Contemporary Maternal Newborn Nursing, 9th Edition By Ladewig – Test Bank

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Contemporary Maternal Newborn Nursing, 9th Edition By Ladewig – Test Bank

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Contemporary Maternal-Newborn Nursing, 9e (Ladewig et al.)

Chapter 2   Family, Culture, and Complementary Health Approaches

 

1) While conducting a family assessment, the nurse determines that a particular family’s structure is binuclear. Some potential challenges inherently faced by binuclear families include:

1. Challenges related to coparenting and joint custody, including negotiation and compromise between the parents about childrearing decisions.
2. Issues related to both parents being employed, including child care, household chores, and spending time together.
3. Challenges related to children interacting with peers and when revealing their parents sexual orientation.
4. Issues related to single parenting, including lack of social and emotional support, need for assistance with childrearing, and financial strain.

Answer:  1

Explanation:  1. Because both parents have equal responsibility and legal rights regarding their biologic child, binuclear families may inherently face challenges related to coparenting and joint custody, including negotiation and compromise between the parents about childrearing decisions.

2. Issues inherently faced by the dual-career/dual-earner family include child care, household chores, and spending time together.
3. Children raised in gay and lesbian families may face challenges related to interacting with peers and when revealing their parents sexual orientation.
4. Binuclear families incorporate coparenting, whereas with single parenting, one parent is responsible for child care. Issues inherently related to single parenting may include lack of social and emotional support, need for assistance with childrearing, and financial strain.

Page Ref: 13

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 2.1-Describe how family type may influence nursing care of the childbearing family.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

2) The nurse is preparing a community presentation on family development. Which of the following statements should the nurse include?

1. The youngest child’s age determines the family’s current stage.
2. A family does not experience overlapping of stages.
3. Family development ends when the youngest child leaves home.
4. The stages describe the family’s progression over time.

Answer:  4

Explanation:  1. The oldest child’s age is the marker for which stage the family is in, except for the two last stages, which occur after the children have left home.

2. Families with more than one child can experience multiple stages simultaneously.
3. Families with more than one child can experience multiple stages simultaneously.
4. Family development stages describe the changes and adaptations that a family goes through over time as children are added to the family.

Page Ref: 14

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Spirit of inquiry | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 2.2-Explain the changes that a childbearing family will undergo based on the developmental tasks to be completed.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

3) The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that the primary use of a family assessment tool is to:

1. Obtain a comprehensive medical history of family members.
2. Determine which clinic the client should be referred to.
3. Predict how a family will likely change with the addition of children.
4. Understand the physical, emotional, and spiritual needs of members.

Answer:  4

Explanation:  1. The focus of a family assessment is the family as one entity. Health of the family is one area that is explored using a family assessment tool.

2. The family assessment tool facilitates understanding of the physical, emotional, and spiritual needs of members. Although referrals might take place as a result of the family assessment findings, understanding of the family is the primary reason the tool is used.
3. The family assessment tool facilitates understanding of the physical, emotional, and spiritual needs of members. Family development models help predict how a family will likely change with the addition of children.
4. The family assessment tool facilitates understanding of the physical, emotional, and spiritual needs of members. Although referrals might take place as a result of the family assessment findings, understanding of the family is the primary reason the tool is used.

Page Ref: 14

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 2.3-Identify information that would be useful to collect when performing a family assessment.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

4) A nurse is caring for a Muslim client who is pregnant. She is anticipating delivery within the next few days. The nurse asks if she and her husband have chosen a name for their baby. The patient quietly shakes her head, “no.” Based upon the patient’s response, the nurse understands that:

1. The client is not happily anticipating the arrival of her baby.
2. Cultural beliefs may require the couple to choose the baby’s name following the birth.
3. The client does not speak English.
4. Cultural beliefs may require that the baby’s name be kept secret until after the delivery.

Answer:  2

Explanation:  1. There is no evidence to support that the client is not happily anticipating her baby’s arrival.

2. In the Muslim culture, it is common to avoid naming the baby until after the baby is born.
3. The client has been conversing with the nurse; no prior interaction suggested a language barrier.
4. Rather than keeping the baby’s name secret, in the Muslim culture, it is common to avoid naming until the baby is born.

Page Ref: 16, 17

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Evaluation/Communication

Learning Outcome:  LO 2.4-Integrate the prevalent cultural norms that affect childbearing and childrearing when providing care to that family.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

5) A woman of Korean descent has just given birth to a son. Her partner wishes to give her sips of hot broth from a thermos that he brought from home. The client has refused your offer of ice chips or other cold drinks. The nurse should:

1. Explain to the client that she can have the broth if she will also drink cold water or juice.
2. Encourage the partner to feed the client sips of broth. Ask if the client would like you to bring her some warm water to drink as well.
3. Explain to the couple that food cant be brought from home but that the nurse will make hot broth for the client.
4. Encourage the client to have the broth after the nurse takes it to the kitchen and boils it first.

Answer:  2

Explanation:  1. Explaining to the client that she can have broth if she will drink cold water or juice first does not show cultural sensitivity and does not respect the client’s beliefs.

