Deck 5: Hereditary and Environmental Influences on Childbearing

Question 1

Which statement made by the nurse is evidence of therapeutic communication for a couple who is undergoing genetic counseling and very concerned about the possibility of having a child with a birth defect as a result of a strong family history on both sides of the family?

A) "It is important to ask other members of your family for any information they can provide that will help obtain more insight into the health history."
B) "Given what you have told me, there is little that anyone can do to improve outcomes."
C) "Although you may feel that you have no options, I can't really discuss these matters as only the physician can provide you with information."
D) "Do you have all your forms filled out correctly? This will make the review easier to accomplish. "

Answer 1

"It is important to ask other members of your family for any information they can provide that will help obtain more insight into the health history."

Question 2

An infant is born with blood type AB. The father is type A and the mother is type B. The father asks why the baby has a blood type different from that of the parents. The nurse's answer should be based on the knowledge that which is true?

A) Both A and B blood types are dominant.
B) Types A and B are recessive when linked together.
C) The baby has a mutation of the parents' blood types.
D) Type A is recessive and links more easily with type B.

Answer 2

Both A and B blood types are dominant.

Question 3

A 35-year-old client has an amniocentesis performed to find out whether her baby has a chromosomal defect. Which statement indicates that the client understands her situation?

A) "The doctor will tell me if I should have an abortion when the test results come back."
B) "When all the lab results come back, my husband and I will make a decision about the pregnancy."
C) "My mother must not find out about all this testing. If she does, she will think I'm having an abortion."
D) "I know there are support groups for parents who have a baby with birth defects, but we have plenty of insurance to cover what we need."

Answer 3

"When all the lab results come back, my husband and I will make a decision about the pregnancy."

Question 4

People who have two copies of the same abnormal autosomal dominant gene will usually be:

A) mildly affected with the disorder.
B) infertile and unable to transmit the gene.
C) carriers of the trait but not affected with the disorder.
D) more severely affected by the disorder than people with one copy of the gene.

Question 5

The parents of a child with a karyotype of 47,XY, +21 ask the nurse what this means. Which is an accurate response by the nurse?

A) This karyotype is for a normal male.
B) This karyotype is for a normal female.
C) This karyotype is for a male with Down syndrome.
D) This karyotype is for a female with Turner's syndrome.

Question 6

During the course of obtaining a genetic history from a female client, you note that there is a family history of a genetic disease on the maternal side but no evidence of symptomatology in the client or the client's children, two girls. Which observation can you make related to genetic expression?

A) Autosomal dominant expression is observed.
B) X-linked dominant trait is observed.
C) More information is needed to determine the answer.
D) Autosomal recessive expression is observed and both the children will be carriers of the disease process.

Question 7

A client tells the nurse at a prenatal interview that she has quit smoking, only has a glass of wine with dinner, and has cut down on coffee to four cups a day. Which response by the nurse will be most helpful in promoting a lifestyle change?

A) "Those few things won't cause any trouble. Good for you."
B) "You need to do a lot better than that. You are still hurting your baby."
C) "Here are some pamphlets for you to study. They will help you to find more ways to improve."
D) "You have made some good progress toward having a healthy baby. Let's talk about the changes you have made."

Question 8

A client presents with curly hair and blue eyes. These findings are consistent with:

A) phenotype.
B) genotype.
C) dominant alleles.
D) recessive traits.

Question 9

Which question posed by the nurse will most likely promote the sharing of sensitive information during a genetic counseling interview?

A) "What kind of defects or diseases seem to run in the family?"
B) "How many people in your family are mentally retarded or handicapped?"
C) "Did you know that you can always have an abortion if the fetus is abnormal?"
D) "Are there any members of your family who have learning or developmental problems?"

Question 10

The nurse receives a report on an infant whose analysis indicates 47 total chromosomes, with the abnormality noted at chromosome 21. What additional assessments will the nurse include when evaluating the infant?

A) Cleft palate
B) Protruding tongue
C) Extra fingers or toes (polydactyly)
D) Intellectual developmental delay

Question 11

Which characteristic is related to Down syndrome?

