Nursing Elites

1. According to a study in 2014 by Skakkebaek et al., who among the following is most likely to have gynecomastia?

• A. Jennifer, a dancer, who has Down syndrome
• B. Frank, a teacher, who is diagnosed with XYY syndrome
• C. Peter, a fashion designer, who has Klinefelter syndrome
• D. Ria, a gym instructor, who is diagnosed with Turner syndrome

Correct answer: C

Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY) and typically have reduced testosterone levels, which can lead to gynecomastia (enlarged breasts). This condition is not usually associated with Down syndrome (choice A), XYY syndrome (choice B), or Turner syndrome (choice D), making them less likely to have gynecomastia.

2. Which neonatal complications are associated with hypertension in the mother?

• A. Intrauterine growth restriction (IUGR) and prematurity.
• B. Seizures and cerebral hemorrhage.
• C. Hepatic or renal dysfunction.
• D. Placental abruption and DIC.

Correct answer: A

Rationale: Neonatal complications associated with maternal hypertension are primarily due to placental insufficiency. The correct answer is A, which includes Intrauterine Growth Restriction (IUGR) and prematurity. These complications arise from inadequate blood flow to the fetus, leading to growth restriction and premature birth. Choices B, seizures, and cerebral hemorrhage are more commonly maternal complications rather than neonatal ones. Choice C, hepatic or renal dysfunction, pertains to maternal complications of hypertensive disorders in pregnancy, not neonatal issues. Choice D, placental abruption, and Disseminated Intravascular Coagulation (DIC) are conditions linked to maternal morbidity and mortality, not neonatal complications.

3. A 17-year-old client gave birth 12 hours ago. She states that she doesn't know how to care for her baby. To promote parent-infant attachment behaviors, which intervention should the nurse implement?

• A. Ask if she has help to care for the baby at home
• B. Provide a video on newborn safety and care
• C. Explore the basis of fears with the client
• D. Encourage rooming in while in the hospital

Correct answer: D

Rationale: Encouraging rooming in while in the hospital is the most appropriate intervention to promote parent-infant attachment behaviors. Rooming in allows the mother to stay with her baby continuously, facilitating bonding and providing the opportunity for the mother to learn how to care for her baby with the nurse's support. Asking if she has help at home (Choice A) does not directly address promoting attachment behaviors. Providing a video on newborn safety and care (Choice B) may offer information but does not actively facilitate immediate bonding. Exploring the basis of fears (Choice C) is important but may not directly address promoting attachment behaviors as effectively as encouraging rooming in.

4. A client at 30 weeks gestation reports that she has not felt the baby move in the last 24 hours. Concerned, she arrives in a panic at the obstetric clinic where she is immediately sent to the hospital. Which assessment warrants immediate intervention by the nurse?

• A. Fetal Heart rate 60 beats per minute
• B. Ruptured amniotic membrane
• C. Onset of uterine contractions
• D. Leaking amniotic fluid

Correct answer: A

Rationale: A fetal heart rate of 60 beats per minute is significantly below the normal range (110-160 bpm) and indicates fetal distress, requiring immediate intervention. This low heart rate can be a sign of fetal compromise or distress, necessitating urgent evaluation and intervention to ensure the well-being of the fetus. Choices B, C, and D do not indicate immediate fetal distress requiring urgent intervention. Ruptured amniotic membrane, onset of uterine contractions, and leaking amniotic fluid are important assessments but do not present an immediate threat to the fetus's life like a severely low fetal heart rate.

5. _________ are problems that stem from the interaction of heredity and environmental factors.

• A. Multifactorial problems
• B. Cognitive problems
• C. Horizon problems
• D. Coronal problems

Correct answer: A

Rationale: Multifactorial problems are conditions that result from the interplay of genetic and environmental factors. These conditions, such as diabetes or heart disease, are not solely determined by genetics or environment but are influenced by a combination of both factors. Choice B, cognitive problems, refers to difficulties related to thinking, learning, and memory and are not specifically linked to genetic and environmental interactions. Choices C and D, horizon problems and coronal problems, are nonsensical terms and do not relate to the interaction of heredity and environmental factors.

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