosum”.
A. Descriptive term meaning long and round ligament
B. This refers to ductus venosus
D. There is no such vessel.
34. Ans. A. Bacteria, esp. E. Coli produce and synthesize prothrombin
B. Manufactured in the liver, not synthesized by bacteria
C. Secreted by the gastric glands, not synthesized by bacteria
D. An orange bile pigment produced by the breakdown of hemoglobin.
35. Ans. D The congenital absence of a vesselin the umbilical cord is often asstd with life threatening congenital anomalies.
A. If the Apgar score 5 minutes later showed marked improvement, there would be no need for placing the infant in the ICU.
b. This is the average weight of a full term newborn
C. The fetus have swallowed some amniotic fluid, not unusual or dangerous.
36. Ans. D. Progesterone acts to reduce contractility of the uterine musculature and to maintain the decidual bed.
A. Elevated progesterone levels would inhibit contractility of the uterine musculature
B. Progesterone, not estrogen, inhibits contractions
C. Would tend to stimulate contractions but is inhibited by progesterone, not estrogen.
37. Ans. C Concentration of the polypeptide, a melanocyte stimulating hormone, rises from the end of the 2nd month of pregnancy until term.
A. High levels of chorionic gonadotropin, secreted by the chorion, are asstd with nausea and vomiting.
B. Related to advancing growth and pressure of the uterus and bladder
D. Due to increased mucoidal secretions
38. Ans. B If the woman had a hemophilic father, she must have had his X chromosome, which carries the recessive gene for hemophilia (if had had his Y chromosome, she would have been male), since her blood clots normally, her other X chromosome carries the dominant gene for normal blood clotting. She is represented by H1h (the H1 being the affected gamete); her normal mate is represented by HY. The cross:
Father
H Y
Mother H1 H1H H1Y
h Hh hY
A. Could happen only if both parents were hemophilacs
C 50% of the male children could be normal
D. 50% of the offspring are affected-male hemophilacs or female carriers
39. Ans. A Oral contraceptives contain varying kinds and dosages of synthetic estrogen and progesterone compounds that mimic natural cyclic hormone changes and prolong the menses.
B. False; since pills contain estrogen, they will minimize menopausal symptoms that are caused by lowered estrogen content.
C. This would be symptomatic of disease not of oral contraceptive usage.
D. It tends to prolong menses by supplying estrogen.
40. Ans. D. Alteration of ovarian hormones cause vasomotor instability, periodic systemic vasodilation is then triggered by the sympathetic nervous system, causing the feeling of warmth
A. Hot flushes may be asstd with under-stimulation of the adrenals
B. acetylcholine does not cause hot flushes, it is the chemical mediator of cholinergic nerve impulses.
C. Gonadotropins do not cause hot flushes, they stimulate the function of the testes and ovaries
41. Ans. C The lack of utilization of gonadotropin by the ovaries causes the elevation of gonadotropin in the blood; ovarian function is diminished; there is little or no follicular activity.
A. There would be a decrease in the secretion of progesterone.
B. There would be an increase in prostaglandin
D. There would be an increase in gonadotropin in the blood, for it is not used by the ovaries.
42. Ans. A. It is the surge of LH secretion in midcycle that is responsible for ovulation
B. When the endometrial wall is built up
C. when the progesterone level is low.
D. Not related; this stimulates ejection of milk
43. Ans. B High levels of plasma estrogen inhibit pituitary secretion of FSH; this effect appears to be mediated by the hypothalamus and its releasing factors
A. LH causes ovlation
C. Low concentration of estrogen may precipitate demineralization of bone
D. Lactogenic hormone (prolactin) stimulates lactation
44. Ans. B Heart rate is vital and critical observation in Apgar scoring at birth
A. Respiratory effort rather than rate is included in the score. The rate is very erratic
C. May or may not be present at this time and not part of the Apgar scoring
D. Should be assessed later and not part of Apgar scoring
45. Ans. C The rate varies with activity, crying will increase the rate, whereas deep sleep will lower it; rate between 120 to 160 is WNL.
