Ladewig 8e TIF Ch04 PDF

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E
Chapter 04
Question 1
Type: MCMA
The nurse is explaining the difference between meiosis and mitosis. Which statement does the nurse include?
Standard Text: Select all that apply.
1. Meiosis is the division of a cell into two exact copies of the original cell.
2. Mitosis is splitting one cell into two, each with half the chromosomes of the original cell.
3. Meiosis is the process by which gametes, or the sperm and ova, are formed.
4. Mitosis occurs in most of the cells of the body.
5. Meiotic division leads to cells that halve the original genetic material.
Correct Answer: 3,5
Rationale 1: Meiosis creates two cells that have half of the chromosomes of the original cell.
Rationale 2: Mitosis creates two cells that are exact copies of the original cell.
Rationale 3: Both sperm and ova are created through meiosis.
Rationale 4: Mitosis is how the majority of cells reproduce so that the new cells have the same structure and
function as the original. Meiosis only occurs in gametes.
Rationale 5: Meiosis creates two cells that have half of the chromosomes of the original cell.
Global Rationale:
Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: LO01 - Differentiate between meiotic cellular division and mitotic cellular division.
Question 2
Type: MCSA
The nurse has completed a presentation on reproduction. Which participant’s statement indicates that the teaching
has been successful?
1. “A male is born with all the sperm he will ever produce.”

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank
Copyright 2014 by Pearson Education, Inc.
2. “Females create new ova throughout their reproductive life.”
3. “Ova separate into two unequally sized cells.”
4. “Each primary spermatocyte divides into four haploid cells.”
Correct Answer: 3
Rationale 1: Males begin spermatogenesis at puberty and continue throughout their life. Each sperm divides into
four haploid cells.
Rationale 2: Females are born with all the ova they will ever produce. The ova begin to be formed in early fetal
life. One ovum is released each month during the reproductive life of a female, from menarche to menopause.
Rationale 3: Each ovum undergoes meiotic division just prior to being released from the graafian follicle. Each
cell created by this meiosis has the same number of chromosomes, but the cytoplasm does not split equally. This
causes a polar body to be produced along with a secondary oocyte.
Rationale 4: Primary spermatocytes contain 46 chromosomes (46XY). Each primary spermatocyte undergoes
meiotic division into two haploid secondary spermatocytes (22X or 22Y). Haploid cells each contain half of the
genetic material of the original cell. Then each secondary spermatocyte undergoes a second meiotic division into
two haploid spermatids (remaining either 22X or 22Y.) Spermatids mature into spermatozoa. Thus, a primary
spermatocyte eventually becomes four haploid spermatozoa.
Global Rationale:

Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: LO02 - Compare the processes by which ova and sperm are produced.
Question 3
Type: MCSA
After teaching a class about the female reproductive system, the nurse asks the attendees to describe the process
of meiosis. Which student response suggests successful comprehension of the material?
1. "Completion of the second meiotic division results in formation of three polar bodies and one ovum."
2. "At the time of ovulation, the first meiotic division begins."
3. "Completion of the first meiotic division produces three polar bodies and one primary oocyte."
4. "At the time of puberty, the second meiotic division begins."
Correct Answer: 1
Rationale 1: Completion of the second meiotic division produces three polar bodies and one ovum.
Rationale 2: The first meiotic division of oocytes begins before the female fetus is born.
Rationale 3: Completion of the first meiotic division produces one polar body and one secondary oocyte.
Rationale 4: The second meiotic division begins at the time of ovulation.
Global Rationale:
Cognitive Level: Understanding

