Growth And Development Across The Lifespan 2nd Edition By Leifer MA RN CNE – Test Bank

Growth And Development Across The Lifespan 2nd Edition By Leifer MA RN CNE – Test Bank

Chapter 6:

Prenatal Influences on Healthy Development Test Bank

MULTIPLE CHOICE

1. The Human Genome Project is credited with the development of significant research on the subject of: a. analysis of chemicals that make up RNA. b. prevention of birth defects. c. ethical use of stem cells. d. gene mapping. ANS: D The Human Genome Project was involved in gene mapping, which determined the make-up of all human genes. DIF: Cognitive Level: Comprehension REF: p. 72 OBJ: 1 TOP: The Genome Project KEY: Nursing Process Step: Implementation MSC: NCLEX: NA 2. The ELSI program has been developed for the purpose of: a. promoting fund raising for the study of gene therapy. b. publishing up-to-date information on the progress of gene therapy. c. evaluating the ethical, legal, and social implications of gene therapy. d. educating the general public about the benefits of gene therapy. ANS: C The ELSI program’s purpose is to evaluate the ethical, legal, and social implications of gene therapy. DIF: Cognitive Level: Application REF: p. 75 OBJ: 1 TOP: ELSI program KEY: Nursing Process Step: NA MSC: NCLEX: NA 3. The newlywed couple most appropriately referred to genetic counseling would be the: a. Jewish couple who feel they must have a male child. b. Caucasian couple who both have family histories of schizophrenia. c. mixed cultural couple of a Japanese wife and American husband. d. African Americans, one of whom has sickle cell trait. ANS: D Counseling is a significant consideration for persons with sickle cell trait who need information about the probability of passing the disease on to the next generation. DIF: Cognitive Level: Analysis REF: p. 75 OBJ: 1 TOP: Genetic counseling KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 4. A woman who is 14 weeks pregnant says that she has abstained from alcohol during her first trimester and would like to know if it is now safe to have a drink with dinner. The health-care worker’s best response would be: a. “As you are in your second trimester, there is no problem with having one drink with dinner.” b. “One drink every night is too much. One drink three times a week should be fine.” c. “Because no one knows how much or how little alcohol it takes to cause fetal problems, it is recommended that you abstain throughout your pregnancy.” d. “Because you are in your second trimester, you can drink as much as you like.” ANS: C Maternal ingestion of substances such as alcohol can interfere with cell growth in the developing fetus. DIF: Cognitive Level: Analysis REF: p. 80 OBJ: 3 TOP: Teratogens KEY: Nursing Process Step: Intervention MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 5. The home health-care worker visiting a pregnant woman in her second trimester observes the patient doing chores and performing errands. Because of a threat to the fetus, the woman should refrain from: a. walking a mile to the grocery store. b. sweeping the floor with a broom. c. using bleach when doing the wash. d. emptying and cleaning the cat box. ANS: D Contact with cat litter boxes poses a threat of contracting toxoplasmosis. DIF: Cognitive Level: Application REF: p. 81 OBJ: 3 TOP: Toxoplasmosis KEY: Nursing Process Step: Intervention MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 6. According to parental role development theory, the reality of the pregnancy occurs for the couple when: a. the mother is aware that she has missed her period. b. the pregnancy is confirmed in the first trimester. c. movement is felt in the second trimester. d. actual plans for the birth are made in the third trimester. ANS: C According to the parental role development theory, the reality of the pregnancy and the introduction of a new baby into a family unit usually occurs in the second trimester when movement is felt and ultrasound pictures are taken. DIF: Cognitive Level: Comprehension REF: p. 82 OBJ: 8 TOP: Parental role development KEY: Nursing Process Step: NA MSC: NCLEX: NA 7. The difference between a nurse midwife and a doula is that a doula is a: a. registered nurse with advanced training in labor and delivery. b. registered nurse with advanced practice education. c. specially trained coach that stays with the mother during labor and delivery. d. medical doctor with advanced education in women’s health. ANS: C A doula is a person who will act as a coach during labor and delivery. This person is not necessarily a nurse. DIF: Cognitive Level: Comprehension REF: p. 83 OBJ: 8 TOP: Doula KEY: Nursing Process Step: NA MSC: NCLEX: NA 8. A new mother of a baby girl who has a 2 1/2-year-old son at home says, “I don’t know how I’ll ever manage both children when I get home.” The most informative response would be: a. “Your son is a big brother now and will love his new sister.” b. “You might consider letting your son stay with his grandparents for several weeks to allow him to adjust to the new baby.” c. “Make sure your husband bonds with your son while you are busy with your new daughter.” d. “You may see babyish behavior in your son, which is a typical reaction.” ANS: D Sibling rivalry is the competition between siblings for parental love and attention. Toddlers may regress and be angry at the birth of a new sister or brother. DIF: Cognitive Level: Application REF: p. 86 OBJ: 10 