Nursing Elites

1. What activities best describe the work of the placenta during pregnancy?

• A. surrounding and cushioning the fetus
• B. combining maternal and fetal blood stores to exchange nutrients
• C. producing hormones that maintain the pregnancy
• D. absorbing vitamins and minerals that can be transferred to the fetus

Correct answer: C

Rationale: The placenta plays a crucial role in producing hormones that are necessary for maintaining pregnancy, supporting fetal development, and preparing the mother's body for childbirth. Choices A, B, and D are incorrect because the placenta's primary function is not to surround and cushion the fetus, combine blood stores for nutrient exchange, or absorb vitamins and minerals. While the placenta does facilitate the exchange of nutrients and oxygen between the mother and fetus, its hormone production is the most critical function during pregnancy.

2. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

3. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

4. Maternal malnutrition at a critical period of development may have lifelong effects on an individual's pattern of genetic expression and on the tendency to develop obesity, which is a concept known as _____.

• A. genetic determination
• B. metabolic tolerance
• C. chromosomal influence
• D. fetal programming

Correct answer: D

Rationale: Fetal programming refers to the concept that maternal nutrition during critical periods of development can have long-term effects on an individual's health and risk of diseases like obesity.

5. What should be the next step in the nursing research process?

• A. Review related literature
• B. Seek permission from the hospital administrator
• C. Identify the research problem
• D. Develop methods for data collection

Correct answer: D

Rationale: The correct answer is 'Develop methods for data collection' (Choice D). In the nursing research process, after the research problem has been identified, the next step would typically be to develop methods for how data will be collected. This is essential to effectively address the research problem. 'Review related literature' (Choice A), while an important step, usually occurs after the research problem has been identified and before methods for data collection are developed. 'Seek permission from the hospital administrator' (Choice B) might be necessary at some point in certain situations, but it is not the immediate next step in the research process. 'Identify the research problem' (Choice C) would typically come before developing methods for data collection. Therefore, according to the typical sequence of steps in the nursing research process, Choice D is correct.

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