NSG333 Child-bearing Family Nursing Final
Exam, 202 Questions and Correct Answers, With
Complete Solution Updated 2024. Actual Exam
Questions Included.
Normal FHR BPM
110 - 160 bpm
Variability: what is normal bpm changes? what is this called?
5-25 bpm changes
moderate variability
Absent Variability: what kind of bpm change?
no change
Minimal Variability: what kind of bpm change?
less than 5 bpm change
Marked Variability: what kind of bpm change?
more than 25 bpm changes
Absent/Minimal Variability is typically caused by...
fetal acidemia secondary to uteroplacental insufficiency, cord compression, a preterm
fetus, maternal hypotension, uterine hyperstimulation, abruptio placenta, or a fetal
dysrhythmia.
Marked Variability is typically caused by...
cord prolapse or compression, maternal hypotension, uterine hyperstimulation, and
abruptio placenta.
Acclerations indicate...
O2 to fetus
T/F Accelerations require intervention by nurse.
False, no interventions needed
Late decelerations are associated with...
uteroplacental insufficiency
What do late decelerations imply?
They imply some degree of fetal hypoxia.
Variable decelerations (irregular, jagged dips) are associated with...
cord compression.
Prolonged decelerations are associated with...
prolonged cord compression,
abruptio placenta,
cord prolapse,
supine maternal position,
vaginal examination,
fetal blood sampling,
maternal seizures,
,regional anesthesia,
or uterine rupture.
VEAL CHOP meaning
Category III FHR interventions
-move mom onto her side, L or R lateral, knee-chest, or hands to knees
-o2 by nonrebreather face mask
-IV fluids to improve intravascular volume and help maternal hypotension
-internal fetal monitoring
-discontinue oxytocin
-prepare for c-section if patterns are not corrected within 30 mins
GTPAL for:
pregnant for the 4th time, delivered an infant at 38 weeks, another at 36 weeks,
one
miscarriage at 8 weeks
G4 T1 P1 A1 L2
GTPAL for:
25 week pregnant w twins, has 5 living children, 4 of the 5 were born at 39 weeks,
1 child born at 27 weeks, one miscarried.
G7 T4 P1 A1 L5
T/F The placenta serves as the interface between the mom and fetus.
True
Placental function depends on...
maternal BP supplying circulation.
T/F Mom and baby share blood via uterine arteries.
False.
at no time during pregnancy is there any direct connection between the blood of the
mom and fetus, there is no mixing of blood.
maternal uterine arteries deliver nutrients to the placenta, which in turn provides
nutrients to the fetus, the mothers uterine veins carry fetal waste away.
Function of placenta
It protects the fetus from immune attack by the mother, removes waste products from
the fetus, induces the mother to bring more food to the placenta, and near the time of
birth, produces hormones that mature fetal organs in the prep for life outside the uterus.
Function of amniotic fluid
maintains a constant body temp for the fetus, permits symmetric growth and
development, cushion the fetus from trauma, allows the umbilical cord to be free from
compression, and promotes fetal movement to enhance musculoskeletal development
Naegele's rule: day of last period is May 21, 2019
February 28, 2020
Purpose of fetal circulation
carry highly oxygenated blood to vital areas (heart and brain) while first shunting it away
from less vital ones (lungs and liver)
Fetal circulation oxygenation occurs where?
Placenta
The three shunts that are present during fetal life
, 1. Ductus venosus
2. Ductus arteriosus
3. Foramen ovale
Which two nutrients are most important for pregnant women?
Folate and iron
T/F Fundal measurement should approximately equal the number of weeks of
gestation until delivery.
False, fundal measurement should approximately equal the number of weeks of
gestation until week 36. After 36 weeks, the fundal height then drops due to lightening
and may no longer correspond with the week of gestation.
For example, a fundal height of 24 cm suggests a fetus at 24 weeks’ gestation.
Placental hormone: Human chorionic gonadotropin (hCG)
• Responsible for maintaining the maternal corpus luteum, which secretes progesterone
and estrogens with synthesis occurring before
implantation
• Production by fetal trophoblast cells until the placenta is developed sufficiently to take
over that function
• Basis for early pregnancy tests because it appears in the maternal bloodstream soon
after implantation
• Production peaks at 8 weeks and then gradually declines
Placental hormone: hPL (also known as human chorionic somatomammotropin
[hCS])
• Preparation of mammary glands for lactation and involved in the process of making
glucose available for fetal growth by altering maternal carbohydrate, fat, and protein
metabolism
• Antagonist of insulin because it decreases tissue sensitivity or alters the ability to use
insulin
• Increase in the amount of circulating free fatty acids for maternal metabolic needs and
decrease in maternal metabolism of glucose to facilitate fetal growth
Placental hormone: Relaxin
• Secretion by the placenta as well as the corpus luteum during pregnancy
• Thought to act synergistically with progesterone to maintain pregnancy
• Increase in flexibility of the pubic symphysis, permitting the pelvis to expand during
delivery
• Dilation of the cervix, making it easier for the fetus to enter the vaginal canal; thought
to suppress the release of oxytocin by the hypothalamus, thus delaying the onset of
labor contractions
Placental hormone: Progesterone
• Often called the "hormone of pregnancy" because of the critical role it plays in
supporting the endometrium of the uterus
• Supports the endometrium to provide an environment conducive to fetal survival
• Produced by the corpus luteum during the first few weeks of pregnancy and then by
the placenta until term
• Initially, causes thickening of the uterine lining in anticipation of implantation of the
fertilized ovum; from then on, it maintains the endometrium, inhibits uterine contractility,
and assists in the development of the breasts for lactation
Exam, 202 Questions and Correct Answers, With
Complete Solution Updated 2024. Actual Exam
Questions Included.
