MN/WK2/PEDS SUCCESS CH2/EX1

When a nurse is teaching a woman about her menstrual cycle she mentions that which of the following is the most important change that happens during the follicular phase of the menstrual cycle? 1. Maturation of the graafian follicle. 2. Multiplication of the fimbriae. 3. Secretion of human chorionic gonadotropin. 4. Proliferation of the endometrium.

1. Maturation of the graafian follicle FSH is elevated during the follicular phase and the graafian follicle matures.

A client has just had an amniocentesis to determine whether or not her baby has an inheritable genetic disease. Which of the following interventions is highest priority at this time? 1. Assess the fetal heart rate. 2. Check the client's temperature. 3. Acknowledge the client's anxiety about the possible findings. 4. Answer questions regarding the genetic abnormality.

1. Assessing the fetal heart rate is the highest priority since, although rare, the fetus may have been injured during the procedure.

A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the following may have contributed to her problem? 1. Athletic activities. 2. Vaccination history. 3. Pet ownership. 4. Genetic history.

1. Athletic activities. If the young woman exercises excessively—for example, as a competitive gymnast or runner—her body fat index will be so low she will become amenorrheic.

An infertility specialist is evaluating whether a woman's cervical mucus contains enough estrogen to support sperm motility. Which of the following tests is the physician conducting? 1. Ferning capacity. 2. Basal body temperature. 3. Culposcopy. 4. Hysterotomy.

1. Ferning capacity. When a woman's cervical mucus is estrogen rich, it is slippery and elastic (thread-like), and when assessed under a microscope, the practitioner will observe "ferning,"—that is, an image that looks like a fern. The woman is then in her fertile period. When she is not in her fertile period, the mucus is thick and gluey.

Once oogenesis is complete, the resultant gamete cell contains how many chromosomes? 1. 23. 2. 46. 3. 47. 4. 92.

1. 23 The haploid number of chromosomes 23, the normal number of chromosomes in the gametes—in this case, in the ovum.

36. A couple, who have been attempting to become pregnant for 5 years, is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? Select all that apply. 1. Anger at others who have babies. 2. Feelings of failure because they can't make a baby. 3. Sexual excitement because they want so desperately to conceive a baby. 4. Sadness because of the perceived loss of being a parent. 5. Guilt on the part of one partner because he or she is not able to give the other a baby.

1, 2, 4, and 5 are correct. 1. Infertility clients often express anger at others who are able to conceive. 2. Infertility clients often express a feeling of personal failure. 4. Sadness is another common feeling expressed by infertility clients. 5. Guilt is commonly expressed by infertility clients. 3. Infertility clients often express an aversion to sex because of the many restrictions/schedules/intrusions that are placed on their sexual relationship.

A 10-week gravid states that her sister's son has been diagnosed with an X-linked recessive disease, muscular dystrophy. She questions the nurse about the disease. Which of the following responses is appropriate for the nurse to make? 1. "Because muscular dystrophy is inherited through the woman, it is advisable for you to see a genetic counselor." 2. "Muscular dystrophy usually occurs as a spontaneous mutation. It is very unlikely that your fetus is affected." 3. "Your child could only acquire muscular dystrophy if both you and your husband carried the gene. You need to check your husband's family history. 4. "If you were to have an amniocentesis and it were to come out positive, I can recommend you to an excellent abortion counselor.

1. "Because muscular dystrophy is inherited through the woman, it is advisable for you to see a genetic counselor." Because muscular dystrophy is X-linked

An infertile woman has been diagnosed with endometriosis. She asks the nurse why that diagnosis has made her infertile. Which of the following explanations is appropriate for the nurse to make? 1. "Scarring surrounds the ends of your tubes preventing your eggs from being fertilized by your partner's sperm." 2. "You are producing insufficient quantities of follicle-stimulating hormone that is needed to mature an egg every month." 3. "Inside your uterus is a benign tumor that makes it impossible for the fertilized egg to implant." 4. "You have a chronic infection of the vaginal tract that makes the secretions hostile to your partner's sperm."

1. "Scarring surrounds the ends of your tubes preventing your eggs from being fertilized by your partner's sperm." Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity. The tissue may be on, for example, the tubes, ovaries, or colon. Adhesions develop from the monthly bleeding at the site of the misplaced endometrial tissue, often resulting in infertility.

At her first prenatal visit, a woman relates that her maternal aunt has cystic fibrosis, an autosomal recessive illness. Which of the following comments is appropriate for the nurse to make at this time? 1. "We can check to see whether or not you are a carrier for cystic fibrosis." 2. "It is unnecessary for you to worry since your aunt is not a direct relation." 3. "You should have an amniocentesis to see whether or not your child has the disease." 4. "Please ask your mother whether she has ever had any symptoms of cystic fibrosis."

