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. When should the low-risk patient, who is 16 weeks pregnant, be advised to return to the prenatal clinic?

• A. 1 week.
• B. 2 weeks.
• C. 3 weeks.
• D. 4 weeks.

Correct answer: D

Rationale: The correct answer is D: 4 weeks. Low-risk pregnant patients typically have prenatal visits every 4 weeks until 28 weeks of gestation. This frequency allows for adequate monitoring of the pregnancy without being overly burdensome on the patient. Choices A, B, and C are incorrect as they do not align with the standard prenatal care schedule for low-risk pregnancies. Visits that are too frequent may cause unnecessary anxiety for the patient, while visits that are too infrequent may miss important opportunities for monitoring and intervention.

3. The _____ is the inner layer of the embryo from which the lungs and digestive system develop.

• A. neural tube
• B. mesoderm
• C. endoderm
• D. umbilical cord

Correct answer: C

Rationale: The endoderm is the correct answer. It is the innermost layer of the embryo that gives rise to organs such as the lungs, digestive system, liver, and pancreas. The neural tube (Choice A) forms the brain and spinal cord, not the lungs or digestive system. Mesoderm (Choice B) develops into structures like muscles, bones, and circulatory system, not the lungs or digestive system. The umbilical cord (Choice D) serves as a connection between the embryo and the placenta, providing nutrients and oxygen, but it is not the layer from which lungs and digestive system develop.

4. 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.

5. According to a study in the year 2013 by Fellman, if a woman is a twin, if her mother was a twin, or if she has previously borne twins, then:

• A. she will bear only monozygotic (MZ) twins.
• B. the chances of her becoming pregnant decrease.
• C. she is likely to be a healthy mother.
• D. the chances rise that she will bear twins.

Correct answer: D

Rationale: According to the study, the chances of a woman bearing twins increase if she is a twin herself, if her mother was a twin, or if she has previously borne twins. Therefore, the correct answer is D. Choice A is incorrect because the study does not specify that she will bear only monozygotic twins. Choice B is incorrect as the study does not mention any decrease in the chances of becoming pregnant. Choice C is incorrect because the study does not provide information about the woman's health status, focusing instead on the likelihood of bearing twins.

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