Nursing Elites

1. Rh incompatibility occurs when an Rh-negative woman is carrying an Rh-positive fetus.

• A. TRUE
• B. FALSE
• C. Sometimes
• D. Never

Correct answer: B

Rationale: Rh incompatibility occurs when an Rh-negative woman is carrying an Rh-positive fetus, not the other way around. Therefore, the statement that an Rh-positive woman is carrying an Rh-negative fetus is incorrect. Rh incompatibility can lead to hemolytic disease of the newborn, where maternal antibodies attack the fetal red blood cells. Choice A is incorrect because the statement is false. Choice C is incorrect as Rh incompatibility has a clear cause and effect relationship. Choice D is incorrect as Rh incompatibility can occur, but it depends on the Rh status of the mother and fetus.

2. 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.

3. Which of the following conditions is considered a multifactorial problem?

• A. Cystic fibrosis
• B. Down syndrome
• C. Diabetes mellitus
• D. XYY syndrome

Correct answer: C

Rationale: The correct answer is 'Diabetes mellitus' because it is a multifactorial disease, influenced by both genetic predisposition and environmental factors. Cystic fibrosis (choice A) is primarily a genetic disorder caused by mutations in the CFTR gene. Down syndrome (choice B) is due to an extra copy of chromosome 21. XYY syndrome (choice D) is a genetic condition where males have an extra Y chromosome. These conditions are not considered multifactorial as their origins are primarily genetic.

4. A perinatal nurse is caring for a woman in the immediate postpartum period. Assessment reveals that the client is experiencing profuse bleeding. What is the most likely cause of this bleeding?

• A. Uterine atony.
• B. Uterine inversion.
• C. Vaginal hematoma.
• D. Vaginal laceration.

Correct answer: A

Rationale: Uterine atony is significant hypotonia of the uterus and is the leading cause of postpartum hemorrhage. It results in the inability of the uterus to contract effectively after delivery, leading to excessive bleeding. Uterine inversion is a rare but serious complication that involves the turning inside out of the uterus, leading to hemorrhage, but it is not the most likely cause of profuse bleeding in this scenario. Vaginal hematoma may cause bleeding but is typically associated with pain as a primary symptom rather than profuse bleeding. Vaginal lacerations can cause bleeding, but in the presence of a firm, contracted uterine fundus, uterine atony is a more likely cause of ongoing profuse bleeding in the postpartum period.

5. According to a study in 2014 by Skakkebaek et al., who among the following is most likely to have gynecomastia?

• A. Jennifer, a dancer, who has Down syndrome
• B. Frank, a teacher, who is diagnosed with XYY syndrome
• C. Peter, a fashion designer, who has Klinefelter syndrome
• D. Ria, a gym instructor, who is diagnosed with Turner syndrome

Correct answer: C

Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY) and typically have reduced testosterone levels, which can lead to gynecomastia (enlarged breasts). This condition is not usually associated with Down syndrome (choice A), XYY syndrome (choice B), or Turner syndrome (choice D), making them less likely to have gynecomastia.

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