Nursing Elites

1. A healthcare provider is assessing a newborn immediately following a vaginal birth. For which of the following findings should the provider intervene?

• A. Molding
• B. Vernix Caseosa
• C. Acrocyanosis
• D. Sternal retractions

Correct answer: D

Rationale: Sternal retractions in a newborn indicate respiratory distress and require immediate intervention. This finding suggests the newborn is having difficulty breathing and needs prompt attention to ensure adequate oxygenation. Molding, the overlapping of fetal skull bones during birth, is a normal and expected process that does not require intervention. Vernix Caseosa, the protective white substance on the skin, and Acrocyanosis, the bluish discoloration of extremities, are both common and benign findings in newborns that do not necessitate immediate action. Therefore, the healthcare provider should focus on addressing sternal retractions to manage the respiratory distress effectively.

2. What information should the nurse include when teaching a client at 41 weeks of gestation about a non-stress test?

• A. This test will confirm fetal lung maturity.
• B. This test will determine the adequacy of placental perfusion.
• C. This test will detect fetal infection.
• D. This test will predict maternal readiness for labor.

Correct answer: B

Rationale: The correct answer is B: 'This test will determine the adequacy of placental perfusion.' The non-stress test is used to assess fetal well-being by monitoring the fetal heart rate in response to its own movements. It helps determine if the fetus is receiving enough oxygen and nutrients through placental perfusion. Choice A is incorrect because confirming fetal lung maturity is typically determined through tests like amniocentesis, not the non-stress test. Choice C is incorrect because detecting fetal infection is not the primary purpose of a non-stress test. Choice D is incorrect because predicting maternal readiness for labor is not the purpose of the non-stress test; it focuses on fetal well-being.

3. A newborn assessment reveals spina bifida occulta. Which maternal factor should the nurse identify as having the greatest impact on the development of this newborn complication?

• A. Tobacco use.
• B. Folic acid deficiency.
• C. Short interval between pregnancies.
• D. Preeclampsia.

Correct answer: B

Rationale: Folic acid deficiency during pregnancy is strongly associated with neural tube defects like spina bifida occulta. Adequate folic acid intake before and during early pregnancy significantly reduces the risk of such complications. Tobacco use (Choice A) is linked to other adverse outcomes but not specifically spina bifida occulta. Short intervals between pregnancies (Choice C) can increase the risk of preterm birth and low birth weight but are not directly linked to spina bifida occulta. Preeclampsia (Choice D) is a hypertensive disorder that poses risks to both the mother and baby but is not the primary factor contributing to spina bifida occulta development.

4. Which of the following is most likely to develop sickle cell anemia?

• A. European American
• B. Native American
• C. African American
• D. Asian American

Correct answer: C

Rationale: Sickle cell anemia is most commonly found in individuals of African American descent. This is because sickle cell trait provides some protection against malaria, and historically, regions where malaria is or was prevalent have higher rates of sickle cell anemia. Therefore, individuals with African ancestry are at a higher risk of developing sickle cell anemia compared to other populations. Choices A, B, and D are less likely to develop sickle cell anemia due to lower genetic prevalence in their respective populations.

5. As women reach the end of their childbearing years, does ovulation become more regular?

• A. TRUE
• B. FALSE
• C. Rarely
• D. Always

Correct answer: B

Rationale: The correct answer is B: FALSE. As women age and reach the end of their childbearing years, ovulation becomes less regular due to hormonal changes associated with menopause. This can result in irregular ovulation patterns or even the cessation of ovulation entirely. Choice A is incorrect because ovulation does not become more regular with age. Choices C and D are also incorrect as they do not accurately reflect the changes in ovulation patterns that occur as women approach the end of their childbearing years.

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