OB QUIZ 2
A 10-week gravid states that her sister's son has been diagnosed with an X-linked recessive disease, Duchenne muscular dystrophy. She questions the nurse about the disease. Which of the following responses is appropriate for the nurse to make?
"Because Duchenne muscular dystrophy is inherited through the woman, it is advisable for you to see a genetic counselor."
A woman is a carrier for hemophilia A, an X-linked recessive illness. Her husband has a normal genotype. The nurse can advise the couple that the probability that their daughter will have the disease is?
0 probability. In recessive x-linked inheritance, girls would have to gave 2 affected "x" genes to exhibit the disease.
The nurse concludes that which client manifestation indicates a need for colposcopy and biopsy for human papilloma virus?
A small soft papillary swelling is most likely human papilloma virus infection, which can be confirmed by colposcopy and directed biopsy.
A woman asks the nurse, "My nuchal fold scan results were abnormal. What does this mean?" Which of the following comments is appropriate for the nurse to make at this time?
An abnormal test indicates that your baby may have down syndrome
A 19-year-old client with multiple sex partners is being counseled about the hepatits B vaccination. During the counseling sessions, which of the following should the nurse advice the client to receive?
Complete series of three intramuscular injections - second shot after one month, third shot after 6 months.
In explaining to a client during her initial prenatal exam the importance of testing pregnant women for gonorrhea, the nurse should tell the client that gonorrhea can cause which problem in the neonate?
Congenital abnormalities - sepsis and intrauterine growth restriction.
A client who has had pelvic inflammatory disease (PID) caused by chlamydia trachomatis is at risk for which of the following?
Ectopic pregnancy - Chlamydia leaves scar tissue on the fallopian tubes which increases the incidence of ectopic pregnancy
Women who are on hormone replacement therapy for an extended period of time have been shown to be high risk for which of the following complications?
Endometrial cancer
A nurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, please place the following four hormones in the chronological order in which they elevate during the menstrual cycle
Gonadotropin-releasing hormone Follicle-stimulating hormone (FSH) Lutenizing hormone (LH) after ovulation - Progesterone rises
A nurse is educating a group of women in her parish about osteoporosis. The nurse should include in her discussion that which of the following is a risk factor for the disease process?
Heavy alcohol consumption -
A woman has undergone amniocentesis, hs been notified that her bay is XX with a 14/21 robertsonian chromosomal translocation. The nurse helps the woman understand which of the following?
It is likely that the baby will be unable to have children when she grows up. - the egg will contain an abnormal quantity of genetic material
When a nurse is teaching a woman about her menstrual cycle, which of the following is the most important change that happens during the follicular phase of the menstrual cycle?
Maturation of the graafian follicule - FSH is elevated during the follicular phase and the graafian follicle matures
During the first prenatal visit, the client denies having had rubella or the rubella vaccine. What would be an appropriate action by the nurse based on this information?
Obtain rubella titer, because the nonimmune client who is pregnant can have a miscarriage or serious congenital abnormalities if they contract rubella.
A man is inherited the gene for familial adenomatous polyposis (FAP), an autosomal dominant disease. He and his wife wish to have a baby. Which of the following would provide the couple with the highest probability of conceiving a healthy child?
Pre-implantation genetic diagnosis - Performed prior to the transfer of the embryo into the woman's fellopian tubes. Only healthy embryos are implanted.
A woman has been diagnosed with syphilis. Which of the following nursing interventions is appropriate?
Question the woman regarding symptoms of other sexually transmitted infections
A woman is taking Fosamax (alendronate) for osteoporosis. The nurse should advise the woman about which of the following when taking the medication?
Remain upright for 30 minutes after taking the medication -
The nurse in a pediatric clinic is caring for a 9-year-old girl who has been diagnosed with gonorrhea. Which of the following actions is appropriate for the nurse to take?
Report the girl's medical findings to child protective services
A woman seen in the emergency department, is diagnosed with pelvic inflammatory disease (PID). Before discharge the nurse should provide the woman with health teaching regarding which of the following?
Sexually transmitted infections - PID usually occurs as a result of an ascending sexually transmitted infection
A woman is informed that she is a carried for Tay-Sachs disease, an autosomalrecessive illness. What is her phenotype?
She exhibits no symptoms of the disease
An asymptomatic woman is being treated for HIV infection at the women's health clinic. Which of the following comments by the woman shows that she understands her care?
Since my partner and I are both HIV positive, we use a condom - HIV is prone to mutation. it is important for clients to use condoms when they have intercourse because if the virus mutates the client will then be infected with two strains of the virus and the progression to AIDS is hastened.
