Nursing Elites

1. A client is receiving oxytocin by continuous IV infusion for labor induction. Which of the following interventions should the nurse include in the plan?

• A. Increase the infusion rate every 30 to 60 minutes.
• B. Maintain the client in a supine position.
• C. Titrate the infusion rate by 4 milliunits/min.
• D. Limit IV intake to 4 L per 24 hours.

Correct answer: A

Rationale: The correct answer is to increase the infusion rate every 30 to 60 minutes. This approach allows for the careful monitoring and adjustment of oxytocin administration during labor induction. Choice B is incorrect because maintaining the client in a supine position can decrease blood flow to the placenta and compromise fetal oxygenation. Choice C is incorrect as titrating the infusion rate by 4 milliunits/min is not a standard practice for oxytocin administration. Choice D is incorrect as limiting IV intake to 4 L per 24 hours is not specifically related to the administration of oxytocin for labor induction.

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. What causes sickle-cell anemia?

• A. A chromosomal abnormality.
• B. A single segment found only on the Y chromosome.
• C. A recessive gene.
• D. A decrease in estrogen levels.

Correct answer: C

Rationale: Sickle-cell anemia is a genetic disorder caused by inheriting two copies of a recessive gene, one from each parent. The correct answer is C. Choice A is incorrect because sickle-cell anemia is not primarily caused by a chromosomal abnormality. Choice B is incorrect as the condition is not linked to a single segment found only on the Y chromosome. Choice D is unrelated as it mentions a decrease in estrogen levels, which is not a cause of sickle-cell anemia.

4. Preconception counseling is crucial for the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?

• A. Frequent episodes of maternal hypoglycemia
• B. Congenital anomalies in the fetus
• C. Hydramnios
• D. Hyperemesis gravidarum

Correct answer: B

Rationale: Preconception counseling is essential as strict metabolic control before conception and in the early weeks of gestation helps reduce the risk of congenital anomalies. Frequent episodes of maternal hypoglycemia usually occur during the first trimester due to hormonal changes, affecting insulin production and use, rather than before conception. Hydramnios is more common in diabetic pregnancies, typically seen in the third trimester, not during early pregnancy. Hyperemesis gravidarum, although it may lead to hypoglycemic events, is related to decreased food intake and glucose transfer to the fetus, exacerbating hypoglycemia rather than being directly associated with poor glycemic control before and during early pregnancy.

5. Dizygotic (DZ) twins share _________ percent of their genes.

• A. 100
• B. 75
• C. 50
• D. 25

Correct answer: C

Rationale: Dizygotic (DZ) twins share approximately 50% of their genes. This is because dizygotic twins, also known as fraternal twins, originate from two separate fertilized eggs and share similar genetic similarity to regular siblings. Choice A (100%) is incorrect because if twins shared 100% of their genes, they would be identical twins (monozygotic). Choice B (75%) is incorrect as it is not the typical genetic similarity seen in dizygotic twins. Choice D (25%) is incorrect as it represents a significantly lower genetic similarity than what is observed in dizygotic twins.

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