2. Encouraging the partner to feed the client sips of broth and asking if the client would like you to bring her some warm water to drink as well is an approach that shows cultural sensitivity. The equilibrium model of health, based on the concept of balance between light and dark, heat and cold, is the foundation for this belief and practice.
3. Explaining to the couple that the hospital does not allow food brought from home but that you will make hot broth for them is an incorrect response.
4. Encouraging the client to have broth after you take it the kitchen and boil it first is an incorrect response because boiling first would make the broth too hot to drink.

Page Ref: 15, 16

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care

Learning Outcome:  LO 2.4-Integrate the prevalent cultural norms that affect childbearing and childrearing when providing care to that family.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

6) The nurse works in a facility that cares for clients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation for nurses new to the facility on the client population of the facility?

1. “Our clients come from a broad range of backgrounds, but we have a good interpreter service.”
2. “Many of our clients come from backgrounds different from your own, but it doesn’t cause problems for the nurses.”
3. “Because most of the doctors are bilingual, we don’t have to deal with the differences in cultural backgrounds of our clients.”
4. “Understanding the common values and health practices of our diverse clients will facilitate better care and health outcomes.”

Answer:  4

Explanation:  1. The role of a foreign language interpreter is to facilitate communication. The interpreter might or might not be able to interpret the cultural practices of patients. An example is a Spanish interpreter: The interpreter might be from Spain but interprets language for patients from Guatemala and Nicaragua, countries about which the interpreter might know virtually nothing.

2. Racial, ethnic, cultural, and religious backgrounds of clients have significant implications for how they perceive health, illness, and health care. It is important for nurses to understand the backgrounds of the client population that attend that facility.
3. Bilingual physicians, like all physicians, have very busy schedules and often do not understand nursing care. It is the responsibility of the nurse to become familiar with the backgrounds of the client population.
4. Because of the implications for care based on cultural background, it is important for nurses to understand the backgrounds of the client population that attend the facility.

Page Ref: 17

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care

Learning Outcome:  LO 2.5-Explain the importance of cultural competency in providing nursing care to the childbearing family.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

7) The nurse manager in a hospital with a large immigrant population is planning an in-service. The nurse manager is aware of how ethnocentrism affects nursing care. Which statement should the nurse manager include? “The belief that ones own values and beliefs are the only or the best values:

1. “Strangers to the United States should adopt U.S. norms and values.”
2. “Can create barriers to communication through misunderstanding.”
3. “Leads to an expectation that patients will exhibit pain the same way.”
4. “Improves the quality of care provided to culturally diverse patient bases.”

Answer:  2

Explanation:  1. Although acculturation involves adoption of some of the majority cultures practices and beliefs, each cultural group will continue to hold and express its own set of values and beliefs.

2. Ethnocentrism is the conviction that ones own values and beliefs either are the only ones that exist or are the best. When the nurse assumes that a client has the same values and beliefs as the nurse, misunderstanding will frequently occur, which in turn can negatively impact nurse client communication.
3. Expression of pain is one area that varies greatly from one culture to another.
4. The belief that ones own values and beliefs are the best will not improve the quality of care provided to culturally diverse client bases.

Page Ref: 17

Cognitive Level:  Application

Client Need&Sub:  Psychosocial Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 2.5-Explain the importance of cultural competency in providing nursing care to the childbearing family.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

8) When preparing to teach a culturally diverse group of childbearing families about hospital birthing options, in order to be culturally competent, the nurse should:

1. Understand that the families have the same values as the nurse.
2. Teach the families how childbearing takes place in the United States.
3. Insist that the clients answer questions instead of their husbands.
4. Learn about the cultural groups that are likely to attend the class.

Answer:  4

Explanation:  1. Assuming that the families have the same values is ethnocentrism.

2. Although it is important to explain health care during pregnancy and childbearing, this is not the top priority.
3. The husbands answering questions might be a cultural norm, and insisting that the patient answer could decrease the family’s trust in the healthcare system.
4. Cultural competence is the development of skills and knowledge necessary to appreciate, understand, and work with individuals from other cultures than the culture of the nurse. Through gaining knowledge of the cultures that are likely to be encountered professionally, the nurse is able to understand the aspects of the client’s culture that might impact how care should best be given to be accepted by the client.

Page Ref: 15

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 2.5-Explain the importance of cultural competency in providing nursing care to the childbearing family.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

9) A nurse is admitting a Mexican woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which question would be most important for the nurse to ask?

1. “What other treatments have you used for your abdominal pain?”
2. “What is your country of origin; where were you were born?”
3. “When you talk to family members, how close do you stand?”
4. “How would you describe your role within your family?”

Answer:  1

Explanation:  1. This question is most important because some traditional or folk remedies include the use of herbs. Because some herbs have medication interactions, this physiologic question is imperative to ask.

2. Although this information is helpful, it is not a physiological issue. Asking about other treatments is a higher priority.
3. Although understanding the client’s perception of appropriate personal space is helpful, it is not a physiological issue. Asking about other treatments is a higher priority.
4. Although understanding the client’s family roles is helpful, it is not a physiological issue. Asking about other treatments is a higher priority.

