Chp 3: Genetics, Conception, Fetal Development & Reproductive Tech.

How many chromosomes are present in the human cell?

46 Each human cell contains 46 chromosomes: 22 homologous pairs of chromosomes and one pair of sex chromosomes, for a total of 46.

A client reported that her menstrual period started 14 days ago and she is unsure of when ovulation will be taking place. Based on the client's history, the nurse notes that the client is ovulating. Which activity does the nurse expect to be happening with this client at this time? Select all that apply. 1. She is unable to get pregnant. 2. The endometrial tissue is about to be sloughed off. 3. The empty Graafian follicles morph to form the corpus luteum. 4. The client's estrogen levels will peak and decrease with the release of the oocyte. 5. Before the surge of luteinizing hormone estrogen levels decrease and progesterone levels increase.

Answer 4, 5 Option 1: It is very possible that the client will be pregnant during the ovulatory phase. Option 2: The endometrial tissue will not slough off on day 14 of the cycle. Option 3: The empty Graafian follicles morph to form the corpus luteum during the luteal phase. Option 4: The client's estrogen levels will peak and decrease with the release of the oocyte during the ovulatory phase. Option 5: Before the surge of luteinizing hormone, estrogen levels decrease and progesterone levels increase during the ovulatory phase.

The nurse is visiting the home of a woman who recently had a fetal demise. Toxoplasmosis is suspected. Which finding would confirm the possibility of toxoplasmosis exposure? Select all that apply. 1. History of having a sexually transmitted infection 2. History of frequently smoking marijuana 3. Having poor air quality at home 4. Having many cats at home 5. Consuming uncooked beef

Answer 4, 5 Option 1: Sexually transmitted infection is not a predisposing factor of toxoplasmosis. Option 2: Smoking marijuana is not a predisposing factor of toxoplasmosis. Option 3: Poor air quality at home is not a predisposing factor of toxoplasmosis. Option 4: Getting contaminated with cat feces exposes pregnant women to toxoplasmosis. Option 5: Consuming uncooked beef exposes pregnant women to toxoplasmosis.

A female client was diagnosed with anovulatory infertility and was prescribed 150 mg/day of Clomiphene (Clomid) for 1 month. The stock volume for the Clomiphene (Clomid) stated 25 mg. The nurse is expected to instruct the client to take _______________ tablets per day? Fill in the blank and enter a numerical value only.

Answer 6 ( DO NOT SAY TABLETS) The nurse would have to calculate the number of tablets the client is to take:150/mg ÷25 x 1 = 6 tablets.

A newly pregnant client is seen in the clinic for her first prenatal appointment. She states she has a family history of an autosomal recessive disease. Which disease has an autosomal recessive pattern of inheritance? 1. Cystic fibrosis 2. Hemophilia 3. Huntington's disease 4. Sickle-cell anemia 5. Tay-Sachs disease

Answer: 1, 4, 5 Option 1: Cystic fibrosis has an autosomal recessive pattern of inheritance. Option 2: Hemophilia is X-linked. Option 3: Huntington's disease has an autosomal dominant pattern of inheritance. Option 4: Sickle-cell anemia has an autosomal recessive pattern of inheritance. Option 5: Tay-Sachs has an autosomal recessive pattern of inheritance.

The nurse is assessing a newborn at birth. When assessing the umbilical cord, she should expect to see how many vessels? 1. One 2. Two 3. Three 4. Four

Answer 3

The nurse is reviewing a client's chart, noting the client has tried assessing for ovulatory dysfunction. Which tool is used for assessing ovulatory dysfunction? 1. Basal body temperature charting (BBT) 2. Endometrial biopsy 3. Hysterosalpingogram 4. Laparoscopy

Answer 1 Option 1: The BBT technique is used by the female partner to take her temperature each morning before rising, using a basal thermometer. The woman's temperature should be recorded daily. Ovulation has occurred if there is a rise in the temperature by 0.4°F for 3 consecutive days. Option 2: Endometrial biopsy is performed to assess the response of the uterus to hormonal signals that occur during the cycle. The biopsy is performed at the end of the menstrual cycle in the clinical or medical office. Option 3: Hysterosalpingogram is a radiological examination that provides information about the endocervical canal, uterine cavity, and fallopian tubes. Under fluoroscopic observation, dye is slowly injected through the cervical canal into the uterus. This examination can detect tubal problems such as adhesions or occlusions and uterine abnormalities, such as fibroids, bicornate uterus, and uterine fistulas. Option 4: Laparoscopy uses an instrument called a laparoscope to visualize and inspect the ovaries, fallopian tubes, and uterus for abnormalities, such as endometriosis and scarring.

Ethical issues arise when clients use assisted reproductive therapies. Which are ethical issues? Select all that apply. 1. Who owns the embryos? 2. Do sperm donor have rights? 3. The surrogate mother funds her own treatment. 4. Who decides what happens with the surplus embryos? 5. Should the surrogate mother do skin-to-skin with the infant after birth?

Answer 1, 2, 4, 5 Option 1: This is an ethical question. Option 2: This is an ethical question. Option 3: This isn't an ethical question. When a client hires a surrogate, the client pays for the surrogate's medical care for having the child. Option 4: This is an ethical question. Option 5: This is an ethical question.

A pregnant client presents to the clinic after a prenatal test detected that her baby boy had a Y-linked inheritance disorder. The client indicates an understanding of Y-linked inheritance disorder when she makes which statement? 1. "Both my partner and I carry this trait and passed it along to our baby." 2. "I am a carrier, so I passed this disease to my baby." 3. "I understand that I also present with this trait and need to be tested." 4. "This disease was passed from my male partner to my baby."