Normal FHR BPM
110 - 160 bpm
Variability: what is normal bpm changes? what is this called?
5-25 bpm changes
moderate variability
Absent Variability: what kind of bpm change?
no change
Minimal Variability: what kind of bpm change?
less than 5 bpm change
Marked Variability: what kind of bpm change?
more than 25 bpm changes
Absent/Minimal Variability is typically caused by...
fetal acidemia secondary to uteroplacental insufficiency, cord compression, a preterm
fetus, maternal hypotension, uterine hyperstimulation, abruptio placenta, or a fetal
dysrhythmia.
Marked Variability is typically caused by...
cord prolapse or compression, maternal hypotension, uterine hyperstimulation, and
abruptio placenta.
Acclerations indicate...
O2 to fetus
T/F Accelerations require intervention by nurse.
False, no interventions needed
Late decelerations are associated with...
uteroplacental insufficiency
What do late decelerations imply?
They imply some degree of fetal hypoxia.
Variable decelerations (irregular, jagged dips) are associated with...
cord compression.
Prolonged decelerations are associated with...
prolonged cord compression,
abruptio placenta,
cord prolapse,
supine maternal position,
vaginal examination,
fetal blood sampling,
maternal seizures,
,regional anesthesia,
or uterine rupture.
VEAL CHOP meaning
Category III FHR interventions
-move mom onto her side, L or R lateral, knee-chest, or hands to knees
-o2 by nonrebreather face mask
-IV fluids to improve intravascular volume and help maternal hypotension
-internal fetal monitoring
-discontinue oxytocin
-prepare for c-section if patterns are not corrected within 30 mins
GTPAL for:
pregnant for the 4th time, delivered an infant at 38 weeks, another at 36 weeks,
one
miscarriage at 8 weeks
G4 T1 P1 A1 L2
GTPAL for:
25 week pregnant w twins, has 5 living children, 4 of the 5 were born at 39 weeks,
1 child born at 27 weeks, one miscarried.
G7 T4 P1 A1 L5
T/F The placenta serves as the interface between the mom and fetus.
True
Placental function depends on...
maternal BP supplying circulation.
T/F Mom and baby share blood via uterine arteries.
False.
at no time during pregnancy is there any direct connection between the blood of the
mom and fetus, there is no mixing of blood.
maternal uterine arteries deliver nutrients to the placenta, which in turn provides
nutrients to the fetus, the mothers uterine veins carry fetal waste away.
Function of placenta
It protects the fetus from immune attack by the mother, removes waste products from
the fetus, induces the mother to bring more food to the placenta, and near the time of
birth, produces hormones that mature fetal organs in the prep for life outside the uterus.
Function of amniotic fluid
maintains a constant body temp for the fetus, permits symmetric growth and
development, cushion the fetus from trauma, allows the umbilical cord to be free from
compression, and promotes fetal movement to enhance musculoskeletal development
Naegele's rule: day of last period is May 21, 2019
February 28, 2020
Purpose of fetal circulation
carry highly oxygenated blood to vital areas (heart and brain) while first shunting it away
from less vital ones (lungs and liver)
Fetal circulation oxygenation occurs where?
Placenta
The three shunts that are present during fetal life
, 1. Ductus venosus
2. Ductus arteriosus
3. Foramen ovale
Which two nutrients are most important for pregnant women?
Folate and iron
T/F Fundal measurement should approximately equal the number of weeks of
gestation until delivery.
False, fundal measurement should approximately equal the number of weeks of
gestation until week 36. After 36 weeks, the fundal height then drops due to lightening
and may no longer correspond with the week of gestation.
For example, a fundal height of 24 cm suggests a fetus at 24 weeks’ gestation.
Placental hormone: Human chorionic gonadotropin (hCG)
• Responsible for maintaining the maternal corpus luteum, which secretes progesterone
and estrogens with synthesis occurring before
implantation
• Production by fetal trophoblast cells until the placenta is developed sufficiently to take
over that function
• Basis for early pregnancy tests because it appears in the maternal bloodstream soon
after implantation
• Production peaks at 8 weeks and then gradually declines
Placental hormone: hPL (also known as human chorionic somatomammotropin
[hCS])
• Preparation of mammary glands for lactation and involved in the process of making
glucose available for fetal growth by altering maternal carbohydrate, fat, and protein
metabolism
• Antagonist of insulin because it decreases tissue sensitivity or alters the ability to use
insulin
• Increase in the amount of circulating free fatty acids for maternal metabolic needs and
decrease in maternal metabolism of glucose to facilitate fetal growth
Placental hormone: Relaxin
• Secretion by the placenta as well as the corpus luteum during pregnancy
• Thought to act synergistically with progesterone to maintain pregnancy
• Increase in flexibility of the pubic symphysis, permitting the pelvis to expand during
delivery
• Dilation of the cervix, making it easier for the fetus to enter the vaginal canal; thought
to suppress the release of oxytocin by the hypothalamus, thus delaying the onset of
labor contractions
Placental hormone: Progesterone
• Often called the "hormone of pregnancy" because of the critical role it plays in
supporting the endometrium of the uterus
• Supports the endometrium to provide an environment conducive to fetal survival
• Produced by the corpus luteum during the first few weeks of pregnancy and then by
the placenta until term
• Initially, causes thickening of the uterine lining in anticipation of implantation of the
fertilized ovum; from then on, it maintains the endometrium, inhibits uterine contractility,
and assists in the development of the breasts for lactation
