Chapter18: Genetic and Reproductive Disorders My Nursing Test Banks

Chapter18: Genetic and Reproductive Disorders

Multiple Choice

1. The thin fold of skin that lies between the labia minora and can be ruptured as a result of sexual intercourse is known as the:

1. Clitoris.

2. Cervix.

3. Hymen.

4. Uterus.

ANS: 3

Feedback
1. The clitoris does not rupture during sexual intercourse.
2. The cervix does not rupture during sexual intercourse.
3. A thin fold of skin that lies between the labia minora and can be ruptured as a result of sexual intercourse is the hymen.
4. The uterus does not rupture during sexual intercourse.

KEY: Content Area: Reproductive  Health| Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: CHAPTER 18 | Type: Multiple Choice

2. The female organ that produces the ova and sex hormones is known as the:

1. Ovum.

2. Ovary.

3. Ovule.

4. Oviform.

ANS: 2

Feedback
1. The ovum is the actual egg released from the ovaries.
2. The female organ that produces the ova and sex hormones is known as the ovary.
3. The ovule is part of plant germination, not human reproduction.
4. The oviform is in the shape of the egg.

KEY: Content Area: Reproductive Health | Integrated Processes: Teaching/Learning | Client Need Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

3. The endometrium is a layer of cells that lines the:

1. Ovary.

2. Perineum.

3. Urethra.

4. Uterus.

ANS: 4

Feedback
1. The ovary has a cortex as the outer layer of cells.
2. The perineum is the part of the body where the gonads are located.
3. The urethra has the longitudinal layer as the outermost layer.
4. The uterus is lined with the endometrium.

KEY: Content Area: Reproductive Health | Integrated Processes: Teaching/Learning | Client Need Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

4. Common injuries to pediatric and adolescent female genital tract include straddle injuries. These injuries result from a fall on a:

1. Bicycle.

2. Wagon.

3. Sidewalk.

4. Step.

ANS: 1

Feedback
1. Bicycles are a common cause of straddle injuries to childrens genitals as a result of falling over a blunt object.
2 Wagons are not a common cause of straddle injuries as they are not a blunt object.
3. Sidewalks are not a common cause of straddle injuries. A child does not fall easily into the periarea when on the sidewalk.
4. Steps are not a common cause of straddle injuries. A child does not fall into a straddled position on the steps easily.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level Application | REF: CHAPTER 18 | Type: Multiple Choice

5.  Clue cells are an indication of:

1. A change in the normal organisms in the mouth.

2. A change in the normal organisms in the stomach.

3. A change in the normal organisms on the skin.

4. A change in the normal organisms in the vagina.

ANS: 4

Feedback
1. These cells are not present in the mouth.
2. These cells are not present within the stomach, and the stomach cannot be visually inspected easily.
3. The skin bruises, but does not exhibit clue cells.
4. Clue cells are an indication of a change in the normal organisms in the vagina.

KEY: Content Area: Reproductive Safety | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

6. Amenorrhea in adolescents becomes a concern if there is no menses by age:

1. 12.

2. 13.

3. 14.

4. 16.

ANS: 4

Feedback
1. The average age of menarche is 12 in the United States. 95 percent of girls have their menses by age 14, thus having no menses by age 12 would not apply.
2. The average age of menarche is 12 in the United States. 95 percent of girls have their menses by age 14, thus having no menses by age 13 would not apply.
3. The average age of menarche is 12 in the United States. 95 percent of girls have their menses by age 14, thus having no menses by age 14 would not apply.
4 The average age of menarche is 12 in the United States. 95 percent of girls have their menses by age 14. Girls would need an endocrine evaluation if they have no menses by age 16.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Health and Promotion Maintenance | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

7. Planning care for a patient with Menorrhagia would include education on all except:

1. Blood count, iron level, and platelet count levels.

2. Blood loss of greater than 80mL is considered a heavy volume.

3. Encouraging a diet of food rich in iron during menses.

4. Avoiding fluid intake with episodes of Menorrhagia.

ANS: 4

Feedback
1. Lab values reflect evidence to support excessive bleeding.
2. The patient should recognize and report accurate amounts of blood loss.
3. Iron-rich foods will help replenish iron lost with heavy bleeding.
4. Fluid intake will help replace volume lost through excessive bleeding.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

8. Common causes of abnormal uterine bleeding in adolescents include pregnancy, use of hormonal contraceptives, hypothyroidism, and infection. Other causes include:

1. Psychogenic causes.

2. Exercise.

3. A polycystic ovary.

4. All the above.

ANS: 4

Feedback
1. Psychogenic issues can lead to abnormal bleeding patterns. Stress is known to cause a high incidence of the abnormal pattern.
2. A lot of exercise can cause the abnormal bleeding and lead to the Athletes Triad.
3. Polycystic ovary disease exhibits abnormal levels of hormones secreted, causing the abnormal bleeding patterns.
4. Each of these conditions can lead to abnormal bleeding patterns.

KEY: Content Area: Reproductive Health | Integrated Processes: Nursing Process | Client Need: Health and Promotion and Maintenance | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

9. The prepuce is the skin that covers:

1. The glans.

2. The vas deferens.

3. The testicles.

4. The epididymis.

ANS: 1

Feedback
1. The prepuce is the skin that covers the glans.
2. The vas deferens does not have prepuce skin.
3. The testicles are covered by the scrotum.
4. The tunica vaginalis covers the epididymis.

KEY: Content Area: Reproductive Health| Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

10. A varicocele is a collection of dilated and tortuous veins in the plexus surrounding the spermatic cord in the scrotum. When planning education for the family on this particular disorder, it is important to include information, such as the fact that varicoceles can:

1. Have increased incidence infertility.

2. Cause pain or feeling of fullness in the scrotum.

3. Have the texture of a bag of worms.

4. All of the above.

ANS: 4

Feedback
1. About 20 percent of men in infertility clinics will have a varicocele.
2. Varicocele can be asymptomatic or cause a dull ache or a feeling of fullness in the scrotum.
3. A palpable varicocele has the texture of a bag of worms.
4. Varicocele can cause increased incidence of infertility, feeling of fullness in the scrotum, and have the texture like that of a bag of worms.

