A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the
client that smoking places the client's newborn at risk for which of the following complications?
Type 1 diabetes mellitus
Hearing loss
Congenital heart defects
Intrauterine growth restriction
The Correct Answer is D
Choice A: Smoking is not directly associated with the development of type 1 diabetes mellitus in the baby.
Choice B: While smoking during pregnancy can have various effects on the baby's health, hearing loss is not one of the common complications.
Choice C: Although smoking during pregnancy is associated with an increased risk of congenital heart defects, intrauterine growth restriction is a more likely complication based on the client's smoking history.
Choice D: Smoking during pregnancy is associated with various adverse outcomes for both the mother and the baby. It can cause intrauterine growth restriction (IUGR), where the baby does not grow at the expected rate and has a lower birth weight. Smoking reduces blood flow to the placenta, which can affect the baby's growth and development.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is: c. 42022
Choice A: 40122
Reason: This choice is incorrect because it indicates 4 pregnancies (correct), 0 term births (correct), 1 preterm birth (correct), 2 abortions (correct), but 2 living children (incorrect). The client has 2 living children, which is correct, but the term and preterm counts are not accurate.
Choice B: 20020
Reason: This choice is incorrect because it indicates 2 pregnancies (incorrect), 0 term births (correct), 0 preterm births (incorrect), 2 abortions (correct), and 0 living children (incorrect). The client has had 4 pregnancies, 1 preterm birth, and 2 living children.
Choice C: 42022
Reason: This choice is correct. It indicates 4 pregnancies (current pregnancy, elective abortion, twins, spontaneous abortion), 0 term births, 2 preterm births (twins at 36 weeks), 2 abortions (elective at 9 weeks, spontaneous at 15 weeks), and 2 living children (twins).
Choice D:
The GTPAL system is used to assess a client's obstetric history:
- G (Gravida): The total number of pregnancies, including the current one.
- T (Term births): The number of pregnancies carried to at least 37 weeks.
- P (Preterm births): The number of pregnancies delivered between 20 and 36 weeks, 6 days.
- A (Abortions): The number of pregnancies ending before 20 weeks (spontaneous or elective).
- L (Living children): The number of children currently alive.
For this client:
G (Gravida): 4 (one elective abortion, one twin pregnancy, one spontaneous abortion, and the current pregnancy).
- T (Term births): 0 (the twin pregnancy was delivered at 36 weeks, which is preterm).
- P (Preterm births): 1 (twins delivered at 36 weeks count as one preterm birth).
- A (Abortions): 2 (one elective abortion at 9 weeks, one spontaneous abortion at 15 weeks).
- L (Living children): 2 (the twins).
Thus, the GTPAL for this client is 4-0-1-2-2.

Correct Answer is C
Explanation
A) Fetal head compression: Fetal head compression would typically result in variable decelerations, not late decelerations.
B) Umbilical cord compression: Umbilical cord compression is associated with variable decelerations, not late decelerations.
C) Uteroplacental insufficiency: Late decelerations occur due to decreased blood flow and oxygen supply to the fetus, which can be caused by uteroplacental insufficiency. This condition can lead to fetal hypoxia during contractions.
D) Maternal bradycardia: Maternal bradycardia would not directly cause late decelerations in the fetal heart rate.
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