PTEST - PREGNANCY REPRODUCTION Matching Questions Figure...

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Unformatted text preview: PREGNANCY REPRODUCTION Matching Questions Figure 28.1 Using Figure 28.1, match the following: 1) Liver. Answer: D Diff: 2 Page Ref: 1126; Fig. 28.11 2) Esophagus. Answer: A Diff: 2 Page Ref: 1126; Fig. 28.11 3) Trachea. Answer: B Diff: 2 Page Ref: 1126; Fig. 28.11 4) Stomach. Answer: C Diff: 2 Page Ref: 1126; Fig. 28.11 5) Pancreas. Answer: E Diff: 2 Page Ref: 1126; Fig. 28.11 Match the following: 6) Protective water‐filled sac surrounding the embryo. Answer: C Diff: 2 Page Ref: 1122 7) Extraembryonic membrane that develops from the trophoblast and forms part of the placenta. Answer: D Diff: 2 Page Ref: 1120 A) Yolk sac B) Allantois C) Amnion D) Chorion 8) Site of early blood cell production, and site from which progenitors of the future germ cells migrate to reach the genital ridges. Answer: A Diff: 2 Page Ref: 1122 9) Structure in humans that is the structural base for the umbilical cord; the solid waste disposal site in nonplacental animals. Answer: B Diff: 2 Page Ref: 1123 Match the following: 10) Leads to the development of a morula and then a blastocyst. Answer: A Diff: 1 Page Ref: 1117 11) Embedding of the blastula in the uterine wall. Answer: B Diff: 1 Page Ref: 1119 A) Cleavage B) Implantation C) Gastrulation D) Fertilization 12) Leads to the formation of the first cell of the new individual. Answer: D Diff: 2 Page Ref: 1114 13) Leads to the establishment of the three primary germ layers. Answer: C Diff: 2 Page Ref: 1123 True/False Questions 1) Conceptus is a term used to describe the developing offspring in a woman. Answer: TRUE Diff: 1 Page Ref: 1114 2) The first weeks of gestation are called the embryonic period. Answer: FALSE Diff: 1 Page Ref: 1114 3) Fertilization occurs while the egg is still in the ovarian follicle. Answer: FALSE Diff: 1 Page Ref: 1114 4) Freshly deposited sperm are not capable of penetrating an oocyte. Answer: TRUE Diff: 1 Page Ref: 1115 5) By 72 hours after fertilization, the egg has divided into more than 160 cells and is called the morula. Answer: FALSE Diff: 1 Page Ref: 1117 6) Implantation begins six days after ovulation. Answer: TRUE Diff: 1 Page Ref: 1119 7) Growth hormone is responsible for the integrity of the corpus luteum. Answer: FALSE Diff: 1 Page Ref: 1120 8) A pregnancy test involves antibodies that detect GH levels in a womanʹs blood or urine. Answer: FALSE Diff: 1 Page Ref: 1120 9) The organs of the developing fetus are recognizable in the first eight weeks. Answer: TRUE Diff: 1 Page Ref: 1133; Tbl. 28.2 10) The first major event in organogenesis is development of the gut. Answer: FALSE Diff: 1 Page Ref: 1126 11) Of the three germ layers, the mesoderm forms more body parts. Answer: TRUE Diff: 1 Page Ref: 1126-1127 12) A pregnant woman urinates more often than usual because the uterus compresses the bladder, and she must also dispose of fetal metabolic wastes. Answer: TRUE Diff: 1 Page Ref: 1135 13) The two hormones responsible for initiating labor are thyroxine and human chorionic thyrotropin. Answer: FALSE Diff: 1 Page Ref: 1136 14) The ʺfluid-filled, hollow ball of cellsʺ stage of development is the blastocyst. Answer: TRUE Diff: 1 Page Ref: 1118 15) The embryonic stage lasts until the end of the eighth week. Answer: TRUE Diff: 1 Page Ref: 1114 16) The embryo is directly enclosed in and protected by the amnion. Answer: TRUE Diff: 1 Page Ref: 1122 17) In fetal circulation, one-way blood bypasses the nonaerated lungs by way of the foramen ovale. Answer: TRUE Diff: 1 Page Ref: 1130 18) An episiotomy is an incision made to widen the vaginal orifice, aiding fetal expulsion. Answer: TRUE Diff: 1 Page Ref: 1137 19) The placenta and its attached fetal membranes are collectively called the afterbirth. Answer: TRUE Diff: 1 Page Ref: 1137 20) Human placental lactogen initiates labor. Answer: FALSE Diff: 2 Page Ref: 1134-1136 21) Surfactant production in premature infants is rarely a factor in providing normal respiratory activity. Answer: FALSE Diff: 2 Page Ref: 1136 22) A blastocyst is a hollow ball of cells, while the morula is a solid ball of cells. Answer: TRUE Diff: 2 Page Ref: 1117-1118 23) A zygote is usually formed within the uterus. Answer: FALSE Diff: 3 Page Ref: 1114 Multiple-Choice Questions 1) The ectodermal cells migrate to form a raised groove known as the ________. A) blastocyst B) amnion formation C) germ cell formation D) primitive streak