TOP: Regression KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 9. The health-care worker observes several interactions between a postpartum woman and her newborn. The behavior that would be assessed as maladaptive is: a. seldom making eye contact with the baby. b. reading a magazine while the baby sleeps. c. cuddling the baby close to her chest. d. telling visitors how well the baby is feeding. ANS: A Bonding is the term often used to describe the emotional relationship that begins to develop between parent and newborn in the first few hours or days after birth. Touch and visual interaction are critical factors in facilitating this process. DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 8 TOP: Bonding KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 10. A 15-year-old mother seems to ignore her newborn. A strategy that the health-care worker can use to facilitate mother–infant attachment in this mother is to: a. tell the mother that she must pay attention to her baby. b. show the mother how the baby initiates interaction in face-to-face encounters. c. demonstrate for the mother different positions for holding her baby while feeding. d. arrange for the mother to watch a video on parent–infant interaction. ANS: B Facilitating the mother’s appreciation of the newborn’s reaction to her in a face-to-face encounter can stimulate bonding. DIF: Cognitive Level: Application REF: p. 89 OBJ: 8 TOP: Stimulation of bonding KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation 11. “Taking hold” is occurring when the new mother: a. requests help with ambulation and perineal care. b. shows interest in learning more about infant care. c. sleeps most of the time when the baby is not present. d. is very excited and talkative about the birth experience. ANS: B According to Reva Rubin, the “taking hold” phase is introduced when the mother begins to initiate care of the newborn and is most receptive to teaching at this stage. DIF: Cognitive Level: Comprehension REF: p. 85, Table 6-2 OBJ: 8 TOP: Transition to motherhood KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 12. During a telephone follow-up conversation 5 days postpartum, the woman tells the health-care worker, “I don’t know what’s wrong with me. I love my baby, but I seem to be crying all the time!” The woman is most likely experiencing: a. taking-in. b. letting go. c. postpartum blues. d. attachment. ANS: C During the transition to motherhood, mood swings are common. Conflicting feelings of happiness and depression are called postpartum blues, and the symptoms are generally self-limiting. DIF: Cognitive Level: Application REF: p. 85 OBJ: 8 TOP: Postpartum blues KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: coping and adaptation 13. The home health-care worker can help a father in his transition to parenthood by: a. pointing out that the infant recognizes his voice. b. asking him what child care arrangements have been made. c. teaching him to tape the baby’s diaper a different way. d. reminding him that he must be ready to help with household chores. ANS: A Fathers develop an intense focus on the newborn, called engrossment. An outstanding response to this is one of strong attraction to the newborn, leading to the development of strong bonds with the infant over time. Subsequently, fathers often reevaluate their relationship with their own parents. DIF: Cognitive Level: Application REF: p. 85 OBJ: 10 TOP: Fathers or significant others KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 14. The mother asks how much her baby will sleep every day. The best response is: a. “He will only wake up to be fed, and you should not bother him between feedings.” b. “A newborn sleeps about 17 hours a day with periods of wakefulness gradually increasing.” c. “He will probably follow your same sleep and wake patterns, so you can expect him to be awake soon.” d. “You should try to limit day sleep to about 3 hours so he will sleep through the night.” ANS: B Neonates sleep 15 to 20 hours a day in the first 3 to 4 weeks of life. By 4 weeks, some infants stay awake from one feeding to the next. DIF: Cognitive Level: Comprehension REF: p. 88 OBJ: 8 TOP: Neonatal sleep patterns KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 15. Parents of a newborn ask about the baby’s vision and specifically want to know what visual stimuli they should provide for the newborn. The most appropriate response is: a. “Babies can see very little until about age 3 months.” b. “It is important to shield the baby’s eyes. You should ask your physician what visual stimulation to offer your child.” c. “The baby’s eyes are immature and must be protected. Any visual stimuli should not contain bright or strong colors.” d. “Newborns have good near vision. A brightly colored mobile to hang over the crib is a good choice for your baby.” ANS: D The newborn can both see and hear. A musical mobile would capture the baby’s attention via hearing and vision. DIF: Cognitive Level: Application REF: p. 91 OBJ: 12 TOP: Visual stimuli KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 16. Characteristics of dizygotic twins include their being: a. of the same sex. b. formed from the same single ovum and sperm. c. always carried to full term. d. similar to each other as any sibling. ANS: D Dizygotic twins (fraternal) occur when two ova are released and both ova are fertilized by two different sperm. The two embryos are not necessarily