Answer: 4 Option 1: This is an example of autosomal recessive inheritance. Option 2: This is an example of X-linked inheritance where females carry the trait. Option 3: Y-linked inheritance only affects males. Option 4: Y-linked inheritance is a sex-linked inheritance that is located on the Y-chromosome. As a result, the disease can only be passed from father to son.

A parent visits the prenatal clinic wanting to know which genome gives babies their genetic makeup. Which is the appropriate answer by the nurse? 1. Gamete 2. Genetics 3. Genotype 4. Genomics

Answer 3 Option 1: A gamete is a mature sexual reproductive cell. Option 2: Genetics scrutinizes the functioning and composition of a single gene. Option 3: A genotype is a person's genetic makeup. Option 4: Genomics helps all genes identify their combined influence on the growth and development of an organism.

In a teaching session with a group of adolescents, the nurse notes that the vulva is comprised of the clitoris, labia majora, labia minora, and the Bartholin's glands. Which statement made by the nurse is true of the Bartholin's glands? 1. "The Bartholin's glands make up the labia majora and minora and cover the urethral and vaginal openings." 2. "The Bartholin's gland is a muscular tube approximately 4 inches long, extending from the cervix to the perineum." 3. "The Bartholin's glands are small masses of erectile tissues anterior to the urethral orifice that respond to sexual stimulus." 4. "Bartholin's glands are located in the floor of the vestibule and keep the mucous membranes moist and lubricate the vagina during sexual intercourse."

Answer 4 Option 1: The labia majora and minora are paired folds of skin that cover the urethral and vaginal openings. Option 2: The vagina is a muscular tube approximately 4 inches long, extending from the cervix to the perineum. Option 3: The clitoris is a small mass of erectile tissue anterior to the urethral orifice that responds to sexual stimulus. Option 4: Bartholin's glands are located in the floor of the vestibule and keep the mucous membranes moist and lubricate the vagina during sexual intercourse.

The nurse is recalling the steps in cell division, beginning at conception and ending with fetal development. List the following steps in order of development: 1. Blastocyst 2. Embryo 3. Fetus 4. Zygote

Answer 4, 1, 2, 3 The fertilized oocyte is a zygote from conception/fertilization until day 3. A blastocyst is a result of mitosis and, at day 5, enters the uterus and will begin implantation. The developing human or embryo is from implantation until 8 weeks of gestation. A fetus has all organ systems formed and will continue to grow and mature from 9 weeks of gestation until birth.

A pregnant client in her second trimester is in the provider's office for an ultrasound. Her provider finds that the fetus has a congenital heart defect. Which condition is the client at risk for during pregnancy? Select all that apply. 1. Oligohydramnios 2. Polyhydramnios 3. One-vessel umbilical cord 4. Two-vessel umbilical cord 5. Three-vessel umbilical cord

Answer: 2, 4 Option 1: A decrease in amniotic fluid is associated with decreased placental function. Option 2: An excess amount of amniotic fluid is associated with chromosomal disorders and gastrointestinal, cardiac, and neural tube defects. Option 3: A one-vessel umbilical cord would be incompatible with life. Option 4: An umbilical cord should have three vessels; two arteries and a vein. When a two-vessel cord is found, it is indicative of cardiac defects. Option 5: A three-vessel umbilical cord is a normal finding.

The nurse is preparing the necessary equipment for a client to have hysterosalpingogram done. Which equipment is the nurse expected to have prepared for this procedure? 1. Fluoroscope 2. Laparoscope 3. Biopsy needle 4. Basal thermometer

Answer 1 Option 1: A fluoroscope is used to observe the dye injected through the cervical canal into the uterus during a hysterosalpingogram. Option 2: A laparoscope is an instrument used to visualize the ovaries, fallopian tubes, and uterus for abnormalities. Option 3: A biopsy needle is used to remove endometrial tissue to assess the response of the uterus to hormonal signals that occur during the cycle. Option 4: A basal thermometer records daily temperature to identify when ovulation has occurred.

In genetic testing, which role would the nurse question performing? 1. Diagnosing a fetus with a genetic disorder 2. Identifying at-risk clients and families 3. Providing emotional support for the client and family 4. Providing a referral to support groups and genetic counseling services

Answer 1 Option 1: Diagnosis of a disorder comes through genetic testing ordered by a provider or genetic counselor. Option 2: Nurses frequently work with clients to obtain histories and can identify at-risk clients and families. Option 3: Nurses provide emotional support and explain the grief process. Option 4: Nurses will work with clients and families and can provide referrals for community resources.

When assessing the newborn, the nurse notes two vessels in the umbilical cord. What should the nurse do next? 1. Call the pediatrician. 2. Start an IV on the infant. 3. Check the infant's pulse oximetry. 4. Listen to the infant's heart sounds.

Answer 1 Option 1: Due to the risk of cardiovascular disease, calling the pediatrician is important in order to let the doctor know what is going on. Option 2: If an infant is medically stable, there is no reason to start an IV. Option 3: This is not an indication whether the infant is stable. Option 4: Though this is part of an assessment, it is not necessary for the next step.

In preparing a client for endometrial biopsy, the nurse stated that this procedure is usually performed at the end of the menstrual cycle. Which is the indication for doing this procedure during this time? 1. To assess the response of the uterus to hormonal signals that occur during the cycle 2. To detect a rapid increase in the luteinizing hormone 36 hours before ovulation 3. To detect tubal adhesions, fibroids, and uterine fistulas 4. To determine the size of the remaining egg reserve

Answer 1 Option 1: Endometrial biopsy is done to assess the response of the uterus to hormonal signals that occur during the cycle. Option 2: Luteinizing hormone surge is done to detect a rapid increase in the luteinizing hormone 36 hours before ovulation. Option 3: A hysterosalpingogram is used to detect tubal adhesions, fibroids, and uterine fistulas. Option 4: Ovarian reserve testing is done to determine the size of the remaining egg reserve.

