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(Complete) Test Bank Maternal Child Nursing Care Perry 4th Edition
(Complete) Test Bank Maternal Child Nursing Care Perry 4th Edition
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Maternal Child Nursing Care 4th EditionPerry Test Bank
, Perry: Maternal Child Nursing Care, 4th Edition
Chapter 8: Genetics, Conception, and Fetal Development Test Bank
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
The chance is one in four that each child produced by this couple will be affected by
PKU disorder. 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.
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. No correlation exists between gender and inheritance of the disorder, because PKU
is an autosomal recessive disorder.
PTS: 1 DIF: Cognitive Level: Application REF: 169
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Planning
2. 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
Genetic testing, including amniocentesis, would need to be performed to determine
whether the fetus is affected. The couple should be given information about the
likelihood of having another baby with this disorder so that they can make an informed
decision. A genetic counselor is the best source for determining genetic probability ratios.
The couple eventually may need emotional support, but the status of the pregnancy must
be determined first.
, PTS: 1 DIF: Cognitive Level: Comprehension REF: 162, 163
OBJ: Client Needs: Physiologic Integrity
TOP: Nursing Process: Planning, Implementation
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.
ANS: A
MSUD is a type of autosomal recessive inheritance disorder in which both genes of a pair
must be abnormal for the disorder to be expressed. MSUD is not an X-linked dominant or
recessive disorder or an autosomal dominant inheritance disorder.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 169
OBJ: Client Needs: Health Promotion and Maintenance TOP:
Nursing Process: Assessment
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
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. Anxiety and altered family relationships, high false positives, and ethnic
and socioeconomic disparity are factors that may be difficulties associated with genetic
testing, but they are not risks associated with testing.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 164
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing
Process: Implementation
5. 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. c. Predictive testing.
b. Recurrence risk. d. Predisposition testing.
ANS: B
, The couple already has a child with a genetic disease; therefore they will be given a
recurrence risk test. If a couple has not yet had children but are known to be at risk for
having children with a genetic disease, they are given an occurrence risk test. This couple
already has a child with a genetic disorder. Predictive testing is used to clarify the genetic
status of an asymptomatic family member. Predisposition testing differs from
presymptomatic testing in that a positive result does not indicate 100% risk of a condition
developing.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 163
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Planning
6. A key finding from the Human Genome Project is:
a. Approximately 20,000 to 25,000 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.
ANS: A
Approximately 20,000 to 25,000 genes make up the human genome; this is only twice as
many as make up the genomes of roundworms and flies. Human beings are 99.9%
identical at the DNA level. Most human genes produce at least three proteins. Single
gene testing (e.g., alpha-fetoprotein) is already standardized for prenatal care.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 164
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment
7. 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 c. Anxiety
b. Interrupted family processes d. Risk for injury
ANS: B
This mother likely will experience a disruption in the family process related to the birth
of a baby with an inherited disorder. Women commonly experience body image
disturbances in the postpartum period, but this is unrelated to giving birth to a child with
Down syndrome. The mother likely will have a mix of emotions that may include
anxiety, guilt, and denial, but this is not the most essential nursing diagnosis for this
family. Risk for injury is not an applicable nursing diagnosis.
, PTS: 1 DIF: Cognitive Level: Application REF: 168
OBJ: Client Needs: Psychosocial Integrity
TOP: Nursing Process: Diagnosis
8. 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.”
ANS: C
Karyotyping provides genetic information such as gender and chromosome structure. The
L/S, not karyotyping, reveals lung maturity. Although karyotyping can detect genetic
anomalies, the range of normal is nondescriptive. Although karyotyping can detect
genetic anomalies, not all such anomalies display obvious physical deformities. The term
deformities is a nondescriptive word. Furthermore, physical anomalies may be present
that are not detected by genetic studies (e.g., cardiac malformations).
PTS: 1 DIF: Cognitive Level: Analysis REF: 166
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing
Process: Implementation
9. 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.
ANS: C
Nurses should be prepared to help with a variety of stress reactions from a couple facing
the possibility of a genetic disorder. Although anyone may have a genetic disorder,
certain disorders appear more often in certain ethnic and racial groups. Genetic health
care is highly individualized because treatments are based on the phenotypic responses of
the individual. Individual nurses at any facility can take a genetic history, although larger
facilities may have better support services.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 161, 162
OBJ: Client Needs: Psychosocial Integrity
, TOP: Nursing Process: Planning
10. 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.
