Nursing Elites

1. A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse?

• A. Blood pressure (BP) increased to 138/86 mm Hg.
• B. Weight gain of 0.5 kg during the past 2 weeks.
• C. Dipstick value of 3+ for protein in her urine.
• D. Pitting pedal edema at the end of the day.

Correct answer: C

Rationale: The correct answer is C. Proteinuria, indicated by a dipstick value of 3+ in the urine, is a significant concern in a patient being monitored for preeclampsia. Proteinuria is a key diagnostic criterion for preeclampsia, and a value of 3+ signifies a substantial amount of protein in the urine, warranting further evaluation. While an increase in blood pressure to 138/86 mm Hg is slightly elevated, it does not meet the diagnostic threshold for severe hypertension in preeclampsia. A weight gain of 0.5 kg over 2 weeks is within normal limits and not as concerning as significant rapid weight gain. Pitting pedal edema, though common in pregnancy, is not a specific indicator of preeclampsia and is considered a less concerning finding compared to significant proteinuria.

2. Which of the following statements is a symptom of cystic fibrosis in children?

• A. Cystic fibrosis leads to uncontrollable muscle movements and personality changes.
• B. Cystic fibrosis leads to the excessive production of thick mucus that clogs the pancreas and lungs.
• C. Cystic fibrosis causes red blood cells to clump together, obstructing small blood vessels and decreasing the oxygen supply.
• D. Cystic fibrosis causes the central nervous system to degenerate, resulting in death.

Correct answer: B

Rationale: The correct answer is B. Cystic fibrosis is a genetic disorder that causes the body to produce thick, sticky mucus. This mucus can clog the airways in the lungs and obstruct the pancreas, leading to severe respiratory and digestive problems. Choice A is incorrect because uncontrollable muscle movements and personality changes are not typical symptoms of cystic fibrosis. Choice C is incorrect because cystic fibrosis does not directly cause red blood cells to clump together and obstruct small blood vessels. Choice D is incorrect because cystic fibrosis primarily affects the respiratory and digestive systems, not the central nervous system.

3. A 30-year-old primigravida delivers a nine-pound (4082 gram) infant vaginally after a 30-hour labor. What is the priority nursing action for this client?

• A. Assess the blood pressure for hypertension.
• B. Gently massage fundus every four hours.
• C. Observe for signs of uterine hemorrhage.
• D. Encourage direct contact with the infant.

Correct answer: C

Rationale: After a prolonged labor and delivery of a large infant, the client is at an increased risk for uterine atony and postpartum hemorrhage, making observation for signs of bleeding a priority. Assessing the blood pressure for hypertension (Choice A) is not the priority in this situation as the immediate concern is postpartum hemorrhage. Gently massaging the fundus every four hours (Choice B) is a routine postpartum care activity but is not the priority in this scenario. Encouraging direct contact with the infant (Choice D) is important for bonding but does not address the immediate risk of uterine hemorrhage after delivery.

4. How many pairs of autosomes does a human zygote contain?

• A. 46
• B. 44
• C. 23
• D. 22

Correct answer: D

Rationale: A human zygote contains 22 pairs of autosomes and one pair of sex chromosomes, totaling 46 chromosomes. Therefore, the correct answer is 22. Choices A, B, and C are incorrect because they do not accurately represent the number of autosomes in a human zygote. Option A (46) represents the total number of chromosomes in a human zygote, not the number of autosomes. Option B (44) is incorrect as it does not account for the correct number of autosomes. Option C (23) is inaccurate since it represents the total number of chromosomes in a human gamete, not the number of autosomes in a zygote.

5. A charge nurse is teaching a group of staff nurses about fetal monitoring during labor. Which of the following findings should the charge nurse instruct the staff members to report to the provider?

• A. Contraction durations of 95 to 100 seconds
• B. Contraction frequency of 2 to 3 minutes apart
• C. Absent early deceleration of fetal heart rate
• D. Fetal heart rate is 140/min

Correct answer: A

Rationale: The correct answer is A. Contraction durations of 95 to 100 seconds are prolonged, indicating uterine hyperstimulation, which can lead to fetal distress and requires immediate intervention. Reporting this finding to the provider is crucial to ensure timely management and prevent adverse outcomes. Choice B, contraction frequency of 2 to 3 minutes apart, is within the normal range and does not raise immediate concerns. Choice C, absent early deceleration of fetal heart rate, is a reassuring finding suggesting fetal well-being. Choice D, a fetal heart rate of 140/min, is also normal for a fetus and does not typically require immediate reporting unless it deviates significantly from the baseline or is accompanied by other concerning signs.

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