KEY: Content Area: Reproductive Disorder | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension/Synthesis | REF: CHAPTER 18 | Type: Multiple Choice

11. The incidence of sexually transmitted diseases is highest among adolescents. In adolescents age 15 to 24, the percentage is estimated to be:

1. 30 percent.

2. 40 percent.

3. 50 percent.

4. 60 percent.

ANS: 3

Feedback
1. The percentage is too low for the age range.
2. The percentage is too low for the age range.
3. Nearly 50 percent of sexually transmitted diseases occur in 15 to 24 year olds.
4. The percentage is too high for the age range.

KEY: Content Area: Reproductive Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

12. Trisomy 13, also known as Patau syndrome, is the least common and most severe of the autosomal trisomies. It has an average survival of:

1. Less than three days.

2. Less than two weeks.

3. Less than six months.

4. Less than five years.

ANS: 1

Feedback
1. Trisomy 13 is the most severe of the autosomal trisomies. It has an average survival of less than three days.
2. Trisomy 13 neonates usually do not live to two weeks of age.
3. Trisomy 13 neonates do not usually live to six months of age.
4. Trisomy 13 do not live to five years of age.

KEY: Content Area: Genetics | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

13. HIV testing should be done on all teens or young adults at a minimum of:

1. Annually.

2. Once.

3. Every 2 years.

4. Every 5 years.

ANS: 2

Feedback
1. Testing does not need to occur annually if the patient is in a monogamous relationship.
2. HIV testing should be done on all teens or young adults at least once.
3. The testing should be done on all teens or young adults at least once in their young life and does not need to occur more often if in a monogamous relationship.
4. HIV testing should be done on all teens or young adults at least once and does not need to be repeated if in a monogamous relationship.

KEY: Content Area: Wellness | Integrated Processes: Teaching/Learning | Client Need: Safe Effective Care Environment | Cognitive Level: Synthesis | REF: CHAPTER 18 | Type: Multiple Choice

14. All the following are true of pelvic inflammatory disease (PID) except that:

1. It is caused most often by genital gonorrhea.

2. It may result in oophoritis, which is an infection of the ovaries.

3. It may result in peritonitis, which is an infection of the abdominal lining.

4. Frequent douching does not increase risk of developing PID.

ANS: 4

Feedback
1. PID is most often caused by genital gonorrhea.
2. PID is often accompanied by involvement of the neighboring pelvic organs, such as the ovaries, causing oophoritis.
3. PID can cause infection of the abdominal lining or peritoneum, leading to peritonitis.
4. Frequent douching can increase the risk of developing PID.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: CHAPTER 18 | Type: Multiple Choice

15. Select the statement that best describes the thelarche stage of puberty in females.

1. Appearance of pubic hair

2. Appearance of breast tissue maturation

3. Onset of first menstrual period

4. All the above

ANS: 2

Feedback
1. Pubic hair shows after thelarche has occurred.
2. The thelarche stage of puberty in females is best described as the appearance of breast tissue maturation.
3. Thelarche occurs prior to the onset of menstruation.
4. The thelarche stage of puberty in females is best described as the appearance of breast tissue maturation.

KEY: Content Area: Reproductive Health | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

16. Congenital Syphilis occurs when the spirochete Treponema palladium is transferred from the pregnant woman to her fetus. Education to the parent should include all of the following except:

1. Infants can be asymptomatic for up to two years after birth.

2. Any rash involving the palms and soles can have an appearance of copper.

3. The central nervous system is rarely affected.

4. Long bone abnormalities with possible fractures may limit movement and give an appearance of paralysis.

ANS: 3

Feedback
1. Infants with Congenital Syphilis can be asymptomatic for up to two years.
2. The rash in Congenital Syphilis involves the palms and soles. It can start as pink or red in color and can turn dark or coppery.
3. The central nervous system involvement can occur with Congenital Syphilis and may involve seizures, hydrocephalous, and developmental delays.
4. Long bone abnormalities may limit movement, giving the appearance of paralysis.

KEY: Content Area: Reproductive Disorders| Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

17. Congenital Hypothyroidism is common in infants with Downs syndrome. Newborn screening for Congenital Hypothyroidism is required in all 50 states. Thyroid studies should be performed several times during the first years of life, and then a minimum of:

1. Every two months.

2. Every month.

3. Every six months.

4. Yearly.

ANS: 4

Feedback
1. The child only needs to be tested once a year after the initial newborn screening.
2. The child does not need to be tested monthly. Once a year is sufficient for the findings.
3. The child does not need to be tested every six months. Screening once per year is sufficient.
4. Testing is done several times during the first year, and then should be done yearly after the initial screening.

KEY: Content Area: Genetics | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

18. The only known disorder where a fetus can survive despite loss of an entire X chromosome is known as:

1. Edwards syndrome.

2. Sturge-Weber syndrome.

3. Turners syndrome.

4. Williams syndrome.

ANS: 3

Feedback
1. Edwards syndrome is a trisomy disorder with a high fatality rate.
2. Sturge-Weber syndrome has a trisomy chromosome.
3. The only known disorder where a fetus can survive despite the loss of an entire X chromosome is known as Turners syndrome.
4. Williams syndrome has multiple areas of chromosome deletion.

KEY: Content Area: Genetics | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

19. Which of the following statements is true of Turners syndrome?

1. It affects only girls. There are no living males with Turners syndrome.

2. It is the result of the loss of an entire X chromosome.

3. Both 1 and 2

4. None of the above

ANS: 3

Feedback
1. Turners syndrome is a condition that only occurs in females.
2. Turners syndrome is the result of an entire X chromosome loss.
3. Turners syndrome only affects females, and it is the result of an entire X chromosome loss.
4. Turners syndrome is the result of an entire X chromosome loss, and it only affects females.