A. Rates below 120 are considered bradycardia, above 180 is bradycardia
B. The normal is option C
D. Below 120 is considered bradycardia.
46. Ans. C Rate is asstd with activity and can be as rapid as 60 bpm; over 60 is considered tachypneic in the infant
A.& B Considered tachypneic in newborn
May go up to 60 with activity
47. Ans. C Injury to the brachial plexus, clavicle or humerus prfevents the abductive ad adductive movements of the upper extremities.
A. These injuries usually cause a symmetric loss of the moro reflex
B. Not usually asstd; however, if the cochlea is undeveloped or the 8th cranial nerve (vestibulocochlear) were injured , it would affect equilibrium and response to the test
D. Children with Down Syndrome exhibit a normal moro reflex.
48. Ans. C Individual twins usually grow at the same rate as singletonsuntil 30 to 32 weekas gestation, then twins don’t gain weight as rapidly as singletons of the same gestational age. The placenta can no longer keep pace with the nutritional requirements of both fetuses after 32 weeks, so there is some growth retardation in twins if they remain in utero at 38 to 40 weeks
49. Ans. A This type of plscenta that develops in monozygotic twins depends on the time at which cleavage of the ovum occurs.
B Cleavage that occurs less than 3 days after fertilization results diamniotic dichorionic twins
C. Cleavage that occurs between 3 to 8 days
D. Cleavage that occurs between 8 and 13days
50. Ans. D Once the mother and the fetus are stabilized, ultrasound evaluation of the placenta should be done to determine the cause of the bleeding.
A. Contraindicated
B. Should not be done as this may lead to vaginal bleeding
C. Won’t detect placenta previa; could detect fetal distress.
51. Ans. D A previous molar gestation increases a woman’s risk for developing subsequent molar gestation by 4 to 5 times.
A. Adolescent and women 40 yrs and older are at increased risk for molar pregnancies.
B. Multigravidas, especially women with previous pregnancy loss
C. Women with lower socioeconomic status are at increased risk
52. Ans. A A pregnant client breaths deeper, which increases the tidal volume of gas moved in and out of the respiratory tract with each breath.
B. The expiratory volume and residual volume decrease as the pregnancy progresses
C. The inspiratory capacity increases during pregnancy
D. O2 consumption is 15 to 20% greater than in the pregnant state.
53. Ans. C Hemoglobin & hematocrit values decrease during pregnancy as the increase in plasma volume exceeds the increase in RBC production.
A. Mastitis is an infection in the breast characterized by a swollen tender breast and flu-like symptoms. This condition is most frequently seen in breast-feeding clients.
B. & D Alterations in acid-base balance during pregnancy results in a state of respiratory alkalosis
54. Ans. D Systolic murmurs are heard in up to 90% of pregnant clients, and disappears soon after delivery.
A. causes effusion of fluid into the pericardial sac; it is not normal in pregnancy
B. Not normal in pregnancy despite increase in intravascular volume.
C. Most often asstd with IV drug use and not a normal finding in pregnancy.
55. Ans. C The incidence of preeclampsia in obese clients is about 7 times more than that in pregnant nonobese clients.
A. B, & D Not asstd with increased incidence in obese pregnant client.
56. Ans. B. Adolescent clients are at risk for delivering a low-birth weight neonates.
A. & D. Not at increased risk
C. Low birth weight; not macrosomia
57. Ans. B Refers to number of times a female has been pregnant, regardless of pregnancy outcome or the number of neonates delivered.
58. Ans. A Fundal height (in cm) should equal the number of weeks’ gestation. This client should have fundal height 15 to 16 cm.
B, C, & D WNL
59. Ans. A Hemmorhoids generally occur during the 2nd & 3rd trimesters as blood stagnates in the lower extremities, resulting from pressure on the pelvic veins and inferior vena cava from the enlarged uterus.
B. C. & D. Common discomforts in the 1st trimester
60. Ans. C Abdominal ultrasound evaluares fetal presentation, fetal heart activity, and amniotic fluid volume. Although it may show increased amniotic fluid volume, thus helping to diagnose maternal diabetes, it is not used for that purpose
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