Nursing Elites

1. A newborn is 24 hours old, and a healthcare provider is caring for them. Which of the following laboratory findings should the healthcare provider report to the provider?

• A. Hgb 20 g/dL
• B. Bilirubin 2 mg/dL
• C. Platelets 200,000/mm3
• D. WBC count 32,000/mm3

Correct answer: D

Rationale: The correct answer is D: WBC count 32,000/mm3. A WBC count of 32,000/mm3 is significantly elevated in a newborn and could indicate an infection, which needs immediate attention and intervention. High white blood cell counts in newborns can be concerning as they may suggest an ongoing infection or other underlying issues that require prompt medical evaluation and treatment. Choices A, B, and C are within normal ranges for a newborn and would not typically warrant immediate reporting to the provider. Hgb levels of 20 g/dL (Choice A) are high for newborns, but this is not as concerning as a significantly elevated WBC count. Bilirubin levels of 2 mg/dL (Choice B) are within normal limits for a newborn and do not indicate immediate issues. Platelet count of 200,000/mm3 (Choice C) is also within the normal range for a newborn and would not require immediate reporting.

2. A client has experienced a fetal demise following a vaginal delivery at term. What should the nurse advise the client?

• A. “You can bathe and dress your baby if you’d like to.”
• B. “If you don’t hold the baby, it will make letting go much harder.”
• C. “You should name the baby so he/she can have an identity.”
• D. “I’m sure you will be able to have another baby when you’re ready.”

Correct answer: A

Rationale: After a fetal demise, allowing the parents to bathe and dress their baby can offer them a sense of closure and help them in their grieving process. This act can provide a tangible way for the parents to bond with their baby and create lasting memories. Option B is incorrect because each individual may have different emotional needs and holding the baby may not be appropriate or helpful for everyone. Option C, while well-intentioned, may not be suitable for all parents as naming the baby could be emotionally challenging. Option D is insensitive as it overlooks the grieving process of losing a baby by suggesting a replacement.

3. Preconception counseling is crucial for the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?

• A. Frequent episodes of maternal hypoglycemia
• B. Congenital anomalies in the fetus
• C. Hydramnios
• D. Hyperemesis gravidarum

Correct answer: B

Rationale: Preconception counseling is essential as strict metabolic control before conception and in the early weeks of gestation helps reduce the risk of congenital anomalies. Frequent episodes of maternal hypoglycemia usually occur during the first trimester due to hormonal changes, affecting insulin production and use, rather than before conception. Hydramnios is more common in diabetic pregnancies, typically seen in the third trimester, not during early pregnancy. Hyperemesis gravidarum, although it may lead to hypoglycemic events, is related to decreased food intake and glucose transfer to the fetus, exacerbating hypoglycemia rather than being directly associated with poor glycemic control before and during early pregnancy.

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. During which of the following periods does the development of arms and legs occur in a pregnancy?

• A. Development of the lungs
• B. Development of the heart
• C. Development of arms and legs
• D. Development of the stomach

Correct answer: C

Rationale: The correct answer is C. The development of arms and legs occurs during the critical period of the fourth to eighth weeks of pregnancy. This timeframe is crucial for the formation of limbs and other key body parts. Choices A, B, and D are incorrect because the development of the lungs, heart, and stomach respectively occurs at different stages of fetal development and is not primarily associated with the fourth to eighth weeks of pregnancy.

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