KEY: Content Area: Genetics | Integrated Processes Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

20. Malignancies are common in children with Downs syndrome. The incidence is 18 times that of the general population for developing:

1. Colon cancer.

2. Leukemia.

3. Pancreatic cancer.

4. Bladder cancer.

ANS: 2

Feedback
1. Children with Downs syndrome are not at high risk for colon cancer.
2. The incidence of children with Downs syndrome developing leukemia is 18 times that of the general population.
3. Children with Downs syndrome are not at an increased risk for pancreatic cancer.
4. Children with Downs syndrome are not at an increased risk for bladder cancer.

KEY: Content Area: Genetics | Integrated Processes: Communication/Documentation | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

21. Downs syndrome children often have instability of the neck at the first and second cervical vertebrae. As a nurse, you explain to the caregiver that he/she should look for signs and symptoms of spinal cord changes, such as:

1. Changes in reflexes.

2. Changes in bowel function.

3. All of the above.

4. None of the above.

ANS: 3

Feedback
1. Signs and symptoms of spinal cord compression include changes in reflexes.
2. Signs and symptoms of spinal cord compression include changes in bowel and bladder function.
3. Signs and symptoms of spinal cord compression include changes in gait, reflexes, and bowel and bladder function.
4. One answer is correct. Signs and symptoms of spinal cord compression include changes in gait, reflexes, and bowel and bladder function.

KEY: Content Area: Musculoskeletal | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Comprehension/Synthesis | REF: CHAPTER 18 | Type: Multiple Choice

22. Children with Sturge-Webers syndrome are at a high risk for:

1. Pediatric stroke.

2. Congenital heart complications.

3. Juvenile arthritis.

4. Type I diabetes.

ANS: 1

Feedback
1. Children with Sturge-Weber syndrome may have blood vessel angiomas in the brain, leading to a higher incidence for pediatric stroke.
2. Children with Sturge-Weber syndrome may have blood vessel angiomas, but this does not affect the heart.
3. Children with Sturge-Weber syndrome may have blood vessel issues, but this does not affect the joints.
4. The child is not at an increased risk for Type I diabetes.

KEY: Content Area: Genetics | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

23. Stereotypic behaviors of males with Fragile X syndrome include a lack of eye contact, aggression, anxiety, and:

1. Jerking legs.

2. Hand flapping.

3. Pill-rolling of the fingers.

4. All of the above

ANS: 2

Feedback
1. Jerking of the legs is not a stereotypical behavior of a child with Fragile X syndrome.
2. Stereotypical behaviors of males with Fragile X syndrome include lack of eye contact, aggression, anxiety, and hand flapping.
3. Pill-rolling of the fingers is not a stereotypical behavior of a child with Fragile X syndrome.
4. Stereotypical behaviors of males with Fragile X syndrome include lack of eye contact, aggression, anxiety, and hand flapping.

KEY: Content Area: Genetics | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

24. Fetal Alcohol Syndrome Disorder (FASD) is divided into four subtypes. As a nurse, you know that the most severe type is:

1. Alcohol-Related Birth Defects.

2. Alcohol-Related Neurodevelopmental Disorder.

3. Partial Fetal Alcohol Syndrome.

4. Fetal Alcohol Syndrome

ANS: 4

Feedback
1. Alcohol-related defects demonstrate the physical appearance of the syndrome.
2. Neurodevelopmental disorders can occur with FASD.
3. Partial Fetal Alcohol Syndrome is not a technical term used in treating FASD.
4. Fetal Alcohol Syndrome (FAS) is the most severe form of FASD and is defined by abnormalities in three domains: poor growth, abnormal brain growth or structure, and specific dysmorphic facial features.

KEY: Content Area: Genetics | Integrated Processes Teaching/Learning| Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

25. Angelman syndrome is the deletion of which chromosome?

1. Maternal chromosome 12

2. Maternal chromosome 15

3. Paternal chromosome 17

4. Paternal chromosome 19

ANS: 2

Feedback
1. Angelman syndrome is not the deletion of the maternal chromosome 12.
2. Angelman syndrome is the deletion of the maternal chromosome 15.
3. Angelman syndrome is not the deletion of the maternal chromosome 17
4. Angelman syndrome is not the deletion of the maternal chromosome 19.

KEY: Content Area: Genetics | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

26. A school nurse is discussing the anatomy of the female reproductive system with a group of eighth grade girls. Identify the information that the nurse should give to the students.

1. The fallopian tubes carry the embryo to the uterus.

2. The endometrium responds to the levels of testosterone in the body.

3. The ovaries hold the ova.

4. The hymen needs to be ruptured in order for pregnancy to occur.

ANS: 3

Feedback
1. Fallopian tubes carry the ovum to the uterus.
2. The endometrium responds to the amount of estrogen and progesterone in the body.
3. The ova are created in the ovaries.
4. The hymen is ruptured during intercourse. The amniotic sac needs to rupture for the delivery of a baby.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

27. Tanners stages begin when _________ occurs in females.

1. Menstruation

2. Menarche

3. Adrenarche

4. Athletes Triad

ANS: 3

Feedback
1. Menstruation occurs later and is not part of the Tanners stages.
2. Menarche occurs later and is not part of the Tanners stages.
3. The adrenal glands begin to produce sex hormones and create the secondary sexual characteristics in females.
4. The Athletes Triad is not part of the Tanners stages.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

28. An 8-year-old girl has been brought to the pediatric clinic because the mother reports that her daughter has pain in her perineal area and a small hematoma on her labia minora. The nurse should ask the child about:

1. The history of sexual intercourse.

2. If she fell on the monkey bars at school in the past few days.

3. If she has not been cleaning herself.

4. None of the above.

ANS: 2

Feedback
1. This age of a child has a higher risk for a straddle injury at play than sexual intercourse.
2. This age of a child has a higher risk of injury at play.
3. Because of the hematoma, the child should be assessed for an injury, not cleaning.
4. The assessment of the child indicates a straddle injury and should be discussed with the child and mother.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: CHAPTER 18 | Type: Multiple Choice