A three month old baby has been diagnosed with cystic fibrosis (CF). The mother says, "How could this happen? I had an amniocentesis during my pregnancy and everything was supposed to be normal!" What must the nurse understand about this situation?
The baby may have an uncommon genetic variant of the disease. - It is impossible to test for all CF variants as there are more than 1000 variants.
The genetic counselor informs a couple that they have a 25% probability of getting pregnant with a child with severe genetic disease. The couple asks the nurse exactly what this means. Which of the following responses by the nurse is appropriate?
Whenever they get pregnant, the fetus may have the disease
Which of the following sexually transmitted infections is characterized by a foul-smelling, yellow-green discharge that is often accompanied by vaginal pain and dysparenuia
Trichomoniasis - STI caused by protozoan. Women who are pregnant may develop pre-term labor. Women who are infected have an increase risk of contracting HIV
A client is put on calcium supplements to maintain bone health. To maximize the absorption, the client is also advised to take which of the following supplements?
Vitamin D
A female client asks the nurse about treatment for HPV warts. The nurse's response should be based on which of the following?
Warts often recur a few months after a client is treated
A client is to have a hysterosalpingogram. In this procedure, the physician will be able to determine which of the following?
Whether or not the fallopian tubes are obstructed - During a hysterosalpingogram, a dye is inserted through the vagina into the uterine cavity. The dye is visualized on x-ray, then travels up into the fallopian tubes. If tubes are blocked owing to scarring or endometriosis, the dye does not ascend.
At her first prenatal visit, a woman relates that her maternal aunt has cystic fibrosis (CF), an autosomal recessive illness. Which of the following comments is appropriate for the nurse to make at this time?
"We can check to see whether or not you are a carrier for cystic fibrosis."
A woman, whose menstrual cycle is 35 days long, states that she often has slight pain on one of her lower abdomen on day 21 of her cycle. She wonders whether she has ovarian cancer. Which of the following is the nurse's best response?
"Women often feel a slight twinge when ovulation occurs" - Ovulation usually occurs 14 days before the first day of the menses
A 25-year-old woman, G0 P0000, enters the infertility clinic stating that she just learned she is positive for the BRCA1 and the BRCA2 genes. She asks the nurse what her options are for getting pregnant and breastfeeding her baby. The nurse should base her reply on which of the following?
Fertility of women who carry the BRCA1/2 genes are similar to that of the unaffected women.
The client is scheduled for a hysterosalpingogram (HSG). What information should the nurse obtain during the preoperative assessment?
History of pelvic inflammatory disease (PID) - A reccurance of PID can happen after HSG, so prophylactic antibiotics should be prescribed.
A woman is noted to have multiple soft warts on her perineum and rectal areas. The nurse suspects that this client is infected with which of the following sexually transmitted infections?
Human papillomavirus (HPV)
Which statement by a gravid client who is a carrier for duchenne muscular dystrophy, an X-linked recessive disease, indicates that she understands the implications of her status.
If I have a girl she will be healthy. Females may carry the disease but won't present it.
A woman asks a nurse about presymptomatic genetic testing for Huntington's disease. The nurse should base her response on which of the followng?
If the woman is positive for the gene for Huntington's, she will develop the disease later in life.
The nurse advises the women to whom she is providing health care teaching at a local church that they should see their health care provider to be assessed for ovarian cancer if they experience which of the following S/S?
Abdominal pain, bloating, and constant feeling of fullness.
A male client has reen color blindness, an X-linked recessive genetic disorder, His wife has no affected genes. Which of the following statements by the nurse is true regarding the couple's potential for having a child who is color blind?
All female carriers will be carriers for color blindness
A female client's test for syphilis has come back positive. In talking with the woman about how the infection is spread, the nurse would discuss that syphilis can be contracted in which ways?
Kissing, oral-genital or genital-genital sexual contact, and biting.
The nurse is educating a group of adolescent women regarding sexually transmitted infections. The nurse knows that learning was achieved when a group member states that the most common sign/symptom of STIs is which of the following?
Lack of signs or symptoms
The nurse is educating a group of women on how to perform a breast self-examination (BSE). Which of the following actions should the nurse advise the woman to take?
Look for dimpling while bending forward from the waist
A woman has been diagnosed wiht rpimary syphilis. Which of the following physicial findings would the nurse expect to see
Pain-free lesion (chancre) - Small round painless lesion that will disappear, even without treatment, after a month or so. Stage 2 a reddish brown rash usually on palms and soles, sores on the mucous membranes, and flu-like symptoms. Stage 3, a year later, dementia, paralysis, numbness and blindness. (non-reversible)
A woman's temperature has just risen 0.4F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the changes?
