A nurse is measuring fundal height at 16 weeks gestation. What is the expected measurement?
8–10 cm
14–18 cm
20–22 cm
24–26 cm
The Correct Answer is B
Fundal height measurement is a non-invasive clinical tool used to assess uterine growth and indirectly estimate fetal development. It is measured in centimeters from the pubic symphysis to the top of the uterine fundus. From weeks 18 to 32, the fundal height in centimeters typically equals the gestational age in weeks ±2 cm. Before 20 weeks, the uterus gradually rises through the abdomen. By 16 weeks, the fundus is typically located midway between the pubic symphysis and the umbilicus, and the expected measurement is approximately 14–18 cm.
Rationale for correct answers
B. At 16 weeks gestation, the uterus has ascended into the abdomen, and the expected fundal height is between 14 and 18 cm. This corresponds anatomically to a position halfway between the pubic symphysis and the umbilicus.
Rationale for incorrect answers
A. A fundal height of 8–10 cm is expected at approximately 12 weeks gestation, when the uterus is still just palpable above the pubic symphysis. At 16 weeks, this measurement would indicate uterine growth lag.
C. A measurement of 20–22 cm correlates with about 20–22 weeks gestation. At this point, the fundus is typically at the level of the umbilicus, not applicable to a 16-week pregnancy.
D. A fundal height of 24–26 cm is appropriate for 24–26 weeks gestation, when the fundus is well above the umbilicus. This would be significantly advanced for a 16-week pregnancy and may indicate incorrect dating or conditions like polyhydramnios.
Take home points
• Fundal height in cm generally matches gestational age in weeks between 18–32 weeks.
• At 16 weeks, fundal height should be 14–18 cm and located midway between symphysis and umbilicus.
• Lower-than-expected height may indicate fetal growth restriction or incorrect dating.
• Higher-than-expected height may suggest multiple gestation or polyhydramnios.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Folic acid supplementation is critical for preventing neural tube defects (NTDs) such as spina bifida and anencephaly, which arise from failure of neural tube closure by day 28 post-conception. Folate, a B-vitamin (B9), is required for DNA synthesis, methylation, and cell division. Since neural tube formation occurs early, often before pregnancy is confirmed, supplementation should begin at least 1 month prior to conception. The recommended daily intake for women of childbearing age is 400 mcg (0.4 mg) of folic acid. For women with a history of NTDs or high-risk conditions (e.g., diabetes, antiseizure therapy), the dosage increases to 4 mg daily.
Rationale for correct answers
C. The CDC and WHO recommend 400 mcg of folic acid daily for all women of childbearing potential to reduce the risk of NTDs. This amount ensures adequate folate status for early embryonic neural tube closure, which completes by the 4th week of gestation.
Rationale for incorrect answers
A. 100 mcg is insufficient for NTD prevention. This dose may be found in food but is below the therapeutic threshold required for reducing neural tube malformations.
B. 200 mcg is still subtherapeutic. Evidence-based guidelines consistently show that at least 400 mcg per day is needed for effective neural tube defect risk reduction.
D. 800 mcg is above the general recommendation. While not harmful in most cases, this higher dose is reserved for special populations or prenatal supplements and is not routinely recommended for all women unless otherwise indicated.
Take home points
• The neural tube closes by day 28; early folic acid intake is essential.
• 400 mcg daily is recommended for all women of reproductive age.
• Higher doses are used in women with prior NTD-affected pregnancies or high-risk conditions.
• Folate is vital for DNA synthesis and embryonic cell division.
Correct Answer is B
Explanation
Fetal eyelid development follows a defined timeline that reflects neurological and anatomical maturation. The eyelids fuse by approximately week 10 to protect the developing eye and remain fused to allow for proper corneal and conjunctival differentiation. By around week 26, the eyelids separate, allowing the fetus to open and close the eyes in response to light and other stimuli. This milestone is associated with optic nerve myelination and increasing visual system activity, though vision remains immature. The retina is still developing, and light perception is limited. This separation coincides with increased blink-startle responses and maturation of REM-like eye movements.
Rationale for correct answers
B. Separation of the eyelids typically occurs by week 26, allowing the fetus to begin opening its eyes. This marks a significant milestone in fetal neurological and sensory development, including initiation of visual reflexes and responses to light.
Rationale for incorrect answers
A. Taste bud development begins much earlier, around weeks 7–8, and by week 14, taste receptors are already functional. While taste sensation continues to mature, this is not a unique milestone of week 26.
C. Formation of fingerprints (dermal ridges) is completed by weeks 17–19, during the second trimester. This unique feature arises due to genetic and intrauterine influences on skin patterning.
D. Complete lung maturation does not occur by week 26. Type II alveolar cells begin surfactant production around weeks 24–28, but full structural and functional lung maturity typically is not achieved until week 36–37.
Take home points
• Fetal eyelids fuse around week 10 and reopen by week 26.
• Eye opening indicates sensory and CNS maturation.
• Fingerprints form between weeks 17–19, earlier than eye opening.
• Lung maturation continues into late third trimester.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.