1. "We can check to see whether or not you are a carrier for cystic fibrosis."

A woman is a carrier for hemophilia, 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: 1. 0% probability. 2. 25% probability. 3. 50% probability. 4. 75% probability.

1. 0% probability.

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? 1. 100% of her children will be affected. 2. Only her female children will be affected. 3. Each fetus will have a 50% probability of being affected. 4. A fetus will only be affected if it inherits a similar gene from its father.

1. 100% of her children will be affected.

A nurse working in an infertility clinic should include which of the following in her discussions with the couple? 1. Adoption as an alternative to infertility treatments. 2. The legal controversy surrounding artificial insemination. 3. The need to seek marriage counseling before undergoing infertility treatments. 4. Statistics regarding the number of couples who never learn why they are infertile.

1. Adoption as an alternative to infertility treatments.

A 25-year-old woman, G0 P0000, enters the infertility clinic stating that she has 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? 1. Fertility of women who carry the BRCA1 and BRCA2 genes is similar to that of unaffected women. 2. Women with these genes should be advised not to have children because the children could inherit the defective genes. 3. Women with these genes should have their ovaries removed as soon as possible to prevent ovarian cancer. 4. Lactation is contraindicated for women who carry the BRCA1 and BRCA 2 genes.

1. Fertility of women who carry the BRCA1 and BRCA2 genes is similar to that of unaffected women. Female clients who are BRCA 1 or 2 positive have similar fertility rates to those who are BRCA 1 or 2 negative.

The nurse is creating a pedigree from a client's family history. Which of the following symbols should the nurse use to represent a female? 1. Circle. 2. Square. 3. Triangle. 4. Diamond.

1. The CIRCLE is the symbol used to represent the FEMALE. 2. The square is the symbol used to represent the male. 3. The triangle is the symbol used to represent a stillborn. 4. The diamond is the symbol used to represent a child of unknown sex.

A couple who has sought fertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occurs? 1. The testes are overheated. 2. The vas deferens is ligated. 3. The prostate gland is enlarged. 4. The flagella are segmented.

1. The testes are overheated. Spermatogenesis occurs in the testes. High temperatures harm the development of the sperm.

The nurse is providing counseling to a group of sexually active single women. Most of the women have expressed a desire to have children in the future, but not within the next few years. Which of the following actions should the nurse suggest the women take to protect their fertility for the future? Select all that apply. 1. Use condoms during intercourse. 2. Refrain from smoking cigarettes. 3. Maintain an appropriate weight for height. 4. Exercise in moderation. 5. Refrain from drinking carbonated beverages.

1. Use condoms during intercourse. 2. Refrain from smoking cigarettes. 3. Maintain an appropriate weight for height. 4. Exercise in moderation.

A female client seeks care at an infertility clinic. Which of the following tests may the client undergo to determine what, if any, infertility problem she may have? Select all that apply. 1. Chorionic villus sampling. 2. Endometrial biopsy. 3. Hysterosalpingogram. 4. Serum progesterone assay. 5. Postcoital test.

2, 3, 4, and 5 are correct. 2. Endometrial biopsy is performed about 1 week following ovulation to detect the endometrium's response to progesterone. 3. Hysterosalpingogram is performed after menstruation to detect whether or not the fallopian tubes are patent. 4. Serum progesterone assay is performed about 1 week following ovulation to determine whether or not the woman's corpus luteum produces enough progesterone to sustain a pregnancy. 5. Postcoital tests are performed about 1-2 days before ovulation to determine whether or not healthy sperm are able to survive in the cervical mucus. 1. Chorionic villus sampling is done to assess for genetic disease in the fetus.

A woman asks the obstetrician's nurse about cord blood banking. Which of the following responses by the nurse would be best? 1. "I think it would be best to ask the doctor to tell you about that." 2. "The cord blood is frozen in case your baby develops a serious illness in the future." 3. "The doctors could transfuse anyone who gets into a bad accident with the blood." 4. "Cord blood banking is very expensive and the blood is rarely ever used."

2. "The cord blood is frozen in case your baby develops a serious illness like leukemia in the future."

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? 1. It is likely that the client received the wrong amniocentesis results. 2. Cerebral palsy is not a genetic disease. 3. The genes that cause cerebral palsy have not yet been discovered. 4. The genetics lab failed to test for cerebral palsy.

2. Cerebral palsy is not a genetic disease. It is caused by a hypoxic injury that can occur at any time during pregnancy, labor and delivery, or the postdelivery period.

34. Nurses working in a midwifery office have attended a conference to learn about factors that increase a woman's risk of becoming infertile. To evaluate the nurses' learning, the conference coordinator tested the nurses' knowledge at the conclusion of the seminar. Which of the following problems should the nurses state increase a client's risk of developing infertility problems? Select all that apply. 1. Women who have menstrual cycles that are up to 30 days long. 2. Women who experience pain during intercourse. 3. Women who have had pelvic inflammatory disease. 4. Women who have excess facial hair. 5. Women who have menstrual periods that are over 5 days long.