Progesterone elevation occurs after ovulation and spikes at about 5-6 days thermogenic - that is, heat producing.
After a sex education class, the school nurse overhears an adolescent woman discussing safe sex practices. Which of the following comments by the young woman indicates that teaching about infection control was effective?
Teen women are most high risk for sexually transmitted infections - the mucous membranes of female teen are more permeable to STIs than the membranes of adults and males.
A nurse is discussing sexual arousal during a preadolescent boys' sexual education class. Which of the following should the nurse base her reply on when a boy asks, "What exactly happens when my body gets aroused anyway?"
When arousal occurs, the penile blood vessels become engorged and an erection is achieved.
A man has been diagnosed with a chlamydial infection. The nurses expect the client to complain of pain at which of the following times?
When urinating
In analyzing, the need for teaching regarding sexual health in a client who is sexually active, which of the following questions is the most important for a nurse to ask?
With whom did you have intercourse? - Learn whether pt is having sex with men/women, and with more than one partner.
A client asks a nurse to express an opinion on the value of taking hormone replacement therapy (HRT). The nurse should be aware that it is recognized that HRT is effective in which of the following situations?
Women experiencing severe menopausal symptoms
It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long, which of the following is an appropriate reply by the nurse?
You are probably ovulating - Breast tenderness and mittelschmerz often occur at the time of ovulation. 14 days before the woman usually menstruates. Mittelschmerz is a twinge near the site of the ovary at the time of ovulation.
A client states that she has been diagnosed wiht fibrocystic breast disease. She asks the nurse, "Does this mean that I have breast cancer?" Which of the following statements by the nurse is appropriate at this time?
You do not have breast cancer, but it is especially important for you to have regular mammograms to monitor for any changes
A woman whose blood type is O-negative states, "My husband is AB+" The mother queries the nurse about what blood type the baby will have. Which of the following blood types should the nurse advise the mother that the baby have?
Your baby could be type A+ Your baby could be type B-
A client is being interviewed prior to becoming pregnant. She states that she has a disease that is transmitted by mitochondrial inheritance. Which of the following statements is consistent with the client's disease?
100% of the children will be affected. - Mitochondrial DNA is inherited through the mothers only. Since all of the woman's gametes contain her mitochondrial DNA, all her offspring will be affected
A nurse teaches a woman who wishes to become pregnant that if she asses for spinnbarkeit she will be able to closely predict her time of ovulation. Which technique should the client be taught to assess for spinnbarkeit?
Assess her vaginal discharge for elasticity and slipperiness - Spinnbarkeit is defined as the "thread" that is created when the vaginal discharge is slippery and elastic at the time of ovulation. The changes are in response to high estrogen levels. The woman inserts her index and middle fingers into her vagina and touches her cervix. After removing her fingers she separates her fingers and "spins a thread" between her fingers. When she is not in her fertile period, the mucus is thick and gluey.
The public health nurse calls a woman and states, "I'm afraid that I have some disturbing news. A man who has been treated for gonorrhea by the health department has told them that he had intercourse with you. It is very important that you seek medical attention." The woman replies, "There is no reason for me to go to the doctor! I feel fine" Which of the following replies by the nurse is appropriate at this time?
That certainly could be the care. Woman often report no symptoms.
A pregnant woman and her husband are both heterozygous for achondroplastic dwarfism, an autosomal dominant disease. The nurse advises the couple that their unborn child has which of the following probabilities of being of normal stature?
The child has a 25% probability of being of normal stature. - both are heterozygous therefore they have one dominant and one recessive gene therefore the genotype of each parent is Aa. Because achondroplasia is a dominant disease, the recessive allele in this scenario is the normal gene. one 1 of the 4 boxes contain 2 recessive, therefore the child has 1/4 chance of being of normal stature
A client who is sexually active is asking the nurse about gardasil, one of the vaccines that is given to prevent HPV. Which of the following should be included int the counseling session?
The most common side effect of the vaccine is pain at the injection site.
A client G4 P4004, states that her hurband has just been diagnosed with polycystic kidney disease, and autosomal dominant disease. The husband is heterozyous of PKD while the client has no PKD genes. The client states "I have not had our children tested because they ahve such a slim chance of inheriting the disease. We intend to wait until they are teens to do the testing." The nurse should base her response based on which of the following?
The woman may be exhibiting the signs of denial since each of the couples children has a 50/50 chance of developing the disease.
