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 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light and asks for her nurse right away, stating 'I’m bleeding a lot.' What is the most likely cause of postpartum hemorrhage in this client?

• A. Retained placental fragments.
• B. Unrepaired vaginal lacerations.
• C. Uterine atony.
• D. Puerperal infection.

Correct answer: C

Rationale: Uterine atony is the most likely cause of bleeding 4 hours after delivery, especially after delivering a macrosomic infant and augmenting labor with oxytocin. Uterine atony is characterized by the inability of the uterine muscles to contract effectively after childbirth, leading to excessive bleeding. The other options, such as retained placental fragments (A), unrepaired vaginal lacerations (B), and puerperal infection (D), are less likely causes of postpartum hemorrhage in this scenario. Retained placental fragments can cause bleeding, but this typically presents earlier than 4 hours postpartum. Unrepaired vaginal lacerations would likely be evident sooner and not typically result in significant bleeding. Puerperal infection is not a common cause of immediate postpartum hemorrhage unless there are other signs of infection present.

3. _______ is a genetic disorder in which blood does not clot properly.

• A. Cystic fibrosis
• B. Hemophilia
• C. Lymphoma
• D. Huntington’s disease

Correct answer: B

Rationale: Hemophilia is a genetic disorder characterized by a deficiency in blood clotting factors, leading to prolonged bleeding. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system, not blood clotting. Lymphoma is a type of cancer originating in the lymphatic system and is not related to blood clotting abnormalities. Huntington's disease is a neurodegenerative genetic disorder that affects a person's ability to move, think, and behave.

4. A newborn who was born post-term is being assessed by a nurse. Which of the following findings should the nurse expect?

• A. A Rh-negative mother who has an Rh-positive infant
• B. A Rh-positive mother who has an Rh-negative infant
• C. A Rh-positive mother who has an Rh-positive infant
• D. A Rh-negative mother who has an Rh-negative infant

Correct answer: A

Rationale: The correct answer is A: 'A Rh-negative mother who has an Rh-positive infant.' In cases where the newborn is born post-term, the mismatched Rh factor between the mother (Rh-negative) and the infant (Rh-positive) can lead to hemolytic disease of the newborn. This condition occurs when maternal antibodies attack fetal red blood cells, causing hemolysis. This can result in jaundice, anemia, and other serious complications for the infant. Choices B, C, and D are incorrect because they do not reflect the mismatched Rh factor scenario that poses a risk for hemolytic disease of the newborn.

5. Which of the following pairs of bases is present in the rungs of the ladder-like structure of deoxyribonucleic acid (DNA)?

• A. Cytosine with guanine.
• B. Rhodamine with biotin.
• C. Diaminopurine with ribozyme.
• D. Serine with tyrosine.

Correct answer: A

Rationale: The correct answer is A: Cytosine with guanine. In the DNA double helix, cytosine always pairs with guanine forming a base pair, and adenine pairs with thymine. These complementary base pairs form the rungs of the ladder-like structure of DNA. Choice B, Rhodamine with biotin, is incorrect as they are not base pairs found in DNA. Choice D, Serine with tyrosine, is incorrect as they are amino acids, not DNA bases. Choice C, Diaminopurine with ribozyme, is also incorrect as ribozyme is an enzyme, not a base, and diaminopurine is not one of the standard bases found in DNA.

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