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Test Bank Health Maternity Care and 9th Womens edition LowdermilkPerry

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HERE IS A SAMPLE FOR YOU TO CHECK OUT – NOT THE FULL CHAPTER:
Chapter 3: Genetics

MULTIPLE CHOICE

1. A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has PKU. The couple tells the nurse that they are planning to have a second baby. Because their daughter has PKU, they are sure that their next baby wont be affected. What response by the nurse is most accurate?
a. ?Good planning; you need to take advantage of the odds in your favor.?
b. ?I think youd better check with your doctor first.?
c. ?You are both carriers, so each baby has a 25% chance of being affected.?
d. ?The ultrasound indicates a boy, and boys are not affected by PKU.?

ANS: C

Feedback
A Incorrect: 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.
B Incorrect: These parents need to discuss their options with their physician. However, an opportune time has presented itself for the couple to receive correct teaching about inherited genetic risks.
C Correct: The chance is one in four that each child produced by this couple will be affected by PKU disorder.
D Incorrect: No correlation exists between gender and inheritance of the disorder, because PKU is an autosomal recessive disorder.

PTS: 1 DIF: Cognitive Level: Application REF: Page 68
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Planning

2. A woman 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. What action by the nurse is most appropriate?
a. Talking to the woman and referring her to a genetic counselor
b. Suggesting that the woman travel to a fetal treatment center for intrauterine surgery
c. Telling her that everything is going to be fine
d. Sitting with her and calmly suggesting that she consider terminating this pregnancy

ANS: A

Feedback
A Correct: Before the woman 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.
B Incorrect: The discussion of potential surgery should be pursuant to genetic counseling.
C Incorrect: This type of statement may give the woman false hope and is not accurate.
D Incorrect: All options should be discussed with the genetic counselor. Furthermore, the guiding principle for genetic counseling is nondirectiveness. This respects the right of the individual or family being counseled to make autonomous decisions.

PTS: 1 DIF: Cognitive Level: Application REF: Page 68
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Planning

3. The nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should:
a. Tell the couple they need to have an abortion within 2 to 3 weeks
b. Explain that the fetus has a 50% chance of having the disorder
c. Discuss options with the couple, including amniocentesis to determine whether the fetus is affected
d. Refer the couple to a psychologist for emotional support

ANS: C

Feedback
A Incorrect: The couple should be given information about the likelihood of having another baby with this disorder so that they can make an informed decision.
B Incorrect: A genetic counselor is the best source for determining genetic probability ratios.
C Correct: Genetic testing, including amniocentesis, would need to be performed to determine whether the fetus is affected.
D Incorrect: The couple eventually may need emotional support, but the status of the pregnancy must be determined first.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 63
OBJ: Client Needs: Physiologic Integrity: Reduction of Risk Potential
TOP: Nursing Process: Planning, Implementation

4. A woman who is gravida 2 and 16 GW comes in for her prenatal appointment. Her 2-year-old daughter is with her and is wearing a sleeveless top. While interacting with her daughter, you note axillary freckling and several caf?-au-lait spots (>2 cm). In reviewing her chart, you would assess for documentation of which genetic disease?
a. Tay-Sachs disease
b. Galactosemia
c. Neurofibromatosis (NF)
d. Phenylketonuria

ANS: C

Feedback
A Incorrect: These disorders are not associated with caf?-au-lait spots.
B Incorrect: These disorders are not associated with caf?-au-lait spots.
C Correct: Clinical manifestations of NF may include axillary freckling and caf?-au-lait spots.
D Incorrect: These disorders are not associated with caf?-au-lait spots.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 63
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment

5. A new father has just been told that his child has trisomy 18. He asks the nurse what made her suspect a problem after the birth. The nurse explains that during the infants newborn assessment, she noted:
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

Feedback
A Incorrect: These clinical manifestations are associated with other chromosomal anomalies, not trisomy 18.
B Incorrect: These clinical manifestations are associated with other chromosomal anomalies, not trisomy 18.
C Incorrect: These clinical manifestations are associated with other chromosomal anomalies, not trisomy 18.
D Correct: Rocker-bottom feet and clenched hands with overlapping fingers are associated with trisomy 18.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 61
OBJ: Client Needs: Health Promotion and Maintenance:
TOP: Nursing Process: Assessment

6. The nurse is assessing the knowledge of new parents with a child born with maple syrup urine disease (MSUD). This is an autosomal recessive inherited disorder, which means that:
a. Both genes of a pair must be abnormal for the disorder to be expressed.
b. Only one copy of the abnormal gene is required for the disorder to be expressed.
c. The disorder occurs in males and heterozygous females.
d. The disorder is carried on the X chromosome.

ANS: A

Feedback
A Correct: MSUD is a type of autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed.
B Incorrect: MSUD is not an X-linked dominant or recessive disorder or an autosomal dominant inheritance disorder. It is an autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed.
C Incorrect: MSUD is not an X-linked dominant or recessive disorder or an autosomal dominant inheritance disorder. It is an autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed.
D Incorrect: MSUD is not an X-linked dominant or recessive disorder or an autosomal dominant inheritance disorder. It is an autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 63
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment

7. In presenting to obstetric nurses interested in genetics, the genetic nurse identifies the primary risk(s) associated with genetic testing as:
a. Anxiety and altered family relationships
b. Denial of insurance benefits
c. High false positives associated with genetic testing
d. Ethnic and socioeconomic disparity associated with genetic testing

ANS: B

Feedback
A Incorrect: These factors may be difficulties associated with genetic testing, but they are not risks associated with testing.
B Correct: Decisions about genetic testing are shaped by socioeconomic status and the ability to pay for the testing. Some types of genetic testing are expensive and are not covered by insurance benefits.
C Incorrect: This factor may be a difficulty associated with genetic testing, but it is not a risk associated with testing.
D Incorrect: This factor may be a difficulty associated with genetic testing, but it is not a risk associated with testing.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 56
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Implementation

8. A mans wife is pregnant for the third time. One child was born with cystic fibrosis, and the other child is healthy. The man wonders what the chance is that this child will have cystic fibrosis. This type of testing is known as:
a. Occurrence risk
b. Recurrence risk
c. Predictive testing
d. Predisposition testing

ANS: B

Feedback
A Incorrect: If a couple has not yet had children but are known to be at risk for having children with a genetic disease, they are given an occurrence risk test. This couple already has a child with a genetic disorder.
B Correct: The couple already has a child with a genetic disease; therefore, they will be given a recurrence risk test.
C Incorrect: Predictive testing is used to clarify the genetic status of an asymptomatic family member.
D Incorrect: Predisposition testing differs from presymptomatic testing in that a positive result does not indicate 100% risk of a condition developing.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 67
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Planning

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