OB1

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

. A 38-week gestation client, Bishop score 1, is advised by her nurse midwife to take evening primrose daily. The office nurse advises the client to report which of the following side effects that has been attributed to the oil? 1. Diarrhea. 2. Pedal edema. 3. Blurred vision. 4. Tinnitus.

1

. Which statement by a gravid client who is a carrier for Duchenne muscular dystrophy, an X-linked recessive disease, indicates that she understands the implications of her status? 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

. The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above prepregnancy levels? Select all that apply. 1. Glucose. 2. Fibrinogen. 3. Hematocrit. 4. Bilirubin. 5. White blood cells.

2, 5

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

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

1

The midwife has just palpated the fundal height at the location noted on the picture below. It is likely that the client is how many weeks pregnant? 1. 12. 2. 20. 3. 28. 4. 3

1

The nurse asks a woman about how the woman's husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which of the following statements? 1. "My husband is ready for the pregnancy to end so that we can have sex again." 2. "My husband has gained quite a bit of weight during this pregnancy." 3. "My husband seems more worried about our finances now than before the pregnancy." 4. "My husband plays his favorite music for my belly so the baby will learn to like it."

1

The nurse is caring for a pregnant client who is a vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods? 1. Tofu, legumes, broccoli. 2. Corn, yams, green beans. 3. Potatoes, parsnips, turnips. 4. Cheese, yogurt, fish.

1

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 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

The nurse notes each of the following findings in a 10-week gestation client. Which of the findings would enable the nurse to tell the client that she is positively pregnant? 1. Fetal heart rate via Doppler. 2. Positive pregnancy test. 3. Positive Chadwick's sign. 4. Montgomery gland enlargements.

1

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

1

When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of? 1. Ambivalence. 2. Depression. 3. Anxiety. 4. Ecstasy.

1

A woman asks the nurse about the function of amniotic fluid. Which of the following statements by the woman indicates that the teaching was successful? Select all that apply. 1. The fluid provides fetal nutrition. 2. The fluid cushions the fetus from injury. 3. The fluid enables the fetus to grow. 4. The fluid provides the fetus with a stable thermal environment. 5. The fluid enables the fetus to practice swallowing.

2,3,4,5

A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? Select all that apply. 1. Backache. 2. Urinary frequency. 3. Dyspnea on exertion. 4. Fatigue. 5. Diarrhea.

2,4

. Which of the following skin changes should the nurse highlight for a pregnant woman's health care practitioner? 1. Linea nigra. 2. Melasma. 3. Petechiae. 4. Spider nevi.

3

A woman has been advised that the reason 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 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

The nurse asks a 31-week gestation client to lie on the examining table during a prenatal examination. In which of the following positions should the client be placed? 1. Orthopneic. 2. Lateral-recumbent. 3. Sims'. 4. Semi-Fowler'

4

A woman whose blood type is O- (negative) states, "My husband is AB+ (positive)." The mother queries the nurse about what blood type the baby will have. Which of the following blood types should the nurse advise the mother that the baby may have? Select all that apply. 1. "Your baby could be type O+ (positive)." 2. "Your baby could be type O- (negative)." 3. "Your baby could be type AB- (negative)." 4. "Your baby could be type A+ (positive)." 5. "Your baby could be type B- (negative)."

4,5

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? 1. Avoid eating greasy foods. 2. Drink orange juice before rising. 3. Consume 1 teaspoon of nutmeg each morning. 4. Eat 3 large meals plus a bedtime snack.

1

60. 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 nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of the pregnancy. Which of the following comments by the client indicates that teaching was successful? Select all that apply. 1. "During the third trimester I may experience frequent urination." 2. "During the third trimester I may experience heartburn." 3. "During the third trimester I may experience nagging backaches." 4. "During the third trimester I may experience persistent headache." 5. "During the third trimester I may experience blurred vision."

1,2,3

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.

1,2,3,4

A 3-month-old baby has been diagnosed with cystic fibrosis (CF). The mother says, "How could this happen? I had an amniocentesis during my pregnancy and everything was supposed to be normal!" What must the nurse understand about this situation? 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

A 36-week gestation gravid lies flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe? 1. Hypertension. 2. Dizziness. 3. Rales. 4. Chloasma.

