Nursing Elites

1. Twins that derive from a single zygote that has split into two are called:

• A. monozygotic (MZ) twins.
• B. fraternal twins.
• C. non-identical twins.
• D. dizygotic (DZ) twins.

Correct answer: A

Rationale: The correct answer is A: monozygotic (MZ) twins. Monozygotic twins, also known as identical twins, occur when a single zygote splits into two embryos, leading to two genetically identical individuals. Choice B, fraternal twins, are twins that develop from two separate eggs fertilized by two different sperm cells, resulting in non-identical siblings. Choice C, non-identical twins, is not a common term used to describe this type of twinning. Choice D, dizygotic (DZ) twins, refer to twins that develop from two separate eggs fertilized by two different sperm cells, leading to non-identical twins.

2. What information should the nurse include when teaching a client at 41 weeks of gestation about a non-stress test?

• A. This test will confirm fetal lung maturity.
• B. This test will determine the adequacy of placental perfusion.
• C. This test will detect fetal infection.
• D. This test will predict maternal readiness for labor.

Correct answer: B

Rationale: The correct answer is B: 'This test will determine the adequacy of placental perfusion.' The non-stress test is used to assess fetal well-being by monitoring the fetal heart rate in response to its own movements. It helps determine if the fetus is receiving enough oxygen and nutrients through placental perfusion. Choice A is incorrect because confirming fetal lung maturity is typically determined through tests like amniocentesis, not the non-stress test. Choice C is incorrect because detecting fetal infection is not the primary purpose of a non-stress test. Choice D is incorrect because predicting maternal readiness for labor is not the purpose of the non-stress test; it focuses on fetal well-being.

3. During a prenatal visit, for which of the following clients should the nurse auscultate the fetal heart rate?

• A. A client who has an ultrasound confirming a molar pregnancy
• B. A client who has a crown-rump length corresponding to 7 weeks gestation
• C. A client who has a positive urine pregnancy test 1 week after missed menses
• D. A client who has felt quickening for the first time

Correct answer: D

Rationale: The correct answer is D because feeling quickening typically occurs around 18-20 weeks of gestation, indicating fetal movement. This is an appropriate time to auscultate the fetal heart rate. Choice A is incorrect because a molar pregnancy is not a viable pregnancy, and auscultating the fetal heart rate in this case is not applicable. Choice B is incorrect because a crown-rump length of 7 weeks gestation is too early for fetal heart rate auscultation. Choice C is incorrect because a positive urine pregnancy test alone does not indicate the appropriate timing for fetal heart rate auscultation.

4. The nurse places one hand above the symphysis while massaging the fundus of a multiparous client whose uterine tone is boggy 15 minutes after delivering a 7-pound, 10-ounce (3220-gram) infant. Which information should the nurse provide to the client about these findings?

• A. The uterus should be firm to prevent an intrauterine infection.
• B. Both the lower uterine segment and the fundus must be massaged.
• C. A firm uterus prevents the endometrial lining from being sloughed.
• D. Clots may form inside a boggy uterus and need to be expelled.

Correct answer: D

Rationale: After childbirth, a boggy uterus indicates poor uterine tone, which can lead to the formation of clots. Massaging the fundus helps the uterus contract and expel clots, reducing the risk of postpartum hemorrhage. Choices A, B, and C are incorrect because the main concern with a boggy uterus is the risk of clot formation and postpartum hemorrhage, not solely preventing intrauterine infection, massaging the lower uterine segment, or preventing the endometrial lining from sloughing.

5. A nurse on a labor and delivery unit is providing teaching to a client who plans to use hypnosis to control labor pain. Which of the following information should the nurse include?

• A. Focusing on controlling body functions
• B. Synchronized breathing is often helpful during hypnosis
• C. Hypnosis can be beneficial if practiced during the prenatal period
• D. Hypnosis is ineffective for controlling pain associated with labor

Correct answer: C

Rationale: Hypnosis can be an effective method of pain control during labor, especially if practiced during the prenatal period. Choice A is not specific to hypnosis and may not be directly related. Choice B is not essential for hypnosis and may not always be required. Choice D is incorrect as hypnosis has been shown to be beneficial for managing labor pain when done correctly, making it an inappropriate option to include in the teaching.

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