2. Dyspareunia, or pain during intercourse, may be a symptom of a sexually transmitted infection (STI) or of endometriosis. Both STIs and endometriosis can adversely affect a woman's fertility. 3. A woman who has had PID is much more likely to have blocked fallopian tubes than a woman who has never had PID. 4. Women who have facial hair (hirsutism) often have polycystic ovarian syndrome (PCO). PCO patients are usually obese and have irregular menses. Women with PCO are very often infertile.

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. 1. Follicle-stimulating hormone. 2. Gonadotropin-releasing hormone. 3. Luteinizing hormone. 4. Progesterone.

2. Gonadotropin-releasing hormone. 1. Follicle-stimulating hormone. 3. Luteinizing hormone. 4. Progesterone. Gonadotropin-releasing hormone stimulates the production of follicle-stimulating hormone (FSH) and lutenizing hormone (LH). FSH rises first and LH follows. After ovulation, progesterone rises.

A woman, who has undergone amniocentesis, has been notified that her baby is XX with a 14/21 Robertsonian chromosomal translocation. The nurse helps the woman to understand which of the following? 1. The baby will have a number of serious genetic defects. 2. It is likely that the baby will be unable to have children when she grows up. 3. Chromosomal translocations are common and rarely problematic. 4. An abortion will probably be the best decision under the circumstances.

2. It is likely that the baby will be unable to have children when she grows up.

A client is receiving Pergonal (menotropins) intramuscularly for ovarian stimulation. Which of the following is a common side effect of this therapy? 1. Piercing rectal pain. 2. Mood swings. 3. Visual disturbances. 4. Jerky tremors.

2. Mood swings and depression are common side effects of the hormonal therapy.

An infertile man is being treated with Viagra (sildenafil citrate) for erectile dysfunction (ED). Which of the following is a contraindication for this medication? 1. Preexisting diagnosis of herpes simplex 2. 2. Nitroglycerin ingestion for angina pectoris. 3. Retinal damage from type I diabetes mellitus. 4. Postsurgical care for resection of the prostate.

2. Nitroglycerin ingestion for angina pectoris. It is unsafe to take Viagra while also taking nitroglycerin for angina.

A 3-month-old baby has been diagnosed with cystic fibrosis. The mother states, "How could this happen? I had an amniocentesis during my pregnancy and everything was supposed to be normal!" What does the nurse understand about this situation? 1. Cystic fibrosis cannot be diagnosed by amniocentesis. 2. The baby may have an uncommon genetic variant of the disease. 3. It is possible that the laboratory technician made an error. 4. Instead of obtaining fetal cells the doctor probably harvested maternal cells.

2. The baby may have an uncommon genetic variant of the disease. The genetic tests that are performed only check for the most common genetic variants of many diseases, including CF. If the baby were positive for an uncommon variant, it would be missed.

The nurse discusses the results of a 3-generation pedigree with the proband who has breast cancer. Which of the following information must the nurse consider? 1. The proband should have a complete genetic analysis done. 2. The proband is the first member of the family to be diagnosed. 3. The proband's first degree relatives should be included in the discussion. 4. The proband's sisters will likely develop breast cancer during their lives.

2. The proband is the first member of the family to be diagnosed.

The nurse is counseling a pregnant couple who are both carriers for phenylketonuria (PKU), an autosomal recessive disease. Which of the following comments by the nurse is appropriate? 1. "I wish I could give you good news, but because this is your first pregnancy, your child will definitely have PKU." 2. "Congratulations, you must feel relieved that the odds of having a sick child are so small." 3. "There is a 2 out of 4 chance that your child will be a carrier like both of you." 4. "There is a 2 out of 4 chance that your child will have PKU."

3. "There is a 2 out of 4 chance that your child will be a carrier like both of you."

A woman asks a nurse about presymptomatic genetic testing for Huntington's disease. The nurse should base her response on which of the following? 1. There is no genetic marker for Huntington's disease. 2. Presymptomatic testing cannot predict whether or not the gene will be expressed. 3. If the woman is positive for the gene for Huntington's, she will develop the disease later in life. 4. If the woman is negative for the gene, her children should be tested to see whether or not they are carriers.

3. If the woman is positive for the gene for Huntington's, she will develop the disease later in life.

Which of the following client responses indicates that the nurse's teaching about care following chorionic villus sampling has been successful? 1. If the baby stops moving, the woman should immediately go to the hospital. 2. The woman should take oral terbutaline every 2 hours for the next day. 3. If the woman starts to bleed or to contract, she should call her physician. 4. The woman should stay on complete bed rest for the next 48 hours.