Client Need Sub:
Learning Outcome: LO02 - Compare the processes by which ova and sperm are produced.
Question 4
Type: MCSA
You are counseling a young woman regarding contraception. When asked if she currently uses any form of
contraception, she replies, "I can't get pregnant because I don't have intercourse on the day I ovulate." Based upon
her response, what information should you include in your teaching?
1. Refraining from intercourse on the day of ovulation will effectively prevent pregnancy.
2. Sperm are believed to be healthy and highly fertile for at least five days.
3. After ovulation, ova are considered fertile for about 72-96 hours.
4. Sperm survive 48-72 hours in the female reproductive tract.
Correct Answer: 4
Rationale 1: Because sperm survive 48-72 hours in the female reproductive tract, avoidance of intercourse for 24
hours will not reliably prevent pregnancy from occurring.
Rationale 2: Sperm are believed to be most fertile for the first 24 hours following entry into the female
reproductive tract.
Rationale 3: Ova are considered fertile for about 12-24 hours after ovulation.
Rationale 4: Sperm survive 48–72 hours in the female reproductive tract.
Global Rationale:

Client Need Sub:

Learning Outcome: LO03 - Describe the components of the fertilization process and how each impacts
fertilization.
Question 5
Type: MCSA
When evaluating information taught about conception and fetal development, the patient verbalizes understanding
about transportation time of the zygote through the fallopian tube and into the cavity of the uterus with which
statement?
1. “It will take at least three days for the egg to reach the uterus.”
2. “It will take eight days for the egg to reach the uterus.”
3. “It will only take 12 hours for the egg to go through the fallopian tube.”
4. “It will take 18 hours for the fertilized egg to implant in the uterus.”
Correct Answer: 1
Rationale 1: It takes at least three days for the egg to reach the uterus.
Rationale 2: “It will take eight days for the egg to reach the uterus” is an incorrect interpretation of the
information on conception.
Rationale 3: “It will only take 12 hours for the egg to go through the fallopian tube” is an incorrect interpretation
of the information on conception.
Rationale 4: “It will take 18 hours for the fertilized egg to implant in the uterus” is an incorrect interpretation of
the information on conception.
Global Rationale:

Client Need Sub:
fertilization.
Question 6
Type: MCSA
If only a small volume of sperm is discharged into the vagina, an insufficient amount of enzymes might be
released when sperm encounters the ovum. In that case, pregnancy would probably not result because:
1. Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus.

2. The block to polyspermy (cortical reaction) would not occur.
3. The fertilized ovum would be unable to implant in the uterus.
4. Sperm would be unable to penetrate the zona pellucida of the ovum.
Correct Answer: 4
Rationale 1: “Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus”
is an incorrect statement.
Rationale 2: The answer choice of the block to polyspermy (cortical reaction) not occurring is incorrect because
it is mediated by release of materials from cortical granules below the ovum’s surface and not the result of low
sperm count.
Rationale 3: The fertilized ovum would be unable to implant in the uterus because fertilization is unlikely to
occur with a low sperm count.
Rationale 4: Sperm would be unable to penetrate the zona pellucida of the ovum because it takes hundreds of
acrosomes (the result of the acrosomal reaction) to rupture and release enough hyaluronic acid to clear the way for
a single sperm to penetrate the ovum’s zona pellucida successfully.
Global Rationale:

Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
fertilization.
Question 7
Type: MCSA
The nurse is caring for a patient who is pregnant with twins. Which statement indicates the patient needs
additional information?
1. “Because both of my twins are boys, I know that they are identical.”
2. “If my twins came from one fertilized egg that split, they are identical.”
3. “If I have one boy and one girl, I will know they came from two eggs.”
4. “It is rare for twins to both be within the same amniotic sac.”
Correct Answer: 1
Rationale 1: Not all same-sex twins are identical or monozygotic, because fraternal, or dizygotic, twins can be the
same gender or different genders.
Rationale 2: When the zygote splits, identical twins share the same genotype result.
Rationale 3: The only way to have twins of different genders is if they came from two separate fertilized ova.
Monozygotic twins are identical and are the same gender.
Rationale 4: Monoamnionic-monochorionic twins are very rare and occur as a result of the zygote splitting seven
or more days after fertilization.
Global Rationale:

