chapter 3 OB

____ 3. The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy? 1. Determine whether termination is still a consideration. 2. Explain they will experience grief, which is normal. 3. Provide additional information about the disorder. 4. Refer them to a disorder-specific support group.

1. Determine whether termination is still a consideration.

____ 19. The nurse is counseling a female patient diagnosed with anovulation as a cause of infertility. Which information does the nurse provide to the patient? Select all that apply. 1. Methods for dietary planning 2. Consultation for myomectomy 3. Refrain from unprotected sex 4. Surgical correction of fallopian tubes 5. Instructions for clomiphene citrate

1. Methods for dietary planning 5. Instructions for clomiphene citrate

____ 9. A patient at 34 weeks gestation is undergoing an ultrasound. The nurse notes that the amniotic fluid is estimated at between 500 and 600 mL. Which deduction does the nurse make from this finding? 1. Oligohydramnios is present. 2. Fluid is normal for gestation age. 3. Polyhydramnios has formed. 4. Follow-up ultrasound is warranted.

1. Oligohydramnios is present.

____ 4. Genomic medicine is an emerging medical discipline that involves using genomic information about an individual as part of the individual's clinical care. Which example does the nurse associate with genomic medicine? 1. Screening of neonates for inherited, treatable genetic diseases 2. Creating drugs specifically for the treatment of cancer 3. Conducting trial studies to determine how drugs effect individuals 4. Tracing and gaining knowledge about how genetic mutations occur

1. Screening of neonates for inherited, treatable genetic diseases

____ 8. A patient at 37 weeks gestation arrives at the labor and delivery unit and reports a rupture of her membranes. Which factor causes the nurse to anticipate the HCP will prescribe a medical method of labor induction? 1. The fetus is viable and the barrier for a sterile uterine environment is breached. 2. The fetus is at risk for "drying out" and causing the mother to have a dry birth. 3. The mother must be maintained on complete bedrest until contractions begin. 4. The mother is at risk for developing an infection and passing it to the fetus.

1. The fetus is viable and the barrier for a sterile uterine environment is breached.

____ 17. A female patient with a history of infertility is scheduled to have a hysterosalpingogram. Which findings can be detected with this procedure? Select all that apply. 1. Tubal occlusions 2. Uterine fibroids 3. Cervical irritation 4. Bicornate uterus 5. Vaginal infection

1. Tubal occlusions 2. Uterine fibroids 4. Bicornate uterus

____ 20. An infertile couple voices concern to the nurse about assisted reproductive technologies (ART). The nurse agrees that ART has created numerous dilemmas. Which potential questions does the nurse discuss with the couple? Select all that apply. 1. Which partner has ownership of the embryos? 2. Should a child be told about donors or surrogates? 3. Are there parental rights for sperm donors? 4. Does a fertility donor have financial obligations? 5. What happens to any surplus embryos?

1. Which partner has ownership of the embryos? 2. Should a child be told about donors or surrogates? 3. Are there parental rights for sperm donors? 5. What happens to any surplus embryos?

____ 1. The nurse is counseling a patient regarding pregnancy. The patient lost her first two pregnancies in the second trimester of gestation for undetermined reasons. Which initial advice does the nurse provide for this patient? 1. Consider adoption. 2. Seek genetic studies. 3. Plan for fertility tests. 4. Attend grief counseling.

2. Seek genetic studies.

____ 10. The nurse works in an infertility clinic and is interviewing a male patient whose partner has been unable to conceive. Which finding obtained during a health history will cause the nurse greatest concern? 1. The patient is a passionate gardener. 2. The patient had a vasectomy reversed. 3. The patient rides a bicycle daily to work. 4. The patient is concerned about infertility.