Page Ref: 17

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care

Learning Outcome:  LO 2.6-Interpret the information collected from a cultural assessment to provide culturally sensitive care.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

10) The labor and delivery nurse is caring for a laboring client who has asked for a priest to visit her during labor. The client’s mother died during childbirth, and although there are no complications during the client’s pregnancy, she is fearful of her own death during labor. What is the best response of the nurse?

1. “Nothing is going to happen to you. Well take very good care of you during your birth.”
2. “Would you like to have an epidural so that you wont feel the pain of the contractions?”
3. “The priest wont be able to prevent complications and might get in the way of your providers.”
4. “Would you like me to contact your parish or our hospital chaplain to come see you?”

Answer:  4

Explanation:  1. Avoid statements of false reassurance, as there are no guarantees in the outcomes during health care. Using these statements shuts down effective communication, as the client’s concern is downplayed.

2. The patients expressed concern is not about pain; it is a fear of death and a desire to see a priest. Address the patients concerns directly.
3. Although this statement is true, it is not therapeutic. It downplays the client’s concerns and will shut down effective communication. Address the concerns the patient expresses.
4. When the client states she wants to see a priest, the nurse should attempt to make arrangements for this visit to occur in a timely manner. Most hospitals have a chaplaincy department that can provide assistance in obtaining the services of a wide variety of religious leaders. Depending on the day of the week and the time of day, the patients own home parish church might be able to provide a priest for pastoral care at the bedside.

Page Ref: 17

Cognitive Level:  Application

Client Need&Sub:  Psychosocial Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care

Learning Outcome:  LO 2.7-Identify ways a nurse might accommodate the religious rituals and practices of the childbearing family.

MNL LO:  Recognize maternal cultural and spiritual factors that affect pregnancy.

 

11) A pregnant client reports experiencing occasional gastroesophageal reflux. She explains that she relieves her symptoms through acupressure treatments, as well as by taking an over-the-counter medication recommended by her obstetrician. The nurse recognizes acupressure to be a form of:

1. Homeopathy.
2. Alternative therapy.
3. Biofeedback.
4. Complementary therapy.

Answer:  4

Explanation:  1. Homeopathy entails using diluted amounts of substances that, if ingested in larger amounts, would produce effects similar to the symptoms of the disorder being treated.

2. Alternative therapy involves the use of a procedure or substance in place of conventional medicine.
3. Biofeedback control pertains to using the mind to control physiologic responses based on the concept that the mind controls the body.
4. Complementary therapy incorporates the use of a procedure or product as an adjunct to conventional medical treatment.

Page Ref: 17, 18

Cognitive Level:  Comprehension

Client Need&Sub:  Physiological Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Coordination of care

Learning Outcome:  LO 2.8-Distinguish between complementary and alternative therapies.

MNL LO:  Recognize common discomforts of pregnancy and measures that can provide relief.

 

 

12) A client reports using “homeopathic remedies” to ease her back pain. In order to more fully explore the client’s use of complementary and alternative medicine (CAM), the nurse should ask:

1. “Will you tell me more about the homeopathic remedies you’re using?”
2. “Are you aware that some complementary and alternative therapies can be dangerous?”
3. “Does your physician approve of your use of homeopathic remedies?”
4. “Have you prioritized your need for comfort above your concern for your baby’s health?”

Answer:  1

Explanation:  1. The nurse should ask direct, nonjudgmental questions when seeking to gain information about a patient’s use of CAM.

2. While tactful warnings regarding the use of CAM may be appropriate, the nurse should first explore the patient’s use of CAM in a nonjudgmental manner.
3. Clients may be reluctant to discuss their use of CAM with their healthcare providers; the nurse should explore the topic using nonjudgmental language.
4. Additional information is needed in order to evaluate the client’s use of CAM, and the topic should be approached without use of disparaging comments.

Page Ref: 18

Cognitive Level:  Application

Client Need&Sub:  Physiological Integrity | Basic Care and Comfort

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care

Learning Outcome:  LO 2.8-Distinguish between complementary and alternative therapies.

MNL LO:  Recognize common discomforts of pregnancy and measures that can provide relief.

 

13) The client pregnant with her first child reports that her husband wants her to visit a homeopath for help with her nausea and vomiting. The client asks what the nurse’s opinion of homeopathy is. The best response by the nurse is:

1. “Homeopathy is unproven and potentially dangerous. Avoid using homeopathic remedies.”
2. “The FDA has approved homeopathic remedies, and practitioners undergo education and certification.”
3. “I cant give you advice about what alternatives to try. Go online and do some research to get information.”
4. “Homeopathy is the same as herbal remedies. Some are safe during pregnancy and some are not.”

Answer:  2

Explanation:  1. Homeopathic remedies are not dangerous. Homeopathic remedies are FDA-approved and have been proven to be effective in treating a wide range of chronic and acute illnesses and conditions.

