Nursing Elites

1. A healthcare provider is assessing a newborn upon admission to the nursery. Which of the following should the provider expect?

• A. Bulging Fontanels
• B. Nasal Flaring
• C. Length from head to heel of 40 cm (15.7 in)
• D. Chest circumference 2 cm (0.8 in) smaller than the head circumference

Correct answer: D

Rationale: Upon admission to the nursery, a healthcare provider should expect the newborn's chest circumference to be slightly smaller than the head circumference. This is a normal finding in newborns due to their physiological development. Bulging fontanels (Choice A) can indicate increased intracranial pressure, which is abnormal. Nasal flaring (Choice B) is a sign of respiratory distress and is also an abnormal finding. While a length from head to heel of 40 cm (15.7 in) (Choice C) falls within the normal range for newborns, it is not a specific expectation upon admission to the nursery. Therefore, the correct expectation for a newborn upon admission is for the chest circumference to be slightly smaller than the head circumference.

2. In contrast to placenta previa, what is the most prevalent clinical manifestation of abruptio placentae?

• A. Bleeding.
• B. Intense abdominal pain.
• C. Uterine activity.
• D. Cramping.

Correct answer: B

Rationale: The correct answer is B: Intense abdominal pain. Pain is absent with placenta previa but can be agonizing with abruptio placentae. While bleeding may be present in varying degrees for both placental conditions, intense abdominal pain is a distinguishing feature of abruptio placentae. Uterine activity and cramping may be present with both placental conditions, but they are not the most prevalent clinical manifestation of abruptio placentae.

3. 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.

4. Does the probability of having a child with Down’s syndrome increase with the age of the parents?

• A. TRUE
• B. FALSE
• C. Sometimes
• D. Never

Correct answer: A

Rationale: The correct answer is A: TRUE. Advanced parental age, particularly maternal age, is associated with an increased risk of Down's syndrome in offspring. As parents get older, the likelihood of having a child with Down's syndrome increases. Choices B, C, and D are incorrect because the risk of Down's syndrome is known to rise with parental age, especially maternal age, due to the increased likelihood of chromosomal abnormalities during egg formation.

5. The _________ is the hollow organ within females in which the embryo and fetus develop.

• A. placenta
• B. ovum
• C. uterus
• D. amniotic sac

Correct answer: C

Rationale: The correct answer is C: uterus. The uterus is the organ where the embryo implants and the fetus develops during pregnancy. The placenta (choice A) is an organ that develops during pregnancy and provides nutrients and oxygen to the fetus, but it is not the organ where the embryo and fetus physically develop. The ovum (choice B) is the female reproductive cell or egg that is fertilized by the sperm to form an embryo, but it is not the organ where the embryo and fetus develop. The amniotic sac (choice D) is a membrane filled with amniotic fluid that surrounds and protects the fetus, but it is not the organ where the embryo and fetus physically develop.

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