29. A girl with a known straddle injury should:

1. Be on bed rest.

2. Be on bed rest, using Sitz baths, and applying ice to the area.

3. Take a Sitz bath every three hours to help control pain.

4. Apply ice to the area only when pain occurs.

ANS: 2

Feedback
1. A Sitz bath and ice to the area are comfort measures that should be included.
2. Bedrest, Sitz baths, and ice will help the area heal and provide comfort for the patient.
3. Ice is needed to decrease edema, and the bed rest will help decrease the chance for rupture.
4. Bedrest and Sitz baths will help decrease the chance for rupture and provide comfort, along with the ice.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

30. The reason prepubescent girls are more susceptible to vulvovaginitis is because:

1. Of the lack of knowledge on keeping the periarea clean.

2. This age range tends to have more wetness in the area.

3. This age range has a higher incidence of placing a foreign body into the vaginal canal.

4. This age range wears cotton underwear.

ANS: 3

Feedback
1. Most girls of this age are aware of how to cleanse the area.
2. A girl of this age is too young for wetness to occur in this area.
3. A girl in this age range begins to experiment and is at a higher risk of placing a foreign body into the vaginal canal.
4. Cotton underwear is preferred for this age range in order to maintain dryness.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

31. A diagnostic tool for pinworms is:

1. X-rays.

2. An ultrasound.

3. A tape Test.

4. A blood sample.

ANS: 3

Feedback
1. An X-ray is not a diagnostic tool for pinworms.
2. An ultrasound is not a diagnostic tool for pinworms.
3. A tape test is used because the pinworms surround the anal opening, will lay eggs, and are attracted to the tape.
4. A blood sample will not indicate pinworms.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

32. A 13-year-old girl has been brought to the outpatient clinic with complaints of pain in her vaginal region after being sick with Influenza A for the last week. The girl states that she can see a raised edge, and it is oozing. The nurse should anticipate:

1. Providing a Sitz bath and ice.

2. Providing education about proper hygiene to the area.

3. Placing a Foley catheter for urination in order to keep the area clean.

4. Educating the girl about not wearing cotton underwear.

ANS: 3

Feedback
1. A Sitz bath may introduce more bacteria to the area and should not be provided.
2. Proper hygiene is important, but not the primary course of action at this point.
3. A Foley catheter will help keep the area clean and reduce the risk of bacteria in the area.
4. The girl should be wearing cotton underwear.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

33. The most common cause of vaginal inflammation and discharge in teenage girls is:

1. Bacterial vaginosis.

2. STIs.

3. Urinary tract infections.

4. Vulvovaginitis.

ANS: 1

Feedback
1. Common in this age range and about one-third of cases resolve on their own.
2. STIs would not resolve on their own and have an increased severity.
3. Urinary tract infections do not resolve on their own and usually do not cause vaginal inflammation.
4. Prepubescent girls more commonly have vulvovaginitis than teens.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

34. A 15 year old comes to the nurses office and states she has a gray discharge on her underwear, and it has a bad odor. The nurse should anticipate:

1. Teaching the girl about good hygiene.

2. Referring the teen to a doctor.

3. Explaining that this is a common occurrence during the teen years.

4. Asking questions about sexual encounters.

ANS: 2

Feedback
1. The gray discharge can indicate an infection, thus a doctor should be seen for further analysis.
2. A doctor referral is needed in order to confirm a diagnosis and proper treatment.
3. This is not a common occurrence and should be addressed.
4. Further assessment by a doctor needs to be done in order to verify and treat the teen.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

35. A 16-year-old teen has come for a checkup at a teen pregnancy outreach center. It is noted that the teen has bacterial vaginosis. A priority teaching topic would be:

1. The increased risk of preterm labor with bacterial vaginosis.

2. The increased risk of a urinary tract infection with bacterial vaginosis.

3. Cleansing the peritoneal area after each urination.

4. Abstaining from sexual intercourse during pregnancy.

ANS: 1

Feedback
1. Bacterial vaginosis can increase the risk for preterm labor. The patient should be evaluated and treated in order to decrease the risk.
2. Urinary tract infections more commonly arise from other bacterial agents.
3. Cleaning the peritoneal area will not treat bacterial vaginosis.
4. Abstaining from sexual intercourse will not cure the bacterial vaginosis.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

36. The most common reason for secondary Amenorrhea to occur in teens is:

1. The Athletes Triad.

2. Pregnancy.

3. Unstable hormone levels.

4. Lack of proper nutrition.

ANS: 2

Feedback
1. The Athletes Triad is the second most common reason for secondary Amenorrhea.
2. Pregnancy is the most common reason.
3. Unstable hormone levels lead to infrequent Amenorrhea, which is not the most common type.
4. The lack of proper nutrition, especially anorexia, can lead to secondary Amenorrhea, but this is not the most common reason.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

37. A teen girl is explaining to the nurse that her menstrual cycle is not like her friends because her bleeding last longer than seven days and is very heavy. Menorrhagia has been previously diagnosed, and the nurse should anticipate:

1. Obtaining laboratory tests to check the girls hemoglobin and hematocrit.

2. Discussing a diet which includes broccoli and other dark leafy vegetables during menses.

3. Teaching the teen how to record the amount of bleeding during her cycle.

4. All of the above should be done with the teen.

ANS: 4

Feedback
1. The hemoglobin and hematocrit should be assessed to make sure that the girl is not anemic.
2. Diet can help maintain the iron level in the body since the bleeding is heavy.
3. Keeping track of bleeding will help the medical providers know the amount, frequency, and duration to create a plan of care.
4. The hemoglobin and hematocrit should be assessed to make sure that the girl is not anemic. Diet can help maintain the iron level in the body since the bleeding is heavy. Keeping track of bleeding will help the medical providers know the amount, frequency, and duration to create a plan of care.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

38. A school nurse is providing sexual education to a group of seventh grade boys. It is important for the nurse to include which of the following in the educational session?

