Nursing Elites

1. Which drug was marketed in the 1960s to pregnant women and caused birth defects such as missing or stunted limbs in infants?

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

Correct answer: C

Rationale: Thalidomide is the correct answer. Thalidomide was a drug marketed in the 1960s to pregnant women as a sedative and anti-nausea medication but tragically led to severe birth defects, including limb deformities, when taken during pregnancy. Progestin (Choice A) and Estrogen (Choice B) are hormones that are not associated with causing birth defects like Thalidomide. Oxytocin (Choice D) is a hormone that plays a role in labor and breastfeeding and is not known to cause birth defects like Thalidomide.

2. A charge nurse is teaching a group of staff nurses about fetal monitoring during labor. Which of the following findings should the charge nurse instruct the staff members to report to the provider?

• A. Contraction durations of 95 to 100 seconds
• B. Contraction frequency of 2 to 3 minutes apart
• C. Absent early deceleration of fetal heart rate
• D. Fetal heart rate is 140/min

Correct answer: A

Rationale: The correct answer is A. Contraction durations of 95 to 100 seconds are prolonged, indicating uterine hyperstimulation, which can lead to fetal distress and requires immediate intervention. Reporting this finding to the provider is crucial to ensure timely management and prevent adverse outcomes. Choice B, contraction frequency of 2 to 3 minutes apart, is within the normal range and does not raise immediate concerns. Choice C, absent early deceleration of fetal heart rate, is a reassuring finding suggesting fetal well-being. Choice D, a fetal heart rate of 140/min, is also normal for a fetus and does not typically require immediate reporting unless it deviates significantly from the baseline or is accompanied by other concerning signs.

3. If an individual receives a recessive gene for eye color from both parents, the:

• A. gender of the child will not determine the expression of that trait.
• B. recessive trait will be expressed in the child.
• C. recessive trait will be expressed in all the offspring.
• D. recessive trait will be suppressed, and the dominant trait will not be expressed.

Correct answer: B

Rationale: When an individual inherits a recessive gene for eye color from both parents, the recessive trait will be expressed in the child. This is because having two copies of the recessive gene overrides the presence of any dominant gene. Choice A is incorrect because the expression of the trait is determined by the genetic makeup, not the gender of the child. Choice C is incorrect as the expression of the recessive trait is certain when both parents pass on the recessive gene, but it does not mean that all offspring will express the trait. Choice D is incorrect because if both parents provide a recessive gene, the dominant trait will not be expressed in the child, but it does not mean it will be suppressed; rather, the recessive trait will be expressed.

4. A primigravida at 36 weeks gestation who is RH-negative experienced abdominal trauma in a motor vehicle collision. Which assessment finding is most important for the nurse to report to the healthcare provider?

• A. Fetal heart rate at 162 beats per minute
• B. Mild contractions every 10 minutes
• C. Trace of protein in the urine
• D. Positive fetal hemoglobin testing

Correct answer: D

Rationale: The correct answer is 'Positive fetal hemoglobin testing' (D). Positive fetal hemoglobin testing (Kleihauer-Betke test) indicates fetal-maternal hemorrhage, which is critical in an RH-negative mother due to the risk of isoimmunization. This condition can lead to sensitization of the mother's immune system against fetal blood cells, potentially causing hemolytic disease of the newborn in subsequent pregnancies. Reporting this finding promptly is crucial for appropriate management and interventions. Choices A, B, and C are not as critical in this scenario. While monitoring fetal heart rate and contractions is important, the detection of fetal-maternal hemorrhage takes precedence due to the serious implications it poses for the current and future pregnancies of an RH-negative mother.

5. Which of the following statements is true about Tay-Sachs disease?

• A. It is most commonly found among children in Jewish families of Eastern European background.
• B. Children who have this disease suffer from excessive production of mucus in the lungs and pancreas.
• C. It is most commonly found among children in Asian American families.
• D. Children who have this disease suffer from muscular dystrophy characterized by a weakening of the muscles.

Correct answer: A

Rationale: The correct answer is A. Tay-Sachs disease is most commonly found among Jewish families of Eastern European descent. It is a fatal genetic disorder that affects the nervous system. Choice B is incorrect because Tay-Sachs disease does not involve excessive mucus production in the lungs and pancreas. Choice C is incorrect as it states that Tay-Sachs disease is most commonly found among Asian American families, which is inaccurate. Choice D is also incorrect because Tay-Sachs disease does not cause muscular dystrophy characterized by weakening of the muscles.

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