A gravid, married client, 24 weeks' gestation, is found to have bacterial vaginosis. Her health care practitioner has ordered metrodinazole to treat the problem. Which of the following educational information is important for the nurse to provide the woman at this time?
The woman must be careful to observe signs of preterm labor
A woman has been diagnosed with PID. Which of the following organisms are the most likely causative agents?
Chlamydia trachomatis & Neisseria gonorrhoeae.
A non pregnant young woman has been diagnosed with bacterial vaginosis. The nurse questions the woman regarding her sexual history, including the frequency of intercourse, how many partners she has and her use of contraceptives. What is the rational for the nurses' questions?
Clients with BV can become infected with HIV and other sexually transmitted infections more easily than uninfected women.
A couple inquires about the inheritance of Huntington's disease (HD) because the prospective father's mother is dying of the illness. There is no history of the disease in his partner's family. The man has never been tested for HD. Which of the following responses by the nurse is appropriate?
Because neither of you have been tested for HD, the most information I can give you is that each and everyone of your children may have the disease.
A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormonal levels would the nurse expect to see?
Both estrogen and progesterone are low. - When the ovum is not fertilized, both estrogen and progesterone levels drop. The hormonal drop is followed by menstruation.
Four women who use superabsorbent tampons during their menses are being seen in the medical clinic. The woman with which of the following findings would lead the nurse to suspect that the woman's complaint are related to her use of tampons rather than to an unrelated medical problem?
Diffuse rash with fever - this is a symptom of TSS Staphylococcus aureus, a bacterium that colonizes the skin, proliferates in the presence of the tampons. Women with the disorder develop a rash, fever, vomiting and diarrhea, muscle aches and chills. 5/100 women who develop TSS die.
A woman states she feels "dirty" during her menses so she often douches to "clean myself". The nurse advises the woman that it is especially important from douching while menstruating because douching will increase the likelihood of her developing which of the following gynecological complications?
Endometriosis - Douching disrupts the normal flora in vagina. And pathogens can be pushed upward --> PID --> Endometriosis
A nurse discusses teratogens with a client during preconceptual counseling. The client demonstrates understanding by making which statement?
Exposure to teratogens poses the greatest risk during the first eight weeks - Organogenisis and cell differentiation occur during the first eight weeks of pregnancy, making the embryo particularly sensitive to teratogens during this time.
The nurse us counseling a woman who has been diagnosed with mild osteoporosis. Which of the following lifestyle changes should the nurse recommend?
Go on daily walks Stop smoking Consume dairy products
During a genetic evaluation, it is discovered that the woman is carrying one autosomal dominant gene for a serious late adult-onset disease, while her partner's history is unremarkable. Based on this information, which of the following family members should be considered high risk and in need for genetic counseling?
The woman's fetus, sisters, brothers, parents. She has a genotype of Aa, therefore one of her parents is the carrier and it is dominant therefore one of her parents will present with the disease. It also will be present in siblings and in child.
The nurse is counseling a pregnant couple who are both carriers of pehylketonuria (PKU), and autosomal recessive disease. Which of the following comments by the nurse is appropriate?
There is 2 out of 4 chance that your child will be a carried like both of you -1/4 that they will present the disease
A triage nurse answers a telephone call from the male partner of a woman who was recently diagnosed with cervical cancer. The man is requesting to be tested for HPV. The nurse's response should be based on which of the following?
There is currently no approved test to detect HPV in men
A client's amniocentesis results were reported as 46, XY. Her obstetrician informed her at the time that everything "looks good." Shortly after birth the baby is diagnosed with cerebral palsy. Which of the following responses will explain this result?
Cerebral palsy is not a genetic disease. It is caused by hypoxic injury that can occur at any time during pregnancy, labor and delivery or the postdelivery period.
A woman has contracted herpes simplex 2 for the first time. Which of the following signs and symptoms is the client likely to complain of?
Flu-Like symptoms - The initial infection of herpes simplex 2 is often symptom free but, if symptoms do occur, the client may complain of flu-like symptoms as well as vesicles at the site of the viral invasion
A pregnant client who is 11 weeks' gestation has come to the office reporting flu-like symptoms. Laboratory studies indicate that she has contracted toxoplasmosis. From which of the following was the infection probably contracted?
Toxoplasmosis is caused by a protoxoan that is spead by ingestion of contaminated raw meat or poor handwashing after contact with cat litter.
A client is to have a hysterosalpingogram. Which of the following information should the nurse provide the client prior to the procedure?
You will be asked to move from side to side so that the x-ray pictures can be taken - A hysterosalpingogram is one of the many tests performed during a standard infertility work-up. The test taker should be familiar with the rationale for each of the tests.
