Nursing Elites

1. Which of the following statements about Rh incompatibility is true?

• A. Rh incompatibility occurs most commonly during a woman’s first pregnancy.
• B. Rh incompatibility is an untreatable condition that leaves a woman infertile for the rest of her life.
• C. Rh incompatibility is an abnormality that is transmitted from generation to generation and carried by a sex chromosome.
• D. Rh incompatibility occurs due to antibodies transmitted to a fetus during subsequent deliveries causing brain damage or death.

Correct answer: D

Rationale: Rh incompatibility occurs when the mother's antibodies attack the fetus's red blood cells, leading to serious complications, usually in subsequent pregnancies. Choice A is incorrect because Rh incompatibility often occurs in subsequent pregnancies, not necessarily the first one. Choice B is incorrect as Rh incompatibility does not render a woman infertile but can lead to complications during pregnancies. Choice C is incorrect as Rh incompatibility is not carried by a sex chromosome but involves the Rh factor on red blood cells.

2. 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.

3. A nurse is reviewing laboratory results for a term newborn who is 24 hours old. Which of the following results require intervention by the nurse?

• A. WBC count 10,000/mm3
• B. Platelets 180,000/mm3
• C. Hemoglobin 20g/dL
• D. Glucose 20 mg/dL

Correct answer: D

Rationale: A glucose level of 20 mg/dL is critically low for a newborn and requires immediate intervention. Hypoglycemia in a newborn can lead to serious complications such as neurologic deficits. The normal range for glucose levels in a newborn is typically 40-60 mg/dL. Choices A, B, and C represent normal or acceptable values for a term newborn and do not require immediate intervention. A WBC count of 10,000/mm3, platelets of 180,000/mm3, and hemoglobin of 20g/dL are all within normal ranges for a term newborn and do not raise immediate concerns.

4. A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. What is the nurse’s highest priority in this situation?

• A. Prepare the woman for imminent birth.
• B. Notify the woman’s primary healthcare provider.
• C. Document the characteristics of the fluid.
• D. Assess the fetal heart rate (FHR) and pattern.

Correct answer: D

Rationale: The correct answer is to assess the fetal heart rate (FHR) and pattern (Choice D). When a multiparous woman's membranes rupture after 8 hours of labor, the nurse's priority is to assess the fetal well-being. Rupture of membranes can lead to potential complications such as umbilical cord prolapse. Monitoring the fetal heart rate and pattern immediately after the rupture of membranes is crucial to ensure the fetus is not in distress. This assessment helps in determining the need for immediate interventions to safeguard the fetus. Documenting the characteristics of the fluid (Choice C) may be necessary but is of lower priority compared to assessing fetal well-being. While preparing the woman for imminent birth (Choice A) is important, assessing the fetal heart rate takes precedence to ensure the fetus is not compromised. Notifying the woman's primary healthcare provider (Choice B) is also important but not the highest priority at this moment.

5. 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.

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