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 C
Explanation
Choice A reason: Penicillin is not a correct option, as it is not effective against chlamydia. Penicillin is an antibiotic that works by inhibiting the cell wall synthesis of bacteria. However, chlamydia is an intracellular bacterium that does not have a cell wall and is resistant to penicillin.
Choice B reason: Acyclovir is not a correct option, as it is not effective against chlamydia. Acyclovir is an antiviral drug that works by inhibiting the DNA synthesis of viruses. However, chlamydia is a bacterium, not a virus, and is not affected by acyclovir².
Choice C reason: Doxycycline is the correct option, as it is one of the recommended medications for the treatment of chlamydia. Doxycycline is a tetracycline antibiotic that works by inhibiting the protein synthesis of bacteria. It can penetrate the cells and kill chlamydia by interfering with its growth and reproduction. The CDC recommends a 7-day course of doxycycline (100 mg orally twice a day) for the treatment of uncomplicated chlamydia infection.
Choice D reason: Podofilox is not a correct option, as it is not effective against chlamydia. Podofilox is a topical medication that works by destroying the tissue of genital warts caused by human papillomavirus (HPV). However, chlamydia is a different infection that does not cause genital warts and is not treated by podofilox.
Correct Answer is C
Explanation
Choice A reason: This is not the correct action, as the rate is not within normal limits. A normal FHR at 30 weeks of gestation is between 110 and 160 beats/min. A rate of 82 beats/min is considered bradycardia (slow heart rate), which can indicate fetal distress or hypoxia (low oxygen).
Choice B reason: This is not the first action, but it may be necessary after confirming the FHR. The nurse should first rule out the possibility of a maternal-fetal heart rate confusion, which can occur when the maternal heart rate is mistakenly counted as the FHR. This can happen if the Doppler or the electronic fetal monitor is placed too close to the maternal pulse or if the maternal heart rate is unusually slow².
Choice C reason: This is the correct action, as it can help differentiate between the maternal and the fetal heart rate. The nurse should assess the woman's radial pulse at the same time as listening to the FHR and compare the rates and rhythms. If the rates are the same or very close, it is likely that the nurse is hearing the maternal heart rate instead of the FHR. If the rates are different, it is likely that the nurse is hearing the FHR and that the fetus has bradycardia.
Choice D reason: This is not the correct action, as it may cause unnecessary anxiety or distress for the woman. The nurse should not allow the woman to hear the heartbeat until the FHR is confirmed and the cause of the bradycardia is determined. The nurse should also explain the situation to the woman and provide reassurance and support.
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