Nursing Elites

1. Why is a client with gestational diabetes being scheduled for an amniocentesis when the fetus has an estimated weight of eight pounds (3629 grams) at 36 weeks gestation? What information is the amniocentesis seeking to obtain?

• A. Presence of a neural tube defect.
• B. Chromosomal abnormalities.
• C. Gender of the fetus.
• D. Fetal lung maturity.

Correct answer: D

Rationale: An amniocentesis in this scenario is most likely being performed to assess fetal lung maturity. This is necessary when considering early delivery due to macrosomia (large fetal size), which is a common concern in gestational diabetes. Evaluating fetal lung maturity is crucial to determine if the fetus's lungs are developed enough to support breathing independently outside the womb. The presence of a neural tube defect and chromosomal abnormalities are not typically assessed through amniocentesis in this situation, and determining the gender of the fetus is not the primary purpose of the procedure here.

2. A healthcare professional is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the healthcare professional include in the plan of care?

• A. Dress the newborn in lightweight clothing.
• B. Avoid using lotion or ointment on the newborn's skin.
• C. Keep the newborn supine throughout treatment.
• D. Measure the newborn's temperature every 8 hours.

Correct answer: B

Rationale: When a newborn is receiving phototherapy, it is important to avoid using lotions or ointments on their skin as these products can lead to skin irritation and burns under the phototherapy lights. Dressing the newborn in lightweight clothing helps ensure proper exposure to the phototherapy lights. Keeping the newborn supine during treatment helps maximize exposure to the light. However, the key consideration in this scenario is to prevent skin irritation and burns by avoiding lotions or ointments.

3. When reviewing the electronic medical record of a postpartum client, which of the following factors places the client at risk for infection?

• A. Meconium-stained amniotic fluid
• B. Placenta previa
• C. Midline episiotomy
• D. Gestational hypertension

Correct answer: C

Rationale: The correct answer is C: Midline episiotomy. An episiotomy is a surgical incision made during childbirth to enlarge the vaginal opening. This procedure increases the risk of infection in the postpartum period due to the incision site being a potential entry point for pathogens. Meconium-stained amniotic fluid (choice A) is a risk factor for fetal distress but does not directly increase the mother's risk of infection. Placenta previa (choice B) is a condition where the placenta partially or completely covers the cervix, leading to potential bleeding issues but not necessarily an increased risk of infection. Gestational hypertension (choice D) is a hypertensive disorder that affects some pregnant women but is not directly associated with an increased risk of infection in the postpartum period.

4. According to a study conducted in 2013 by Fellman, what affects the chances of having twins?

• A. Increase when a woman conceives at a younger age.
• B. Increase with parental age.
• C. Decrease with the frequency of intercourse before conception.
• D. Decrease with the use of fertility drugs.

Correct answer: B

Rationale: The correct answer is B. According to the study by Fellman in 2013, the chances of having twins actually increase with parental age. Choice A is incorrect as the study does not specify a younger age for conceiving to increase the chances of twins. Choice C is incorrect as the frequency of intercourse before conception is not a highlighted factor in the study. Choice D is also incorrect as the study does not discuss the impact of fertility drugs on the likelihood of having twins.

5. Dizygotic (DZ) twins share _________ percent of their genes.

• A. 100
• B. 75
• C. 50
• D. 25

Correct answer: C

Rationale: Dizygotic (DZ) twins share approximately 50% of their genes. This is because dizygotic twins, also known as fraternal twins, originate from two separate fertilized eggs and share similar genetic similarity to regular siblings. Choice A (100%) is incorrect because if twins shared 100% of their genes, they would be identical twins (monozygotic). Choice B (75%) is incorrect as it is not the typical genetic similarity seen in dizygotic twins. Choice D (25%) is incorrect as it represents a significantly lower genetic similarity than what is observed in dizygotic twins.

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