2. Homeopathic remedies are FDA-approved and have been proven to be effective in treating a wide range of chronic and acute illnesses and conditions.
3. It is appropriate for the nurse to provide factual information to educate a client who has asked a question. Not all clients have access to computers, nor do they know how to do an internet search.
4. Herbalism and homeopathy are not the same. Herbs are available in many stores and preparations; some have been proven to be dangerous during pregnancy. Homeopathy is a system of “like curing like,” in which the symptom being treated would be a symptom of taking too much of the substance in a non-homeopathic form.

Page Ref: 18

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care

Learning Outcome:  LO 2.9-Describe the benefits and risks of the various complementary and alternative therapies to the childbearing family.

MNL LO:  Recognize common discomforts of pregnancy and measures that can provide relief.

 

 

14) Complementary and alternative therapies have many benefits for the childbearing family and others. However, many of these remedies have associated risks. Which of the following situations would be considered risks? Select all that apply.

1. Getting a massage from a licensed massage therapist for back pain, prescribed by the primary caregiver
2. Sampling a homeopathic medicine from a friend to reduce swelling in the legs
3. Getting a chiropractic treatment for low back pain due to discomforts of pregnancy without telling the primary health care provider
4. Taking an herbal preparation suggested by a health food store worker for treatment of leg pain
5. Joining a group that practices tai chi weekly to help with physical fitness and movement

Answer:  2, 3, 4

Explanation:  1. Getting a massage from a licensed massage therapist for back pain, prescribed by the primary caregiver, is a perfectly good use of complementary therapies.

2. Trying out a homeopathic medicine from a friend to reduce swelling in your legs is a risk factor when considering these therapies. Lack of standardization, lack of regulation and research to substantiate their safety and effectiveness, and inadequate training and certification of some healers make some therapies risky.
3. Getting a chiropractic treatment for low back pain due to discomforts of pregnancy without telling the primary health care provider is a risk factor when considering these therapies. Lack of standardization, lack of regulation and research to substantiate their safety and effectiveness, and inadequate training and certification of some healers make some therapies risky.
4. Taking an herbal preparation suggested by a health food store worker for treatment of leg pain is a risk factor when considering these therapies. Lack of standardization, lack of regulation and research to substantiate their safety and effectiveness, and inadequate training and certification of some healers make some therapies risky.
5. Joining a group that practices tai chi weekly to help with physical fitness and movement is a perfectly good use of complementary therapies.

Page Ref: 18

Cognitive Level:  Application

Client Need&Sub:  Safe and Effective Care Environment | Management of Care

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Coordination of care

Learning Outcome:  LO 2.9-Describe the benefits and risks of the various complementary and alternative therapies to the childbearing family.

MNL LO:  Recognize common discomforts of pregnancy and measures that can provide relief.

 

 

15) The labor and delivery unit nurse manager is incorporating complementary and alternative therapies into the units policies and procedures. Which statement should the nurse manager include during an in-service educational presentation for the nursing staff?

1. “Policies have been developed for using massage and aromatherapy.”
2. “When clients ask questions you don’t know, tell them to look online.”
3. “Because herbs are dangerous during pregnancy, we will not use them.”
4. “Be sure to ask clients what alternative therapies they have used.”

Answer:  1

Explanation:  1. The development of written policies and procedures facilitates safe nursing practice, which in turn promotes client safety.

2. Online information can vary in its accuracy. Reputable sources (electronic or print) should be recommended for further client education.
3. This statement is false. Many herbs can be safely used during pregnancy.
4. What the client has used in the past does not predict what she is open to using at present. It is more important to develop written policies and procedures.

Page Ref: 19, 20

Cognitive Level:  Application

Client Need&Sub:  Physiological Integrity | Basic Care and Comfort

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential V: Healthcare policy, finance, and regulatory environments | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care

Learning Outcome:  LO 2.10-Formulate nursing care within the nurse practice act and with the informed consent of the client when using appropriate complementary therapies with childbearing families.

MNL LO:  Recognize common discomforts of pregnancy and measures that can provide relief.

 

16) A nurse is discussing the 8 stages of the family cycle with the parents of a 12-year-old child. Which stages should the nurse discuss first? Select all that apply.

1. Readjustment of the marital relationship, parent/child establishment of separate identities outside of family
2. Facilitating peer relationships while maintaining family dynamics
3. Marriage between partners, identification as part of family, establishment of goals for future, interaction and building relationship
4. Increase in child’s independence, parents concentrate on shift to aging parent careers and marital relationship
5. Established family network, socialization of child, reinforce independence in child when apart from parents

Answer:  2, 4

Explanation:  1. The nurse would explain the stage the family is in and the next stage the family will be going into.

2. The nurse would explain the stage the family is in and the next stage the family will be going into.
3. The nurse would explain the stage the family is in and the next stage the family will be going into.
4. The nurse would explain the stage the family is in and the next stage the family will be going into.
5. The nurse would explain the stage the family is in and the next stage the family will be going into.

Page Ref: 14

Cognitive Level:  Application

Client Need&Sub:  Physiological Integrity | Basic Care and Comfort

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care

Learning Outcome:  LO 2.10-Formulate nursing care within the nurse practice act and with the informed consent of the client when using appropriate complementary therapies with childbearing families.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

 

17) The nurse is discussing culture with the Japanese family and practices to which they subscribe. Which examples clearly define acculturation? Select all that apply.