After assessing a woman who had an in vitro fertilization done, the nurse documented "readiness for enhanced knowledge." Which statement made by the woman would have prompted the nurse to document "readiness for enhanced knowledge"? 1. "My eggs were harvested and fertilized in a laboratory before being inserted into my uterus." 2. "Sperm that was removed from the semen was deposited directly into my cervix via a catheter." 3. "A zygote was placed into my fallopian tube via laparoscopy 1 day after the oocyte was retrieved from me." 4. "The sperm and my oocytes were mixed outside of my body and then placed into the fallopian tube via laparoscopy."

Answer 1 Option 1: In vitro fertilization is a procedure in which eggs are harvested and fertilization occurs outside the body in a laboratory. Option 2: Artificial insemination allows sperm that has been removed from semen to be deposited directly into the cervix via a plastic catheter. Option 3: Zygote intrafallopian transfer is a procedure in which a zygote is placed into the fallopian tube via laparoscopy 1 day after the oocyte is retrieved from the woman. Option 4: Gamete intrafallopian transfer is when the sperm and oocytes are mixed outside of the woman's body and then placed into the fallopian tube via laparoscopy.

A woman who is being prepped for preimplantation testing worries because she is unsure of what the procedure entails. Which statement by the nurse best describes preimplantation testing? 1. "A cell from the developing fetus will be removed for genetic testing prior to the transferring of the in-vitro embryo into your uterus." 2. "Both you and your partner will be tested to identify who carries one copy of a gene mutation." 3. "Screening will be done to detect genetic disorders that can be treated early in life." 4. "This test allows for the early detection of genetic disorders, such as hemophilia."

Answer 1 Option 1: Preimplantation testing detects genetic changes in embryos that were created using assisted reproductive techniques. Option 2: Carrier testing is done when there is a family history of genetic disorder. Option 3: Newborn screening detects genetic disorders that can be treated early in life. Option 4: Prenatal testing allows for the early detection of genetic disorders, such as hemophilia.

During which day of a typical 28-day menstrual cycle does the follicular phase occur? 1. Cycle days 1 to 13 2. Cycle days 15 to 28 3. Cycle day 14 4. Cycle day 1 to 5

Answer 1 Option 1: The follicular phase is the phase when follicles in the ovary mature. It ends with ovulation. The main hormone controlling this stage is estradiol. The follicular phase begins on the first day of menstruation and ends with ovulation. Option 2: This is the Luteal phase (days 15 to 28). This phase begins on the fifteenth day and lasts until the end of the cycle. Option 3: This the ovulation phase. Option 4: This is the menstrual phase. The uterus sheds its inner lining of soft tissue and blood vessels, which exits the body from the vagina in the form of menstrual fluid.

A couple was recently diagnosed with a genetic disorder in pregnancy. The couple decided to continue with their pregnancy. They asked the nurse where else they could get more information. Which response by the nurse is most appropriate? 1. "The health team is here if you want to talk about how you feel." 2. "Avoid using websites as they do not provide accurate information about the disorder." 3. "There is no need to worry because I have given you all the information you need to know." 4. "There is no support group for parents who have children with the same genetic disorder."

Answer 1 Option 1: The health team is a source for providing appropriate information on genetic disorders. Option 2: Selected websites are appropriate sources of information on genetic disorders. Option 3: The nurse is not the sole provider for information on genetic disorders. Option 4: Support groups provide information for parents who have children with the same genetic disorder.

The nurse is teaching a new nurse about the placenta's oxygen pathway to the newborn. The nurse understands that high levels of oxygenated blood come from what part of the fetal circulation? 1. Placenta and umbilical vein 2. Placenta and umbilical artery 3. Umbilical artery and umbilical vein 4. Ductus arteriosus

Answer 1 Option 1: The placenta provides high levels of oxygenated blood from the fetal circulation and the umbilical vein brings it to the fetus. Option 2: Umbilical arteries carry unoxygenated blood from the fetus to placenta. Option 3: The placenta is the powerhouse for the blood supply; the vessels carry this supply. Option 4: The ductus arteriosus carries oxygenated blood from the pulmonary artery to the aorta, bypassing fetal lungs. But it does not carry the blood from the placenta.

Which umbilical blood vessels carry oxygenated blood from the placenta to the fetus? 1. One umbilical vein 2. One umbilical artery 3. Two umbilical arteries 4. Two umbilical veins

Answer 1 Option 1: There is one umbilical vein in the umbilical cord that carries oxygenated blood from the placenta to the fetus. Option 2: There are two umbilical arteries. Option 3: The two umbilical arteries that are present in the umbilical cord carry deoxygenated blood from the fetus to the placenta. Option 4: There is only one umbilical vein.

The nurse is reviewing a client's charts before admission for an induction of labor. Which client would have extra assistance at delivery? 1. The client who was diagnosed with oligohydramnios 2. The client who is having her fifth baby 3. The client who is pregnant with her first baby and had a treated UTI during pregnancy 4. The client who has had hyperemesis gravidarum during the pregnancy

Answer 1 Option 1: This delivery will require an extra person who is trained in neonatal resuscitation to manage an infant in distress due to low amniotic fluid volume. Option 2: This delivery does not need extra personnel if the infant is term with no complications. Option 3: This is not a problem unless the client is currently infected with a fever. Option 4: This does not affect the delivery process.

