Nursing Elites

1. A healthcare provider is teaching a prenatal class about immunizations that newborns receive following birth. Which of the following immunizations should the provider include in the teaching?

• A. Hepatitis B
• B. Rotavirus
• C. Pneumococcal
• D. Varicella

Correct answer: A

Rationale: The correct answer is Hepatitis B. Newborns receive the Hepatitis B vaccine shortly after birth to provide protection against the virus. Rotavirus, Pneumococcal, and Varicella vaccines are typically administered at later stages of infancy or childhood, not immediately after birth. Rotavirus vaccine helps prevent severe diarrhea, Pneumococcal vaccine protects against infections like pneumonia and meningitis, and Varicella vaccine prevents chickenpox. However, these vaccines are not part of the routine immunizations given to newborns immediately after birth.

2. 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.

3. A nurse is developing an educational program about hemolytic diseases in newborns for a group of newly licensed nurses. Which of the following genetic information should the nurse include in the program as a cause of hemolytic disease?

• A. The mother is Rh positive, and the father is Rh negative
• B. The mother is Rh negative, and the father is Rh positive
• C. The mother and the father are both Rh positive
• D. The mother and the father are both Rh negative

Correct answer: B

Rationale: The correct answer is B: 'The mother is Rh negative, and the father is Rh positive.' Hemolytic disease of the newborn occurs when an Rh-negative mother carries an Rh-positive fetus, leading to Rh incompatibility. In this scenario, the mother produces antibodies against the Rh antigen present in the fetus, which can result in hemolysis of the fetal red blood cells. Choices A, C, and D do not describe the Rh incompatibility that leads to hemolytic disease in newborns. Therefore, they are incorrect.

4. Which of the following pairs share 100% of their genes?

• A. Biovular twins
• B. Fraternal twins
• C. Dizygotic (DZ) twins
• D. Monozygotic (MZ) twins

Correct answer: D

Rationale: The correct answer is Monozygotic (MZ) twins. Monozygotic twins, also known as identical twins, share 100% of their genes because they originate from the same fertilized egg that splits into two. Fraternal twins (choice B), also known as dizygotic (DZ) twins (choice C), result from two separate fertilized eggs and share approximately 50% of their genes. Biovular twins (choice A) is not a term used in genetics and does not describe a type of twinning.

5. When obtaining a health history from a client, a nurse in a woman’s health clinic should identify which of the following findings as increasing the client’s risk for developing pelvic inflammatory disease (PID)?

• A. Recurrent Cystitis
• B. Frequent Alcohol Use
• C. Use of Oral Contraceptives
• D. Chlamydia Infection

Correct answer: D

Rationale: Chlamydia infection is a significant risk factor for developing pelvic inflammatory disease (PID). PID is often caused by untreated sexually transmitted infections (STIs) like Chlamydia and Gonorrhea that ascend from the vagina to the upper reproductive organs. Recurrent cystitis (choice A) is more related to urinary tract infections, frequent alcohol use (choice B) is not directly linked to PID, and the use of oral contraceptives (choice C) does not increase the risk of developing PID.

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