Nursing Elites

1. A client at 26 weeks gestation was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks what she should do next. What information should the nurse provide?

• A. Reassure the client that the AFP results are likely to be a false reading.
• B. Explain that a sonogram should be scheduled for definitive results.
• C. Inform her that a repeat alpha-fetoprotein (AFP) test should be evaluated.
• D. Discuss options for intrauterine surgical correction of congenital defects.

Correct answer: B

Rationale: An elevated AFP level during pregnancy can indicate potential fetal anomalies. Further evaluation is necessary to confirm the findings and assess the need for additional interventions. Scheduling a sonogram is the appropriate next step as it can provide more definitive results and help identify any underlying issues. Choice A is incorrect because dismissing the elevated AFP level as a false reading without further investigation can lead to missing important information about the baby's health. Choice C is not the best immediate action, as scheduling a sonogram would provide more detailed information than just repeating the AFP test. Choice D is incorrect as discussing intrauterine surgical correction is premature at this stage and not typically indicated based solely on an elevated AFP level.

2. What is the structure of deoxyribonucleic acid (DNA)?

• A. single spiral
• B. double helix
• C. sphere
• D. cube

Correct answer: B

Rationale: The correct answer is B: double helix. DNA is structured as a double helix, resembling a twisted ladder made up of two strands of nucleotides. Choice A, single spiral, is incorrect as DNA is not a single spiral structure. Choice C, sphere, is incorrect as DNA does not form a spherical shape. Choice D, cube, is incorrect as DNA does not have a cubic structure. Understanding the double helix structure of DNA is essential as it allows for the storage and transmission of genetic information in living organisms.

3. The actual sets of traits that people exhibit are called their genotypes.

• A. TRUE
• B. FALSE
• C. Possibly
• D. Always

Correct answer: B

Rationale: The actual sets of traits that people exhibit are called phenotypes, not genotypes. Genotypes refer to the genetic makeup of an individual.

4. According to a study in 2013 by van Gameren-Oosterom, individuals with Down syndrome:

• A. are unlikely to die from cardiovascular problems by middle age.
• B. have no specific characteristic features.
• C. show deficits in cognitive development.
• D. are likely to have only 46 chromosomes.

Correct answer: C

Rationale: The correct answer is C. According to a study in 2013 by van Gameren-Oosterom, individuals with Down syndrome often exhibit deficits in cognitive development. This is a common characteristic of Down syndrome, along with other health challenges. Choice A is incorrect because individuals with Down syndrome are at a higher risk of cardiovascular problems, contrary to being unlikely to die from them. Choice B is incorrect as Down syndrome is associated with specific characteristic features such as distinctive facial characteristics, making the statement that they have no specific features incorrect. Choice D is incorrect as individuals with Down syndrome have an extra copy of chromosome 21, resulting in a total of 47 chromosomes, not 46.

5. What nursing diagnosis is the most appropriate for a woman experiencing severe preeclampsia?

• A. Risk for injury to mother and fetus, related to central nervous system (CNS) irritability.
• B. Risk for altered gas exchange.
• C. Risk for deficient fluid volume, related to increased sodium retention secondary to the administration of magnesium sulfate.
• D. Risk for increased cardiac output, related to the use of antihypertensive drugs.

Correct answer: A

Rationale: The most appropriate nursing diagnosis for a woman experiencing severe preeclampsia is 'Risk for injury to mother and fetus, related to central nervous system (CNS) irritability.' Severe preeclampsia poses a significant risk of injury to both the mother and the fetus due to complications such as seizures, stroke, and placental abruption. 'Risk for altered gas exchange' is not the priority diagnosis as pulmonary edema is more common in severe preeclampsia. 'Risk for deficient fluid volume' is incorrect as sodium retention in severe preeclampsia often leads to fluid overload. 'Risk for increased cardiac output' is also incorrect as antihypertensive drugs are used to reduce cardiac output in this condition.

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