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. A client who is 5 days postpartum is being taught about signs of effective breastfeeding. Which information should the nurse include in the teaching?

• A. Feeling a tugging sensation when the baby is sucking
• B. Expecting the baby to have two to three wet diapers in a 24-hour period
• C. The baby’s urine should appear dark and concentrated
• D. The breast should stay firm after the baby breastfeeds

Correct answer: A

Rationale: Feeling a tugging sensation while the baby is sucking indicates an effective latch and milk transfer during breastfeeding. This sensation means that the baby is effectively drawing milk from the breast. Choice B is incorrect because infants should ideally have six to eight wet diapers in a 24-hour period to show adequate hydration. Choice C is incorrect as a dark and concentrated urine may indicate dehydration, which is not a sign of effective breastfeeding. Choice D is incorrect as the breast should soften after the baby breastfeeds, indicating that the baby has effectively emptied the breast of milk.

3. Which of the following statements is true about Tay-Sachs disease?

• A. It is most commonly found among children in Jewish families of Eastern European background.
• B. Children who have this disease suffer from excessive production of mucus in the lungs and pancreas.
• C. It is most commonly found among children in Asian American families.
• D. Children who have this disease suffer from muscular dystrophy characterized by a weakening of the muscles.

Correct answer: A

Rationale: The correct answer is A. Tay-Sachs disease is most commonly found among Jewish families of Eastern European descent. It is a fatal genetic disorder that affects the nervous system. Choice B is incorrect because Tay-Sachs disease does not involve excessive mucus production in the lungs and pancreas. Choice C is incorrect as it states that Tay-Sachs disease is most commonly found among Asian American families, which is inaccurate. Choice D is also incorrect because Tay-Sachs disease does not cause muscular dystrophy characterized by weakening of the muscles.

4. What determines a child’s sex?

• A. Presence of teratogens at the time of conception.
• B. Sex chromosome received from the mother.
• C. Presence of teratogens at the time of ovulation.
• D. Sex chromosome received from the father.

Correct answer: D

Rationale: The correct answer is the sex chromosome received from the father. The father contributes either an X or Y chromosome, which determines the child's sex. This occurs at the moment of fertilization when the sperm carrying either an X (resulting in a female) or Y (resulting in a male) chromosome fertilizes the egg. Choices A, B, and C are incorrect because the presence of teratogens at the time of conception or ovulation does not determine the child's sex. While the sex chromosome received from the mother is important, it is the father's contribution that ultimately determines the child's sex.

5. Which of the following is a sexually transmitted infection that, in advanced stages, can attack major organ systems?

• A. Rubella
• B. Syphilis
• C. Cystic fibrosis
• D. Phenylketonuria

Correct answer: B

Rationale: Syphilis is the correct answer. Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. If left untreated, it can progress through various stages and potentially attack major organ systems, causing severe complications. Rubella, Cystic fibrosis, and Phenylketonuria are not sexually transmitted infections. Rubella is a viral infection, Cystic fibrosis is a genetic disorder affecting the lungs and digestive system, and Phenylketonuria is a genetic metabolic disorder. These conditions do not typically affect major organ systems in the same way as untreated syphilis.

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