Nokea
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.
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Four clients at full term present to the labor and delivery unit at the same time. Which client should a nurse assess first?
- A. Multipara with contractions occurring every three minutes
- B. Multipara scheduled for non-stress test and biophysical profile
- C. Primipara with vaginal show and leaking membranes
- D. Primipara with burning on urination and urinary frequency
Correct Answer: C
Rationale: A primipara with vaginal show and leaking membranes requires immediate assessment as she may be in active labor or at risk of infection. The vaginal show and leaking membranes suggest potential rupture of membranes and the start of labor. Assessing her first ensures prompt management and monitoring. The other options, while important, do not indicate immediate or emergent needs. Contractions every three minutes in a multipara can be managed with ongoing monitoring; non-stress tests and biophysical profiles can be scheduled and are not acute needs. Burning on urination and urinary frequency in a primipara may indicate a urinary tract infection, which is important but not as urgent as assessing for active labor or rupture of membranes.
What is the central layer of the embryo from which the bones and muscles develop?
- A. neural tube
- B. mesoderm
- C. ectoderm
- D. umbilical cord
Correct Answer: B
Rationale: The correct answer is mesoderm. The mesoderm is the middle layer of the embryo that gives rise to the bones, muscles, and other connective tissues. The neural tube (choice A) develops into the nervous system, not bones and muscles. The ectoderm (choice C) forms the skin and nervous system, not bones and muscles. The umbilical cord (choice D) is a structure that connects the developing fetus to the placenta; it is not a layer of the embryo that gives rise to bones and muscles.
A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider?
- A. A client with a urinary output of 300 ml in 8 hours
- B. A client reporting abdominal cramping during breastfeeding
- C. A client receiving magnesium sulfate with absent deep tendon reflexes
- D. A client reporting lochia rubra requiring changing perineal pads every 3 hours
Correct Answer: C
Rationale: The correct answer is C because in a client receiving magnesium sulfate, absent deep tendon reflexes can indicate magnesium toxicity, which requires immediate intervention to prevent serious complications. Choices A, B, and D are common postpartum occurrences that do not typically warrant immediate provider notification. A urinary output of 300 ml in 8 hours, abdominal cramping during breastfeeding, and frequent changing of perineal pads due to lochia rubra are within the expected range of postpartum recovery and do not indicate an urgent need for provider notification.
A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding indicates that preterm labor is occurring?
- A. Estriol is not found in maternal saliva.
- B. Irregular, mild uterine contractions occur every 12 to 15 minutes.
- C. Fetal fibronectin is present in vaginal secretions.
- D. The cervix is effacing and dilated to 2 cm.
Correct Answer: D
Rationale: The correct answer is D. Cervical changes such as effacement and dilation to 2 cm are strong indicators of imminent preterm labor. These changes, combined with regular contractions, can signify labor at any gestation. Estriol can be detected in maternal plasma as early as 9 weeks of gestation. Levels of salivary estriol have been linked to preterm birth. Irregular, mild contractions occurring every 12 to 15 minutes without cervical change are generally not concerning. While the presence of fetal fibronectin in vaginal secretions between 24 and 36 weeks of gestation may predict preterm labor, its predictive value is limited (20%-40%). Therefore, cervical changes provide more reliable information regarding the risk of preterm labor.
What is the purpose of amniocentesis?
- A. To induce abortion
- B. To detect genetic abnormalities in the fetus
- C. To determine the baby's gender
- D. To monitor fetal growth
Correct Answer: B
Rationale: Amniocentesis is a diagnostic procedure used to detect genetic abnormalities in the fetus, such as chromosomal disorders like Down syndrome. It is not performed to induce abortion. The primary purpose of amniocentesis is to assess the genetic health of the fetus, not to determine the baby's gender (Choice C). While amniocentesis can provide information about the baby's health and development, it is not primarily used for monitoring fetal growth (Choice D). Therefore, the correct answer is B.