Nokea
While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of:
- A. Trisomy numeric abnormality
- B. Multifactorial inheritance
- C. X-linked recessive inheritance
- D. Chromosomal deletion
Correct Answer: A
Rationale: Down syndrome is caused by trisomy 21, an extra chromosome 21, a numeric abnormality. Multifactorial inheritance involves genes and environment, X-linked affects males primarily, and deletions miss chromosome parts, none fitting Down syndrome.
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Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which response by the nurse would be most appropriate?
- A. I'm sorry you lost your baby.
- B. Why are you crying?
- C. Will a pill help your pain?
- D. A baby still wasn't formed in your womb.
Correct Answer: A
Rationale: Saying 'I'm sorry you lost your baby' acknowledges the client's emotional loss empathetically. Asking why she's crying invalidates her feelings, focusing on physical pain ignores emotional needs, and claiming the baby wasn't formed is inaccurate and insensitive, as miscarriage involves loss at any stage.
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 a cushion to help protect your baby from injury.
- B. The amount of fluid remains fairly constant throughout the pregnancy.
- C. The fluid is mostly protein to provide nourishment to your baby.
- D. This fluid acts as a transport mechanism for oxygen and nutrients.
Correct Answer: A
Rationale: Amniotic fluid cushions the fetus against injury, aiding movement and growth. Its volume varies (peaks at term), is mostly water (not protein), and doesn't transport oxygen or nutrients, which the placenta handles.
Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?
- A. Marijuana
- B. Cocaine
- C. Nicotine
- D. Caffeine
Correct Answer: B
Rationale: Cocaine causes tachycardia, hypertension, and vasoconstriction, risking placental abruption and fetal distress. Marijuana causes relaxation, nicotine raises heart rate but vasodilates, and caffeine mildly stimulates but doesn't constrict vessels.
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition?
- A. Maternal diabetes
- B. Fetal anencephaly
- C. Placental abruption
- D. Neural tube defects
Correct Answer: B
Rationale: Oligohydramnios (low amniotic fluid) is linked to fetal anencephaly, where absent brain development reduces fetal urine, a fluid source. Maternal diabetes causes polyhydramnios, abruption affects bleeding, and neural tube defects don't directly reduce fluid.
A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating:
- A. Hemoconcentration by hypertension
- B. A multiple gestation pregnancy
- C. Greater-than-expected weight gain
- D. Iron-deficiency anemia
Correct Answer: D
Rationale: A hemoglobin of 11 g/dL is low for the second trimester (10.5-14 g/dL), suggesting iron-deficiency anemia, especially with symptoms like fatigue. Hemoconcentration raises hemoglobin, multiple gestation lowers it slightly, and weight gain is unrelated.