Deck 49: Nursing Care of the Child With an Alteration in Genetics

Question 1

The nurse is teaching a couple about the pros and cons of genetic testing. Which of the following statements best describes the capabilities of genetic testing?

A) "Various genetic tests help the physician choose appropriate treatments."
B) "Genetic testing helps couples avoid having children with fatal diseases."
C) "Genetic tests identify people at high risk for preventable conditions."
D) "Some genetic tests can give a probability for developing a disorder."

Answer 1

"Some genetic tests can give a probability for developing a disorder."

Question 2

The nurse is caring for a couple who is having a triple screen done. The nurse would least likely expect which of the following to be tested?

A) a-Fetoprotein
B) Human chorionic gonadotropin
C) Unconjugated estriol
D) Testosterone

Answer 2

Testosterone

Question 3

The nurse is caring for 3-day-old girl with Down syndrome whose mother had no prenatal care. Which of the following will be the priority nursing diagnosis?

A) Imbalanced nutrition, less than body requirements related to the effects ofhypotonia
B) Deficient knowledge related to the presence of a genetic disorder
C) Delayed growth and development related to a cognitive impairment
D) Impaired physical mobility related to poor muscle tone

Answer 3

Imbalanced nutrition, less than body requirements related to the effects ofhypotonia

Question 4

The nurse is assessing a 4-year-old boy whose mother was 40 years old when he was born. Which of the following findings suggests this child has a genetic disorder?

A) Inquiry determines the child had feeding problems.
B) Observation shows nasal congestion and excess mucus.
C) Inspection reveals low-set ears with lobe creases.
D) Auscultation reveals the presence of wheezing.

Question 5

The nurse is teaching the parents of a 1-month-old girl with Down syndrome how to maintain good health for the child. Which instruction would the nurse be least likely to include?

A) Getting cervical radiographs between 3 and 5 years of age
B) Adhering to the special dietary needs of the child
C) Getting an echocardiogram before 3 months of age
D) Monitoring for symptoms of respiratory infection

Question 6

The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. Which of the following would be most important for the nurse to incorporate into the plan of care when working with this family?

A) Gathering information from at least three generations
B) Informing the family of the need for a wide range of information
C) Maintaining the confidentiality of the information
D) Presenting the information in a nondirective manner

Question 7

The nurse is obtaining the health history for a 15-month-old boy from the parents. The child is not yet speaking. Which finding would be eliminated as a risk factor for a possible genetic disorder?

A) The child is male and Caucasian.
B) The grandmother and father have hearing impairments.
C) The child was a breech delivery 3 weeks early.
D) The mother was 37 when she became pregnant.

Question 8

The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely?

A) Interrupted family process related to the child's diagnosis
B) Deficient knowledge deficit related to the genetic disorder
C) Grieving related to the child's poor prognosis
D) Ineffective coping related to stress of providing care

Question 9

The nurse is caring for a 9-year-old boy with achondroplasia. Which of the following would the nurse expect to assess?

A) Narrow passages from the nose to the throat
B) Slim stature, hypotonia, and a narrow face
C) Craniosynostosis and a small nasopharynx
D) Trident hand and persistent otitis media

Question 10

The nurse is teaching a couple about X-linked disorders. They are concerned that they might pass on hemophilia to their children. Which of the following responses indicates the need for further teaching?

A) "The father can't be a carrier if he doesn't have hemophilia."
B) "If the father doesn't have it, then his kids won't either."
C) "If the mother is a carrier, her daughter could be one too."
D) "If the mother is a carrier, her sons may have hemophilia."

Question 11

When teaching a class about trisomy 21, the instructor would identify this disorder as due to which of the following?

A) Nondisjunction
B) X-linked recessive inheritance
C) Genomic imprinting
D) Autosomal dominant inheritance

Question 12

The nurse is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. Which of the following would the nurse include as a major congenital anomaly?

A) Overlapping digits
B) Polydactyly
C) Umbilical hernia
D) Cleft palate

Question 13

The nurse is caring for a couple who have just learned that their infant has a genetic disorder. Which of the following would be least appropriate for the nurse to do at this time?