1. A first generation Italian lives in an Italian community in the United States and follows Italian traditions and values, continues to speak Italian.
2. A 65-year-old was born and raised in Pennsylvania, moved to Georgia at the age of 40, has a change in pronunciation and customs.
3. A Native American from the reservation goes to Phoenix to live and go to school. The Native American goes home on the weekends to help the family with chores, when sick goes home for traditional healing.
4. The granddaughter of a Chinese immigrant has lived in the United States all of her life including college. She spends most of her time with American friends, dresses as they do and appreciates their values and interests.
5. A young couple were raised and grew up in Mexico, decided to move to the United States. They attend school, acquire professional jobs and eventually start a family. They learn English and speak English when speaking to their children, and follow the holidays of the United States.

Answer:  2, 4, 5

Explanation:  1. Italian, living in an Italian community and follows Italian traditions and values, speaks Italian this does not define acculturation.

2. Pennsylvanian, moved to Georgia, has changed pronunciation and customs, this is an example of acculturation.
3. Native American, moves away from reservation, goes home frequently to help family, when sick goes home for traditional healing, this does not define acculturation.
4. Relative of Chinese immigrant, spends most of time with American friends, dresses like Americans and values their interests, this is an example of acculturation.
5. Mexican immigrants, attend school in U.S., have professional jobs in U.S., learn and speak English language at home and with children, follow U.S. holidays, this is an example of acculturation.

Page Ref: 15

Cognitive Level:  Application

Client Need&Sub:  Psychosocial Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VIII: Professionalism and professional values | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 2.10-Formulate nursing care within the nurse practice act and with the informed consent of the client when using appropriate complementary therapies with childbearing families.

MNL LO:  Relate the effect of culture and family to the childbearing experience.

 

Chapter 4   Conception and Fetal Development

 

1) The nurse is explaining the difference between meiosis and mitosis. Which statement does the nurse include? Select all that apply.

1. Meiosis is the division of a cell into two exact copies of the original cell.
2. Mitosis is the splitting of one cell into two, each with half the chromosomes of the original cell.
3. Meiosis is the process by which gametes, or the sperm and ova, are formed.
4. Mitosis occurs in most of the cells of the body.
5. Meiotic division leads to cells that halve the original genetic material.

Answer:  3, 5

Explanation:  1. Meiosis creates two cells that have half of the chromosomes of the original cell.

2. Mitosis creates two cells that are exact copies of the original cell.
3. Both sperm and ova are created through meiosis.
4. Mitosis is how the majority of cells reproduce so that the new cells have the same structure and function as the original. Meiosis only occurs in gametes.
5. Meiosis creates two cells that have half of the chromosomes of the original cell.

Page Ref: 42, 43

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential I: Liberal education for Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 4.1-Differentiate between meiotic cellular division and mitotic cellular division.

MNL LO:  Analyze the components of the fertilization process.

 

2) The nurse has completed a presentation on reproduction. Which participants statement indicates that the teaching has been successful?

1. “A male is born with all the sperm he will ever produce.”
2. “Females create new ova throughout their reproductive life.”
3. “Ova separate into two unequally sized cells.”
4. “Each primary spermatocyte divides into four haploid cells.”

Answer:  3

Explanation:  1. Males begin spermatogenesis at puberty and continue throughout their life. Each sperm divides into four haploid cells.

2. Females are born with all the ova they will ever produce. The ova begin to be formed in early fetal life. One ovum is released each month during the reproductive life of a female, from menarche to menopause.
3. Each ovum undergoes meiotic division just prior to being released from the graafian follicle. Each cell created by this meiosis has the same number of chromosomes, but the cytoplasm does not split equally. This causes a polar body to be produced along with a secondary oocyte.
4. Primary spermatocytes contain 46 chromosomes (46XY). Each primary spermatocyte undergoes meiotic division into two haploid secondary spermatocytes (22X or 22Y). Haploid cells each contain half of the genetic material of the original cell. Then each secondary spermatocyte undergoes a second meiotic division into two haploid spermatids (remaining either 22X or 22Y.) Spermatids mature into spermatozoa. Thus, a primary spermatocyte eventually becomes four haploid spermatozoa.

Page Ref: 43, 44

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 4.2-Compare the processes by which ova and sperm are produced.

MNL LO:  Analyze the components of the fertilization process.

 

3) After teaching a class about the female reproductive system, the nurse asks the attendees to describe the process of meiosis. Which student response suggests successful comprehension of the material?

1. “Completion of the second meiotic division results in formation of three polar bodies and one ovum.”
2. “At the time of ovulation, the first meiotic division begins.”
3. “Completion of the first meiotic division produces three polar bodies and one primary oocyte.”
4. “At the time of puberty, the second meiotic division begins.”

Answer:  1

Explanation:  1. Completion of the second meiotic division produces three polar bodies and one ovum.

