Deck 8: Preconception, genetics, conception, and Fetal Development

Question 1

In practical terms regarding genetic health care,which of the following should the nurse be aware of?

A) Genetic disorders equally affect all socioeconomic backgrounds, races, and ethnic groups.
B) Genetic health care is more concerned with populations than individuals.
C) It is most important to provide emotional support to the family during genetic counselling.
D) Taking genetic histories is only done in large university hospital and tertiary-care centres.

Answer 1

It is most important to provide emotional support to the family during genetic counselling.

Question 2

A pregnant woman at 25 weeks' gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise.Which response by the nurse is most accurate?

A) "That must have been a coincidence; babies can't respond like that."
B) "The fetus is demonstrating the aural reflex."
C) "Babies respond to sound starting at about 24 weeks of gestation."
D) "Let me know if it happens again; we need to report that to your midwife."

Answer 2

"Babies respond to sound starting at about 24 weeks of gestation."

Question 3

What is responsible for the transportation of oxygen and carbon dioxide to and from the maternal bloodstream?

A) Decidua basalis
B) Blastocyst
C) Germ layer
D) Chorionic villi

Answer 3

Chorionic villi

Question 4

With regard to the estimation and interpretation of the recurrence of risks for genetic disorders,what should nurses be aware of?

A) With a dominant disorder, the likelihood of the second child also having the condition is 100%.
B) An autosomal recessive disease carries a one in eight risk of the second child also having the disorder.
C) Disorders involving maternal ingestion of drugs carry a one in four chance of being repeated in the second child.
D) The risk factor remains the same no matter how many affected children are already in the family.

Question 5

The nurse is assessing the knowledge of new parents with a child born with maple syrup urine disease ( MSUD ).The nurse knows that this is an autosomal recessive inherited disorder,which means which of the following?

A) Both genes of a pair must be abnormal for the disorder to be present.
B) Only one copy of the abnormal gene is required for the disorder to be present.
C) The disorder occurs in males and heterozygous females.
D) The disorder is carried on the X chromosome.

Question 6

A woman who is 8 months pregnant asks the nurse,"Does my baby have any antibodies to fight infection?" What is the most appropriate response by the nurse?

A) "Your baby has all the immunoglobulins (Ig) necessary: IgG, IgM, and IgA."
B) "Your baby won't receive any antibodies until he is born and you breastfeed him."
C) "Your baby does not have any antibodies to fight infection."
D) "Your baby has IgG and IgM."

Question 7

A woman asks the nurse,"What protects my baby's umbilical cord from being squashed while the baby's inside of me?" What is the nurse's best response?

A) "Your baby's umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby."
B) "Your baby's umbilical floats around in blood anyway."
C) "You don't need to worry about things like that."
D) "The umbilical cord is a group of blood vessels that are very well protected by the placenta."

Question 8

Which of the following is a key finding from the Human Genome Project?

A) Approximately 20,000 to 25,000 genes make up the genome.
B) All human beings are 95.9% identical at the DNA level.
C) Human genes produce only one protein per gene; other mammals produce three proteins per gene.
D) Single gene testing will become a standardized test for all pregnant patients in the future.

Question 9

At approximately how many weeks of gestation does lecithin form on the alveolar surfaces,the eyelids open,and the fetus measures approximately 27 cm crown to rump,and weighs approximately 1100 g?

A) 20 weeks
B) 24 weeks
C) 26 weeks
D) 28 weeks

Question 10

The nurse is providing genetic counselling for an expectant couple who already have a child with trisomy 18.What should the nurse do?

A) Tell the couple they need to terminate the pregnancy within 2 to 3 weeks.
B) Explain that the fetus has a 50% chance of having the disorder.
C) Discuss options, including amniocentesis, to determine whether the fetus is affected.
D) Refer the couple to a psychologist for emotional support.

Question 11

What should nurses be aware of with regard to prenatal genetic testing?

A) Integrated prenatal screening can determine risk of carrying a fetus with Down syndrome.
B) Carrier screening tests are used to look for gene mutations of people already showing symptoms of a disease.
C) Predisposition testing predicts with near certainty that symptoms will appear.
D) Presymptomatic testing is used to predict the likelihood of breast cancer.

Question 12

A couple has been counselled for genetic anomalies.They ask you,"What is karyotyping?" What is the nurse's best response about karyotyping?

A) "It will reveal if the baby's lungs are mature."
B) "It will predict if your baby will develop normally."
C) "It will identify your baby's gender and information about chromosomes."
D) "It will detect any physical deformities the baby has."

Question 13

A father and mother are carriers of phenylketonuria (PKU).Their 2-year-old daughter has PKU.The couple tells the nurse that they are planning to have a second baby.Because their daughter has PKU,they are sure that their next baby won't be affected.What response by the nurse is most accurate?

