population health exam

what hormonal shifts occur postpartum to initiate and sustain lactation?

Decreased placental hormone levels allow prolactin to exert its full effect, while suckling stimulates oxytocin release for milk ejection.

What happens to the corpus luteum if pregnancy does NOT occur?

It degenerates into the corpus albicans

When is the placenta considered fully functional?

12 weeks gestation

The fetal shunt that bypasses the liver is called

Ductus venosus

Which statement indicates that a mother understands why her newborn receives vitamin K?

“It helps my baby’s blood clot properly.”

What is the main cause of nasal congestion during pregnancy?

Increased estrogen

Which of the following findings is diagnostic of preeclampsia?

Hypertension and proteinuria after 20 weeks

The milk ejection reflex is primarily stimulated by which hormone?

Oxytocin

Which hormone maintains the endometrium during early pregnancy?

Progesterone

The fetal shunt that allows blood to pass from the right atrium to the left atrium is:

Foramen ovale

A postpartum client is breastfeeding and reports uterine cramping during feeds.
What is the nurse’s best response?

“This is caused by oxytocin and helps your uterus contract.”

A breastfeeding mother asks how prolactin differs from oxytocin. The nurse
correctly explains:

Prolactin produces milk; oxytocin causes milk ejection

Adequate folic acid intake before and during early pregnancy helps prevent:

Spina bifida

Live attenuated vaccines (e.g., MMR) are generally:

Contraindicated during pregnancy

Colostrum is especially rich in:

Antibodies and immune cells

Which structure of the blastocyst becomes the placenta?

Trophoblast

Which hormone maintains the corpus luteum in early pregnancy?

Human chorionic gonadotropin (hCG)

What is the primary role of the placenta

To provide exchange of oxygen, nutrients, and waste products between the mother and fetus, as well as produce hormones that support pregnancy.

Around what gestational week does surfactant production begin?

Around 24 weeks gestation

Which fetal shunt bypasses the liver?

Ductus venosus

What triggers the closure of the fetal shunts (ductus arteriosus & foramen ovale) after
birth?

The newborn’s first breaths cause increased oxygen levels and changes in pressure within the heart and lungs. These changes lead to closure of the ductus arteriosus and foramen ovale.

Why do newborns have low vitamin K levels?

Newborns have low vitamin K because only small amounts cross the placenta, their intestines initially have few vitamin K–producing bacteria, and breast milk contains relatively little vitamin K.

Which hormone is responsible for stimulating milk production?

Prolactin

The corpus luteum continues to produce progesterone throughout the entire pregnancy.
True or False?

False. Why: The corpus luteum produces progesterone during early pregnancy, but the placenta takes over progesterone production by the end of the first trimester.

The placenta is fully functional by the end of the first trimester. True or False?

True

What is the primary role of surfactant in the fetal lungs?

To reduce surface tension in the alveoli and prevent them from collapsing, allowing the lungs to expand more easily after birth.

What is the main purpose of vernix caseosa?

To protect and moisturise the fetal skin, helping protect it from prolonged exposure to amniotic fluid.

In fetal circulation, the foramen ovale allows blood to move from the left atrium to the right
atrium. True or False?

False. Correct: The foramen ovale allows blood to move from the right atrium to the left atrium, bypassing the fetal lungs.

Identify and describe stages of pre-embryonic development

• Fertilization: A sperm and egg unite in the fallopian tube to form a zygote.

• Zygote travels to the uterus: The zygote undergoes repeated cell division as it travels down the fallopian tube.

• Blastocyst formation: The developing zygote becomes a hollow ball of cells called a blastocyst.

• Implantation: The blastocyst attaches to and implants into the uterine lining (endometrium).

What does human embryogenesis mean?

Human embryogenesis is the process of development of the embryo during the first 8 weeks after fertilization. After this period, development is referred to as fetal development.

Why is it recommended for women to take folic acid if trying to get pregnant?

