MARGOT-DESEVO MATERNAL AND CHILD NURSING
CHAPTER 2
Sexuality
1. A nurse is discussing sexual arousal during a
preadolescent boys’ sex education class. Which of
the following should the nurse base her reply on
when a boy asks, “What exactly happens when my
body gets aroused, anyway?”
1. The vas deferens thickens and expands.
2. The sympathetic nerves of the penis are
stimulated.
3. The corpora of the penis become engorged.
4. The prepuce of the penis elongates.
2. A woman, whose menstrual cycle is 35 days long,
states that she often has a slight pain on one side of
her lower abdomen on day 21 of her cycle. She
wonders whether or not she has ovarian cancer.
What is the nurse’s best response?
1. “Women often feel a slight twinge when ovulation
occurs.”
2. “Ovarian cancer is a possibility and you should
seek medical attention as soon as possible.”
3. “Ovarian cancer is unlikely because the pain is not
a constant pain.”
4. “It is more likely that such pain indicates an ovarian
cyst because pain is more common with that
problem.”
3. A nurse is explaining to a client about monthly
hormonal changes. Starting with Day 1 of the
menstrual cycle, please place the following four
hormones in the chronological order in which they
elevate during the menstrual cycle.
1. Follicle-stimulating hormone.
2. Gonadotropin-releasing hormone.
3. Luteinizing hormone.
4. Progesterone.
4. A 54-year-old client calls her health care
practitioner complaining of frequency and burning
when she urinates. Which of the following factors that
occurred within the preceding 3 days likely
contributed to this client’s problem?
1. She had intercourse with her partner.
2. She returned from a trip abroad.
3. She stopped taking hormone replacement
therapy.
4. She started a weight-lifting exercise program.
5. A woman’s temperature has just risen 0.4°F and
will remain elevated during the remainder of her
cycle. She expects to menstruate in about 2 weeks.
Which of the following hormones is responsible for
the change?
1. Estrogen.
2. Progesterone.
3. Luteinizing hormone (LH).
4. Follicle-stimulating hormone (FSH).
6. A woman is menstruating. If hormonal studies
were to be done at this time, which of the following
hormonal levels would the nurse expect to see?
1. Both estrogen and progesterone are high.
2. Estrogen is high and progesterone is low.
3. Estrogen is low and progesterone is high.
4. Both estrogen and progesterone are low.
7. A nurse teaches a woman who wishes to become
pregnant that if she assesses for spinnbarkeit she will
be able closely to predict her time of ovulation. Which
technique should the client be taught in order to
assess for spinnbarkeit?
1. Take her temperature each morning before rising.
2. Carefully feel her breasts for glandular
development.
3. Monitor her nipples for signs of tingling and
sensitivity.
4. Assess her vaginal discharge for elasticity and
slipperiness.
8. In analyzing the need for teaching regarding
sexual health in a client who is sexually active, which
of the following questions is the most important for a
nurse to ask?
1. “How old are your children?”
2. “Did you have intercourse last evening?”
3. “With whom do you have intercourse?”
4. “Do you use vaginal lubricant?”
9. When a nurse is teaching a woman about her
menstrual cycle she mentions that which of the
following is the most important change that happens
during the follicular phase of the menstrual cycle?
1. Maturation of the graafian follicle.
2. Multiplication of the fimbriae.
3. Secretion of human chorionic gonadotropin.
4. Proliferation of the endometrium.
10. It is day 17 of a woman’s menstrual cycle. She is
complaining of breast tenderness and pain in her
lower left quadrant. The woman states that her cycle
is usually 31 days long. Which of the following is an
appropriate reply by the nurse?
1. “You are probably ovulating.”
2. “Your hormone levels should be checked.”
3. “You will probably menstruate early.”
4. “Your breast changes are a worrisome sign.”
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
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12. The nurse is teaching a class on reproduction.
When asked about the development of the ova, the
nurse would include which of the following?
1. Meiotic divisions begin during puberty.
2. At the end of meiosis, four ova are created.
3. Each ovum contains the diploid number of
chromosomes.
4. Like sperm, ova have the ability to propel
themselves.
13. A client complaining of secondary amenorrhea is
seeking care from her gynecologist. Which of the
following may have contributed to her problem?