Answer: D Diff: 1 Page Ref: 1123 2) The result of polyspermy in humans is ________. A) multiple births B) a nonfunctional zygote C) interruption of meiosis D) mitotic insufficiency Answer: B Diff: 1 Page Ref: 1115 3) It is impossible for sperm to be functional (able to fertilize the egg) until after ________. A) the tail disappears B) they become spermatids C) they undergo capacitation D) they have been stored in the uterus for several days Answer: C Diff: 1 Page Ref: 1115 4) Milk ejection or let-down reflex is stimulated by which of the following hormones associated with pregnancy? A) inhibin B) oxytocin C) prolactin D) gonadotropin Answer: B Diff: 1 Page Ref: 1138 5) Estrogen and progesterone maintain the integrity of the uterine lining and prepare the mammary glands to secrete milk. Which of the following structures makes this possible during the first three months of pregnancy? A) the amnion B) the chorion C) corpus luteum D) corona radiata Answer: C Diff: 1 Page Ref: 1120 6) The placenta, a vitally important metabolic organ, is made up of a contribution from mother and fetus. Which portion is from the fetus? A) chorion B) umbilicus C) yolk sac D) amnion Answer: A Diff: 1 Page Ref: 1120 7) Relaxin is a hormone produced by the placenta and ovaries. The function of this hormone is to ________. A) block the pain of childbirth B) ensure the implantation of the blastula C) relax the pubic symphysis D) prevent morning sickness Answer: C Diff: 1 Page Ref: 1134 8) Hyaluronidase and proteinase are enzymes. How do they function in reproduction? A) They neutralize the mucous secretions of the uterine mucosa. B) They direct the sperm to the egg through chemical messengers. C) They act to break down the protective barriers around the egg, allowing the sperm to penetrate. D) Their function is unknown. Answer: C Diff: 1 Page Ref: 1115 9) Which of the following is not a germ layer? A) ectoderm B) mesoderm C) epiderm D) endoderm Answer: C Diff: 1 Page Ref: 1123 10) The formation of endodermal and ectodermal germ layers occurs at ________. A) fertilization B) cleavage C) gastrulation D) blastula formation Answer: C Diff: 1 Page Ref: 1123 11) The lateral mesoderm forms ________. A) the notochord B) the urinary system C) the skeletal muscles D) the epithelial lining of the GI tract Answer: D Diff: 1 Page Ref: 1126-1127 12) Which of the following is a highly unlikely method of producing a child? A) embryo transfer B) ectopic implantation C) artificial insemination D) gamete intrafallopian transfer Answer: B Diff: 1 Page Ref: 1139 13) Failure of the foramen ovale to close at birth may result in ________. A) direct aeration of blood B) edema of the extremities C) no blood circulation through the body D) mixing of oxygenated and nonoxygenated blood Answer: D Diff: 1 Page Ref: 1130 14) Implantation involves ________. A) placenta completion B) formation of germ layers C) fusion of egg and sperm D) embedding of the blastula in the uterine wall Answer: D Diff: 1 Page Ref: 1119 15) The umbilical arteries carry ________. A) waste products to the placenta B) oxygen and food to the fetus C) oxygen and metabolic wastes to the placenta D) oxygen and waste products to the fetus Answer: A Diff: 1 Page Ref: 1130 16) The correct sequence of preembryonic structures is ________. A) zygote, blastocyst, morula B) zygote, morula, blastocyst C) blastocyst, morula, zygote D) morula, zygote, blastocyst Answer: B Diff: 1 Page Ref: 1117-1118 17) One sign of an infantʹs physical condition that is first noticed at birth is which of the following? A) color B) temperature C) crying D) size Answer: A Diff: 1 Page Ref: 1137 18) Hormones concerned with events of lactation include ________. A) estrogen B) oxytocin C) progesterone D) hCG Answer: B Diff: 1 Page Ref: 1138 19) Just after implantation occurs, nutrition of the young embryo is primarily provided by ________. A) simple diffusion of nutrients from the uterine secretions B) nutrient stores in the embryonic cells C) the blood supply of the placenta D) digestion of endometrial cells Answer: D Diff: 1 Page Ref: 1119 20) Onset of labor may be a result of all of the following factors except ________. A) secretion of oxytocin B) high estrogen levels C) aspirin and similar drugs D) increased emotional and physical stress Answer: C Diff: 1 Page Ref: 1135-1136 21) Select the correct statement about fertilization. A) Both spermatozoa and the ovulated secondary oocyte remain viable for about 72 hours in the female reproductive tract. B) Millions