of the same sex and will resemble each other no more than any other siblings. Many twins are born prematurely as the uterus becomes overdistended. DIF: Cognitive Level: Application REF: p. 79 OBJ: 6 TOP: Dizygotic twins KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 17. A young, newly pregnant woman who led a sedentary life prior to pregnancy asks what sort of exercise would be beneficial. Helpful suggestions would be to engage in regular: a. aggressive exercise at a gym. b. jogging. c. lifting free weights. d. swimming. ANS: D Swimming is a good light exercise program to recommend to a previously sedentary pregnant woman. DIF: Cognitive Level: Application REF: p. 80 OBJ: 5 TOP: Exercise KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: physiological adaptation 18. Warnings that are appropriate to an exercising pregnant woman in her second trimester of pregnancy would include: a. limiting water while exercising to prevent hypertension. b. avoiding exercises that require the supine position. c. performing exaggerated range-of-motion exercises. d. exercising strenuously to supply extra heat and blood to the placenta. ANS: B Exercising should be moderated so that no supine positions are assumed after the second trimester to avoid cord compression. While exercising, adequate hydration should be maintained. Excessive heat increases the oxygen needs of the fetus and should be avoided. DIF: Cognitive Level: Comprehension REF: p. 80 OBJ: 5 TOP: Exercise KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: reduction of risk 19. The pH of the female reproductive tract and estrogen level have an effect on fertilization in that they: a. soften the ovum to enhance fertilization. b. can trap defective sperm. c. determine the sex of the fetus. d. affect the speed of the ova and sperm entering the fallopian tube. ANS: D Vaginal pH and the estrogen level of the female enhance the speed of the movement of the sperm and the ova into the fallopian tube where fertilization occurs. DIF: Cognitive Level: Comprehension REF: p. 75 OBJ: 4 TOP: Fetal development KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development 20. The young pregnant woman with type 2 diabetes mellitus should get at least ____ minutes of exercise a day to control weight and blood glucose. a. 10 b. 15 c. 30 d. 60 ANS: C Thirty minutes per day of light exercise will help control weight and control glucose levels. DIF: Cognitive Level: Comprehension REF: p. 80 OBJ: 3 TOP: Exercise during pregnancy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: physiological adaptation 21. Development of neural tube defects seems to be more common in the fetuses of pregnant women whose diet is low in: a. iron. b. vitamin D. c. folic acid. d. essential amino acids. ANS: C Research has shown a higher incidence of neural tube defects in fetuses of women with folic acid deficiency. In 1992 the U.S. Public Health Service recommended that all women of childbearing years consume 0.4 mg of folic acid daily. DIF: Cognitive Level: Comprehension REF: p. 78 OBJ: 3 TOP: Folic acid KEY: Nursing Process Step: NA MSC: NCLEX: NA 22. The term fetus refers to an embryo that is _____ weeks old. a. 2 b. 3 c. 6 d. 9 ANS: D From the 9th week of life, the embryo is called a fetus. DIF: Cognitive Level: Comprehension REF: p. 75 OBJ: 3 TOP: Fetus KEY: Nursing Process Step: NA MSC: NCLEX: NA 23. The Moro (startle) reflex, which is present at birth, disappears normally at the age of: a. 3 months. b. 4 months. c. 5 months. d. 6 months. ANS: A The Moro (startle) reflex disappears 1 to 3 months after birth. DIF: Cognitive Level: Comprehension REF: p. 90, Table 6-3 OBJ: NA TOP: Reflexes KEY: Nursing Process Step: NA MSC: NCLEX: NA 24. Good prenatal nutrition is stressed to an expectant mother because poor nutrition could increase the baby’s risk of _____________ in later life. a. diabetes b. kidney failure c. respiratory disorders d. coronary artery disease ANS: D Inadequate prenatal nutrition can alter the structure of the baby’s body and lead to coronary artery disease or stroke. DIF: Cognitive Level: Application REF: p. 79 OBJ: 7 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 25. The prenatal intervention that would be most helpful to a prospective father about his new role would be to: a. explain the physiological and psychological changes he can expect in the mother. b. demonstrate diapering and bathing techniques. c. let him verbalize his feelings about the pregnancy and fatherhood. d. encourage him to think about his role in the pregnancy. ANS: C Future changes in sleep patterns, household responsibility, and financial concerns are stressful to the father and may need to be verbalized. DIF: Cognitive Level: Application REF: p. 86 OBJ: 9 TOP: Paternal adaptations during the prenatal phase KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation 26. The single most important influence on appropriate growth and disease prevention at all stages of development is: a. nutrition. b. heredity. c. culture. d. environment. ANS: A Lack of proper nutrition during critical periods of fetal development can cause maldevelopment or malfunction of a specific organ or system that may not be manifested until adulthood. One of the goals of Health People 2020 is to prevent disease in the next generation by improving the nutrition of mothers and babies. DIF: Cognitive Level: Comprehension REF: p. 80 OBJ: 7 