OB: Chapter 10: Fetal Development and Genetics

When describing the characteristics of the amniotic fluid to a pregnant woman, the nurse would include which information?

The amount gradually fluctuates during pregnancy.

When describing the characteristics of the amniotic fluid to a pregnant woman, which would the nurse include?

The amount gradually fluctuates during pregnancy.

A baby is born with what the primary care provider believes is a diagnosis of trisomy 21. This means that the infant has three number 21 chromosomes. What factor describes this genetic change?

The client has a nondisjunction occurring during meiosis.

When preparing a presentation for a group of pregnant women about fetal circulation, the nurse would explain that which structure is primarily responsible for ensuring that highly oxygenated blood reaches the fetal brain?

foramen ovale

Genetics-related health care is basic to the holistic practice of nursing. What should nursing practice in genetics include?

gathering relevant family and medical history information

A nurse is providing prenatal care to a pregnant woman. Understanding a major component of this care, the nurse would conduct a risk assessment for:

genetic conditions and disorders.

A woman is to undergo chorionic villus sampling as part of a risk assessment for genetic disorders. What statement would the nurse include when describing this test to the woman?

"A small piece of tissue from the fetal placenta will be removed and analyzed."

A woman at 15 weeks' gestation works at a daycare center thinks she may have just been exposed to rubella at work. The client asks how this may affect her fetus. What is the best response the nurse can give?

"By the end of the eighth week all of the organ systems and major structures are present, so exposure to any teratogen can lead to birth defects. More assessments are needed."

A client who is six weeks' pregnant asks the prenatal nurse, "What development has taken place with my baby by now?" Which information should the nurse include in the response? Select all that apply.

"By week 3 there would be the beginning development of the brain, spinal cord, and heart." "By week 4 the arms and legs begin to grow and develop." "By week 5 the heart now beats and the eyes and ears can be seen." "By week 6 the lungs begin forming and the baby circulation is established."

At prenatal classes a client asks the nurse how long it takes to actually become pregnant after having sexual intercourse. What is the nurse's best response?

"Conception happens about 72 hours after fertilization of the ovum."

A client at a prenatal class requests information on how the gender of a baby is determined. Which statement made by the nurse would be most accurate?

"Gender is determined at conception and depends on whether the ovum is fertilized by a Y-bearing or an X-bearing sperm."

The nurse is seeing a client who is going to be married in a month. This client has a history of Huntington disease in her family. The genetic testing has come back, and the client has just been told she carries the gene for Huntington disease and will develop the disease when she gets older. The client asks the nurse if this information is confidential and if it will remain that way. The nurse explains to the client that her family should be told and so should her fiancé. The client forcefully tells the nurse "no." She is not going to tell either her family or her fiancé. What is the nurse's best response?

"I will respect your wishes and keep your information confidential. I do wish you would reconsider though"

A nurse is conducting a presentation for a group of nurses at the prenatal clinic on basic genetic information. After teaching the group about genetics, the nurse determines that the teaching was effective based on which statement by the group?

"My genome is my genetic blueprint."

A pregnant client is scheduled to undergo chorionic villi sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed?

10 to 12 weeks of gestation

A nurse is counseling a couple who have a 5-year-old daughter with Down syndrome. The nurse recognizes that their daughter's genome is represented by which chromosone combination?

47XX21+

A client has been informed that the result of her pregnancy test indicates that she is 3 weeks' pregnant. Which instructions should the nurse give the client in regard to her condition?

Stop using drugs, alcohol, and tobacco.

A pregnant woman of Jewish descent comes to the clinic for counseling and tells the nurse that she is worried her baby may be born with a genetic disorder. Which disease does the nurse identify to be a risk for this client's baby based on the family's ancestry?

Tay-Sachs

A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome?

Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg.

For which client is preimplantation genetic diagnosis (PGD) a viable option?

Client whose partner has cystic fibrosis

A woman, who is 18 weeks' gestation, is at a follow-up appointment regarding the positive test results of alpha-fetoprotein testing. Which would the nurse suspect with the positive test result?

Down syndrome

Nondisjunction of a chromosome results in which diagnosis?

Down syndrome

At a prenatal checkup with a client at 7 weeks' gestation, the nurse would identify what as a normal finding?

Fetal heart sounds are heard.

A nurse is conducting prenatal classes and is reviewing the stages of fetal development. When discussing the preembryonic stage, the nurse informs the group that this stage begins and ends at which time?

It begins at fertilization and lasts through the end of the second week after fertilization.

A couple wants to start a family. They are concerned that their child will be at risk for cystic fibrosis because they each have a cousin with cystic fibrosis. They are seeing a nurse practitioner for preconceptual counseling. What would the nurse practitioner tell them about cystic fibrosis?

It is an autosomal recessive disorder.

A pregnant client and her husband have had a session with a genetic specialist. What is the role of the nurse after the client has seen a specialist?

Review what has been discussed with the specialist.

The primary care provider has prescribed a karyotype for a newborn. The mother questions what the type of information that will be provided by the test. What information should be included in the nurse's response?

The karyotype will assess the baby's chromosomal makeup.

Which event will result in zygote formation?

The nucleus of the ovum and sperm make contact and combine chromosomes.

