week 5 quiz 4
When a child is hospitalized, one component of their plan of care is the use of therapeutic play. This care is often provided by a(n) _____________.
child life specialist
10. The major advantage of chorionic villus sampling (CVS) over amniocentesis is that it a. Is not an invasive procedure b. Does not require hospitalization c. Has less risk of spontaneous abortion d. Is performed earlier in pregnancy
D
The results of a nonstress test shows three fetal heart rate accelerations with fetal movement that peak at 15 beats per minute above baseline and last 15 seconds. The nurse's next action should be to A. apply acoustic stimulation for 1 second for further testing. B. continue to test for 40 additional minutes. C. prepare the woman for a contraction stress test. D. do nothing.
D
1. A pregnant womans biophysical profile score is 8. She asks the nurse to explain the results. The nurses best response is a. The test results are within normal limits. b. Immediate delivery by cesarean birth is being considered. c. Further testing will be performed to determine the meaning of this score. d. An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery.
A
3. The nurse providing care for the pregnant woman understands that a factor indicating the need for fetal diagnostic procedures is a. Maternal diabetes b. Maternal age older than 30 years c. Previous infant more than 3000 g at birth d. Weight gain of 25 pounds
A
A 3 year old child cries, kicks, and clings to the father when the parents try to leave the hospital room. What is the nurse's best response to the parents about this behavior? a. "Your child is showing a normal response to the stress of hospitalization." b. "Your child is not coping effectively with hospitalization. We'll need to get a consult from the doctor due to this behavioral problem." c. "It is helpful for parents to stay with children during hospitalization." d. "You can avoid this if you leave after your child fall
A
In which age group does the child's active imagination during unfamiliar experiences increase the stress of hospitalization? a. Toddlers b. Preschoolers c. School age children d. Adolescents
B
Which diagnostic test evaluates the effect of fetal movement on fetal heart activity? A Contraction stress test (CST) B. Sonography C. Biophysical profile D. Nonstress test (NST)
D
What is an age appropriate nursing intervention to facilitate psychological adjustment for an adolescent expected to have a prolonged hospitalization? Select all that apply. a. Encourage parents to bring in homework and schedule study times. b. Allow the adolescent to wear street clothes. c. Involve the parents in care. d. Follow home routines. e. Encourage parents to bring in favorite foods.
A, B, E
A nurse teaches clients about patterns of inheritance for genetic disorders among adults. Which disorders have an autosomal dominant pattern of inheritance? (Select all that apply.) a. Breast cancer b. Alzheimer disease c. Hemophilia d. Huntington disease e. Marfan syndrome f. Cystic fibrosis
A, D, E
Which situation poses the greatest challenge to the nurse working with a child and family? a. Twenty four hour observation b. Emergency hospitalization c. Outpatient admission d. Rehabilitation admission
B
Which statement is true of multifactorial disorders? a. They may not be evident until later in life. b. They are usually present and detectable at birth. c. The disorders are characterized by multiple defects. d. Secondary defects are rarely associated with multifactorial disease.
B
Chromosomes are composed of genes, which are composed of DNA. Abnormalities are either numerical or structural in nature. Which abnormalities are structural? Select all that apply. a. Part of a chromosome is missing. b. The material within a chromosome is rearranged. c. One or more sets of chromosomes are added. d. Entire single chromosome is added. e. Two chromosomes adhere to each other.
A, B, E
A baby is born with blood type AB. The father is type A, and the mother is type B. The father asks why the baby has a blood type different from those of his parents. The nurses answer should be based on the knowledge that a. Both A and B blood types are dominant. b. The baby has a mutation of the parents blood types. c. Type A is recessive and links more easily with type B. d. Types A and B are recessive when linked together.
A
A nurse obtains health histories when admitting clients to a medical surgical unit. With which client would the nurse discuss predisposition genetic testing? a. Middle age woman whose mother died at age 48 of breast cancer. b. Young man who has all the symptoms of rheumatoid arthritis. c. Pregnant woman whose father has sickle cell disease. d. Middle age man of Eastern European Jewish ancestry.
A
The karyotype of a person is 47, XY, +21. This person is a a. Normal male b. Male with Down syndrome c. Normal female d. Female with Turner syndrome
B
7. The nurses role in diagnostic testing is to provide a. Advice to the couple b. Assistance with decision making c. Information about the tests d. Reassurance about fetal safety
C
13. The purpose of initiating contractions in a CST is to a. Determine the degree of fetal activity. b. Apply a stressful stimulus to the fetus. c. Identifying fetal acceleration patterns. d. Increase placental blood flow
B
People who have two copies of the same abnormal autosomal dominant gene will usually be a. More severely affected by the disorder than will people with one copy of the gene b. Infertile and unable to transmit the gene c. Carriers of the trait but not affected with the disorder d. Mildly affected with the disorder
A
The nurse is arranging transfer of a 6 year old child with acute renal failure from intensive care to a regular pediatric unit. With which child should the nurse place this child? A. A 5 year old with a fractured femur B. A 4 year old who has gastroenteritis C. A 7 year old recovering from surgery for a ruptured appendix D. A 6 year old with pneumonia
A
A nurse cares for a pregnant client who has a family history of sickle cell disease. The client is unsure if she wants to participate in genetic testing. What action would the nurse take? a. Provide information about the risks and benefits of genetic testing. b. Empathize with the client and share a personal story about a hereditary disorder. c. Teach the client that early detection can minimize transmission to the fetus. d. Advocate for the client and her baby by encouraging genetic testing.