2. The first meiotic division of oocytes begins before the female fetus is born.
3. Completion of the first meiotic division produces one polar body and one secondary oocyte.
4. The second meiotic division begins at the time of ovulation.

Page Ref: 43

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 4.2-Compare the processes by which ova and sperm are produced.

MNL LO:  Analyze the components of the fertilization process.

 

 

4) You are counseling a young woman regarding contraception. When asked if she currently uses any form of contraception, she replies, “I can’t get pregnant because I don’t have intercourse on the day I ovulate.” Based upon her response, what information should you include in your teaching?

1. Refrain from intercourse on the day of ovulation will effectively prevent pregnancy.
2. Sperm are believed to be healthy and highly fertile for at least five days.
3. After ovulation, ova are considered fertile for about 72 to 96 hours.
4. Sperm survive 48 to 72 hours in the female reproductive tract.

Answer:  4

Explanation:  1. Because sperm survive 48 to 72 hours in the female reproductive tract, avoidance of intercourse for 24 hours will not reliably prevent pregnancy from occurring.

2. Sperm are believed to be most fertile for the first 24 hours following entry into the female reproductive tract.
3. Ova are considered fertile for about 12 to 24 hours after ovulation.
4. Sperm survive 48 to 72 hours in the female reproductive tract.

Page Ref: 44, 45

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 4.3-Analyze the components of the fertilization process and how each may impact fertilization.

MNL LO:  Compare advantages, disadvantages, risk factors, and contraindications of contraception methods.

 

5) When evaluating information taught about conception and fetal development, the patient verbalizes understanding about transportation time of the zygote through the fallopian tube and into the cavity of the uterus with which statement?

1. “It will take at least three days for the egg to reach the uterus.”
2. “It will take eight days for the egg to reach the uterus.”
3. “It will only take 12 hours for the egg to go through the fallopian tube.”
4. “It will take 18 hours for the fertilized egg to implant in the uterus.”

Answer:  1

Explanation:  1. It takes at least three days for the egg to reach the uterus.

2. “It will take eight days for the egg to reach the uterus” is an incorrect interpretation of the information on conception.
3. “It will only take 12 hours for the egg to go through the fallopian tube” is an incorrect interpretation of the information on conception.
4. “It will take 18 hours for the fertilized egg to implant in the uterus” is an incorrect interpretation of the information on conception.

Page Ref: 46, 47

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 4.3-Analyze the components of the fertilization process and how each may impact fertilization.

MNL LO:  Compare the different stages and factors influencing embryonic and fetal organ system development.

 

6) If only a small volume of sperm is discharged into the vagina, an insufficient quantity of enzymes might be released when sperm encounters the ovum. In that case, pregnancy would probably not result because:

1. Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus.
2. The block to polyspermy (cortical reaction) would not occur.
3. The fertilized ovum would be unable to implant in the uterus.
4. Sperm would be unable to penetrate the zona pellucida of the ovum.

Answer:  4

Explanation:  1. This is an incorrect statement.

2. This is incorrect because it is mediated by release of materials from cortical granules below the ovum’s surface and not the result of low sperm count.
3. The fertilized ovum would be unable to implant in the uterus because fertilization is unlikely to occur with a low sperm count.
4. Sperm would be unable to penetrate the zona pellucida of the ovum because it takes hundreds of acrosomes (the result of the acrosome reaction) to rupture and release enough hyaluronic acid to clear the way for a single sperm to penetrate the ovum’s zona pellucida successfully.

Page Ref: 44, 45

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential I: Liberal education for Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health promotion

Learning Outcome:  LO 4.3-Analyze the components of the fertilization process and how each may impact fertilization.

MNL LO:  Analyze the components of the fertilization process.

 

7) The nurse is caring for a client who is pregnant with twins. Which statement indicates the client needs additional information?

1. “Because both of my twins are boys, I know that they are identical.”
2. “If my twins came from one fertilized egg that split, they are identical.”
3. “If I have one boy and one girl, I will know they came from two eggs.”
4. “It is rare for twins to both be within the same amniotic sac.”

Answer:  1

Explanation:  1. Not all same-sex twins are identical or monozygotic, because fraternal, or dizygotic, twins can be the same gender or different genders.

2. When the zygote splits, identical twins share the same genotype result.
3. The only way to have twins of different genders is if they came from two separate fertilized ova. Monozygotic twins are identical and are the same gender.
4. Monoamnionic-monochorionic twins are very rare and occur as a result of the zygote splitting seven or more days after fertilization.

Page Ref: 49, 50

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 4.5-Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL LO:  Compare the different stages and factors influencing embryonic and fetal organ system development.

 

 

8) A pregnant client asks you to describe the differences between monozygotic and dizygotic twins. Which statement should you include in your teaching?

1. “Dizygotic twinning occurs less frequently than does monozygotic twinning.”
2. “Monozygotic twins originate from division of the fertilized ovum at different stages.”
3. “Dizygotic twins share one placenta and one chorion.”
4. “Monozygotic twins are also referred to as ‘fraternal twins.”

Answer:  2

Explanation:  1. Dizygotic twinning occurs more frequently than does monozygotic twinning.

