MATERNAL CHILD TEST 2 CHAPTER 10 FETAL DEVEOPMENT AND GENETICS
A nurse is caring for a 37-year-old pregnant client who is expecting twin boys. The client smoked prior to conception but has stopped during the pregnancy. A relative of the client has Klinefelter syndrome, and the client wants to find out more about the disorder. Which information will the nurse provide to the client during genetic counseling? A. There is a greater risk of Klinefelter syndrome due to the client's age. B. Klinefelter syndrome occurs only in girls and not boys. C. Having twins increases the risk of Klinefelter syndrome. D. The client's previous smoking habit will increase the risk of a genetic disorder.
There is a greater risk of Klinefelter syndrome due to the client's age. Explanation: The risk of trisomies such as Klinefelter syndrome increases with the age of the mother at the time of pregnancy. Klinefelter syndrome occurs only in males. Having twins does not increase the risk of Klinefelter syndrome for the babies, nor does the client's previous smoking habit have any bearing on the risk for Klinefelter syndrome.
A pregnant client is scheduled to undergo chorionic villus sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed? 10 to 12 weeks' gestation 7 to 9 weeks' gestation 5 to 6 weeks' gestation 4 to 5 weeks' gestation
10 to 12 weeks' gestation Explanation: Chorionic villus sampling (CVS) is typically performed between 10 to 12 weeks' gestation. Sometimes it may be offered up to 14 weeks. The test is not conducted before 10 weeks' gestation.
A pregnant client who is planning to have genetic testing asks the nurse when she should schedule her amniocentesis. What should the nurse tell the client? 10 weeks 24 weeks 30 weeks 16 weeks
16 weeks Explanation: The nurse should tell the client that an amniocentesis is typically scheduled between 15 and 18 weeks' gestation.
The nurse is conducting an initial history and assessment on a client at 10 weeks' gestation who is pregnant with her first child. Which question is a priority for the nurse to ask the client at this time? A. "Does anyone in your or the father's family have any genetic disorders?" B. "Do you plan to breastfeed or bottle feed your new baby?" C. "Are you planning to develop a birth plan for use during the birthing process?" D. "Was your mother or grandmother diagnosed with gestational diabetes?"
A. "Does anyone in your or the father's family have any genetic disorders?" Explanation: Due to the timing of the client's pregnancy, it is a priority for the nurse to assess for potential risk factors for genetic abnormalities. The client is in the appropriate time frame to begin genetic testing if desired. The nurse will determine the client's feeding preference and plans to have a birth plan closer to birth to allow the client time to research these topics and make an informed decision about both. Gestational diabetes is not thought to be genetic in nature. The client will be tested for gestational diabetes regardless of family history during her second trimester.
A recently married couple come to the prenatal clinic because they are concerned about genetic testing. The husband is of Jewish heritage. The nurse should recommend the couple undergo genetic testing to determine if the fetus has which disorder common among Ashkenazi Jews (Jews of Eastern European lineage)? A. Tay-Sachs disease B. Down syndrome C. cystic fibrosis D. Turner syndrome
A. Tay-Sachs disease Explanation: Tays-Sachs disease is a autosomal recessive disorder that occurs primarily in Ashkenazi Jews.
The nurse is conducting an initial history and assessment on a client at 10 weeks' gestation who is pregnant with her first child. Which question is a priority for the nurse to ask the client at this time? A. "Does anyone in your or the father's family have any genetic disorders?" B. "Do you plan to breastfeed or bottle feed your new baby?" C. "Are you planning to develop a birth plan for use during the birthing process?" D. "Was your mother or grandmother diagnosed with gestational diabetes?"
A. "Does anyone in your or the father's family have any genetic disorders?" Explanation: Due to the timing of the client's pregnancy, it is a priority for the nurse to assess for potential risk factors for genetic abnormalities. The client is in the appropriate time frame to begin genetic testing if desired. The nurse will determine the client's feeding preference and plans to have a birth plan closer to birth to allow the client time to research these topics and make an informed decision about both. Gestational diabetes is not thought to be genetic in nature. The client will be tested for gestational diabetes regardless of family history during her second trimester.
