Deck 5: Genetics, Conception, and Fetal Development

Question 1

A pregnant woman at 25 weeks of 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 1

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

Question 2

Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that:

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

Answer 2

Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing.

Question 3

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.

Answer 3

It serves as a source of oral fluid and a repository for waste from the fetus.

Question 4

In practical terms regarding genetic health care, nurses should be aware that:

A) Genetic disorders affect equally people of all socioeconomic backgrounds, races, and ethnic groups.
B) Genetic health care is more concerned with populations than individuals.
C) The most important of all nursing functions is providing emotional support to the family during counseling.
D) Taking genetic histories is the province of large universities and medical centers.

Question 5

The nurse must be cognizant that an individual's genetic makeup is known as his or her:

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

Question 6

The nurse caring for the laboring woman should know that meconium is produced by:

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

Question 7

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 favor."
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 8

The nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should:

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

Question 9

Regarding the development of the respiratory system, maternity nurses should be aware that:

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 10

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

A) "Your baby has all the immune globulins (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 11

A key finding from the Human Genome Project is:

A) Approximately 30,000 to 40,000 genes make up the genome.
B) All human beings are 80.99% 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 12

You are a maternal-newborn nurse caring for a mother who just delivered a baby born with Down syndrome. What nursing diagnosis would be the 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 13

The _____ is/are responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream.

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

Question 14

With regard to the structure and function of the placenta, the maternity nurse should be aware that:

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 such as cigarette smoke to which the mother is exposed.
D) Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.

Question 15

At approximately _____ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and weighs approximately 1110

A) 20
B) 24
C) 28
D) 30

Question 16

Regarding the estimation and interpretation of the recurrence of risks for genetic disorders, nurses should be aware that:

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 17

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 18

In presenting to obstetric nurses interested in genetics, the genetic nurse identifies the primary risk(s) associated with genetic testing as:

A) Anxiety and altered family relationships.
B) Denial of insurance benefits.
C) High false positives associated with genetic testing.
D) Ethnic and socioeconomic disparity associated with genetic testing.

Question 19

With regard to prenatal genetic testing, nurses should be aware that:

A) Maternal serum screening can determine whether a pregnant woman is at risk of carrying a fetus with Down syndrome.
B) Carrier screening tests 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 20

Sally comes in for her first prenatal examination. This is her first child. She asks you (the nurse), "How does my baby get air inside my uterus?" The correct response is:

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 21

____________________ twins is another term for fraternal twins. These twins may be the same or different sexes and genetically are no more alike than siblings born at different times.

Question 22

Congenital disorders refer to conditions that are present at birth. These disorders may be inherited and caused by environmental factors or maternal malnutrition. Toxic exposures have the greatest effect on development between 15 and 60 days of gestation. For the nurse to be able to conduct a complete assessment of the newly pregnant patient, she should understand the significance of exposure to known human teratogens. These include (choose all that apply):

A) Infections.
B) Radiation.
C) Maternal conditions.
D) Drugs.
E) Chemicals.
F) None of the above

Question 23

Very fine hairs, called ____________________, appear first at 12 weeks of gestation on the fetus's eyebrows and upper lip. By 20 weeks they cover the entire body.

Question 24

The fetal concentration of glucose is lower than the glucose level in the maternal blood because of the rapid metabolism by the fetus.

Question 25

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:

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.