Nursing Elites

1. On the first postpartum day, the nurse examines the breasts of a new mother. Which condition is the nurse most likely to find?

• A. Firm, larger, and very tender to the touch
• B. Slightly firm with an immediate let-down response
• C. Soft with no change from before delivery
• D. Filling and secreting colostrum

Correct answer: D

Rationale: On the first postpartum day, the nurse is most likely to find the breasts filling and secreting colostrum. Colostrum secretion is common as the body prepares for breastfeeding in the initial days after delivery. Choice A is incorrect as breasts are not typically very tender immediately postpartum. Choice B is incorrect as an immediate let-down response is more related to lactation rather than the first postpartum day. Choice C is incorrect as the breasts typically undergo changes, such as filling with colostrum, after delivery.

2. 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.

3. A client at 27 weeks of gestation with preeclampsia is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

• A. Urine protein concentration of 200 mg/24 hr.
• B. Creatinine level of 0.8 mg/dL
• C. Hemoglobin level of 14.8 g/dL
• D. Platelet count of 60,000/mm3

Correct answer: D

Rationale: A platelet count of 60,000/mm3 is significantly low and can indicate HELLP syndrome, a severe complication of preeclampsia that involves hemolysis, elevated liver enzymes, and low platelet count. HELLP syndrome requires prompt medical intervention to prevent serious maternal and fetal complications. The other findings listed are within normal limits or not directly related to the severe condition associated with HELLP syndrome.

4. Which field of biology studies heredity?

• A. Etiology.
• B. Ecology.
• C. Genetics.
• D. Eugenics.

Correct answer: C

Rationale: Genetics is the branch of biology that focuses on the study of heredity and variation in organisms. Etiology (choice A) deals with the causes of diseases, not heredity. Ecology (choice B) is concerned with the relationships between organisms and their environment, not specifically heredity. Eugenics (choice D) is a controversial field that involves improving the genetic quality of the human population through selective breeding, which is different from the study of heredity itself.

5. A perinatal nurse is caring for a woman in the immediate postpartum period. Assessment reveals that the client is experiencing profuse bleeding. What is the most likely cause of this bleeding?

• A. Uterine atony.
• B. Uterine inversion.
• C. Vaginal hematoma.
• D. Vaginal laceration.

Correct answer: A

Rationale: Uterine atony is significant hypotonia of the uterus and is the leading cause of postpartum hemorrhage. It results in the inability of the uterus to contract effectively after delivery, leading to excessive bleeding. Uterine inversion is a rare but serious complication that involves the turning inside out of the uterus, leading to hemorrhage, but it is not the most likely cause of profuse bleeding in this scenario. Vaginal hematoma may cause bleeding but is typically associated with pain as a primary symptom rather than profuse bleeding. Vaginal lacerations can cause bleeding, but in the presence of a firm, contracted uterine fundus, uterine atony is a more likely cause of ongoing profuse bleeding in the postpartum period.

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