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 27. The most effective time for interaction between parents and the new baby is when the baby is in the state of: a. active alert. b. crying. c. drowsiness. d. quiet alert. ANS: D During the quiet alert state, the infant responds to the environment by staring at close-range objects and people. This is a good time for visual contact and conversation by the sibling. DIF: Cognitive Level: Comprehension REF: p. 88 OBJ: 10 TOP: Developmental tasks and responses KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 28. A woman delivered a baby 1 hour ago. The nurse is ready to assist her with breastfeeding. The woman states she cannot breastfeed until her “good” milk comes in. She says she is afraid the “thin” milk will harm the baby. The nurse’s best response is: a. “You should begin breastfeeding now or your milk will never come in.” b. “I understand that you believe this colostrum is unhealthy for the baby. Let’s talk about feeding alternatives until your milk comes in.” c. “If you don’t provide your baby with the benefits of colostrum, he will have more childhood illnesses than normal.” d. “Your baby will not learn to suck correctly if you don’t start breastfeeding now.” ANS: B In the provision of culturally competent care, the nurse needs to understand and respect the beliefs and practices of the families in his or her care. DIF: Cognitive Level: Application REF: p. 88 OBJ: 7 TOP: Culturally competent care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: psychosocial adaptation 29. After the delivery of the newborn, the major focus for its well-being is to: a. initiate hydration. b. provide nutrition. c. prevent heat loss. d. stimulate bonding. ANS: C After delivery, the newborn is dried, placed in a prewarmed bed, and the head is covered to minimize heat loss. DIF: Cognitive Level: Application REF: p. 83 OBJ: NA TOP: Heat loss KEY: Nursing Process Step: NA MSC: NCLEX: NA 30. After delivery, the new father is staring intently at his newborn and lightly running his fingertips over the baby’s face. The father is beginning: a. parenting. b. engrossment. c. development. d. identification. ANS: B Fathers or significant others develop an intense focus on the newborn, called engrossment. Characteristics of engrossment include touch and eye-to-eye contact as the father seeks to identify features both unique to the newborn and similar to himself. An outstanding response is one of strong attachment to the infant and a sense of increased self-esteem. DIF: Cognitive Level: Knowledge REF: p. 85 OBJ: 8 TOP: Fathers or significant others KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 31. A Chinese woman rejects the plan for her to bring the newborn to the health clinic before the seventh day of life to repeat the test for phenylketonuria (PKU) stating that it is too early for her to come. The culturally competent health-care worker would ask: a. “Do you lack transportation to the clinic?” b. “Isn’t your baby’s health important enough to come to the clinic?” c. “Do you realize that the state requires this test to be done?” d. “Do you need more time to heal after your delivery?” ANS: D To provide culturally competent care, the health-care worker must understand that in some cultures the postpartum period may last 30 days or longer, with the woman forbidden from leaving the home. DIF: Cognitive Level: Analysis REF: p. 88 OBJ: 9 TOP: Culturally competent care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation MULTIPLE RESPONSE 32. Methods of holding a neonate that are comforting and consoling to the baby and reinforce bonding include: (Select all that apply.) a. holding baby upright on parent’s knee. b. placing the nude baby on the naked chest of the parent. c. swaddling the baby. d. cuddling the baby. e. the football hold supporting baby with one arm. ANS: B, C, D Close, warm positions quiet and soothe a baby and encourage bonding. DIF: Cognitive Level: Comprehension REF: p. 89 OBJ: 10 TOP: Comfort and bonding KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 33. In speaking with a group of parents, the health-care worker informs them that in the case of a premature delivery, the fetus of 25 weeks gestation has many attributes that would help support extrauterine life. These include: (Select all that apply.) a. surfactant in the lungs. b. respiratory movements. c. a functioning central nervous system (CNS). d. smooth skin. e. subcutaneous fat. ANS: A, B The 2-week-old fetus is viable and has surfactant in the lungs and has begun respiratory movements, but the CNS is not fully functional. There is no subcutaneous fat; therefore, the skin is wrinkled. DIF: Cognitive Level: Analysis REF: p. 76, Table 6-1 OBJ: 3 TOP: Viability KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development COMPLETION 34. A complete set of DNA contained in all human cells is referred to as a(n) __________. ANS: genome A genome is a complete set of DNA that is contained in all cells. DIF: Cognitive Level: Comprehension REF: p. 73 OBJ: 1 TOP: Genome KEY: Nursing Process Step: NA MSC: NCLEX: NA 35. A _________ ________ can now be programmed to destroy a defective gene, allowing a pure gene to replace it. ANS: suicide gene Suicide genes are therapeutic genes that destroy defective genes allowing for a pure gene to replace it. DIF: Cognitive Level: Comprehension REF: p. 74 OBJ: 1 TOP: Suicide gene KEY: Nursing Process Step: NA MSC: NCLEX: NA