Nursing Elites

1. Which of the following statements is true about Tay-Sachs disease?

• A. It is most commonly found among children in Jewish families of Eastern European background.
• B. Children who have this disease suffer from excessive production of mucus in the lungs and pancreas.
• C. It is most commonly found among children in Asian American families.
• D. Children who have this disease suffer from muscular dystrophy characterized by a weakening of the muscles.

Correct answer: A

Rationale: The correct answer is A. Tay-Sachs disease is most commonly found among Jewish families of Eastern European descent. It is a fatal genetic disorder that affects the nervous system. Choice B is incorrect because Tay-Sachs disease does not involve excessive mucus production in the lungs and pancreas. Choice C is incorrect as it states that Tay-Sachs disease is most commonly found among Asian American families, which is inaccurate. Choice D is also incorrect because Tay-Sachs disease does not cause muscular dystrophy characterized by weakening of the muscles.

2. When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition?

• A. Regular heart rate and hypertension.
• B. Increased urinary output, tachycardia, and dry cough.
• C. Shortness of breath, bradycardia, and hypertension.
• D. Dyspnea, crackles, and an irregular, weak pulse.

Correct answer: D

Rationale: In pregnant women with cardiac problems, signs of cardiac decompensation include dyspnea, crackles, an irregular, weak, and rapid pulse, rapid respirations, a moist and frequent cough, generalized edema, increasing fatigue, and cyanosis of the lips and nailbeds. Choice A is incorrect as a regular heart rate and hypertension are not typically associated with cardiac decompensation. Choice B is incorrect as increased urinary output and dry cough are not indicative of cardiac decompensation, only tachycardia is. Choice C is incorrect as bradycardia and hypertension are not typically seen in cardiac decompensation; dyspnea is a critical sign instead.

3. The client who is 40 weeks gestation seems upset and tells the nurse that the physician told her she needs to have a nonstress test. The client asks why she needs the test. The nurse’s best response would be:

• A. This is a test to see if your stress level is affecting your baby’s growth and well-being.
• B. This is a test to see if your baby will be able to withstand the stress of labor.
• C. This is a test to assess your baby’s well-being now that you are due to deliver soon.
• D. This is a test to let us know if your baby needs to be delivered to avoid a bad outcome.

Correct answer: C

Rationale: The correct response is C because the nonstress test is specifically used to assess the baby's well-being close to the due date. It helps determine if the baby is receiving enough oxygen and nutrients in the womb. Choice A is incorrect as the test does not assess the mother's stress level but focuses on fetal well-being. Choice B is incorrect as the test does not predict the baby's ability to withstand labor. Choice D is incorrect because the test does not solely indicate if the baby needs to be delivered to avoid a bad outcome; rather, it assesses the current well-being of the baby.

4. Do neural tube defects cause an elevation in the alpha-fetoprotein (AFP) level in the mother’s blood?

• A. Yes
• B. No
• C. Possibly
• D. Never

Correct answer: A

Rationale: Yes, neural tube defects can cause an elevation in AFP levels in the mother’s blood. AFP levels are often used as a screening marker during pregnancy to detect neural tube defects. Choice B is incorrect because an elevation in AFP levels can indeed occur in the presence of neural tube defects. Choice C is not the best option as it leaves room for uncertainty when the relationship between neural tube defects and AFP elevation is well-established. Choice D is incorrect as neural tube defects are known to influence AFP levels in the maternal blood.

5. The nurse is planning discharge teaching for four mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?

• A. A primiparous woman who has recently migrated to the US with her spouse
• B. A multiparous client who lives with her husband and his family members
• C. A multiparous female with a large family living in a community
• D. A primiparous adolescent living at home with her parents and significant other

Correct answer: A

Rationale: A primiparous woman who has recently migrated to the US with her spouse is at the highest risk for psychological difficulties during the postpartum period. Recent migration and adjustment to a new environment can increase the risk of postpartum depression, especially when combined with the challenges of being a new mother. Choice B, a multiparous client living with her husband and his family, may have social support from family members, which can be protective against psychological difficulties. Choice C, a multiparous female with a large family living in a community, also indicates potential social support. Choice D, a primiparous adolescent living at home with her parents and significant other, may have a support system in place with her family and significant other.

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