Updated Test Bank for Maternity & Women’s Health Care (11th Ed.) by Lowdermilk

Updated Test Bank for Maternity & Women’s Health
Care (11th Ed.) by Lowdermilk

Chapter 01: 21st Century Maternity and Women’s Health Nursing


1. Which condition or treatment reduces the risk of morbidity in women with the inherited
factor V Leiden disorder?
a. Anticoagulant therapy
b. Pregnancy
c. Oral contraceptives
d. Hormone replacement therapy
CORRECT ANSWER: A
Factor V Leiden is the most common inherited risk factor for primary or recurrent venous
thromboembolism. It is an autosomal recessive disorder that increases an individual‘s risk for
blood clots in the legs and pulmonary emboli. This risk significantly increases if the woman is
pregnant or is taking oral contraceptives or hormone replacement therapy. Prophylactic
anticoagulation therapy decreases the risk of comorbidities.

DIF: Cognitive Level: Understand REF: p. 51 TOP: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity

2. Nurses who elect to practice in the field of obstetrics must have a basic working knowledge
of genetics. What is the correct term used to describe an individual‘s genetic makeup?
a. Genotype
b. Phenotype
c. Karyotype
d. Chromotype
CORRECT ANSWER: 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.




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, DIF: Cognitive Level: Remember REF: p. 44
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. The U.S. Department of Health and Human Services has designated Thanksgiving Day as
National Family History Day. The U.S. Surgeon General encourages family members to
discuss important family health information while sharing in holiday gatherings. Why is
this initiative significant to nurses?
a. Few genetic tests are available that identify this information.
b. Only physiciCORRECT ANSWER should obtain this detailed information.
c. Clients cannot accurately complete these histories on their own.
d. Family history is the single most cost-effective source for genetic information.
CORRECT ANSWER: D
Although more than 1000 genetic tests are available, the single most cost-effective piece of
genetic information is the family history. Nurses are ideally suited to take the lead in ongoing
efforts to recognize the significance of the family history as an important source of genetic
information. A computerized tool called My Family Health Portrait is available free of charge
(https://familyhistory.hhs.gov/fhh-web/home.action). Other tools designed to help the lay
community in completing their family histories are available to the public.

DIF: Cognitive Level: Understand REF: pp. 42-43
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

4. A maternal-newborn nurse is caring for a mother who just delivered a baby born with
Down syndrome. Which 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
CORRECT ANSWER: B
This mother will likely experience a disruption in the family process related to the birth of a
baby with an inherited disorder. Therefore, the probable nursing diagnosis for this family is
―Interrupted family processes.‖ Women commonly experience ―body image disturbances
in the postpartum period‖; however, this nursing diagnosis is unrelated to giving birth to a
child with Down syndrome. The mother will likely have a mix of emotions that may include
anxiety, guilt, and denial, but this nursing diagnosis is not the most essential for this family.
―Risk for injury‖ is not an applicable nursing diagnosis.

DIF: Cognitive Level: Apply REF: p. 48 TOP: Nursing Process: Diagnosis
MSC: Client Needs: Psychosocial Integrity

5. A couple has been counseled for genetic anomalies. They ask you, ―What is
karyotyping?‖ Which description is most accurate?
a. ―Karyotyping will reveal if the baby‘s lungs are mature.‖
b. ―Karyotyping will reveal if the 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.‖




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, CORRECT ANSWER: C
Karyotyping provides genetic information such as gender and chromosomal structure. The
lecithin/sphingomyelin (L/S) ratio, not karyotyping, reveals lung maturity. Although
karyotyping can detect genetic anomalies, the range of normal is nondescriptive, and not all
such anomalies display obvious physical deformities. The term deformities is a nondescriptive
word, and physical anomalies may be present that are not detected by genetic studies (e.g.,
cardiac malformations).

DIF: Cognitive Level: Analyze REF: p. 46
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

6. Which statement regarding genetic health care is most important to the nurse practicing in
this specialty?
a. Genetic disorders equally affect people of all socioeconomic backgrounds,
races, and ethnic groups.
b. Genetic health care is more concerned with populations than individuals.
c. Providing emotional support to the family during counseling is the most
important of all nursing functions.
d. Taking genetic histories is the province of large universities and medical centers.
CORRECT ANSWER: C
Perhaps the most important of all nursing functions is the ability to provide emotional support.
Nurses should be prepared to help with various 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.

DIF: Cognitive Level: Understand REF: p. 55 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity

7. Which statement most accurately describes dominant genetic disorders?
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.
CORRECT ANSWER: 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% (i.e.,
one-in-two). An autosomal recessive disease carries a one-in-four chance of recurrence. In
disorders involving maternal ingestion of drugs, subsequent children would be at risk only if
the mother continued to take the drugs; the rate of risk would be difficult to calculate.

DIF: Cognitive Level: Understand REF: p. 55 TOP: Nursing Process: Diagnosis



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, MSC: Client Needs: Health Promotion and Maintenance

8. Which statement regarding chromosomal abnormalities is most accurate?
a. Chromosomal abnormalities 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 chromosomal structure.
d. Unbalanced trCORRECT ANSWERlocation results in a mild abnormality that
the child will outgrow.
CORRECT ANSWER: B
Aneuploidy is an abnormality of number that is also the leading genetic cause of mental
retardation. Chromosomal abnormalities occur in fewer than 1% of newborns. Down
syndrome is the most common form of a trisomal abnormality, an abnormality of
chromosome number (47 chromosomes). Unbalanced trCORRECT ANSWERlocation
is an abnormality ofchromosomal structure that often has serious clinical effects.

DIF: Cognitive Level: Understand REF: p. 46 TOP: Nursing Process: Diagnosis
MSC: Client Needs: Psychosocial Integrity

9. Which type of genetic tests in clinical practice are most often offered to clients with a
family history of disease?
a. Single-gene disorders
b. Carrier screening
c. Predictive value testing
d. Predispositional testing
CORRECT ANSWER: A
Most tests now offered are tests for single-gene disorders in clients with clinical symptoms or
clients who have a family history of a genetic disease. Carrier screening is used to identify
individuals who have a gene mutation for a genetic condition but do not display symptoms.
Predictive value testing is used only to clarify the genetic status of asymptomatic family
members. Predispositional testing differs from the other types of genetic screening in that a
positive result does not indicate a 100% chance of developing the condition.

DIF: Cognitive Level: Understand REF: p. 43 TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance

In evaluating the level of a pregnant woman‘s risk of having a low-birth-weight (LBW) infant,
which factor is the most important for the nurse to consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
CORRECT ANSWER:
A
For African-American births, the incidence of LBW infants is twice that of Caucasian births.
Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in potential
infant mortality rates, but it is not the most important. Additionally, smoking is a modifiable
risk factor. Poor nutrition is an important factor in potential infant mortality rates, but it is not
the most important. Additionally, nutritional status is a modifiable risk factor. Maternal
education is an important factor in potential infant mortality rates, but it is not the most
important. Additionally, maternal education is a modifiable risk factor.

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