Chapter 3: Genetics, Conception, Fetal Development, and Reproductive Technology

An ultrasound of a fetus' heart shows that "normal fetal circulation is occurring." Which of the following statements is consistent with the finding?

. A right to left shunt is seen between the atria. This is correct. The foramen ovale is a duct between the atria. In fetal circulation, there is a right to left shunt through the duct.

A couple who has sought infertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur?

. The testes are overheated. Spermatogenesis occurs in the testes. High temperatures harm the development of the sperm.

During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from:

2 to 8 weeks The period of organogenesis lasts from approximately the second until the eighth week of gestation during which time the embryo undergoes rapid growth and differentiation. During organogenesis, the embryo is extremely vulnerable to teratogens such as medications, alcohol, tobacco, caffeine, illegal drugs, radiation, heavy metals, and maternal (TORCH) infections. Structural fetal defects are most likely to occur during this period because exposure to teratogens either before or during a critical period of development of an organ can cause a malformation.

A major fetal development characteristic at 16 weeks' gestation is:

Teeth begin to form

A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 weeks' gestation is approximately

800 mL Amniotic fluid first appears at about 3 weeks. There are approximately 30 mL of amniotic fluid present at 10 weeks' gestation, and this amount increases to approximately 800 mL at 24 weeks' gestation. After that time, the total fluid volume remains fairly stable until it begins to decrease slightly as the pregnancy reaches term.

A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis?

The couple has established a set schedule for their sexual encounters. Couples who "schedule" intercourse often complain that their sexual relationship is unsatisfying.

A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have a potential effect on sperm maturity? (Select all that apply.)

a. The man rides a bike to and from work each day. b. The man takes a calcium channel blocker for the treatment of hypertension. The daily riding of a bike can be the cause of prolonged heat exposure to the testicles. Prolonged heat exposure is a gonadotoxin. A number of medications, such as calcium channel blockers, can have an effect on sperm production.

A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? (Select all that apply.)

a. Anger at others who have babies. b. Feelings of failure because they cannot make a baby. d. Guilt on the part of one partner because he or she is unable to give the other a baby. a. Infertile couples often feel anger toward couples who have babies. b. Infertile couples often express feelings of personal failure. d. Guilt is often expressed by the couple.

The clinic nurse recognizes that pregnant women who are in particular need of support are those who (select all that apply):

b. Are awaiting genetic testing results d. Are trying to conceal this pregnancy as long as possible A second pregnancy is not an indication of a woman in need of additional support. A support system may be lacking for women who are trying to conceal a pregnancy or for women who are trying to keep the news of their pregnancy from relatives or friends until results from genetic tests are known

3. The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following?a. Ductus venosus b. Foramen ovale c. Ductus arteriosus d. Internal iliac artery

ANS: c Feedback a. The ductus venosus connects the umbilical vein to the inferior vena cava. b. The foramen ovale is the opening between the right and left atria. c. Correct. d. The internal iliac artery connects the external iliac artery to the umbilical artery.

. A diagnostic test commonly used to assess problems of the fallopian tubes is:a. Endometrial biopsyb. Ovarian reserve testingc. Hysterosalpingogramd. Screening for sexually transmitted infections

ANS: c Feedback a. Endometrial biopsy provides information on the response of the uterus to hormonal signals. b. Ovarian reserve testing is used to assess ovulatory functioning. c. Correct. Hysterosalpingogram provides information on the endocervical canal, uterine cavity, and fallopian tubes. d. STIs can cause adhesions within the fallopian tubes, but screening cannot confirm that adhesions are present.

Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risks to her unborn child from the potential effects of exposure to toxoplasmosis?a. "I will avoid rare lamb."b. "I will wear a mask when cleaning my cat's litter box."c. "I understand that exposure to toxoplasmosis can cause blindness in the baby."d. "I will avoid rare beef."

ANS: b Feedback a. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb is ingested. b. Correct. Pregnant women and women who are attempting pregnancy should avoid contact with cat feces. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb is ingested. Wearing a mask will not decrease the risk through ingestion of the parasite. c. Exposure to toxoplasmosis can cause fetal death, mental retardation, and blindness. d. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb is ingested.