The nurse is providing a client with education about teratogens at her first prenatal appointment at 8 weeks. The nurse knows that education has been successful when the client makes which statement? 1. "I will have my partner change the cat's litter box from now on." 2. "I cannot eat chicken for the risk of toxoplasmosis." 3. "I should only report prescription medications; herbal supplements are safe." 4. "I do not have to worry about teratogens until my second trimester, when the baby is fully formed."

Answer 1 Option 1: Toxoplasma is a parasite found in cat feces that is considered a teratogen and should be avoided by pregnant women. Option 2: Toxoplasmosis is a teratogen found in uncooked beef or lamb; campylobacter is found in uncooked chicken. Option 3: The client should report all prescription and over-the-counter medications, as well as vitamins and herbal supplements. Option 4: The fetus is most vulnerable to the effects of teratogens during the first 8 weeks of pregnancy. In the second trimester, the fetus can develop growth restrictions due to teratogen exposure.

A newly pregnant woman asks the nurse, "Why do I have to have all of this genetic testing?" What is an appropriate response for the nurse? Select all that apply. 1. "Genetic testing can assist in a better understanding of how to prevent disease." 2. "Genetic testing can help us diagnose any genetic disease you or your partner may be a carrier for and whether you could pass it on to your baby." 3. "Genetic testing can help prepare you and your partner if the child does have a disease." 4. "Genetic testing can detect who your baby will look like at birth." 5. "Genetic Testing will show the color of the baby's eyes."

Answer 1, 2, 3 Option 1: This is correct. The more testing done and studies conducted, the more healthcare providers will learn to prevent diseases. Option 2: This is a true statement because an infant can have a genetic disease if the mother and/or father carry the gene. Option 3: This is important for the family to know because they will have time to understand their new role as the parents of a child with a genetic disease. Option 4: The phenotype is what tells who the baby will look like. This cannot be seen until the infant is born because a phenotype is an outward expression of genes. Option 5: The phenotype is what distinguishes the color of the baby's eyes. This cannot be seen until the infant is born because a phenotype is an outward expression of genes.

Which statements indicate a phenotype? Select all that apply. 1. "The child has brown hair." 2. "Wow, he sounds exactly like his father." 3. "She has the most beautiful blue eyes." 4. "I carry the mutation in my genes for diabetes." 5. "He is short like his mother."

Answer 1, 2, 3, 5 Option 1: Brown hair is an outward expression of a phenotype. Option 2: The sound of your voice is an outward expression of a phenotype. Option 3: Blue eyes are an outward expression of a phenotype. Option 4: Diabetes mutation genes are examples of genotypes. Option 5: Height is an example of a phenotype.

A couple visited the clinic and wanted to know their likelihood of conceiving a child with a genetic disorder. Which risk factor, identified by the nurse, is correct? Select all that apply. 1. Their first child was born with a genetic disorder. 2. There is a family history of genetic disorders. 3. Both partners are younger than 35 years old. 4. The woman is older than 35 years old. 5. Both parents have a genetic disorder.

Answer 1, 2, 4, 5 Option 1: A previous pregnancy that resulted in a genetic disorder puts the couple at risk of having a baby with a genetic disorder. Option 2: Family history of genetic disorder passes on the genes to the parents. Option 3: Being younger than 35 years old minimizes the risk of having a child with a genetic disorder. Option 4: Women who are older than 35 years old are at a greater risk of having a baby with a genetic disorder. Option 5: If both parents have a genetic disorder, there is a greater risk of conceiving a child with a genetic disorder.

A neonate was admitted shortly after birth with a history of the mother who consumed at least six alcoholic beverages per day during pregnancy. For which feature of fetal alcohol syndrome should the nurse expect to assess? Select all that apply. 1. Microcephaly 2. Cardiac defects 3. Cerebral infarction 4. Neural tubal defects 5. Unusual facial features

Answer 1, 2, 5 Option 1: Microcephaly is a characteristic of fetal alcohol syndrome. Option 2: Cardiac defects are characteristics of fetal alcohol syndrome. Option 3: Cocaine increases the neonate risk of having a cerebral infarction. Option 4: Carbamazepine increases the neonate in having neural tubal defects. Option 5: Unusual facial features are characteristics of fetal alcohol syndrome.

The nurse is teaching the new pregnant mother about the placenta and its many roles in fetal development. Which statements show an understanding of the hormones the placenta produces? Select all that apply. 1. "Progesterone is the hormone that makes you feel bloated." 2. "Testosterone is produced only if you are having a boy." 3. "Human chorionic gonadotropin doubles or triples the longer you are pregnant." 4. "Human placental lactogen helps in the production of breast milk." 5. "Estrogen is the reason for my pregnancy glow."

Answer 1, 3, 4, 5 Option 1: This hormone is produced by the placenta. Option 2: This hormone is not produced by the placenta. Option 3: This hormone is produced by the placenta. Option 4: This hormone is produced by the placenta. Option 5: The estrogen hormone is produced by the placenta.

During a health assessment, a client was asked to state her last menstrual period. She replied, "This is my second day of having my menstrual flow." Which phase of the ovarian cycle would the nurse determine the client is in currently? 1. Luteal phase 2. Follicular phase 3. Proliferative phase 4. Ovulatory phase

Answer 2 Option 1: The luteal phase begins after ovulation and lasts for 14 days. Option 2: The follicular phase begins the first day of menstruation and lasts 12 to 14 days. Option 3: The proliferative phase occurs following menstruation and ends with ovulation. Option 4: The ovulatory phase begins when estrogen levels peak and ends with the release of the oocyte.