A client at a preconception screening appointment indicates to the nurse that she is a carrier of muscular dystrophy, an X-linked recessive trait. Her partner does not have the trait. Which statement made by the client indicates an understanding of the implications? A. "Each time I have a child, there is a 25% chance a female child will be a carrier." B. "Because this is an X-linked recessive trait, any male children will not be affected." C. "There are more affected females than males with this particular trait." D. "There is a good chance all my future children will be affected with this trait."
A. "Each time I have a child, there is a 25% chance a female child will be a carrier." Explanation: X-linked recessive inheritance affects more males than females. There is no male-to-male transmission but any man who is affected with an X-linked recessive disorder will have carrier daughters. If a woman is a carrier, there is a 25% chance she will have an "affected son," a 25% chance that her daughter will be a "carrier," a 25% chance that she will have an "unaffected" son, and a 25% chance her daughter will be a "noncarrier."
A nurse is conducting a presentation for a group of nurses at the prenatal clinic on basic genetic information. After teaching the group about genetics, the nurse determines that the teaching was effective based on which statement by the group? A. "My genome is my genetic blueprint." B. "My parents gave me good phenotypes." C. "Your outward characteristics show some interesting genotypes." D. "A secondary goal of determining my genome is to find new treatments."
A. "My genome is my genetic blueprint." Explanation: An individual's genome represents his or her genetic blueprint, which determines genotype (the gene pairs inherited from parents) and phenotype (observed outward characteristics of an individual). A primary goal of human genome project (HGP) is to translate the findings into new strategies for the prevention, diagnosis, and treatment of genetic diseases and disorders.
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: A. 1 in 4. B. 2 in 4. C. 3 in 4. D. 0 in 4.
A. 1 in 4. Explanation: Autosomal recessive inherited diseases occur at a 1-in-4 incidence in offspring. The possibility of a chance happening does not change for a second pregnancy.
A pregnant client is scheduled to undergo chorionic villus sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed? A. 10 to 12 weeks' gestation B. 7 to 9 weeks' gestation C. 5 to 6 weeks' gestation D. 4 to 5 weeks' gestation
A. 10 to 12 weeks' gestation Explanation: Chorionic villus sampling (CVS) is typically performed between 10 to 12 weeks' gestation. Sometimes it may be offered up to 14 weeks. The test is not conducted before 10 weeks' gestation.
A nurse is counseling a couple who have a 5-year-old daughter with Down syndrome. The nurse recognizes that their daughter's genome is represented by which chromosome combination? A. 47XX21+ B. 47XY21+ C. 46XX D. 46XX5p-
A. 47XX21+ Explanation: In Down syndrome, the person has an extra chromosome 21, so this is abbreviated as 47XX21+ (for a female) or 47XY21+ (for a male). 46XX is a normal genome for a female. The abbreviation 46XX5p- is the abbreviation for a female with 46 total chromosomes but with the short arm of chromosome 5 missing (Cri-du-chat syndrome).
A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take? A. Immediately stop the nurse. B. Call the client later and apologize. C. Contact the health care provider. D. Tell the unlicensed assistive personnel
A. Immediately stop the nurse. Explanation: The nurse should interrupt the nurse and remind him or her that it is important not to impose personal values onto the client.
A woman at 15 weeks' gestation is about to undergo amniocentesis. Which nursing intervention should be made first? A. Obtain a signed consent form. B. Have the client void. C. Place the client in supine position. D. Observe the fetal heart rate monitor.
A. Obtain a signed consent form. Explanation: Nursing responsibilities for assessment procedures include seeing a signed consent form has been obtained as needed (necessary if the procedure poses any risk to the mother or fetus that would not otherwise be present, as is the case with amniocentesis). All of the answers are nursing interventions that should be made before or during amniocentesis, but having the client sign a consent form should be completed before the others.
A client at 38 weeks' gestation is diagnosed with placental insufficiency. Which prescription from the health care provider will the nurse anticipate? A. Prepare the client for an induction of labor. B. Discharge the client home with daily nonstress testing. C. Assess the client's blood pressure every 2 hours. D. Administer one dose of betamethasone.
A. Prepare the client for an induction of labor. Explanation: Placental insufficiency is a serious complication where the placenta no longer works properly to provide nutrition and oxygen to the fetus, nor remove waste products from the fetus. Because this client's fetus is at full term, the nurse would anticipate an induction of labor or a cesarean birth. The client is not stable enough to be sent home for monitoring. Hypertension can be a cause of placental insufficiency; however, at this point in the pregnancy, birth is the best option. Betamethasone is a steroid given to clients to hasten preterm fetal lung development. This client is at term and does not need betamethasone.
A multigravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? A. The end of the second trimester B. The end of the first trimester C. The end of the third trimester D. The end of the fourth trimester
A. The end of the second trimester Explanation: During the second trimester, fetal growth is significant. The fetus begins this trimester 3 inches long and weighing less than 1 oz (0.8 gm). By the end of the second trimester, the fetus is about 15 inches long and weighs more than 2 lbs (1000 gm). Major organs develop to the point that the fetus may survive (with help) outside the womb. The fetus would not be able to survive at the end of the first trimester. The end of the third trimester is the expected time of deliver. The fourth trimester involves the time after delivery.
The process of oogenesis begins before birth but is not complete until the childbearing years. At what point does the second meiotic division occur in this process? A. at the time of fertilization by the sperm B. at the time of division of the secondary oocyte and the first polar body C. when the ovum attaches to the uterine wall D. as the ovum is expelled from the corpus luteum
A. at the time of fertilization by the sperm Explanation: The first meiotic division occurs before ovulation, forming a secondary oocyte and a polar body. The polar body disintegrates due to lack of cytoplasm. This leads to the second meiotic division as the sperm fertilizes the oocyte. The second division occurs long before attachment to the uterine wall and after the division, producing the polar body as the ovum leaves the ovary.
A nurse working in the newborn nursery hears an innocent murmur on auscultation of a 24-hour-old infant's chest. The nurse recognizes this as most likely the result of which condition? A. delayed fetal shunt closure B. dysfunctional foramen ovule C. congenital defect D. attached umbilical cord stump
A. delayed fetal shunt closure Explanation: Functional closure of all fetal shunts usually occurs anywhere from the first hour to three to four weeks after birth. These delayed fetal shunt closures are usually not associated with a heart lesion. If they are still present at a later date, evaluation may be warranted
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? A. genetic disorders B. preterm labor C. gestational diabetes D. cervical insufficiency
A. genetic disorders Explanation: Women over the age of 35 are at increased risk of having a fetus with an abnormal karyotype or other genetic disorders. Gestational diabetes, cervical insufficiency, and preterm labor are risks for any pregnant woman.
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? A. maintains the endometrial lining of the uterus during pregnancy B. ensures the corpus luteum of the ovary continues to produce estrogen C. contributes to mammary gland development D. regulates maternal glucose, protein, and fat levels
A. maintains the endometrial lining of the uterus during pregnancy Explanation: Progesterone is necessary to maintain the endometrial lining of the uterus during pregnancy. It is human chorionic gonadotropin (hCG) that acts to ensure the corpus luteum of the ovary continues to produce estrogen and progesterone. Estrogen contributes to mammary gland development, and human placental lactogen regulates maternal glucose, protein, and fat levels
The nurse is explaining the ultrasound procedure to a pregnant client and mentions part of the purpose is to evaluate the amniotic fluid. When questioned by the client how the amniotic fluid helps the fetus, which functions should the nurse point out? Select all that apply. A. Provides physical protection B. Helps regulate temperature C. Produces necessary hormones D. Provides unrestricted movement E. Helps permit symmetrical growth
A/B/D/E Amniotic fluid fills the amniotic cavity. It serves four main functions for the fetus: physical protection, temperature regulation, provision of unrestricted movement, and symmetrical growth. The amniotic fluid does not produce hormones. Hormones are produced by the placenta.
During a clinical rotation at a prenatal clinic, a client asks a nurse what causes certain birth defects. The nurse replies that they can be caused by teratogens. What does the severity of the defects depend on? Select all that apply. A. when during development the conceptus is exposed to the teratogen B. the age of the father C. the particular teratogen to which the fetus is exposed D. the age of any siblings E. the food preferences of the father
A/C Explanation: A teratogen is a substance that causes birth defects. The severity of the defect depends on when during development the conceptus is exposed to the teratogen and the particular teratogenic agent to which the fetus is exposed.
A client of African descent at 12 weeks' gestation states concern about her fetus having a genetic disorder. Which statement by the nurse is most appropriate? A. "You will be tested soon to see if anything is wrong with your baby." B. "Does anyone in your or your partner's families have a genetic disorder?" C. "Do you want to terminate the pregnancy if a genetic disorder is found?" D. "Your health care provider can discuss this concern with you."