A
A 39 year old is seeing the nursemidwife for her first prenatal visit. The pregnancy was a surprise "I thought I was going through the change of life." This is her first pregnancy, and she has no previous health problems. She does not smoke and drank one alcoholic beverage a week until she discovered she was pregnant. Which part of the woman's history shows the highest risk for the fetus developing a chromosomal abnormality such as trisomy 21 and therefore alerts the nurse-midwife to discuss doing genetic studies on the fetus? A The fact that the woman is 39 years old Maternal age greater than 35 is the highest risk factor for chromosomal abnormalities such as trisomy 21. The low alcohol intake and not planning for the pregnancy are not risk factors for this disorder. The perimenopausal state does not increase the risk of trisomy 21, unless it is related to being more than 35 years old. B Chances that the woman is perimenopausal Maternal age greater than 35 is the highest risk factor for chromosomal abnormalities such as trisomy 21. The low alcohol intake and not planning for the pregnancy are not risk factors for this disorder. The perimenopausal state does not increase the risk of tris
A
A hospitalized toddler clings to a worn, tattered blanket and screams whenever anyone tries to take the blanket away. What explanation for her attachment to the blanket should the nurse remembering using developmental theory? A. The blanket is an important transitional object. B. The toddler has not bonded adequately with her mother. C. The blanket encourages immature behavior. D. The developmental task of individuation separation has not been mastered.-
A
On which aspect of fetal diagnostic testing do parents usually place the most importance? A. Safety of the fetus B. Cost of the procedure C. Physical discomfort caused by the procedure D. IND. Duration of the test
A
A primary health care provider prescribes genetic testing for a client who has a family history of colorectal cancer. Which action would the nurse take before scheduling the client for the procedure? a. Confirm that informed consent was obtained and placed on the patient's chart. b. Provide genetic counseling to the client and the patient's family members. c. Assess if the client is prepared for the risk of psychological side effects. d. Respect the patient's right not to share the results of the genetic test.
A
A toddler's parents have had to leave him for several days during his hospitalization. Which behavior by the toddler should the nurse identify as demonstration of the protest phase of separation anxiety? A. Clinging to parent B. Regression to earlier behavior C. Lack of activity D. Depression sadness
A
A woman is admitted to the labor unit in active labor. She informs the nurse that she has had no prenatal care. She has been taking Fioricet (acetaminophen, butalbital, caffeine) for pain throughout the pregnancy. The nurse is aware that this drug is classified as X and therefore ? A is a teratogen and the fetus may be harmed. A class X medication means that the drug is well established as being harmful to a fetus and should not be used during pregnancy. Class A drugs have no demonstrated fetal risk. Class B and C drugs suggest possible harm, but no studies have been done on humans to prove safety. Teratogens typically cause more than one defect. B information is not sufficient to determine if the fetus will be harmed. A class X medication means that the drug is well established as being harmful to a fetus and should not be used during pregnancy. Class A drugs have no demonstrated fetal risk. Class B and C drugs suggest possible harm, but no studies have been done on humans to prove safety. Teratogens typically cause more than one defect. C will not harm the fetus. A class X medication means that the drug is well established as being harmful to a fetus and should not be used during pregn
A
A woman tells the nurse at a prenatal interview that she has quit smoking, only has a glass of wine with dinner, and has cut down on coffee to four cups a day. What response by the nurse will be most helpful in promoting a lifestyle change? a. You have made some good progress toward having a healthy baby. Lets talk about the changes you have made. b. You need to do a lot better than that. You are still hurting your baby. c. Here are some pamphlets for you to study. They will help you find more ways to improve. d. Those few things wont cause any trouble. Good for you.
A
A woman who is 6 weeks' pregnant is scheduled for an ultrasound. She asks the nurse what can be seen at this stage of the pregnancy. The nurse would be correct if she responded A. the baby's heartbeat. B. the sex of the baby. C. fetal presentation. D. characteristics of the baby's face.
A
A woman who is 8 months' pregnant had a biophysical profile test done. The results give a score of 4/10. The nurse can anticipate that the next plan of action may be to A. consider delivery. B. send the woman home and retest in 1 week. C. retest the woman in 3 hours. D. admit the woman for bed rest and to monitor maternal vital signs.
A
Both members of an expectant couple are carriers for phenylketonuria (PKU), an autosomal recessive disorder. In counseling them about the risk to their unborn child, the nurse should tell them that a. The child has a 25% chance of being affected. b. The child will be a carrier, like the parents. c. The child has a 50% chance of being affected. d. One of four of their children will be affected.
A
During teaching to an antepartum patient, it is important for the nurse to give information about ways to avoid some birth defects. One area of concern that can be taught at this time is ? A lifestyle changes. Lifestyle changes such as stopping alcohol consumption, stopping smoking, and avoiding chemicals and medications that are teratogenic can prevent some birth defects. Genetic counseling should be done prior to pregnancy. Adequate exercise and prenatal checkups are important for a healthy outcome of a pregnancy but are not associated with birth defects. B the need for adequate exercise. Lifestyle changes such as stopping alcohol consumption, stopping smoking, and avoiding chemicals and medications that are teratogenic can prevent some birth defects. Genetic counseling should be done prior to pregnancy. Adequate exercise and prenatal check-ups are important for a healthy outcome of a pregnancy but are not associated with birth defects. C the need for genetic counseling. Lifestyle changes such as stopping alcohol consumption, stopping smoking, and avoiding chemicals and medications that are teratogenic can prevent some birth defects. Genetic counseling should be done prior to pregnancy
A
How should the nurse advise parents whose preschooler used to sleep through the night and now awakens at intervals after a short hospitalization? a. Regressive behavior after a hospitalization is normal and usually short term. b. The child is probably expressing anger. c. Egocentric behavior often manifests itself when the child is left alone to sleep. d. The child is probably feeling pain and needs further evaluation.