1. Athletic activities.
2. Vaccination history.
3. Pet ownership.
4. Genetic history.
Infertility
15. A couple is seeking infertility counselling. During
the history, it is noted that the man is a cancer
survivor, drinks one beer every night with dinner, and
takes a sauna every day after work. Which of the
following is an appropriate response by the nurse?
1. It is unlikely that any of these factors is impacting
his fertility.
2. Daily alcohol consumption could be causing his
infertility problems.
3. Sperm may be malformed when exposed to the
heat of the sauna.
4. Cancer survivors have the same fertility rates as
healthy males.
16. A nurse is teaching an infertile couple about how
the sperm travel through the man’s body during
ejaculation. Please put the following five major
structures in order, beginning with the place where
spermatogenesis occurs and continuing through the
path that the sperm and semen travel until
ejaculation.
1. Epididymis.
2. Prostate.
3. Testes.
4. Urethra.
5. Vas deferens.
18. The nurse is providing counseling to a group of
sexually active single women. Most of the women
have expressed a desire to have children in the
future, but not within the next few years. Which of the
following actions should the nurse suggest the
women take to protect their fertility for the future?
Select all that apply.
1. Use condoms during intercourse.
2. Refrain from smoking cigarettes.
3. Maintain an appropriate weight for height.
4. Exercise in moderation.
5. Refrain from drinking carbonated beverages.
19. a couple is seeking advice regarding actions that
they can take to increase their potential of becoming
pregnant. Which of the following recommendations
should the nurse give to the couple?
1. The couple should use vaginal lubricants during
intercourse.
2. The couple should delay having intercourse until
the day of ovulation.
3. The woman should refrain from douching.
4. The man should be on top during intercourse.
20. A nurse working in an infertility clinic should
include which of the following in her discussions with
the couple?
1. Adoption as an alternative to infertility treatments.
2. The legal controversy surrounding artificial
insemination.
3. The need to seek marriage counseling before
undergoing infertility treatments.
4. Statistics regarding the number of couples who
never learn why they are infertile.
21. An Orthodox Jewish couple is seeking infertility
counselling. The woman states that her menstrual
cycle is 21 days long. After testing, no physical
explanation is found for the infertility. Which of the
following may explain why the woman has been
unable to conceive?
1. Her Kosher diet is lacking in the essential nutrients
needed for achieving optimal reproductive health.
2. The positions allowed Orthodox Jewish couples
during intercourse hinder the process of fertilization.
3. Orthodox Jewish couples are known to have a high
rate of infertility because of inborn genetic diseases.
4. Orthodox Jewish couples refrain from intercourse
during menses and for seven days after it ends.
22. An infertile woman has been diagnosed with
endometriosis. She asks the nurse why that
diagnosis has made her infertile. Which of the
following explanations is appropriate for the nurse to
make?
1. “Scarring surrounds the ends of your tubes
preventing your eggs from being fertilized by your
partner’s sperm.”
2. “You are producing insufficient quantities of
follicle-stimulating hormone that is needed to mature
an egg every month.”
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
CHAPTER 2
3. “Inside your uterus is a benign tumor that makes it
impossible for the fertilized egg to implant.”
4. “You have a chronic infection of the vaginal tract
that makes the secretions hostile to your partner’s
sperm.”
23. A Roman Catholic couple is infertile. Their health
care practitioner advises them that their best chance
of getting pregnant is via in vitro fertilization with a
mixture of the man’s sperm and donor sperm. Which
of the following issues, related to this procedure,
should the nurse realize may be in conflict with the
couple’s religious beliefs? Select all that apply.
1. The man will ejaculate by masturbation into a
specially designed condom.
2. The woman may become pregnant with donor
sperm.
3. Fertilization is occurring in the artificial
environment of the laboratory.
4. More embryos will be created than will be used to
inseminate the woman.
5. The woman will receive medications to facilitate
the ripening of her ova.
24. Infertility increases a client’s risk of which of the
following diseases?
1. Diabetes mellitus.
2. Nystagmus.
3. Cholecystitis.
4. Ovarian cancer.
25. A client is to receive Pergonal (menotropins)
injections for infertility prior to in vitro fertilization.
Which of the following is the expected action of this
medication?