of sperm cells are destroyed by the vaginaʹs acidic environment. C) If estrogen is present, the pathway through the cervical opening is blocked from sperm entry. D) Once inside the uterus, most sperm cells are protected and remain viable. Answer: B Diff: 1 Page Ref: 1115 22) Implantation ________. A) begins about 24 hours after fertilization B) is usually completed by the sixth day after ovulation C) signals the division of the trophoblast into two distinct layers D) begins as the inner cell mass adheres to the endometrial wall Answer: C Diff: 1 Page Ref: 1119 23) The surface cells of the inner cell mass become ________. A) a structure called the embryonic disc B) one of the fetal membranes C) the primitive streak D) the notochord Answer: C Diff: 1 Page Ref: 1123 24) Muscle tissue is formed by the ________. A) mesoderm B) ectoderm C) endoderm D) epiderm Answer: A Diff: 2 Page Ref: 1126-1127 25) Neural tissue is formed by the ________. A) epiderm B) endoderm C) mesoderm D) ectoderm Answer: D Diff: 2 Page Ref: 1123 26) The trophoblast is responsible for forming the ________. A) allantois B) archenteron C) placental tissue D) lining of the endometrium Answer: C Diff: 2 Page Ref: 1119-1120 27) The cardiovascular system of a newborn must be adjusted after the infant takes its first breath. Which of the following is also true? A) The foramen ovale between the atria of the fetal heart closes at the moment of birth. B) The ductus venosus is disconnected at the severing of the umbilical cord and all visceral blood goes into the vena cava. C) The urinary system is activated at birth. D) The ductus arteriosus constricts and is converted to the ligamentum arteriosum. Answer: D Diff: 2 Page Ref: 1137-1138 28) Sperm move to the uterine tube through uterine contractions and the energy of their own flagella. What other factor is involved in sperm movement? A) hormonal attraction to the ova B) reverse peristalsis of the uterus and uterine tubes C) the cilia on the apex of the cells lining the endometrium D) the increased temperature in the vagina, which stimulates sperm motility Answer: B Diff: 2 Page Ref: 1115 29) At which stage of labor is the ʺafterbirthʺ expelled? A) dystocia B) expulsion C) placental D) full dilation Answer: C Diff: 2 Page Ref: 1137 30) Which hormone is not produced by the placenta? A) human placental lactogen B) human chorionic thyrotropin C) relaxin D) inhibin Answer: D Diff: 2 Page Ref: 1120-1122 31) During which stage of labor is the fetus delivered? A) dilation stage B) expulsion stage C) placental stage D) gastrula stage Answer: B Diff: 2 Page Ref: 1137 32) Implantation of the blastocyst is the result of all of the following except ________. A) phagocytosis by the trophoblast cells B) proteolytic enzymes produced by the trophoblast cells C) settling of the blastocyst onto the prepared uterine lining D) stickiness of the trophoblast cells over the inner cell mass Answer: A Diff: 2 Page Ref: 1119 33) Cleavage as part of embryonic development is distinctive because it involves ________. A) cell division by mitosis with little or no growth between successive divisions B) the fusion of gametes C) splitting the cell into two separate cells D) meiosis Answer: A Diff: 2 Page Ref: 1117-1118 34) Which of the following is true in reference to what may pass through the placental barriers? A) nutrients and respiratory gases only B) hormones, blood cells, and nutrients C) nutrients, respiratory gases, wastes, and alcohol D) respiratory gases, hormones, nutrients, and blood cells Answer: C Diff: 2 Page Ref: 1122 35) Which of the following is not usually considered a teratogen? A) aspirin B) wine C) thalidomide D) German measles Answer: A Diff: 2 Page Ref: 1130 36) Derivatives of the ectoderm include ________. A) serosae of the ventral body cavity B) epithelium of the reproductive tract C) epithelium of the pineal and pituitary glands D) connective tissues Answer: C Diff: 2 Page Ref: 1123 37) Derivatives of the mesoderm include ________. A) tooth enamel B) endothelium of blood and lymph vessels C) glandular derivatives of the digestive tract D) epithelium of the digestive tract Answer: B Diff: 2 Page Ref: 1126-1127 38) Derivatives of the endoderm include ________. A) epithelium of the respiratory tract B) synovial membranes of the joints C) blood, bone marrow, and lymphoid tissue D) organs of the urogenital system Answer: A Diff: 2 Page Ref: 1123-1126 39) Developmental events during weeks 13-16 include ________. A) the face looking