B. "Does anyone in your or your partner's families have a genetic disorder?" Explanation: Assessing family history is important to help identify individuals and couples who could benefit from genetic testing for carrier identification. Although the client will have the option to be tested, the nurse would discuss the client's current concern and not dismiss it. The nurse would not state "to see if anything is wrong" because finding an indication of a disorder does not mean something is "wrong" with the fetus. The nurse would not initially discuss termination, nor dismiss the client to the health care provider to discuss.
A 45-year-old man has just been diagnosed with Huntington disease. He and his spouse are concerned about their four children. Based on the knowledge of patterns of inheritance, how will the nurse respond? A. "This disorder is carried on the X chromosome so only your female children would be affected." B. "Each of your children will have a 50% chance of inheriting the disease." C. "Both genes of a pair must be abnormal for the disorder to occur in your children." D. "Your male children are more likely to be affected than your female children."
B. "Each of your children will have a 50% chance of inheriting the disease." Explanation: Huntington disease is an autosomal dominant disorder. A single gene in the heterozygous state is capable of producing the phenotype. In these cases, the abnormal or mutant gene overshadows the normal gene and the individual will demonstrate signs and symptoms of the disorder. The affected person usually has one affected parent. The defect occurs on the autosome not on the X chromosome; therefore, autosomal dominant inherited conditions affect female and male family members equally and follow a vertical pattern of inheritance in families. A person who has an autosomal dominant inherited condition carries a gene mutation for that condition on one chromosome pair. Each of that person's offspring has a 50% chance of inheriting the gene mutation for the condition and a 50% chance of inheriting the normal version of the gene.
The nurse is caring for a client following the birth of the newborn with several birth defects. The client states, "I know the baby has defects because of something I did wrong during my pregnancy. I feel like a horrible mom." How will the nurse respond? A. "I understand...I have a daughter with medical defects due to the medication I took while pregnant." B. "I hear you saying this is a difficult situation. Tell me more about how you are feeling" C. "You should not blame yourself...these things happen for a reason and at least you have other children." D. "That is one reason we always ask pregnant women to tell us all the medication they take."
B. "I hear you saying this is a difficult situation. Tell me more about how you are feeling" Explanation: The nurse will offer emotional support without judgment or blame and will encourage the continued expression of the client's feelings. Acknowledging the situation is difficult for the client and asking the client to tell more will open up communication lines and assist in developing a trusting relationship between the client and nurse. These actions also will help the client sort through her feelings. The nurse would not blame the client by indicating what the client should have done or should not have done. The nurse would not blame the client by implying the client did not tell the health care provider about all of her medications. The nurse would not use a cliche such as "these things happen for a reason and at least you have other children." These statements do not help the client process through her grief and fear of causing the birth defects. The nurse would be hesitant to share her own personal situation during this conversation, because it does not open up the communication for the client and implies that the nurse, like the client, caused her newborn's medical concerns.
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? A. "We have counseling services available, and I recommend them to everyone facing these circumstances." B. "I will alert your entire family about this so you don't have to." C. "I will support you in any decision that you make." D. "I will give you as much information as I can about this condition."
B. "I will alert your entire family about this so you don't have to." Explanation: It is necessary to maintain confidentiality at all times, which prevents health care providers from alerting family members about any inherited characteristic unless the family member has given consent for the information to be revealed.
A couple has just been notified that their unborn child carries a genetic disorder. The couple expresses concern that the insurance company will not cover the costs associated with the medical bills for the child. What is the most appropriate response by the nurse? A. "The insurance company may consider it a preexisting condition since you know." B. "There are laws in place that prohibit that from happening." C. "The insurance company may ask you to change policies once the baby is born." D. "They will charge you a higher premium every month."
B. "There are laws in place that prohibit that from happening." Explanation: The Genetic Information Nondiscrimination Act of 2008 prohibits insurance companies from denying coverage or charging higher premiums based solely on genetic predisposition.
