Neonatal Nurse Practitioner Practice Exam

Which condition is characterized by decreased fetal growth due to insufficient placental blood flow?

1. Symmetrical intrauterine growth restriction

2. Asymmetrical intrauterine growth restriction

3. Neonatal abstinence syndrome

4. Preterm labor

The correct answer is: Asymmetrical intrauterine growth restriction

The correct response is associated with asymmetrical intrauterine growth restriction (IUGR), which is characterized by a disproportionate growth pattern where the head circumference is often maintained while the body and extremities show growth restriction. This condition typically arises due to factors that lead to decreased placental blood flow, resulting in reduced nutrient and oxygen delivery to the fetus. Asymmetrical IUGR is often due to conditions like hypertension, placental insufficiency, or other disease states that impair the placenta's ability to function adequately, leading to the fetus prioritizing the development of the brain over the body as a mechanism to cope with the adverse conditions. The implications for nursing and neonatal care are significant, as these infants may have a higher risk of complications but often have better neurological outcomes than those with symmetrical IUGR. In contrast, symmetrical IUGR usually denotes a more uniform restriction of growth, often due to chromosomal abnormalities or infectious causes that affect fetal growth globally instead of selectively. Conditions like neonatal abstinence syndrome and preterm labor relate to other complications, such as drug withdrawal effects or premature delivery, respectively, rather than directly to placental blood flow issues affecting fetal growth. Understanding these dynamics is crucial for neonatal assessment and management.