A
How will the nurse respond to a client who has a family history of polycystic kidney disease and states, "I would like to have genetic testing, but I don't want my family to know the results"? A. Assures the client that confidentiality will be maintained. B. Explains that keeping the secret is not legal C. Asks why the client does not want other family members to know the results D. Tells the client "If I were in your shoes, I would want to let my family member know so they could make their own choices about genetic testing."
A
In planning care for a new patient in the prenatal clinic, the nurse is aware that various test are available to screen for fetal abnormalities. One that is used early in pregnancy is ? A chorionic villus sampling. Chorionic villus sampling is done in the first trimester. The chromosomes will be analyzed for fetal abnormalities. Folic acid intake is extremely important early in the pregnancy to prevent fetal abnormalities. However, blood testing for folic acid levels and CBC will not screen for fetal abnormalities. Testing for metabolic disorders is done on the newborn. B testing fetal blood for metabolic disorders. Chorionic villus sampling is done in the first trimester. The chromosomes will be analyzed for fetal abnormalities. Folic acid intake is extremely important early in the pregnancy to prevent fetal abnormalities. However, blood testing for folic acid levels and CBC will not screen for fetal abnormalities. Testing for metabolic disorders is done on the newborn. C. maternal blood test for folic acid levels. Chorionic villus sampling is done in the first trimester. The chromosomes will be analyzed for fetal abnormalities. Folic acid intake is extremely important early in the pre
A
The nurse is teaching a woman in her second trimester about an upcoming ultrasonography exam. The nurse knows her teaching has been successful when the woman states A. "I will drink several glasses of water about an hour before I come in for the test." B. "I will empty my bladder just before the test." C. "I will not eat or drink anything for 8 hours prior to coming in for the test." D. "I will plan on staying at the doctor's office for about 2 hours after the test so you can check to make sure the baby was not harmed during the procedure."
A
The nurse notes that the parents of a child in the intensive care unit (ICU) seem to spend a lot of time talking with the parents of another child who is in the ICU. How should the nurse best interpret this behavior? A. Parent to-parent support is valuable. B. A situation has developed because the parents are unhappy with the care. C. This situation has the potential to increase friction between the parents and staff. D. Parent-to-parent dependence is unhealthy. -
A
The parents of a 4year-old child who is scheduled for cardiac surgery next week call the hospital and ask how to prepare their child for surgery. What information should the nurse use when replying to the parents? A. Children who are prepared demonstrate less fear and stress during hospitalization. B. Preparation should have begun at least 2 to 3 weeks before hospitalization. C. Children who are prepared demonstrate overwhelming fear by the time hospitalization occurs. D. Preparation at this age will only increase the child's stress. -
A
When teaching the client and family about genetic testing, what information is most important for the nurse to include in the teaching plan? A. Diagnostic genetic testing can determine whether the client is at risk for a specific disorder. B. Genetic test results will be shared with family members who may be affected. C. Informed consent is needed from all family members before genetic testing is performed. D. Genetic test results can show improvement or worsening of a genetic disorder.
A
Which activity related to genetic counseling of a client best illustrates the role of the medicalsurgical nurse? A. Ensures that the client understands the consequences of having genetic testing. B. Explains the test results to client's family. C. Encourages the client who has a positive family history for a genetic disorder to undergo genetic testing. D. Discloses the results of a genetic test to the client.-
A
Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? A. Multiple marker screening B. Lecithin/sphingomyelin (L/S) ratio C. Biophysical profile D. Type and crossmatch of maternal and fetal serum
A
Which client demographic information will the nurse collect that could have a significant influence on genetic susceptibility to a specific genetic disorder? A. Nutrition status B. Education C. Ethnicity/Race D. Profession
A
Which is the most developmentally appropriate intervention when working with the hospitalized adolescent? a. Encourage peers to call and visit when the adolescent's condition allows. b. Encourage the adolescent's friends to continue with their daily activities; the adolescent has concrete thinking and will understand. c. Discourage questions and concerns about the effects of the illness on the adolescent's appearance. d. Ask the parents how the adolescent usually copes in new situations.
A
Which pedigree finding indicates to the nurse that a client's health problem follows an autosomal dominant pattern of inheritance? A. Only affected parents have children with the health problem. B.The health problem appears consistently only in men and boys. C.The daughter of an affected mother does not demonstrate the health problem. D. Children of unaffected parents have the health problem.
A
Which play activity should the nurse implement to enhance deep breathing exercises for a toddler? a. Blowing bubbles b. Throwing a Nerf ball c. Using a spirometer d. Keeping a chart of deep breathing
A
Which statement about the role of a gene in the synthesis of a specific protein is correct? A. A dominant gene triggers protein synthesis, whereas a recessive gene prevents protein synthesis. B. For protein synthesis, all regions of RNA are transcribed into DNA. C. For protein synthesis, all regions of DNA are transcribed into RNA. D. A gene provides the instructions for the correct amino acid sequence to produce a specific protein.
A
1. Transvaginal ultrasonography is often performed during the first trimester. While preparing your 6 week gestation patient for this procedure, she expresses concerns over the necessity for this test. The nurse should explain that this diagnostic test may be necessary to determine which of the following? Select all that apply. a. Multifetal gestation b. Bicornate uterus c. Presence and location of pregnancy (intrauterine or elsewhere) d. Amniotic fluid volume e. Presence of ovarian cysts
A, B, C, E
A nurse cares for a client who recently completed genetic testing that revealed that she has a BRCA1 gene mutation. What actions would the nurse take next? (Select all that apply.) a. Assess the patient's response to the test results. b. Assist the client to make a plan for prevention and risk reduction. c. Disclose the information to the medical insurance company. d. Discuss potential risks for other members of her family. e. Encourage support by sharing the results with family members. f. Recommend the client complete weekly breast self examinations.