Which is an appropriate assistance the nurse can provide to the couple who found out during pregnancy that their child has a genetic disorder? Select all that apply. 1. Provide credible websites containing information specifically about the genetic disorder. 2. Leave them be. They have time to learn about it later on in the pregnancy or when the child is born. 3. Encourage them to communicate with one another. 4. Find a support group for the couple. 5. Ask the couple closed-ended questions.

Answer 1,3, 4 Option 1: When a client starts to search the Internet, they come across inaccurate information. Option 2: Though this is a case of always learning more, this should not be what the nurse does. Giving clients the most information up front and at diagnosis can help them begin the process of understanding. Option 3: Many couples have a hard time communicating when they don\"t have the "dream" child. It's important be a team in this because it can lead to stress on both parents. Option 4: Finding a support group can help when the parents are feeling alone. Encourage them to go and share their situation with others who are going through it. Option 5: Asking closed-ended questions that require only a "yes" or "no" response will not help with discovering the couple's needs.

The nurse assessing a neonate determines that the neonate was born at 36 weeks gestation because the testes are in the upper portions of the scrotum. which other features of a neonate born at 36 weeks gestation does the nurse expect to find? 1. Weighs 2,100 grams, is 30 cm long, and has an increased amount of adipose tissue 2. Weighs 2,900 grams, is 34 cm long, and lanugo begins to disappear 3. Weighs 820 grams, is 23 cm long, and lungs begins to develop surfactant 4. Weighs 1,300 grams, is 27 cm long, and lungs are not fully mature

Answer 2 Option 1: A neonate who is born at 32 weeks gestation is expected to weigh 2,100 grams, be 30 cm long, and have an increased amount of adipose tissue. Option 2: A neonate who is born at 36 weeks gestation is expected to weigh 2,900 grams, be 34 cm long, and their lanugo should begin to disappear. Option 3: A neonate who is born at 24 weeks gestation is expected to weigh 820 grams, be 23 cm long, and its lungs should begin to develop surfactant. Option 4: A neonate who is born at 28 weeks gestation is expected to weigh 1,300 grams, be 27 cm long, and their lungs should not be fully mature.

While counseling a couple diagnosed with infertility, the nurse documented "social isolation" on the chart. Which statement made by the woman would have caused the nurse to come to this conclusion? 1. "I feel pressure having to adhere to a prescribed sexual routine as part of our treatment." 2. "I do not want to be a part of my family reunion this year. I am not ready to meet my sister's baby." 3. "My husband should be blamed. He was promiscuous in his early years." 4. "Are you sure that I am really pregnant? I want to repeat the test."

Answer 2 Option 1: A prescribed sexual routine could lead to sexual dysfunction. Option 2: Neglecting relationships with family members can cause social isolation. Option 3: Blaming her spouse could result in marital strain. Option 4: Once pregnancy is achieved, women often have difficulty perceiving themselves as pregnant.

A couple visiting the clinic voiced their concern that their unborn baby might have Trisomy 21 at birth. Which test would the nurse recommend for this couple? 1. Carrier testing 2. Prenatal testing 3. Newborn screening 4. Preimplantation testing

Answer 2 Option 1: Carrier testing is done when there is a family history of genetic disorders. Option 2: Prenatal testing allows for the early detection of genetic disorders such as Trisomy 21. Option 3: Newborn screening detects genetic disorders that can be treated early in life. Option 4: Preimplantation testing detects genetic changes in embryos that are created using assisted reproductive techniques.

A male client is seen at the provider's office for infertility. Which issue would the nurse question as a cause of male infertility? 1. Attending daily cycling classes at the local gym 2. Having an overweight body mass index 3. Smoking two to three cigarettes a day 4. Taking a calcium channel blocker for hypertension

Answer 2 Option 1: Cycling can increase heat exposure to the testicles, which can affect the development of sperm. Option 2: Obesity is a risk factor for women with infertility, not for men. Option 3: Smoking can increase male infertility and affect development of sperm. Option 4: Calcium channel blockers can affect the development of mature sperm and can lead to infertility.

A couple was scheduled for an artificial insemination procedure. Which fertility condition does the nurse expect to find documented in the couple's medical record as a reason for needing this procedure? 1. Unexplained infertility 2. Diminished sperm motility 3. Bilaterally blocked fallopian tubes 4. Unsuccessful vasectomy reversal

Answer 2 Option 1: Gamete intrafallopian transfer is a procedure used for unexplained infertility. Option 2: Artificial insemination is done when there is diminished sperm motility. Option 3: Embryo transfer is a procedure used for bilaterally blocked fallopian tubes. Option 4: Testicular sperm aspiration is done when vasectomy reversal is unsuccessful.

The nurse is conducting an investigation on the effects of teratogenic agents on the newborn. The nurse found that exposure to some viruses during pregnancy may result in blindness in the newborn. What are the possible viral infections the nurse would have identified that can cause blindness in newborns? 1. Syphilis, rubella, and Zika 2. Chicken pox, rubella, and Zika 3. Syphilis, cytomegalovirus, and Zika 4. Cytomegalovirus, rubella, and chicken pox

Answer 2 Option 1: Syphilis and rubella do not cause blindness among newborns. Option 2: Chicken pox, rubella, and Zika are viruses that may lead to blindness. Option 3: Syphilis and cytomegalovirus do not cause blindness among newborns. Option 4: Cytomegalovirus and rubella do not cause blindness among newborns.

