Nursing Elites

1. A client who delivered a healthy newborn an hour ago asked the nurse when she can go home. Which information is most important for the nurse to provide the client?

• A. After the baby no longer demonstrates acrocyanosis
• B. After the baby receives the vitamin K injection
• C. When ambulating to avoid causing dizziness
• D. When there is no significant vaginal bleeding

Correct answer: D

Rationale: The most critical information for the nurse to provide the client is ensuring that there is no significant vaginal bleeding before discharge. This is vital to prevent complications such as postpartum hemorrhage. Options A, B, and C are important aspects of postpartum care, but assessing and managing vaginal bleeding takes precedence due to its potential seriousness.

2. Polygenic traits are those that are:

• A. developed during adolescence.
• B. transmitted by the mother.
• C. uncommon in humans.
• D. determined by several pairs of genes.

Correct answer: D

Rationale: Polygenic traits, such as height and skin color, are determined by several pairs of genes working together. These traits are influenced by the combined effects of multiple genes across the genome, rather than being controlled by a single gene pair. Choices A, B, and C are incorrect because polygenic traits are not specifically developed during adolescence, transmitted by the mother, or uncommon in humans. Understanding polygenic traits is essential in genetics as they demonstrate the complexity of genetic inheritance and the influence of multiple genes on a single trait.

3. Twins that derive from a single zygote that has split into two are called:

• A. monozygotic (MZ) twins.
• B. fraternal twins.
• C. non-identical twins.
• D. dizygotic (DZ) twins.

Correct answer: A

Rationale: The correct answer is A: monozygotic (MZ) twins. Monozygotic twins, also known as identical twins, occur when a single zygote splits into two embryos, leading to two genetically identical individuals. Choice B, fraternal twins, are twins that develop from two separate eggs fertilized by two different sperm cells, resulting in non-identical siblings. Choice C, non-identical twins, is not a common term used to describe this type of twinning. Choice D, dizygotic (DZ) twins, refer to twins that develop from two separate eggs fertilized by two different sperm cells, leading to non-identical twins.

4. What maternal factor should the nurse identify as having the greatest impact on the development of spina bifida occulta in a newborn?

• A. Short interval between pregnancies
• B. Folic acid deficiency
• C. Preeclampsia
• D. Tobacco use

Correct answer: B

Rationale: Folic acid deficiency during pregnancy is a well-known risk factor for neural tube defects, including spina bifida occulta, making supplementation critical in prenatal care. Folic acid plays a crucial role in neural tube formation during early pregnancy. Short intervals between pregnancies do not directly impact the development of spina bifida occulta. Preeclampsia is a hypertensive disorder of pregnancy and is not directly linked to spina bifida occulta. While tobacco use during pregnancy has various adverse effects, it is not the primary factor influencing the development of spina bifida occulta in newborns.

5. A client in labor requests nonpharmacological pain management. Which of the following nursing actions promotes client comfort?

• A. Assisting the client into a squatting position
• B. Having the client lie in a supine position
• C. Applying fundal pressure during contractions
• D. Encouraging the client to void every 6 hours

Correct answer: A

Rationale: Assisting the client into a squatting position promotes comfort during labor. This position can help relieve pain by utilizing gravity, allowing the pelvic outlet to widen, and potentially facilitating the progress of labor. Lying in a supine position (Choice B) can hinder labor progression and increase discomfort. Applying fundal pressure (Choice C) can be inappropriate and may cause harm as it is not routinely recommended during labor. Encouraging the client to void every 6 hours (Choice D) is important for bladder management but does not directly address pain relief during labor.

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