Nursing Elites

1. When children who are reared by adoptive parents are nonetheless more similar to their natural parents in a trait, it can be concluded that:

• A. the genetic characteristics of the children change over time.
• B. heredity is solely responsible for how a child grows.
• C. the environment is solely responsible for the development of those characteristics.
• D. genetics play a role in the development of those characteristics.

Correct answer: D

Rationale: When children exhibit traits that are more similar to their biological parents than their adoptive parents, it indicates a strong genetic influence on those traits. This similarity suggests that genetics play a significant role in the development of the observed characteristics. Choice A is incorrect because genetic characteristics do not change over time in this context. Choice B is incorrect as it implies that heredity is the only factor, disregarding the impact of the environment. Choice C is also incorrect as it suggests that only the environment influences trait development, overlooking the genetic contribution.

2. Following an amniocentesis, a nurse is caring for a client. The nurse should observe the client for which of the following complications?

• A. Hyperemesis
• B. Proteinuria
• C. Hypoxia
• D. Hemorrhage

Correct answer: D

Rationale: After an amniocentesis, the nurse should monitor the client for potential complications, with hemorrhage being a significant concern due to the invasive nature of the procedure. Hyperemesis (severe vomiting), proteinuria (excessive protein in the urine), and hypoxia (low oxygen levels) are not typically associated with amniocentesis and are less likely to occur compared to hemorrhage, which is a more common complication that requires prompt recognition and intervention.

3. A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider?

• A. A client with a urinary output of 300 ml in 8 hours
• B. A client reporting abdominal cramping during breastfeeding
• C. A client receiving magnesium sulfate with absent deep tendon reflexes
• D. A client reporting lochia rubra requiring changing perineal pads every 3 hours

Correct answer: C

Rationale: The correct answer is C because in a client receiving magnesium sulfate, absent deep tendon reflexes can indicate magnesium toxicity, which requires immediate intervention to prevent serious complications. Choices A, B, and D are common postpartum occurrences that do not typically warrant immediate provider notification. A urinary output of 300 ml in 8 hours, abdominal cramping during breastfeeding, and frequent changing of perineal pads due to lochia rubra are within the expected range of postpartum recovery and do not indicate an urgent need for provider notification.

4. At 31 weeks gestation, a client with a fundal height measurement of 25 cm is scheduled for a series of ultrasounds to be performed every two weeks. Which explanation should the nurse provide?

• A. Assessment for congenital anomalies
• B. Recalculation of gestational age
• C. Evaluation of fetal growth
• D. Determination of fetal presentation

Correct answer: C

Rationale: The correct answer is C: 'Evaluation of fetal growth.' A fundal height measurement smaller than expected may indicate intrauterine growth restriction (IUGR), requiring serial ultrasounds to monitor fetal growth. Assessing for congenital anomalies (choice A) is usually done through detailed anatomy scans earlier in pregnancy. Recalculating gestational age (choice B) is typically unnecessary at this stage unless there are concerns about accuracy. Determining fetal presentation (choice D) is usually done closer to term to plan for the mode of delivery.

5. 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.

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