A, B, D
The traditional areas of school health nursing that are still prevalent in many school systems include (select all that apply) a. Health screening b. Emergency care c. Intensive care d. Communicable disease management e. Health care advice
A, B, D, E
A nurse cares for a client who is scheduled for genetic testing. What actions would the nurse include in the patient's pretesting assessment? (Select all that apply.) a. Assess the client's understanding of the genetic test. b. Obtain physical assessment data relevant to the at risk disorder. c. Discuss prevention, early detection, and treatment options. d. Assess the client's perception of the test results. e. Discuss client rights and obligations regarding disclosure of information.
A, B, E
2. Percutaneous umbilical cord sampling (PUBS), also called cordocentesis, involves the aspiration of fetal blood from the umbilical cord for prenatal diagnosis or therapy. Major indications include (select all that apply) a. Rh disease b. Fetal well being c. Infection d. Lung maturity e. Karyotyping
A, C, E
Environmental substances known or thought to harm the fetus include (Select all that apply.) A Zika infection. Cocaine use, infections with toxoplasmosis and Zika, and tetracycline use during pregnancy are known or thought to harm the fetus. Penicillin and the flu virus are not. B toxoplasmosis infection. Cocaine use, infections with toxoplasmosis and Zika, and tetracycline use during pregnancy are known or thought to harm the fetus. Penicillin and the flu virus are not. C flu virus. Cocaine use, infections with toxoplasmosis and Zika, and tetracycline use during pregnancy are known or thought to harm the fetus. Penicillin and the flu virus are not. D penicillin. Cocaine use, infections with toxoplasmosis and Zika, and tetracycline use during pregnancy are known or thought to harm the fetus. Penicillin and the flu virus are not. D cocaine. Cocaine use, infections with toxoplasmosis and Zika, and tetracycline use during pregnancy are known or thought to harm the fetus. Penicillin and the flu virus are not.E Tetracycline. Cocaine use, infections with toxoplasmosis and Zika, and tetracycline use during pregnancy are known or thought to harm the fetus. Penicillin and the flu virus are not.
A,B,D,E
The nurse educator is providing information to a group of new nurses in a pediatric hospital. What information should the nurse include regarding the care of hospitalized preschoolers? (Select all that apply.) A. Their thinking is egocentric. B. Preschoolers need to have some control of their hospital day. C. Children this age express feelings of shame and guilt D. The child may be able to relate perceptions of what is happening by the use of drawings. E. Home bedtime routines should be avoided in the hospital because of possible confusion. F. Children this age like to have a variety of areas to roam or use unless very ill.
A,B,D,F
15. In many settings, nurses may perform nonstress tests (NST), conduct an initial assessment of the woman and begin necessary interventions for nonreassuring results. These nursing procedures are accomplished after additional education and training under established protocols. Which nursing action is necessary when preparing the patient for the NST? a. Position the woman on her left side. b. Be certain that the woman is seated comfortably in a reclining chair. c. Encourage the woman to drink one liter of water prior to the test. d. Place conduction gel on the womans abdomen with one belt.
B
5. The primary reason for evaluating alpha fetoprotein (AFP) levels in maternal serum is to determine if the fetus has a. Hemophilia b. A neural tube defect c. Sickle cell anemia d. A normal lecithin/sphingomyelin (L/S) ratio
B
A 5year-old girl's sibling has died from sudden infant death syndrome (SIDS). The parents are concerned because she showed more outward grief when her cat died than she is showing now. Based on the nurse's understanding of death in child development, how should the nurse explain this behavior to the parents? A. "This is suggestive of maladaptive coping and referral for counseling is needed." B. "The death may be so painful and threatening that the child is denying the death for now." C. "The child is not old enough to have formed a significant attachment to her sibling." D. "The child is not old enough to have a concept of death."-
B
A nurse consults a genetic counselor for a client whose mother has Huntington disease and is considering genetic testing. The client states, "I know I want this test. Why do I need to see a counselor?" How would the nurse respond? a. "The counselor will advise you on whether you can have children or need to adopt." b. "Genetic testing can be a stressful experience. Counseling can provide support and education throughout the process." c. "There is no cure for this disease. The counselor will determine if there is any benefit to genetic testing." d. "Genetic testing is expensive. The counselor will advocate for you and help you obtain financial support."
B
A preschool aged child tells the nurse "I was bad, that's why I got sick." What is the best rationale for this child's statement? a. The child has a fear that mutilation will lead to death. b. The child's imagination is very active, and he may believe the illness is a result of something he did. c. The child has a general understanding of body integrity at this age. d. The child will not have fear related to an IV catheter initiation but will have fear of an impending surgery.
B
Based on concepts related to the normal growth and development of children, which child would have the most difficulty with separation from family during hospitalization? a. A 5 month old infant b. A 15 month old toddler c. A 4 year old child d. A 7 year old child
B
How does the nurse respond to a client who wishes to become pregnant and has a family member with cystic fibrosis, asks about the need for genetic testing? A. Reminds the client that genetic testing is very expensive. B. Refers the client to a genetic counselor. C. Asks the client whether a positive genetic test result would change her plans to become pregnant. D. Explains that cystic fibrosis is an autosomal dominant disorder and if she or her partner does not have the disorder, there is no risk to have affected children.
B
The nurse is working in an OB/GYN office, where part of her duties include obtaining a patients history and performing an initial assessment. Which woman is likely to be referred for genetic counseling after her first visit? a. A pregnant woman who will be 40 years or older when her infant is born b. A woman whose partner is 38 years of age c. A patient who carries a Y linked disorder d. An anxious woman with a normal quadruple screening result
B
The nurse is working with families and their children in an outpatient surgical center. What information about the family and the surgical experience is most important for the nurse to consider when working with these families? A. Waiting during surgery is not as stressful for parents in such a center. B. Families need to be prepared for what to expect after discharge. C. Anxiety is minimal for both parents and the child in such a center. D. Accurate and complete discharge teaching is the responsibility of the surgeon.