A) Actively listening to the parents' concerns
B) Teaching the parents about the child's medical needs
C) Providing time for the parents to ask questions
D) Offering suggestions for support services

Question 14

When providing guidance to the parents of a child with Down syndrome, which of the following would be most appropriate?

A) Encourage the parents to home-school the child.
B) Advise the parents that the child will need monthly thyroid testing.
C) Instruct them on the need for yearly dental visits.
D) Teach the parents about the need for a high-fiber diet.

Question 15

Which of the following would lead the nurse to suspect that a child has Turner syndrome?

A) Webbed neck
B) Microcephaly
C) Gynecomastia
D) Cognitive delay

Question 16

When performing a physical examination on a small child, the nurse observes approximately 8 to 10 light-brown spots concentrated primarily on the trunk and extremities, two small lumps on the posterior trunk, and axillary freckling. The nurse interprets these findings to suggest which of the following?

A) Klinefelter syndrome
B) Neurofibromatosis
C) Fragile X syndrome
D) Sturge-Weber syndrome

Question 17

After teaching a class about inborn errors of metabolism, the instructor determines that additional teaching is needed when the class identifies which of the following as an example of an inborn error of metabolism?

A) Galactosemia
B) Maple syrup urine disease
C) Achondroplasia
D) Tay-Sachs disease

Question 18

When teaching the parents of a child with phenylketonuria, the nurse would instruct them to include which of the following foods in the child's diet?

A) Milk
B) Oranges
C) Meat
D) Eggs

Question 19

When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, which of the following would be the highest priority?

A) Assisting with scheduling follow-up visits
B) Establishing a trusting relationship
C) Teaching the family what to expect
D) Using measures to promote growth and development

Question 20

A group of students are reviewing information about major and minor congenital disorders. The students demonstrate understanding of the information when they identify which of the following as a minor disorder?

A) Webbed neck
B) Omphalocele
C) Cutaneous hemangioma
D) Facial asymmetry

Question 21

The nurse is assessing an infant and notes that the infant's urine has a musty odor. Which of the following would the nurse suspect?

A) Maple syrup urine disease
B) Tyrosinemia
C) Phenylketonuria
D) Trimethylaminuria

Question 22

A nursing instructor is preparing a class discussion on the benefits and drawbacks associated with genetic advances and the Human Genome Project. Which of the following would the instructor address as a potential problem?

A) Early detection possibilities
B) Risk profiling
C) Focus on causes
D) Rapid diagnosis

Question 23

A nurse is reviewing an article about genetic disorders and patterns of inheritance. The nurse demonstrates understanding of the information by identifying which of the following as an example of an autosomal dominant genetic disorder?

A) Neurofibromatosis
B) Cystic fibrosis
C) Tay-Sachs disease
D) Sickle cell disease

Question 24

A nursing student is preparing an oral presentation about autosomal recessive inheritance. Which of the following must occur for an offspring to demonstrate signs and symptoms of the disorder with this type of inheritance?

A) Both parents must be heterozygous carriers.
B) One parent must have the disease.
C) The mother must be a carrier.
D) The father must be affected by the disease.

Question 25

A pregnant woman is to undergo testing to evaluate for chromosomal abnormalities. Which test would the nurse expect to be done the earliest?

A) Amniocentesis
B) Chorionic villi sampling
C) Triple screen
D) Fetal nuchal translucency

Question 26

A child is diagnosed with cri-du-chat syndrome. Which of the following would the nurse expect to assess? Select all answers that apply.

A) Hypertonia
B) Short stature
C) Simian crease
D) Wide and flat nasal bridge
E) Hydrocephaly

Question 27

The nurse is assessing a 2-day-old newborn and suspects Down syndrome based on which of the following? Select all answers that apply.

A) Flat facial profile
B) Downward slant to the eyes
C) Large tongue compared to mouth
D) Simian crease
E) Epicanthal folds
F) Rigid joints

Question 28

When describing Prader-Willi syndrome to a group of nursing students, the instructor would describe this condition as one affecting which chromosome?

A) 4
B) 5
C) 11
D) 15

Question 29

A group of nursing students are reviewing information about neurocutaneous syndromes. The students demonstrate an understanding of these disorders when they identify which of the following as an example?

A) Sturge-Weber syndrome
B) Marfan syndrome
C) Apert syndrome
D) Achondroplasia