Summative (Finals)

B

What is the primary role of the neuroendocrine system during pregnancy?

A) To regulate only the mother's digestive system

B) To maintain the body's internal balance and coordinate changes for a healthy pregnancy

C) To produce blood cells for the fetus

D) To increase maternal bone density

C

Which hormone is released by the posterior pituitary to manage labor and initiate lactation?

A) Prolactin

B) Estrogen

C) Oxytocin

D) Cortisol

B

When is routine screening for GDM typically conducted?

A) 10-14 weeks

B) 24-28 weeks

C) 32-36 weeks

D) Only after birth

B

What is a "hallmark" fetal indicator of uncontrolled GDM detected via ultrasound?

A) Microcephaly

B) Macrosomia

C) Oligohydramnios

D) Low birth weight

A

Which symptom is associated with the "classic" presentation of GDM?

A) Extreme thirst (Polydipsia)

B) Sudden weight loss

C) Hypotension

D) Decreased urination

B

Untreated GDM increases the risk of what for the baby later in life?

A) Type 1 Diabetes

B) Type 2 Diabetes

C) Chronic kidney disease

D) Liver failure

B

What causes Gestational Diabetes Insipidus?

A) Lack of insulin production

B) Placental enzymes breaking down vasopressin (ADH)

C) High blood sugar levels

D) Destruction of the adrenal cortex

C

What test confirms the rupture of membranes (amniotic fluid leakage)?

A) OGTT

B) Water Deprivation

C) Nitrazine and Ferning tests

D) Serum Sodium

C

What cervical length is highly predictive of preterm birth?

A) > 40 mm

B) 30 - 35 mm

C) < 20 mm

D) 25 mm

C

Pre-term labor is defined as labor beginning before how many completed weeks?

A) 32 weeks

B) 34 weeks

C) 37 weeks

D) 40 weeks

C

A nurse explains that fertilization usually occurs in which part of the female reproductive system?

A. Uterus

B. Cervix

C. Ampulla of the fallopian tube

D. Ovary

D

A patient asks how the egg moves toward the uterus after ovulation. Which structure primarily helps

in this movement?

A. Endometrium

B. Cervical mucus

C. Myometrium

D. Cilia of the fallopian tube

A

A woman is diagnosed with damaged fallopian tube cilia. Which complication is she at highest risk

for?

A. Ectopic Pregnancy

B. Hypertension

C. Diabetes

D. Urinary tract infection

A

A couple is trying to conceive. The nurse explains that fertilization begins when:

A. The sperm fuses with the ovum

B. The ovum implants in the uterus

C. The embryo reaches the uterus

D. Ovulation occurs

D

A patient presents with severe unilateral abdominal pain and vaginal spotting. What condition

should the nurse suspect?

A. Dysmenorrhea

B. Appendicitis

C. Urinary tract infection

D. Ectopic Pregnancy

D

A nurse is teaching about tubal transport. Which hormone increases ciliary movement?

A. Insulin

B. Progesterone

C. Cortisol

D. Estrogen

C

A patient with a history of pelvic infections is having difficulty conceiving. What is the most likely

cause?

A. Increased ovulation

B. Faster fertilization

C. Tubal scarring and blockage

D. Increased hormone levels

B

A fetus is diagnosed with an abnormal number of chromosomes during screening. This condition is

called:

A. Infertility

B. Aneuploidy

C. Endometriosis

D. Ectopic pregnancy

C

A patient complains of chronic pelvic pain and painful menstruation. Which condition is most likely

affecting her fertility?

A. Pneumonia

B. Gastritis

C. Endometriosis

D. Hypertension

B

A nurse explains that if the fertilized egg does not reach the uterus on time, what may happen?

A. Increased hormone production

B. Implantation in the fallopian tube

C. Immediate delivery

D. Normal fetal growth

B

What is implantation?

A. Release of egg

B. Attachment of fertilized egg to uterus

C. Formation of sperm

D. Menstruation

C

When does implantation usually occur?

A. 1–2 days after fertilization

B. 3–4 days after fertilization

C. 6–10 days after fertilization

D. 2 weeks after fertilization

C

Which hormone is first produced after implantation?