B
The purpose of initiating contractions in a contraction stress test is to A. increase placental blood flow. B. apply a stressful stimulus to the fetus. C. identify fetal acceleration patterns. D. determine the degree of fetal activity.
B
What is the effect of a mutation involving the loss of 7 bases in the gene for insulin on the amino acid sequencing of the protein and blood glucose control? A. Limited insulin is produced. B. Ineffective insulin is produced. C. Excessive insulin is produced. D. Normal continues to be produced.
B
When assisting with the collection of a specimen for chromosome analysis, the nurse must ? A place the collection tubes on ice immediately. Specimens for chromosome analysis must contain living cells, because chromosomes are visible microscopically only in living dividing cells. B ensure that the cells in the specimen stay alive. Specimens for chromosome analysis must contain living cells, because chromosomes are visible microscopically only in living dividing cells. C observe the length of time required for clot formation. Specimens for chromosome analysis must contain living cells, because chromosomes are visible microscopically only in living dividing cells. D provide collection tubes that have no preservatives. Specimens for chromosome analysis must contain living cells, because chromosomes are visible microscopically only in living dividing cells.
B
When doing genetic counseling with a pregnant woman, the nurse will need to do additional teaching if the patient states ? A. "Since both my husband and I carry the gene for cystic fibrosis, my baby has a 50% chance of also being a carrier for the gene."B blood type is dominant; however, both parents may have an "O" recessive gene that can be passed on to a child. Families of Jewish descent, FrenchCanadians, and those with roots in Eastern Europe have a higher incident of Tay-Sachs. Color blindness is an X-linked recessive disorder; girls tend to be carriers, and boys will develop the problem. Cystic fibrosis is an autosomal recessive disorder, so if both parents are carriers, then there is a 50% chance that an offspring will be a carrier. B. "Both my husband and I are B blood type, so our baby will have to be B type also." B blood type is dominant; however, both parents may have an "O" recessive gene that can be passed on to a child. Families of Jewish descent, French-Canadians, and those with roots in Eastern Europe have a higher incident of Tay-Sachs. Color blindness is an X-linked recessive disorder; girls tend to be carriers, and boys will develop the problem. Cystic fibrosis is an
B
Which nursing intervention is necessary before a second trimester transabdominal ultrasound? A. Place the woman NPO for 12 hours. B. Instruct the woman to drink 1 to 2 quarts of water. C. Administer a soapsuds enema. D. Perform an abdominal prep.
B
Which question most likely elicits information about how a family is coping with a child's hospitalization? a. "Was this admission an emergency?" b. "How has your child's hospitalization affected your family?" c. "Who is taking care of your other children while you are here?" d. "Is this the child's first hospitalization?"
B
Which statement about the structure and forms of DNA is true? A. Humans have 23 individual chromosomes B. Every time a cell divides, it must replicate its DNA. C. Each new cell will contain two strands of DNA after cell division. D. Red blood cells carry genes and genetic information.
B
Why is observation for 24 hours in an acute care setting often appropriate for children? a. Longer hospital stays are more costly. b. Children become ill quickly and recover quickly. c. Children feel less separation anxiety when hospitalized for 24 hours. d. Families experience less disruption during short hospital stays.
B
You are a maternal newborn nurse caring for a mother who just delivered a baby born with Down syndrome. What nursing diagnosis is the most essential in caring for the mother of this infant? a. Disturbed body image b. Interrupted family processes c. Anxiety d. Risk for injury
B
Mechanical forces that interfere with normal prenatal development include oligohydramnios and fibrous amniotic bands. A patient at 34 weeks of gestation has reported to the OB triage unit for assessment of oligohydramnios. The nurse assigned to care for this patient is aware that prolonged oligohydramnios may result in (select all that apply) a. Intrauterine limb amputations b. Clubfoot c. Delayed lung development d. Other fetal abnormalities e. Fetal deformations
B, C, D
What are the most common types of inheritance patterns associated with single gene traits? (Select all that apply.) A Karyotype dominant B Sex linked recessive C Autosomal recessive D Autosomal dominant E Karyotype recessive F Sex linked dominant -
B,C,D,F
Which compounds represent the nitrogenous bases that compose human DNA? (Select all that apply.) A. Nicotine B. Thymine C Guanine D. Cytosine E. Furosine F. Adenine G. Benzine
B,C,F
Which information obtained during assessment indicates to the nurse that a client may have an increased risk for a health problem with a genetic component? (Select all that apply.) A. The client's mother has a brother who is married to the client's father's sister. B. A sister and an uncle both have the same rare cardiac valve problem. C The client has a 20 year history of cigarette smoking and alcohol consumption. D. A specific health problem is present in the family at twice the incidence of the general population. E. The client's grandmother had both breast cancer and ovarian cancer. F. The client has a fraternal twin.
B,D,E
14. Which response by the nurse is most appropriate to this statement: This test isnt my idea, but my husband insists? a. Dont worry. Everything will be fine. b. Why dont you want to have this test? c. Y oure concerned about having this test? d. Its your decision.
C
17. Ultrasonography is an important and safe technique used in antepartum surveillance. It provides critical information related to fetal activity, gestational age and fetal well being. Which statement regarding ultrasonography during pregnancy is most accurate? a. Ultrasonography uses infrared technology to create an image. b. Ultrasonography is only utilized as an adjunct to more invasive tests. c. Ultrasonography is not harmful to the fetus. d. Ultrasonography is not a component of biophysical profile testing.