3. If the woman starts to bleed or to contract, she should call her physician.

A man has 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? 1. Amniocentesis. 2. Chorionic villus sampling. 3. Pre-implantation genetic diagnosis. 4. Gamete intrafallopian transfer.

3. Pre-implantation genetic diagnosis.

A couple is seeking advice regarding actions that they can take to increase their potential of becoming pregnant. Which of the following recommendations should the nurse give to the couple? 1. The couple should use vaginal lubricants during intercourse. 2. The couple should delay having intercourse until the day of ovulation. 3. The woman should refrain from douching. 4. The man should be on top during intercourse.

3. The woman should refrain from douching. Douching can change the normal flora and the pH in the vagina, making the environment hostile to the sperm.

A woman asks the nurse, "My nuchal fold scan results were abnormal. What does that mean?" Which of the following comments is appropriate for the nurse to make at this time? 1. "I am sorry to tell you that your baby will be born with a serious deformity." 2. "The results show that your child will have cri du chat syndrome." 3. "The test is done to see if you are high risk for preterm labor." 4. "An abnormal test indicates that your baby may have Down syndrome."

4. "An abnormal test indicates that your baby may have Down syndrome." This statement is true, but the definitive diagnosis can only be made via genetic testing.

31. A client has been notified that because of fallopian tube obstruction, her best option for becoming pregnant is through in vitro fertilization. The client asks the nurse about the procedure. Which of the following responses is correct? 1. "During the stimulation phase of the procedure, the physician will make sure that only one egg reaches maturation." 2. "Preimplantation genetic diagnosis will be performed on your partner's sperm to make sure that the sperm are normal." 3. "After ovarian stimulation, you will be artificially inseminated with your partner's sperm." 4. "Any extra embryos will be preserved for you if you wish to conceive again in the future."

4. "Any extra embryos will be preserved for you if you wish to conceive again in the future." Since multiple embryos are usually created during the in vitro process, there are often more embryos created than are implanted. The couple may preserve the embryos.

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? 1. Both estrogen and progesterone are high. 2. Estrogen is high and progesterone is low. 3. Estrogen is low and progesterone is high. 4. Both estrogen and progesterone are low.

4. 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.

A client wants to undergo amniocentesis because she has a family history of breast cancer. Which of the following choices is the most important information for the nurse to discuss with the client regarding the request? 1. The breast cancer gene is highly penetrant. 2. The breast cancer gene has moderate expressivity. 3. The amniocentesis could result in a miscarriage. 4. The majority of breast cancers are not inherited.

4. The most important information for the nurse to provide the client is that the vast majority of cases of breast cancer are not inherited.

The genetic counselor informs a couple that they have a 25% probability of getting pregnant with a child with a severe genetic disease. The couple asks the nurse exactly what that means. Which of the following responses by the nurse is appropriate? 1. Their first child will have the genetic disease. 2. If they have four children, one of the children will have the disease. 3. Their fourth child will have the genetic disease. 4. Whenever they get pregnant, the fetus may have the disease.

4. Whenever they get pregnant, the fetus may have the disease. Every time the woman gets pregnant there is a possibility (25% chance) that she is carrying a child with the disease.

A client is to have a hysterosalpingogram. In this procedure, the physician will be able to determine which of the following? 1. Whether or not the ovaries are maturing properly. 2. If the endometrium is fully vascularized. 3. If the cervix is incompetent. 4. Whether or not the fallopian tubes are obstructed.

4. Whether or not the fallopian tubes are obstructed.

Which of the following is an attainable short-term goal for an 8-week gravid client who has a family history of cystic fibrosis? 1. Have a sweat chloride test done. 2. Seek out genetic counseling. 3. Undergo chorionic villus sampling. 4. Be seen by a pulmonologist.

2. Seek out genetic counseling.

What is the rationale for testing all neonates for maple syrup urine disease (MSUD) when only 1 in 100,000-300,000 children will be born with the disease? 1. To encourage the parents to have genetic testing done. 2. To prevent neurological disease in affected children. 3. To reduce the amount of money insurance companies must pay for sick MSUD children. 4. To persuade pharmaceutical companies to develop medications to treat children with MSUD.

2. Rationale for newborn testing for maple syrup urine disease: It is done to prevent neurological disease in affected children.

Which instruction by the nurse should be included in the teaching plan for an infertile woman who has been shown to have a 28-day biphasic menstrual cycle? 1. Douche with a cider vinegar solution immediately before having intercourse. 2. Schedule intercourse every day from day 8 to day 14 of the menstrual cycle. 3. Be placed on follicle-stimulating hormone therapy by the fertility specialist. 4. Assess the basal body temperature pattern for at least 6 more months.

2. Schedule intercourse every day from day 8 to day 14 of the menstrual cycle. Pregnancy is most likely to occur with daily intercourse from 6 days before ovulation up to the day of ovulation.