A. Estrogen

B. Progesterone

C. hCG

D. Testosterone

B

Which hormone helps maintain uterine lining?

A. Testosterone

B. Progesterone

C. Insulin

D. Cortisol

C

A patient presents with unilateral abdominal pain, vaginal spotting, and dizziness.

Which condition should the nurse suspect?

A. Molar pregnancy

B. Threatened miscarriage

C. Ectopic pregnancy

D. Normal implantation

B

Which of the following is a life-threatening complication of ectopic pregnancy?

A. Hyperemesis gravidarum

B. Tubal rupture leading to internal bleeding

C. Placental insufficiency

D. Fetal growth restriction

B

Which of the following is the definition of threatened miscarriage?

A. Pregnancy loss with open cervix

B. Vaginal bleeding with closed cervix and viable fetus

C. Severe abdominal pain with no bleeding

D. Complete expulsion of fetus

C

Which of the following is the most common early sign of threatened miscarriage?

A. Severe abdominal pain

B. Heavy bleeding with clots

C. Slight vaginal bleeding

D. Absence of fetal heartbeat

C

What is the genetic material in a complete molar pregnancy?

A. From both mother and father

B. Only from the mother

C. Only from the father

D. Absent

C

Which of the following is a key feature of molar pregnancy?

A. Viable fetus with normal placenta

B. Low hCG levels

C. Grape-like vesicles in the uterus

D. Absence of trophoblastic activity

B

The placenta primarily functions to:

A. Produce gametes

B. Exchange gases, nutrients, and wastes between mother and fetus

C. Generate nerve impulses for fetal development

D. Store calcium for fetal bones

B

In a normal pregnancy, extravillous trophoblasts (EVTs) are responsible for remodeling the spiral arteries. Which of the following best describes the NORMAL outcome of complete spiral artery remodeling?

A. The spiral arteries remain narrow to maintain high uterine vascular resistance.

B. The spiral arteries become wide, low-resistance vessels that slowly bathe the intervillous space.

C. The spiral arteries are completely replaced by venous sinusoids.

D. The spiral arteries are blocked by fibrin plugs until the third trimester.

C

A nursing student reviews fetal Doppler results showing absent end-diastolic flow in the umbilical artery. In the context of preeclampsia, what does this finding suggest?

A. The fetus is appropriately redistributing blood to peripheral organs.

B. Placental vascular resistance is low, allowing adequate fetal perfusion.

C. Placental vascular resistance is critically HIGH, indicating severe uteroplacental insufficiency and risk of fetal demise.

D. The umbilical vein is obstructed by a true knot.

C

The nurse is caring for a patient with severe preeclampsia. The physician orders magnesium sulfate. What is the PRIMARY nursing reason for administering magnesium sulfate in this patient?

A. To lower blood pressure by vasodilation

B. To reduce proteinuria by improving glomerular filtration

C. To prevent seizures (eclampsia)

D. To improve uteroplacental blood flow by relaxing spiral arteries

B

Which characteristic is the hallmark sign of placenta previa?

A. Painful, Dark Red Vaginal Bleeding

B. Painless, Bright Red Vaginal Bleeding

C. Persistent uterine contractions

D. Board-like rigidity of the abdomen

C

What is the primary reason for avoiding vaginal examinations in a patient with suspected placenta previa?

A. It increases the risk of maternal infection.

B. It may induce premature rupture of membranes.

C. It can cause immediate, massive placental hemorrhage.

D. It interferes with the accuracy of ultrasound results.

B

Which factor is considered the most significant risk for the development of placenta previa?

A. Maternal hypertension.

B. Previous uterine scarring (e.g., C-section).

C. Low maternal protein intake.

D. Primigravida (first-time pregnancy).

C

Which fetal finding is most associated with placental abruption?

A. Fetal tachycardia with variability

B. Increased fetal movement

C. Late decelerations

D. Normal FHR

B

Which best defines placental abruption?

A. Placenta implants in the lower uterine segment

B. Premature separation of the placenta before delivery

C. Failure of placental formation

D. Retention of placenta after delivery

C

Which substance is released from the damaged placenta that can lead to DIC?