1. Prepuce is present on all maturing boys.

2. The testicles house the sperm.

3. Sperm is produced in the glans.

4. The scrotum is another word for testicles.

ANS: 2

Feedback
1. Pre-Puce may not be pronounced on some boys and can be difficult to identify.
2. Testicles maintain the sperm in a male.
3. The sperm is produced in the seminiferous tubules.
4. The testicles and epididymides are parts of the scrotum.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

39. A teenage boy has an uncircumcised penis and is receiving instruction on how to clean the area. The nurse knows that the teen understands the teaching when he states:

1. I only need to clean the area once a week.

2. I will need to use force to retract the foreskin in order to clean the penis.

3. I need to pull the foreskin over the glans when it is dry.

4. I should not need to cleanse the area often.

ANS: 3

Feedback
1. The area should be cleansed every day, just like other parts of the body.
2. The foreskin should pull back easily. If force is needed, medical attention should be sought.
3. The foreskin should be placed over the glans after it is dry.
4. The area needs to be cleaned in order to make sure that bacteria are removed.

KEY: Content Area: Reproductive Health | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | REF: CHAPTER 18 | Type: Multiple Choice

40. A teen has been diagnosed with pathologic phimosis. The teen may experience:

1. Dysuria.

2. Polyuria.

3. Bleeding while urinating.

4. The inability to urinate.

ANS: 1

Feedback
1. Painful urination occurs because the foreskin is irritated.
2. There is no increase in urination with phimosis.
3. Bleeding may occur around the penis, but does not come from the urethra.
4. The patient can urinate, but it may be painful.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

41. In order to decrease the occurrence of zipper injuries in boys, the nurse should provide education on all of the following except:

1. Carefully zipping pants once underwear is pulled up.

2. Wear sweat pants if zipper injuries are a common occurrence.

3. Do not force the zipper up.

4. Ask for help with a zipper if it is difficult.

ANS: 2

Feedback
1. Underwear should be worn in order to have a barrier between the zipper and penis.
2. A child should be allowed to wear whatever clothing he wants. The child needs education on how to prevent injury.
3. Forcing the zipper could pinch the area.
4. Asking for help can be embarrassing, but explaining that injury can happen may encourage a child to ask for help.

KEY: Content Area: Reproductive Health | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

42. A neonate is having a circumcision performed. What can the nurse do to provide comfort for the neonate during the procedure?

1. Encourage non-nutritive sucking with a small amount of sucrose.

2. Strap the neonates legs down so that the neonate cannot kick.

3. Attempt to feed the neonate during the procedure.

4. All of the above should be provided.

ANS: 1

Feedback
1. Sucrose reacts with the tongue in order to provide comfort, and the sucking is a comfort measure for a neonate.
2. The baby can be swaddled for comfort on the lower legs. Strapping is considered a restraint.
3. Feeding during the procedure places the child at risk for aspiration.
4. Only providing the non-nutritive suck is safe for the neonate.

KEY: Content Area: Reproductive Health | Integrated Processes: Caring | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

43. A 12-year-old boy has been admitted to the pediatric unit for torsion of his left testicle. The nurse should provide:

1. Pain management as ordered.

2. Information about a Doppler ultrasound.

3. Prepare the family and child for possible surgery.

4. All of the above should be provided.

ANS: 4

Feedback
1. If a patient is feeling pain, it should be addressed.
2. The Doppler ultrasound will be used to monitor the blood flow to the area.
3. Surgery may be needed for the child in order to correct the torsion.
4. If a patient is feeling pain, it should be addressed. The Doppler ultrasound will be used to monitor the blood flow to the area. Surgery may be needed for the child in order to correct the torsion.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Caring | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

44. In order to help decrease the pain after an inguinal hernia repair, the nurse should provide the patient with:

1. A pillow when coughing and breathing deeply.

2. Ice to the surgical site.

3. Pain medication as prescribed.

4. All of the above should be provided for the patient.

ANS: 4

Feedback
1. The pillow can be used as a splint to help hold the muscles when coughing.
2. The ice will help relieve pain.
3. The pain medication should be taken as prescribed because the level of pain will be higher and take longer to dissipate if not given on schedule.
4. The pillow can be used as a splint to help hold the muscles when coughing. The ice will help relieve pain. The pain medication should be taken as prescribed because the level of pain will be higher and take longer to dissipate if not given on schedule.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

45. The school nurse is planning a class about contraception for high school students. She is going to discuss various contraceptive methods and sexually transmitted infections (STIs). Identify a priority education topic for this class

1. Spermicides effectiveness with gonorrhea and Chlamydia, but not HIV

2. Spermicides ineffectiveness with sexually transmitted diseases

3. Spermicides effectiveness with HIV

4. Spermicides are not recommended for teens under the age of 15.

ANS: 2

Feedback
1. Spermicides are used for the prevention of conception and do not prevent STIs.
2. Spermicides are used for pregnancy prevention and are ineffective against STIs.
3. Spermicides are not a preventable measure against HIV.
4. Spermicides can be used by any age group.

KEY: Content Area: Reproductive Health/Wellness | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

46. A patient comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before and receives the diagnosis of Herpes. The nurse will anticipate providing teaching for which medication that the physician is most likely to order?

1. Azithromycin

2. Penicillin

3. Acyclovir

4. Rocephin

ANS: 3

Feedback
1. Azithromycin is an antibiotic. The patient needs an antiviral medication.
2. Penicillin is an antibiotic. The patient needs an antiviral medication.
3. Herpes will be treated with an antiviral, like Acyclovir.
4. Rocephin is an antibiotic. The patient needs an antiviral medication.