C
A 35 year old woman has an amniocentesis performed to find out whether her baby has a chromosome defect. Which statement by this patient indicates that she understands her situation? a. The doctor will tell me if I should have an abortion when the test results come back. b. I know support groups exist for parents who have a baby with birth defects, but we have plenty of insurance to cover what we need. c. When all the lab results come back, my husband and I will make a decision about the pregnancy. d. My mother must not find out about all this testing. If she does, she will think Im having an abortion.
C
Which statement should a counselor make when telling a couple about the prenatal diagnosis of genetic disorders? a. Diagnosis can be obtained promptly through most hospital laboratories. b. Common disorders can quickly be diagnosed through blood tests. c. A comprehensive evaluation will result in an accurate diagnosis. d. Diagnosis may be slow and could be inconclusive.
D
A client is typed and crossmatched for a unit of blood. Which statement by the nurse indicates a need for further genetic education? a. "Blood type is formed from three gene alleles: A, B, and O." b. "Each blood type allele is inherited from the mother or the father." c. "If the patient's blood type is AB, then the client is homozygous for that trait." d. "If the client has dominant and recessive alleles, the dominant will be expressed."
C
A couple has been counseled for genetic anomalies. They ask you, What is karyotyping? Your best response is a. Karyotyping will reveal if the babys lungs are mature. b. Karyotyping will reveal if your baby will develop normally. c. Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes. d. Karyotyping will detect any physical deformities the baby has
C
A nurse cares for a client who has a genetic mutation that increases the risk for colon cancer. The client states that he/she does not want any family to know about this result. How would the nurse respond? a. "It is required by law that you inform your siblings and children about this result so that they also can be tested and monitored for colon cancer." b. "It is not necessary to tell your siblings because they are adults, but you would tell your children so that they can be tested before they decide to have children of their own." c. "It is not required that you tell anyone about this result. However, your siblings and children may also be at risk for colon cancer and this information might help them." d. "It is your decision to determine with whom, if anyone, you discuss this test result. However, you may be held liable if you withhold this information and a family member gets colon cancer."
C
A nurse cares for a client who has a specific mutation in the a1AT (alpha1 antitrypsin) gene. What action would the nurse take? a. Teach the client to perform monthly breast self examinations and schedule an annual mammogram. b. Support the client when sharing test results and encourages family members to be screened for cancer. c. Advise the client to limit exposure to secondhand smoke and other respiratory irritants. d. Obtain a complete health history to identify other genetic problems associated with this gene mutation.
C
A nurse cares for a client who recently completed genetic testing and received a negative result. The client states, "I feel guilty because so many of my family members are carriers of this disease and I am not." How would the nurse respond? a. "You are not genetically predisposed for this disease but you could still become ill. Let's discuss a plan for prevention." b. "Since many of your family members are carriers, you would undergo further testing to verify the results are accurate." c. "We usually encourage clients to participate in counseling after receiving test results. Can I arrange this for you?" d. "It is normal to feel this way. I think you would share this news with your family so that they can support you."
C
A nurse is educating a client about genetic screening. The client asks why red green color blindness, an Xlinked recessive disorder noted in some family members, is expressed more frequently in males than females. How would the nurse respond? a. "Females have a decreased penetrance rate for this gene mutation and are therefore less likely to express the trait." b. "Females have two X chromosomes and one is always inactive. This inactivity decreases the effect of the gene." c. "The incidence of Xlinked recessive disorders is higher in males because they do not have a second X chromosome to balance expression of the gene." d. "Males have only one X chromosome, which allows the Xlinked recessive disorder to be transmitted from father to son."
C
A nurse needs to start an intravenous (IV) line on an 8year-old to begin administering IV antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" Which response by the nurse is the most appropriate one by the nurse? A. "I need to start the IV right now because your doctor ordered it to get you better." B. "Do you want the IV started now or in an hour after you eat something?" C. "Do you want ice cream or a sandwich after you get your IV started?" D. "You let me know when you're ready for me to start your IV."
C
A woman had a chorionic villus sampling procedure. Prior to discharge the nurse should teach her to report what symptom that may be an indication of a complication? A. Lack of fetal movement B. Nausea and vomiting C. Vaginal bleeding or passage of amniotic fluid D. Frequent urination
C
A woman who is 8 months pregnant has been advised to have an amniocentesis. She asked the nurse the reason for the procedure. The usual reason for an amniocentesis during this period of pregnancy would be to A. detect levels of alpha fetoprotein. B. measure amniotic fluid amounts. C. determine fetal lung maturity. D. identify chromosomal abnormalities.-
C
Having explanations for all procedures and selecting their own meals from hospital menus is an important coping mechanism for which age group? a. Toddlers b. Preschoolers c. School age children d. Adolescents
C
Home care is being considered for a young child who is ventilator dependent. Which factor is most important in deciding whether home care is appropriate? a. Level of parents' education b. Presence of two parents in the home c. Preparation and training of family d. Family's ability to assume all health care costs
C
How can a woman avoid exposing her fetus to teratogens? a. Update her immunizations during the first trimester of her pregnancy. b. Use saunas and hot tubs during the winter months only. c. Use only class A drugs during her pregnancy. d. Use alcoholic beverages only in the first and third trimesters of pregnancy.
C
In practical terms regarding genetic health care, nurses should be aware that a. Genetic disorders equally affect people of all socioeconomic backgrounds, races, and ethnic groups. b. Genetic health care is more concerned with populations than individuals. c. The most important of all nursing functions is providing emotional support to the family during counseling. d. Taking genetic histories is the province of large universities and medical centers.
C
A client who tests positive for a mutation in the BRCA1 gene allele asks a nurse to be present when she discloses this information to her adult daughter. How would the nurse respond? a. "I will request a genetic counselor who is more qualified to be present for this conversation." b. "The test results can be confusing; I will help you interpret them for your daughter." c. "Are you sure you want to share this information with your daughter, who may not test positive for this gene mutation?" d. "This conversation may be difficult for both of you; I will be there to provide support."
