Nursing Elites

1. Which synthetic hormone is used to prevent miscarriages and can cause masculinization of the fetus?

• A. Testosterone
• B. Estrogen
• C. Progestin
• D. Oxytocin

Correct answer: C

Rationale: Progestin is the synthetic hormone used to prevent miscarriages. While it is beneficial in maintaining pregnancy, in some cases, it can lead to masculinization of the fetus. Testosterone (Choice A) and estrogen (Choice B) are not typically used to prevent miscarriages and do not cause masculinization of the fetus in this context. Oxytocin (Choice D) is a hormone involved in labor and breastfeeding, but it is not used to prevent miscarriages nor does it cause masculinization of the fetus.

2. A healthcare provider is reviewing laboratory results for a client who is pregnant. The healthcare provider should expect which of the following laboratory values to increase?

• A. RBC count
• B. Bilirubin
• C. Fasting blood glucose
• D. BUN

Correct answer: A

Rationale: During pregnancy, the body increases the production of red blood cells (RBCs) to meet the increased oxygen demands. This physiological response is known as physiological anemia of pregnancy. Therefore, the RBC count is expected to increase during pregnancy. Bilirubin levels may remain relatively stable, fasting blood glucose levels might fluctuate due to gestational diabetes, and blood urea nitrogen (BUN) levels are not typically affected by pregnancy, making them less likely to increase in this scenario. The correct answer is A because an increase in RBC count is a normal physiological adaptation to pregnancy to support the increased oxygen needs of the mother and the growing fetus. Bilirubin, a product of red blood cell breakdown, is more related to liver function and not expected to increase during pregnancy. Fasting blood glucose levels may vary due to gestational diabetes, but it is not a consistent finding in all pregnant individuals. BUN levels are related to kidney function and are not typically impacted by pregnancy, making it an unlikely choice for an expected increase in laboratory values during pregnancy.

3. Which procedure is used to detect neural tube defects such as spina bifida and certain chromosomal abnormalities?

• A. Artificial insemination
• B. Amniocentesis
• C. Endometriosis
• D. Alpha-fetoprotein (AFP) assay

Correct answer: D

Rationale: The correct answer is the Alpha-fetoprotein (AFP) assay. This blood test measures the level of AFP in a pregnant woman's blood, aiding in the detection of neural tube defects and certain chromosomal abnormalities in the fetus. Choice A, artificial insemination, is a method used to facilitate fertilization and is not related to detecting fetal abnormalities. Choice B, amniocentesis, involves collecting amniotic fluid for genetic testing, not directly measuring AFP levels. Choice C, endometriosis, is a medical condition involving abnormal tissue growth and is not a procedure for detecting fetal abnormalities. Therefore, the Alpha-fetoprotein (AFP) assay is the most appropriate option for detecting neural tube defects such as spina bifida and certain chromosomal abnormalities.

4. A pregnant client mentions in her history that she changes the cat's litter box daily. Which test should the nurse anticipate the healthcare provider to prescribe?

• A. Biophysical profile
• B. Fern test
• C. Amniocentesis
• D. TORCH screening

Correct answer: D

Rationale: The correct answer is D, TORCH screening. TORCH screening is done to detect infections such as toxoplasmosis, which can be contracted from handling cat litter and is harmful during pregnancy. Biophysical profile (choice A) is a prenatal ultrasound evaluation. Fern test (choice B) is used to assess for amniotic fluid leakage. Amniocentesis (choice C) involves taking a sample of amniotic fluid to test for genetic abnormalities and certain infections, not specifically related to toxoplasmosis from cat litter.

5. When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition?

• A. Regular heart rate and hypertension.
• B. Increased urinary output, tachycardia, and dry cough.
• C. Shortness of breath, bradycardia, and hypertension.
• D. Dyspnea, crackles, and an irregular, weak pulse.

Correct answer: D

Rationale: In pregnant women with cardiac problems, signs of cardiac decompensation include dyspnea, crackles, an irregular, weak, and rapid pulse, rapid respirations, a moist and frequent cough, generalized edema, increasing fatigue, and cyanosis of the lips and nailbeds. Choice A is incorrect as a regular heart rate and hypertension are not typically associated with cardiac decompensation. Choice B is incorrect as increased urinary output and dry cough are not indicative of cardiac decompensation, only tachycardia is. Choice C is incorrect as bradycardia and hypertension are not typically seen in cardiac decompensation; dyspnea is a critical sign instead.

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