Nursing Elites

1. A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following clients should the nurse assess first?

• A. A client who has diabetes mellitus and an HbA1c of 5.8%
• B. A client who has preeclampsia and a creatinine level of 1.1 mg/dL
• C. A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L
• D. A client who has placenta previa and a hematocrit of 36%

Correct answer: C

Rationale: A sodium level of 110 mEq/L is critically low and can indicate severe dehydration and electrolyte imbalance, requiring immediate intervention.

2. 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.

3. A healthcare provider is assessing a preterm newborn who is at 32 weeks of gestation. Which of the following finding should the healthcare provider expect?

• A. Minimal arm recoil
• B. Popliteal angle of less than 90°
• C. Creases over the entire sole
• D. Sparse lanugo

Correct answer: A

Rationale: When assessing a preterm newborn at 32 weeks of gestation, healthcare providers should expect minimal arm recoil. This finding is common in preterm infants due to lower muscle tone. Choice B, a popliteal angle of less than 90°, is incorrect for this age group. Creases over the entire sole (Choice C) typically develop at term age, not at 32 weeks of gestation. Sparse lanugo (Choice D) is a normal finding in preterm infants but is not specific to those at 32 weeks of gestation.

4. In the Ballard Gestational Age Assessment Tool, the nurse determines that a 15-month-old infant has a gestational age of 42 weeks. Based on this finding, which intervention is most important for the nurse to implement?

• A. Provide blow-by oxygen
• B. Provide a capillary blood glucose test
• C. Draw arterial blood gases
• D. Apply a pulse oximeter to the foot

Correct answer: B

Rationale: Late preterm infants, such as those with a gestational age of 42 weeks, are at higher risk for hypoglycemia due to immature metabolic regulation. Monitoring capillary blood glucose is crucial to detect and manage hypoglycemia promptly. Providing blow-by oxygen (Choice A) is not indicated for an infant at risk for hypoglycemia. Drawing arterial blood gases (Choice C) is not the primary intervention for assessing hypoglycemia. Applying a pulse oximeter to the foot (Choice D) is not directly related to monitoring blood glucose levels in this context.

5. Females with Turner syndrome:

• A. possess more thymine than cytosine.
• B. are taller than average.
• C. produce little estrogen.
• D. are more likely to give birth to twins.

Correct answer: C

Rationale: Turner syndrome is a chromosomal disorder in females characterized by short stature and underdeveloped ovaries, resulting in low estrogen production. This leads to symptoms such as delayed puberty and infertility. Choice A is incorrect because the chromosomal abnormality in Turner syndrome does not affect the thymine-cytosine ratio. Choice B is incorrect as females with Turner syndrome are typically shorter than average. Choice D is incorrect as Turner syndrome does not increase the likelihood of giving birth to twins.

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