D
People who have two copies of the same abnormal autosomal dominant gene will usually be ? A infertile and unable to transmit the gene. People who have two copies of an abnormal gene are usually more severely affected by the disorder because they have no normal gene to maintain normal function. Having two copies of the same abnormal autosomal dominant gene does not always lead to infertility. Therefore, the individual may be able to transmit the gene. Because the gene is dominant, the individual will manifest the disorder and not just be a carrier. B mildly affected with the disorder. People who have two copies of an abnormal gene are usually more severely affected by the disorder because they have no normal gene to maintain normal function. Having two copies of the same abnormal autosomal dominant gene does not always lead to infertility. Therefore, the individual may be able to transmit the gene. Because the gene is dominant, the individual will manifest the disorder and not just be a carrier. C more severely affected by the disorder than people with one copy of the gene. People who have two copies of an abnormal gene are usually more severely affected by the disorder because they have
C
The nurse is explaining the results of a maternal serum alphafetoprotein screening test to the woman. The nurse knows the woman does not understand the teaching if she says A. "Since the levels are low, my baby may have Down syndrome." B. "Since I am not sure about the date of my last menstrual period, the test result cannot be accurately interpreted." C. "Since the levels were within normal limits, I know the baby does not have any anomalies." D. "I know that the levels are high, but that does not always mean something is wrong with the baby."-
C
The parents of a child who is ventilator dependent tell the nurse that their insurance company wants their child discharged. The parents tell the nurse that they do not want their child home "under any circumstances." Which factor is most important in working with this family? A. Presence and training of the two parents in the home B. The family's ability to assume all health care expenses C. The reason(s) why the family does not want the child at home D. The level of the parents' education
C
What is the best action for the nurse to take when a 5 year old child who requires another 2 days of IV antibiotics cries, screams, and resists having the IV restarted? a. Exit the room and leave the child alone until he stops crying. b. Tell the child big boys and girls "don't cry." c. Let the child decide which color arm board to use with the IV. d. Administer a narcotic analgesic for pain to quiet the child.
C
What is the best explanation for a 2 year old child who is quiet and withdrawn on the fourth day of a hospital admission? a. The child is protesting her separation from her caregivers. b. The child has adjusted to the hospitalization. c. The child is experiencing the despair stage of separation. d. The child has reached the stage of detachment.
C
What is the primary disadvantage associated with outpatient and day facility care? a. Increased cost b. Increased risk of infection c. Lack of physical connection to the hospital d. Longer separation of the child from family
C
What is the purpose of amniocentesis for the patient hospitalized at 34 weeks with pregnancy induced hypertension? a. Identification of abnormal fetal cells b. Detection of metabolic disorders c. Determination of fetal lung maturity d. Identification of sex of the fetus
C
When is the most accurate time to determine gestational age through ultrasound? A. Second trimester B. Third trimester C. First trimester D. There is no difference in accuracy among the trimesters
C
Which drug therapy modifications does the nurse anticipate will be needed for a client who is an ultrametabolizer of a specific category of antibiotic drugs? A. No changes in drug therapy will be needed. B. The usual dosage will be increased.CO C. The client will require a different category of antibiotic. D. The usual dosage will be decreased.
C
Which is an appropriate nursing intervention for the hospitalized neonate? a. Assign the neonate to a room with other neonates. b. Provide play activities in the hospital room. c. Offer the neonate a pacifier between feedings. d. Request that parents bring a security object from home.
C
Which therapeutic approach will best help a 7 year old child cope with a lengthy course of intravenous antibiotic therapy? a. Arrange for the child to go to the playroom daily. b. Ask the child to draw you a picture of himself or herself. c. Allow the child to participate in injection play. d. Give the child stickers for cooperative behavior.
C
Which type of direct to-consumer genetic testing will the nurse tell the client is relatively low risk? A. Examining whether a known health problem is likely to respond to a specific drug category B. Deciding whether or not to have children C. Providing information about client's ethnic, racial, and geographic make-up D. Determining whether a client has an increased risk for a specific disorder -
C
While working with the pregnant woman in her first trimester, the nurse is aware that chorionic villus sampling can be performed during pregnancy as early as _____ weeks. a. 4 b. 8 c. 10 d. 12
C
A nurse completes pedigree charts for clients at a community health center. Which diagnoses would the nurse refer for carrier genetic testing? (Select all that apply.) a. Breast cancer b. Colorectal cancer c. Cystic fibrosis d. Hemophilia e. Huntington disease f. Sickle cell disease
C, D, F
4. When is the best time to determine gestational age based on biparietal diameter through ultrasound? a. 4to6 weeks b. 5to7 weeks c. 7 to 10 weeks d. 12 to 20 weeks
D
A 23year-old client who discovers she is positive for a BRCA1 gene mutation that increases her risk for developing breast cancer says "I do not want to cut off my breasts!" What is the nurse's best response? A. "That would provide the greatest protection from developing breast cancer." B. "Have you discussed this with your husband?" C. "Get retested next year. The results could change if you eat a healthy diet." D. "Let's discuss some other options."-
D
A 3 1/2 year old child who is toilet trained has had several "accidents" since hospital admission. What is the nurse's best action in this situation? a. Find out how long the child has been toilet trained at home. b. Encourage the parents to scold the child.c. Explain how to use a bedpan and place it close to the child. d. Follow home routines of elimination.
