Nokea
A mother spontaneously delivers a newborn infant in the taxicab while on the way to the hospital. The emergency room nurse reported the mother has active herpes (HSV II) lesions on the vulva. Which intervention should the nurse implement first when admitting the neonate to the nursery?
- A. Document the newborn's temperature on the flow sheet.
- B. Place the newborn in the isolation area of the nursery.
- C. Obtain a blood specimen for a serum glucose level.
- D. Administer the vitamin K injection.
Correct Answer: B
Rationale: Newborns exposed to active herpes lesions are at high risk for neonatal herpes, which can be severe. Placing the newborn in isolation is crucial as it helps prevent the spread of the virus and allows for close monitoring. Documenting the newborn's temperature, obtaining a blood specimen for a serum glucose level, and administering the vitamin K injection are important interventions but are not the priority when dealing with a potential infectious risk like neonatal herpes.
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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.
When both alleles' effects are shown, there is said to be:
- A. codominance.
- B. preponderance.
- C. ascendance.
- D. concurrence.
Correct Answer: A
Rationale: The correct answer is A: codominance. Codominance refers to a genetic scenario where both alleles in a gene pair are fully expressed, leading to a phenotype that displays traits from both alleles equally. This is distinct from incomplete dominance where the traits blend. Choices B, C, and D are incorrect. Preponderance does not specifically relate to the expression of alleles. Ascendance and concurrence do not describe the genetic concept of codominance where both alleles are fully expressed.
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.
What nursing diagnosis is the most appropriate for a woman experiencing severe preeclampsia?
- A. Risk for injury to mother and fetus, related to central nervous system (CNS) irritability.
- B. Risk for altered gas exchange.
- C. Risk for deficient fluid volume, related to increased sodium retention secondary to the administration of magnesium sulfate.
- D. Risk for increased cardiac output, related to the use of antihypertensive drugs.
Correct Answer: A
Rationale: The most appropriate nursing diagnosis for a woman experiencing severe preeclampsia is 'Risk for injury to mother and fetus, related to central nervous system (CNS) irritability.' Severe preeclampsia poses a significant risk of injury to both the mother and the fetus due to complications such as seizures, stroke, and placental abruption. 'Risk for altered gas exchange' is not the priority diagnosis as pulmonary edema is more common in severe preeclampsia. 'Risk for deficient fluid volume' is incorrect as sodium retention in severe preeclampsia often leads to fluid overload. 'Risk for increased cardiac output' is also incorrect as antihypertensive drugs are used to reduce cardiac output in this condition.
A client has bacterial vaginosis. Which of the following medications should the nurse expect to administer?
- A. Metronidazole
- B. Fluconazole
- C. Acyclovir
- D. Clindamycin
Correct Answer: A
Rationale: Metronidazole is the correct choice for treating bacterial vaginosis as it is the first-line medication recommended for this condition. Metronidazole works by disrupting the DNA structure of bacteria, making it an effective treatment. Choice B, Fluconazole, is an antifungal medication primarily used for treating fungal infections, not bacterial vaginosis. Choice C, Acyclovir, is an antiviral medication used to treat viral infections, not bacterial vaginosis. Choice D, Clindamycin, is also used to treat bacterial infections but is not the first-line treatment for bacterial vaginosis, making it an incorrect choice in this scenario.