A client is to receive Pergonal (menotropins) injections for infertility prior to in vitro fertilization. Which of the following is the expected action of this medication? 1. Prolongation of the luteal phase. 2. Stimulation of ovulation. 3. Suppression of menstruation. 4. Promotion of cervical mucus production.

2. Stimulation of ovulation. Pergonal is administered to infertile women to increase follicular growth and maturation of the follicles and to stimulate ovulation.

24. Infertility increases a client's risk of which of the following diseases? 1. Diabetes mellitus. 2. Nystagmus. 3. Cholecystitis. 4. Ovarian cancer.

4. Ovarian cancer.

A woman, whose menstrual cycle is 35 days long, states that she often has a slight pain on one side of her lower abdomen on day 21 of her cycle. She wondering whether or not she has ovarian cancer. What is the nurse's best response? 1. "Women often feel a slight twinge when ovulation occurs." 2. "Ovarian cancer is a possibility and you should seek medical attention as soon as possible." 3. "Ovarian cancer is unlikely because the pain is not a constant pain." 4. "It is more likely that such pain indicates an ovarian cyst because pain is more common with that problem."

1. "Women often feel a slight twinge when ovulation occurs." the discomfort, at the location of the ovary where ovulation occurs, is called mittleschmerz. Ovulation usually occurs 14 days before the first day of the menses.

A genetic counselor's report states, "The genetic nomenclature for this fetus is 46, XX." How should the nurse who reads this report interpret the cytogenetic results? 1. The baby is female with a normal number of chromosomes. 2. The baby is hermaphroditic male with female chromosomes. 3. The baby is male with an undisclosed genetic anomaly. 4. There is insufficient information to answer this question.

1. The baby is female with a normal number of chormosomes. The normal number of chromosomes is present—46—and the child is a female - XX.

A couple is seeking infertility counseling. The practitioner has identified the factors listed below in the woman's health history. Which of these findings may be contributing to the couple's infertility? 1. The client is 36 years old. 2. The client was 13 years old when she started to menstruate. 3. The client works as a dental hygienist 3 days a week. 4. The client jogs 2 miles every day.

1. The client is 36 years old. The eggs of an older woman (for reproductive purposes considered 35 years ) do age and fertility is reduced.

A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? 1. The couple has established a set schedule for their sexual encounters. 2. The couple has been married for more than eight years. 3. The couple lives with one set of parents. 4. The couple has close friends who gave birth to a baby within the last year.

1. The couple has established a set schedule for their sexual encounters.

A woman's temperature has just risen 0.4°F 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 change? 1. Estrogen. 2. Progesterone. 3. Luteinizing hormone (LH). 4. Follicle-stimulating hormone (FSH).

2. Progesterone elevation occurs after ovulation and spikes at about 5-6 days after ovulation. Progesterone is thermogenic—that is, heat producing. Progesterone is the reason why women's temperatures are elevated following ovulation.

A nurse is teaching an infertile couple about how the sperm travel through the man's body during ejaculation. Please put the following five major structures in order, beginning with the place where spermatogenesis occurs and continuing through the path that the sperm and semen travel until ejaculation. 1. Epididymis. 2. Prostate. 3. Testes. 4. Urethra. 5. Vas deferens.

3,1,5,2,4 3. Testes. 1. Epididymis. 5. Vas deferens 2. Prostate. 4. Urethra. (3)The sperm are produced in the testes. (1) They then proceed to the epididymisv where they mature (5)The vas deferens is the conduit through which the sperm first travel during ejaculation. 2)The prostate encircling the neck of the urethra, produces a fluid that protects the sperm (4)and, finally, the sperm exit the male body via the urethra.

A woman whose blood type is O (negative) states, "My husband is AB (positive). What blood type will my baby have?" Which of the following is the best response for the nurse to make? 1. "Your baby could be type O but it is impossible to predict the Rh status." 2. "Your baby will be either AB (positive) or AB (negative)." 3. "Your baby could be any blood type except type O or type AB." 4. "Your baby will definitely be Rh (positive)."

3. "Your baby could be any blood type except type O or type AB." The offspring could be blood type AO (type A) or BO (type B), but it cannot be type O since the father is AB and cannot be type AB since mother is type O.

A woman who is a carrier for sickle cell anemia is advised that if her baby has two recessive genes, the penetrance of the disease is 100%, but the expressivity is variable. Which of the following explanations will clarify this communication for the mother? All babies with 2 recessive sickle cell genes will: 1. Develop painful vaso-occlusive crises during their first year of life. 2. Exhibit at least some signs of the disease while in the neonatal nursery. 3. Show some symptoms of the disease but the severity of the symptoms will be individual. 4. Be diagnosed with sickle cell trait but will be healthy and disease-free through- out their lives.

