MATERNITY PRACTICE EXAM 1
Questions & Answers
The nurse is teaching a couple about the pros and cons of genetic testing. Which
statement by
the nurse best describes the limits of genetic testing?
A. "Various genetic tests help the primary care provider 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: D
Rationale: The fact that some tests only provide a probability for developing a disorder
raises a problem. A serious limitation of these susceptibility tests is that some people
who carry a disease-associated mutation never develop the disease. Choosing
appropriate treatments,
avoiding having children with fatal diseases, and identifying those at high risk affirm the
value of genetic tests.
The nurse is counseling a couple who suspect that they could bear a child with a
genetic abnormality. What would be most important for the nurse to do when working
with this family?
A. Gather information for three generations.
B. Inform the family of the need for information.
C. Maintain the confidentiality of the information.
D. Present the information in a factual, nondirective manner. - Answer: D
Rationale: It is essential to respect client autonomy and present information in a factual,
nondirective manner. In these situations, the nurse needs to understand that the choice
is the couple's to make. Gathering information for three generations obtains a broad
overview of what
has been seen in both sides of the family. Maintaining confidentiality of the information
is as important as with any other client information gathered. Informing the family of the
need for
information is necessary because of its personal nature.
The nurse is teaching a couple about X-linked disorders because they are concerned
that they
might pass on hemophilia to their children. Which response 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 will have hemophilia." - Answer: B
Rationale: Males are more affected than females. A male has only one X chromosome,
and all the genes on his X chromosome will be expressed whereas a female will usually
,need both X chromosomes to carry the disease. There is no male-to-male transmission
(since no X chromosome from the male is transmitted to male offspring), but any man
who is affected will have carrier daughters. If a woman is a carrier, there is a 50%
chance that her sons will be affected and a 50% chance that her daughters will be
carriers.
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?
A. Down syndrome
B. sickle-cell anemia
C. cardiac defects
D. respiratory disorders - Answer: A
Rationale: Decreased levels might indicate Down syndrome or trisomy 18. Sickle cell
anemia may be identified by chorionic villus sampling. Levels would be increased with
cardiac defects, such as tetralogy of Fallot. It does not detect respiratory disorders.
The nurse is conducting a presentation for a young adult community group about fetal
development and pregnancy. The nurse determines that the teaching was successful
when the group identifies that the sex of offspring is determined at which time?
A. during meiosis cell division
B. at fertilization
C. when the morula forms
D. during oogenesis - Answer: B
Rationale: Sex determination occurs at the time of fertilization. Meiosis refers to cell
division resulting in the formation of an ovum or sperm with half the number of
chromosomes. The
morula develops after a series of four cleavages following the formation of the zygote.
Oogenesis refers to the development of a mature ovum, which has half the number of
chromosomes.
During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important,
but can you tell me more about it?" When describing amniotic fluid to a pregnant
woman, which description would the nurse most likely include?
A. "This fluid acts as transport mechanism for oxygen and nutrients."
B. "The fluid is mostly protein to provide nourishment to your baby."
C. "This fluid acts as a cushion to help to protect your baby from injury."
D. "The amount of fluid remains fairly constant throughout the pregnancy." - Answer: C
Rationale: Amniotic fluid protects the floating embryo and cushions the fetus from
trauma. The placenta acts as a transport mechanism for oxygen and nutrients. Amniotic
fluid is primarily water with some organic matter. Throughout pregnancy, amniotic fluid
volume fluctuates.
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert
for the
,development of which condition?
A. maternal diabetes
B. placental insufficiency
C. neural tube defects
D. fetal gastrointestinal malformations - Answer: B
Rationale: A deficiency of amniotic fluid, oligohydramnios, is associated with
uteroplacental insufficiency and fetal renal abnormalities. Excess amniotic fluid is
associated with maternal diabetes, neural tube defects, and malformations of the
gastrointestinal tract and central nervous system.
A couple comes to the clinic for preconception counseling and care. As part of the visit,
the
nurse teaches the couple about fertilization and initial development, stating that the
zygote
formed by the union of the ovum and sperm consists of how many chromosomes?
A. 22
B. 23
C. 44
D. 46 - Answer: D
Rationale: With fertilization, the ovum, containing 23 chromosomes, and the sperm,
containing 23 chromosomes, join, forming a zygote with a diploid number or 46
chromosomes.
After teaching a pregnant woman about the hormones produced by the placenta, the
nurse
determines that the teaching was successful when the woman identifies which hormone
produced
as being the basis for pregnancy tests?
A. human placental lactogen (hPL)
B. estrogen (estriol)
C. progesterone (progestin)
D. human chorionic gonadotropin (hCG) - Answer: D
Rationale: The placenta produces hCG, which is the basis for pregnancy tests. This
hormone preserves the corpus luteum and its progesterone production so that the
endometrial lining is maintained. Human placental lactogen modulates fetal and
maternal metabolism and participates
in the development of the breasts for lactation. Estrogen causes enlargement of the
woman's breasts, uterus, and external genitalia and stimulates myometrial contractility.
