The nurse in the OB/GYN clinic is caring for several couples who are planning to get pregnant.
For which couple(s) would the nurse recommend genetic counseling? (Select all that apply).
The female who is 37 and male partner who is 52 years old.
The client who had a macrosomic baby due to gestational diabetes.
The couple who has a child with a congenital anomaly.
The couple with a history of 3 miscarriages.
The client with a family history of an X-linked disorder.
Correct Answer : A,C,D,E
This scenario involves preconception care and identifying reproductive risk factors. Knowledge of advanced parental age, recurrent pregnancy loss, and heritable genetic conditions is applied to determine which clients require specialized counseling to assess risks for chromosomal abnormalities or genetic disorders.
Choice A rationale
Advanced maternal age (≥ 35) and paternal age (≥ 40) increase the risk of chromosomal abnormalities like Down syndrome or new gene mutations. Counseling helps couples understand these statistical risks and available prenatal diagnostic testing options.
Choice B rationale
Macrosomia related to gestational diabetes is a metabolic and glycemic management issue rather than a primary genetic disorder. This clinical history does not typically warrant genetic counseling unless other risk factors for congenital anomalies are present.
Choice C rationale
Having a child with a congenital anomaly increases the risk of recurrence in subsequent pregnancies. Genetic counseling is essential to identify the inheritance pattern and provide the couple with specific risks for future children.
Choice D rationale
Recurrent pregnancy loss, defined as 3 or more miscarriages, may be caused by parental balanced translocations or other genetic factors. Investigation through counseling and karyotyping is recommended to identify the underlying cause of losses.
Choice E rationale
A family history of X-linked disorders, such as hemophilia or Duchenne muscular dystrophy, carries a specific inheritance risk. Counseling allows the client to understand the probability of passing the gene to their offspring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E","F"]
Explanation
The scenario requires an understanding of obstetric assessment and monitoring. Knowledge of prenatal diagnostics, physical assessment techniques for neurological and gestational health, and laboratory screening for infection or metabolic changes is necessary to identify appropriate nursing interventions within a comprehensive care plan.
Choice A rationale
Glucose tolerance tests screen for gestational diabetes mellitus by measuring blood glucose response to sugar loads. Normal fasting glucose is < 95 mg/dL. This monitors metabolic status and prevents maternal or neonatal complications during the pregnancy.
Choice B rationale
Assessing deep tendon reflexes evaluates neuromuscular irritability. It is crucial for clients at risk of preeclampsia or those receiving magnesium sulfate. Normal reflexes are 2+. Abnormal findings can indicate impending seizures or magnesium toxicity.
Choice C rationale
The non-stress test monitors fetal heart rate patterns in response to fetal movement. A reactive test shows two or more accelerations in twenty minutes. This non-invasive procedure assesses fetal well being and placental oxygenation.
Choice D rationale
A complete blood count monitors hemoglobin and hematocrit levels to detect anemia. Normal hemoglobin in pregnancy is > 11 g/dL. It also assesses white blood cell counts for infection and platelets for clotting disorders.
Choice E rationale
Vaginal examinations determine cervical dilation, effacement, and fetal station during labor. This assessment helps the nurse track labor progression. It is also used to evaluate for the rupture of membranes or presence of vaginal bleeding.
Choice F rationale
Urine dipsticks screen for proteinuria, glycosuria, and ketones. Proteinuria ≥ 1+ can indicate preeclampsia. Glucose in the urine may suggest diabetes. This bedside test provides immediate data regarding the client's renal and metabolic status.
Correct Answer is ["A","B","E"]
Explanation
Safe newborn feeding practices require applying knowledge of infant anatomy and physiology to prevent aspiration and gas distension. Proper technique involves positioning, air management, and gastric decompression to ensure nutritional intake while maintaining airway patency and gastrointestinal comfort.
Choice A rationale
Burping frequently removes swallowed air from the stomach, preventing gastric distension and reducing the risk of regurgitation or colic. It is a standard safety intervention to ensure the infant remains comfortable and digests the formula effectively.
Choice B rationale
Semi-upright positioning uses gravity to keep formula at the bottom of the stomach and air at the top. This reduces the risk of aspiration and reflux, providing a safer environment for swallowing compared to lying flat.
Choice C rationale
Placing a newborn in a supine position during feeding is dangerous because it significantly increases the risk of aspiration and choking. Formula can easily enter the trachea or flow into the eustachian tubes, causing ear infections.
Choice D rationale
Propping a bottle is contraindicated because it prevents the infant from controlling the flow, leading to overfeeding or choking. It also limits essential skin-to-skin contact and increases the risk of developing dental caries or infections.
Choice E rationale
Keeping the nipple full of formula ensures the infant sucks liquid rather than air. This technique minimizes aerophagia, which causes painful gas, bloating, and excessive spitting up, leading to a more efficient and comfortable feeding experience.
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