1. Prolongation of the luteal phase.
2. Stimulation of ovulation.
3. Suppression of menstruation.
4. Promotion of cervical mucus production.
26. A 35-year-old client is being seen for her yearly
gynecological examination. She states that she and
her partner have been trying to become pregnant for
a little over 6 months, and that a friend had recently
advised her partner to take ginseng to improve the
potency of his sperm. The woman states that they
have decided to take their friend’s advice. On which
of the following information should the nurse base his
or her reply?
1. Based on their history, the client and her partner
have made the appropriate decision regarding their
fertility.
2. Ginseng can cause permanent chromosomal
mutations and should be stopped immediately.
3. It is unnecessary to become concerned about this
woman’s fertility because she has only tried to
become pregnant for a few months.
4. Although ginseng may be helpful, it would be
prudent to encourage the woman to seek fertility
counseling.
27. a couple is seeking infertility counseling. The
practitioner has identified the factors listed below in
the woman’s health history. Which of these findings
may be contributing to the couple’s infertility?
1. The client is 36 years old.
2. The client was 13 years old when she started to
menstruate.
3. The client works as a dental hygienist 3 days a
week.
4. The client jogs 2 miles every day.
28. A couple who has sought fertility counseling has
been told that the man’s sperm count is very low. The
nurse advises the couple that spermatogenesis is
impaired when which of the following occurs?
1. The testes are overheated.
2. The vas deferens is ligated.
3. The prostate gland is enlarged.
4. The flagella are segmented.
29. A nurse working with an infertile couple has made
the following nursing diagnosis: Sexual dysfunction
related to decreased libido. Which of the following
assessments is the likely reason for this diagnosis?
1. The couple has established a set schedule for their
sexual encounters.
2. The couple has been married for more than eight
years.
3. The couple lives with one set of parents.
4. The couple has close friends who gave birth to a
baby within the last year.
30. An infertile man is being treated with Viagra
(sildenafil citrate) for erectile dysfunction
(ED). Which of the following is a contraindication for
this medication?
1. Preexisting diagnosis of herpes simplex 2.
2. Nitroglycerin ingestion for angina pectoris.
3. Retinal damage from type I diabetes mellitus.
4. Postsurgical care for resection of the prostate.
31. A client has been notified that because of
fallopian tube obstruction, her best option for
becoming pregnant is through in vitro fertilization.
The client asks the nurse about the procedure. Which
of the following responses is correct?
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
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1. “During the stimulation phase of the procedure, the
physician will make sure that only one egg reaches
maturation.”
2. “Preimplantation genetic diagnosis will be
performed on your partner’s sperm to make sure that
the sperm are normal.”
3. “After ovarian stimulation, you will be artificially
inseminated with your partner’s sperm.”
4. “Any extra embryos will be preserved for you if you
wish to conceive again in the future.”
32. A client asks the nurse about the gamete
intrafallopian transfer (GIFT) procedure. Which of the
following responses would be appropriate for the
nurse to make?
1. Fertilization takes place in the woman’s body.
2. Zygotes are placed in the fallopian tubes.
3. Donor sperm are placed in a medium with donor
eggs.
4. A surrogate carries the infertile woman’s fetus.
33. A client who is undergoing ovarian stimulation for
infertility calls the infertility nurse and states, “My
abdomen feels very bloated, my clothes are very
tight, and my urine is very dark.” Which of the
following is the appropriate statement for the nurse
to make at this time?
1. “Please take a urine sample to the lab so they can
check it for an infection.”
2. “Those changes mean that you will menstruate
within the next three days.”
3. “It is important for you to come into the office to be
examined today.”
4. “Abdominal bloating is an expected response to
the medications.”
34. Nurses working in a midwifery office have
attended a conference to learn about factors that
increase a woman’s risk of becoming infertile. To
evaluate the nurses’ learning, the conference
coordinator tested the nurses’ knowledge at the
conclusion of the seminar. Which of the following
problems should the nurses state increase a client’s
risk of developing infertility problems? Select all that
apply.
1. Women who have menstrual cycles that are up to
30 days long.
2. Women who experience pain during intercourse.
3. Women who have had pelvic inflammatory
disease.
4. Women who have excess facial hair.
5. Women who have menstrual periods that are over
5 days long.
35. An infertility specialist is evaluating whether a
woman’s cervical mucus contains enough estrogen
to support sperm motility. Which of the following tests
is the physician conducting?