Client Need Sub:
Learning Outcome: LO05 - Compare the factors and processes by which fraternal (dizygotic) and identical
(monozygotic) twins are formed.
Question 8
Type: MCSA
A pregnant patient asks you to describe the differences between monozygotic and dizygotic twins. Which
statement should you include in your teaching?
1. Dizygotic twinning occurs less frequently than does monozygotic twinning.
2. Monozygotic twins originate from division of the fertilized ovum at different stages.
3. Dizygotic twins share one placenta and one chorion.
4. Monozygotic twins are also referred to as "fraternal" twins.
Correct Answer: 2
Rationale 1: Dizygotic twinning occurs more frequently than does monozygotic twinning.
Rationale 2: Monozygotic twins originate from division of the fertilized ovum at different stages of early
development.
Rationale 3: Dizygotic twins each have a separate chorion and amnion.
Rationale 4: Monozygotic twins are also referred to as "identical" twins.
Global Rationale:

Client Need Sub:

Question 9
Type: MCSA
Which statement by a pregnant patient would indicate that additional teaching was necessary?
1. “Because of their birth relationship, fraternal twins are more similar to each other than if they had been born
singly.”
2. “Identical twins can be the same or different sex.”
3. “Congenital abnormalities are more prevalent in identical twins.”
4. “Identical twins occur more frequently than fraternal twins.”
Correct Answer: 3
Rationale 1: Fraternal twins are not more similar to each other than if they had been born singly.
Rationale 2: Identical or monozygotic twins have identical chromosomal structures and therefore are always the
same sex.
Rationale 3: Due to variations in the timing of the splitting of the embryo, congenital abnormalities such as
conjoining are more common in monozygotic twins.
Rationale 4: Dizygotic, or fraternal, twins occur more frequently than do monozygotic twins.
Global Rationale:

Client Need Sub:
Question 10
Type: MCSA
The nurse is creating a poster for pregnant mothers. Which description of fetal development does the nurse
include?
1. Four layers of cells form after the embryo is at the ball stage.
2. After fertilization, the cells only become larger for several weeks.

3. Most organs are formed by 8 weeks after fertilization.
4. The embryonic stage is from fertilization until 5 months.
Correct Answer: 3
Rationale 1: Three primary germ layers form from the ball of undifferentiated cells called the blastocyst:
ectoderm, mesoderm, and endoderm.
Rationale 2: After fertilization, the cells reproduce by mitosis, resulting in more cells, not larger cells.
Rationale 3: Most organs are formed during the embryonic stage, which lasts from the 15th day after fertilization
until the end of the 8th week after fertilization.
Rationale 4: The embryonic stage begins on the 15th day after fertilization and ends at the completion of the 8th
week after fertilization.
Global Rationale:
Cognitive Level: Applying

Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO04 - Summarize the processes that occur during the cellular multiplication and
differentiation stages of intrauterine development and their effect on the structures that form.
Question 11
Type: MCSA
The nurse is presenting an early pregnancy class to a group of pregnant women. Which statement indicates a need
for further education? “The placenta:
1. “Develops and grows larger until about 20 weeks’ gestation.”
2. “Creates hormones and enzymes that are necessary during pregnancy.”
3. “Ages and becomes less permeable during the last month of pregnancy.”
4. “Floats in the amniotic sac and filters waste products from the fetus.”
Correct Answer: 4
Rationale 1: The chorionic villi of the placenta become more differentiated with time. The placenta grows in size
until about 20 weeks. After this point, the placenta thickens but does not increase in size.
Rationale 2: The placenta creates glycogen, cholesterol, hormones such as human chorionic gonadotropin (hCG),
and enzymes such as sulfatase and insulinase.