A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication? a. Decrease the symptoms of endometriosis b. Increase serum progesterone levels c. Stimulate release of FSH and LH d. Reduce the acidity of vaginal secretions

ANS: c Feedback a. Clomiphene Citrate will not reduce a client's symptoms of endometriosis. b. Clomiphene Citrate will not increase a client's progesterone levels. c. Clomiphene Citrate stimulates release of FSH and LH. d. Clomiphene Citrate will not reduce the acidity of vaginal secretions.

1. The color of a person's hair is an example of which of the following?a. Genomeb. Sex-link inheritancec. Genotyped. Phenotype

ANS: d Feedback a. Genome is an organism's complete set of DNA. b. Sex-link inheritance refers to genes or traits that are located only on the X chromosome. c. Genotype refers to a person's genetic makeup. d. Correct. Phenotype refers to how genes are outwardly expressed, such as eye color, hair color, and height.

A woman at 40 weeks' gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct?a. It indicates that there is a 25% increase in amniotic fluid.b. It indicates that there is a 25% reduction of amniotic fluid.c. It indicates that there is a 50% increase in amniotic fluid.d. It indicates that there is a 50% reduction of amniotic fluid.

ANS: d Feedback a. Oligohydramnios is a decrease, not an increase in amniotic fluid. b. Oligohydramnios is a 50% reduction in amniotic fluid. c. Oligohydramnios is a decrease, not an increase in amniotic fluid. d. Correct. Oligohydramnios refers to a decreased amount of amniotic fluid of less than 500 mL at term or 50% reduction of normal amounts.

The ovarian cycle includes which of the following phases? (Select all that apply.

Follicular phase Ovulatory phase Luteal phase Follicular phase, ovulatory phase, and luteal phase are part of the ovarian cycle

A nurse is teaching a woman about her menstrual cycle. The nurse states that __________ is the most important change that happens during the secretory phase of the menstrual cycle.

Proliferation of the endometrium The proliferation of the endometrium occurs during the secretory phase of the menstrual cycle.

The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the:

Secretory phase The secretory phases occurs from the time of ovulation to the period just prior to menses, or approximately days 15 to 26.

The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of __________.

Sickle cell anemia c. Sickle cell anemia is an autosomal recessive illness. This client needs to be seen by a genetic counselor.

Karen, a 26-year-old woman, has come for preconception counseling and asks about caring for her cat as she has heard that she "should not touch the cat during pregnancy." The clinic nurse's best response is:

Toxoplasmosis is a concern during pregnancy, so it is important to have someone else change the cat's litter pan and also to avoid consuming uncooked meat. Women need to be aware that Toxoplasma gondii, a single-celled parasite, is responsible for the infection toxoplasmosis. The majority of individuals who become infected with toxoplasmosis are asymptomatic, although when present, symptoms are described as "flu like" and include glandular pain and enlargement and myalgia. Severe toxoplasmosis infection may cause damage to the fetal brain, eyes, or other organs. Toxoplasmosis is usually acquired by consuming raw or poorly cooked meat that has been contaminated with T. gondii. Toxoplasmosis may also be acquired through close contact with feces from an infected animal (usually cats) or soil that has been contaminated with T. gondii.

Which of the following places a couple at higher risk for conceiving a child with a genetic abnormality? (Select all that apply.)

a. Maternal age over 35 years b. Partner who has a genetic disorder Fertility decreases after 35 years. A partner contributes half of the chromosomal makeup, and genetic disorders can be inherited. Maternal diabetes can have an effect on the fetus/neonate, such as causing complications such as macrosomia and hypoglycemia, but these are not genetic disorders.

A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.)

b. Endometrial biopsy c. Hysterosalpingogram d. Serum FSH analysis b. Endometrial biopsy is performed about 1 week following ovulation to detect the endometrium's response to progesterone. c. Hysterosalpingogram is used to determine if fallopian tubes are patent. d. Serum FSH levels are used to assess ovarian function.