human and the body beginning to outgrow the head B) the cardiovascular system becoming fully functional C) all body systems being present in rudimentary form D) myelination of nervous structures beginning Answer: A Diff: 2 Page Ref: 1132; Tbl. 28.2 40) Developmental events during weeks 17-20 include ________. A) mesenteric attachments completing B) limbs achieving final proportions C) notochord degenerating D) eyes opening Answer: B Diff: 2 Page Ref: 1132; Tbl. 28.2 41) Developmental events during weeks 21-30 include ________. A) quickening, which occurs first B) the hard palate fusing C) bile starting to be secreted D) distal limp bones beginning to ossify Answer: D Diff: 2 Page Ref: 1132; Tbl. 28.2 42) Which metabolic change does not occur as the placenta enlarges? A) increased human placental lactogen secretion B) increased levels of estrogen C) increased human chorionic thyrotropin secretion D) increased levels of calcitonin Answer: D Diff: 2 Page Ref: 1134-1135 43) Select the correct statement about the special fetal blood vessels. A) The distal parts of the umbilical arteries form the superior vesical arteries. B) The fossa ovalis becomes the foramen ovale. C) The umbilical vein becomes the ligamentum teres. D) The hepatic portal vein forms from the umbilical artery. Answer: C Diff: 2 Page Ref: 1128-1130 44) Which of the following statements about the events of fertilization is not true? A) The two pronuclei divide. B) The head of the sperm forms the male pronucleus. C) The secondary oocyte completes the second meiotic division. D) Hyaluronidase and proteinases of the sperm disperse the cells of the corona radiata of the oocyte. Answer: A Diff: 2 Page Ref: 1115-1116 45) Which developmental event occurs during the embryonic period? A) Weak spontaneous muscle contractions just begin. B) Eyes and ears assume characteristic position and shape. C) Blood is formed in the bone marrow. D) Eyelashes and eyebrows are present. Answer: A Diff: 2 Page Ref: 1132; Tbl. 28.2 46) The decidua basalis is ________. A) destined to remain in the uterus after the birth of the infant B) located between the developing embryo and the myometrium C) not a maternal contribution to the placenta D) the tissue that surroundsthe uterine cavity face of the implanted embryo Answer: B Diff: 2 Page Ref: 1122 Fill-in-the-Blank/Short Answer Questions 1) The first ʺmilkʺ the mother produces is called ________. Answer: colostrum Diff: 1 Page Ref: 1138 2) As the newborn suckles, her motherʹs pituitary produces ________ to assist in producing milk. Answer: oxytocin Diff: 1 Page Ref: 1138 3) The act of giving birth is called ________. Answer: parturition Diff: 1 Page Ref: 1135 4) After the egg is fertilized, it is called a ________. Answer: zygote Diff: 1 Page Ref: 1114 5) The ________ cells of the blastocyst will take part in placental formation. Answer: trophoblast Diff: 1 Page Ref: 1118 6) The ________ stage of development is the first in which all three germ layers of tissue are evident. Answer: gastrula Diff: 1 Page Ref: 1123 7) ________ is a tissue with star-shaped cells that are free to migrate widely throughout the embryo. Answer: Mesenchyme Diff: 1 Page Ref: 1123 8) Neural tissue develops from the ________. Answer: ectoderm Diff: 1 Page Ref: 1123 9) During pregnancy some women develop increased pigmentation of the skin of the nose and cheek, a condition called ________. Answer: chloasma Diff: 2 Page Ref: 1133 10) The first axial support for the embryo is called the ________. Answer: notochord Diff: 2 Page Ref: 1123 11) At what time in the pregnancy is the placenta fully prepared to fulfill the needs of the developing fetus? Answer: placenta is fully formed and functional as a nutritive, respiratory, excretory, and endocrine organ The by the end of the third month of pregnancy. Diff: 1 Page Ref: 1122 12) Briefly describe the events leading to the implantation of the blastocyst in the uterus, including how it is nourished. Answer: blastocyst floats freely in the uterine cavity for three or four days, during which time it is The nourished by uterine secretions. Six days after ovulation, implantation begins. The trophoblast determines the readiness of the endometrium for implantation. If the mucosa is prepared for implantation, the blastocyst becomes embedded high in the uterus. Diff: 2 Page Ref: 1118-1119 13) How are the metabolic needs of the implanted embryo provided for? Answer: Initially, the implanted embryo obtains nutrition by digesting the endometrial