1. Ferning capacity.
2. Basal body temperature.
3. Culposcopy.
4. Hysterotomy.
36. A couple, who have been attempting to become
pregnant for 5 years, is seeking assistance from an
infertility clinic. The nurse assesses the clients’
emotional responses to their infertility. Which of the
following responses would the nurse expect to find?
Select all that apply.
1. Anger at others who have babies.
2. Feelings of failure because they can’t make a
baby.
3. Sexual excitement because they want so
desperately to conceive a baby.
4. Sadness because of the perceived loss of being a
parent.
5. Guilt on the part of one partner because he or she
is not able to give the other a baby.
37. A client is to undergo a postcoital test for
infertility. The nurse should include which of the
following statements in the client’s preprocedure
counseling?
1. “You will have the test the day after your
menstruation ends.”
2. “You will have a dye put into your vein that will
show up on x-ray.”
3. “You should refrain from having intercourse for the
four days immediately prior to the test.”
4. “You should experience the same sensations you
feel when your doctor does your Pap test.”
38. A client is to have a hysterosalpingogram. In this
procedure, the physician will be able to determine
which of the following?
1. Whether or not the ovaries are maturing properly.
2. If the endometrium is fully vascularized.
3. If the cervix is incompetent.
4. Whether or not the fallopian tubes are obstructed.
39. A client’s basal body temperature chart for one
full month is shown below. Based on the
temperatures shown, what can the nurse conclude?
1. It is likely that the client has not ovulated.
2. The client’s fertile period is between 12 and 18
days.
3. The client’s period is abnormally long.
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
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4. It is likely that her progesterone levels rose on day
15.
40. Which instruction by the nurse should be included
in the teaching plan for an infertile woman who has
been shown to have a 28-day biphasic menstrual
cycle?
1. Douche with a cider vinegar solution immediately
before having intercourse.
2. Schedule intercourse every day from day 8 to day
14 of the menstrual cycle.
3. Be placed on follicle-stimulating hormone therapy
by the fertility specialist.
4. Assess the basal body temperature pattern for at
least 6 more months.
41. A couple has been told that the male partner, who
is healthy, is producing no sperm “because he has
cystic fibrosis.” Which of the following explanations is
accurate in relation to this statement?
1. Since the man is healthy he could not possibly
have cystic fibrosis.
2. Men with cystic fibrosis often have no epididymis.
3. The expressivity of cystic fibrosis is variable.
4. Cystic fibrosis is a respiratory illness having
nothing to do with reproduction.
42. A female client seeks care at an infertility clinic.
Which of the following tests may the client undergo
to determine what, if any, infertility problem she may
have? Select all that apply.
1. Chorionic villus sampling.
2. Endometrial biopsy.
3. Hysterosalpingogram.
4. Serum progesterone assay.
5. Postcoital test.
43. A client is hospitalized in the acute phase of
severe ovarian hyperstimulation syndrome. The
following nursing diagnosis has been identified: Fluid
volume excess (extravascular) related to third
spacing. Which of the following nursing goals is
highest priority in relation to this diagnosis?
1. Client’s weight will be within normal limits by date
of discharge.
2. Client’s skin will show no evidence of breakdown
throughout hospitalization.
3. Client’s electrolyte levels will be within normal
limits within one day.
4. Client’s lung fields will remain clear throughout
hospitalization.
44. A client is receiving Pergonal (menotropins)
intramuscularly for ovarian stimulation. Which of the
following is a common side effect of this therapy?
1. Piercing rectal pain.
2. Mood swings.
3. Visual disturbances.
4. Jerky tremors.
45. A client is to have a hysterosalpingogram. Which
of the following information should the nurse provide
the client prior to the procedure?
1. “The test will be performed through a small incision
next to your belly button.”
2. “You will be on bed rest for a full day following the
procedure.”
3. “An antibiotic fluid will be instilled through a tube in
your cervix.”
4. “You will be asked to move from side to side so
that x-ray pictures can be taken.”
Genetics
46. The nurse is creating a pedigree from a client’s
family history. Which of the following symbols should
the nurse use to represent a female?
1. Circle.
2. Square.
3. Triangle.
4. Diamond.
47. A woman has been advised that the reason why
she has had a number of spontaneous abortions is
because she has an inheritable mutation. Which of
the following situations is consistent with this
statement?
