Nursing Elites

1. Which of the following statements is true of sickle-cell anemia?

• A. It is typically managed with treatments such as pain relief medications.
• B. It is caused by a mutation in the beta-globin gene.
• C. It leads to the obstruction of small blood vessels and decreased oxygen delivery.
• D. It is more prevalent in individuals of African, Mediterranean, Middle Eastern, and Indian descent.

Correct answer: C

Rationale: The correct answer is C. Sickle-cell anemia results from a mutation in the beta-globin gene, causing red blood cells to become sickle-shaped. These misshapen cells can obstruct small blood vessels, leading to reduced oxygen delivery to tissues. Choices A, B, and D are incorrect because sickle-cell anemia is typically managed with treatments such as pain relief medications, hydration, and in severe cases, blood transfusions. It is caused by a specific mutation in the beta-globin gene, not by the inability to metabolize phenylalanine. Additionally, sickle-cell anemia is more prevalent in individuals of African, Mediterranean, Middle Eastern, and Indian descent, not exclusive to any specific gender.

2. What is the most critical action in caring for the newborn immediately after birth?

• A. Keeping the airway clear.
• B. Fostering parent-newborn attachment.
• C. Drying the newborn and wrapping the infant in a blanket.
• D. Administering eye drops and vitamin K.

Correct answer: A

Rationale: The most critical action in caring for the newborn immediately after birth is keeping the airway clear. This is essential to ensure that the newborn can breathe effectively and prevent any respiratory distress. Fostering parent-newborn attachment, although important, is not the most critical action immediately after birth. Drying the newborn and wrapping the infant in a blanket is important for temperature regulation but is not as critical as maintaining a clear airway. Administering eye drops and vitamin K is typically done later and is not the most critical action immediately after birth.

3. Rh incompatibility occurs when an Rh-negative woman is carrying an Rh-positive fetus.

• A. TRUE
• B. FALSE
• C. Sometimes
• D. Never

Correct answer: B

Rationale: Rh incompatibility occurs when an Rh-negative woman is carrying an Rh-positive fetus, not the other way around. Therefore, the statement that an Rh-positive woman is carrying an Rh-negative fetus is incorrect. Rh incompatibility can lead to hemolytic disease of the newborn, where maternal antibodies attack the fetal red blood cells. Choice A is incorrect because the statement is false. Choice C is incorrect as Rh incompatibility has a clear cause and effect relationship. Choice D is incorrect as Rh incompatibility can occur, but it depends on the Rh status of the mother and fetus.

4. A 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light and asks for her nurse right away, stating 'I’m bleeding a lot.' What is the most likely cause of postpartum hemorrhage in this client?

• A. Retained placental fragments.
• B. Unrepaired vaginal lacerations.
• C. Uterine atony.
• D. Puerperal infection.

Correct answer: C

Rationale: Uterine atony is the most likely cause of bleeding 4 hours after delivery, especially after delivering a macrosomic infant and augmenting labor with oxytocin. Uterine atony is characterized by the inability of the uterine muscles to contract effectively after childbirth, leading to excessive bleeding. The other options, such as retained placental fragments (A), unrepaired vaginal lacerations (B), and puerperal infection (D), are less likely causes of postpartum hemorrhage in this scenario. Retained placental fragments can cause bleeding, but this typically presents earlier than 4 hours postpartum. Unrepaired vaginal lacerations would likely be evident sooner and not typically result in significant bleeding. Puerperal infection is not a common cause of immediate postpartum hemorrhage unless there are other signs of infection present.

5. Is a low sperm count or lack of sperm the most common infertility problem in men?

• A. TRUE
• B. FALSE
• C. Rarely
• D. Never

Correct answer: A

Rationale: A low sperm count or lack of sperm is indeed one of the most common causes of infertility in men. Factors such as hormonal imbalances, genetic issues, reproductive anatomy problems, and lifestyle factors can also contribute to male infertility. Choice B is incorrect because a low sperm count is a prevalent issue among men facing infertility, making it a common problem. Choices C and D are incorrect as they do not accurately reflect the prevalence of low sperm count as a cause of infertility in men.

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