A nurse is discussing fetal circulation with a group of nursing students.The ductus venosus, foramen ovale, and ductus arteriosus are key factors in fetal circulation.Which of the following explains the purpose of these shunts in fetal circulation?
To bypass the lungs and direct oxygenated blood to the brain and body.
To ensure proper development of the fetal heart.
To regulate blood pressure in the fetus.
To facilitate gas exchange in the lungs.
The Correct Answer is A
Choice A rationale
The ductus venosus, foramen ovale, and ductus arteriosus are shunts in fetal circulation that bypass the lungs and liver, directing oxygenated blood to the brain and body. The foramen ovale allows blood to flow from the right atrium to the left atrium, bypassing the lungs. The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass the lungs. The ductus venosus shunts blood from the umbilical vein to the inferior vena cava, bypassing the liver.
Choice B rationale
This choice is incorrect because the primary purpose of these shunts is not to ensure proper development of the fetal heart. While they do play a role in directing blood flow, their main function is to bypass the non-functional fetal lungs and liver.
Choice C rationale
This choice is incorrect because the shunts are not primarily involved in regulating blood pressure in the fetus. Their main function is to direct oxygenated blood to vital organs like the brain and heart.
Choice D rationale
This choice is incorrect because the shunts bypass the lungs, which are not yet functional in the fetus. Gas exchange occurs in the placenta, not the fetal lungs.
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Correct Answer is C
Explanation
Choice A rationale
Allowing the older sibling to hear the baby’s heartbeat at a prenatal visit can help them feel involved and connected to the new baby. This can be a positive experience and does not require follow-up by the nurse.
Choice B rationale
Enrolling the older sibling in a sibling preparation class at the hospital is a good way to prepare them for the arrival of the new baby. These classes often provide valuable information and help older siblings understand what to expect.
Choice C rationale
Bringing the new baby home as a surprise can be problematic. It may cause the older sibling to feel excluded or unprepared for the new addition to the family. It is important to involve the older sibling in the process and prepare them for the changes that will come with the new baby.
Choice D rationale
Allowing the older sibling to pick out a gift for the baby and having a gift for them from the baby can help foster a positive relationship between the siblings. This approach can make the older sibling feel valued and included.
Correct Answer is B
Explanation
Choice A rationale
Lisinopril is not a beta blocker; it is an ACE inhibitor. Beta blockers, such as metoprolol, are generally considered safer during pregnancy compared to ACE inhibitors. Beta blockers work by blocking the effects of adrenaline on your heart and blood vessels, which helps to lower blood pressure. However, they are not without risks and should be used under medical supervision during pregnancy.
Choice B rationale
Lisinopril is an ACE inhibitor, which is contraindicated during pregnancy, especially in the second and third trimesters. ACE inhibitors can cause fetal renal dysfunction, oligohydramnios, and even fetal death. Therefore, it is essential to discuss alternative medications that are safer during pregnancy.
Choice C rationale
This statement is incorrect because ACE inhibitors, including lisinopril, are not safe to continue during pregnancy. They pose significant risks to the fetus, particularly in the later stages of pregnancy.
Choice D rationale
Lisinopril is not an angiotensin II receptor blocker (ARB); it is an ACE inhibitor. ARBs, like ACE inhibitors, are also contraindicated during pregnancy due to similar risks of fetal toxicity and adverse outcomes.