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

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason: The NST has no known contraindications, as it is a non-invasive and safe test that does not stimulate uterine contractions or cause fetal distress. It is the most widely used method of antepartum fetal surveillance.

Choice B reason: The NST is not slightly more expensive than the CST, as it requires less time and equipment. The NST usually takes 20 to 40 minutes, while the CST may take up to 2 hours. The NST only needs a fetal monitor, while the CST also needs an intravenous line and oxytocin infusion.

Choice C reason: The NST does not have fewer false-positive results than the CST, as it has a higher rate of nonreactive results that may indicate fetal compromise when there is none. A nonreactive NST is one that does not show at least two accelerations of the fetal heart rate of 15 beats per minute or more lasting 15 seconds or more in a 20-minute period.

Choice D reason: The NST is not more sensitive in detecting fetal compromise than the CST, as it has a lower predictive value for fetal well-being. A reactive NST is one that shows at least two accelerations of the fetal heart rate of 15 beats per minute or more lasting 15 seconds or more in a 20-minute period. However, a reactive NST does not rule out the possibility of fetal hypoxia or acidosis.

A. Venipuncture for blood work should be performed on the affected arm. B. The blood pressure (BP) cuff should not be applied to the affected arm. C. The affected arm should be held down close to the woman's side. D. The affected arm should be used for intravenous (IV) therapy. E. The affected arm should be used for intravenous (IV) therapy.

Correct Answer is B

Explanation

Choice A reason: This is incorrect because venipuncture for blood work should be avoided on the affected arm. The mastectomy may have involved the removal of lymph nodes, which can impair the lymphatic drainage and increase the risk of lymphedema (swelling) in the arm. Venipuncture can cause further damage or infection to the arm.

Choice B reason: This is correct because the BP cuff should not be applied to the affected arm. The BP cuff can exert pressure on the arm and interfere with the blood and lymph flow. This can also increase the risk of lymphedema or pain in the arm.

Choice C reason: This is incorrect because the affected arm should not be held down close to the woman's side. The woman should be encouraged to elevate the arm above the level of the heart and perform gentle exercises to promote circulation and prevent stiffness. The arm should not be immobilized or restricted.

Choice D reason: This is incorrect because the affected arm should not be used for IV therapy. IV therapy can introduce fluids or medications into the arm that can affect the blood and lymph flow. It can also cause irritation or infection to the arm.

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What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Compared with contraction stress test (CST), nonstress test (NST) for antepartum fetal assessment:

Correct Answer is A

Explanation

What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

Correct Answer is B

Explanation

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