A) "Good planning; you need to take advantage of the odds in your favour."
B) "I think you'd better check with your doctor first."
C) "You are both carriers, so each baby has a 25% chance of being affected."
D) "The ultrasound indicates a boy, and boys are not affected by PKU."

Question 14

The nurse caring for the labouring woman should know that meconium is produced by which of the following?

A) Fetal intestines
B) Fetal kidneys
C) Amniotic fluid
D) The placenta

Question 15

What should the nurse be aware of with regard to chromosome abnormalities?

A) They occur in approximately 10% of newborns.
B) Abnormalities of number are the leading cause of pregnancy loss.
C) Down syndrome is a result of an abnormal chromosome structure.
D) Unbalanced translocation results in a mild abnormality that the child will outgrow.

Question 16

During a presentation to obstetric nurses interested in genetics,what does the genetic nurse identify as the primary factor to consider with genetic testing?

A) Anxiety and altered family relationships
B) Accessibility related to the availability of genetic testing
C) High false-positive rates associated with genetic testing
D) Ethnic and socioeconomic disparity associated with genetic testing

Question 17

The nurse must be cognizant that the term for an individual's genetic makeup is known as which of the following?

A) Genotype
B) Phenotype
C) Karyotype
D) Chromotype

Question 18

You are a maternal-newborn nurse caring for a mother who just delivered a baby born with Down syndrome.What nursing diagnosis would be most essential in caring for the mother of this infant?

A) Disturbed body image
B) Interrupted family processes
C) Anxiety
D) Risk for injury

Question 19

A man's wife is pregnant for the third time.One child was born with cystic fibrosis and the other child is healthy.The man wonders what the chance is that this child will have cystic fibrosis.This type of testing is known as which of the following?

A) Occurrence risk
B) Recurrence risk
C) Predictive testing
D) Predisposition testing

Question 20

A woman's cousin gave birth to an infant with a congenital heart anomaly.The woman asks the nurse when such anomalies occur during development.Which response by the nurse is most accurate?

A) "We don't really know when such defects occur."
B) "It depends on what caused the defect."
C) "They occur between the third and fifth weeks of development."
D) "They usually occur in the first 2 weeks of development."

Question 21

What should the nurse be able to tell parents when they have questions about multiple births?

A) Multiple births are increasing because of the use of fertility drugs.
B) Dizygotic twins ( two fertilized ova ) have the potential to be conjoined twins.
C) Identical twins are more common in White families.
D) Fraternal twins are same gender, usually male.

Question 22

The nurse caring for a pregnant patient knows that her health teaching regarding fetal circulation has been effective when the patient reports that she has been sleeping in which position?

A) In a side-lying position
B) On her back with a pillow under her knees
C) With the head of the bed elevated
D) On her abdomen

Question 23

A maternity nurse should be aware of which fact about the amniotic fluid?

A) It serves as a source of oral fluid and a repository for waste from the fetus.
B) The volume remains about the same throughout the term of a healthy pregnancy.
C) A volume of less than 300 mL is associated with gastrointestinal malformations.
D) A volume of more than 2 L is associated with fetal renal abnormalities.

Question 24

Selina comes in for her first prenatal examination.This is her first child.She asks the nurse,"How does my baby get air inside my uterus?" What is the nurse's best response?

A) "The baby's lungs work in utero to exchange oxygen and carbon dioxide."
B) "The baby absorbs oxygen from your blood system."
C) "The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream."
D) "The placenta delivers oxygen-rich blood through the umbilical artery to the baby's abdomen."

Question 25

Which of the following is the most basic information a maternity nurse should know concerning conception?

A) Ova are considered fertile 48 to 72 hours after ovulation.
B) Sperm remain viable in the woman's reproductive system for an average of 12 to 24 hours.
C) Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum.
D) Implantation in the endometrium occurs 6 to 10 days after conception.

Question 26

Which of the following should the nurse be aware of with regard to the development of the respiratory system?

A) The respiratory system does not begin developing until after the embryonic stage.
B) The infant's lungs are considered mature when the lecithin/sphingomyelin (L/S) ratio is 1:1, at about 32 weeks.
C) Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity.
D) Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks.

Question 27

With regard to the structure and function of the placenta,the maternity nurse should be aware of which of the following?

A) As the placenta widens, it gradually thins to allow easier passage of air and nutrients.
B) As one of its early functions, the placenta acts as an endocrine gland.
C) The placenta is able to keep out most potentially toxic substances.
D) Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.

Question 28

The measurement of lecithin in relation to sphingomyelin (L/S ratio)is used to determine fetal lung maturity.Which ratio reflects maturity of the lungs?

A) 1.4:1
B) 1.8:1
C) 2:1
D) 1:1

Question 29

At what age is the embryo or fetus less susceptible to teratogens?

A) 4 weeks
B) 6 weeks
C) 8 weeks
D) 10 weeks