Nursing Elites

1. A healthcare professional is caring for a client who is 14 weeks of gestation. At which of the following locations should the healthcare professional place the Doppler device when assessing the fetal heart rate?

• A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis
• B. Left Upper Abdomen
• C. Two fingerbreadths above the umbilicus
• D. Lateral at the Xiphoid Process

Correct answer: A

Rationale: At 14 weeks of gestation, the uterus is still relatively low in the abdomen. Placing the Doppler midline 2 to 3 cm above the symphysis pubis is appropriate for assessing the fetal heart rate. This location allows for better detection of the fetal heart tones as the uterus is at a lower position during this stage of pregnancy. Placing the Doppler on the left upper abdomen would not be ideal at 14 weeks gestation as the uterus is not yet at that level. Placing it two fingerbreadths above the umbilicus or lateral at the xiphoid process would also not be accurate for locating the fetal heart rate at this stage of gestation.

2. A 16-year-old gravida 1 para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She's not presently convulsing. Which intervention should the nurse plan to include in this client's nursing care plan?

• A. Allow liberal family visitation
• B. Keep an airway at the bedside
• C. Assess temperature every hour
• D. Monitor blood pressure, pulse, and respiration every 4 hours

Correct answer: B

Rationale: Keeping an airway at the bedside is crucial for a client with eclampsia, as there is a high risk of seizures that can obstruct the airway. Allowing liberal family visitation (choice A) may not be a priority at this time and can be overwhelming for the client. Assessing temperature every hour (choice C) is not directly related to managing eclampsia. Monitoring blood pressure, pulse, and respiration every 4 hours (choice D) is important but not as immediate as ensuring airway patency.

3. Which of the following statements about Rh incompatibility is true?

• A. Rh incompatibility occurs most commonly during a woman’s first pregnancy.
• B. Rh incompatibility is an untreatable condition that leaves a woman infertile for the rest of her life.
• C. Rh incompatibility is an abnormality that is transmitted from generation to generation and carried by a sex chromosome.
• D. Rh incompatibility occurs due to antibodies transmitted to a fetus during subsequent deliveries causing brain damage or death.

Correct answer: D

Rationale: Rh incompatibility occurs when the mother's antibodies attack the fetus's red blood cells, leading to serious complications, usually in subsequent pregnancies. Choice A is incorrect because Rh incompatibility often occurs in subsequent pregnancies, not necessarily the first one. Choice B is incorrect as Rh incompatibility does not render a woman infertile but can lead to complications during pregnancies. Choice C is incorrect as Rh incompatibility is not carried by a sex chromosome but involves the Rh factor on red blood cells.

4. 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.

5. Which neonatal complications are associated with hypertension in the mother?

• A. Intrauterine growth restriction (IUGR) and prematurity.
• B. Seizures and cerebral hemorrhage.
• C. Hepatic or renal dysfunction.
• D. Placental abruption and DIC.

Correct answer: A

Rationale: Neonatal complications associated with maternal hypertension are primarily due to placental insufficiency. The correct answer is A, which includes Intrauterine Growth Restriction (IUGR) and prematurity. These complications arise from inadequate blood flow to the fetus, leading to growth restriction and premature birth. Choices B, seizures, and cerebral hemorrhage are more commonly maternal complications rather than neonatal ones. Choice C, hepatic or renal dysfunction, pertains to maternal complications of hypertensive disorders in pregnancy, not neonatal issues. Choice D, placental abruption, and Disseminated Intravascular Coagulation (DIC) are conditions linked to maternal morbidity and mortality, not neonatal complications.

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