A pregnant mother who was exposed to teratogens is now admitted with a diagnosis of fetal growth restriction. In order for this medical diagnosis to be made, the nurse would determine the mother was mostly likely exposed to teratogens during which period? 1. Before getting pregnant 2. After 13 weeks of gestation 3. During the period of organogenesis 4. During the first 8 weeks of gestation

Answer 2 Option 1: The effects of teratogens depend on when it occurs in pregnancy and not before pregnancy. Option 2: Exposure to teratogens after 13 weeks of gestation may cause fetal growth restriction. Option 3: Exposure to teratogens during the period of organogenesis can cause gross structural defects. Option 4: Exposure to teratogens during the first 8 weeks of gestation can cause gross structural defects.

During a teaching session, the nurse asked the clients to differentiate between the scrotum and the ovaries. Which statement made by the client is correct? 1. "The scrotum is a muscular gland beneath the urinary bladder and surrounds the first inch of the urethra as it extends from the bladder. The ovaries are the site of egg implantation and expand during pregnancy to accommodate the fetus." 2. "The scrotum is a loose bag of skin and connective tissue in which the two testes are suspended; the ovaries are two oval-shaped organs, each about 4 cm long, located on either side of the uterus." 3. "The scrotum is referred to the Cowper's glands, located below the prostate gland; the ovaries are located on the floor of the vestibules and have ducts that open into the mucous of the vaginal orifice." 4. "The scrotum is a coiled, tube-like structure on the posterior surface of each testis. The ovaries are fringe-like projections that protrude and partially surround the fallopian tubes."

Answer 2 Option 1: The prostate is a muscular gland beneath the urinary bladder and surrounds the first inch of the urethra as it extends from the bladder. The uterus is the site of egg implantation and expands during pregnancy to accommodate the fetus. Option 2: The scrotum is a loose bag of skin and connective tissue in which the two testes are suspended; the ovaries are two oval-shaped organs, each about 4 cm long, located on either side of the uterus. Option 3: The bulbourethral glands also referred to the Cowper's glands and are located below the prostate gland. The Bartholin's glands, located in the floor of the vestibules, have ducts that open into the mucous of the vaginal orifice. Option 4: The epididymis is a coiled, tube-like structure on the posterior surface of each testis; the ends of the fallopian tube are fringe-like projections that protrude and partially surround the ovaries.

The nurse is attempting to learn more to prepare for their new fertility center job. To understand the role of FSH and LF in the menstrual cycle, which does the nurse need to know? 1. FSH & LH induce the production of milk in the breasts. 2. FSH & LH are released by the anterior pituitary gland. 3. FSH & LH are secreted by the corpus luteum. 4. The FSH and LH are released by the adrenal glands.

Answer 2 Option 1: This is not the role of FSH & LH, which are primary responsible for the menstrual cycle. Option 2: The FSH and LH are released by the anterior pituitary gland. Option 3: The FSH and LH are released by the anterior pituitary gland, not the corpus luteum. Option 4: The FSH and LH are released by the anterior pituitary gland, not the adrenal glands.

The nurse is teaching a couple who is having trouble conceiving. Which statement shows the couple requires further teaching? 1. "I know most couples who are having trouble conceiving never learn the reason for their infertility." 2. "I had all the testing done and nothing is wrong with me. He doesn't need to go get tested." 3. "If I lose weight, it might help me conceive." 4. "I should find a new job because working at the polluted factory might be exposing me to bad conditions for getting pregnant."

Answer 2 Option 1: This statement is not true. Around 80% of couples find out why they cannot conceive. Option 2: Both couples should get tested if there is a problem with infertility. Option 3: This is true because obesity is a risk factor for infertility. Option 4: Being exposed to pollution at work is another risk factor for infertility.

The nurse is seeing a woman at 18 weeks gestation for an assessment due to an increased risk for intrauterine growth restriction. To which drug or chemical should the nurse be concerned the mother has been exposed? Select all that apply. 1.Alcohol 2. Angiotensin-converting enzyme (ACE) inhibitors 3. Carbamazepine (anticonvulsants) 4. Cocaine 5. Warfarin (coumadin)

Answer 2, 3, 4 Option 1: Drinking alcohol during pregnancy increases the risk for fetal alcohol syndrome (FAS). With FAS, newborn symptoms include low birth weight, microcephaly, mental retardation, unusual facial features, and cardiac defects. Option 2: Taking ACE inhibitors during pregnancy increases the risk for intrauterine growth restriction, as well as renal tubular dysplasia or neonatal death. Option 3: Taking anticonvulsants while pregnant increases the risk for intrauterine growth restriction, as well as neural tubal and craniofacial defects. Option 4: Taking cocaine while pregnant increases the risk for placental abnormalities, which may also include intrauterine growth restriction. Option 5: Taking coumadin while pregnant increases the risk for spontaneous abortion, fetal demise, fetal or newborn hemorrhage, and central nervous system abnormalities, no intrauterine growth restriction.

After assessing a couple that was referred to have a gamete intrafallopian transfer (GIFT) done, the nurse documented "knowledge deficit". Which statement made by the couple would have prompted the nurse to document "knowledge deficit"? Select all that apply. 1. "GIFT allows fertilization to take place inside the fallopian tube." 2. "Through in vitro fertilization, our embryo will be placed in the uterine cavity via a catheter." 3. "Our oocytes will be harvested and fertilization will occur outside the female body in a laboratory." 4. "The sperms that were aspirated directly from the testicles will be injected into the harvested eggs." 5. "During GIFT our sperm and oocytes will be mixed outside of the woman's body and then placed in the fallopian tube via laparoscopy."

