Deck 6: Genetics, conception, and Fetal Development

Question 1

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

A)Genetic disorders affect people of all socioeconomic backgrounds, races, and ethnic groups equally.
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.

Answer 1

The most important of all nursing functions is providing emotional support to the family during counseling.

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

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

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

Answer 3

Both genes of a pair must be abnormal for the disorder to be expressed.

Question 4

A key finding from the Human Genome Project is:

A)Approximately 20,000 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 clients in the future.

Question 5

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 6

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 7

With regard to chromosome abnormalities,nurses should be aware that:

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 8

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 9

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 10

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

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 11

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-positive results associated with genetic testing.
D)Ethnic and socioeconomic disparity associated with genetic testing.

Question 12

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 1110g.

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

Question 13

With regard to 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 14

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 15

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 16

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 17

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 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 18

A couple has been counseled for genetic anomalies.They ask you,"What is karyotyping?" Your best response is:

A)"Karyotyping will reveal if the baby's lungs are mature."
B)"Karyotyping will reveal if your baby will develop normally."
C)"Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes."
D)"Karyotyping will detect any physical deformities the baby has."

Question 19

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 20

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:

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

Question 21

Along with gas exchange and nutrient transfer,the placenta produces many hormones necessary for normal pregnancy.These include (select all that apply)

A)Human chorionic gonadotropin (hCG)
B)Insulin
C)Estrogen
D)Progesterone
E)Testosterone

Question 22

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 23

Which congenital malformations result from multifactorial inheritance (Select all that apply)?

A)Cleft lip
B)Congenital heart disease
C)Cri du chat syndrome
D)Anencephaly
E)Pyloric stenosis

Question 24

A woman who is 16 weeks pregnant asks the nurse,"Is it possible to tell by ultrasound if the baby is a boy or girl yet?" The best answer is:

A)"A baby's sex is determined as soon as conception occurs."
B)"The baby has developed enough that we can determine the sex by examining the genitals through ultrasound."
C)"Boys and girls look alike until about 20 weeks after conception, and then they begin to look different."
D)"It might be possible to determine your baby's sex, but the external organs look very similar right now."

Question 25

With regard to the development of the respiratory system,maternity nurses should be understand 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 26

The nurse caring for a pregnant client knows that her health teaching regarding fetal circulation has been effective when the client 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.

Question 27

Some of the embryo's intestines remain within the umbilical cord during the embryonic period because the:

A)Umbilical cord is much larger at this time than it will be at the end of pregnancy.
B)Intestines begin their development within the umbilical cord.
C)Nutrient content of the blood is higher in this location.
D)Abdomen is too small to contain all the organs while they are developing.

Question 28

As relates 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 29

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 30

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 white families.
D)Fraternal twins are same gender, usually male.

Question 31

A new mother asks the nurse about the "white substance" covering her infant.The nurse explains that the purpose of vernix caseosa is to:

A)Protect the fetal skin from amniotic fluid.
B)Promote normal peripheral nervous system development.
C)Allow transport of oxygen and nutrients across the amnion.
D)Regulate fetal temperature.

Question 32

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 33

A woman is 15 weeks pregnant with her first baby.She asks how long it will be before she feels the baby move.The best answer is:

A)"You should have felt the baby move by now."
B)"Within the next month, you should start to feel fluttering sensations."
C)"The baby is moving; however, you can't feel it yet."
D)"Some babies are quiet, and you don't feel them move."

Question 34

The placenta allows exchange of oxygen,nutrients,and waste products between the mother and fetus by:

A)Contact between maternal blood and fetal capillaries within the chorionic villi.
B)Interaction of maternal and fetal pH levels within the endometrial vessels.
C)A mixture of maternal and fetal blood within the intervillous spaces.
D)Passive diffusion of maternal carbon dioxide and oxygen into the fetal capillaries.

Question 35

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 client,she should understand the significance of exposure to known human teratogens.These include (Select all that apply):

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

Question 36

The most basic information a maternity nurse should have concerning conception is that:

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.