What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant?
Genetic changes and anomalies
Intrauterine growth restriction
Fetal addiction to the substance inhaled
Extensive central nervous system damage
The Correct Answer is B
Choice A reason: Genetic changes and anomalies are not the most dangerous effect, as they are rare and not directly caused by smoking. Smoking can increase the risk of some birth defects, such as cleft lip and cleft palate, but these are not genetic changes and can be corrected by surgery. Smoking can also cause chromosomal abnormalities in the eggs, but these usually result in miscarriage or stillbirth, not live births.
Choice B reason: Maternal smoking is a significant risk factor for intrauterine growth restriction (IUGR). Nicotine and carbon monoxide from cigarettes reduce oxygen supply to the fetus, leading to lower birth weights and smaller body lengths.
Choice C reason: Fetal addiction to the substance inhaled is not the most dangerous effect, as it is not permanent and can be treated by medication and supportive care. Smoking can expose the fetus to nicotine, carbon monoxide, and other harmful chemicals, which can cross the placenta and affect the fetal brain and nervous system. Smoking can also cause withdrawal symptoms in the newborn, such as irritability, tremors, and difficulty feeding.
Choice D reason: Although prenatal exposure to smoking can affect neurodevelopment and is associated with behavioral issues, extensive central nervous system damage is not the most immediate or dangerous effect. The most critical concern remains intrauterine growth restriction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Braxton Hicks contractions are irregular, painless uterine contractions that occur throughout pregnancy. They are a probable sign of pregnancy, not a positive sign.
Choice B reason: Fetal movement palpated by the nurse-midwife is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. It can be detected as early as 16 to 20 weeks of gestation.
Choice C reason: A positive pregnancy test is a probable sign of pregnancy, as it indicates the presence of human chorionic gonadotropin (hCG) in the urine or blood. However, it is not a definitive sign, as other conditions can cause elevated hCG levels.
Choice D reason: Quickening is the first perception of fetal movement by the mother, which usually occurs between 16 and 20 weeks of gestation. It is a presumptive sign of pregnancy, not a positive sign.
Correct Answer is D
Explanation
Choice A reason: Maternal placenta previa is not a common complication of gestational diabetes mellitus. Placenta previa is a condition in which the placenta covers the cervix, which can cause bleeding and preterm labor. The risk factors for placenta previa include previous cesarean delivery, multiple pregnancy, advanced maternal age, and smoking.
Choice B reason: Maternal hyperemesis and neonatal low birth weight are not directly related to gestational diabetes mellitus. Hyperemesis is a severe form of nausea and vomiting during pregnancy that can cause dehydration and weight loss. The causes of hyperemesis are not well understood, but it may be influenced by hormonal changes, genetic factors, and psychological factors². Neonatal low birth weight is defined as a birth weight of less than 2,500 grams, which can be caused by many factors, such as prematurity, intrauterine growth restriction, maternal infection, and maternal malnutrition.
Choice C reason: Maternal premature rupture of membranes and neonatal sepsis are not specific to gestational diabetes mellitus. Premature rupture of membranes is a condition in which the amniotic sac breaks before labor begins, which can increase the risk of infection and preterm delivery. The causes of premature rupture of membranes are not clear, but some possible factors include infection, inflammation, stress, and trauma. Neonatal sepsis is a life-threatening infection in newborns, which can be caused by bacteria, viruses, or fungi. The risk factors for neonatal sepsis include prematurity, low birth weight, maternal infection, and invasive procedures⁵.
Choice D reason: Maternal preeclampsia and fetal macrosomia are the most common and serious complications of gestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine, which can lead to organ damage, seizures, and death. The exact cause of preeclampsia is unknown, but it may be related to abnormal placental development, immune system dysfunction, and genetic factors⁶. Fetal macrosomia is a condition in which the baby is larger than normal, usually weighing more than 4,000 grams at birth. This can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, and cesarean section. The main cause of fetal macrosomia is excessive maternal glucose, which stimulates fetal insulin production and growth.
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