A nurse is reinforcing teaching with a client who smokes one pack of cigarettes per day.
The nurse should instruct the client that her newborn is at increased risk for which of the following clinical manifestations?
Low birth weight.
Hyperactivity.
Hypersensitivity to noise.
Craniofacial abnormalities.
The Correct Answer is A
Choice A rationale:
Maternal smoking is a major risk factor for low birth weight. Studies have consistently shown that infants born to mothers who smoke during pregnancy are more likely to be born prematurely and have a lower birth weight compared to infants born to non-smoking mothers.
Nicotine, a primary component in cigarettes, is a vasoconstrictor that reduces blood flow to the placenta. This decreased blood flow can deprive the developing fetus of oxygen and essential nutrients, leading to impaired growth and development.
Carbon monoxide, another harmful substance in cigarette smoke, binds to hemoglobin in the blood, reducing its ability to carry oxygen. This can also contribute to fetal hypoxia and growth restriction.
Smoking can also interfere with placental function, further compromising the delivery of nutrients and oxygen to the fetus.
Choice B rationale:
While some studies have suggested a possible link between maternal smoking and hyperactivity in children, the evidence is not conclusive. Further research is needed to establish a definitive association.
Choice C rationale:
There is no clear evidence to suggest that maternal smoking directly causes hypersensitivity to noise in newborns.
Choice D rationale:
Craniofacial abnormalities are not typically associated with maternal smoking. They are more commonly caused by genetic factors or exposure to certain medications or substances during pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A:
While fetal maturity is a factor in the timing of amniocentesis, it's not the primary reason for waiting until 14 weeks.
Earlier in pregnancy, fetal cells are less abundant in the amniotic fluid, making it more challenging to obtain a sufficient sample for accurate testing.
Additionally, the procedure carries a slightly higher risk of miscarriage before 14 weeks.
Choice B:
The audibility of the fetal heartbeat is not directly related to the timing of amniocentesis.
It's typically possible to hear the heartbeat by Doppler ultrasound around 10-12 weeks, but this doesn't mean there's enough amniotic fluid for amniocentesis.
Choice D:
The accuracy of genetic results is not dependent on the timing of amniocentesis after 14 weeks.
As long as a sufficient sample of amniotic fluid is obtained, the accuracy of the results is not affected by gestational age.
Choice C:
The most accurate explanation for why amniocentesis is not performed before 14 weeks is the amount of amniotic fluid. Before 14 weeks, there's typically not enough amniotic fluid to safely extract a sample without potentially harming the fetus or the placenta.
By 14 weeks, there's usually enough fluid to adequately cushion the fetus and the needle during the procedure, reducing the risks involved.
Correct Answer is C
Explanation
The correct answer is choice C, Abruptio placentae.
Choice A rationale:
A prolapsed cord is an obstetric emergency where the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. It’s a rare condition but can occur during labor if the baby is not yet engaged, and the water breaks. The main concern is that the cord can become compressed, cutting off the baby’s oxygen supply. However, it does not typically present with continuous abdominal pain and vaginal bleeding without labor.
Choice B rationale:
Premature rupture of membranes (PROM) refers to a patient whose membranes have ruptured before the onset of labor. While PROM can lead to complications, it is not typically associated with continuous abdominal pain and vaginal bleeding. PROM is more often characterized by the sudden release of fluid from the vagina.
Choice C rationale:
Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterus. It is a serious condition that can occur in the third trimester and is associated with continuous abdominal pain and vaginal bleeding, which are the symptoms described in the question. This condition poses significant risks to both the mother and the fetus, including fetal distress, preterm birth, and maternal hemorrhage.
Choice D rationale:
Placenta previa is a condition where the placenta covers the cervix either completely or partially. It can cause painless, bright red vaginal bleeding but is not typically associated with abdominal pain. The bleeding with placenta previa is usually not continuous but rather occurs in episodes.
In this scenario, the continuous abdominal pain and vaginal bleeding are classic signs of abruptio placentae, making Choice C the most likely diagnosis.
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