Progesterone maintains the endometrium.
When describing genetic disorders to a group of couples planning to have children, the
nurse
would identify which as an example of an autosomal dominant inheritance disorder?
A. Huntington disease
B. sickle cell disease
C. phenylketonuria
, D. cystic fibrosis - Answer: A
Rationale: Huntington disease is an example of an autosomal dominant inheritance
disorder. Sickle cell disease, phenylketonuria, and cystic fibrosis are examples of
autosomal recessive inheritance disorders.
Which mother is in the fetal stage of development?
A. a pregnant mother who is one week pregnant
B. a pregnant mother who is five weeks' pregnant
C. a pregnant mother who is seven weeks' pregnant
D. a pregnant mother who is thirty weeks' pregnant - Answer: D
Rationale: The fetal stage of development during pregnancy occurs at the end of the
eighth week
and continues through to birth. The mother at one week gestation is in the preembryonic
stage. The mothers at five weeks and seven weeks are in the embryonic stage.
Which event will result in zygote formation?
A. The nucleus of the ovum and sperm make contact and combine chromosomes.
B. The nucleus of the ovum carries forth the genetic information at implantation.
C. The nucleus of the sperm and the fallopian tube make contact and combines
chromosomes.
D. The nucleus of the sperm carries forth the genetic information at implantation. -
Answer: A
Rationale: When the nucleus from the ovum and the nucleus of the sperm make
contact, they lose their respective nuclear membranes and combine their maternal and
paternal chromosomes. Because each nucleus contains a haploid number of
chromosomes (23), this union restores the diploid number (46). The resulting zygote
begins the process of a new life.
When describing gender determination at a prenatal class, the nurse would include
which
statement?
A. "Gender is determined when the primary oocyte completes its first mitotic division."
B. "Gender is determined when the sperm and the oocyte undergo the process of
mitosis."
C. "Gender is determined when the ovum and the spermatozoon undergo the process
of meiosis."
D. "Gender is determined at fertilization when the ovum is fertilized." - Answer: D
Rationale: Gender is determined at fertilization and depends on whether the ovum is
fertilized by a Y-bearing sperm or an X-bearing sperm. Approximately half of sperm
carry the XX chromosome, and the other half carries XY. An XX zygote will become a
female, and an XY zygote will become a male. X- and Y-bearing sperm determine the
gender.
During a prenatal class, the nurse is describing what happens when the ovum is
fertilized by the sperm. Which statement would the nurse most likely include?
A. The zygote is transported into the uterine cavity.
Questions & Answers
The nurse is teaching a couple about the pros and cons of genetic testing. Which
statement by
the nurse best describes the limits of genetic testing?
A. "Various genetic tests help the primary care provider 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: D
Rationale: The fact that some tests only provide a probability for developing a disorder
raises a problem. A serious limitation of these susceptibility tests is that some people
who carry a disease-associated mutation never develop the disease. Choosing
appropriate treatments,
avoiding having children with fatal diseases, and identifying those at high risk affirm the
value of genetic tests.
The nurse is counseling a couple who suspect that they could bear a child with a
genetic abnormality. What would be most important for the nurse to do when working
with this family?
A. Gather information for three generations.
B. Inform the family of the need for information.
C. Maintain the confidentiality of the information.
D. Present the information in a factual, nondirective manner. - Answer: D
Rationale: It is essential to respect client autonomy and present information in a factual,
nondirective manner. In these situations, the nurse needs to understand that the choice
is the couple's to make. Gathering information for three generations obtains a broad
overview of what
has been seen in both sides of the family. Maintaining confidentiality of the information
is as important as with any other client information gathered. Informing the family of the
need for
information is necessary because of its personal nature.
The nurse is teaching a couple about X-linked disorders because they are concerned
that they
might pass on hemophilia to their children. Which response 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 will have hemophilia." - Answer: B
Rationale: Males are more affected than females. A male has only one X chromosome,
and all the genes on his X chromosome will be expressed whereas a female will usually
,need both X chromosomes to carry the disease. There is no male-to-male transmission
(since no X chromosome from the male is transmitted to male offspring), but any man
who is affected will have carrier daughters. If a woman is a carrier, there is a 50%
chance that her sons will be affected and a 50% chance that her daughters will be
carriers.
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?
A. Down syndrome
B. sickle-cell anemia
C. cardiac defects
D. respiratory disorders - Answer: A
Rationale: Decreased levels might indicate Down syndrome or trisomy 18. Sickle cell
anemia may be identified by chorionic villus sampling. Levels would be increased with
cardiac defects, such as tetralogy of Fallot. It does not detect respiratory disorders.
The nurse is conducting a presentation for a young adult community group about fetal
development and pregnancy. The nurse determines that the teaching was successful
when the group identifies that the sex of offspring is determined at which time?
A. during meiosis cell division
B. at fertilization
C. when the morula forms
D. during oogenesis - Answer: B
Rationale: Sex determination occurs at the time of fertilization. Meiosis refers to cell
division resulting in the formation of an ovum or sperm with half the number of
chromosomes. The
morula develops after a series of four cleavages following the formation of the zygote.
