Nursing Elites

1. A healthcare professional is caring for a client who is 14 weeks of gestation. At which of the following locations should the healthcare professional place the Doppler device when assessing the fetal heart rate?

• A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis
• B. Left Upper Abdomen
• C. Two fingerbreadths above the umbilicus
• D. Lateral at the Xiphoid Process

Correct answer: A

Rationale: At 14 weeks of gestation, the uterus is still relatively low in the abdomen. Placing the Doppler midline 2 to 3 cm above the symphysis pubis is appropriate for assessing the fetal heart rate. This location allows for better detection of the fetal heart tones as the uterus is at a lower position during this stage of pregnancy. Placing the Doppler on the left upper abdomen would not be ideal at 14 weeks gestation as the uterus is not yet at that level. Placing it two fingerbreadths above the umbilicus or lateral at the xiphoid process would also not be accurate for locating the fetal heart rate at this stage of gestation.

2. A nurse is reviewing laboratory results for a term newborn who is 24 hours old. Which of the following results require intervention by the nurse?

• A. WBC count 10,000/mm3
• B. Platelets 180,000/mm3
• C. Hemoglobin 20g/dL
• D. Glucose 20 mg/dL

Correct answer: D

Rationale: A glucose level of 20 mg/dL is critically low for a newborn and requires immediate intervention. Hypoglycemia in a newborn can lead to serious complications such as neurologic deficits. The normal range for glucose levels in a newborn is typically 40-60 mg/dL. Choices A, B, and C represent normal or acceptable values for a term newborn and do not require immediate intervention. A WBC count of 10,000/mm3, platelets of 180,000/mm3, and hemoglobin of 20g/dL are all within normal ranges for a term newborn and do not raise immediate concerns.

3. The healthcare provider is planning care for a client at 30 weeks gestation who is experiencing preterm labor. Which medication is most important in preventing this fetus from developing respiratory distress syndrome?

• A. Ampicillin 1 gram IV push every 8 hours
• B. Betamethasone 12 mg deep IM
• C. Terbutaline 0.25 mg subcutaneously every 15 minutes for 3 doses
• D. Butorphanol tartrate 1 mg IV push every 2 hours as needed

Correct answer: B

Rationale: Betamethasone is a corticosteroid given to stimulate fetal lung maturity and reduce the risk of respiratory distress syndrome in preterm infants. Ampicillin (Choice A) is an antibiotic and does not prevent respiratory distress syndrome. Terbutaline (Choice C) is a tocolytic used to inhibit contractions and does not directly prevent respiratory distress syndrome. Butorphanol tartrate (Choice D) is an opioid analgesic and does not have a role in preventing respiratory distress syndrome in preterm infants.

4. If an individual receives a recessive gene for eye color from both parents, the:

• A. gender of the child will not determine the expression of that trait.
• B. recessive trait will be expressed in the child.
• C. recessive trait will be expressed in all the offspring.
• D. recessive trait will be suppressed, and the dominant trait will not be expressed.

Correct answer: B

Rationale: When an individual inherits a recessive gene for eye color from both parents, the recessive trait will be expressed in the child. This is because having two copies of the recessive gene overrides the presence of any dominant gene. Choice A is incorrect because the expression of the trait is determined by the genetic makeup, not the gender of the child. Choice C is incorrect as the expression of the recessive trait is certain when both parents pass on the recessive gene, but it does not mean that all offspring will express the trait. Choice D is incorrect because if both parents provide a recessive gene, the dominant trait will not be expressed in the child, but it does not mean it will be suppressed; rather, the recessive trait will be expressed.

5. A new mother who is a lacto-ovo vegetarian plans to breastfeed her infant. Which information should the nurse provide prior to discharge?

• A. Continue prenatal vitamins with B12 while breastfeeding
• B. Avoid using Lanolin-based nipple cream or ointment
• C. Offer iron-fortified supplemental formula daily
• D. Weigh the baby weekly to evaluate the newborn's growth

Correct answer: A

Rationale: The correct answer is A: 'Continue prenatal vitamins with B12 while breastfeeding.' Vitamin B12 is crucial for lacto-ovo vegetarian mothers to prevent deficiencies in both the mother and the infant. Choice B is incorrect as Lanolin-based nipple cream is safe for use during breastfeeding. Choice C is not necessary unless there are specific indications for iron supplementation. Choice D, weighing the baby weekly, is important for monitoring growth but not specifically related to the mother's diet.

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