KEY: Content Area: Reproductive Disorders Pharmacology | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

47. The nurse is educating a group of adolescents about sexually transmitted infections (STIs). The nurse knows that the adolescents understand the education when they state that the most common symptom of an STI is:

1. Menstrual cramping.

2. Heavy menstrual bleeding.

3. Cold and flu like symptoms.

4. No sign or symptom.

ANS: 4

Feedback
1. The majority of STIs do not present with a sign or symptom.
2. The majority of STIs do not present with a sign or symptom.
3. The majority of STIs do not present with a sign or symptom.
4. The majority of STIs do not present with a sign or symptom, which makes treatment difficult.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

48. The nurse knows that which of the following patients is at greatest risk for contracting Chlamydia?

1. A 16-year-old, sexually active girl using no contraceptives

2. An 18-year-old girl who is using condoms during intercourse

3. A 17-year-old girl who is using a sponge as a contraceptive

4. A 15-year-old girl using abstinence

ANS: 1

Feedback
1. Contraceptives help prevent the spread of STIs. Not using contraceptives places the teen at a higher risk for infection.
2. Condoms help prevent the spread of STIs.
3. A sponge can help with the prevention of STIs.
4. Abstinence means that the teen is not having intercourse with another individual with STIs, and thus does not present a risk for infection.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

49. The nurse is seeing teenage patients in the pregnancy and sexual outreach center. Which patient would you anticipate instructing on the use of ceftriaxone IM and doxycycline orally?

1. A pregnancy teen with Gonorrhea and a yeast infection

2. A nonpregnant teen with Gonorrhea and Chlamydia

3. A pregnant teen with Syphilis

4. A teen boy with Chlamydia and Trichomoniasis

ANS: 2

Feedback
1. A pregnant teen with Gonorrhea and a yeast infection cannot be treated with these medications because of the risk to the fetus.
2. A nonpregnant teen can take these medications.
3. Syphilis is not treated effectively with these medications.
4. Chlamydia and Trichomoniasis is not effectively treated with these medications.

KEY: Content Area: Reproductive Disorders Pharmacology | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: CHAPTER 18 | Type: Multiple Choice

50. The nurse is discharging a teenage patient after hospitalization for Pelvic Inflammatory Disease. Identify the statement that would indicate that the teaching was not effective

1. I might have infertility later in life because of this infection.

2. It is important for me to finish my antibiotics.

3. When I get older and want to have children, I am at a higher risk for a tubal pregnancy because of the PID.

4. My PID was caused by a yeast infection.

ANS: 4

Feedback
1. PID can cause scarring, which prevents a female from becoming pregnant later in life.
2. The antibiotics should be taken for the prescribed course in order to decrease the risk of infection a second time.
3. PID can cause scarring, which prevents a female from becoming pregnant later in life and puts the female at risk for tubal pregnancies.
4. PID is caused by an untreated or undertreated STI.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | REF: CHAPTER 18 | Type: Multiple Choice

51. The nurse is preparing a class on reproduction. She knows that the cell division process that results in two identical cells, each with the same number of chromosomes as the original cell, is called:

1. Meiosis.

2. Mitosis.

3. Oogenesis.

4. Gametogenesis.

ANS: 2

Feedback
1. Has half the genetic makeup
2. The two identical parts
3. This is the creation process for the female.
4. This is the creating process for the male.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

52. A nurse teaches newly pregnant teen moms that if an ovum is fertilized and implants itself in the endometrium, the hormone that the fertilized egg begins to secrete is called:

1. Human Chorionic Gonadotropin.

2. Estrogen.

3. Progesterone.

4. Luteinizing hormone.

ANS: 1

Feedback
1. HCG is the hormone secreted in order to indicate pregnancy from the ovum.
2. Estrogen is present in all females with menarche.
3. Progesterone is present in all females with menarche.
4. The luteinizing hormone is responsible for the release of the ovum from the ovaries.

KEY: Content Area: Reproductive and Genetic Disorders | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

53. Which of the following features are indications of Downs syndrome?

1. A protruding tongue

2. Small, low-set ears

3. Mid-face hypoplasia

4. All of the above may be features of Downs syndrome.

ANS: 4

Feedback
1. A child with Downs syndrome tends to have a protruding tongue.
2. Low-set ears are a feature of children with Downs syndrome.
3. Mid-face hypoplasia is a common feature for children with Downs syndrome.
4. A protruding tongue, small, low-set ears, and mid-face hypoplasia are common in children with Downs syndrome.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

54. When feeding an infant with Downs syndrome, it is important for the nurse to recognize that:

1. The infant will need extra support because of the weight of the head.

2. Infants with Downs syndrome tend to be lethargic and hypotonic, making it difficult to feed.

3. The infants protruding tongue can may it difficult to breastfeed.

4. The infant usually has a very strong suck and needs to be paced while eating.

ANS: 2

Feedback
1. All infants should have head support while feeding in order to prevent choking.
2. Infants with Downs syndrome tend to be hypotonic, which can make eating difficult.
3. An infant can learn to latch in order to breastfeed.
4. A child with Downs syndrome tends to have a weaker suck and takes a longer period of time to eat.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

55. A mother is asking the nurse about the age her daughter with Downs syndrome can be expected to start walking. Her other three children were walking by 10 months of age. The nurse knows that motor skill development for children with Downs syndrome takes:

1. About the same amount of time as children without Downs syndrome.

2. About twice as long as usual for a child without Downs syndrome.

3. About three times as long as usual for a child without Downs syndrome.

4. A significantly long time, with a large majority never learning to walk.

ANS: 2

Feedback
1. Because of the hypotonia, children with Downs syndrome lag behind in motor skill development.
2. An infant with Downs syndrome usually needs twice the length of time to develop motor skills.
3. An infant with Downs syndrome usually needs twice the length of time to develop motor skills.
4. An infant with Downs syndrome takes more time to develop motor skills, but does eventually learn to walk.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