A. Estrogen

B. Progesterone

C. Tissue factor (thromboplastin)

D. Oxytocin

B

A pregnant woman at 36 weeks’ gestation is diagnosed with polyhydramnios. Which assessment finding is the nurse most likely to observe?

A. Severe oliguria

B. Difficulty breathing due to diaphragmatic pressure

C. Decreased fetal movement from lack of space

D. Sunken maternal abdomen

B

A fetus with esophageal atresia is at high risk for developing polyhydramnios because the fetus:

A. Produces excessive lung secretions

B. Cannot properly swallow and absorb amniotic fluid

C. Has decreased renal perfusion

D. Experiences placental degeneration

C

A nurse is explaining the major source of amniotic fluid during the third trimester. Which statement is correct?

A. Maternal plasma filtration is the primary source

B. Fetal skin diffusion becomes dominant

C. Fetal urine production becomes the major source

D. Placental hormones produce most of the fluid

B

During labor, a patient with oligohydramnios develops variable fetal heart rate decelerations. Which complication is the nurse most concerned about?

A. Placenta previa

B. Umbilical cord compression

C. Excess fetal movement

D. Maternal hyperglycemia

B

A pregnant woman at 42 weeks’ gestation is diagnosed with oligohydramnios. Which physiologic change most likely contributed to this condition?

A. Increased fetal swallowing

B. Placental senescence reducing fetal renal perfusion

C. Excessive fetal urine production

D. Increased pulmonary secretions

A

A nurse is caring for a patient with severe oligohydramnios. Which nursing intervention should be performed first to improve placental perfusion?

A. Place the patient in a left lateral position

B. Encourage ambulation

C. Restrict fluid intake

D. Position the patient supine

B

A woman suddenly develops cyanosis, hypotension, and respiratory distress during labor. The healthcare team suspects amniotic fluid embolism (AFE). What is the priority nursing action?

A. Encourage oral hydration

B. Administer high-flow oxygen immediately

C. Place the patient in Trendelenburg position

D. Prepare the patient for discharge

C

Which finding best differentiates oligohydramnios from polyhydramnios?

A. AFI greater than 24 cm

B. Deepest vertical pocket greater than 8 cm

C. AFI less than or equal to 5 cm

D. Excessive fetal movement

B

A nurse explains to a student that amniotic fluid mainly helps prevent fetal injury by:

A. Stimulating fetal metabolism

B. Acting as a shock absorber against trauma

C. Increasing fetal blood pressure

D. Preventing placental attachment

B

A patient with gestational diabetes develops polyhydramnios. Which mechanism best explains this condition?

A. Maternal dehydration reduces fluid volume

B. Fetal hyperglycemia causes osmotic diuresis and excessive urine production

C. Placental aging decreases amniotic fluid production

D. Decreased fetal swallowing causes renal failure

C

Fetal development refers to:

A. Growth of the placenta only

B. Formation of maternal hormones

C. Progressive growth of a fertilized egg into a baby

D. Development after birth only

B

Which maternal factor is a primary determinant of placental efficiency and fetal viability?

A. Exercise

B. Maternal nutrition

C. Sleep pattern

D. Maternal height

C

Which vitamin deficiency is strongly associated with neural tube defects?

A. Vitamin C

B. Vitamin D

C. Folic acid

D. Vitamin K

C

The most common type of neural tube defect is:

A. Anencephaly

B. Encephalocele

C. Spina bifida

D. Iniencephaly

C

Which neural tube defect results in absence of major parts of the brain and skull?

A. Spina bifida occulta

B. Encephalocele

C. Anencephaly

D. Myelomeningocele

B

The most common cause of anemia worldwide is:

A. Vitamin D deficiency

B. Iron deficiency

C. Protein deficiency

D. Calcium deficiency

C

After birth, fetal iron stores usually support the infant for:

A. 1–2 months

B. 2–3 months

C. 4–6 months

D. 12 months

C

Which type of IUGR involves proportionally small body parts?

