Nursing Elites

1. What is the purpose of amniocentesis?

• A. To induce abortion
• B. To detect genetic abnormalities in the fetus
• C. To determine the baby's gender
• D. To monitor fetal growth

Correct answer: B

Rationale: Amniocentesis is a diagnostic procedure used to detect genetic abnormalities in the fetus, such as chromosomal disorders like Down syndrome. It is not performed to induce abortion. The primary purpose of amniocentesis is to assess the genetic health of the fetus, not to determine the baby's gender (Choice C). While amniocentesis can provide information about the baby's health and development, it is not primarily used for monitoring fetal growth (Choice D). Therefore, the correct answer is B.

2. What is the primary rationale for thoroughly drying the infant immediately after birth?

• A. Stimulates crying and lung expansion.
• B. Removes maternal blood from the skin surface.
• C. Reduces heat loss from evaporation.
• D. Increases blood supply to the hands and feet.

Correct answer: C

Rationale: The primary rationale for thoroughly drying the infant immediately after birth is to reduce heat loss from evaporation. This helps maintain the infant's body temperature and prevent hypothermia. Choice A (Stimulates crying and lung expansion) is incorrect because drying the infant is not primarily done to stimulate crying but rather to prevent heat loss. Choice B (Removes maternal blood from the skin surface) is incorrect as the main reason is to prevent heat loss, not to remove maternal blood. Choice D (Increases blood supply to the hands and feet) is also incorrect as drying the infant is not intended to increase blood supply but rather to regulate body temperature.

3. What term is used to describe each member of a pair of genes?

• A. allele
• B. zygote
• C. autosome
• D. node

Correct answer: A

Rationale: The correct answer is 'allele.' An allele refers to one of two or more versions of a gene located at the same position on a chromosome. In genetics, alleles are responsible for variations in inherited traits. Choice B, 'zygote,' is incorrect as a zygote is a fertilized egg cell formed by the fusion of two gametes. Choice C, 'autosome,' is incorrect as autosomes are non-sex chromosomes that determine an individual's genetic traits excluding sex-linked characteristics. Choice D, 'node,' is incorrect as it does not relate to the concept of genes or genetic inheritance.

4. A 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light and asks for her nurse right away, stating 'I’m bleeding a lot.' What is the most likely cause of postpartum hemorrhage in this client?

• A. Retained placental fragments.
• B. Unrepaired vaginal lacerations.
• C. Uterine atony.
• D. Puerperal infection.

Correct answer: C

Rationale: Uterine atony is the most likely cause of bleeding 4 hours after delivery, especially after delivering a macrosomic infant and augmenting labor with oxytocin. Uterine atony is characterized by the inability of the uterine muscles to contract effectively after childbirth, leading to excessive bleeding. The other options, such as retained placental fragments (A), unrepaired vaginal lacerations (B), and puerperal infection (D), are less likely causes of postpartum hemorrhage in this scenario. Retained placental fragments can cause bleeding, but this typically presents earlier than 4 hours postpartum. Unrepaired vaginal lacerations would likely be evident sooner and not typically result in significant bleeding. Puerperal infection is not a common cause of immediate postpartum hemorrhage unless there are other signs of infection present.

5. What should be the primary focus of nursing care in the transitional phase of labor for a client who anticipates an unmedicated delivery?

• A. Assessing the strength of uterine contractions
• B. Re-evaluating the need for medication
• C. Reminding her to push 3 times with each contraction
• D. Assisting her to maintain control

Correct answer: D

Rationale: During the transitional phase of labor, which is the most intense phase, the primary focus of nursing care for a client who anticipates an unmedicated delivery should be assisting her to maintain control. This is essential to help her manage the intense pain and anxiety associated with this phase without the use of medication. Assessing the strength of uterine contractions (Choice A) is important but not the primary focus during the transitional phase. Re-evaluating the need for medication (Choice B) is not applicable as the client anticipates an unmedicated delivery. Reminding her to push 3 times with each contraction (Choice C) is more related to the pushing stage of labor and not the transitional phase.

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