56. Which type of malignancy is more common in children with Downs syndrome?

1. Leukemias

2. Osteosarcomas

3. Large cell carcinomas

4. Non-small cell carcinomas

ANS: 1

Feedback
1. Leukemias are common the most common malignancy in children with Downs syndrome.
2. Osteosarcoma is not prevalent in children with Downs syndrome.
3. Large cell carcinomas are not prevalent in children with Downs syndrome.
4. Non-small cell carcinomas are rare in children with Downs syndrome.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

57. A mother reports that her 3-year-old child with Downs syndrome snores loudly when sleeping. This occurs because:

1. Small nasal passageways are common with the syndrome

2. Hypopharynx and hypotonia are present with this syndrome.

3. Large tonsils are common with the syndrome.

4. Large adenoids are common with the syndrome

ANS: 2

Feedback
1. The nasal passageways are of normal size.
2. The hypopharynx and hypotonia leads to an airway that is obstructed, causing the snoring.
3. Tonsils are a normal size.
4. Adenoids are a normal size.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

58. An infant has been born with a known diagnosis of Trisomy 13. The nurse should note that:

1. End-of-life care will be important for the family and the infant.

2. Genetic testing will need to be done immediately after arriving to the neonatal intensive care unit.

3. The family should not hold the child.

4. Education about reducing the chance for another child with Trisomy 13 should be provided for the family.

ANS: 1

Feedback
1. A child with Trisomy 13 has a short life expectancy. Helping the parents provide comfort care for the infant will be an important care for the nurse to provide.
2. Children with Trisomy 13 have particular markers for the disease. The genetic testing will need to be done, but not immediately upon arrival to the unit.
3. Holding and comforting the infant helps with bonding between the parent and child.
4. Trisomy 13 is not known to have a genetic link, so other pregnancies are at little risk.

KEY: Content Area: Genetic Disorders | Integrated Processes: Caring | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

59. A common heart defect noted in children with Trisomy 18 is:

1. Coarctation of the aorta.

2. A one ventricle heart.

3. An ASD and a VSD are present.

4. Obstruction on the right side of the heart.

ANS: 1

Feedback
1. The lengthening of the aortic arch is common in infants with Trisomy 18.
2. Most infants born with Trisomy 18 have a four ventricle heart.
3. These heart defects are common in children with Downs syndrome, not Trisomy 18.
4. Coarctation of the aorta is the most common defect for a child with Trisomy 18.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

60. A nurse is caring for a child with Turners syndrome. As the nurse listens to the childs heart and lungs, she would anticipate auscultating:

1. A high-pitched gurgle.

2. A low-pitched gurgle.

3. Wheezing in the lungs.

4. Crackles in the lungs.

ANS: 4

Feedback
1. A high-pitched gurgle is not noted in the lung sounds because of where the heart defect is located.
2. A low-pitched gurgle is not noted in the lung sounds because of where the heart defect is located.
3. Wheezes are not commonly heard in a child with Turners syndrome.
4. Crackles in lungs are common in a child with Turners syndrome because of the left-sided heart defects.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

61. Which of the following diseases are screened for in the newborn screen procedure?

1. Sickle Cell disease

2. Neurofibromatosis

3. PKU

4. Downs syndrome

ANS: 3

Feedback
1. A separate blood screen is needed for children at risk for Sickle Cell disease.
2. This is not diagnosed in children until the teen years.
3. This is identified on the newborn screen. Results are quickly given to identify if an adjustment to the newborns diet should be made.
4. Testing for Downs syndrome is done if physical characteristics or assessments indicate concern.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

62. Which of the following children are at an increased risk for seizures?

1. A 2-year-old girl with Turners syndrome

2. An 8-year-old boy with neurofibromatosis Type 2

3. An infant born with Trisomy 13

4. A 16-year-old boy with Downs syndrome

ANS: 2

Feedback
1. Girls with Turners syndrome are not at an increased risk for seizure activity.
2. This child is at a higher risk for seizures because of the tumor locations on the brain.
3. A child with Trisomy 13 is not at a higher risk for seizures.
4. A boy with Downs syndrome is not at an increased risk for seizure activity.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

63. Ash leaf lesions are a cardinal sign for:

1. Tuberous Sclerosis.

2. Sturge-Weber syndrome.

3. Cri-Du-Chat syndrome.

4. Williams syndrome.

ANS: 1

Feedback
1. The cardinal sign of Tuberous Sclerosis is the ash leaf lesion.
2. Cardinal sign is a port-wine stain
3. Cardinal sign is the cat cry
4. Cardinal sign is the lacy iris pattern

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Choice

64. A mother who has achondroplasia asks the nurse if her infant will be at risk for the same diagnosis. The nurse knows that:

1. If the father has the same diagnosis, then the child has a 50% chance of having achondroplasia.

2. If the father does not have the same diagnosis, then the child has a75% chance of having achondroplasia.

3. Over 80 percent of the people with achondroplasia are born to parents with normal height, so the infant may be of normal height.

4. Achondroplasia is rare, and the mother should watch for signs and symptoms as the child grows.

ANS: 1

Feedback
1. With both parents having the disorder, the child has a 50% chance of achondroplasia.
2. The child has a lower chance of achondroplasia if the father is of normal height.
3. Most children with achondroplasia have a parent with it.
4. Achondroplasia is usually prevalent at birth.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

65. A nurse is plotting the growth grid for a child with a known diagnosis of achondroplasia. The nurse should know that:

1. A specific growth grid should be used for patients with achondroplasia.

2. The weight of the child will be above the normal limits while the height is below the normal limits.

3. A child with this diagnosis will not usually live past the age of 10.

4. This diagnosis occurs mostly in boys.

ANS: 1

Feedback
1. A child with this known diagnosis should be tracked on a growth grid specifically for achondroplasia.
2. Weight will be within normal limits for a child.
3. A child with this diagnosis can lead a relatively normal life span.
4. This diagnosis can occur in both males and females.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

