Nursing Elites

1. When should a provider order a maternal serum alpha-fetoprotein (MSAFP) screening for pregnant clients?

• A. A client who has mitral valve prolapse
• B. A client who has been exposed to AIDS
• C. All pregnant clients
• D. A client who has a history of preterm labor

Correct answer: C

Rationale: Maternal serum alpha-fetoprotein (MSAFP) screening is recommended for all pregnant clients to assess the risk of neural tube defects. It is a routine screening test used to detect increased levels of alpha-fetoprotein in maternal blood, which may indicate a higher risk for conditions such as neural tube defects in the developing fetus. Therefore, all pregnant clients, regardless of their medical history or risk factors, should undergo MSAFP screening as part of routine prenatal care. Choices A, B, and D are incorrect because the MSAFP screening is not specific to certain medical conditions or histories; it is a standard screening procedure for all pregnant individuals to evaluate neural tube defect risk in the fetus.

2. During the admission assessment of a newborn, which anatomical landmark should be used for measuring the newborn's chest circumference?

• A. Sternal notch
• B. Nipple line
• C. Xiphoid process
• D. Fifth intercostal space

Correct answer: B

Rationale: When measuring a newborn's chest circumference, the appropriate anatomical landmark to use is the nipple line. This point is consistent and allows for accurate and standardized measurements across all newborn assessments. The sternal notch is not typically used for chest circumference measurements in newborns. The xiphoid process is located at the lower end of the sternum and is not an appropriate landmark for chest circumference measurement. The fifth intercostal space is typically used for locating the point of maximal impulse (PMI) during cardiac assessments, not for measuring chest circumference.

3. While caring for a newborn, a nurse auscultates an apical heart rate of 130/min. Which of the following actions should the nurse take?

• A. Ask another nurse to verify the heart rate.
• B. Document this as an expected finding.
• C. Call the provider to further assess the newborn.
• D. Prepare the newborn for transport to the NICU.

Correct answer: B

Rationale: An apical heart rate of 130/min is within the expected range for a newborn. It is not necessary to seek verification from another nurse, call the provider for further assessment, or prepare for NICU transport based on this heart rate. Documenting the heart rate as an expected finding is the appropriate action in this situation as it falls within the normal range for a newborn's heart rate.

4. During an assessment, a healthcare provider observes small pearly white nodules on the roof of a newborn's mouth. This finding is a characteristic of which of the following conditions?

• A. Mongolian spots
• B. Milia spots
• C. Erythema toxicum
• D. Epstein's pearls

Correct answer: D

Rationale: Epstein's pearls are small pearly white nodules commonly observed on the roof of a newborn's mouth. They are considered a normal finding and typically disappear without treatment. It is essential for healthcare providers to recognize these benign nodules to differentiate them from other conditions and provide appropriate education to parents. The other choices are incorrect: A) Mongolian spots are blue or purple birthmarks commonly found on the skin; B) Milia spots are tiny white bumps on a newborn's nose and face; C) Erythema toxicum presents as a rash of flat red splotches with small bumps that can appear on a baby's skin.

5. Which of the following medications should the provider prescribe for a client with gonorrhea?

• A. Ceftriaxone
• B. Fluconazole
• C. Metronidazole
• D. Zidovudine

Correct answer: A

Rationale: Ceftriaxone is the preferred medication to treat gonorrhea, a bacterial infection. It is essential to promptly treat gonorrhea to prevent complications such as pelvic inflammatory disease, infertility, and the spread of the infection to others. Fluconazole is used for fungal infections, Metronidazole treats certain bacterial and parasitic infections, and Zidovudine is an antiretroviral medication used in HIV treatment; none of these are appropriate for gonorrhea.

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