A. Asymmetric IUGR

B. Secondary IUGR

C. Symmetric IUGR

D. Brain-sparing IUGR

B

The “brain-sparing effect” in IUGR means:

A. Reduced blood flow to brain

B. Increased blood flow to brain at expense of other organs

C. Brain stops growing

D. Increased kidney perfusion

B

Infants with IUGR are at higher risk for:

A. Macrosomia

B. Large for gestational age

C. Hypoglycemia and hypothermia

D. Hypertension at birth only

C

Which defect in Tetralogy of Fallot is primarily responsible for decreased pulmonary blood flow and cyanosis?

A. Overriding aorta

B. Ventricular septal defect

C. Pulmonary stenosis

D. Right ventricular hypertrophy

B

The “boot-shaped heart” commonly seen on chest X-ray in Tetralogy of Fallot is mainly due to:

A. Left ventricular enlargement

B. Right ventricular hypertrophy

C. Pulmonary edema

D. Enlarged left atrium

C

A child with Tetralogy of Fallot squats after physical activity because squatting:

A. Decreases oxygen demand

B. Increases pulmonary resistance

C. Increases systemic vascular resistance and reduces right-to-left shunting

D. Slows heart rate significantly

A

In Transposition of the Great Arteries, severe cyanosis occurs because:

A. Oxygenated and deoxygenated blood cannot mix effectively

B. Pulmonary circulation is completely absent

C. The left ventricle cannot pump blood

D. The ductus venosus remains op

B

Which assessment finding is most expected in a newborn with Transposition of the Great Arteries?

A. Mild cyanosis relieved by oxygen therapy

B. Profound cyanosis shortly after birth

C. Bounding pulses with machinery murmur

D. Bradycardia with hypertension

C

Prostaglandin E1 is commonly administered in infants with Transposition of the Great Arteries to:

A. Close the ductus arteriosus

B. Reduce pulmonary blood flow

C. Maintain ductus arteriosus patency for blood mixing

D. Decrease systemic circulation

B

Which hemodynamic change occurs in Patent Ductus Arteriosus?

A. Right-to-left shunting from pulmonary artery to aorta

B. Left-to-right shunting from aorta to pulmonary artery

C. Complete obstruction of pulmonary circulation

D. Equal pressure between ventricles only

A

The continuous “machinery-like” murmur heard in Patent Ductus Arteriosus is caused by:

A. Turbulent blood flow between the aorta and pulmonary artery

B. Mitral valve regurgitation

C. Obstruction in the pulmonary valve

D. Blood flow through the foramen ovale

B

A major complication of untreated Patent Ductus Arteriosus is:

A. Decreased pulmonary blood flow

B. Eisenmenger syndrome due to pulmonary hypertension

C. Severe aortic stenosis

D. Tet spells during crying

B

Which statement best differentiates Tetralogy of Fallot from Transposition of the Great Arteries?

A. TOF mainly causes left-to-right shunting, while TGA causes valve obstruction

B. TOF involves obstructed pulmonary flow with mixed defects, while TGA involves switched great vessels

C. TOF is acyanotic, while TGA is always acyanotic

D. TOF results from patent ductus arte

C

The earliest site of fetal hematopoiesis is:

A. Bone marrow

B. Liver

C. Yolk sac

D. Spleen

B

The phase where blood formation shifts mainly to the liver is called:

A. Mesoblastic phase

B. Hepatic phase

C. Myeloid phase

D. Medullary phase

C

The primary function of erythrocytes is to:

A. Fight infection

B. Form clots

C. Carry oxygen

D. Produce antibodies

C

Platelets are best described as:

A. Full blood cells

B. Immature RBCs

C. Cell fragments from megakaryocytes

D. Immune cells

B

Which hormone stimulates red blood cell production in fetal hematopoiesis?

