Nursing Elites

1. During the client’s initial prenatal visit, which of the following would indicate a need for further assessment?

• A. History of diabetes for 6 years.
• B. Exercises three times a week.
• C. Occasional use of over-the-counter pain relievers.
• D. Maternal age 30 years.

Correct answer: A

Rationale: A history of diabetes for 6 years indicates a pre-existing medical condition that can significantly impact both the mother and the developing fetus during pregnancy. This necessitates further assessment and monitoring to manage potential complications. Regular exercise (Choice B) is generally beneficial during pregnancy and does not raise immediate concerns. Occasional use of over-the-counter pain relievers (Choice C) is common and does not necessarily indicate a need for further assessment during the initial visit. Maternal age of 30 years (Choice D) falls within the normal range for childbearing and is not a standalone factor requiring immediate further assessment.

2. When obtaining a health history from a client, a nurse in a woman’s health clinic should identify which of the following findings as increasing the client’s risk for developing pelvic inflammatory disease (PID)?

• A. Recurrent Cystitis
• B. Frequent Alcohol Use
• C. Use of Oral Contraceptives
• D. Chlamydia Infection

Correct answer: D

Rationale: Chlamydia infection is a significant risk factor for developing pelvic inflammatory disease (PID). PID is often caused by untreated sexually transmitted infections (STIs) like Chlamydia and Gonorrhea that ascend from the vagina to the upper reproductive organs. Recurrent cystitis (choice A) is more related to urinary tract infections, frequent alcohol use (choice B) is not directly linked to PID, and the use of oral contraceptives (choice C) does not increase the risk of developing PID.

3. Preconception counseling is crucial for the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?

• A. Frequent episodes of maternal hypoglycemia
• B. Congenital anomalies in the fetus
• C. Hydramnios
• D. Hyperemesis gravidarum

Correct answer: B

Rationale: Preconception counseling is essential as strict metabolic control before conception and in the early weeks of gestation helps reduce the risk of congenital anomalies. Frequent episodes of maternal hypoglycemia usually occur during the first trimester due to hormonal changes, affecting insulin production and use, rather than before conception. Hydramnios is more common in diabetic pregnancies, typically seen in the third trimester, not during early pregnancy. Hyperemesis gravidarum, although it may lead to hypoglycemic events, is related to decreased food intake and glucose transfer to the fetus, exacerbating hypoglycemia rather than being directly associated with poor glycemic control before and during early pregnancy.

4. What additional assessment is required for the postoperative care of a pregnant woman who undergoes abdominal surgery for appendicitis?

• A. Intake and output (I&O) and intravenous (IV) site.
• B. Signs and symptoms of infection.
• C. Vital signs and incision.
• D. Fetal heart rate (FHR) and uterine activity.

Correct answer: D

Rationale: The correct additional assessment for postoperative care of a pregnant woman requiring abdominal surgery for appendicitis is monitoring the fetal heart rate (FHR) and uterine activity. This is crucial due to the presence of the fetus. Continuous fetal and uterine monitoring should be prioritized to ensure the well-being of both the mother and the baby. While assessing I&O levels and the IV site are common postoperative care procedures, they are not specific to the unique needs of a pregnant woman. Evaluating for signs and symptoms of infection is important for any postoperative patient but is not the additional assessment required specifically for a pregnant woman in this scenario. Routine vital signs and incision evaluation are standard components of postoperative care but do not address the specific needs related to the fetus and the uterus in this case.

5. Which of the following pairs of bases is present in the rungs of the ladder-like structure of deoxyribonucleic acid (DNA)?

• A. Cytosine with guanine.
• B. Rhodamine with biotin.
• C. Diaminopurine with ribozyme.
• D. Serine with tyrosine.

Correct answer: A

Rationale: The correct answer is A: Cytosine with guanine. In the DNA double helix, cytosine always pairs with guanine forming a base pair, and adenine pairs with thymine. These complementary base pairs form the rungs of the ladder-like structure of DNA. Choice B, Rhodamine with biotin, is incorrect as they are not base pairs found in DNA. Choice D, Serine with tyrosine, is incorrect as they are amino acids, not DNA bases. Choice C, Diaminopurine with ribozyme, is also incorrect as ribozyme is an enzyme, not a base, and diaminopurine is not one of the standard bases found in DNA.

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