Nursing Elites

1. A client who is 28 weeks pregnant and not up-to-date on current immunizations should anticipate receiving which of the following immunizations following birth?

• A. Pneumococcal
• B. Hepatitis
• C. Human papillomavirus
• D. Rubella

Correct answer: D

Rationale: The correct answer is D, Rubella. Rubella vaccine is recommended postpartum to prevent congenital rubella syndrome in future pregnancies. Pneumococcal and Hepatitis vaccines are not routinely given postpartum. Human papillomavirus vaccine is not typically administered immediately after birth but rather at a later age to prevent HPV infections.

2. A client tells the nurse that she thinks she's pregnant. Which signs or symptoms provide the best indication that the client is pregnant?

• A. Morning sickness.
• B. Breast tenderness.
• C. Amenorrhea.
• D. Hegar's sign.

Correct answer: D

Rationale: Hegar's sign, which is a softening of the lower uterine segment, is considered a probable sign of pregnancy as it indicates changes in the cervix and uterus that occur during pregnancy. Amenorrhea, the absence of menstruation, is a common early sign of pregnancy but can also be due to other factors. Morning sickness, nausea and vomiting, can be a sign of early pregnancy but is not as specific as Hegar's sign. Breast tenderness is a common symptom in early pregnancy due to hormonal changes, but it is not as definitive as Hegar's sign in indicating pregnancy.

3. When do mothers usually feel the first fetal movements during pregnancy?

• A. At 18-20 weeks
• B. During the first month
• C. Rarely
• D. Never

Correct answer: A

Rationale: Mothers usually feel the first fetal movements, known as 'quickening,' around the 18th to 20th week of pregnancy. Feeling fetal movements during the first month is unlikely and uncommon. Therefore, option B is incorrect. Options C and D are also incorrect as mothers typically do feel fetal movements during pregnancy, just not during the first month.

4. During the client’s initial prenatal visit, which of the following would indicate a need for further assessment?

• A. History of diabetes for 6 years.
• B. Exercises three times a week.
• C. Occasional use of over-the-counter pain relievers.
• D. Maternal age 30 years.

Correct answer: A

Rationale: A history of diabetes for 6 years indicates a pre-existing medical condition that can significantly impact both the mother and the developing fetus during pregnancy. This necessitates further assessment and monitoring to manage potential complications. Regular exercise (Choice B) is generally beneficial during pregnancy and does not raise immediate concerns. Occasional use of over-the-counter pain relievers (Choice C) is common and does not necessarily indicate a need for further assessment during the initial visit. Maternal age of 30 years (Choice D) falls within the normal range for childbearing and is not a standalone factor requiring immediate further assessment.

5. Before meiosis, a sperm cell:

• A. contains 46 chromosomes.
• B. contains two X chromosomes.
• C. is significantly larger than an egg cell.
• D. contains both an X and a Y chromosome.

Correct answer: A

Rationale: Before meiosis, a sperm cell contains 46 chromosomes. This is because sperm cells, like other somatic cells, have a diploid number of chromosomes. During meiosis, the number of chromosomes is halved to 23 to combine with an egg cell during fertilization. Choice B is incorrect because a sperm cell carries either an X or a Y chromosome, not both (Choice D). Choice C is incorrect as sperm cells are generally smaller than egg cells, which is an adaptation that aids in motility and penetration of the egg during fertilization.

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