D
A nurse cares for an adult client who has received genetic testing. The patient's mother asks to receive the results of the genetic tests. Which action would the nurse take? a. Obtain a signed consent from the client allowing test results to be released to the mother. b. Invite the mother and other family members to participate in genetic counseling with the client. c. Encourage the mother to undergo genetic testing to determine if she has the same risks as her child. d. Direct the mother to speak with the client and support the client's decision to share or not share the results.
D
A woman is in active labor and about to deliver a baby girl (diagnosed by ultrasound). The woman's husband has hemophilia A. The nursery nurse planning to care for the infant needs to be aware that she ? A will have a 50% chance of being a carrier but will not have the disorder. Hemophilia is an Xlinked recessive disorder. The father will pass the disorder to 100% of their daughters, and the daughters will become carriers. B will be a hemophilic and therefore must be prepared for bleeding problems. Hemophilia is an X-linked recessive disorder. The father will pass the disorder to 100% of their daughters, and the daughters will become carriers. C will neither be a carrier nor have the disorder. Hemophilia is an X-linked recessive disorder. The father will pass the disorder to 100% of their daughters, and the daughters will become carriers. D will be a carrier. Hemophilia is an X-linked recessive disorder. The father will pass the disorder to 100% of their daughters, and the daughters will become carriers.
D
An NST in which two or more fetal heart rate (FHR) accelerations of 15 beats per minute (bpm) or more occur with fetal movement in a 20 minute period is termed a. Nonreactive b. Positive c. Negative d. Reactive
D
Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that a. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. b. Screening for maternal serum alpha fetoprotein (MSAFP) levels is recommended between 10 and 12 weeks of gestation in order to give parents time to consider options. c. Percutaneous umbilical blood sampling (PUBS) is one of the multiple marker screen tests for Down syndrome. d. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.
D
The home health nurse outlines short and long term goals for a 10 year old child with many complex health problems. Who should agree on these goals? a. Family and nurse b. Child, family, and nurse c. All professionals involved d. Child, family, and all professionals involved
D
The nurse is discussing toddler development with the mother of a 2 1/2 year old child. Which statement by the mother indicates she has an understanding of how to help her daughter succeed in a developmental task while hospitalized? a. "I always help my daughter complete tasks to help her achieve a sense of accomplishment." b. "I provide many opportunities for my daughter to play with other children her age." c. "I consistently stress the difference between right and wrong to my daughter." d. "I encourage my daughter to do things for herself when she can."
D
The nursery nurse is called in to the delivery room of a 22year-old primigravida. The delivery nurse informs the nursery nurse that the patient had oligohydramnios throughout the pregnancy. In planning care for the newborn, the nursery nurse is aware that the baby may develop? A low blood sugar. Prolonged oligohydramnios interferes with fetal lung development. Therefore, the nurse needs to assess for respiratory problems. Other potential problems include fibrous amniotic bands that can result in fetal deformations or intrauterine limb amputation. Low blood sugar and jaundice are not associated with oligohydramnios. B jaundice. Prolonged oligohydramnios interferes with fetal lung development. Therefore, the nurse needs to assess for respiratory problems. Other potential problems include fibrous amniotic bands that can result in fetal deformations or intrauterine limb amputation. Low blood sugar and jaundice are not associated with oligohydramnios. C there are no potential problems associated with oligohydramnios. Prolonged oligohydramnios interferes with fetal lung development. Therefore, the nurse needs to assess for respiratory problems. Other potential problems include fibrous amniotic
D
Under which conditions can an epigenetic event be beneficial? A. When the DNA of a fetus or infant is different from the mother's DNA. B. Only when it has no effect on gene expression. C. Only when the event can be modified by a change in diet. D. When it results in the silencing of a gene mutation.
D
What is the best nursing response to the mother of a 4 year old child who asks what she can do to help the child cope with a sibling's repeated hospitalizations? a. Recommend that the child be sent to visit the grandmother until the sibling returns home. b. Inform the parent that the child is too young to visit the hospital. c. Assume the child understands that the sibling will soon be discharged because the child asks no questions. d. Help the mother give the child a simple explanation of the treatment, and encourage the mother to have the child visit the hospitalized sibling.
D
What should the nurse advise the mother of a 4 year old child to bring with her child to the outpatient surgery center on the day of surgery? a. Snacks b. Fruit juice boxes c. All of the child's medications d. One of the child's favorite toys
D
Which client statement indicates to the nurse correct understanding about genetic testing? A. "Everyone needs to have genetic testing done." B. "After I change my health behaviors, I can repeat the test and anticipate better results." C. "I don't want to know how I am going to die." D. "Just because I have an increased risk does not mean that I will get the disease."
D
Which intervention helps a hospitalized toddler feel a sense of control? a. Assign the same nurses to care for the child. b. Put a cover over the child's crib. c. Require parents to stay with the child. d. Follow the child's usual routines for feeding and bedtime.
D
Which question by the nurse will most likely promote sharing of sensitive information during a genetic counseling interview? a. How many people in your family are mentally retarded or handicapped? b. What kinds of defects or diseases seem to run in the family? c. Did you know that you can always have an abortion if the fetus is abnormal? d. Are there any family members who have learning or developmental problems?
D
Which observations made by the nurse constructing a client pedigree indicate a probable sex linked recessive transmission of a health problem rather than any other inheritance pattern? (Select all that apply.) A The problem is expressed in both siblings in identical (monozygotic) twins. B The problem appears to "skip" generations. C Males and females are equally affected. D Sons of affected fathers do not have the disorder. E Siblings are affected when parents are unaffected. F Males are affected 8 times more often than females. -
D,F
A designated safe place can enhance the child's security while in the hospital. For example, intrusive procedures that may cause discomfort or anxiety are best done in the child's room. Is this statement true or false?
F
After a serious illness or trauma the child's ability to function may change. Once the acute situation has resolved, the child may be transferred to a __________ hospital
rehabilitation