2

A 16-year-old, G1 P0000, is being seen at her 10-week gestation visit. She tells the nurse that she felt the baby move that morning. Which of the following responses by the nurse is appropriate? 1. "That is very exciting. The baby must be very healthy." 2. "Would you please describe what you felt for me?" 3. "That is impossible. The baby is not big enough yet." 4. "Would you please let me see if I can feel the baby

2

. 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

A woman, 6 weeks pregnant, is having a vaginal examination. Which of the following would the practitioner expect to find? 1. Thin cervical muscle. 2. An enlarged ovary. 3. Thick cervical mucus. 4. Pale pink vaginal wall.

2

A woman is 36 weeks' gestation. Which of the following tests will be done during her prenatal visit? 1. Glucose challenge test. 2. Amniotic fluid volume assessment. 3. Vaginal and rectal cultures. 4. Karyotype analysis.

3

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 she is carrying a baby who will "develop diabetes." Which of the following replies 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

14. What is the function of the highlighted region on the drawing below? 1. It produces a fluid that nourishes the sperm. 2. It secretes a fluid that neutralizes the acidic environment of the vagina. 3. It is the reservoir where sperm mature. 4. It contracts during ejaculation, forcing the sperm and fluid out of the urethra

3

A 34-week gestation woman calls the obstetric office stating, "Since last night I have had three nosebleeds." Which of the following responses by the nurse is appropriate? 1. "You should see the doctor to make sure you are not becoming severely anemic." 2. "Do you have a temperature?" 3. "One of the hormones of pregnancy makes the nasal passages prone to bleeds." 4. "Do you use any inhaled drugs?"

3

A client asks the nurse what was meant when the physician told her she had a positive Chadwick's sign. Which of the following information about the finding would be appropriate for the nurse to convey at this time? 1. "It is a purplish stretch mark on your abdomen." 2. "It means that you are having heart palpitations." 3. "It is a bluish coloration of your cervix and vagina." 4. "It means the doctor heard abnormal sounds when you breathed in."

3

A client makes the following statement after finding out that her pregnancy test is positive, "This is not a good time. I am in college and the baby will be due during final exams!" Which of the following responses by the nurse would be most appropriate at this time? 1. "I'm absolutely positive that everything will turn out all right." 2. "I suggest that you e-mail your professors to set up an alternate plan." 3. "It sounds like you're feeling a little overwhelmed right now." 4. "You and the baby's father will find a way to get through the pregnancy.

3

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

Below are four important landmarks of fetal development. Please place them in chronological order: 1. Four-chambered heart is formed. 2. Vernix caseosa is present. 3. Blastocyst development is complete. 4. Testes have descended into the scrotal sac.

3,1,2,4

. A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? 1. Nausea. 2. Dyspnea. 3. Urinary frequency. 4. Leg cramping.

4

. 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 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

. 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

A nurse is advising a pregnant woman about the danger signs of pregnancy. The nurse should teach the mother that she should notify the physician immediately if she experiences which of the following signs/symptoms? Select all that apply. 1. Convulsions. 2. Double vision. 3. Epigastric pain. 4. Persistent vomiting. 5. Polyuria.

4321

A gravida's fundal height is noted to be at the xiphoid process. The nurse is aware that which of the following fetal changes is likely to be occurring at the same time in the pregnancy? 1. Surfactant is formed in the fetal lungs. 2. Eyes begin to open and close. 3. Respiratory movements begin. 4. Spinal column is completely formed

1

A 10-week gravid states that her sister's son has been diagnosed with an X-linked recessive disease, Duchenne muscular dystrophy. She questions the nurse about the disease. Which of the following responses is appropriate for the nurse to make? 1. "Because Duchenne muscular dystrophy is inherited through the woman, it is advisable for you to see a genetic counselor." 2. "Duchenne muscular dystrophy usually occurs as a spontaneous mutation. It is very unlikely that your fetus is affected." 3. "Your child could acquire Duchenne muscular dystrophy only 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 be positive for Duchenne muscular dystrophy, I could recommend you to an excellent abortion counselor."