Rationale 3: The placenta is designed to last for 40 weeks, the average length of human gestation. The
permeability to nutrients and oxygen begins to decrease starting at about 36 weeks as a part of the aging of the
placenta.
Rationale 4: The placenta is attached to the uterine wall, and does not float in the amniotic sac. One function of
the placenta is to filter metabolic waste products from the baby’s blood so that they can be excreted by the mother.
Global Rationale:

Client Need Sub:
Learning Outcome: LO06 - Describe the development, structure, and functions of the placenta and umbilical
cord during intrauterine life (embryonic and fetal development).
Question 12
Type: MCSA
The nurse is working with a patient who has experienced a fetal death in utero at 20 weeks. The patient asks what
her baby will look like when it is delivered. Which statement by the nurse is the best response?
1. “Your baby will be covered in fine hair called lanugo.”
2. “Your child will have arm and leg buds, but not fully formed limbs.”
3. “A white, cheesy substance called vernix caseosa will be on the skin.”
4. “The genitals of the baby will be ambiguous.”
Correct Answer: 1
Rationale 1: Downy fine hair called lanugo covers a 20-week fetus.
Rationale 2: Limb buds have developed by 35 days post-fertilization. At 20 weeks, the fetus will have well
developed well differentiated arms and legs.
Rationale 3: Vernix caseosa forms at about 24 weeks. This fetus is only 20 weeks and will not have vernix.
Rationale 4: The genitals are apparent by 12 weeks after fertilization. This fetus would have had specifically male
or female genitals 8 weeks ago.
Global Rationale:
Cognitive Level: Applying

Client Need Sub:

Learning Outcome: LO07 - Contrast the significant changes in growth and development of the fetus at 4, 6, 12,
16, 20, 24, 28, 36, and 40 weeks’ gestation.
Question 13
Type: MCSA
At her first prenatal visit, the patient states, "I'm five weeks' pregnant now and I would like to hear my baby's
heartbeat today." How should the nurse respond?
1. Prepare to assist with auscultation of the fetal heartbeat using a fetoscope.
2. Explain to the patient that the fetal heart does not begin to beat until approximately 7 weeks' gestation.
3. Anticipate that the patient will be scheduled for Doppler ultrasound.
4. Explain to the patient that the fetal heartbeat is not yet detectable at 5 weeks' gestation.
Correct Answer: 4
Rationale 1: Fetal heart tones can be identified through use of a fetoscope at approximately the 20th week of
pregnancy.
Rationale 2: The fetal heart begins to beat by the 4th week of gestation.
Rationale 3: Generally, fetal heart tones cannot be heard until approximately the 8th week of pregnancy by
ultrasound Doppler device.
Rationale 4: While the tubular heart begins to form during the 3rd week, fetal heart tones generally are not be
detectable until at least 7 weeks' gestation.
Global Rationale:

Client Need Sub:
Learning Outcome: LO07 - Contrast the significant changes in growth and development of the fetus at 4, 6, 12,
16, 20, 24, 28, 36, and 40 weeks’ gestation.
Question 14
Type: MCSA
The patient at 18 weeks’ gestation thinks she might have been exposed to a toxin at work that could affect fetal
development. The patient asks the nurse what organs might be affected at this point in pregnancy. The best
response of the nurse is:
1. “The brain is developing now and could be affected.”

2. “Because you are in the second trimester, there is no danger.”
3. “The internal organs like the heart and lungs could be impacted.”
4. “It’s best to not worry about possible problems with your baby.”
Correct Answer: 1
Rationale 1: Maximum brain growth and myelination are occurring at this point in fetal development.
Rationale 2: Although the greatest danger from teratogens is during the embryonic stage (the first 8 weeks of
pregnancy), the fetus at 20 weeks is still vulnerable to exposure to teratogens.
Rationale 3: The heart, lungs, and other internal organs form during the embryonic state, or the first 8 weeks of
pregnancy. During their formation is when they are most likely to be affected by a teratogen.
Rationale 4: Avoid telling patients to not worry. Doing so indicates to the patient that you don’t care about their
concerns and will end effective communication.
Global Rationale:

