CH 1, 2, 10

Which statement made by parents at a genetic counseling session indicate understanding of the risks to their child for the disorder of dwarfism?

"There is a 25% chance our newborn may be affected by the disorder if we are carriers."

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

Before World War II women moved from home to hospital births. What was the primary reason for that shift in maternity care?

They were convinced that setting would improve birth outcomes.

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.

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

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

Nondisjunction of a chromosome results in which diagnosis?

Down syndrome

Which type of genetic test would be used to detect the possibility of Down syndrome?

chromosomal analysis

A nurse is providing care to a client who has undergone a mastectomy. The nurse provides the woman with information about where to obtain a breast prosthesis. This is an example of which type of community-based nursing intervention?

health system referral

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

A nursing student is explaining to a newly pregnant woman what happens during each stage of fetal development. At which stage does the nurse inform the woman that the lungs are fully shaped?

end of 16 weeks

A pregnant client arrives at the community health center for a routine check-up. She informs the nurse that a relative on her mother's side has hemophilia, and she wants to know the chances of her child acquiring hemophilia. Which characteristics of hemophilia should the nurse explain to the client to help her understand the odds of acquiring the disease? Select all that apply.

- Affected individuals are usually males. - Female carriers have a 50% chance of transmitting the disorder to their sons. - Females are affected by the condition if it is a dominant X-linked disorder.

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.

The nurse is caring for a 7-year-old boy and his family, who are immigrants. Which intervention will most significantly affect the success of the care provided?

Communicating with sensitivity using understandable terms

A clinical nurse specialist is conducting a review class for a group of nurses about cultural compentence and cultural diversity. The nurse determines that teh teaching was successful when the group identifies which term as reflecting the view of the world and set of traditions of a specific social group passed down through generations?

Culture

Morbidity rates among children are most highly associated with which cause?

Environmental factors

When counseling potential parents about genetic disorders, which statement would be appropriate?

Environmental influences may affect multifactorial inheritance.

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role?

Facilitating return to school by working with the school nurse

Implantation generally occurs at which place on the uterus?

the upper posterior surface

A group of women are attending a community presentation regarding the leading health concerns of women. Which interventions should the nurse recommend to have the greatest impact on the leading cause of death?

weight control and being knowledgeable about family history of cardiovascular disease

A fertilized ovum is known as which structure?

zygote

Cystic fibrosis is an example of which type of inheritance?

autosomal recessive

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

phenotype

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

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.

The purpose of a circulatory shunt, such as the ductus arteriosus, is to:

permit oxygenated blood to supply the most important fetal organs.

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 pregnant woman undergoing amniocentesis asks her nurse why the baby needs this fluid. What would be an accurate response from the nurse?

"Amniotic fluid cushions your baby to prevent injury."

A pregnant client in the first trimester asks the nurse about taking medications while she is pregnant. She tells the nurse that she heard that it can be harmful to the fetus if medications are taken at certain times during pregnancy. What is the best response by the nurse?

"Exposure to certain substances during the embryonic phase may be harmful to the developing fetus."

A couple has just learned that their son will be born with Down syndrome. The nurse shows a lack of understanding when making which statement?

"I will alert your entire family about this so you don't have to."

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 client at a preconception screening meeting indicates to the nurse that she is a carrier of muscular dystrophy. Which statement made by the client indicates an understanding of the implications?

"If I have a female child there is a 25% chance she will be a carrier."

A nurse who specializes in maternal and child health care performs many varied functions in diverse settings over the course of a year. Which action would the nurse be least likely to do, as it would be outside the nurse's scope of practice?

Assist in the treatment and recovery of a woman with ovarian cancer.

A client comes to the clinic for genetic testing. The nurse asks her to sign consent forms to obtain their medical records. The client wants to know why the geneticist needs their old medical records. What is the nurse's best response?

"Your medical information is needed so that all the appropriate information and counseling are provided to you."

The nurse explains to a pregnant woman that the germ layers that develop in the embryo and become different organs and tissues consist of which layers? Select all that apply.

- ectoderm - mesoderm - endoderm

A woman who has a recessive gene for sickle cell anemia marries a man who also has a recessive gene for sickle cell anemia. Their first child is born with sickle cell anemia. The chance that their second child will develop this disease is:

1 in 4

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 report that they are both carriers for a condition. The medical history reveals neither of them have have symptoms of the condition. In the event this couple conceives a child, what is the likelihood they will have a child who will have the disorder?

25%

Two parents with two recessive genes each for six toes have what chance they will have a child with six toes?

25%

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 chromosome combination?

