Nursing Elites

1. A newborn is being assessed following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method?

• A. Hypoglycemia
• B. Polycythemia
• C. Facial Palsy
• D. Bronchopulmonary dysplasia

Correct answer: C

Rationale: Facial palsy is a known complication of forceps-assisted birth. During forceps delivery, pressure applied to the facial nerve can result in facial palsy. The newborn may present with weakness or paralysis of the facial muscles on one side. Hypoglycemia (Choice A) is not directly related to forceps-assisted birth. Polycythemia (Choice B) is a condition characterized by an increased number of red blood cells and is not typically associated with forceps delivery. Bronchopulmonary dysplasia (Choice D) is a lung condition that primarily affects premature infants who require mechanical ventilation and prolonged oxygen therapy, not a direct outcome of forceps-assisted birth.

2. Following a traumatic delivery, an infant receives an initial Apgar score of 3. Which intervention is most important for the nurse to implement?

• A. Page the pediatrician STAT
• B. Continue resuscitative efforts
• C. Repeat the Apgar assessment in 5 minutes
• D. Inform the parents of the infant's condition

Correct answer: B

Rationale: In a situation where an infant receives a low Apgar score of 3 following a traumatic delivery, the most crucial intervention for the nurse to implement is to continue resuscitative efforts. A low Apgar score indicates that the newborn is in distress and requires immediate medical attention to support breathing, heart rate, muscle tone, reflex irritability, and color. Continuing resuscitative efforts is essential to provide life-saving interventions promptly. Paging the pediatrician may cause a delay in crucial interventions, repeating the Apgar assessment in 5 minutes is not appropriate as immediate action is needed to stabilize the infant, and informing parents should not take precedence over providing immediate medical care to the newborn.

3. Once the testes have developed in the embryo, they begin to produce male sex hormones, or _____.

• A. androgens
• B. genotypes
• C. blastocysts
• D. teratogens

Correct answer: A

Rationale: Androgens are male sex hormones, such as testosterone, produced by the testes after they have developed in the embryo. Androgens are responsible for the development of male secondary sexual characteristics. Genotypes refer to an individual's genetic makeup, not hormones. Blastocysts are early stage embryos, not male sex hormones. Teratogens are substances that can interfere with fetal development, not male sex hormones produced by the testes.

4. A client with hyperemesis gravidarum is being cared for by a nurse. Which of the following laboratory tests should the nurse anticipate?

• A. Urine Ketones
• B. Rapid plasma reagin
• C. Prothrombin time
• D. Urine culture

Correct answer: A

Rationale: Urine ketones should be anticipated as a laboratory test for a client with hyperemesis gravidarum because it helps assess the severity of dehydration and malnutrition, which are common complications of this condition. Choice B, rapid plasma reagin, is a test for syphilis and is not relevant to hyperemesis gravidarum. Choice C, prothrombin time, is a measure of blood clotting function and is not typically indicated for hyperemesis gravidarum. Choice D, urine culture, is used to identify bacteria in the urine and is not directly related to assessing dehydration and malnutrition in clients with hyperemesis gravidarum.

5. A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take?

• A. Provide a calm environment
• B. Monitor blood glucose levels every hour
• C. Initiate seizure precautions
• D. Place the infant on their back with legs extended

Correct answer: C

Rationale: Initiating seizure precautions is crucial when caring for an infant with neonatal abstinence syndrome due to the increased risk of seizures. Providing a calm environment (Choice A) is important to reduce stimulation as these infants may be irritable. Monitoring blood glucose levels (Choice B) is not typically a priority in neonatal abstinence syndrome unless specific signs or symptoms suggest the need for this assessment. Placing the infant on their back with legs extended (Choice D) does not directly address the potential complications associated with neonatal abstinence syndrome, such as seizures.

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