Chapter 05 Genetics, Conception, and Fetal Development

Chapter 05  Genetics, Conception, and Fetal Development

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. 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.”

ANS: C

Feedback
A
This couple still has an increased likelihood of having a child with PKU. Having one child already with PKU does not guarantee that they will not have another.
B
These parents need to discuss their options with their physician. However, an opportune time has presented itself for the couple to receive correct teaching about inherited genetic risks.
C
The chance is one in four that each child produced by this couple will be affected by PKU disorder.
D
No correlation exists between gender and inheritance of the disorder, because PKU is an autosomal recessive disorder.

DIF: Cognitive Level: Application REF: 147
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Planning

2. 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.

ANS: B

Feedback
A
The placenta widens until week 20 and continues to grow thicker.
B
The placenta produces four hormones necessary to maintain the pregnancy.
C
Toxic substances such as nicotine and carbon monoxide readily cross the placenta into the fetus.
D
Optimal circulation occurs when the woman is lying on her side.

DIF: Cognitive Level: Comprehension REF: 156
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Assessment

3. 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.

ANS: C

Feedback
A
The couple should be given information about the likelihood of having another baby with this disorder so that they can make an informed decision.
B
A genetic counselor is the best source for determining genetic probability ratios.
C
Genetic testing, including amniocentesis, would need to be performed to determine whether the fetus is affected.
D
The couple eventually may need emotional support, but the status of the pregnancy must be determined first.

DIF: Cognitive Level: Comprehension REF: 144, 145
OBJ: Client Needs: Physiologic Integrity
TOP: Nursing Process: Planning, Implementation

4. 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.

ANS: B

Feedback
A
These factors may be difficulties associated with genetic testing, but they are not risks associated with testing.
B
Decisions about genetic testing are shaped by socioeconomic status and the ability to pay for the testing. Some types of genetic testing are expensive and are not covered by insurance benefits.
C
This factor may be a difficulty associated with genetic testing, but it is not a risk associated with testing.
D
This factor may be a difficulty associated with genetic testing, but it is not a risk associated with testing.

DIF: Cognitive Level: Comprehension REF: 142, 143
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Implementation

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.”

ANS: C

Feedback
A
This is an inaccurate statement.
B
Regardless of the cause, the heart is vulnerable during its period of development, the third to fifth weeks.
C
The cardiovascular system is the first organ system to function in the developing human. Blood vessel and blood formation begins in the third week, and the heart is developmentally complete in the fifth week.
D
This is an inaccurate statement.

DIF: Cognitive Level: Application REF: 158
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Evaluation