3. Show some symptoms of the disease but the severity of the symptoms will be individual.

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? 1. "Because HD is an autosomal dominant disease, each and every one of your children will have a 1 in 4 chance of having the disease." 2. "Because only one of you has a family history of HD, the probability of any of your children having the disease is less than 10%." 3. "Because HD is such a devastating disease, if there is any chance of passing the gene along, it would be advisable for you to adopt." 4. "Because neither of you has been tested for HD, the most information I can give you is that each and every one of your children may have the disease."

4. "Because neither of you has been tested for HD, the most information I can give you is that each and every one of your children may have the disease."

A client is to undergo a postcoital test for infertility. The nurse should include which of the following statements in the client's preprocedure counseling? 1. "You will have the test the day after your menstruation ends." 2. "You will have a dye put into your vein that will show up on x-ray." 3. "You should refrain from having intercourse for the four days immediately prior to the test." 4. "You should experience the same sensations you feel when your doctor does your Pap test."

4. "You should experience the same sensations you feel when your doctor does your Pap test."

A client is to have a hysterosalpingogram. Which of the following information should the nurse provide the client prior to the procedure? 1. "The test will be performed through a small incision next to your belly button." 2. "You will be on bed rest for a full day following the procedure." 3. "An antibiotic fluid will be instilled through a tube in your cervix." 4. "You will be asked to move from side to side so that x-ray pictures can be taken."

4. "You will be asked to move from side to side so that x-ray pictures can be taken."

An Orthodox Jewish couple is seeking infertility counseling. The woman states that her menstrual cycle is 21 days long. After testing, no physical explanation is found for the infertility. Which of the following may explain why the woman has been unable to conceive? 1. Her Kosher diet is lacking in the essential nutrients needed for achieving optimal reproductive health. 2. The positions allowed Orthodox Jewish couples during intercourse hinder the process of fertilization. 3. Orthodox Jewish couples are known to have a high rate of infertility because of inborn genetic diseases. 4. Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends.

4. Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends. Jewish law does prohibit intercourse during the menses and for 7 days following menses. The woman then goes through a cleansing bath called a mikvah before she and her husband may have intercourse. With such a short cycle, she is ovulating during the time frame in which intercourse is restricted.

A woman is informed that she is a carrier for Tay Sachs disease, an autosomal recessive illness. What is her phenotype? 1. She has one recessive gene and one normal gene. 2. She has two recessive genes. 3. She exhibits all symptoms of the disease. 4. She exhibits no symptoms of the disease.

4. She exhibits no symptoms of the disease.

A woman who has had multiple miscarriages is advised to go through genetic testing. The client asks the nurse the rationale for this recommendation. The nurse should base his or her response on which of the following? 1. The woman's pedigree may exhibit a mitochondrial inheritance pattern. 2. The majority of miscarriages are caused by genetic defects. 3. A woman's chromosomal pattern determines her fertility. 4. There is a genetic marker that detects the presence of an incompetent cervix.

2. The majority of miscarriages are caused by genetic defects.

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? 1. "How old are your children?" 2. "Did you have intercourse last evening?" 3. "With whom do you have intercourse?" 4. "Do you use vaginal lubricant?"

3. "With whom do you have intercourse?" The nurse is trying to learn whether or not the client is having intercourse with more than one partner and/or whether the client has intercourse with men, women, or both.

A woman is seeking genetic counseling during her pregnancy. She has a strong family history of diabetes mellitus. She wishes to have an amniocentesis to determine whether or not she is carrying a baby who will "develop diabetes." Which of the following replies by the nurse would be most appropriate for the nurse to make? 1. "Doctors don't do amniocenteses to detect diabetes." 2. "Diabetes cannot be diagnosed by looking at the genes." 3. "Although diabetes does have a genetic component, diet and exercise also determine whether or not someone is diabetic." 4. "Even if the baby doesn't carry the genes for diabetes, the baby could still develop the disease."

3. "Although diabetes does have a genetic component, diet and exercise also determine whether or not someone is diabetic." Diabetes is one of the many diseases that has both a genetic and an environmental component.

A couple has been told that the male partner, who is healthy, is producing no sperm "because he has cystic fibrosis." Which of the following explanations is accurate in relation to this statement? 1. Since the man is healthy he could not possibly have cystic fibrosis. 2. Men with cystic fibrosis often have no epididymis. 3. The expressivity of cystic fibrosis is variable. 4. Cystic fibrosis is a respiratory illness having nothing to do with reproduction.

3. The expressivity of cystic fibrosis is variable. Cystic fibrosis can be expressed in a number of ways. Some affected individuals have very serious illness resulting in early death, while others experience few symptoms.

A male client has green 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? 1. All male children will be color blind. 2. All female children will be color blind. 3. All male children will be carriers for color blindness. 4. All female children will be carriers for color blindness.

