Nursing Elites

1. Which of the following statements is true of Down’s syndrome?

• A. Down’s syndrome is usually caused by an extra copy of chromosome 21 in an individual.
• B. The symptoms of Down’s syndrome are similar to those of sickle-cell anemia.
• C. Down’s syndrome is caused by a sexually transmitted infection (STI) during conception.
• D. The probability of having a child with Down’s syndrome increases with the age of the parents.

Correct answer: D

Rationale: The correct answer is D. The likelihood of having a child with Down’s syndrome increases as the age of the parents increases, particularly the mother's age. Choice A is incorrect because Down’s syndrome is caused by an extra copy of chromosome 21, not a defect in the sex chromosomes. Choice B is incorrect as the symptoms of Down’s syndrome and sickle-cell anemia are different. Choice C is also incorrect as Down’s syndrome is not caused by a sexually transmitted infection during conception.

2. The healthcare provider prescribes 10 units per liter of oxytocin via IV drip to augment a client's labor because she is experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin?

• A. Contraction duration of 100 seconds.
• B. Four contractions in 10 minutes.
• C. Uterus is soft.
• D. Early deceleration of fetal heart rate.

Correct answer: A

Rationale: A contraction duration of 100 seconds is too long and can indicate uterine hyperstimulation, which can lead to fetal distress and other complications. This prolonged contraction duration suggests that the uterus is not relaxing adequately between contractions, potentially compromising fetal oxygenation. Choice B, 'Four contractions in 10 minutes,' is a sign of tachysystole, which is concerning but not as immediately critical as the prolonged contraction duration. Choice C, 'Uterus is soft,' is not a reason to discontinue oxytocin; in fact, it is a normal finding. Choice D, 'Early deceleration of fetal heart rate,' while indicating fetal distress, is not a direct result of the oxytocin and may require intervention but not immediate discontinuation of the medication.

3. The nurse has received a report regarding a client in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment?

• A. Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm above the ischial spines.
• B. Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines.
• C. Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm below the ischial spines.
• D. Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm below the ischial spines.

Correct answer: B

Rationale: The correct interpretation of the assessment provided is that the cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines. In the given assessment, the measurements are ordered as dilation, effacement, and station. Choice A is incorrect as it wrongly places the presenting part below the ischial spines. Choice C is incorrect because it places the presenting part below the ischial spines. Choice D is also incorrect as it incorrectly states that the presenting part is below the ischial spines, even though it correctly mentions the dilation and effacement of the cervix.

4. Do sebaceous glands cause a developing organism to grow arms or wings, skin, or scales?

• A. True
• B. False
• C. Possibly
• D. Never

Correct answer: B

Rationale: The correct answer is B: False. Sebaceous glands are associated with the skin's oil production and have no role in the development of limbs or body coverings. Sebaceous glands primarily produce sebum, an oily substance that lubricates and waterproofs the skin and hair. Choices A, C, and D are incorrect because sebaceous glands do not influence the growth of arms, wings, skin, or scales in a developing organism.

5. 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.

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