Nursing Elites

1. The healthcare provider is planning care for a client at 30 weeks gestation who is experiencing preterm labor. Which medication is most important in preventing this fetus from developing respiratory distress syndrome?

• A. Ampicillin 1 gram IV push every 8 hours
• B. Betamethasone 12 mg deep IM
• C. Terbutaline 0.25 mg subcutaneously every 15 minutes for 3 doses
• D. Butorphanol tartrate 1 mg IV push every 2 hours as needed

Correct answer: B

Rationale: Betamethasone is a corticosteroid given to stimulate fetal lung maturity and reduce the risk of respiratory distress syndrome in preterm infants. Ampicillin (Choice A) is an antibiotic and does not prevent respiratory distress syndrome. Terbutaline (Choice C) is a tocolytic used to inhibit contractions and does not directly prevent respiratory distress syndrome. Butorphanol tartrate (Choice D) is an opioid analgesic and does not have a role in preventing respiratory distress syndrome in preterm infants.

2. When both of the alleles for a trait, such as hair color, are the same, the person is said to be _____ for that trait.

• A. monozygous
• B. dizygous
• C. homozygous
• D. hemizygous

Correct answer: C

Rationale: A person is homozygous for a trait when they have two identical alleles for that trait. In this case, both alleles are the same, indicating a homozygous genotype. Choice A, 'monozygous,' is incorrect as it refers to identical twins originating from a single fertilized egg. Choice B, 'dizygous,' is also incorrect as it refers to fraternal twins or individuals that develop from two separate fertilized eggs. Choice D, 'hemizygous,' is incorrect because it describes a genetic condition where only one allele is present in a diploid organism, typically related to genes on the sex chromosomes.

3. If an individual receives a recessive gene for eye color from both parents, the:

• A. gender of the child will not determine the expression of that trait.
• B. recessive trait will be expressed in the child.
• C. recessive trait will be expressed in all the offspring.
• D. recessive trait will be suppressed, and the dominant trait will not be expressed.

Correct answer: B

Rationale: When an individual inherits a recessive gene for eye color from both parents, the recessive trait will be expressed in the child. This is because having two copies of the recessive gene overrides the presence of any dominant gene. Choice A is incorrect because the expression of the trait is determined by the genetic makeup, not the gender of the child. Choice C is incorrect as the expression of the recessive trait is certain when both parents pass on the recessive gene, but it does not mean that all offspring will express the trait. Choice D is incorrect because if both parents provide a recessive gene, the dominant trait will not be expressed in the child, but it does not mean it will be suppressed; rather, the recessive trait will be expressed.

4. A healthcare provider is assessing a newborn immediately following a vaginal birth. For which of the following findings should the provider intervene?

• A. Molding
• B. Vernix Caseosa
• C. Acrocyanosis
• D. Sternal retractions

Correct answer: D

Rationale: Sternal retractions in a newborn indicate respiratory distress and require immediate intervention. This finding suggests the newborn is having difficulty breathing and needs prompt attention to ensure adequate oxygenation. Molding, the overlapping of fetal skull bones during birth, is a normal and expected process that does not require intervention. Vernix Caseosa, the protective white substance on the skin, and Acrocyanosis, the bluish discoloration of extremities, are both common and benign findings in newborns that do not necessitate immediate action. Therefore, the healthcare provider should focus on addressing sternal retractions to manage the respiratory distress effectively.

5. A client is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?

• A. Hypotension
• B. Polyuria
• C. Bilateral crackles
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Bilateral crackles. Bilateral crackles indicate respiratory complications, which can occur as an adverse effect of an epidural block with opioid analgesics. Hypotension (Choice A) is a common side effect of epidural opioids but is not typically monitored via crackles. Polyuria (Choice B) is excessive urination and is not directly associated with epidural blocks. Hyperglycemia (Choice D) is high blood sugar levels and is not a typical adverse effect of epidural opioids.

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