4. All female children will be carriers for color blindness.

A 35-year-old client is being seen for her yearly gynecological examination. She states that she and her partner have been trying to become pregnant for a little over 6 months, and that a friend had recently advised her partner to take ginseng to improve the potency of his sperm. The woman states that they have decided to take their friend's advice. On which of the following information should the nurse base his or her reply? 1. Based on their history, the client and her partner have made the appropriate decision regarding their fertility. 2. Ginseng can cause permanent chromosomal mutations and should be stopped immediately. 3. It is unnecessary to become concerned about this woman's fertility because she has only tried to become pregnant for a few months. 4. Although ginseng may be helpful, it would be prudent to encourage the woman to seek fertility counseling.

4. Although ginseng may be helpful, it would be prudent to encourage the woman to seek fertility counseling. Because fertility drops as a woman ages, it is advisable to encourage the couple to use conventional therapies in conjunction with the complementary therapy to maximize their potential of becoming pregnant.

A client is hospitalized in the acute phase of severe ovarian hyperstimulation syndrome. The following nursing diagnosis has been identified: Fluid volume excess (extravascular) related to third spacing. Which of the following nursing goals is highest priority in relation to this diagnosis? 1. Client's weight will be within normal limits by date of discharge. 2. Client's skin will show no evidence of breakdown throughout hospitalization. 3. Client's electrolyte levels will be within normal limits within one day. 4. Client's lung fields will remain clear throughout hospitalization.

4. Client's lung fields will remain clear throughout hospitalization.

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 of genetic counseling? Select all that apply. 1. The woman's fetus. 2. The woman's sisters. 3. The woman's brothers. 4. The woman's parents. 5. The woman's partner.

1, 2, 3, and 4 are correct. 1. The woman's fetus has a 1 in 2, or 50%, probability of having the gene. 2. The woman's sisters have a 1 in 2, or 50%, probability of having the gene. 3. The woman's brothers have a 1 in 2, or 50%, probability of having the gene. 4. One of the woman's parents definitely has the gene. Since the age of onset can be as late as age 50, the parents' symptoms may not yet have appeared.

Which statement by a gravid client who is a carrier for muscular dystrophy, an X-linked recessive disease, indicates that she understands the implications of her status? 1. "If I have a girl, she will be healthy." 2. "None of my children will be at risk of the disease." 3. "If I have a boy, he will be a carrier." 4. "I am going to abort my fetus because it will be affected."

1. "If I have a girl, she will be healthy." female children of carriers may carry the disease but do not express the disease.

10. 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? 1. "You are probably ovulating." 2. "Your hormone levels should be checked." 3. "You will probably menstruate early." 4. "Your breast changes are a worrisome sign."

1. "You are probably ovulating." Breast tenderness and mittleschmerz often occur at the time of ovulation.

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? 1. 25% probability. 2. 50% probability. 3. 75% probability. 4. 100% probability.

1. 25% probability of being of normal stature.

A client asks the nurse about the gamete intrafallopian transfer (GIFT) procedure. Which of the following responses would be appropriate for the nurse to make? 1. Fertilization takes place in the woman's body. 2. Zygotes are placed in the fallopian tubes. 3. Donor sperm are placed in a medium with donor eggs. 4. A surrogate carries the infertile woman's fetus.

1. Fertilization takes place in the woman's body. Although the gametes are placed in the fallopian tubes artificially, fertilization does occur within the woman's body.

The nurse is teaching a class on reproduction. When asked about the development of the ova, the nurse would include which of the following? 1. Meiotic divisions begin during puberty. 2. At the end of meiosis, four ova are created. 3. Each ovum contains the diploid number of chromosomes. 4. Like sperm, ova have the ability to propel themselves.

1. Meiotic divisions begin during puberty.

A 54-year-old client calls her health care practitioner complaining of frequency and burning when she urinates. Which of the following factors that occurred within the preceding 3 days likely contributed to this client's problem? 1. She had intercourse with her partner. 2. She returned from a trip abroad. 3. She stopped taking hormone replacement therapy. 4. She started a weight-lifting exercise program.

1. The fact that the client had intercourse in the last 3 days likely led to the symptoms she is reporting, which are symptoms of a urinary tract infection (UTI)

Most children born into families look similar but are not exactly the same. The children appear different because homologous chromosomes exchange genetic material at which of the following? 1. Centromere. 2. Chiasma. 3. Chromatid. 4. Codon.

2. Chiasma. A chiasma is the site where crossing over between non-sister chromatids takes place. At this site, genetic material is swapped between the chromatids.

