A nurse is caring for a client in the obstetric clinic who is 22 weeks of gestation, calculated by her last menstrual period.The fundal height measurement is 19 centimeters.This measurement could indicate which of the following? (Select all that apply).
Intrauterine growth restriction.
Consistent for estimated gestational age by LMP.
Fetal anomaly.
Polyhydramnios.
Miscalculation of due date.
Correct Answer : A,C,E
Choice A rationale
Intrauterine growth restriction (IUGR) can result in a smaller fundal height measurement than expected for gestational age. This condition indicates that the fetus is not growing at the normal rate inside the womb.
Choice B rationale
A fundal height measurement of 19 centimeters at 22 weeks of gestation is not consistent with the estimated gestational age by LMP. Typically, the fundal height in centimeters should be approximately equal to the number of weeks of gestation.
Choice C rationale
Fetal anomalies can affect the size and growth of the fetus, leading to discrepancies in fundal height measurements. This could result in a smaller or larger than expected measurement.
Choice D rationale
Polyhydramnios, or excessive amniotic fluid, would typically result in a larger fundal height measurement than expected for gestational age. Therefore, this choice is incorrect.
Choice E rationale
Miscalculation of the due date can lead to discrepancies in fundal height measurements. If the gestational age is miscalculated, the fundal height may not match the expected measurement for the given weeks of gestation.
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Correct Answer is D
Explanation
Choice A rationale
Striae gravidarum, or stretch marks, are a common occurrence during pregnancy due to the rapid stretching of the skin. They are not a medical emergency and do not require immediate attention from a healthcare provider.
Choice B rationale
During pregnancy, the nipples and areola typically become darker, not paler, as the breasts enlarge. This change is due to hormonal influences and increased blood flow to the area.
Choice C rationale
Fetal movement, also known as quickening, is usually felt by the mother between 18 to 25 weeks of gestation, not as early as 10 weeks. At 10 weeks, the fetus is still too small for its movements to be felt by the mother.
Choice D rationale
Some nausea and vomiting, known as morning sickness, is normal during pregnancy. However, if a pregnant woman is unable to keep food or water down, it is important to contact a healthcare provider to ensure she and the baby are receiving adequate nutrition and hydration.
Correct Answer is B
Explanation
Choice A rationale
The mother’s size does not significantly impact the effects of teratogen exposure on fetal development. Teratogens are substances that cause congenital abnormalities in a developing fetus, and their impact is more related to the timing, duration, and type of exposure rather than the mother’s physical characteristics.
Choice B rationale
The timing and duration of exposure are critical factors in determining the effects of teratogen exposure. Teratogens can cause the most harm during specific periods of fetal development, particularly during the first trimester when organogenesis occurs. The duration of exposure also influences the severity of the effects, with prolonged exposure leading to more significant developmental issues.
Choice C rationale
The type of teratogen is also important, as different teratogens can cause different types of congenital abnormalities. For example, alcohol can lead to fetal alcohol syndrome, while certain medications can cause neural tube defects. However, the timing and duration of exposure are generally considered more critical factors.
Choice D rationale
The father’s health does not directly impact the effects of teratogen exposure on fetal development. Teratogens affect the fetus through the mother’s exposure to harmful substances during pregnancy.