Answer 2, 3, 4 Option 1: GIFT allows fertilization to take place inside the fallopian tube. Option 2: Embryo transfer is when an embryo is placed in the uterine cavity via a catheter. Option 3: In vitro fertilization is a procedure in which oocytes are harvested and fertilization occurs outside the female body in a laboratory. Option 4: Artificial insemination is a procedure in which the sperm that were aspirated directly from the testicles will be injected into the harvested eggs. Option 5: GIFT is a procedure that mixes sperm and oocytes outside of the woman's body, which are then placed in the fallopian tube via laparoscopy.

A male partner was evaluated by a urologist and was asked to do a semen analysis. Which instruction should the nurse give to the couple? Select all that apply. 1. A urine sample can be collected at home to identify the ideal time for intercourse. 2. The specimen should be brought to the site within an hour of collection. 3. Abstain from sex for 2-3 days before providing a masturbated sample of semen. 4. Measure the temperature before getting out of bed in the mornings. 5. Several semen analyses may be required.

Answer 2, 3, 5 Option 1: A urine sample collected at home to identify the ideal time for intercourse is an instruction for the female partner to detect any surge in the luteinizing hormone. Option 2: "The specimen should be brought to the site within an hour of collection" is a key instruction that should be given to the couple. Option 3: Abstaining from sex for 2 to 3 days before providing a masturbated sample of semen is a key instruction that should be given to the couple. Option 4: Measuring the temperature before getting out of bed in the mornings is an instruction for the female partner to determine if ovulation has occurred. Option 5: "Several semen analyses may be required" is a key instruction that should be given to the couple.

A male partner was diagnosed with infertility and a determination is to be made as to which treatment is best. Which nursing assessment is an indication for a surgical intervention to treat his condition? 1. Over production of sperm antibodies 2. Infections of the genitourinary tract 3. Inguinal hernia 4. Poor nutrition

Answer 3 Option 1: Corticosteroids are used to decrease the production of sperm antibodies. Option 2: Antibodies are used to treat infections of the genitourinary tract. Option 3: Surgical intervention is used to correct an inguinal hernia. Option 4: Lifestyle changes will be encouraged for a person with poor nutrition.

An evaluation of a client's sperm shows that the sperm are immature due to hormonal imbalance. Which hormone does the nurse determine caused the sperm to be immature?\ 1. Follicle-stimulating hormone 2. Luteinizing hormone 3. Testosterone 4. Estrogen

Answer 3 Option 1: Follicle-stimulating hormone stimulates testosterone production. Option 2: Luteinizing hormone promotes the maturation of the sperm. Option 3: Testosterone stimulates the sperm production. Option 4: Estrogen promotes the growth of the ovarian gland.

A pregnant client states, "I am afraid to have sex with my husband because I don't want the baby to get infected with anything." Which is the nurse's best response to help the client understand the safety of the fetus? 1. "If your husband doesn't use a condom, your baby will contract an infection your husband has." 2. "Your baby can get sick if you get a yeast infection during the pregnancy." 3. "Unless you or your husband has a sexually transmitted disease, your infant is protected with the amniotic sac during the pregnancy." 4. "Having intercourse can break the amniotic sac; therefore, couples should not engage in intercourse while pregnant."

Answer 3 Option 1: The amniotic sac prevents bacteria from entering the amniotic fluid through the vagina. So, the male partner's use or nonuse of a condom will not affect the developing fetus. However, STIs may still be transmitted to the mother. Option 2: A yeast infection is common during pregnancy. While it needs to be treated, it won't cause the fetus to have an infection. Option 3: This answer is correct because the amniotic sac provides a sterile environment for the fetus that prevents bacteria from entering the amniotic fluid through the vagina. Option 4: Sometimes the amniotic sac breaks after sex, but it is not contraindicated unless the client is at risk for preterm labor and is instructed to be on pelvic rest or to abstain from intercourse while pregnant.

During a teaching session, the nurse had a discussion on the issue of Y-linked inheritance. Which response by the father indicates that learning has taken place? 1. "The baby inherited the disease from my wife." 2. "My grand-aunt has the same condition." 3. "I passed on the condition to my baby." 4. "We both gave the baby our disease."

Answer 3 Option 1: The baby's mother can be a carrier of the trait, but will not be able to pass on the condition. Option 2: The grand-aunt can be a carrier of the trait, but will not be able to pass on the condition. Option 3: The mutation is located only on the Y chromosome and can be passed only from father to son. Option 4: The mutation is located only on the Y chromosome; women cannot pass on the sex-linked trait.

After assessing a couple planning to terminate their pregnancy based on the results of the genetic test, the nurse documented "anticipatory grieving". What is the nurse's appropriate plan of care for this couple? 1. Reiterating to the couple that grieving is abnormal 2. Advising the couple to separate from each other for a week 3. Discussing with the couple the stages of grief they will experience 4. Warning the couple that thinking about their "dream child" is of concern

Answer 3 Option 1: The couple should be informed that grieving is a normal process following the termination of a pregnancy due to genetic disorder. Option 2: The couple should be encouraged to communicate and share their emotions after the termination of the pregnancy. Option 3: The stages of grieving should be included in the plan of care for a couple wanting to terminate a pregnancy. Option 4: Grieving over the loss of a "dream child" is normal and this should be discussed with the couple.

During a written exam, a nursing student was asked to list the structures derived from the primary germ layers. The student states that the mucosa of the oral and nasal cavities is derived from the ectoderm. Which other statement about the primary germ made by the student is correct? 1. The mucosa of the esophagus, stomach, and intestines are developed from the mesoderm. 2. The bone marrow, blood, and lymphatic tissues are developed from the ectoderm. 3. The epidermis, hair, and nail follicles are developed from the ectoderm. 4. The lens, cornea, and internal ear are developed from the mesoderm.