The nurse is caring for four pregnant clients. Which client will the nurse highlight for the health care provider as being at highest risk for carrying a child with a genetic abnormality? A. 38-year-old client whose partner is 43 years of age and who have a child diagnosed with hypoplastic left heart syndrome B. 36-year-old client with thalassemia whose partner is 55 years of age and who have a son with Duchenne muscular dystrophy C. 28-year-old client diagnosed with hemophilia whose partner is 38 years of age and has hypertension D. 17-year-old client diagnosed with schizophrenia whose partner is 15 years of age and has type 2 diabetes
B. 36-year-old client with thalassemia whose partner is 55 years of age and who have a son with Duchenne muscular dystrophy Explanation: The nurse knows the 36-year-old client with thalassemia whose partner is 55 years of age and have a son with Duchenne muscular dystrophy is at highest risk with 3 risk factors. Maternal age of 35 or older, paternal age 50 or older, having a genetic disorder (such as thalassemia or hemophilia) already having a child with a genetic disorder (such as Duchenne muscular dystrophy), family history of genetic disorders, and exposure to a known risk factor (such as certain drugs or infections) are all known risk factors. Nongenetic disorders which are not risk factors include type 2 diabetes, hypoplastic left heart syndrome, hypertension, and schizophrenia.
When counseling potential parents about genetic disorders, which statement would be appropriate? A. Genetic disorders primarily follow Mendelian laws of inheritance. B. Environmental influences may affect multifactorial inheritance. C. All genetic disorders involve a similar number of abnormal chromosomes. D. The absence of genetic disorders in both families eliminates the possibility of having a child with a genetic disorder.
B. Environmental influences may affect multifactorial inheritance. Explanation: It is difficult to predict with certainty the incidence of genetic disorders because in some disorders, more than one gene is involved and environmental insults may play a role (cleft palate, for example).
Amniotic fluid is produced throughout the pregnancy by the fetal membranes. Amniotic fluid has four major functions. What is one of these functions? A. Medium in which to test organ maturity B. Physical protection C. Provide fluid to keep the fetus hydrated D. Restriction of movement
B. Physical protection Explanation: Amniotic fluid serves four main functions for the fetus: physical protection, temperature regulation, provision of unrestricted movement, and symmetrical growth.
The nurse prepares a couple to have a karyotype performed. What describes a karyotype? A. a blood test that will reveal an individual's homozygous tendencies B. a visual presentation of the chromosome pattern of an individual C. the gene carried on the X or Y chromosome D. the dominant gene that will exert influence over a correspondingly located recessive gene
B. a visual presentation of the chromosome pattern of an individual Explanation: A karyotype is a photograph of a person's chromosomes aligned in order.
Genetics-related health care is basic to the holistic practice of nursing. What should nursing practice in genetics include? A. identifying genetic markers B. gathering relevant family and medical history information C. providing advice on termination of pregnancy D. discouraging females to conceive after the age of 40 years
B. gathering relevant family and medical history information Explanation: The nurse's role in genetic counseling is to provide information, collect relevant data, offer support, and coordinate resources. The nurse should not provide advice on terminating a pregnancy, nor attempt to discourage women 40+ from trying to conceive. The nurse also does not identify genetic markers.
A nurse is discussing the importance of good nutrition to a young pregnant client. The nurse would point out that the growing fetus is getting nutrition from the mother via which structure? A. decidua B. placenta C. amniotic fluid D. umbilical arteries
B. placenta Explanation: The placenta is a flat, round structure which forms on the decidua and attaches to the fetus by the umbilical cord. The placenta is the organ responsible for supplying nutrients and oxygenated blood to the fetus. The amniotic fluid surrounds the fetus and provides protection, temperature regulation, allows movement, and symmetric growth. It collects urine and other waste products from the fetus. The decidua is the name given to the endometrium after the pregnancy starts. The umbilical arteries carry waste products away from the fetus to the placenta, where they are filtered out into the maternal body for proper disposal.
A fertilized ovum is known as which structure? A. fetus B. zygote C. embryo D. chorion
B. zygote Explanation: A fertilized ovum is known as a zygote and is the beginning of potential individual human development. The developing human organism is known as an embryo from the time it implants on the uterine wall until the eighth week after inception and as a fetus from the beginning of the ninth week after fertilization through birth. The chorion is the outermost cell layer that surrounds the embryo and fluid cavity.
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. A. Affected individuals will have affected parents. B. Affected individuals are usually males. C. Daughters of an affected male are unaffected and are not carriers. D. Female carriers have a 50% chance of transmitting the disorder to their sons. E. Females are affected by the condition if it is a dominant X-linked disorder.