66. Hydrocephalus has been diagnosed in a fetus. At the delivery for the neonate, the nurse should anticipate:

1. A lethargic neonate.

2. A larger than average head circumference.

3. A stillbirth.

4. A neonate that appears the same as a counterpart without the diagnosis.

ANS: 2

Feedback
1. The neonate may have a tone similar to a healthy baby.
2. The head will be larger because of the extra fluid around the brain.
3. There is no indication of fetal demise.
4. The head circumference will be enlarged, and thus will not look similar to other newborns.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

67. When working with a child with Fragile X syndrome, it is important to:

1. Pace the assessment because the child will become anxious if it is done too quickly.

2. Make direct eye contact so that the child knows you are speaking.

3. Perform a passive range of motion exercises.

4. Postpone immunizations until the child is able to understand what is occurring.

ANS: 1

Feedback
1. Keeping the child calm will allow the nurse to complete a full assessment. Children with the syndrome tend to get anxious easily.
2. The child becomes more anxious if direct eye contact is made.
3. The child needs an active range of motion exercises.
4. Immunizations should be given on schedule because the cognitive level of the child is limited in most cases.

KEY: Content Area: Genetic Disorders | Integrated Processes: Caring | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

68. A new mother has just received news that her newborn has been diagnosed with Prayer-Willis syndrome. The nurse knows that the mother needs more education when she states:

1. My child will need regular checkups for scoliosis and osteoporosis.

2. My baby may not show pain like my other children.

3. I can breastfeed my baby for as long as I want.

4. I need to get early child interventions for her to function on her best level.

ANS: 3

Feedback
1. Regular checkups are needed in order to monitor development.
2. The child may not show pain.
3. The child can breastfeed and is encouraged to, but not for as long as the mother would like.
4. Early interventions will allow for a proactive approach for the child.

KEY: Content Area: Genetic Disorders | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | REF: CHAPTER 18 | Type: Multiple Choice

69. A family with a child with genetic defects needs:

1. Education on the syndrome or disease process.

2. To be well-informed about treatment options.

3. Support from trained professionals in order to cope with the situation.

4. All of the above are correct.

ANS: 4

Feedback
1. Education will allow the family to be proactive for the childs needs.
2. Parents who are well-informed about the childs disease process are able to be proactive for the childs needs.
3. A family that has professionals to help with the childs needs will feel supported.
4. Education, information, and support will benefit the childs success.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Choice

70. Children born with Fetal Alcohol syndrome will have long-term effects when dealing with:

1. Cognitive development.

2. Emotional development.

3. Physical development.

4. All of the above can be long-term effects related to Fetal Alcohol syndrome.

ANS: 4

Feedback
1. The child will have long-term effects with cognitive development.
2. The child will have long-term effects with emotional development.
3. The child may have long-term effects with physical development.
4. Cognitive, emotional, and physical development may be impaired because of prenatal alcohol exposure.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: CHAPTER 18 | Type: Multiple Choice

71. A common response for a child with Fetal Alcohol Syndrome in an environment with a lot of activity is:

1. Screaming or crying because the child is overstimulated.

2. Walking away to a quiet place to regroup.

3. Refusing to follow the rules.

4. Becoming aggressive because the child wants to get away from the activity.

ANS: 1

Feedback
1. Because of the brain damage from alcohol in utero, the child is unable to handle environments with high activity.
2. The child needs to be taught how to remove himself/herself from a situation in order to regroup.
3. A child with Fetal Alcohol Syndrome will follow consistent rules.
4. A child with Fetal Alcohol Syndrome will need breaks from high activity levels, but usually does not become aggressive.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: CHAPTER 18 | Type: Multiple Choice

72. A child with Alcohol-Related Neurodevelopmental Disorder (ARND) will exhibit which of the following types of behavior?

1. High scores on math and computation testing

2. Refuse to participate in social events

3. Have difficulty with verbal expression

4. Have high scores on reading, but not comprehension

ANS: 3

Feedback
1. The child may have trouble with computation and math because of the areas of the brain affected by alcohol consumption in utero.
2. The child will be able to participate in social events.
3. The child may have speech delays because of the areas of the brain affected by alcohol consumption in utero.
4. The child will have low reading scores because of the alcohol exposure.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: CHAPTER 18 | Type: Multiple Choice

True or False

73. A girl who has never experienced primary menarche by the age of 16 should be evaluated.

ANS: T

Feedback
1. An evaluation should be performed to make sure that there is no structural or hormonal reason for the lack of menarche.
2. An evaluation should be performed to make sure that there is no structural or hormonal reason for the lack of menarche.

KEY: Content Area: Reproductive Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: True/False

Multiple Response

74. A child with the diagnosis of a neurofibromatosis requires which of the following nursing interventions? Select all that apply.

1. Blood pressure check

2. Scoliosis screen

3. Maintain a growth grid

4. Skin exam

5. Daily weight checks

ANS: 1, 2, 3, 4

Feedback
1. Blood pressure checks are needed at least yearly because of a high incidence of hypertension.
2. Screen should be conducted at every visit because of the high incidence of scoliosis.
3. A growth grid will enable accurate measurements for the child.
4. Skin exams are needed to inspect for caf au lait spots.
5. Head circumference should be done at every visit in order to make sure that growth is occurring.
6. Weight checks only need to be done on medical visits, not daily.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: CHAPTER 18 | Type: Multiple Response

75. A nurse is attempting to perform an assessment on a child with a diagnosis of Prayer-Willis Syndrome. Identify characteristics common with this diagnosis. Select all that apply.

1. Almond-shaped eyes

2. Aggressive behavior

3. Only found in females

4. Manipulative behavior patterns

5. Small mouth

ANS: 1, 2, 4

Feedback
1. Almond-shaped eyes are a common characteristic.
2. Aggressive behavior is a common characteristic.
3. Found in males
4. Manipulative behavior patterns are a common characteristic.
The child has an average-sized mouth.

KEY: Content Area: Genetic Disorders | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: CHAPTER 18 | Type: Multiple Response

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