2. Monozygotic twins originate from division of the fertilized ovum at different stages of early development.
3. Dizygotic twins each have a separate chorion and amnion.
4. Monozygotic twins are also referred to as “identical” twins.

Page Ref: 49, 50

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 4.5-Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL LO:  Compare the different stages and factors influencing embryonic and fetal organ system development.

 

9) Which statement by a pregnant client would indicate that additional teaching was necessary?

1. “Because of their birth relationship, fraternal twins are more similar to each other than if they had been born singly.”
2. “Identical twins can be the same or different sex.”
3. “Congenital abnormalities are more prevalent in identical twins.”
4. “Identical twins occur more frequently than fraternal twins.”

Answer:  3

Explanation:  1. Fraternal twins are not more similar to each other than if they had been born singly.

2. Identical or monozygotic twins have identical chromosomal structures and therefore are always the same sex.
3. Due to variations in the timing of the splitting of the embryo, congenital abnormalities such as conjoining are more common in monozygotic twins.
4. Dizygotic, or fraternal, twins occur more frequently than do monozygotic twins.

Page Ref: 49, 50

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 4.5-Compare the factors and processes by which fraternal (dizygotic) and identical (monozygotic) twins are formed.

MNL LO:  Compare the different stages and factors influencing embryonic and fetal organ system development.

 

 

10) The nurse is creating a poster for pregnant mothers. Which description of fetal development does the nurse include?

1. Four layers of cells form after the embryo is at the ball stage.
2. After fertilization, the cells only become larger for several weeks.
3. Most organs are formed by 8 weeks after fertilization.
4. The embryonic stage is from fertilization until 5 months.

Answer:  3

Explanation:  1. Three primary germ layers form from the ball of undifferentiated cells called the blastocyst: ectoderm, mesoderm, and endoderm.

2. After fertilization, the cells reproduce by mitosis, resulting in more cells, not larger cells.
3. Most organs are formed during the embryonic stage, which lasts from the 15th day after fertilization until the end of the 8th week after fertilization.
4. The embryonic stage begins after fertilization on day 15 and ends at the completion of 8 weeks’ gestation.

Page Ref: 55

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 4.4-Summarize the processes that occur during the cellular multiplication and differentiation stages of intrauterine development and their effect on the structures that form.

MNL LO:  Compare options for client education of factors affecting embryonic and fetal development.

 

11) The nurse is presenting an early pregnancy class to a group of pregnant women. Which statement indicates a need for further education?

1. “The placenta develops and grows larger until about 20 weeks’ gestation.”
2. “The placenta creates hormones and enzymes that are necessary during pregnancy.”
3. “The placenta ages and becomes less permeable during the last month of pregnancy.”
4. “The placenta floats in the amniotic sac and filters waste products from the fetus.”

Answer:  4

Explanation:  1. The chorionic villi of the placenta become more differentiated with time. The placenta grows in size until about 20 weeks. After this point, the placenta thickens but does not increase in size.

2. The placenta creates glycogen, cholesterol, hormones such as human chorionic gonadotropin (hCG), and enzymes such as sulfatase and insulinase.
3. The placenta is designed to last for 40 weeks, the average length of human gestation. The permeability to nutrients and oxygen begins to decrease starting at about 36 weeks as a part of the aging of the placenta.
4. The placenta is attached to the uterine wall, and does not float in the amniotic sac. One function of the placenta is to filter metabolic waste products from the baby’s blood so that they can be excreted by the mother.

Page Ref: 51—53

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 4.6-Describe the development, structure, and functions of the placenta and umbilical cord during intrauterine life (embryonic and fetal development).

MNL LO:  Compare the various methods of prepared childbirth education.

 

12) The nurse is working with a client who has experienced a fetal death in utero at 20 weeks. The client asks what her baby will look like when it is delivered. Which statement by the nurse is the best response?

1. “Your baby will be covered in fine hair called lanugo.”
2. “Your child will have arm and leg buds, but not fully formed limbs.”
3. “A white, cheesy substance called vernix caseosa will be on the skin.”
4. “The genitals of the baby will be ambiguous.”

Answer:  1

Explanation:  1. Downy fine hair called lanugo covers a fetus at 20 weeks’ gestation.

2. Limb buds have developed by 35-days postfertilization. At 20 weeks, the fetus will have well developed well differentiated arms and legs.
3. Vernix caseosa forms at about 24 weeks. This fetus is only 20 weeks and will not have vernix.
4. The genitals are apparent by 12 weeks after fertilization. At 20 weeks’ gestation, the fetus would have specifically male or female genitals.

Page Ref: 55, 56

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 4.7-Contrast the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 36, and 40 weeks’ gestation.

MNL LO:  Implement specific nursing interventions related to caring for families experiencing perinatal loss.

 

 

13) At her first prenatal visit, the client states, “I’m five weeks’ pregnant now and I would like to hear my baby’s heartbeat today.” How should the nurse respond?

