Nursing Elites

1. What information should the nurse include when teaching a client at 41 weeks of gestation about a non-stress test?

• A. This test will confirm fetal lung maturity.
• B. This test will determine the adequacy of placental perfusion.
• C. This test will detect fetal infection.
• D. This test will predict maternal readiness for labor.

Correct answer: B

Rationale: The correct answer is B: 'This test will determine the adequacy of placental perfusion.' The non-stress test is used to assess fetal well-being by monitoring the fetal heart rate in response to its own movements. It helps determine if the fetus is receiving enough oxygen and nutrients through placental perfusion. Choice A is incorrect because confirming fetal lung maturity is typically determined through tests like amniocentesis, not the non-stress test. Choice C is incorrect because detecting fetal infection is not the primary purpose of a non-stress test. Choice D is incorrect because predicting maternal readiness for labor is not the purpose of the non-stress test; it focuses on fetal well-being.

2. _____ are environmental agents that can harm the embryo or fetus.

• A. Mutations
• B. Autosomes
• C. Teratogens
• D. Androgens

Correct answer: C

Rationale: Teratogens are environmental agents, such as drugs, chemicals, or infections, that can cause harm to a developing embryo or fetus. Mutations (Choice A) refer to changes in the DNA sequence and are not environmental agents. Autosomes (Choice B) are chromosomes that are not involved in determining an individual's sex and are not environmental agents that harm the embryo or fetus. Androgens (Choice D) are a group of hormones that are more related to male sexual development and function, not environmental agents that harm the embryo or fetus.

3. What should be the primary focus of nursing care in the transitional phase of labor for a client who anticipates an unmedicated delivery?

• A. Assessing the strength of uterine contractions
• B. Re-evaluating the need for medication
• C. Reminding her to push 3 times with each contraction
• D. Assisting her to maintain control

Correct answer: D

Rationale: During the transitional phase of labor, which is the most intense phase, the primary focus of nursing care for a client who anticipates an unmedicated delivery should be assisting her to maintain control. This is essential to help her manage the intense pain and anxiety associated with this phase without the use of medication. Assessing the strength of uterine contractions (Choice A) is important but not the primary focus during the transitional phase. Re-evaluating the need for medication (Choice B) is not applicable as the client anticipates an unmedicated delivery. Reminding her to push 3 times with each contraction (Choice C) is more related to the pushing stage of labor and not the transitional phase.

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. Which of the following conditions is considered a multifactorial problem?

• A. Cystic fibrosis
• B. Down syndrome
• C. Diabetes mellitus
• D. XYY syndrome

Correct answer: C

Rationale: The correct answer is 'Diabetes mellitus' because it is a multifactorial disease, influenced by both genetic predisposition and environmental factors. Cystic fibrosis (choice A) is primarily a genetic disorder caused by mutations in the CFTR gene. Down syndrome (choice B) is due to an extra copy of chromosome 21. XYY syndrome (choice D) is a genetic condition where males have an extra Y chromosome. These conditions are not considered multifactorial as their origins are primarily genetic.

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