Nursing Elites

1. What is the process in which the double helix of deoxyribonucleic acid (DNA) duplicates?

• A. Amniocentesis
• B. Mitosis
• C. Meiosis
• D. Mutation

Correct answer: B

Rationale: Mitosis is the correct answer because it is the process of cell division in which a cell duplicates its DNA and divides into two identical daughter cells. During mitosis, the DNA is replicated, and each daughter cell receives an identical copy of the genetic material. Amniocentesis is a medical procedure to collect amniotic fluid for prenatal genetic testing and is not related to DNA duplication. Meiosis is a type of cell division that produces gametes with half the genetic material of the parent cell, leading to genetic diversity. Mutation is a permanent alteration in the DNA sequence that can lead to genetic variations but is not the process of DNA duplication.

2. Do neural tube defects cause an elevation in the alpha-fetoprotein (AFP) level in the mother’s blood?

• A. Yes
• B. No
• C. Possibly
• D. Never

Correct answer: A

Rationale: Yes, neural tube defects can cause an elevation in AFP levels in the mother’s blood. AFP levels are often used as a screening marker during pregnancy to detect neural tube defects. Choice B is incorrect because an elevation in AFP levels can indeed occur in the presence of neural tube defects. Choice C is not the best option as it leaves room for uncertainty when the relationship between neural tube defects and AFP elevation is well-established. Choice D is incorrect as neural tube defects are known to influence AFP levels in the maternal blood.

3. Which of the following is a sexually transmitted infection that, in advanced stages, can attack major organ systems?

• A. Rubella
• B. Syphilis
• C. Cystic fibrosis
• D. Phenylketonuria

Correct answer: B

Rationale: Syphilis is the correct answer. Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. If left untreated, it can progress through various stages and potentially attack major organ systems, causing severe complications. Rubella, Cystic fibrosis, and Phenylketonuria are not sexually transmitted infections. Rubella is a viral infection, Cystic fibrosis is a genetic disorder affecting the lungs and digestive system, and Phenylketonuria is a genetic metabolic disorder. These conditions do not typically affect major organ systems in the same way as untreated syphilis.

4. The nurse places one hand above the symphysis while massaging the fundus of a multiparous client whose uterine tone is boggy 15 minutes after delivering a 7-pound, 10-ounce (3220-gram) infant. Which information should the nurse provide to the client about these findings?

• A. The uterus should be firm to prevent an intrauterine infection.
• B. Both the lower uterine segment and the fundus must be massaged.
• C. A firm uterus prevents the endometrial lining from being sloughed.
• D. Clots may form inside a boggy uterus and need to be expelled.

Correct answer: D

Rationale: After childbirth, a boggy uterus indicates poor uterine tone, which can lead to the formation of clots. Massaging the fundus helps the uterus contract and expel clots, reducing the risk of postpartum hemorrhage. Choices A, B, and C are incorrect because the main concern with a boggy uterus is the risk of clot formation and postpartum hemorrhage, not solely preventing intrauterine infection, massaging the lower uterine segment, or preventing the endometrial lining from sloughing.

5. A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider?

• A. A client with a urinary output of 300 ml in 8 hours
• B. A client reporting abdominal cramping during breastfeeding
• C. A client receiving magnesium sulfate with absent deep tendon reflexes
• D. A client reporting lochia rubra requiring changing perineal pads every 3 hours

Correct answer: C

Rationale: The correct answer is C because in a client receiving magnesium sulfate, absent deep tendon reflexes can indicate magnesium toxicity, which requires immediate intervention to prevent serious complications. Choices A, B, and D are common postpartum occurrences that do not typically warrant immediate provider notification. A urinary output of 300 ml in 8 hours, abdominal cramping during breastfeeding, and frequent changing of perineal pads due to lochia rubra are within the expected range of postpartum recovery and do not indicate an urgent need for provider notification.

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