A newborn is being assessed by a nurse who was born post-term. Which of the following findings should the nurse expect?
- A. Nails extending over tips of fingers
- B. Large deposits of subcutaneous fat
- C. Pale, translucent skin
- D. Thin covering of fine hair on shoulders and back
Correct Answer: A
Rationale: Post-term newborns often have longer nails that extend over the tips of their fingers due to the extended gestation period. This occurs because the baby continues to grow in utero past the typical 40 weeks of gestation. Choices B, C, and D are incorrect as large deposits of subcutaneous fat, pale translucent skin, and a thin covering of fine hair on shoulders and back are not typically associated with post-term newborns. Longer nails are a common finding in post-term newborns due to the prolonged time spent in the womb, allowing for more nail growth compared to infants born at term.
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A client at 30 weeks gestation reports that she has not felt the baby move in the last 24 hours. Concerned, she arrives in a panic at the obstetric clinic where she is immediately sent to the hospital. Which assessment warrants immediate intervention by the nurse?
- A. Fetal Heart rate 60 beats per minute
- B. Ruptured amniotic membrane
- C. Onset of uterine contractions
- D. Leaking amniotic fluid
Correct Answer: A
Rationale: A fetal heart rate of 60 beats per minute is significantly below the normal range (110-160 bpm) and indicates fetal distress, requiring immediate intervention. This low heart rate can be a sign of fetal compromise or distress, necessitating urgent evaluation and intervention to ensure the well-being of the fetus. Choices B, C, and D do not indicate immediate fetal distress requiring urgent intervention. Ruptured amniotic membrane, onset of uterine contractions, and leaking amniotic fluid are important assessments but do not present an immediate threat to the fetus's life like a severely low fetal heart rate.
What is the structure of deoxyribonucleic acid (DNA)?
- A. single spiral
- B. double helix
- C. sphere
- D. cube
Correct Answer: B
Rationale: The correct answer is B: double helix. DNA is structured as a double helix, resembling a twisted ladder made up of two strands of nucleotides. Choice A, single spiral, is incorrect as DNA is not a single spiral structure. Choice C, sphere, is incorrect as DNA does not form a spherical shape. Choice D, cube, is incorrect as DNA does not have a cubic structure. Understanding the double helix structure of DNA is essential as it allows for the storage and transmission of genetic information in living organisms.
A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?
- A. "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide."
- B. "The drug keeps your baby from requiring too much sedation."
- C. "Surfactant is used to reduce episodes of periodic apnea."
- D. "Your baby needs this medication to fight a possible respiratory tract infection."
Correct Answer: A
Rationale: Artificial surfactant can be administered as an adjunct to oxygen and ventilation therapy for premature infants with respiratory distress syndrome (RDS). It helps improve respiratory compliance by aiding in the exchange of oxygen and carbon dioxide until the infant can produce enough surfactant naturally. The correct explanation to the parents would be that surfactant therapy enhances the baby's lung function by facilitating the exchange of oxygen and carbon dioxide. Choice B is incorrect because surfactant therapy does not affect sedation needs. Choice C is inaccurate as surfactant is not used to reduce episodes of periodic apnea. Choice D is incorrect as surfactant is not administered to fight respiratory tract infections; it specifically targets improving lung function in RDS.
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.
A client who is at 24 weeks of gestation is receiving teaching about expected changes during pregnancy. Which of the following information should the nurse include?
- A. Your stomach will empty rapidly
- B. You should expect your uterus to double in size
- C. You should anticipate nasal stuffiness
- D. Your nipples will become lighter in color
Correct Answer: C
Rationale: Nasal stuffiness is a common symptom during pregnancy due to increased blood flow and hormonal changes. This symptom is caused by the increased blood volume and hormonal changes that lead to swelling of the nasal passages. Choices A, B, and D are incorrect. Stomach emptying rate does not significantly change during pregnancy; the uterus does not double in size at 24 weeks but rather grows steadily, and nipples typically darken in color due to increased pigmentation.