1

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. History of asthma.

1

A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant? 1. Chorionic gonadotropin. 2. Oxytocin. 3. Prolactin. 4. Luteinizing hormone

1

Which of the following exercises should be taught to a pregnant woman who complains of backaches? 1. Kegeling. 2. Pelvic tilting. 3. Leg lifting. 4. Crunching.

2

When analyzing the need for health teaching of a prenatal multigravida, the nurse should ask which of the following questions? 1. "What are the ages of your children?" 2. "What is your marital status?" 3. "Do you ever drink alcohol?" 4. "Do you have any allergies

3

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

A woman is a carrier for hemophilia A, an X-linked recessive illness. Her husband has a normal genotype. The nurse can advise the couple that the probability that their daughter will have the disease is : 1. 0% probability. 2. 25% probability. 3. 50% probability. 4. 75% probability.

1

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 wonders whether she has ovarian cancer. Which of the following is the nurse's best response? 1. "Women often feel a slight twinge when ovulation occurs." 2. "You should seek medical attention as soon as possible since ovarian cancer is definitely a possibility." 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

At her first prenatal visit, a woman relates that her maternal aunt has cystic fibrosis (CF), an autosomal recessive illness. Which of the following comments is appropriate for the nurse to make at this time? 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

Which of the following vital sign changes should the nurse highlight for a pregnant woman's obstetrician? 1. Prepregnancy blood pressure (BP) 100/60 and third trimester BP 140/90. 2. Prepregnancy respiratory rate (RR) 16 rpm and third trimester RR 22 rpm. 3. Prepregnancy heart rate (HR) 76 bpm and third trimester HR 88 bpm. 4. Prepregnancy temperature (T) 98.6ºF and third trimester T 99.2ºF.

1

night. Which of the following assessments should the nurse make? 1. Dietary evaluation. 2. Goodell's sign. 3. Hegar's sign. 4. Posture evaluation.

1

A nurse is working in the prenatal clinic. Which of the following findings seen in third-trimester pregnant women would the nurse consider to be within normal limits? Select all that apply. 1. Leg cramps. 2. Varicose veins. 3. Hemorrhoids. 4. Fainting spells. 5. Lordosis.

1,2,3,5

A woman has just completed her first trimester. Which of the following fetal structures can the nurse tell the woman are well formed at this time? Select all that apply. 1. Genitals. 2. Heart. 3. Fingers. 4. Alveoli. 5. Kidneys.

1,2,3,5,

Which of the following findings in an 8-week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? Select all that apply. 1. Body mass index of 17 kg/ mm2. 2. Rubella titer of 1:8. 3. Blood pressure of 100/60 mm Hg. 4. Hematocrit of 30%. 5. Hemoglobin of 13.2 g/dL.

1,2,4

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

A client, in her third trimester, is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy. How should the nurse respond? 1. "Don't worry. You'll know the difference when the contractions start." 2. "The contractions may feel just like a backache, but they will come and go." 3. "Contractions are a lot worse than your pregnancy aches and pains." 4. "I understand. You don't want to come to the hospital before you are in labor.

2

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

The nurse is evaluating the 24-hour dairy intake of four gravid clients. Which of the following clients consumed the highest number of dairy servings during 1 day? The client who consumed: 1. 4 oz whole milk, 2 oz hard cheese, 1 cup of pudding made with milk and 2 oz cream cheese. 2. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 11 / 2 oz hard cheese. 3. 1cup cottage cheese, 8 oz whole milk, 1 cup buttermilk, and 1 / 2 oz hard cheese. 4. 1 / 2 cup frozen yogurt, 8 oz skim milk, 4 oz cream cheese, and 11 / 2 cup cottage cheese.

2

The nurse midwife tells a client that the baby is growing and that ballottement was evident during the vaginal examination. How should the nurse explain what the nurse midwife means by ballottement? 1. The nurse midwife saw that the mucous plug was intact. 2. The nurse midwife felt the baby rebound after being pushed. 3. The nurse midwife palpated the fetal parts through the uterine wall. 4. The nurse midwife assessed that the baby is head down.

