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 B
Explanation
Choice A:
While rupture of fetal membranes is a potential risk with placenta previa, it's not the primary reason to avoid a pelvic exam. If the membranes are already ruptured, a pelvic exam may be necessary to assess cervical dilation and fetal station.
However, in the absence of ruptured membranes, the risk of profound bleeding outweighs the benefits of a pelvic exam in women with placenta previa.
Choice C:
Preterm labor is a potential complication of placenta previa, but it's not directly caused by a pelvic exam. If preterm labor is suspected, a pelvic exam may be necessary to assess cervical dilation and fetal station.
However, in the absence of preterm labor signs, a pelvic exam is not routinely recommended in women with placenta previa due to the risk of bleeding.
Choice D:
Infection is a potential risk with any invasive procedure, including a pelvic exam. However, it's not a major concern in women with placenta previa compared to the risk of bleeding.
Proper sterile technique during the exam can significantly reduce the risk of infection.
Choice B:
Profound bleeding is the most significant risk associated with a pelvic exam in women with placenta previa. The placenta is located abnormally low in the uterus, covering or partially covering the cervix. Any manipulation of the cervix, such as during a pelvic exam, can disrupt the placenta's attachment and cause significant bleeding.
This bleeding can be life-threatening for both the mother and the fetus. Therefore, it's crucial to avoid pelvic exams in women with placenta previa unless there's a compelling clinical reason to perform one.
Correct Answer is B
Explanation
The correct answer is choice b. Placenta previa.
Choice A rationale:
Threatened abortion typically occurs in the first trimester and involves vaginal bleeding with or without abdominal pain. It is not associated with late pregnancy bleeding.
Choice B rationale:
Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester. It occurs when the placenta covers the cervix, leading to bleeding as the cervix begins to dilate.
Choice C rationale:
Preterm labor involves uterine contractions leading to cervical changes before 37 weeks of gestation. While it can cause bleeding, it is usually accompanied by regular contractions and not typically described as bright red bleeding.
Choice D rationale:
Abruptio placentae involves the premature separation of the placenta from the uterine wall, leading to painful, dark red vaginal bleeding. It is often associated with abdominal pain and uterine tenderness, which differentiates it from placenta previa.
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