A client who is 37 years of age presents to the health care clinic for her first prenatal checkup. Due to her advanced age, the nurse should prepare to talk with the client about her increased risk for what complication?

genetic disorders

The fetus receives blood flow from the mother via the placenta and umbilical cord. What is the route of fetal circulation through the umbilical cord?

The one umbilical vein carries oxygen rich blood to the fetus from the placenta.

A woman is to undergo karyotyping. The nurse best explains this testing as:

a picture-like analysis of the number, form, and size of the woman's chromosomes.

The nurse prepares a couple to have a karyotype performed. What describes a karyotype?

a visual presentation of the chromosome pattern of an individual

Down syndrome may occur because of a translocation defect. This means the:

additional chromosome was inherited because it was attached to a normal chromosome.

A pregnant client has heard about Down syndrome and wants to know about the risk factors associated with it. What would the nurse include as a risk factor?

advanced maternal age

The fluid-filled, inner membrane sac surrounding the fetus is which structure?

amnion

What are the two fetal membranes?

chorion and amnion

A 40-year-old client is in her 10th week of pregnancy. So far, her pregnancy appears to be healthy, with no abnormal results from standard diagnostic tests. Because of her age, however, the client is a candidate for which diagnostic tests? Select all that apply.

chorionic villi sampling amniocentesis Chorionic villi sampling (CVS) and amniocentesis are both techniques that may be offered to women who are older than 35 years of age, or to those whose triple/quadruple screen is abnormal, to further screen for genetic disorders. CVS is generally performed 10 to 13 weeks after the LMP. Women of all ages are offered routine sonogram screening (a nuchal translucency scan) and analysis of maternal serum levels of alpha-fetoprotein (MSAFP) by a quadruple screen early in pregnancy to evaluate for neural tube, abdominal wall, or chromosomal disorders in the fetus. pg 326

A nurse working in the newborn nursery hears an innocent murmur on auscultation of a 24-hour-old infant's chest. The nurse recognizes this as most likely the result of which condition?

delayed fetal shunt closure

A gene that is expressed when paired with another gene for the same trait is called:

dominant

A nurse is providing genetic counseling to a pregnant client. Which are nursing responsibilities related to counseling the client? Select all that apply.

explaining basic concepts of probability and disorder susceptibility ensuring complete informed consent to facilitate decisions about genetic testing knowing basic genetic terminology and inheritance patterns The responsibilities of the nurse while counseling the client include knowing basic genetic terminology and inheritance patterns and explaining basic concepts of probability and disorder susceptibility. The nurse should ensure complete informed consent to facilitate decisions about genetic testing. The nurse should explain ethical and legal issues related to genetics as well. The nurse should never instruct the client on which decision to make and should let the client make the decision. pg 325

Fetal circulation differs from the circulatory path of the newborn infant. In utero the fetus has a hole connecting the right and left atria of the heart. This allows oxygenated blood to quickly pass to the major organs of the body. What is this hole called?

foramen ovale

The nurse is explaining the process of conception and implantation to a group of women attending a preconception planning education program. When describing the hormones involved in these events, the nurse would identify which hormone as being responsible for ensuring implantation of the embryo at the beginning of conception?

human chorionic gonadotropin (hCG)

A nurse is interviewing the family members of a pregnant client to obtain a genetic history. While asking questions, which information would be most important?

if couples are related to each other or have blood ties

When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem?

low-set ears

A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone?

maintains the endometrial lining of the uterus during pregnancy

An 18-year-old pregnant woman asks the nurse why she has to have a routine alpha-fetoprotein serum level drawn. The nurse explains that this:

may reveal chromosomal abnormalities.

A nursing student correctly identifies that a person's outward appearance or expression of genes is referred to as the:

phenotype

What is the organ with a rich blood supply that supplies the developing organism with food and oxygen and carries away waste for excretion by the mother?

placenta

A nurse is providing care to a woman who has just found out that she is pregnant. The nurse is describing the events that have occurred and the structures that are forming. When describing the trophoblast to the client, the nurse would explain that this structure forms:

placenta.

The placenta is the site where antibodies in the mother's blood pass into the fetal circulation. These antibodies give passive immunity to the fetus for several common childhood diseases. There are some infections for which the mother does not provide antibodies to the fetus. What infection is the fetus not protected from?

rubella

Girls with Turner syndrome will usually exhibit:

short stature.

Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S?

sickle cell anemia

A nurse is conducting a presentation at a community health center about congenital malformations. The nurse describes that some common congenital malformations can occur and are recognized to be caused by multiple genetic and environmental factors. Which example would the nurse most likely cite?

spina bifida

Nurses are expected to know how to use the first genetic test. What is it?

the family history

Genetic testing has revealed that a couple's unborn child shows the possibility of mosaicism. When counseling this couple, the nurse explains this means that:

the genetic abnormality occurred after fertilization and during the mitotic cell division.

Implantation generally occurs at which place on the uterus?

the upper posterior surface

A number of inherited diseases can be detected in utero by amniocentesis. Which disease can be detected by this method?

trisomy 21

When providing education on pre-conceptual considerations to a female client and her spouse, the nurse knows that teratogens during the embryonic stage pose the greatest risk to the fetus. The nurse describes this stage as occurring during which time frame?

weeks 2 to 8

In attempting to determine what caused a child to be born with deafness, the nurse can explore with the mother if she had exposure to a teratogenic agent during which weeks' gestation?

weeks 3 to 8

A fertilized ovum is known as which structure?

zygote