Nursing Elites

1. A nurse is reviewing laboratory results for a term newborn who is 24 hours old. Which of the following results require intervention by the nurse?

• A. WBC count 10,000/mm3
• B. Platelets 180,000/mm3
• C. Hemoglobin 20g/dL
• D. Glucose 20 mg/dL

Correct answer: D

Rationale: A glucose level of 20 mg/dL is critically low for a newborn and requires immediate intervention. Hypoglycemia in a newborn can lead to serious complications such as neurologic deficits. The normal range for glucose levels in a newborn is typically 40-60 mg/dL. Choices A, B, and C represent normal or acceptable values for a term newborn and do not require immediate intervention. A WBC count of 10,000/mm3, platelets of 180,000/mm3, and hemoglobin of 20g/dL are all within normal ranges for a term newborn and do not raise immediate concerns.

2. What is the typical sex chromosome pattern for males?

• A. XX
• B. XYY
• C. XY
• D. XXY

Correct answer: C

Rationale: The correct answer is C: XY. In males, the typical sex chromosome pattern consists of one X chromosome and one Y chromosome. Choice A (XX) is the sex chromosome pattern for females. Choice B (XYY) is a chromosomal disorder where males have an extra Y chromosome. Choice D (XXY) is the sex chromosome pattern associated with Klinefelter syndrome, a condition where males have an extra X chromosome.

3. The mother of a breastfeeding 24-hour old infant is very concerned about the techniques involved in breastfeeding. She calls the nurse with each feeding to seek reassurance that she is doing it right. She tells the nurse, "Now my daughter is not getting enough to eat." Which response would be best for the nurse to make?

• A. Feed your baby hourly until you feel confident that your child is receiving enough milk.
• B. Don't worry, soon your milk will come in, and you will feel how full your breasts are.
• C. Since you are so concerned, you should probably supplement breastfeeding with formula.
• D. If your baby's urine is straw-colored, she's getting enough milk.

Correct answer: D

Rationale: Reassuring the mother that the baby's urine color can be an indicator of adequate hydration can help her feel more confident in her breastfeeding.

4. A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. The client shows the nurse her readings for the past few days. Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates?

• A. 75 mg/dl before lunch. This is low; better eat now.
• B. 115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time.
• C. 115 mg/dl 2 hours after lunch. This is too high; it is time for insulin.
• D. 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.

Correct answer: D

Rationale: 50 mg/dl after waking from a nap is too low. During hours of sleep, glucose levels should not be less than 60 mg/dl. Snacks before sleeping can be helpful. The premeal acceptable range is 60 to 99 mg/dl. The readings 1 hour after a meal should be less than 129 mg/dl. Two hours after eating, the readings should be less than 120 mg/dl.

5. When both alleles' effects are shown, there is said to be:

• A. codominance.
• B. preponderance.
• C. ascendance.
• D. concurrence.

Correct answer: A

Rationale: The correct answer is A: codominance. Codominance refers to a genetic scenario where both alleles in a gene pair are fully expressed, leading to a phenotype that displays traits from both alleles equally. This is distinct from incomplete dominance where the traits blend. Choices B, C, and D are incorrect. Preponderance does not specifically relate to the expression of alleles. Ascendance and concurrence do not describe the genetic concept of codominance where both alleles are fully expressed.

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