OB Final Exam Prep U Questions and Answers/Rationales fall 2022/2023

OB PREP U CHP 10 An older pregnant woman has come to the clinic for her first prenatal visit. She asks the nurse about age guidelines for genetic counseling and prenatal testing. The nurse informs the client that genetic counseling and prenatal testing should be performed for all pregnant women in which age group? Which event will result in zygote formation? During the embryonic stage of pregnancy, what changes would the mother note in her body to signal that she is pregnant? A client who has one child with a genetic disorder tells the nurse, “I told my husband I was ready to have another baby and now he does not want to be intimate with me.” What is the most appropriate nursing diagnosis for this client? A recently married couple come to the prenatal clinic because they are concerned about genetic testing. The husband is of Jewish heritage. What testing should the nurse recommend to the couple? The nurse prepares a couple to have a karyotype performed. What describes a karyotype? Implantation generally occurs at which place on the uterus? Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S? In developing a plan of care for a 5-year-old child with Down syndrome, what should be a priority for the nurse in meeting the expected growth and development outcomes for this child? A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age? Cystic fibrosis is an example of which type of inheritance? Three sisters decide to have genetic testing done because their mother and their maternal grandmother died of breast cancer. Each of the sisters has the BRCA1 gene mutation. The nurse explains that just because they have the gene does not mean that they will develop breast cancer. What does the nurse explain their chances of developing breast cancer depend on? A nursing student is explaining to a newly pregnant woman what happens during each stage of fetal development. At which stage does the nurse inform the woman that the lungs are fully shaped? While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a: A nurse is describing what happens at fertilization as the zygote begins life. Which statement is most accurate? A client at a preconception screening meeting indicates to the nurse that she is a carrier of muscular dystrophy. Which statement made by the client indicates an understanding of the implications? The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information? A client comes to the clinic with concerns about her pregnancy. She is in her first trimester and is now experiencing moderate abdominal pain on the right side. What would be the nurse’s first action? A 4-year-old child is recently diagnosed with Wilms tumor. The health care provider suggests that the child's siblings have genetic testing performed. What is the best response by the nurse when explaining this to the parents? A nurse is caring for a 32-year-old Jewish client who is pregnant with a female baby. The parents are not directly related by blood. The mother reports that her husband's cousin had an infant born with Tay-Sachs disease that died two years ago and she is concerned about her baby. Which information does the nurse need to give the client to help alleviate her concerns regarding her baby having the same disease? A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take? A mutligravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embyonic stage? A pregnant client asks the nurse if the fetus can be tested for Down syndrome. Which statement by the nurse is most appropriate? A pregnant woman undergoes a triple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's estriol and alpha-fetoprotein levels are decreased with high hCG levels? Nondisjunction of a chromosome results in which diagnosis? Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S? A nurse is providing genetic counseling to a pregnant client. Which are nursing responsibilities related to counseling the client? Select all that apply. A mother has come to the clinic with her 13-year-old daughter to find out why she has not started her menses. After a thorough examination and history, genetic testing is prescribed to rule out which abnormality? The nurse is assessing a young female who just found out she is pregnant. She is is now reporting vague abdominal discomfort. After noting the client has a history of PID, the nurse predicts the health care provider will give priority to ruling out which situation? A 4-year-old child is recently diagnosed with Wilms tumor. The health care provider suggests that the child's siblings have genetic testing performed. What is the best response by the nurse when explaining this to the parents? A nurse assesses that a 7-year-old male client has a prominent lower jaw, large ears, speech deficits, and displays hyperactivity. The nurse identifies this as being most likely related to which diagnosis? During a preconception teaching session, the nurse tells participants to increase their intake of which food groups to reduce the incidence of neural tube disorders? Select all that apply. A pregnant woman has a child at home who has been diagnosed with neurofibromatosis. She asks the nurse what she should look for in the new baby that would indicate that it also has neurofibromatosis. What sign should the nurse instruct the woman to look for in the new baby? A couple has just learned that their unborn son has a chromosome disorder that results in an extra X chromosome. The primary care provider explains that secondary sex characteristics will not develop in this child at puberty and that his testes will remain small and produce ineffective sperm. The nurse recognizes that this child likely has: While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a: A nurse is discussing the importance of good nutrition to a young pregnant client. The nurse would point out that the growing fetus is getting nutrition from the mother via which structure? The nursing instructor is presenting a class on the various classifications of twins. The instructor determines the session is successful after the students correctly choose which classification that indicates twins have separate amniotic sacs and placentas? Chapter 11: Maternal Adaptation During Pregnancy The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse? - A client who has just given a blood sample for pregnancy testing in the health care provider's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy? Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to: - A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely? A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth? A 17-year-old client arrives for an annual examination and reports no changes since the last exam; however, the nurse assesses a postive Chadwick sign, slightly enlarged uterus, and subsequent positive urine pregnancy test. Which task should the nurse prioritize to assist this client who is denying any possibility that she is pregnant? The nurse is assessing a pregnant client at her 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are? The nurse is teaching a pregnant teenager the importance of proper nutrition and adequate weight gain throughout the pregnancy. What is the best response when the client refuses to eat due to fear of possible weight gain? A client who suspects she is pregnant asks the nurse about the accuracy of home pregnancy tests. The nurse would tell the client that: The client at 18 weeks' gestation states,