Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests?
A. Human placental lactogen (hPL).
Human placental lactogen (hPL) is a hormone produced by the placenta that promotes mammary gland growth for lactation. It also helps regulate maternal glucose and lipid metabolism. However, hPL is not the basis for pregnancy tests, as it is not produced by the fertilized egg and does not maintain the corpus luteum.
B. Estrogen (estriol).
Estrogen (estriol) is a steroid hormone produced by the placenta that stimulates the growth of the uterus and allows it to contract by countering the effect of progesterone. It also prepares the breasts for milk production and enhances fetal organ development. However, estrogen is not the basis for pregnancy tests, as it is not produced by the fertilized egg and does not maintain the corpus luteum.
C. Progesterone (progestin).
Progesterone (progestin) is a steroid hormone produced by the ovaries and by the placenta during pregnancy. Progesterone supports the lining of the uterus, which provides the environment for the fetus and the placenta to grow. It also prevents the shedding of the lining and suppresses uterine contractions, which are important in preventing labor from occurring before the end of pregnancy. However, progesterone is not the basis for pregnancy tests, as it is not produced by the fertilized egg and does not maintain the corpus luteum.
D. Human chorionic gonadotropin (hCG).
Human chorionic gonadotropin (hCG) is a hormone produced by the fertilized egg after it implants in the uterus. hCG helps maintain the corpus luteum during the early stages of pregnancy, which is essential for producing progesterone. hCG levels rise rapidly in the first few weeks of pregnancy and can be detected in urine or blood samples. Therefore, hCG is the basis for pregnancy tests, as it indicates that a fertilization and implantation have occurred.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Custom Maternal Newborn Proctored Exam. Take the full exam now
Full Explanation
A. Human placental lactogen (hPL) is a hormone produced by the placenta that helps regulate the metabolism of the mother and fetus, but it is not used as the basis for pregnancy tests. It plays a role in modulating the metabolic state of the mother during pregnancy to facilitate the energy supply of the fetus.
B. Estrogen (estriol) is another hormone produced by the placenta, which is important for maintaining pregnancy and preparing the body for childbirth. However, it is not the hormone detected by pregnancy tests. Estriol levels increase significantly during pregnancy but are not used as a marker for pregnancy tests.
C. Progesterone (progestin) is crucial for maintaining the uterine lining and supporting early pregnancy. While it is essential for a successful pregnancy, it is not the hormone that pregnancy tests detect. Progesterone helps prevent uterine contractions and supports the endometrium.
D. Human chorionic gonadotropin (hCG) is the hormone detected by pregnancy tests. It is produced by the placenta shortly after the embryo attaches to the uterine lining. The presence of hCG in the blood or urine is a reliable indicator of pregnancy, which is why it is the basis for pregnancy tests.
Similar Questions
A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not.”. Which of the following should the nurse recognize as a sign of true labor?
A. Rupture of the membranes.
Rupture of the membranes is not a reliable sign of true labor, as it can occur before or during labor, or be artificially induced by the provider. •
B. Pattern of contractions.
Pattern of contractions can vary depending on the stage and phase of labor, and can also be influenced by factors such as hydration, activity, and medication. Contractions alone do not indicate true labor unless they are accompanied by cervical changes. •
C. Changes in the cervix.
Changes in the cervix, such as effacement (thinning) and dilation (opening), are the most accurate indication of true labor. Cervical changes are caused by the pressure of the presenting part and the force of the contractions. The nurse should assess the cervix periodically to determine the progress of labor. •
D. Station of the presenting part.
Station of the presenting part refers to the relationship of the fetal head to the maternal ischial spines, which are bony landmarks in the pelvis. Station can range from -5 (high) to +5 (low), with 0 being at the level of the ischial spines. Station does not indicate true labor, as it can vary depending on the parity, pelvic shape, and fetal position of the client.
Full Explanation
Choice A reason:
Rupture of the membranes is not a reliable sign of true labor, as it can occur before or during labor, or be artificially induced by the provider. • Choice B reason:
Patterns of contractions can vary depending on the stage and phase of labor, and can also be influenced by factors such as hydration, activity, and medication. Contractions alone do not indicate true labor unless they are accompanied by cervical changes. • Choice C reason:
Changes in the cervix, such as effacement (thinning) and dilation (opening), are the most accurate indication of true labor. Cervical changes are caused by the pressure of the presenting part and the force of the contractions. The nurse should assess the cervix periodically to determine the progress of labor. • Choice D reason:
The station of the presenting part refers to the relationship of the fetal head to the maternal ischial spines, which are bony landmarks in the pelvis. The station can range from -5 (high) to +5 (low), with 0 being at the level of the ischial spines. Station does not indicate true labor, as it can vary depending on the parity, pelvic shape, and fetal position of the client.
The student nurse learns that the hormone necessary for milk production is
A. Estrogen.
Estrogen. Estrogen is a hormone that plays a role in the development of the mammary glands and the ductal system during pregnancy. However, estrogen does not directly produce milk. In fact, high levels of estrogen during pregnancy inhibit milk secretion by blocking prolactin. Therefore, estrogen is not the hormone necessary for milk production. •
B. Prolactin.
Prolactin. Prolactin is the hormone responsible for the production of breast milk. Prolactin is secreted by the pituitary gland in response to suckling or nipple stimulation. Prolactin levels rise during pregnancy and peak after delivery, when the sudden drop in estrogen and progesterone allows prolactin to take over and initiate lactation. Therefore, prolactin is the hormone necessary for milk production.
