Nokea
The nurse is reviewing a clients prenatal history. Which prescribed medication does the nurse understand is not considered a teratogen and prescribed during pregnancy?
- A. Phenytoin (Dilantin)
- B. Warfarin (Coumadin)
- C. Isotretinoin (Accutane)
- D. Heparin sodium (Heparin)
Correct Answer: D
Rationale: Teratogens, agents that cause birth defects when present in the prenatal environment, account for the majority of adverse intrauterine effects not attributable to genetic factors. Types of teratogens include drugs (phenytoin [Dilantin], warfarin [Coumadin], isotretinoin [Accutane]). Heparin is the anticoagulant used during pregnancy and is not a teratogen. It does not cross the placenta.
You may also like to solve these questions
Parents ask the nurse about the characteristics of autosomal recessive inheritance. Which is characteristic of autosomal recessive inheritance?
- A. Affected individuals have unaffected parents.
- B. Affected individuals have one affected parent.
- C. Affected parents have a 50% chance of having an affected child.
- D. Affected parents will have unaffected children.
Correct Answer: A
Rationale: Parents who are carriers of a recessive gene are asymptomatic. For a child to be affected, both parents must have a copy of the gene, which is passed to the child. Both parents are asymptomatic but can have affected children. In autosomal recessive inheritance, there is a 25% chance that each pregnancy will result in an affected child. In autosomal dominant inheritance, affected parents can have unaffected children.
Parents ask the nurse about the characteristics of autosomal dominant inheritance. Which statement is characteristic of autosomal dominant inheritance?
- A. Females are affected with greater frequency than males.
- B. Unaffected children of affected individuals will have affected children.
- C. Each child of a heterozygous affected parent has a 50% chance of being affected.
- D. Any child of two unaffected heterozygous parents has a 25% chance of being affected.
Correct Answer: C
Rationale: In autosomal dominant inheritance, only one copy of the mutant gene is necessary to cause the disorder. When a parent is affected, there is a 50% chance that the chromosome with the gene for the disorder will be contributed to each pregnancy. Males and females are equally affected. The disorder does not skip a generation. If the child is not affected, then most likely he or she is not a carrier of the gene for the disorder. In autosomal recessive inheritance, any child of two unaffected heterozygous parents has a 25% chance of being affected.
Which is characteristic of X-linked recessive inheritance?
- A. There are no carriers.
- B. Affected individuals are principally males.
- C. Affected individuals are principally females.
- D. Affected individuals will always have affected parents.
Correct Answer: B
Rationale: In X-linked recessive disorders, the affected individuals are usually male. With recessive traits, usually two copies of the gene are needed to produce the effect. Because the male only has one X chromosome, the effect is visible with only one copy of the gene. Females are usually only carriers of X-linked recessive disorders. The X chromosome that does not have the recessive gene will produce the normal protein, so the woman will not show evidence of the disorder. The transmission is from mother to son. Usually the mother and father are unaffected.
Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their childs cleft lip. Which statement should the nurse give as a response?
- A. This is a type of deformation and can sometimes be prevented.
- B. Studies show that taking folic acid during pregnancy can prevent this defect.
- C. This is a genetic disorder and has a 25% chance of happening with each pregnancy.
- D. The malformation occurs at approximately 5 weeks of gestation; there is no known way to prevent this.
Correct Answer: D
Rationale: Cleft lip, an example of a malformation, occurs at approximately 5 weeks of gestation when the developing embryo naturally has two clefts in the area. There is no known way to prevent this defect. Deformations are often caused by extrinsic mechanical forces on normally developing tissue. Club foot is an example of a deformation often caused by uterine constraint. Cleft lip is not a genetic disorder; the reasons for this occurring are still unknown. Taking folic acid during pregnancy can help to prevent neural tube disorders but not cleft lip defects.
The nurse is assessing a neonate who was born 1 hour ago to healthy white parents in their early forties. Which finding should be most suggestive of Down syndrome?
- A. Hypertonia
- B. Low-set ears
- C. Micrognathia
- D. Long, thin fingers and toes
Correct Answer: B
Rationale: Children with Down syndrome have low-set ears. Infants with Down syndrome have hypotonia, not hypertonia. Micrognathia is common in trisomy 16, not Down syndrome. Children with Down syndrome have short hands with broad fingers.