Nokea
The nurse is assessing the knowledge of new parents with a child born with maple syrup urine disease (MSUD). This is an autosomal recessive inherited disorder, which means that:
- A. Both genes of a pair must be abnormal for the disorder to be expressed.
- B. Only one copy of the abnormal gene is required for the disorder to be expressed.
- C. The disorder occurs in males and heterozygous females.
- D. The disorder is carried on the X chromosome.
Correct Answer: A
Rationale: MSUD is a type of autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed.
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A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility?
- A. The patient works as a ballroom dance instructor.
- B. The patient is turning 37 years old this year.
- C. The patient has hot flashes and mood swings.
- D. The patient was treated for a pelvic inflammatory disease while in college.
Correct Answer: C
Rationale: The correct answer is C because hot flashes and mood swings can indicate hormonal imbalances, which are common causes of infertility. This symptom suggests potential issues with ovulation or other reproductive system functions. Choice A is irrelevant to infertility. Choice B, age alone does not indicate infertility. Choice D, a history of pelvic inflammatory disease can cause infertility, but symptoms indicating current hormonal imbalances are of more immediate concern.
With regard to chromosome abnormalities, nurses should be aware that:
- A. They 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 chromosome structure.
- D. Unbalanced translocation results in a mild abnormality that the child will outgrow.
Correct Answer: B
Rationale: Aneuploidy is an abnormality of number that also is the leading genetic cause of mental retardation.
At which point in the pregnancy can a woman first feel fetal movement (quickening)?
- A. 12 weeks
- B. 16 weeks
- C. 20 weeks
- D. 24 weeks
Correct Answer: C
Rationale: The correct answer is C (20 weeks) because quickening, the first perception of fetal movement by the mother, typically occurs around this time. At 20 weeks, the fetus is large enough for its movements to be noticeable to the mother. Before 20 weeks, the fetus is too small and the movements are not strong enough to be felt. Choices A, B, and D are incorrect because they are too early in the pregnancy for the mother to feel fetal movement. By 20 weeks, the fetus has developed enough for the mother to perceive its movements, making option C the correct answer.
Why do infants born at 25 weeks' gestation have a poor survival rate?
- A. Cardiac development is incomplete.
- B. Fetal lung alveoli are not present in sufficient numbers.
- C. Gastrointestinal development is incomplete.
- D. Sucking reflex is not present.
Correct Answer: B
Rationale: The correct answer is B because infants born at 25 weeks' gestation have a poor survival rate due to insufficient numbers of fetal lung alveoli. This leads to respiratory distress and difficulty in oxygen exchange, impacting their chances of survival. Choice A is incorrect as cardiac development is not the primary factor affecting survival. Choice C is incorrect as gastrointestinal development does not directly impact survival at this stage. Choice D is incorrect as the sucking reflex is not a critical factor in survival compared to respiratory function.
Fetal circulation includes 3 shunts. Match each shunt to its physiologic action. Ductus venosus
- A. Connects the pulmonary artery and the aorta, bypassing the lungs.
- B. Connects the right and left atria.
- C. Connects the right and left ventricles.
- D. Allows the umbilical vein to bypass the liver to flow into the inferior vena cava.
Correct Answer: D
Rationale: Ductus venosus allows the umbilical vein to bypass the liver.