A. Insulin

B. Erythropoietin (EPO)

C. Oxytocin

D. Prolactin

B

Placental insufficiency primarily results from:

A. Excess fetal blood production

B. Poor trophoblast invasion and low placental perfusion

C. Increased maternal RBC count

D. Excess amniotic fluid

B

Hemolytic Disease of the Newborn is mainly caused by:

A. Viral infection

B. Maternal-fetal blood incompatibility

C. Placental rupture

D. Excess fetal iron

B

The most severe complication of untreated hyperbilirubinemia is:

A. Anemia

B. Kernicterus

C. Hypertension

D. Polycythemia

B

TORCH infections are transmitted through:

A. Airborne droplets

B. Vertical (transplacental) transmission

C. Skin contact

D. Mosquito bites

C

A key sign of placental insufficiency is:

A. Bradycardia

B. Maternal hypoglycemia

C. Fetal hypoxia

D. Increased fetal movement

B

During intrauterine life, where does the fetus primarily get oxygen?

A. Lungs

B. Placenta

C. Liver

D. Kidneys

C

Which fetal structure allows blood to bypass the liver?

A. Foramen ovale

B. Ductus arteriosus

C. Ductus venosus

D. Umbilical artery

B

What is the main function of surfactant?

A. Increase blood flow

B. Reduce alveolar surface tension

C. Stimulate breathing

D. Transport oxygen

C

At what stage does significant surfactant production begin?

A. Embryonic stage

B. Pseudoglandular stage

C. Canalicular stage

D. Saccular stage

C

Which condition is primarily caused by surfactant deficiency?

A. Meconium Aspiration Syndrome (MAS)

B. Persistent Pulmonary Hypertension (PPHN)

C. Respiratory Distress Syndrome (RDS)

D. Pneumothorax

B

What happens to pulmonary vascular resistance after the first breath?

A. Increases

B. Decreases

C. Remains the same

D. Becomes unstable

C

Which is a common sign of neonatal respiratory distress?

A. Bradycardia

B. Hypothermia

C. Nasal flaring

D. Decreased urine output

B

Meconium Aspiration Syndrome (MAS) is most commonly associated with:

A. Prematurity

B. Post-term pregnancy

C. Multiple gestation

D. Maternal anemia

C

Which fetal shunt closes due to increased left atrial pressure after birth?

A. Ductus arteriosus

B. Ductus venosus

C. Foramen ovale

D. Umbilical vein

B

A premature neonate presents with tachypnea, cyanosis, and low oxygen saturation. What is the most likely underlying problem?

A. Airway obstruction

B. Surfactant deficiency

C. Cardiac defect

D. Infection

C

Which phase marks the earliest stage of fetal immune system development?

a. Bone marrow phase

b. Thymic phase

c. Yolk sac phase

d. Lymph node phase

C

Which organ serves as the primary site of blood cell production in the fetus while the

bone marrow is still immature?

a. Yolk sac

b. Thymus

c. Fetal liver

d. Spleen

C

Why is the fetal immune system considered functionally limited?

a. It has no blood supply

b. It cannot produce any immune cells

c. It has reduced ability to mount a full immune response

d. It is fully active before birth

B

Which statement best describes fetal immune system development?

a. It is fully mature at the start of pregnancy

b. It develops gradually but remains immature until after birth

c. It is only activated after exposure to pathogens after birth

d. D. It is not present during fetal life

C

T-Lymphocyte Immunodeficiency is caused by a problem with which chromosome?

a. Genes

b. Adenine

c. Chromosome 22

d. Chromosome X

B

In T-Lymphocyte Immunodeficiency, which organ is missing or too small (insufficient)?

a. Heart

b. Thymus gland

c. Liver

d. Bone marrow

B

What is the main problem in B-Lymphocyte Immunodeficiency?

a. Body cannot make T-cells.

b. Body cannot make antibodies (B-cells).

c. Infant is born too early.

d. Placenta is too large.

B

Why are babies with B-Lymphocyte Immunodeficiency usually healthy for the first few months?

a. They are born with a strong immune system.

b. They get protective antibodies from their mother.

c. They do not come into contact with germs.

d. T-cells do all the work.

B

Why are very premature babies at high risk for infection?

a. They have too many T-cells.

b. The infant missed the bulk transfer of antibodies from the mother.

c. Their thymus gland has already disappeared.

d. They have a chromosomal defect.

C

Which condition is a life-threatening intestinal swelling common in premature infants?

a. DiGeorge Syndrome

b. Bruton’s Disease

c. Necrotizing Enterocolitis (NEC)

d. Thymic Aplasia