2

The nurse plans to provide anticipatory guidance to a 10-week gravid client who is being seen in the prenatal clinic. Which of the following information should be a priority for the nurse to provide? 1. Pain management during labor. 2. Methods to relieve backaches. 3. Breastfeeding positions. 4. Characteristics of the newbor

2

Which of the following choices can the nurse teach a prenatal client is equivalent to one 2 oz protein serving? 1. 4 tbsp peanut butter. 2. 2 eggs. 3. 1 cup cooked lima beans. 4. 2 ounces mixed nuts.

2

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.

2,1,3,4

third-trimester client is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the visit? Select all that apply. 1. Blood glucose. 2. Blood pressure. 3. Fetal heart rate. 4. Urine protein. 5. Pelvic ultrasound.

2,3,4

e nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the physician? Select all that apply. 1. 17 weeks' gestation; denies feeling fetal movement. 2. 24 weeks' gestation; fundal height at the umbilicus. 3. 27 weeks' gestation; salivates excessively. 4. 34 weeks' gestation; experiences uterine cramping. 5. 37 weeks' gestation; complains of hemorrhoidal pain.

2,4

A nurse is discussing the serving sizes in the grain food group with a new prenatal client. Which of the following foods equals 1 ounce serving size from the grain group? Select all that apply. 1. 1 bagel. 2. 1 slice of bread. 3. 1 cup cooked pasta. 4. 1 tortilla. 5. 1 cup dry cereal

2,4,5

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

A nurse midwife has advised a 39-week gestation gravid to take evening primrose oil 2,500 mg daily as a complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions? 1. Relieve back strain. 2. Improve development of colostrum. 3. Ripen the cervix. 4. Reduce the incidence of hemorrhoids.

3

A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2012. Using Nagele's rule, the nurse calculates the client's estimated date of delivery as: 1. May 30, 2013. 2. June 20, 2013. 3. June 27, 2013. 4. July 3, 2013.

3

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

Which of the following client responses indicates that the nurse's teaching about care following chorionic villus sampling (CVS) 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

woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks' gestation; delivered a daughter, now 5 years old, at 39 weeks' gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman's gravidity and parity? 1. G4 P2121. 2. G4 P1212. 3. G5 P112

3

A 12-week gestation client tells the nurse that she and her husband eat sushi at least once per week. She states, "I know that fish is good for me, so I make sure we eat it regularly." Which of the following responses by the nurse is appropriate? 1. "You are correct. Fish is very healthy for you." 2. "You can eat fish, but sushi is too salty to eat during pregnancy." 3. "Sushi is raw. Raw fish is especially high in mercury." 4. "It is recommended that fish be cooked to destroy harmful bacteria."

4

A 37-week gravid client states that she noticed a "white liquid" leaking from her breasts during a recent shower. Which of the following nursing responses is appropriate at this time? 1. Advise the woman that she may have a galactocele. 2. Encourage the woman to pump her breasts to stimulate an adequate milk supply. 3. Assess the liquid because a breast discharge is diagnostic of a mammary infection. 4. Reassure the mother that this is normal in the third trimester

4

A client asks the nurse, "Could you explain how the baby's blood and my blood separate at delivery?" Which of the following responses is appropriate for the nurse to make? 1. "When the placenta is born, the circulatory systems separate." 2. "When the doctor clamps the cord, the blood stops mixing." 3. "The separation happens after the baby takes the first breath. The baby's oxygen no longer has to come from you." 4. "The blood actually never mixes. Your blood supply and the baby's blood supply are completely separate."

4

A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse's best response? 1. "Because the organ systems in the baby are developing right now, it is risky to take medicine." 2. "You can take any of the over-the-counter medications because they are all safe in pregnancy." 3. "The physician will prescribe a category 'X' medication for you." 4. "You can take acetaminophen because it is a category 'B' medicine."