2. The patient had a vasectomy reversed.

____ 13. After counseling with an obstetrician about infertility, a couple is advised to undergo testicular sperm aspiration. The nurse is aware that the procedure may be recommended for which infertility? 1. Blocked fallopian tubes 2. Unsuccessful vasectomy reversal 3. Poor cervical mucus production 4. Diminished sperm motility

2. Unsuccessful vasectomy reversal

____ 6. The nurse is teaching a class about embryonic and fetal development to couples in the early stage of pregnancy. For which reason does the nurse emphasize the first 8 weeks of gestation? 1. Pregnancies often abort before or at this time of development. 2. Lack of size and movement prevents confirmation of pregnancy. 3. All organ systems are developing during this period. 4. Factors that can interrupt the pregnancy are no longer a concern.

3. All organ systems are developing during this period.

____ 14. The nurse is counseling a female patient who has unsuccessfully attempted to become pregnant through a variety of methods and treatments for infertility. Which psychosocial manifestation is the nurse most likely to recognize? 1. Close connections with extended family 2. Strong intimate relationship with her partner 3. Difficulty accepting pregnancy if it does occur 4. Greater focus on career and job opportunities

3. Difficulty accepting pregnancy if it does occur

____ 12. The nurse works in a urologist's office. A male patient is scheduled for routine fertility testing. For which test does the nurse refrain from making preparation? 1. STI screening 2. Hormonal levels 3. Sexual functioning 4. Ejaculate analysis

3. Sexual functioning

____ 16. A female carries one positive genetic marker for Huntington's disease. Her partner does not have any markers for the disease. For which reason is it so important for this family to identify persons with the genetic marker? 1. The Huntington gene is recessive. 2. All of the couple's offspring will have the disease. 3. Symptoms do not manifest until 30 to 50 years of age. 4. The expression of the disease is varied by individual.

3. Symptoms do not manifest until 30 to 50 years of age.

____ 2. The nurse is discussing genetically linked diseases with a couple planning a pregnancy. The female states, "I am concerned because there is a history of sickle-cell disease in my family." Which information from the nurse is correct? 1. Any offspring will have the disease. 2. Only male children will have the disease. 3. The male partner needs genetic testing. 4. The couple should not become pregnant.

3. The male partner needs genetic testing.

____ 11. A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility? 1. The patient works as a ballroom dance instructor. 2. The patient is turning 37 years old this year. 3. The patient has hot flashes and mood swings. 4. The patient was treated for a pelvic inflammatory disease while in college.

3. The patient has hot flashes and mood swings.

____ 5. A patient who has just received confirmation that she is pregnant is distressed because she has a seizure disorder that she manages with carbamazepine. Which is the nurse's greatest concern? 1. The carbamazepine may be discontinued. 2. The pregnancy is likely to end with fetal demise. 3. The fetus will experience loss of vision and hearing. 4. Carbamazepine is teratogenic and causes neural and facial defects.

4. Carbamazepine is teratogenic and causes neural and facial defects.

____ 7. A patient at 13 weeks gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother? 1. Fetal waste products and CO2 pass through the placenta to the mother. 2. The placenta is a special organ developed to create nutrients and oxygen. 3. The mother's blood and fetus's blood mix for an exchange of nutrients. 4. Glucose, amino acids, and oxygen pass through the placenta from mother to baby.

4. Glucose, amino acids, and oxygen pass through the placenta from mother to baby.

____ 15. An infertile couple learns that the female is unable to produce viable eggs. The male partner suggests the use of a surrogate as a means of having a child. The female states, "I don't want your baby with another woman!" The nurse is aware of which psychosocial issue with this couple? 1. The male blames the female for the infertility. 2. The female is jealous of the surrogate's fertility. 3. The male needs to have a child with his genes. 4. The female is experiencing self-esteem issues.

4. The female is experiencing self-esteem issues.

____ 18. A male patient is diagnosed with low sperm count as the cause of infertility. Which interventions will the nurse recommend to improve the patient's sperm count? Select all that apply. 1. Yoga or relaxation techniques 2. Surgical repair of an inguinal hernia 3. Switch to underwear made from cotton 4. Avoidance of showers with hot water temperature 5. Consultation to change hypertension drugs

1. Yoga or relaxation techniques 2. Surgical repair of an inguinal hernia 5. Consultation to change hypertension drugs