Oogenesis refers to the development of a mature ovum, which has half the number of
chromosomes.
During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important,
but can you tell me more about it?" When describing amniotic fluid to a pregnant
woman, which description would the nurse most likely include?
A. "This fluid acts as transport mechanism for oxygen and nutrients."
B. "The fluid is mostly protein to provide nourishment to your baby."
C. "This fluid acts as a cushion to help to protect your baby from injury."
D. "The amount of fluid remains fairly constant throughout the pregnancy." - Answer: C
Rationale: Amniotic fluid protects the floating embryo and cushions the fetus from
trauma. The placenta acts as a transport mechanism for oxygen and nutrients. Amniotic
fluid is primarily water with some organic matter. Throughout pregnancy, amniotic fluid
volume fluctuates.
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert
for the
,development of which condition?
A. maternal diabetes
B. placental insufficiency
C. neural tube defects
D. fetal gastrointestinal malformations - Answer: B
Rationale: A deficiency of amniotic fluid, oligohydramnios, is associated with
uteroplacental insufficiency and fetal renal abnormalities. Excess amniotic fluid is
associated with maternal diabetes, neural tube defects, and malformations of the
gastrointestinal tract and central nervous system.
A couple comes to the clinic for preconception counseling and care. As part of the visit,
the
nurse teaches the couple about fertilization and initial development, stating that the
zygote
formed by the union of the ovum and sperm consists of how many chromosomes?
A. 22
B. 23
C. 44
D. 46 - Answer: D
Rationale: With fertilization, the ovum, containing 23 chromosomes, and the sperm,
containing 23 chromosomes, join, forming a zygote with a diploid number or 46
chromosomes.
After teaching a pregnant woman about the hormones produced by the placenta, the
nurse
determines that the teaching was successful when the woman identifies which hormone
produced
as being the basis for pregnancy tests?
A. human placental lactogen (hPL)
B. estrogen (estriol)
C. progesterone (progestin)
D. human chorionic gonadotropin (hCG) - Answer: D
Rationale: The placenta produces hCG, which is the basis for pregnancy tests. This
hormone preserves the corpus luteum and its progesterone production so that the
endometrial lining is maintained. Human placental lactogen modulates fetal and
maternal metabolism and participates
in the development of the breasts for lactation. Estrogen causes enlargement of the
woman's breasts, uterus, and external genitalia and stimulates myometrial contractility.
Progesterone maintains the endometrium.
When describing genetic disorders to a group of couples planning to have children, the
nurse
would identify which as an example of an autosomal dominant inheritance disorder?
A. Huntington disease
B. sickle cell disease
C. phenylketonuria
, D. cystic fibrosis - Answer: A
Rationale: Huntington disease is an example of an autosomal dominant inheritance
disorder. Sickle cell disease, phenylketonuria, and cystic fibrosis are examples of
autosomal recessive inheritance disorders.
Which mother is in the fetal stage of development?
A. a pregnant mother who is one week pregnant
B. a pregnant mother who is five weeks' pregnant
C. a pregnant mother who is seven weeks' pregnant
D. a pregnant mother who is thirty weeks' pregnant - Answer: D
Rationale: The fetal stage of development during pregnancy occurs at the end of the
eighth week
and continues through to birth. The mother at one week gestation is in the preembryonic
stage. The mothers at five weeks and seven weeks are in the embryonic stage.
Which event will result in zygote formation?
A. The nucleus of the ovum and sperm make contact and combine chromosomes.
B. The nucleus of the ovum carries forth the genetic information at implantation.
C. The nucleus of the sperm and the fallopian tube make contact and combines
chromosomes.
D. The nucleus of the sperm carries forth the genetic information at implantation. -
Answer: A
Rationale: When the nucleus from the ovum and the nucleus of the sperm make
contact, they lose their respective nuclear membranes and combine their maternal and
paternal chromosomes. Because each nucleus contains a haploid number of
chromosomes (23), this union restores the diploid number (46). The resulting zygote
begins the process of a new life.
When describing gender determination at a prenatal class, the nurse would include
which
statement?
A. "Gender is determined when the primary oocyte completes its first mitotic division."
B. "Gender is determined when the sperm and the oocyte undergo the process of
mitosis."
C. "Gender is determined when the ovum and the spermatozoon undergo the process
of meiosis."
D. "Gender is determined at fertilization when the ovum is fertilized." - Answer: D
Rationale: Gender is determined at fertilization and depends on whether the ovum is
fertilized by a Y-bearing sperm or an X-bearing sperm. Approximately half of sperm
carry the XX chromosome, and the other half carries XY. An XX zygote will become a
female, and an XY zygote will become a male. X- and Y-bearing sperm determine the
gender.
During a prenatal class, the nurse is describing what happens when the ovum is
fertilized by the sperm. Which statement would the nurse most likely include?
A. The zygote is transported into the uterine cavity.