Answer 3 Option 1: The mucosa of the esophagus, stomach, and intestines are developed from the endoderm. Option 2: The bone marrow, blood, and lymphatic tissues are developed from the mesoderm. Option 3: The epidermis, hair, and nail follicles are developed from the ectoderm. Option 4: The lens, cornea, and internal ear are developed from the ectoderm.

The nurse is reviewing a client's chart and comes across genetic testing results. When answering questions from the family, which statement would prompt the nurse to provide further education? 1. "The human cell has 46 chromosomes." 2. "The human cell has 22 homologous pairs." 3. "The human cell has two pairs of sex chromosomes." 4. "The human cell has XX or YY chromosomes."

Answer 3 Option 1: This human cell does have 46 chromosomes. Option 2: The human cell does have 22 homologous pairs. Option 3: The human cell has one pair of sex chromosomes. It is abnormal to have two pairs. The normal result is one pair of chromosomes, female or male. Option 4: The XX or YY chromosomes are the sex chromosomes.

The nurse is teaching a woman who is 8 weeks pregnant to avoid teratogens. Which client statement indicates the need for further teaching? 1. "I won't change the cat's litter box during the pregnancy." 2. "It's important to exercise during my pregnancy." 3. "I will schedule my next appointment as soon as I leave." 4. "I will not eat sushi during my pregnancy."

Answer 3 Option 1: This statement shows the client understands that changing the cat's litter box can lead to being exposed and possibly being infected with toxoplasmosis. Option 2: Exercising is important, even during pregnancy, to stay healthy. Option 3: This shows the client understands that prenatal care is important, but does not address understanding of teratogens. Option 4: It can be unsafe to eat raw fish during pregnancy, but it is not teratogenic.

A nurse is providing emotional support for a woman experiencing infertility. Which statement would require further assessment from the nurse? 1. "Due to my infertility, I have felt isolated and alone. Thus, my provider suggested therapy for depression." 2. "I feel like I am less of a woman because I am unable to become pregnant." 3. "I am afraid of what my partner will do if I am unable to become pregnant in the next few months." 4. "We are hesitant to spend the money on assisted reproductive technology due to the ethical dilemmas that can occur."

Answer 3 Option 1: Women with infertility commonly experience social and intimate isolation due to concerns with infertility, which can become the focus of a relationship. Option 2: Self-esteem issues are common in infertility. Option 3: This comment raises a red flag of intimate partner violence. Although infertility can be stressful on a couple, violence should be further assessed and reported. Option 4: Many couples may decide against assisted reproductive technology due to ethical dilemmas such as: costs, lack of insurance coverage, questions regarding whether the donor should have any responsibilities, questions regarding who owns the embryos, etc.

The treatment of infertility depends on the cause. For what reason would surgery be an indication for a male who is infertile? Select all that apply. 1. Abnormal sperm counts due to lifestyle practices 2. Hormonal imbalance due to endocrine factors 3. Inguinal hernia due to poor lifting techniques 4. Varicocele caused by straining to pass feces 5. Overproduction of sperm antibodies

Answer 3, 4 Option 1: Changing lifestyle practices could improve sperm count. Option 2: Hormone therapy could correct hormonal imbalance. Option 3: Inguinal hernia repair will help to facilitate sperm transport. Option 4: Repairing the varicocele will help to facilitate sperm transport. Option 5: Corticosteroids could be used to decrease the production of sperm antibodies

A woman has opted to have a gamete intrafallopian transfer (GIFT) done. Which fertility condition in her history would indicate to the nurse that this is the correct procedure? 1. Unexplained infertility 2. Diminished sperm motility 3. Bilaterally blocked fallopian tubes 4. Failed infertility treatment for anovulation

Answer 4 Option 1: Gamete intrafallopian transfer is a procedure used for unexplained infertility. Option 2: Artificial insemination is used when there is diminished sperm motility. Option 3: Embryo transfer is a procedure used for bilaterally blocked fallopian tubes. Option 4: Gamete intrafallopian transfer is a procedure used for failed infertility treatment for anovulation.

A client is asking for a Clomiphene (Clomid) prescription for infertility because she heard "it works." Which would the nurse evaluate before suggesting medication for infertility? 1. Has she and her partner had hormone testing? 2. Does she have a history of uterine fibroids? 3. Has she had surgery to clear her fallopian tubes? 4. How long has the couple been trying to conceive?

Answer 4 Option 1: Hormone levels should be evaluated before attempting Clomiphene as a reproductive medication, but not as the first question. Option 2: This is a good question to ask because it can inhibit pregnancy, but it's not an appropriate first question to ask. Option 3: This procedure can help for conception, but it should not be the first question asked. Option 4: This is a question to ask first before invasive testing and an evaluation of infertility.

The nurse meets with a couple that was diagnosed with infertility after two years of trying to get pregnant. They are scheduled to have a gamete intrafallopian transfer (GIFT) done. Which fertility condition should the nurse expect to be an indication for this couple's need for assisted fertility technology? 1. The man not having any vas deferens 2. The man had an unsuccessful vasectomy reversal 3. The woman having bilaterally blocked fallopian tubes 4. Having a history of failed infertility treatment for anovulation

Answer 4 Option 1: Testicular sperm aspiration is the assisted fertility technology for men without any vas deferens. Option 2: Testicular sperm aspiration is the assisted fertility technology for unsuccessful vasectomy reversal. Option 3: Embryonic transfer is a procedure used to unblock fallopian tubes. Option 4: Having a history of failed infertility treatment for anovulation is an indication for GIFT.