Because the neural tube, which develops into the baby's brain and spinal cord, forms very early in pregnancy—often before a woman knows she is pregnant. Taking folic acid before conception and during early pregnancy helps reduce the risk of neural tube defects.

What does folic acid do?

Folic acid (folate) supports the development of the baby's neural tube and helps prevent neural tube defects such as spina bifida.

Blood flow through the foetus is more complicated than after the baby is birth as the placenta the placenta is doing the work that the baby’s lungs will do after birth in addition to also functioning as the gastrointestinal tract, liver and kidneys for the growing fetus. Describe it in your own words

The placenta provides oxygen and nutrients and removes waste because the fetal lungs, liver and kidneys are not fully functioning yet.

• Umbilical vein: oxygen-rich blood → fetus

• Ductus venosus: bypasses liver

• Foramen ovale: right atrium → left atrium, bypasses lungs

• Ductus arteriosus: pulmonary artery → aorta, bypasses lungs

• Umbilical arteries: oxygen-poor blood → placenta

what hormone is primary responsible for maintaining pregnancy during the first trimester?

Progesterone.

The normal duration of a full-term pregnancy is:

39–40 weeks

Which maternal physiological change commonly occurs during pregnancy?

Increased cardiac output

The fundus of the uterus is typically level with the umbilicus at approximately:

20 weeks gestation

Foetal viability is generally considered possible from:

24 weeks gestation

Which nutrient is most important for preventing neural tube defects?

Folic acid

Which foetal organ is primarily responsible for producing urine that contributes to amniotic fluid volume in the second half of pregnancy?

Kidneys

Which condition is characterised by hypertension and proteinuria after 20 weeks of pregnancy?

Preeclampsia

The purpose of the placenta is primarily to:

Exchange nutrients, gases, and waste products

The first stage of labour begins with:

Onset of regular contractions causing cervical change

Which maternal infection is associated with congenital abnormalities if contracted during pregnancy?

Rubella

Gestational diabetes increases the risk of:

Macrosomia

What is the primary function of amniotic fluid?

Protect and cushion the foetus

Which of the following is a common risk factor for placenta previa?

Previous caesarean birth

A woman with painless vaginal bleeding in late pregnancy may have:

Placenta previa

Maternal iron deficiency during pregnancy may result in:

Anaemia

From a population health perspective, which intervention is most likely to reduce the incidence and severity of postpartum mental health disorders?

Providing routine postnatal mental health screening and early referral services for all mothers

What is the primary role of trophoblast cells during early pregnancy?

Form the outer layer of the blastocyst and contribute to placenta formation

Which immunisation is routinely recommended during pregnancy to help protect both the mother and the newborn from serious infection?

Influenza vaccine

What are some of the majour functions of the placenta?

Exchange of oxygen, nutrients, and waste products between the mother and foetus

Excessive nausea and vomiting during pregnancy is known as:

Hyperemesis gravidarum

Which foetal circulatory structure allows blood to bypass the foetal lungs by shunting blood from the pulmonary artery to the aorta?

Ductus arteriosus

The second stage of labour ends with:

Birth of the baby

Which vitamin is essential for calcium absorption and foetal skeletal development?

Vitamin D

An ectopic pregnancy most commonly occurs in the:

Fallopian tube

Which statement best explains why folic acid and iodine are added to commercially produced bread in New Zealand and Australia?

To reduce the risk of neural tube defects and support healthy brain development in the population

Which statement best explains the purpose of administering the whooping cough (pertussis) vaccine during pregnancy?

It provides maternal antibodies that help protect the newborn from pertussis in the first months of life

Which statement best describes Braxton Hicks contractions?

They are irregular, usually painless uterine contractions that do not cause cervical change

Which statement made by a pregnant woman demonstrates the best understanding of the purpose of folic acid supplementation?

“Folic acid helps prevent neural tube defects in my baby, so it is important to take it early in pregnancy.”

Which nursing intervention is most appropriate for a pregnant woman who continues to smoke cigarettes?

Provide non-judgmental smoking cessation education and referral to support services