B/D/E The nurse should explain to the client that individuals with hemophilia are usually males. Female carriers have a 50% chance of transmitting the disorder to their sons, and females are affected by the condition if it is a dominant X-linked disorder. Offspring of nonhemophilic parents may be hemophilic. Daughters of an affected male are usually carriers.
A nurse is present when a health care provider tells a couple that the results of their genetic testing came back normal. Later, the nurse notes that the completed genetic report identifies the couple positive for a genetic disorder. What is the most appropriate action by the nurse? A. Call the couple and tell them the truth. B. Do nothing; it is not the nurse's decision. C. Report it to the nursing supervisor. D. Call the medical review board.
C. Report it to the nursing supervisor. Explanation: The nurse has an obligation to report unethical behavior and should report the discrepancy to the nursing supervisor
A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information? A. The female fertility period is from Day 12 to Day 21 of her menstrual cycle. B. Fertilization can occur only if intercourse occurs on the day of ovulation. C. The window of opportunity for conception is from 3 days before to 2 days following ovulation. D. Since a sperm can only live 12 to 24 hours after ejaculation, fertility is limited to 1 day before to 1 day after ovulation.
C. The window of opportunity for conception is from 3 days before to 2 days following ovulation. Explanation: Since sperm are viable for 24 to 72 hours after ejaculation and the ovum remains fertile for a maximum of 48 hours after ovulation, the window is from 3 days before to 2 days after ovulation
Cystic fibrosis is an example of which type of inheritance? A. autosomal dominant B. autosomal recessive C. X-linked recessive D. multifactorial
C. autosomal recessive Explanation: Cystic fibrosis is an autosomal recessive inherited condition. Huntington disease would be an example of an autosomal dominant inherited condition. Hemophilia is an X-linked recessive inherited condition. Cleft lip is a multifactorial inherited condition.
The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? A. provides rich blood supply to decidua B. maintains nutrient-rich decidua C. continues progesterone production by corpus luteum D. sustains life of placenta
C. continues progesterone production by corpus luteum Explanation: The corpus luteum is responsible for producing progesterone until this function is assumed by the placenta. hCG is a fail-safe mechanism to prolong the life of the corpus luteum and ensure progesterone production. Estrogen is responsible for providing a rich blood supply to the decidua. Progesterone helps maintain a nutrient-rich decidua
Which question would be most important for a nurse to ask a G2P1 client who has a child with sickle cell anemia? A. "When was your last exacerbation?" B. "Have you done well to control your stress?" C. "Do you know the sex of your baby?" D. "Did you and your partner get genetic testing?"
D. "Did you and your partner get genetic testing?" Explanation: The nurse should assess whether the client has had genetic testing completed. If not, the client should be referred for testing.
When educating parents on recessive genetic disease statistics, the nurse understands that which statement by the parents indicates an accurate understanding of genetic inheritance? A. "My children will have a 50/50 chance of having a genetic disease." B. "If I have four children, only one will have the disease." C. "With each child the odds of inheritance decrease significantly." D. "Each child will have a 25% chance of developing the disease."
D. "Each child will have a 25% chance of developing the disease." Explanation: The statistics of inheritance are reset with each pregnancy; therefore, each pregnancy has the same statistical probability of displaying the genetic disease.
A nurse is conducting a class for nursing students on genetic inheritance and is focusing specifically on X-linked recessive disorders. Which statement by a nursing student would indicate appropriate learning has occurred? A. "Males cannot be carriers if they do not have the disorder." B. "If the female is the carrier, the daughter can be too." C. "If the male does not have it, the children will not either." D. "If the female is the carrier, the sons may have the disorder."
D. "If the female is the carrier, the daughter can be too." Explanation: Because females have two X chromosomes, if they receive an X-linked recessive disorder from the mother, they can be a carrier of the disorder just like the mother.
Which question would be most important for a nurse to ask a G2P1 client who has a child with sickle cell anemia? A. "When was your last exacerbation?" B. "Have you done well to control your stress?" C. "Do you know the sex of your baby?" D. "Did you and your partner get genetic testing?"
D. Did you and your partner get genetic testing?" Explanation: The nurse should assess whether the client has had genetic testing completed. If not, the client should be referred for testing.