ANS: A
Maternal serum screening identifies the risk for the neural tube defect and the specific
chromosome abnormality involved in Down syndrome. Carriers of some diseases such as
sickle cell disease do not display symptoms. Predisposition testing determines
susceptibility such as for breast cancer; presymptomatic testing indicates that, if the gene
is present, symptoms are certain to appear.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 164
OBJ: Client Needs: Physiologic Integrity TOP: Nursing Process: Planning
11. 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.
ANS: D
Each pregnancy is an independent event. The risk factor (e.g., one in two, one in four)
remains the same for each child, no matter how many children are born to the family. In a
dominant disorder the likelihood of recurrence in subsequent children is 50% (one in
two). An autosomal recessive disease carries a one in four chance of recurrence.
Subsequent children would be at risk only if the mother continued to take drugs; the rate
of risk would be difficult to calculate.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 163
OBJ: Client Needs: Health Promotion and Maintenance TOP:
Nursing Process: Diagnosis
,12. The nurse must be cognizant that an individual’s genetic makeup is known as his or her:
a. Genotype. c. Karyotype.
b. Phenotype. d. Chromotype.
ANS: A
The genotype comprises all the genes the individual can pass on to a future generation.
The phenotype is the observable expression of an individual’s genotype. The karyotype is
a pictorial analysis of the number, form, and size of an individual’s chromosomes.
Genotype refers to an individual’s genetic makeup.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 166
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment
13. 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.
ANS: B
Aneuploidy is an abnormality of number that also is the leading genetic cause of mental
retardation. Chromosome abnormalities occur in fewer than 1% of newborns. Down
syndrome is the most common form of trisomal abnormality, an abnormality of
chromosome number (47 chromosomes). Unbalanced translocation is an abnormality of
chromosome structure that often has serious clinical effects.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 166
OBJ: Client Needs: Psychosocial Integrity
TOP: Nursing Process: Diagnosis
14. 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
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. “We don’t really know when such defects
, occur” is an inaccurate statement. Regardless of the cause, the heart is vulnerable during
its period of development, the third to fifth weeks. “They usually occur in the first 2
weeks of development” is an inaccurate statement.
PTS: 1 DIF: Cognitive Level: Application REF: 179, 180
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Evaluation
15. 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.”
ANS: C
“Babies respond to sound starting at about 24 weeks of gestation” is an accurate
statement. “That must have been a coincidence; babies can’t respond like that”
is inaccurate. Fetuses respond to sound by 24 weeks. Acoustic stimulations can evoke a
fetal heart rate response. There is no such thing as an aural reflex. The statement, “Let me
know if it happens again; we need to report that to your midwife” is not appropriate; it
gives the impression that something is wrong.
PTS: 1 DIF: Cognitive Level: Application REF: 182
OBJ: Client Needs: Health Promotion and Maintenance TOP:
Nursing Process: Evaluation
16. 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 g.
a. 20 c. 28
b. 24 d. 30
ANS: C
These are all milestones in human development that occur at approximately 28 weeks.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 186
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment
17. The nurse caring for the laboring woman should know that meconium is produced by:
a. Fetal intestines. c. Amniotic fluid.
b. Fetal kidneys. d. The placenta.
, ANS: A
As the fetus nears term, fetal waste products accumulate in the intestines as dark green–
to-black, tarry meconium.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 181
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment
18. 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.”
ANS: 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” is the most appropriate response. “Your baby’s umbilical floats around in
blood anyway” is inaccurate. “You don’t need to worry about things like that” is not
appropriate response. It negates the client’s need for teaching and discounts her feelings.
The placenta does not protect the umbilical cord. The cord is protected by the
surrounding Wharton jelly.
PTS: 1 DIF: Cognitive Level: Application REF: 176
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Planning
19. The _____ is/are responsible for oxygen and carbon dioxide transport to and from the
maternal bloodstream.
a. Decidua basalis c. Germ layer
b. Blastocyst d. Chorionic villi
ANS: D
Chorionic villi are fingerlike projections that develop out of the trophoblast and extend
into the blood-filled spaces of the endometrium. The villi obtain oxygen and nutrients
from the maternal bloodstream and dispose of carbon dioxide and waste products into the
maternal blood. The decidua basalis is the portion of the decidua (endometrium) under
the blastocyst where the villi attach. The blastocyst is the embryonic development stage
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