Nursing Elites

1. A woman has experienced iron deficiency anemia during her pregnancy. She had been taking iron for 3 months before the birth. The client gave birth by cesarean 2 days earlier and has been having problems with constipation. After assisting her back to bed from the bathroom, the nurse notes that the woman’s stools are dark (greenish-black). What should the nurse’s initial action be?

• A. Perform a guaiac test and record the results.
• B. Recognize the finding as abnormal and report it to the primary health care provider.
• C. Recognize the finding as a normal result of iron therapy.
• D. Check the woman’s next stool to validate the observation.

Correct answer: C

Rationale: The nurse should recognize that dark stools are a common side effect in clients who are taking iron replacement therapy. Dark stools are a known, expected result of iron supplementation and are not indicative of a complication unless other symptoms of GI bleeding are present. A guaiac test would be necessary if there were concerns about gastrointestinal bleeding. Recognizing dark stools as a consequence of iron therapy is an essential nursing assessment skill and does not require immediate reporting. Checking the next stool to confirm the observation is unnecessary as the presence of dark stools in this context is already an expected outcome of iron supplementation.

2. After meiosis, each new cell nucleus contains _____ chromosomes.

• A. 46
• B. 35
• C. 23
• D. 12

Correct answer: C

Rationale: After meiosis, each resulting cell contains 23 chromosomes. Meiosis is a process that involves two sequential divisions resulting in four daughter cells, each with half the number of chromosomes as the parent cell. In humans, the parent cell has 46 chromosomes (diploid), and after meiosis, the resulting cells (sperm or ova) have 23 chromosomes (haploid). Choice A (46 chromosomes) is incorrect because this is the number of chromosomes in a human diploid cell before meiosis. Choices B (35 chromosomes) and D (12 chromosomes) are incorrect as they do not represent the correct number of chromosomes after meiosis in human cells.

3. A mother spontaneously delivers a newborn infant in the taxicab while on the way to the hospital. The emergency room nurse reported the mother has active herpes (HSV II) lesions on the vulva. Which intervention should the nurse implement first when admitting the neonate to the nursery?

• A. Document the newborn's temperature on the flow sheet.
• B. Place the newborn in the isolation area of the nursery.
• C. Obtain a blood specimen for a serum glucose level.
• D. Administer the vitamin K injection.

Correct answer: B

Rationale: Newborns exposed to active herpes lesions are at high risk for neonatal herpes, which can be severe. Placing the newborn in isolation is crucial as it helps prevent the spread of the virus and allows for close monitoring. Documenting the newborn's temperature, obtaining a blood specimen for a serum glucose level, and administering the vitamin K injection are important interventions but are not the priority when dealing with a potential infectious risk like neonatal herpes.

4. Twenty-year-old Jack is extremely tall and has very thick facial hair. Most of his male secondary sex characteristics are also more pronounced than men of his age. In this scenario, Jack is most likely:

• A. an XYY male.
• B. diagnosed with Klinefelter syndrome.
• C. an XXY male.
• D. diagnosed with Down syndrome.

Correct answer: A

Rationale: The correct answer is A: an XYY male. Individuals with XYY syndrome often exhibit increased height and more pronounced secondary male characteristics, such as thick facial hair. Choice B, Klinefelter syndrome (XXY), typically presents with less prominent male secondary sex characteristics due to the presence of an extra X chromosome. Choice C, XXY male, refers to Klinefelter syndrome, which does not align with the description of Jack having more pronounced male secondary sex characteristics. Choice D, Down syndrome, is caused by a trisomy of chromosome 21 and is not associated with the physical characteristics described in the scenario.

5. What causes sickle-cell anemia?

• A. A chromosomal abnormality.
• B. A single segment found only on the Y chromosome.
• C. A recessive gene.
• D. A decrease in estrogen levels.

Correct answer: C

Rationale: Sickle-cell anemia is a genetic disorder caused by inheriting two copies of a recessive gene, one from each parent. The correct answer is C. Choice A is incorrect because sickle-cell anemia is not primarily caused by a chromosomal abnormality. Choice B is incorrect as the condition is not linked to a single segment found only on the Y chromosome. Choice D is unrelated as it mentions a decrease in estrogen levels, which is not a cause of sickle-cell anemia.

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