Chapter 03- Nursing and Genomics LowdermilkMaternity & Women's Health Care, 12th Edition
Updated Solution 2022
1. A father and mother are carriers of
... [Show More] phenylketonuria (PKU). Their 2-year-old daughter
has the condition. The couple tells the nurse that they are expecting a second baby.
Because their daughter has PKU, they are certain that this baby will not be affected.
Which response by the nurse is the most accurate?
a. "Good planning. You need to take advantage of the odds that are in your favor."
b. "I think you'd better first check with your physician."
c. "You are both carriers; therefore, each baby has a 25% chance of being affected."
d. "The ultrasound indicates a boy, and boys are not affected by PKU." - ANS: C
Each child conceived by this couple has a one-in-four chance of being affected with the
PKU disorder. This couple still has an increased likelihood of having a child with PKU;
having one child already with PKU does not guarantee that they will not have another.
These parents need to discuss their options with their physician since the pregnancy
has already occurred. However, an opportune time has presented itself for the couple to
receive correct teaching about inherited genetic risks. No correlation exists between
gender and inheritance of the disorder, because PKU is an autosomal recessive
disorder
2. A client is 5 months pregnant. On a routine ultrasound scan, the physician discovers
that the fetus has a diaphragmatic hernia. The woman becomes distraught and asks the
nurse what she should do. Which response would be most suitable?
a. Talk to the client and refer her to a genetic counselor.
b. Suggest that the client travel to a fetal treatment center for intrauterine surgery.
c. Tell her that everything is going to be fine.
d. Sit with the client, and calmly suggest that she consider terminating this pregnancy. -
ANS: A
Before the client makes any decisions, she should discuss this newly discovered
information with a genetic counselor. Genetic counselors can help with the diagnosis
and management of families affected by genetic conditions. The discussion of potential
surgery should be pursuant to genetic counseling. Telling the woman that everything is
going to be fine may give her false hope and is not accurate. All options should be
discussed with the genetic counselor. Furthermore, the guiding principle for genetic
counseling is nondirection, which respects the right of the individual or family who are
being counseled to make autonomous decisions.
3. A new father has just been told that his infant has trisomy 18. Which identifying
physical feature is unique to an infant with this genetic disorder?
a. Microcephaly and capillary hemangiomas
b. Epicanthal folds and a simian crease
c. Oblique palpebral fissures and Cri du chat syndrome
d. Rocker-bottom feet and clenched hands with overlapping fingers - ANS: D... [Show Less]