1. A client developed skin cancer after being exposed
to the sun.
2. A client developed colon cancer from an inherited
dominant gene.
3. A reciprocal translocation was reported on a
client’s genetic analysis.
4. A client’s left arm failed to develop when she was
a fetus.
48. Which of the following client responses indicates
that the nurse’s teaching about care following
chorionic villus sampling has been successful?
1. If the baby stops moving, the woman should
immediately go to the hospital.
2. The woman should take oral terbutaline every 2
hours for the next day.
3. If the woman starts to bleed or to contract, she
should call her physician.
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
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4. The woman should stay on complete bed rest for
the next 48 hours.
49. A pregnant woman and her husband are both
heterozygous for achondroplastic dwarfism, an
autosomal dominant disease. The nurse advises the
couple that their unborn child has which of the
following probabilities of being of normal stature?
1. 25% probability.
2. 50% probability.
3. 75% probability.
4. 100% probability.
50. A couple inquires about the inheritance of
Huntington’s disease (HD) because the prospective
father’s mother is dying of the illness. There is no
history of the disease in his partner’s family. The man
has never been tested for HD. Which of the following
responses by the nurse is appropriate?
1. “Because HD is an autosomal dominant disease,
each and every one of your children will have a 1 in
4 chance of having the disease.”
2. “Because only one of you has a family history of
HD, the probability of any of your children having the
disease is less than 10%.”
3. “Because HD is such a devastating disease, if
there is any chance of passing the gene along, it
would be advisable for you to adopt.”
4. “Because neither of you has been tested for HD,
the most information I can give you is that each and
every one of your children may have the disease.”
51. A client, G4 P4004, states that her husband has
just been diagnosed with polycystic kidney disease
(PKD), an autosomal dominant disease. The
husband is heterozygous for PKD, while the client
has no PKD genes. The client states, “I have not had
our children tested because they have such a slim
chance of inheriting the disease.
We intend to wait until they are teenagers to do the
testing.” The nurse should base her reply on which of
the following?
1. Because affected individuals rarely exhibit
symptoms before age 60, the children should be
allowed to wait until they are adults to be tested.
2. The woman may be exhibiting signs of denial since
each of the couple’s children has a 50/50 chance of
developing the disease.
3. Because the majority of the renal cysts that
develop in affected individuals are harmless, it is
completely unnecessary to have the children tested.
4. The woman’s husband should be seen by a
genetic specialist since he is the person who is
carrying the affected gene.
52. A woman is a carrier for hemophilia, an X-linked
recessive illness. Her husband has a normal
genotype. The nurse can advise the couple that the
probability that their daughter will have the disease
is:
1. 0% probability.
2. 25% probability.
3. 50% probability.
4. 75% probability.
53. At her first prenatal visit, a woman relates that her
maternal aunt has cystic fibrosis, an autosomal
recessive illness. Which of the following comments is
appropriate for the nurse to make at this time?
1. “We can check to see whether or not you are a
carrier for cystic fibrosis.”
2. “It is unnecessary for you to worry since your aunt
is not a direct relation.”
3. “You should have an amniocentesis to see
whether or not your child has the disease.”
4. “Please ask your mother whether she has ever had
any symptoms of cystic fibrosis.”
54. A woman asks the nurse, “My nuchal fold scan
results were abnormal. What does that mean?”
Which of the following comments is appropriate for
the nurse to make at this time?
1. “I am sorry to tell you that your baby will be born
with a serious deformity.”
2. “The results show that your child will have cri du
chat syndrome.”
3. “The test is done to see if you are high risk for
preterm labor.”
4. “An abnormal test indicates that your baby may
have Down syndrome.”
55. A 10-week gravid states that her sister’s son has
been diagnosed with an X-linked recessive disease,
muscular dystrophy. She questions the nurse about
the disease. Which of the following responses is
appropriate for the nurse to make?
1. “Because muscular dystrophy is inherited through
the woman, it is advisable for you to see a genetic
counselor.”
2. “Muscular dystrophy usually occurs as a
spontaneous mutation. It is very unlikely that your
fetus is affected.”
3. “Your child could only acquire muscular dystrophy
if both you and your husband carried the gene. You
need to check your husband’s family history.
