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In practical terms regarding genetic health care, nurses should be aware that:
- A. Genetic disorders affect people of all socioeconomic backgrounds, races, and ethnic groups equally.
- B. Genetic health care is more concerned with populations than individuals.
- C. The most important of all nursing functions is providing emotional support to the family during counseling.
- D. Taking genetic histories is the province of large universities and medical centers.
Correct Answer: C
Rationale: Nurses should be prepared to help with various stress reactions from a couple facing the possibility of a genetic disorder.
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The nurse would anticipate that a patient with elevated levels of which hormone would require radiologic imaging of the brain?
- A. TSH
- B. prolactin
- C. progesterone
- D. FSH
Correct Answer: B
Rationale: The correct answer is B: prolactin. Elevated prolactin levels can indicate a pituitary tumor, which may require brain imaging. TSH, progesterone, and FSH are not typically associated with the need for brain imaging. TSH is related to thyroid function, progesterone to the menstrual cycle, and FSH to reproductive health. Prolactin is the hormone primarily associated with lactation and can be elevated due to various reasons, including pituitary tumors. Therefore, in a patient with elevated prolactin levels, brain imaging is necessary to assess for the presence of a pituitary tumor.
A patient at 13 weeks gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother?
- A. Fetal waste products and CO2 pass through the placenta to the mother.
- B. The placenta is a special organ developed to create nutrients and oxygen.
- C. The mother’s blood and fetus’s blood mix for an exchange of nutrients.
- D. Glucose, amino acids, and oxygen pass through the placenta from mother to baby.
Correct Answer: D
Rationale: Step-by-step rationale for choice D being correct:
1. Glucose, amino acids, and oxygen are essential nutrients for fetal growth.
2. These nutrients pass through the placenta from the mother's blood to the baby's blood.
3. This exchange occurs via diffusion and active transport processes.
4. The placenta acts as a barrier, filtering out harmful substances like waste products and CO2.
5. This process ensures the baby receives necessary nutrients for development.
Summary of why other choices are incorrect:
A: Fetal waste products and CO2 pass from the baby to the mother, not the other way around.
B: The placenta facilitates nutrient and oxygen exchange but does not create them.
C: The mother's and baby's blood do not mix; exchange of nutrients occurs through the placental barrier.
After counseling with an obstetrician about infertility, a couple is advised to undergo testicular sperm aspiration. The nurse is aware that the procedure may be recommended for which infertility?
- A. Blocked fallopian tubes
- B. Unsuccessful vasectomy reversal
- C. Poor cervical mucus production
- D. Diminished sperm motility
Correct Answer: B
Rationale: Step 1: Testicular sperm aspiration is a procedure to retrieve sperm directly from the testicles.
Step 2: If a vasectomy reversal was unsuccessful, it means there is no sperm in the ejaculate due to the blocked vas deferens.
Step 3: Testicular sperm aspiration can be recommended in such cases to retrieve sperm for assisted reproductive techniques.
Summary:
A: Blocked fallopian tubes do not involve male infertility; they affect female fertility.
C: Poor cervical mucus production is a female factor, not male.
D: Diminished sperm motility may require other treatments, not testicular sperm aspiration.
A 27-year-old patient presents with injuries sustained in a motor vehicle accident. She was wearing her seatbelt and has multiple bruises and scrapes along her abdomen. She complains of pain 3/10 in her abdomen. She is G1P0 and is at 14 weeks’ gestation. A bedside ultrasound scan confirms that the fetus is stable and not in any distress. The patient is Rh negative, and her husband is Rh positive. What do you anticipate being the next step?
- A. Obtain a urinalysis.
- B. Administer Rh(D) immune globulin (RhoGAM).
- C. Confirm with the provider that she can be discharged home.
- D. Schedule a follow-up ultrasound.
Correct Answer: B
Rationale: The correct answer is B: Administer Rh(D) immune globulin (RhoGAM). In this scenario, the patient is Rh negative and her husband is Rh positive, which puts her at risk for Rh isoimmunization. Administration of Rh(D) immune globulin (RhoGAM) helps prevent the mother's immune system from developing antibodies against the Rh-positive fetus's blood, thereby protecting future pregnancies. This intervention is crucial in preventing hemolytic disease of the newborn.
Choice A: Obtaining a urinalysis is not indicated in this case as the patient's main concern is her abdominal pain and pregnancy status, not related to her urinalysis.
Choice C: Discharging the patient without administering Rh(D) immune globulin would be inappropriate as it puts future pregnancies at risk of complications due to Rh incompatibility.
Choice D: Scheduling a follow-up ultrasound is not the immediate next step. Administering Rh(D) immune globulin is the priority to
The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy?
- A. Determine whether termination is still a consideration.
- B. Explain they will experience grief, which is normal.
- C. Provide additional information about the disorder.
- D. Refer them to a disorder-specific support group.
Correct Answer: A
Rationale: The correct answer is A because it respects the couple's decision-making autonomy. The nurse should support their choice to continue the pregnancy without suggesting termination. Providing information, emotional support, and connecting them with a support group are appropriate actions. It is crucial to respect the couple's decision and provide compassionate care regardless of their choice. The other choices are incorrect because they may undermine the couple's autonomy and may not be aligned with their wishes.