C. Progesterone.
Progesterone. Progesterone is a hormone that also contributes to the development of the mammary glands and the alveoli during pregnancy. However, like estrogen, progesterone does not directly produce milk. Progesterone also inhibits milk secretion by blocking prolactin during pregnancy. Therefore, progesterone is not the hormone necessary for milk production. •
D. Lactogen.
Lactogen. Lactogen is not a hormone, but a general term for any substance that stimulates lactation. There are different types of lactogens, such as human placental lactogen (hPL), which is produced by the placenta during pregnancy and has some lactogenic effects on the mammary glands. However, hPL is not the main hormone responsible for milk production. That role belongs to prolactin. Therefore, lactogen is not the hormone necessary for milk production.
Full Explanation
The correct answer is choice B. Prolactin.
Choice A reason:
Estrogen. Estrogen is a hormone that plays a role in the development of the mammary glands and the ductal system during pregnancy. However, estrogen does not directly produce milk.
In fact, high levels of estrogen during pregnancy inhibit milk secretion by blocking prolactin. Therefore, estrogen is not the hormone necessary for milk production. • Choice B reason:
Prolactin. Prolactin is the hormone responsible for the production of breast milk. Prolactin is secreted by the pituitary gland in response to suckling or nipple stimulation. Prolactin levels rise during pregnancy and peak after delivery, when the sudden drop in estrogen and progesterone allows prolactin to take over and initiate lactation. Therefore, prolactin is the hormone necessary for milk production. • Choice C reason:
Progesterone. Progesterone is a hormone that also contributes to the development of the mammary glands and the alveoli during pregnancy. However, like estrogen, progesterone does not directly produce milk. Progesterone also inhibits milk secretion by blocking prolactin during pregnancy. Therefore, progesterone is not the hormone necessary for milk production. •
Choice D reason:
Lactogen. Lactogen is not a hormone, but a general term for any substance that stimulates lactation. There are different types of lactogens, such as human placental lactogen (hPL), which is produced by the placenta during pregnancy and has some lactogenic effects on the mammary glands. However, hPL is not the main hormone responsible for milk production. That role belongs to prolactin. Therefore, lactogen is not the hormone necessary for milk production.
For which patient should the oxytocin (Pitocin) infusion be discontinued immediately?
A. A woman in early labor with contractions every 5 minutes lasting 40 seconds each.
The woman in early labor with contractions every 5 minutes lasting 40 seconds each does not require the immediate discontinuation of the oxytocin (Pitocin) infusion. Early labor is characterized by mild and infrequent contractions as the cervix begins to dilate and efface.
B. A woman in active labor with contractions every 30 minutes lasting 60 seconds each.
The woman in active labor with contractions every 30 minutes lasting 60 seconds each also does not warrant immediate discontinuation of the oxytocin (Pitocin) infusion. Active labor typically involves regular and stronger contractions as the cervix continues to dilate and the baby progresses downward.
C. A woman in active labor with contractions every 2 to 3 minutes lasting 70 to 80 seconds each.
The woman in active labor with contractions every 2 to 3 minutes lasting 70 to 80 seconds each does not require immediate cessation of the oxytocin (Pitocin) infusion. These contractions are within the expected range for active labor and may be considered normal.
D. A woman in transition with contractions every 1.5 minutes lasting 95 seconds each.
The woman in transition with contractions every 1.5 minutes lasting 95 seconds each should have the oxytocin (Pitocin) infusion discontinued immediately. Transition is the most intense phase of labor, characterized by rapid and strong contractions as the cervix completes dilation. Prolonged and frequent contractions during this phase can lead to uterine hyperstimulation, which can compromise fetal oxygenation and result in fetal distress. Discontinuing the oxytocin infusion is necessary to reduce the intensity and frequency of contractions, ensuring better fetal well-being during this critical phase of labor.
Full Explanation
Choice A reason:
The woman in early labor with contractions every 5 minutes lasting 40 seconds each does not require the immediate discontinuation of the oxytocin (Pitocin) infusion. Early labor is characterized by mild and infrequent contractions as the cervix begins to dilate and efface. Choice B reason:
The woman in active labor with contractions every 30 minutes lasting 60 seconds each also does not warrant immediate discontinuation of the oxytocin (Pitocin) infusion. Active labor typically involves regular and stronger contractions as the cervix continues to dilate and the baby progresses downward.
Choice C reason:
The woman in active labor with contractions every 2 to 3 minutes lasting 70 to 80 seconds each does not require immediate cessation of the oxytocin (Pitocin) infusion. These contractions are within the expected range for active labor and may be considered normal.
Choice D reason:
The woman in transition with contractions every 1.5 minutes lasting 95 seconds each should have the oxytocin (Pitocin) infusion discontinued immediately. Transition is the most intense phase of labor, characterized by rapid and strong contractions as the cervix completes dilation. Prolonged and frequent contractions during this phase can lead to uterine hyperstimulation, which can compromise fetal oxygenation and result in fetal distress. Discontinuing the oxytocin infusion is necessary to reduce the intensity and frequency of contractions, ensuring better fetal well-being during this critical phase of labor.