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
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4. “If you were to have an amniocentesis and it were
to come out positive, I can recommend you to an
excellent abortion counselor.
56. The genetic counselor informs a couple that they
have a 25% probability of getting pregnant with a
child with a severe genetic disease. The couple asks
the nurse exactly what that means. Which of the
following responses by the nurse is appropriate?
1. Their first child will have the genetic disease.
2. If they have four children, one of the children will
have the disease.
3. Their fourth child will have the genetic disease.
4. Whenever they get pregnant, the fetus may have
the disease.
57. A client has just had an amniocentesis to
determine whether or not her baby has an inheritable
genetic disease. Which of the following interventions
is highest priority at this time?
1. Assess the fetal heart rate.
2. Check the client’s temperature.
3. Acknowledge the client’s anxiety about the
possible findings.
4. Answer questions regarding the genetic
abnormality.
58. Once oogenesis is complete, the resultant
gamete cell contains how many chromosomes?
1. 23.
2. 46.
3. 47.
4. 92.
59. Based on the karyotype shown below, which of
the following conclusions can the nurse make about
the female baby?
1. She has a genetically normal karyotype.
2. She has trisomy 21.
3. She has fragile X syndrome.
4. She has an autosomal monosomy.
60. A genetic counselor’s report states, “The genetic
nomenclature for this fetus is 46, XX.” How should
the nurse who reads this report interpret the
cytogenetic results?
1. The baby is female with a normal number of
chromosomes.
2. The baby is hermaphroditic male with female
chromosomes.
3. The baby is male with an undisclosed genetic
anomaly.
4. There is insufficient information to answer this
question.
61. The nurse is analyzing the three-generation
pedigree below. In which generation is the proband?
1. I.
2. II.
3. III.
4. There is not enough information to answer this
question.
62. A woman is seeking genetic counseling during
her pregnancy. She has a strong family history of
diabetes mellitus. She wishes to have an
amniocentesis to determine whether or not she is
carrying a baby who will “develop diabetes.” Which
of the following replies by the nurse would be most
appropriate for the nurse to make?
1. “Doctors don’t do amniocenteses to detect
diabetes.”
2. “Diabetes cannot be diagnosed by looking at the
genes.”
3. “Although diabetes does have a genetic
component, diet and exercise also determine
whether or not someone is diabetic.”
4. “Even if the baby doesn’t carry the genes for
diabetes, the baby could still develop the disease.”
63. A 25-year-old woman, G0 P0000, enters the
infertility clinic stating that she has just learned she is
positive for the BRCA1 and the BRCA2 genes. She
asks the nurse what her options are for getting
pregnant and breastfeeding her baby. The nurse
should base her reply on which of the following?
1. Fertility of women who carry the BRCA1 and
BRCA2 genes is similar to that of unaffected women.
2. Women with these genes should be advised not to
have children because the children could inherit the
defective genes.
3. Women with these genes should have their
ovaries removed as soon as possible to prevent
ovarian cancer.
4. Lactation is contraindicated for women who carry
the BRCA1 and BRCA 2 genes.
64. A woman asks a nurse about presymptomatic
genetic testing for Huntington’s disease. The nurse
should base her response on which of the following?
1. There is no genetic marker for Huntington’s
disease.
2. Presymptomatic testing cannot predict whether or
not the gene will be expressed.
3. If the woman is positive for the gene for
Huntington’s, she will develop the disease later in life.
4. If the woman is negative for the gene, her children
should be tested to see whether or not they are
carriers.
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
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65. A woman, who has undergone amniocentesis,
has been notified that her baby is XX with a 14/21
Robertsonian chromosomal translocation. The nurse
helps the woman to understand which of the
following?
1. The baby will have a number of serious genetic
defects.
2. It is likely that the baby will be unable to have
children when she grows up.
3. Chromosomal translocations are common and
rarely problematic.
4. An abortion will probably be the best decision
under the circumstances
66. A woman who has had multiple miscarriages is
advised to go through genetic testing. The client asks
the nurse the rationale for this recommendation. The
nurse should base his or her response on which of
the following?
1. The woman’s pedigree may exhibit a mitochondrial
inheritance pattern.
2. The majority of miscarriages are caused by
genetic defects.
3. A woman’s chromosomal pattern determines her
fertility.