cells, but by the second month, the placenta is providing all the nourishment and oxygen the embryo requires. The placenta is also responsible for disposing of embryonic metabolic wastes. Diff: 2 Page Ref: 1120-1123 14) Describe the events of the oocyte from sperm penetration to first cleavage. Answer: After sperm penetration, the oocyte completes meiosis II and releases the second polar body. The two nuclei swell into pronuclei and join each other to form a zygote. The cell then undergoes its first mitosis and cell division to form two daughter cells. Diff: 2 Page Ref: 1115-1117 15) Define Braxton-Hicks contractions. Answer: Braxton-Hicks contractions are the weak, irregular uterine contractions resulting from the increase in estrogen production, causing oxytocin receptors to form on the myometrial cells of the uterus, antagonizing progesteroneʹs quieting influence on the uterine muscle. Diff: 2 Page Ref: 1136 16) List four factors that help to precipitateparturition. Answer: Four factors that help to precipitate parturition include: (1) estrogen peaks to its highest levels in the motherʹs blood, causing irregular uterine contractions due to oxytocin and negation of progesteroneʹs influence on the uterine muscle; (2) prostaglandins are stimulated by the increase in oxytocin to act as uterine muscle stimulants; (3) hypothalamic involvement causes a greater contractile force; and (4) certain cells of the fetus begin to produce oxytocin, which in turn acts on the placenta, stimulating production and release of prostaglandins. Diff: 2 Page Ref: 1135-1136 17) Briefly describe the physiological changes occurring in the mother during pregnancy. Answer: Excessive salivation often occurs, and many women suffer nausea until their systems become adjusted to elevated levels of estrogen and progesterone. Heartburn is common due to displacement of the esophagus and crowding of the stomach by the growing fetus in the uterus. Additional wastes from fetal metabolism cause the production of more urine. Due to pressure on the bladder by the uterus, urination is more frequent. Vital capacity increases during pregnancy, as does respiratory rate. Residual volume decreases and many women exhibit dyspnea. Total body water rises, acting as a safeguard against blood loss during birth. Blood volume increases, blood pressure and pulse rise, and cardiac output increases. Diff: 3 Page Ref: 1135 18) Describe the events allowing monospermy. Answer: Two mechanisms ensure monospermy. As soon as the plasma membrane of one sperm makes contact with the oocyte membrane, sodium channels open and ionic sodium moves into the oocyte from the extracellular space, causing its membrane to depolarize. This prevents other sperm from fusing with the oocyte membrane. The depolarization also causes ionic calcium to be released into the oocyte cytoplasm, activating the oocyte and preparing it for cell division. It also causes the cortical granules to spill their contents into the extracellular space beneath the zona pellucida. This spilled material binds with water, and as it swells, detaches all sperm still in contact with the oocyte membrane. Diff: 3 Page Ref: 1115 19) When do we begin to call the developing individual a fetus rather than an embryo? Answer: begin to call the developing individual a fetus at the beginning of the ninth week. We Diff: 1 Page Ref: 1114 Clinical Questions 1) A 30-year old woman is admitted to the emergency room. Her husband, who rode in the ambulance with her, said that she had suddenly complained of severe pain in the right iliac region of her abdomen, and then had collapsed. Upon examination, she was shown to have signs of internal hemorrhage and her abdominal muscles were rigid. Her menstrual history revealed that she had missed her last menstrual period. A diagnosis of ruptured tubal, or ectopic, pregnancy was made and surgery scheduled. What is an ectopic pregnancy, and why is it problematic? Answer: ectopic pregnancy occurs when the embryo implants in any site other than the uterus. In a tubal An pregnancy the embryo tries to implant in the uterine tube. It is unable to establish a placenta or accommodate growth, and the uterine tube ruptures. Diff: 3 Page Ref: 1141 2) Mrs. Phang, eight months pregnant with her first child, makes an appointment with her obstetrician to investigate the cause of vaginal bleeding. Since it is actually more ʺspottingʺ than frank bleeding, and painless, she is becoming worried. Ultrasound visualization of her abdomen shows