47XX21+

A female client is a Duchenne muscular dystrophy carrier. Her husband does not have the gene. She is planning to conceive and wants to understand the chances of her child acquiring the disease. What information should the nurse give to the client?

A female child will not be affected by the condition.

What is the key nursing role when managing the health care of a child living with a foster family?

Advocating for the child and the services needed

A nurse is visiting the home of a mother and her newborn. The woman's family members are present when the nurse arrives. What is the nurse's best approach to the situation?

Assess the family members' interactions with the newborn and one another

The nurse in a free clinic is caring for a 1-year-old girl and her single mother. Which nursing intervention would most likely be needed initially?

Assessing the child's nutritional status

A nurse is reviewing an article on genotypes. The nurse demonstrates understanding of the information by identifying which designation as homozygous dominant?

BB

A client who has just given birth is concerned about the high rate of infant mortality in the United States. She is anxious about the health of her child and wants to know ways to keep her baby healthy. Which recommendation would best meet this goal?

Breast-feed the infant.

The nurse is beginning an assessment with a pregnant client from a non-English-speaking culture. The interpreter is having difficulty understanding what the client is trying to say and the client is becoming frustrated. Which nursing diagnosis would be most appropriate for this situation?

Impaired verbal communication

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

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries?

Low birth weight

The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation?

Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating health care?

Parents

Which concept characterizes transcultural nursing?

Planning care compatible with the client's health belief system

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 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

A pregnant client comes to the local health clinic for her scheduled prenatal visit. On her chart, the nurse notices that the client indicated that she resides in an extended family situation. Which arrangement would validate this information?

She lives with her grandmother, her uncle, her mother, and her younger sister.

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject best supports the emphasis on preventive care?

Showing the mother how to teach hand washing to her child

A homeless client diagnosed with human papillomavirus (HPV) is seen in the maternity clinic requesting a pregnancy test. Which nursing action would be the best example of the secondary level of prevention?

Suggest she have a Papanicolaou (Pap) smear

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?

Teach injury prevention and proper safety practices.

A nurse is developing a plan of care for a client of Muslim faith. Which action demonstrates an understanding of providing culturally competent care?

The client is asked if there are any meal preferences to be included in the care plan

The community health nurse is seeing a mother and newborn for the first home visit. Which information best indicates an understanding of visiting clients in their home?

The home visit is a way of monitoring the well-being of all family members

The nurse is caring for a pregnant Arab American woman. Which statement most accurately describes the client's potential health care beliefs?

The husband makes all the health care decisions for the wife.

The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?

The importance of crossing streets safely

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.

When describing birth during the 18th century, which description would be most accurate regarding maternal care during pregnancy and birth?

The majority of births occurred in the home with female midwives in attendance.

When designing a class on the history of birth and maternal care, which information would the nurse include in describing care during the 18th century?

The majority of births occurred in the home with female midwives.

The emergency nurse is providing care for a pregnant woman admitted with a broken femur, blackened eye, and multiple contusions. She admits her partner is abusive. Which activity would be considered at the tertiary level of prevention?

The nurse contacts the crisis social worker for assistance

A nurse is planning to provide home care to a family. The nurse assesses the client's community based on which rationale?

It can reveal if there are aspects about a community that contributed to an illness.

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.

Women having in vitro fertilization (IVF) can have both the egg and sperm examined for genetic disorders of single gene or chromosome concerns before implantation.

True

A community-based nurse has a different set of skills than those of counterparts who work in a hospital. Community-based nurses also face unique issues and challenges. What is one of the unique aspects of community-based nursing?

Autonomous

A pregnant woman experiencing morning sickness has asked her nurse about ways to reduce or alleviate it. After receiving education and information from the nurse, which statement would indicate that the client understood the information?

"I'll discuss with my primary care provider whether it is a good idea for me to use sea-bands."

A nurse informs a 19-year-old client that she is pregnant. The client immediately states that she plans to have an abortion. What would be the most appropriate response from the nurse to this client?

"I'll put together the information that you will need."

The nurse is presenting to a shelter for abused women and children and is asked by a participant, "What does the No Child Left Behind Act mean?" How should the nurse best respond?

"It is a Federal program that will ensure all children in classrooms receive up-to-date research-based curriculum."

A 33-week gestation infant dies after 1 week of life in the neonatal intensive care unit. This infant's death rate would be classified under which statistical category?

neonatal death

Girls with Turner syndrome will usually exhibit:

short stature

A couple had decided not to circumcise their newborn for nonreligious reasons. What is the appropriate response from the nurse?

"OK, great. I will let the physician know."

