Nursing Elites

1. Do dizygotic (DZ) twins run in families?

• A. Yes
• B. No
• C. Rarely
• D. Never

Correct answer: A

Rationale: Yes, dizygotic (DZ) twins can run in families. This is due to genetic factors that influence hyperovulation, where a woman releases multiple eggs during her menstrual cycle. This genetic predisposition can be passed down through generations, increasing the likelihood of having dizygotic twins. Choices B, C, and D are incorrect because the statement that dizygotic twins run in families is true, as supported by scientific evidence. It is important to note that while the genetic predisposition for dizygotic twins can run in families, it does not guarantee that every generation will have twins, as other factors also play a role in twin pregnancies.

2. Which of the following statements is true of Down’s syndrome?

• A. Down’s syndrome is usually caused by an extra copy of chromosome 21 in an individual.
• B. The symptoms of Down’s syndrome are similar to those of sickle-cell anemia.
• C. Down’s syndrome is caused by a sexually transmitted infection (STI) during conception.
• D. The probability of having a child with Down’s syndrome increases with the age of the parents.

Correct answer: D

Rationale: The correct answer is D. The likelihood of having a child with Down’s syndrome increases as the age of the parents increases, particularly the mother's age. Choice A is incorrect because Down’s syndrome is caused by an extra copy of chromosome 21, not a defect in the sex chromosomes. Choice B is incorrect as the symptoms of Down’s syndrome and sickle-cell anemia are different. Choice C is also incorrect as Down’s syndrome is not caused by a sexually transmitted infection during conception.

3. A client who is receiving prenatal care is at her 24-week appointment. Which of the following laboratory tests should the nurse plan to conduct?

• A. Group B strep culture
• B. 1-hour glucose tolerance test
• C. Rubella titer
• D. Blood type and Rh

Correct answer: B

Rationale: The correct answer is B: 1-hour glucose tolerance test. At around 24-28 weeks of gestation, a pregnant individual is typically screened for gestational diabetes. The 1-hour glucose tolerance test helps in identifying elevated blood sugar levels during pregnancy. Choice A, Group B strep culture, is not typically performed at the 24-week appointment but later in the third trimester to screen for Group B streptococcus colonization. Choice C, Rubella titer, is usually checked early in pregnancy to determine immunity to rubella. Choice D, Blood type and Rh, is important for determining the client's blood type and Rh status, but it is usually done earlier in pregnancy and not specifically at the 24-week appointment.

4. An individual’s phenotype reflects both genetic and environmental influences.

• A. phenotype
• B. chromosome
• C. allele
• D. genotype

Correct answer: A

Rationale: The correct answer is A: phenotype. A phenotype is the observable characteristics of an individual, which result from the interaction of their genotype with the environment. This interaction between genetics and the environment determines how genes are expressed and how traits are manifested in an individual. Choices B, C, and D are incorrect because chromosomes, alleles, and genotypes are components of an individual's genetic makeup, but they do not directly reflect the observable traits influenced by both genetics and the environment.

5. The nurse places one hand above the symphysis while massaging the fundus of a multiparous client whose uterine tone is boggy 15 minutes after delivering a 7-pound, 10-ounce (3220-gram) infant. Which information should the nurse provide to the client about these findings?

• A. The uterus should be firm to prevent an intrauterine infection.
• B. Both the lower uterine segment and the fundus must be massaged.
• C. A firm uterus prevents the endometrial lining from being sloughed.
• D. Clots may form inside a boggy uterus and need to be expelled.

Correct answer: D

Rationale: After childbirth, a boggy uterus indicates poor uterine tone, which can lead to the formation of clots. Massaging the fundus helps the uterus contract and expel clots, reducing the risk of postpartum hemorrhage. Choices A, B, and C are incorrect because the main concern with a boggy uterus is the risk of clot formation and postpartum hemorrhage, not solely preventing intrauterine infection, massaging the lower uterine segment, or preventing the endometrial lining from sloughing.

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