that the placenta is formed across the internal os of the cervix, and she is ordered to her bed for the remainder of the pregnancy. What name is given to Mrs. Phangʹs condition? Why is it an extremely serious condition? Why was she ordered to have complete bed rest for the remainder of her pregnancy? Answer: Mrs. Phangʹs condition is called placenta previa. It is an extremely serious condition because as the uterus and cervix stretch, tearing of the placenta may occur. She was ordered to have complete bed rest to keep physical activity at a minimum so that the placenta would not tear away. Diff: 3 Page Ref: 1141 3) A mother who has been nursing her infant for over seven months is beginning to have problems throughout the day with nausea. Is there a connection? Answer: mother was not taking birth control pills because she assumed that she could not get pregnant The while nursing. Under normal conditions that would be true, but after a few months some women do begin to ovulate again. This mother is probably pregnant again. Diff: 3 Page Ref: 1139 4) A 28-year-old woman has been in the first stage of labor for several hours. Her uterine contractions are weak, and her labor is not progressing normally. Since the woman insists upon a vaginal delivery, the physician orders that pitocin (a synthetic oxytocin) be infused. What will the effect of pitocin be? What is the normal mechanism by which oxytocin acts to promote birth? Answer: Pitocin will act on the placenta, stimulating production and release of prostaglandins. The pitocin and prostaglandins are powerful uterine muscle stimulants. Oxytocin normally causes frequent and vigorous contractions of the uterine wall. Diff: 3 Page Ref: 1136 5) A client is 32 years old and is admitted to the labor and delivery unit. Her contractions are now every 2-3 minutes lasting 70-90 seconds with strong intensity. After 3 hours her water breaks and she feels a strong urge to push. Upon examination the client is completely dilated. What stage of labor is she in? Is this data normal or abnormal? Answer: second stage of labor lasts from full dilation to delivery of the infant. The length of her labor has The been abnormal. Although this phase can take as long as 2 hours, it is typically 50 minutes in a first birth and around 20 minutes in subsequent births. Diff: 3 Page Ref: 1137 6) A client is 19 years old, single, and a college student. She has been sexually active and has not used birth control on a regular basis. She is now pregnant and is in her first trimester. She is at the OB/GYN clinic for her first prenatal visit. In assessing her nutrition, the nurse discovers the client drinks heavily on a regular basis. She also states she does not like milk. What information should the nurse give the client regarding nutrition? Answer: Since many potentially harmful substances can cross placental barriers and enter the fetal blood, the nurse should instruct the client to not drink alcohol. The nurse should warn the client that her fetus could become inebriated as well. The nurse should inform the client to take multivitamins containing folic acid to reduce the risk of birth defects. The client should increase her daily calorie intake by 300 calories to sustainproper fetal growth. Diff: 3 Page Ref: 1134 7) The lactation nurse visits a first-time mother six hours after her delivery of a healthy 8-pound boy. The client is giving the baby boy a bottle of sugar water. She tells the lactation nurse that she does not seem to be producing milk. What should the nurse say to the client? Answer: nurse should explain that she wonʹt produce true milk until two to three days later. During this The delay, colostrum is produced that contains protein, vitamin A, and minerals and is rich in antibodies that are necessary for the baby. The nurse should explain that continual milk production depends on mechanical stimulation of the nipples, normally provided by the sucking infant. Diff: 2 Page Ref: 1138-1139 8) The client is in her first trimester of pregnancy. She complains of feeling nauseated and has vomited on occasion. She tells the nurse that she did not have this with her first pregnancy. She asks the nurse, ʺWhat is causing this and when will it end?ʺ How should the nurse respond? Answer: nurse should explain that nausea is a common occurrence during the first trimester of pregnancy The caused by elevated levels of progesterone and estrogen. Diff: 2 Page Ref: 1135 ...
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