Nursing Elites

1. A client in the transition phase of labor reports a pain level of 7 on a scale of 0 to 10. Which of the following actions should the nurse take?

• A. Instruct the client to use effleurage.
• B. Apply counterpressure to the client's sacrum.
• C. Assist the client with patterned-paced breathing.
• D. Teach the client the technique of biofeedback.

Correct answer: B

Rationale: During the transition phase of labor, a client may experience intense back pain due to the pressure of the baby descending. Applying counterpressure to the client's sacrum can help alleviate this discomfort. Effleurage is a light stroking massage technique that may not provide adequate relief for intense back pain. Patterned-paced breathing is beneficial for managing contractions but may not directly address back pain. Biofeedback is a technique that helps individuals gain awareness and control of certain physiological functions, but it may not be the most appropriate intervention for acute labor pain.

2. _____ is a type of estrogen, prescribed in the 1940s and 1950s to pregnant women, that is said to have caused testicular, vaginal, and cervical cancer in some offspring.

• A. Androsterone
• B. Adiponectin
• C. Progestin
• D. Diethylstilbestrol

Correct answer: D

Rationale: Diethylstilbestrol (DES) is a synthetic estrogen that was prescribed to pregnant women in the 1940s and 1950s to prevent miscarriages. However, it was later discovered that DES exposure in utero could lead to health issues in offspring, including an increased risk of testicular, vaginal, and cervical cancer. Choice A, Androsterone, is a steroid hormone produced in small amounts in humans and unlikely to be associated with the adverse effects described. Choice B, Adiponectin, is a protein hormone that plays a role in regulating glucose levels and fatty acid breakdown, not related to the adverse effects mentioned. Choice C, Progestin, is a synthetic form of progesterone used in birth control and hormone therapy, not linked to the specific health concerns associated with DES exposure.

3. Individuals with Klinefelter syndrome produce:

• A. less estrogen than normal males.
• B. less testosterone than normal males.
• C. less adenine than normal males.
• D. less thymine than normal males.

Correct answer: B

Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY), leading to reduced production of testosterone, the primary male sex hormone. This deficiency can result in various physical and developmental characteristics associated with the syndrome. Estrogen levels may actually be relatively elevated due to the imbalance between testosterone and estrogen. Choices C and D are incorrect as adenine and thymine are nucleotide bases found in DNA and are not related to hormone production.

4. A client at 37 weeks gestation presents to labor and delivery with contractions every two minutes. The nurse observes several shallow small vesicles on her pubis, labia, and perineum. The nurse should recognize the client is exhibiting symptoms of which condition?

• A. Genital Warts
• B. Syphilis
• C. Herpes Simplex Virus
• D. German Measles

Correct answer: C

Rationale: The correct answer is C: Herpes Simplex Virus (HSV). HSV can present with small vesicles on the genital area, and it is a concern during labor due to the risk of transmission to the newborn. Genital warts (Choice A) are caused by the human papillomavirus (HPV) and typically present as flesh-colored growths, not vesicles. Syphilis (Choice B) manifests as painless sores and can have systemic effects but does not typically present with vesicles. German measles (Choice D), also known as Rubella, is a viral illness characterized by a red rash, fever, and lymphadenopathy, not vesicles.

5. Does a blastocyst gain mass only when it receives nourishment from outside?

• A. TRUE
• B. FALSE
• C. Sometimes
• D. Always

Correct answer: A

Rationale: A blastocyst does indeed require external nourishment from the mother's body to continue developing and gaining mass. Without this external nourishment, the blastocyst would not be able to grow and develop properly. Therefore, the statement that a blastocyst gains mass only when it receives nourishment from outside is true. Choices B, C, and D are incorrect because they do not accurately reflect the dependency of a blastocyst on external nourishment for its development and growth.

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