A client, G4 P4004, states that her husband has just been diagnosed with polycystic kidney disease (PKD), an autosomal dominant disease. The husband is heterozygous for PKD, while the client has no PKD genes. The client states, "I have not had our children tested because they have such a slim chance of inheriting the disease. We intend to wait until they are teenagers to do the testing." The nurse should base her reply on which of the following? 1. Because affected individuals rarely exhibit symptoms before age 60, the children should be allowed to wait until they are adults to be tested. 2. The woman may be exhibiting signs of denial since each of the couple's children has a 50/50 chance of developing the disease. 3. Because the majority of the renal cysts that develop in affected individuals are harmless, it is completely unnecessary to have the children tested. 4. The woman's husband should be seen by a genetic specialist since he is the person who is carrying the affected gene.

2. The woman may be exhibiting signs of denial since each of the couple's children has a 50/50 chance of developing the disease.

A Roman Catholic couple is infertile. Their health care practitioner advises them that their best chance of getting pregnant is via in vitro fertilization with a mixture of the man's sperm and donor sperm. Which of the following issues, related to this procedure, should the nurse realize may be in conflict with the couple's religious beliefs? Select all that apply. 1. The man will ejaculate by masturbation into a specially designed condom. 2. The woman may become pregnant with donor sperm. 3. Fertilization is occurring in the artificial environment of the laboratory. 4. More embryos will be created than will be used to inseminate the woman. 5. The woman will receive medications to facilitate the ripening of her ova.

23) 1, 2, 3, and 4 are the correct choices. 1. Masturbation, as well as the use of a condom, even for the express purpose of creating life, are considered sins in the Catholic tradition. 2. Procreation with the man's sperm alone is unlikely. The addition of the donor sperm makes this unacceptable in the eyes of the Catholic Church since a woman should only become pregnant by her husband. 3. According to the precepts of the Catholic church, fertilization may only take place within the body of the woman. 4. It is immoral, in the Catholic tradition, to create more embryos than are needed to conceive.

A client who is undergoing ovarian stimulation for infertility calls the infertility nurse and states, "My abdomen feels very bloated, my clothes are very tight, and my urine is very dark." Which of the following is the appropriate statement for the nurse to make at this time? 1. "Please take a urine sample to the lab so they can check it for an infection." 2. "Those changes mean that you will menstruate within the next three days." 3. "It is important for you to come into the office to be examined today." 4. "Abdominal bloating is an expected response to the medications."

3. "It is important for you to come into the office to be examined today."

A woman has been advised that the reason why she has had a number of spontaneous abortions is because she has an inheritable mutation. Which of the following situations is consistent with this statement? 1. A client developed skin cancer after being exposed to the sun. 2. A client developed colon cancer from an inherited dominant gene. 3. A reciprocal translocation was reported on a client's genetic analysis. 4. A client's left arm failed to develop when she was a fetus.

3. A reciprocal translocation was reported on a client's genetic analysis which can result in infertility.

A couple is seeking infertility counseling. During the history, it is noted that the man is a cancer survivor, drinks one beer every night with dinner, and takes a sauna every day after work. Which of the following is an appropriate response by the nurse? 1. It is unlikely that any of these factors is impacting his fertility. 2. Daily alcohol consumption could be causing his infertility problems. 3. Sperm may be malformed when exposed to the heat of the sauna. 4. Cancer survivors have the same fertility rates as healthy males.

3. Sperm may be malformed when exposed to the heat of the sauna. The high temperature of the sauna could alter the number and morphology of the sperm.

A nurse is discussing sexual arousal during a preadolescent boys' sex 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?" 1. The vas deferens thickens and expands. 2. The sympathetic nerves of the penis are stimulated. 3. The corpora of the penis become engorged. 4. The prepuce of the penis elongates.

3. The corpora of the penis become engorged. When arousal occurs, the penile blood vessels become engorged and an erection is achieved.

A nurse teaches a woman who wishes to become pregnant that if she assesses for spinnbarkeit she will be able closely to predict her time of ovulation. Which technique should the client be taught in order to assess for spinnbarkeit? 1. Take her temperature each morning before rising. 2. Carefully feel her breasts for glandular development. 3. Monitor her nipples for signs of tingling and sensitivity. 4. Assess her vaginal discharge for elasticity and slipperiness.

4. 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.

A woman is pregnant. During amniocentesis it is discovered that her child has Down syndrome with a mosaic chromosomal configuration. She asks the nurse what that means. What is the nurse's best response? 1. "Instead of two number 21 chromosomes, your child has three." 2. "Your baby's number 21 chromosomes have black and white bands on them." 3. "Some of your baby's number 21 chromosomes are longer than others." 4. "Some of your baby's cells have two number 21 chromosomes and some have three."

4. Mosaicism is characterized by the fact that some of the cells of the body have the abnormal number of chromosomes but some of the cells have the normal number. This may happen with rapid disjunction. In Down syndrome, it means that some of the cells have three number 21 chromosomes and some have the normal number of two number 21 chromosomes. Mosaicism is not specific to Down syndrome but can occur with other chromosomal abnormalities.