Nursing Elites

1. A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?

• A. “Surfactant improves the ability of your baby’s lungs to exchange oxygen and carbon dioxide.”
• B. “The drug keeps your baby from requiring too much sedation.”
• C. “Surfactant is used to reduce episodes of periodic apnea.”
• D. “Your baby needs this medication to fight a possible respiratory tract infection.”

Correct answer: A

Rationale: Artificial surfactant can be administered as an adjunct to oxygen and ventilation therapy for premature infants with respiratory distress syndrome (RDS). It helps improve respiratory compliance by aiding in the exchange of oxygen and carbon dioxide until the infant can produce enough surfactant naturally. The correct explanation to the parents would be that surfactant therapy enhances the baby’s lung function by facilitating the exchange of oxygen and carbon dioxide. Choice B is incorrect because surfactant therapy does not affect sedation needs. Choice C is inaccurate as surfactant is not used to reduce episodes of periodic apnea. Choice D is incorrect as surfactant is not administered to fight respiratory tract infections; it specifically targets improving lung function in RDS.

2. Before meiosis, a sperm cell:

• A. contains 46 chromosomes.
• B. contains two X chromosomes.
• C. is significantly larger than an egg cell.
• D. contains both an X and a Y chromosome.

Correct answer: A

Rationale: Before meiosis, a sperm cell contains 46 chromosomes. This is because sperm cells, like other somatic cells, have a diploid number of chromosomes. During meiosis, the number of chromosomes is halved to 23 to combine with an egg cell during fertilization. Choice B is incorrect because a sperm cell carries either an X or a Y chromosome, not both (Choice D). Choice C is incorrect as sperm cells are generally smaller than egg cells, which is an adaptation that aids in motility and penetration of the egg during fertilization.

3. A nurse is planning to teach a group of clients who are breastfeeding after returning to work. Which of the following instructions should the nurse include in the teaching?

• A. “Thawed breast milk can be refrigerated for up to 24 hours.”
• B. “Breast milk can be stored in a deep freezer for 12 months.”
• C. “Breast milk can be stored at room temperature for up to 4 hours.”
• D. “Thawed breast milk that is unused cannot be refrozen.”

Correct answer: B

Rationale: The correct answer is B: “Breast milk can be stored in a deep freezer for 12 months.” This instruction is important for mothers returning to work to ensure a long-term storage option for breast milk. Choice A is incorrect because thawed breast milk should be used within 24 hours if stored in the refrigerator. Choice C is incorrect as breast milk can be kept at room temperature for only up to 4 hours. Choice D is incorrect as thawed breast milk that is unused should not be refrozen due to safety concerns.

4. A client is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?

• A. Hypotension
• B. Polyuria
• C. Bilateral crackles
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Bilateral crackles. Bilateral crackles indicate respiratory complications, which can occur as an adverse effect of an epidural block with opioid analgesics. Hypotension (Choice A) is a common side effect of epidural opioids but is not typically monitored via crackles. Polyuria (Choice B) is excessive urination and is not directly associated with epidural blocks. Hyperglycemia (Choice D) is high blood sugar levels and is not a typical adverse effect of epidural opioids.

5. In the structure of deoxyribonucleic acid (DNA), which of the following bases combines with thymine?

• A. Cytosine
• B. Adenine
• C. Rhodamine
• D. Serine

Correct answer: B

Rationale: The correct answer is B: Adenine. In the structure of DNA, adenine pairs with thymine through hydrogen bonding, forming one of the complementary base pairs that make up the double helix structure of DNA. Cytosine pairs with guanine, not thymine. Rhodamine and serine are not DNA bases and do not participate in DNA base pairing. Therefore, choices A, C, and D are incorrect.

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