A client's older child has sickle-cell anemia, an autosomal recessive disorder. The client is now pregnant with a new partner and asks about the chances of this child having sickle-cell anemia. How does the nurse respond? A. Because this child is female, the child will not be affected by sickle-cell anemia. B. You will need to check with your health care provider about this question. C. Because you are a sickle-cell gene carrier, the child has a 50% chance of being affected. D. Sickle-cell anemia is a recessive gene, so the child will be affected only if your new partner also carries this gene.
D. Sickle-cell anemia is a recessive gene, so the child will be affected only if your new partner also carries this gene. Explanation: Autosomal recessive disorders, such as sickle-cell anemia, are inherited when both parents are carriers of the gene. They are not sex-linked. Because this pregnancy is with a new partner, inheritance of the disorder is only possible if the new partner is also a carrier of this gene.
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? A. socioeconomic status of the family members B. avoidance of questions on race or ethnic background C. specific physical characteristics of family members D. if couples are related to each other or have blood ties
D. if couples are related to each other or have blood ties Explanation: While obtaining the genetic history of the client, the nurse should find out if the members of the couple are related to each other or have blood ties, as this increases the risk of many genetic disorders. The socioeconomic status or the physical characteristics of family members do not have any significant bearing on the risk of genetic disorders. The nurse should ask questions about race or ethnic background because some races are more susceptible to certain disorders than others.
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? A. socioeconomic status of the family members B. avoidance of questions on race or ethnic background C. specific physical characteristics of family members D. if couples are related to each other or have blood ties
D. if couples are related to each other or have blood ties Explanation: While obtaining the genetic history of the client, the nurse should find out if the members of the couple are related to each other or have blood ties, as this increases the risk of many genetic disorders. The socioeconomic status or the physical characteristics of family members do not have any significant bearing on the risk of genetic disorders. The nurse should ask questions about race or ethnic background because some races are more susceptible to certain disorders than others.
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: A. is a screening test for placental function. B. tests the ability of her heart to accommodate C. the pregnancy. D. may reveal chromosomal abnormalities. E. measures the fetal liver function.
D. may reveal chromosomal abnormalities. Explanation: An alpha-fetoprotein analysis is a cost-effective screening test to detect chromosomal and open-body-cavity disorders.
Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S? A. Marfan syndrome B. hemophilia C. Tay-Sachs disease D. sickle cell anemia
D. sickle cell anemia Explanation: Sickle cell anemia is an example of a genetic condition caused by a small gene mutation that affects protein structure, producing hemoglobin S. Marfan syndrome is an autosomal dominant inherited condition. Hemophilia is an X-linked recessive inherited condition. Tay-Sachs disease is an autosomal recessive inherited condition.
A client presents to the hospital experiencing a spontaneous abortion (miscarriage) at 8 weeks' gestation, which is the third spontaneous abortion (miscarriage) in 2 years. The health care provider offers to send the products of conception for genetic testing. The client expresses not understanding the reason for this action. How does the nurse explain? A. Many spontaneous abortions (miscarriages) occur due to chromosomal disorders and this testing may determine if this is the cause. B. This testing will help to determine if your hormone levels are causing the recurrent spontaneous abortions (miscarriages). C. It will reassure you to find out if the baby had anomalies that were not compatible with life. D. If you do not want to have this testing done, we will respect that decision.
Many spontaneous abortions (miscarriages) occur due to chromosomal disorders and this testing may determine if this is the cause. Explanation: Many spontaneous abortions (miscarriages) occur due to chromosomal disorders, and genetic testing may be completed to find out if this was the cause of this spontaneous abortion (miscarriage). The testing will not determine hormone levels, and the client may need further testing to determine the cause of recurrent spontaneous abortions (miscarriages). If the client declines testing the decision will be respected, but the client should be provided with information to make an informed decision first. The nurse should not assume how the client will feel or respond to learning if there were or were not genetic abnormalities.
A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age? A. an error in math when calculating B. mistaking implantation bleeding for last menstrual period (LMP) C. amount of weight gain of mother in early weeks of pregnancy D. not seeking prenatal care in the beginning
mistaking implantation bleeding for last menstrual period (LMP) Explanation: The most common cause is implantation bleeding, which can occur as the blastocyst implants itself into the endometrium. This bleeding can be mistaken for a scanty menstrual period and can lead to miscalculation of fetal age by 2 weeks. The other choices might also contribute, especially the math miscalculation, but are not the primary reason.