1. Prepare to assist with auscultation of the fetal heartbeat using a fetoscope.
2. Explain to the client that the fetal heart does not begin to beat until approximately 7 weeks’ gestation.
3. Anticipate that the client will be scheduled for Doppler ultrasound.
4. Explain to the client that the fetal heartbeat is not yet detectable at 5 weeks’ gestation.

Answer:  4

Explanation:  1. Fetal heart tones can be identified through use of a fetoscope at approximately 20 weeks’ gestation.

2. The fetal heart begins to beat by 4 weeks’ gestation.
3. Generally, fetal heart tones cannot be heard until approximately 8 weeks’ gestation by ultrasound Doppler device.
4. While the tubular heart begins to form during the third week, fetal heart tones generally are not be detectable until at least 7 weeks’ gestation.

Page Ref: 55, 56

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 4.7-Contrast the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 36, and 40 weeks’ gestation.

MNL LO:  Compare the different stages and factors influencing embryonic and fetal organ system development.

 

14) The client, at 18 weeks’ gestation, thinks she might have been exposed to a toxin at work that could affect fetal development. The client asks the nurse what organs might be affected at this point in pregnancy. The best response of the nurse is:

1. “The brain is developing now and could be affected.”
2. “Because you are in the second trimester, there is no danger.”
3. “The internal organs like the heart and lungs could be impacted.”
4. “Its best to not worry about possible problems with your baby.”

Answer:  1

Explanation:  1. Maximum brain growth and myelination are occurring at this point in fetal development.

2. Although the greatest danger from teratogens is during the embryonic stage (the first 8 weeks of pregnancy), the fetus at 20 weeks is still vulnerable to exposure to teratogens.
3. The heart, lungs, and other internal organs form during the embryonic state, or the first 8 weeks of pregnancy. During their formation is when they are most likely to be affected by a teratogen.
4. Avoid telling patients to not worry. Doing so indicates to the patient that you don’t care about their concerns and will end effective communication.

Page Ref: 56

Cognitive Level:  Analyzing

Client Need&Sub:  Psychosocial Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 4.8-Identify the factors that influence congenital malformations of the various organ systems.

MNL LO:  Compare the different stages and factors influencing embryonic and fetal organ system development.

 

15) The nurse is preparing a preconception information class. Information about causes of fetal organ malformation in the first trimester will be presented. What prenatal influences on the intrauterine environment should be included in the instruction? Select all that apply.

1. The use of saunas or hot tubs
2. The use of drugs
3. The quality of the sperm or ovum
4. Maternal nutrition
5. Age of the mother at conception

Answer:  1, 2, 4

Explanation:  1. The use of saunas or hot tubs is associated with maternal hyperthermia and neural tube defects.

2. Many drugs can have teratogenic effects.
3. The quality of the sperm or ovum can affect fertility but not organ formation.
4. Maternal nutrition, if deficient, can cause damage to the fetus. Vitamins and folic acid taken prior to and during the pregnancy can have beneficial effects.
5. A maternal age of 35 or older is associated with genetic defects that occur at conception, not with first-semester organ malformation.

Page Ref: 46, 60—61

Cognitive Level:  Analyzing

Client Need&Sub:  Physiological Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 4.8-Identify the factors that influence congenital malformations of the various organ systems.

MNL LO:  Relate various factors to their effect on pregnancy outcomes.

 

 

16) A woman at 20 weeks’ gestation finds that her blood type is O. She tells the nurse that her boyfriends blood type is AB, and asks what blood type her child will have. Which blood types should the nurse tell the woman her child may have? Select all that apply.

1. O
2. A
3. B
4. OA
5. AB

Answer:  2, 3

Explanation:  1. Type O is recessive so it will not be the child’s blood type.

2. The child could be Type A.
3. The child could be Type B.
4. Type OA is a fictitious blood type.
5. Because the mother is Type O, the child cannot be AB.

Page Ref: 53, 56

Cognitive Level:  Application

Client Need&Sub:  Safe and Effective Care Environment | Management of Care

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 4.7-Contrast the significant changes in growth and development of the fetus at 4, 6, 12, 16, 20, 24, 28, 36, and 40 weeks’ gestation.

MNL LO:  Relate various factors to their effect on pregnancy outcomes.

 

17) A woman had a genetic evaluation and it is discovered that she carries on autosomal dominant gene for Huntington’s disease, while her husbands history is ordinary. Which family members should be referred for genetic counseling? Select all that apply.

1. The woman’s brothers
2. The woman’s sisters
3. The woman’s parents
4. The woman’s husband
5. The woman’s children

Answer:  1, 2, 3, 5

Explanation:  1. The woman’s brothers would have a 50 percent probability of having the gene.

2. The woman’s sisters would have a 50 percent probability of having the gene.
3. One of the parents has the gene; manifestation of the disease has not happened yet.
4. The husbands history is unremarkable.
5. The woman’s children have a 50 percent probability of having the gene.

Page Ref: 42—44

Cognitive Level:  Application

Client Need&Sub:  Safe and Effective Care Environment | Management of Care

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care

Learning Outcome:  LO 4.8-Identify the factors that influence congenital malformations of the various organ systems.

MNL LO:  Contrast the various genetic inheritance patterns.