4. There is a genetic marker that detects the
presence of an incompetent cervix.
67. A nurse has just taken a family history on a 10-
week gravid client and created the family pedigree
shown below. Which of the following actions should
the nurse take at this time?
1. Advise the woman that she should have an
amniocentesis.
2. Encourage the doctor to send her for genetic
counseling.
3. Ask the woman if she knew any of the relatives
who died.
4. Inform the woman that her pedigree appears
normal.
68. A woman is informed that she is a carrier for Tay
Sachs disease, an autosomal recessive illness. What
is her phenotype?
1. She has one recessive gene and one normal gene.
2. She has two recessive genes.
3. She exhibits all symptoms of the disease.
4. She exhibits no symptoms of the disease.
69. During a genetic evaluation, it is discovered that
the woman is carrying one autosomal dominant gene
for a serious late adult-onset disease while her
partner’s history is unremarkable. Based on this
information, which of the following family members
should be considered high risk and in need of genetic
counseling? Select all that apply.
1. The woman’s fetus.
2. The woman’s sisters.
3. The woman’s brothers.
4. The woman’s parents.
5. The woman’s partner.
70. Which statement by a gravid client who is a
carrier for muscular dystrophy, an X-linked recessive
disease, indicates that she understands the
implications of her status?
1. “If I have a girl, she will be healthy.”
2. “None of my children will be at risk of the disease.”
3. “If I have a boy, he will be a carrier.”
4. “I am going to abort my fetus because it will be
affected.”
71. A man has inherited the gene for familial
adenomatous polyposis (FAP), an autosomal
dominant disease. He and his wife wish to have a
baby. Which of the following would provide the
couple with the highest probability of conceiving a
healthy child?
1. Amniocentesis.
2. Chorionic villus sampling.
3. Pre-implantation genetic diagnosis.
4. Gamete intrafallopian transfer.
72. A woman asks the obstetrician’s nurse about
cord blood banking. Which of the following responses
by the nurse would be best?
1. “I think it would be best to ask the doctor to tell you
about that.”
2. “The cord blood is frozen in case your baby
develops a serious illness in the future.”
3. “The doctors could transfuse anyone who gets into
a bad accident with the blood.”
4. “Cord blood banking is very expensive and the
blood is rarely ever used.”
73. A 3-month-old baby has been diagnosed with
cystic fibrosis. The mother states, “How could this
happen? I had an amniocentesis during my
pregnancy and everything was supposed to be
normal!” What does the nurse understand about this
situation?
1. Cystic fibrosis cannot be diagnosed by
amniocentesis.
2. The baby may have an uncommon genetic variant
of the disease.
3. It is possible that the laboratory technician made
an error.
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
CHAPTER 2
4. Instead of obtaining fetal cells the doctor probably
harvested maternal cells.
74. The nurse discusses the results of a 3-generation
pedigree with the proband who has breast cancer.
Which of the following information must the nurse
consider?
1. The proband should have a complete genetic
analysis done.
2. The proband is the first member of the family to be
diagnosed.
3. The proband’s first degree relatives should be
included in the discussion.
4. The proband’s sisters will likely develop breast
cancer during their lives.
75. The nurse is analyzing the pedigree shown
below. How should the nurse interpret the genotype
of the individual in location II-4?
1. Affected male.
2. Unaffected female.
3. Stillborn child.
4. Child of unknown sex.
76. The nurse is analyzing the pedigree shown
below. How should the nurse interpret the genotype
of the individuals in locations IV-9 and IV-10?
1. Fraternal twins.
2. Unaffected couple.
3. Proband and sister.
4. Known heterozygotes.
77. A woman who is a carrier for sickle cell anemia is
advised that if her baby has two recessive genes, the
penetrance of the disease is 100%, but the
expressivity is variable. Which of the following
explanations will clarify this communication for the
mother? All babies with 2 recessive sickle cell genes
will:
1. Develop painful vaso-occlusive crises during their
first year of life.
2. Exhibit at least some signs of the disease while in
the neonatal nursery.
3. Show some symptoms of the disease but the
severity of the symptoms will be individual.
4. Be diagnosed with sickle cell trait but will be
healthy and disease-free throughout their lives.
78. Analyze the pedigree below. Which of the
following inheritance patterns does the pedigree
depict?