Client Need: Psychosocial Integrity
Client Need Sub:
Learning Outcome: LO08 - Compare the vulnerable periods during which malformations of the various organ
systems may occur, resulting in congenital malformations.
Question 15
Type: MCMA
The nurse is preparing a preconception information class. Information about causes of fetal organ malformation in
the first trimester will be presented. What prenatal influences on the intrauterine environment should be included
in the instruction?
Standard Text: Select all that apply.
1. The use of saunas or hot tubs
2. The use of drugs
3. The quality of the sperm or ovum
4. Maternal nutrition
5. Age of the mother at conception
Correct Answer: 1,2,4

Rationale 1: The use of saunas or hot tubs is associated with maternal hyperthermia and neural tube defects.
Rationale 2: Many drugs can have teratogenic effects.
Rationale 3: The quality of the sperm or ovum can affect fertility but not organ formation.
Rationale 4: Maternal nutrition, if deficient, can cause damage to the fetus. Vitamins and folic acid taken prior to
and during the pregnancy can have beneficial effects.
Rationale 5: A maternal age of 35 or older is associated with genetic defects that occur at conception, not with
first-semester organ malformation.
Global Rationale:

Client Need: Physiological Integrity
Client Need Sub:
Learning Outcome: LO08 - Compare the vulnerable periods during which malformations of the various organ
systems may occur, resulting in congenital malformations.


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Ladewig, Contemporary Maternal-Newborn Nursing, 8/E

Standard Text: Select all that apply.

4. Mitosis occurs in most of the cells of the body.

Correct Answer: 3,5

Rationale 3: Both sperm and ova are created through meiosis.

Cognitive Level: Analyzing

1. “A male is born with all the sperm he will ever produce.”

3. “Ova separate into two unequally sized cells.”

4. “Each primary spermatocyte divides into four haploid cells.”

Cognitive Level: Analyzing

2. "At the time of ovulation, the first meiotic division begins."

4. "At the time of puberty, the second meiotic division begins."

Rationale 4: The second meiotic division begins at the time of ovulation.

Cognitive Level: Understanding

4. Sperm survive 48-72 hours in the female reproductive tract.

Rationale 4: Sperm survive 48–72 hours in the female reproductive tract.

Cognitive Level: Understanding

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

Cognitive Level: Understanding

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

3. The fertilized ovum would be unable to implant in the uterus.

4. Sperm would be unable to penetrate the zona pellucida of the ovum.

Cognitive Level: Understanding

Cognitive Level: Understanding

1. Dizygotic twinning occurs less frequently than does monozygotic twinning.

3. Dizygotic twins share one placenta and one chorion.

4. Monozygotic twins are also referred to as "fraternal" twins.

Rationale 3: Dizygotic twins each have a separate chorion and amnion.

Rationale 4: Monozygotic twins are also referred to as "identical" twins.

Cognitive Level: Analyzing

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

2. “Identical twins can be the same or different sex.”

3. “Congenital abnormalities are more prevalent in identical twins.”

4. “Identical twins occur more frequently than fraternal twins.”

Cognitive Level: Understanding

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

4. The embryonic stage is from fertilization until 5 months.

Cognitive Level: Applying

1. “Develops and grows larger until about 20 weeks’ gestation.”

2. “Creates hormones and enzymes that are necessary during pregnancy.”

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

Cognitive Level: Understanding

1. “Your baby will be covered in fine hair called lanugo.”

3. “A white, cheesy substance called vernix caseosa will be on the skin.”

4. “The genitals of the baby will be ambiguous.”

Rationale 1: Downy fine hair called lanugo covers a 20-week fetus.

Cognitive Level: Applying

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

1. Prepare to assist with auscultation of the fetal heartbeat using a fetoscope.

3. Anticipate that the patient will be scheduled for Doppler ultrasound.

Cognitive Level: Analyzing

1. “The brain is developing now and could be affected.”

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

Cognitive Level: Analyzing

Standard Text: Select all that apply.

1. The use of saunas or hot tubs

2. The use of drugs

3. The quality of the sperm or ovum

5. Age of the mother at conception

Correct Answer: 1,2,4

Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank

Rationale 2: Many drugs can have teratogenic effects.

Cognitive Level: Analyzing