A recently licensed nurse is orienting to a pediatric unit in an acute care facility. The nurse is discussing causes of infant mortality with the preceptor. Which statement by the preceptor most accurately addresses this problem?

"The most common cause of infant deaths is chromosomal abnormalities and congenital anomalies, which we have no control over."

A prenatal nurse is preparing a presentation for clients on the various roles of a midwife in the management of their maternity care. Which information would the nurse include in the presentation to describe their role? Select all that apply.

- According to their scope of practice, midwives are the primary obstetrical care providers. - Midwives have postgraduate training in the care of normal pregnancy and birth. - Midwives have a certified designation from accredited bodies identifying their scope of practice.

A nurse is working with a culturally diverse patient population. Which strategy would the nurse most likely use to assist in recognizing cultural influences on pain perception? Select all that apply.

- Appreciate that the meaning of pain varies among cultures. - Appreciate that not all people communicate or express their level of pain in the same way. - Recognize that communication of pain may not even be acceptable within a culture. - Develop an awareness of personal values and beliefs. - Use an assessment tool (e.g., rating scale from 1 to 10) to assist in measuring the pain.

The nurse is caring for a minor child who has voiced an interest in becoming emancipated. What information can the nurse provide to the client? (Select all that apply.)

- Emancipation requires a minor to live apart from their parents. - An emancipated minor needs to be self-supporting. - The courts will have to approve the request for emancipation.

A labor and birth nurse is admitting an adolescent client with her mother. The client appears to be upset, and the nurse wants to find out why. How should the nurse proceed? Select all that apply.

- Make note of the client's and parent's nonverbal expressions. - Maintain eye contact throughout the discussion. - During the discussion maintain an open posture, with arms uncrossed

What are examples of culturally sensitive care? Select all that apply.

- Providing discharge instructions in Spanish to a Hispanic patient who speaks in broken English. - Nodding hello instead of shaking hands with an Orthodox Jewish male. - Providing a Middle Eastern woman an extra gown for covering up.

When a labor and delivery nurse tells a coworker that an Asian client probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as:

stereotype

A nurse is working as part of a research team evaluating children for participation in a research study. The nurse demonstrates respect when the nurse obtains assent from children over which age?

7

The nurse evaluates a family to see if they are a good candidate for home care. Which factor would be most important to see in their home or of the family?

A dedicated home-care provider

After teaching a prenatal class about maternal mortality rates, the nurse determines that the teaching has been effective when the participants identify which ethnic group as having the highest ratio of maternal mortality?

African American mothers

A public health nurse is developing a plan to implement strategies to assist in lowering of maternal and infant mortality rates for African American women. Which factors should not be included in the plan?

African American women have adequate obstetrical insurance coverage.

The nurse notes that a 5-year-old boy is approaching obesity. Which is the priority intervention?

Assessing the diet of the child and family

Advocacy for the client is an important aspect of community-based nursing. What is one way a nurse can advocate for a child client?

Assisting the family to apply for Medicaid or other forms of health care reimbursement

In an effort to improve the health status of women and their children, several national campaigns have been implemented. The campaign that reduced the incidence of Sudden Infant Death Syndrome (SIDS) by 50% was the:

Back to Sleep Campaign

A 40-year-old pregnant client tells her nurse that she would like to give birth in a birthing center because she wants several friends and family members to be there and will have more freedom at the center. What would be the most important factor for the nurse to point out when discussing this option with the client?

Birthing centers do not always have pediatricians on staff if the newborn has special needs.

A nurse is working as a team member implementing a primary prevention program in the community to help reduce the incidence of HIV infection. Which action would be most appropriate for the nurse to implement?

Educate clients in how to practice safe sex

A young mother with an ill child tells the visiting nurse that she belongs to the Christian Scientist religious group and will not seek medical attention for the child. Which statement best reflects the mother's religion's beliefs about health?

Healing will come through prayer and spiritual regeneration only.

To assess the sociocultural aspects of the family of an adolescent in an ambulatory clinic, what would you try to find out more about?

His family structure

A group of nurses are discussing the most recent statistics on death due to prematurity in the United States. Which action, if implemented, would have the greatest impact on improving outcomes?

Improve women's access to receiving prenatal care.

An expectant mother has arranged for her massage therapist to provide gentle hand, arm, and neck massage for the client while she is in labor in the hospital. Which trend in today's health care environment is most related to this arrangement?

Increasing use of alternative treatment modalities

Which information is true of home care as a whole?

It is increasing because new technology makes so many procedures available in the home.

The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained?