A) Up-slanting eyes
B) Abnormal genitalia
C) Bleeding tendency
D) Edema of extremities

Question 12

A clinic nurse is planning a teaching session for childbearing-age female clients. Which should the nurse include in the teaching session with regard to avoiding exposing a fetus to teratogens?

A) Use only category A medications during pregnancy.
B) Immunizations should be updated during the first trimester of pregnancy.
C) Use of saunas and hot tubs during pregnancy should be during the winter months only.
D) Alcoholic beverages can be consumed in the first and third trimesters of pregnancy.

Question 13

The nurse is teaching prenatal clients about avoiding substances or conditions that can harm the fetus. Which should the nurse include in the teaching session? (Select all that apply.)

A) Elimination of use of alcohol
B) Avoidance of supplemental folic acid replacement
C) Stabilization of blood glucose levels in a diabetic client with insulin
D) Avoidance of nonurgent radiologic procedures during the pregnancy
E) Avoidance of maternal hyperthermia to temperatures of 37.8° C (100° F) or higher

Question 14

Identification of a newborn's blood indicates type AB. Based on this assessment, which statement is correct?

A) Each parent had recessive genes for type O.
B) One parent had type O and the other parent had type A.
C) One parent had type A and the other parent had type B.
D) Each parent had type A.

Question 15

The clinic nurse is reviewing charts on prenatal clients. Which client histories should the nurse understand that a referral to a genetic counselor is warranted? (Select all that apply.)

A) A father who is aged 35
B) A client having a first baby at age 30
C) A family history of unexplained stillbirths
D) A client with a family history of birth defects
E) A client who is a carrier of an X-linked disorder

Question 16

Which statement is true of multifactorial disorders?

A) They may not be evident until later in life.
B) They are usually present and detectable at birth.
C) The disorders are characterized by multiple defects.
D) Secondary defects are rarely associated with them.

Question 17

The patient indicates to the clinic nurse that she is trying to become pregnant. The clinic nurse reviews the patient's chart and notes the following laboratory values: blood type O-, RPR nonreactive, rubella nonimmune, HCT 35%. Which laboratory value is most concerning to the nurse?

A) HCT 35%
B) Blood type O-
C) RPR nonreactive
D) Rubella nonimmune

Question 18

Testing for the cause of anomalies in a stillborn infant is being done. The mother angrily asks the nurse how long these tests are going to take. The nurse should understand that the mother is:

A) exhibiting normal grief behavior.
B) trying to place blame on someone.
C) being impatient and unreasonable.
D) feeling guilty and blaming herself.

Question 19

A nurse is working with a client to obtain information needed for genetic counseling. Which tool will be used to obtain this information?

A) Braden scale
B) Genogram
C) Chorionic villus sampling (CVS)
D) Serum protein electrophoresis

Question 20

Which point should the nurse include when telling a couple about the prenatal diagnosis of genetic disorders?

A) The diagnosis may be slow and could be inconclusive.
B) A comprehensive evaluation will result in an accurate diagnosis.
C) Common disorders can be quickly diagnosed through blood tests.
D) Diagnosis can be obtained promptly through most hospital laboratories.

Question 21

Two healthy parents who carry the same abnormal autosomal recessive gene have what percentage chance of having a child affected with the disorder caused by this gene? Record your answer as a whole number.
_____%

Question 22

Match each term with the correct definition.

X-linked recessive

A)Two genes are required to produce the trait.
B)A single copy of the gene is enough to produce the trait.
C)Only one copy of the gene is needed to cause the disorder in the male.

Question 23

Match each term with the correct definition.

Autosomal recessive

A)Two genes are required to produce the trait.
B)A single copy of the gene is enough to produce the trait.
C)Only one copy of the gene is needed to cause the disorder in the male.

Question 24

Match each term with the correct definition.

Autosomal dominant

A)Two genes are required to produce the trait.
B)A single copy of the gene is enough to produce the trait.
C)Only one copy of the gene is needed to cause the disorder in the male.

Question 25

The nurse is explaining genetics to a group of nursing students. Which are autosomal recessive disorders that the nurse should include in the teaching session? (Select all that apply.)

A) Hemophilia
B) Cystic fibrosis
C) Sickle cell disease
D) Turner's syndrome
E) Phenylketonuria (PKU) disease