4

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

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

A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time? 1. "We expect you to gain about 1 lb per week, so your weight is a little low at this time." 2. "Most women gain no weight during the first trimester, so I would suggest you eat fewer desserts for the next few weeks." 3. "You entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need." 4. "Your weight gain is exactly what we would expect it to be at this tim

4

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

The partner of a gravida accompanies her to her prenatal appointment. The nurse notes that the father of the baby has gained weight since she last saw him. Which of the following comments is most appropriate for the nurse to make to the father? 1. "I see that you are gaining weight right along with your partner." 2. "You and your partner will be able to go on a diet together after the baby is born." 3. "I can see that you are a bad influence on your partner's eating habits." 4. "I am so glad to see that you are taking so much interest in your partner's pregnancy."

4

A client has just had an amniocentesis to determine whether 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 abnormalit

1

A gravid woman and her husband inform the nurse that they have just moved into a three-story home that was built in the 1930s. Which of the following is critical for the nurse to advise the woman to protect the unborn child? 1. Stay out of any rooms that are being renovated. 2. Drink water only from the hot water tap. 3. Refrain from entering the basement. 4. Climb the stairs only once per day.

1

A gravid woman who recently emigrated from mainland China is being seen at her first prenatal visit. She was never vaccinated in her home country. An injection to prevent which of the following communicable diseases should be administered to the woman during her pregnancy? 1. Influenza. 2. Mumps. 3. Rubella. 4. Varicell

1

A pregnant client is lactose intolerant. Which of the following foods could this woman consume to meet her calcium needs? 1. Turnip greens. 2. Green beans. 3. Cantaloupe. 4. Nectarines.

1

A Chinese immigrant is being seen in the prenatal clinic. When providing nutrition counseling, which of the following factors should the nurse keep in mind? 1. Many Chinese eat very little protein. 2. Many Chinese believe pregnant women should eat cold foods. 3. Many Chinese are prone to anemia. 4. Many Chinese believe strawberries can cause birth defect

2

A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to make at this time? 1. "Your period is probably just irregular." 2. "We could do a blood test to check." 3. "Home pregnancy test results are very accurate." 4. "My recommendation would be to repeat the test in one wee

2

A client states that she is a strong believer in vitamin supplements to maintain her health. The nurse advises the woman that it is recommended to refrain from consuming excess quantities of which of the following vitamins during pregnancy? 1. Vitamin C. 2. Vitamin D. 3. Vitamin B2 (niacin). 4. Vitamin B12 (cobalamin).

2

A client who was seen in the prenatal clinic at 20 weeks' gestation weighed 128 lb at that time. Approximately how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks' gestation? 1. 129 to 130 lb. 2. 131 to 132 lb. 3. 133 to 134 lb. 4. 135 to 136 lb.

2

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

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 throughout their lives.

3

After nutrition counseling, a woman, G3 P1101, proclaims that she certainly can't eat any strawberries during her pregnancy. Which of the following is the likely reason for this statement? 1. The woman is allergic to strawberries. 2. Strawberries have been shown to cause birth defects. 3. The woman believes in old wives' tales. 4. The premature baby died because the woman ate strawberries.

3

An ultrasound of a fetus's heart shows that normal fetal circulation is occurring. Which of the following statements should the nurse interpret as correct in relation to the fetal circulation? 1. The foramen ovale is a hole between the ventricles. 2. The umbilical vein contains oxygen-poor blood. 3. The right atrium contains both oxygen-rich and oxygen-poor blood. 4. The ductus venosus lies between the aorta and pulmonary arter

3

A client is 35 weeks' gestation. Which of the following findings would the nurse expect to see? 1. Nausea and vomiting. 2. Maternal ambivalence. 3. Fundal height 10 cm above the umbilicus. 4. Use of three pillows for sleep comfort.

4

A client is having an ultrasound assessment done at her prenatal appointment at 8 weeks' gestation. She asks the nurse, "Can you tell what sex my baby is yet?" Which of the following responses would be appropriate for the nurse to make at this time? 1. "The technician did tell me the sex, but I will have to let the doctor tell you what it is." 2. "The organs are completely formed and present, but the baby is too small for them to be seen." 3. "The technician says that the baby has a penis. It looks like you are having a boy." 4. "I am sorry. It will not be possible to see which sex the baby is for another month or so."