Learning the mother is not the custodial parent

The nurse is updating the records of a 10-year-old boy who had his appendix removed. Which action could jeopardize the privacy of the child's medical records?

Letting another nurse use the nurse's log-in session

A woman has presented to the clinic with her sick school-aged child. The child's mother reports she rarely has enough money to meet the health care needs of her chronically ill child. What information should be provided to the woman?

Medicaid may be available to low-income parents and their children

A woman in her 15th week of pregnancy is about to undergo amniocentesis. Which nursing intervention should be made first?

Obtain a signed consent form

A nurse is caring for a 31-year-old pregnant client who is subjected to abuse by her partner. The client has developed a feeling of hopelessness and does not feel confident in dealing with the situation at home, which makes her feel suicidal. Which nursing intervention should the nurse offer to help the client deal with her situation?

Provide emotional support to empower the client to help herself.

A pregnant client arrives at the maternity clinic for a routine check-up. The client has been reading books on pregnancy and wants to know ways to prevent the incidence of neural tube defects (NTDs) in her fetus. Which recommendation should the nurse offer the client to reduce the risk of NTDs for this fetus?

Take folic acid supplements each day.

A nurse is faced with an ethical conflict involving the care of a child. The child's parents disagree with the physician about the use of a feeding tube. The nurse sees the benefits and limitations of both parties' views. What action would be most appropriate?

Take the issue to the Institutional Ethics Committee for advice.

A nurse admits a young boy who lives in a homeless shelter with his pregnant teenage mother. What would nurse realize to be a priority when planning his case management?

The toddler's situation puts him at risk for higher incidence of disease and limited access to appropriate care.

Smoking may be a cause of ectopic (tubal) pregnancy.

True

A nurse is addressing a group of women on the issue of women's health during their reproductive years. Which reason does the nurse provide regarding the need for comprehensive, community-centered care to women during this time period?

Women's health care needs change with their reproductive goals

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

a visual presentation of the chromosome pattern of an individual

The nurse is concluding her initial visit with a client 28 weeks pregnant on bedrest for premature rupture of membranes. What information should the nurse consider when determining the timing of the next home visit?

amount of supervision and health education needed by the client

When a woman is admitted to the labor-and-delivery unit, her husband says he is going to work and asks you to call when the baby is born. Your best response to this husband would be to

ask him if he knows that he can stay with his wife during labor

A new mother tells the obstetrical nurse that her mother notices so much has changed in maternity care in recent years. One change she could likely be referring to is:

newborns stay at the mother's bedside with the family as long as it is well

The nurse is caring for a pregnant woman and her family who are immigrants. Which intervention would be the priority for helping to achieve a successful outcome?

communicating using understandable terms

The nurse is conducting a postpartum home visit. Which action would not necessarily be a responsibility of a visit?

conducting a well-baby visit to start the child's immunizations

The pediatric nurse knows that the state of children's health in the United States is evaluated by specific determinants and measures of health status. These determinants include:

race and ethnicity

A pregnant teenager is not certain that she will like home care because she is afraid she will feel lonely. The nurse should suggest that:

everyone could eat together

In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the:

family

A nurse is speaking with a client who has just learned that she is pregnant with her first child. The nurse reads in the client's chart that she does not drink alcohol on a regular basis. However, the nurse decides to go ahead and warn the client about the dangers of drinking alcohol while pregnant. Which phase of health care would this action be classified as?

health promotion

A nurse is reviewing the statistical outcomes related to fetal deaths nationwide and notes that the numbers have changed over the last several decades. The best explanation would be:

improved prenatal care has reduced the numbers of fetal deaths.

A nurse doing an admission assessment on a new Chinese American client notices that the client will not make eye contact. The most likely reason for this is that it:

is a sign of respect

A client, 6 hours post-birth, has a severe postpartum hemorrhage that the health care providers are unable to control. She succumbed to the hemorrhage in the intensive care unit. The client's death would become part of the:

maternal mortality rate

A 15-year-old pregnant client living with her divorced mom is brought into the emergency department by her boyfriend requiring a dilatation and curettage (D & C) after a miscarriage. Who will the nurse approach to sign the consent for the D & C?

the parent who has custody

A nurse encourages both partners in a lesbian family to come into the examining room with the newborn during a well-baby check. What type of nursing is the nurse practicing?

transcultural nursing

The term used to guide the cultural aspects of nursing care and respect individual differences is:

transcultural nursing

A 33-year-old pregnant client asks the nurse about testing for birth defects that are safe for both her and her fetus. Which test would the nurse state as being safe and noninvasive?

ultrasound