Nursing Elites

1. 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.

2. Are sperm much larger than ova?

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

Correct answer: B

Rationale: The correct answer is B: FALSE. Ova, also known as eggs, are actually the largest cells in the human body, while sperm are significantly smaller. This size difference is due to the different functions of the two gametes. Sperm are specialized for motility to reach and fertilize the egg, while ova contain nutrients and cellular machinery needed for fertilization and early embryonic development. Choices A, C, and D are incorrect because sperm are not larger than ova; they are much smaller in size.

3. Which of the following processes happen during mitosis?

• A. Strands of deoxyribonucleic acid (DNA) break apart.
• B. Adenine combines with its appropriate partner, cytosine.
• C. Sperm and ova cells are created.
• D. Twenty-three chromosomes are created.

Correct answer: A

Rationale: The correct process that happens during mitosis is the breaking apart, replication, and division of DNA strands into two new cells, each with the same number of chromosomes as the original cell. Choice B is incorrect because it describes base pairing in DNA, not a process specific to mitosis. Choice C is incorrect as the creation of sperm and ova cells is related to meiosis, not mitosis. Choice D is incorrect because chromosomes are not created during mitosis; they are replicated and divided equally between the daughter cells.

4. Thalidomide was marketed in the 1960s as a treatment for:

• A. insomnia and nausea.
• B. infertility and impotence.
• C. Down syndrome.
• D. Turner syndrome.

Correct answer: A

Rationale: Thalidomide was initially marketed as a treatment for insomnia and nausea, particularly in pregnant women. However, it was later found to cause severe birth defects, leading to significant consequences. Choice B, infertility and impotence, is incorrect as thalidomide was not marketed for these conditions. Choices C and D, Down syndrome and Turner syndrome, are genetic conditions and not conditions for which thalidomide was intended as a treatment.

5. Four clients at full term present to the labor and delivery unit at the same time. Which client should a nurse assess first?

• A. Multipara with contractions occurring every three minutes
• B. Multipara scheduled for non-stress test and biophysical profile
• C. Primipara with vaginal show and leaking membranes
• D. Primipara with burning on urination and urinary frequency

Correct answer: C

Rationale: A primipara with vaginal show and leaking membranes requires immediate assessment as she may be in active labor or at risk of infection. The vaginal show and leaking membranes suggest potential rupture of membranes and the start of labor. Assessing her first ensures prompt management and monitoring. The other options, while important, do not indicate immediate or emergent needs. Contractions every three minutes in a multipara can be managed with ongoing monitoring; non-stress tests and biophysical profiles can be scheduled and are not acute needs. Burning on urination and urinary frequency in a primipara may indicate a urinary tract infection, which is important but not as urgent as assessing for active labor or rupture of membranes.

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