4

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

An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? Select all that apply. 1. Amenorrhea. 2. Breast tenderness. 3. Quickening. 4. Frequent urination. 5. Uterine growth

1,2,3,4,

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

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

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

A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? Select all that apply. 1. Pap smear. 2. Mammogram. 3. Glucose challenge test. 4. Biophysical profile. 5. Complete blood count

1,5

A father experiencing couvade syndrome is likely to exhibit which of the following symptoms/behaviors? Select all that apply. 1. Heartburn. 2. Promiscuity. 3. Hypertension. 4. Bloating. 5. Abdominal pain

1,4,5

A nurse has just taken a family history on a 10-week gravid client and created the family pedigree shown below. Each of the darkened symbols represents a person with a serious illness. Which of the following actions should the nurse take at this time? 1. Advise the woman that she should have an amniocentesis. 2. Encourage the doctor to send her for genetic counseling. 3. Ask the woman if she knew any of the relatives who died. 4. Inform the woman that her pedigree appears normal.

2

A woman delivers a fetal demise that has lanugo covering the entire body, nails that are present on the fingers and toes, but eyes that are still fused. Prior to the death, the mother stated that she had felt quickening. Based on this information, the nurse knows that the baby is about how many weeks' gestation? 1. 15 weeks. 2. 22 weeks. 3. 29 weeks. 4. 36 weeks.

2

A woman in her third trimester advises the nurse that she wishes to breastfeed her baby, "but I don't think my nipples are right." Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time? 1. Advise the client that it is unlikely that she will be able to breastfeed. 2. Refer the client to a lactation consultant for advice. 3. Call the labor room and notify them that a client with inverted nipples will be admitted. 4. Teach the woman exercises to evert her nipples.

2

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

An 18-week gestation client telephones the obstetrician's office stating, "I'm really scared. I think I have breast cancer. My breasts are filled with tumors." The nurse should base the response on which of the following? 1. Breast cancer is often triggered by pregnancy. 2. Nodular breast tissue is normal during pregnancy. 3. The woman is exhibiting signs of a psychotic break. 4. Anxiety attacks are especially common in the second trimester.

2

Based on the karyotype shown below, which of the following conclusions can the nurse make about the female baby? 1. She has a genetically normal karyotype. 2. She has trisomy 21. 3. She has fragile X syndrome. 4. She has an autosomal monosomy.

2

The blood of a pregnant client was initially assessed at 10 weeks' gestation and reassessed at 38 weeks' gestation. Which of the following results would the nurse expect to see? 1. Rise in hematocrit from 34% to 38%. 2. Rise in white blood cells from 5,000 cells/mm3 to 15,000 cells/mm3. 3. Rise in potassium from 3.9 mEq/L to 5.2 mEq/L. 4. Rise in sodium from 137 mEq/L to 150 mEq/L.

2

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

The following four changes occur during pregnancy. Which of them usually increases the father's interest and involvement in the pregnancy? 1. Learning the results of the pregnancy test. 2. Attending childbirth education classes. 3. Hearing the fetal heartbeat. 4. Meeting the obstetrician or midwife

3

The glucose challenge screening test is performed at or after 24 weeks' gestation to assess for the maternal physiological response to which of the following pregnancy hormones? 1. Estrogen. 2. Progesterone. 3. Human placental lactogen. 4. Human chorionic gonadotropi

3

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

When assessing the fruit intake of a pregnant client, the nurse notes that the client usually eats 1 piece of fruit per day and drinks a 12 oz glass of fruit juice per day. Which of the following is the most important communication for the nurse to make? 1. "You are effectively meeting your daily fruit requirements." 2. "Fruit juices are excellent sources of folic acid." 3. "It would be even better if you were to consume more whole fruits and less fruit juice." 4. "Your fruit intake far exceeds the recommended daily fruit intake."

3

A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the preprocedure teaching? 1. Fast for 12 hours before the test. 2. Bring a urine specimen to the laboratory on the day of the test. 3. Be prepared to have 4 blood specimens taken on the day of the test. 4. The test should take one hour to complete.

4

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