Nursing Elites

1. Why is a client with gestational diabetes being scheduled for an amniocentesis when the fetus has an estimated weight of eight pounds (3629 grams) at 36 weeks gestation? What information is the amniocentesis seeking to obtain?

• A. Presence of a neural tube defect.
• B. Chromosomal abnormalities.
• C. Gender of the fetus.
• D. Fetal lung maturity.

Correct answer: D

Rationale: An amniocentesis in this scenario is most likely being performed to assess fetal lung maturity. This is necessary when considering early delivery due to macrosomia (large fetal size), which is a common concern in gestational diabetes. Evaluating fetal lung maturity is crucial to determine if the fetus's lungs are developed enough to support breathing independently outside the womb. The presence of a neural tube defect and chromosomal abnormalities are not typically assessed through amniocentesis in this situation, and determining the gender of the fetus is not the primary purpose of the procedure here.

2. On the first postpartum day, the nurse examines the breasts of a new mother. Which condition is the nurse most likely to find?

• A. Firm, larger, and very tender to the touch
• B. Slightly firm with an immediate let-down response
• C. Soft with no change from before delivery
• D. Filling and secreting colostrum

Correct answer: D

Rationale: On the first postpartum day, the nurse is most likely to find the breasts filling and secreting colostrum. Colostrum secretion is common as the body prepares for breastfeeding in the initial days after delivery. Choice A is incorrect as breasts are not typically very tender immediately postpartum. Choice B is incorrect as an immediate let-down response is more related to lactation rather than the first postpartum day. Choice C is incorrect as the breasts typically undergo changes, such as filling with colostrum, after delivery.

3. What term is used to describe each member of a pair of genes?

• A. allele
• B. zygote
• C. autosome
• D. node

Correct answer: A

Rationale: The correct answer is 'allele.' An allele refers to one of two or more versions of a gene located at the same position on a chromosome. In genetics, alleles are responsible for variations in inherited traits. Choice B, 'zygote,' is incorrect as a zygote is a fertilized egg cell formed by the fusion of two gametes. Choice C, 'autosome,' is incorrect as autosomes are non-sex chromosomes that determine an individual's genetic traits excluding sex-linked characteristics. Choice D, 'node,' is incorrect as it does not relate to the concept of genes or genetic inheritance.

4. A newborn nursery protocol includes a prescription for ophthalmic erythromycin 5% ointment to both eyes upon a newborn's admission. What action should the nurse take to ensure adequate installation of the ointment?

• A. Instill a thin ribbon into each lower conjunctival sac
• B. Occlude the inner canthus after retracting the eyelids
• C. Mummy wrap the infant before instilling the ointment
• D. Stabilize the instilling hand on the neonate's head

Correct answer: A

Rationale: To ensure adequate installation of the ophthalmic erythromycin 5% ointment in a newborn, the nurse should instill a thin ribbon into each lower conjunctival sac. This method helps to ensure proper distribution and effectiveness of the medication to prevent neonatal conjunctivitis. Choices B, C, and D are incorrect. Occluding the inner canthus after retracting the eyelids, mummy wrapping the infant, or stabilizing the instilling hand on the neonate's head are not appropriate actions for ensuring the proper installation of the ointment.

5. In the context of an average ejaculation, which of the following statements is true about sperm?

• A. The average count of sperm in the ejaculate is 2.5 billion.
• B. Sperm in the ejaculate find the ovum by following the current of the fluid coming from the cervix.
• C. Only 1 in 1,000 sperm in the ejaculate will ever approach an ovum.
• D. Most of the sperm in the ejaculate move about in a random pattern in the vagina.

Correct answer: C

Rationale: Out of millions of sperm released during ejaculation, only a small fraction, about 1 in 1,000, will approach the ovum. This statement is true as sperm face many obstacles and challenges on their journey to reach and fertilize an ovum. Choice A is incorrect because the average count of sperm in an ejaculate is typically in the millions, not billions. Choice B is incorrect as sperm do not find the ovum by following the current of fluid; they navigate using other mechanisms. Choice D is incorrect because while some sperm may move randomly in the vagina, the ones that approach the ovum do so through a more purposeful and directed movement.

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