Nursing Elites

1. A nurse in a prenatal clinic is caring for a group of clients. Which of the following clients should the nurse recommend for further evaluation and possible intervention?

• A. A client who is at 28 weeks gestation and has a negative Coombs titer
• B. A client who is 39 weeks of gestation and has a negative contraction stress test
• C. A client who is at 35 weeks of gestation and has a biophysical profile of 6
• D. A client who is at 37 weeks of gestation and has an L/S ratio of 2:1

Correct answer: C

Rationale: A biophysical profile of 6 at 35 weeks of gestation indicates a need for further evaluation and possible intervention. A negative Coombs titer at 28 weeks gestation (Choice A) is within normal limits. A negative contraction stress test at 39 weeks gestation (Choice B) is expected as the pregnancy nears term. An L/S ratio of 2:1 at 37 weeks of gestation (Choice D) is consistent with fetal lung maturity.

2. What is the expected date of delivery for a woman whose last menstrual period was on April 20th?

• A. January 20th
• B. January 27th
• C. January 29th
• D. January 31st

Correct answer: B

Rationale: The expected date of delivery is calculated by adding 9 months and 7 days to the last menstrual period. For April 20th, the expected date is January 27th. Therefore, the correct answer is B. Choice A, January 20th, is incorrect as it does not account for the additional 7 days. Choice C, January 29th, and Choice D, January 31st, are also incorrect as they do not consider the standard calculation method for estimating the due date.

3. What percentage of term newborns have a congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion?

• A. 2% to 4%
• B. 10% to 20%
• C. 5% to 10%
• D. 7% to 9%

Correct answer: A

Rationale: The correct answer is A: 2% to 4%. According to research, 2% to 4% of term newborns have congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion. Choices B, C, and D provide percentages that are higher than the actual prevalence of congenital heart disease in newborns caused by environmental factors, making them incorrect.

4. Your 54-year-old male HIV-positive patient has just expired. How should you care for this deceased patient?

• A. Bathe the patient, but it is still necessary to use standard precautions because the patient is deceased.
• B. Place the patient in a negative pressure isolated area of the morgue.
• C. Double shroud the patient to prevent the spread of infection.
• D. Bathe the patient using the same standard precautions you used when he was alive.

Correct answer: D

Rationale: Even after a patient has expired, standard precautions should be maintained to prevent the spread of infection. Bathing the deceased patient should be done using the same standard precautions followed when the patient was alive. This includes using personal protective equipment and following proper infection control procedures. Choices A, B, and C are incorrect because standard precautions must still be adhered to even after the patient has passed away to ensure safety and prevent the transmission of infections.

5. Which patient is at greatest risk for papilledema?

• A. An elderly patient with cataracts and macular degeneration
• B. A male patient with hypothyroidism
• C. A male patient with hyperthyroidism
• D. An adolescent with a closed head injury

Correct answer: D

Rationale: An adolescent with a closed head injury is at the highest risk for papilledema due to increased intracranial pressure. Papilledema is often a consequence of elevated intracranial pressure, which can occur in conditions like head trauma. Choices A, B, and C do not directly correlate with an increased risk of papilledema compared to a closed head injury, which is more likely to lead to elevated intracranial pressure and subsequent papilledema.

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