Maternal-Newborn Chapter 4

MATERNAL-NEWBORN CHAPTER 4 EXAM 2024 WITH 100% CORRECT ANSWERS A clinic nurse is planning a teaching session for childbearing-age female patients. Which information should the nurse include in the teaching session with regard to avoiding exposing a fetus to teratogens? A: eliminate use of acne medication B: immunizations should be updated during the first rimester of pregnancy C: use of saunas and hot hubs during pregnancy should be during the winter months only D: alcoholic beverages can be consumed in the first and third trimesters of pregnancy - correct answer A: eliminate use of acne medication Elimination of non therapeutic drugs is the best action to avoid teratogen exposure. Acne medication is not essential during pregnancy. Immunizations for diseases such as rubella are contraindicated during pregnancy. Use of saunas and hot tubs are not recommended because maternal hyperthermia is a significant teratogen. Alcohol is an environmental substance known to be teratogenic and should not be consumed during pregnancy. The parents of a child with a karyotype of 47, XY, +21 ask the nurse what this means. Which is the most 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 - correct answer C: this karyotype is for a male with Down syndrome This child is male because his chromosomes are XY. He has one extra copy of chromosome 21 (for a total of 47, instead of 46), resulting in Down syndrome. A normal female would have 46 chromosomes and XX for the sex chromosomes. A normal male would have 46 chromosomes. A female with Turner's syndrome would have 45 chromosomes; the sex chromosome would have just one X. People who have two copies of the same abnormal autosomal dominant gene are generally: 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 - correct answer D: more severely affected by the disorder than people with one copy of the gene People who have two copies of an abnormal gene are usually more severely affected by the disorder because they have no normal gene to compensate and maintain normal function. Those mildly affected with the disorder will have only one copy of the abnormal gene. Infertility may or may not be caused by chromosomal defects. A carrier of a trait has one recessive gene. 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: 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 - correct answer A: both A and B blood types are dominant Types A and B are equally dominant, and the baby can thus inherit one from each parent. Both types A and B are dominant, not recessive. The infant has inherited both blood types from the parents and this is not a mutation. Both blood types A and B are equally dominant. Which statement regarding multifactorial disorders is correct? 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 - correct answer B: they are usually present and detectable at birth Multifactorial disorders result from an interaction between a person's genetic susceptibility and environmental conditions that favor development of the defect. They are characteristically present and detectable at birth. They are usually single isolated defects, although the primary defect may cause secondary defects. Secondary defects can occur with multifactorial disorders. Which information should the nurse include when discussing the prenatal diagnosis of genetic disorders with an expectant couple? A: the diagnosis may be slow and could be inconclusive B: a comprehensive evaluation will result in an accurate diagnosis C: common disorder can be quickly diagnosed through blood tests D: diagnosis can be obtained promptly through most hospital laboratories - correct answer A: the diagnosis may be slow and could be inconclusive Even the best efforts at diagnosis do not always yield the information needed to counsel the patient. The process may require many visits over several weeks. Some tests must be sent to special laboratories, which take additional time. Despite a comprehensive evaluation, a diagnosis may never be established. At this time there are no rapid result blood tests available to diagnose genetic disorders. Some tests must be sent to a special laboratory, which requires a longer waiting period for results. A patient tells the nurse at a prenatal interview that she has quit smoking, and only has one glass of wine with dinner. Which response by the nurse will be most helpful in prompting 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." - correct answer D: "You have made some good progress toward having a healthy baby. Let's talk about the changes you have made." Praising her for making positive changes is an effective technique for motivating a patient. She still has risk factors to alter for optimal outcome, and a gentle maneuver to help her see these for herself will be most likely to succeed. Alcohol consumption is still a major risk factor and needs to be addressed in a positive, nonjudgmental manner. The statement, "You need to do a lot better" is belittling to the patient; she will be less likely to confide in the nurse. The nurse is not acknowledging the efforts that the patient has already accomplished by offering pamphlets; those accomplishments need to be praised to motivate the patient to continue.