1. Autosomal recessive.
2. Mitochondrial inheritance.
3. X-linked recessive.
4. Y-linked trait.
79. Analyze the pedigree below. Which of the
following inheritance patterns does the pedigree
depict?
1. Autosomal dominant.
2. Mitochondrial inheritance.
3. X-linked recessive.
4. Y-linked trait.
80. The nurse is counseling a pregnant couple who
are both carriers for phenylketonuria (PKU), an
autosomal recessive disease. Which of the following
comments by the nurse is appropriate?
1. “I wish I could give you good news, but because
this is your first pregnancy, your child will definitely
have PKU.”
2. “Congratulations, you must feel relieved that the
odds of having a sick child are so small.”
3. “There is a 2 out of 4 chance that your child will be
a carrier like both of you.”
4. “There is a 2 out of 4 chance that your child will
have PKU.”
81. A male client has green color blindness, an X-
linked recessive genetic disorder. His wife has no
affected genes. Which of the following statements by
the nurse is true regarding the couple’s potential for
having a child who is color blind?
1. All male children will be color blind.
2. All female children will be color blind.
3. All male children will be carriers for color
blindness.
4. All female children will be carriers for color
blindness.
82. A woman whose blood type is O_ (negative)
states, “My husband is AB_ (positive).
What blood type will my baby have?” Which of the
following is the best response for the nurse to make?
1. “Your baby could be type O but it is impossible to
predict the Rh status.”
2. “Your baby will be either AB_ (positive) or AB_
(negative).”
3. “Your baby could be any blood type except type O
or type AB.”
4. “Your baby will definitely be Rh_ (positive).”
83. A client’s amniocentesis results were reported as
46, XY. Her obstetrician informed her at the time that
everything “looks good.” Shortly after birth the baby
is diagnosed with cerebral palsy. Which of the
following responses will explain this result?
 MARGOT-DESEVO MATERNAL AND CHILD NURSING
CHAPTER 2

1. It is likely that the client received the wrong
amniocentesis results.
2. Cerebral palsy is not a genetic disease.
3. The genes that cause cerebral palsy have not yet
been discovered.
4. The genetics lab failed to test for cerebral palsy.
84. Most children born into families look similar but
are not exactly the same. The children appear
different because homologous chromosomes
exchange genetic material at which of the following?
1. Centromere.
2. Chiasma.
3. Chromatid.
4. Codon.
85. A client is being interviewed prior to becoming
pregnant. She states that she has a disease that is
transmitted by mitochondrial inheritance. Which of
the following statements is consistent with the client’s
disease?
1. 100% of her children will be affected.
2. Only her female children will be affected.
3. Each fetus will have a 50% probability of being
affected.
4. A fetus will only be affected if it inherits a similar
gene from its father.
88. Which of the following is an attainable short-term
goal for an 8-week gravid client who has a family
history of cystic fibrosis?
1. Have a sweat chloride test done.
2. Seek out genetic counseling.
3. Undergo chorionic villus sampling.
4. Be seen by a pulmonologist.
89. What is the rationale for testing all neonates for
maple syrup urine disease (MSUD) when only 1 in
100,000–300,000 children will be born with the
disease?
1. To encourage the parents to have genetic testing
done.
2. To prevent neurological disease in affected
children.
3. To reduce the amount of money insurance
companies must pay for sick MSUD children.
4. To persuade pharmaceutical companies to
develop medications to treat children with MSUD.

86. A client wants to undergo amniocentesis because

she has a family history of breast cancer. Which of
the following choices is the most important
information for the nurse to discuss with the client
regarding the request?
1. The breast cancer gene is highly penetrant.
2. The breast cancer gene has moderate
expressivity.
3. The amniocentesis could result in a miscarriage.
4. The majority of breast cancers are not inherited.

87. A woman is pregnant. During amniocentesis it is

discovered that her child has Down syndrome with a
mosaic chromosomal configuration. She asks the
nurse what that means. What is the nurse’s best
response?
1. “Instead of two number 21 chromosomes, your
child has three.”
2. “Your baby’s number 21 chromosomes have black
and white bands on them.”
3. “Some of your baby’s number 21 chromosomes
are longer than others.”
4. “Some of your baby’s cells have two number 21
chromosomes and some have three.”