Nursing Elites

1. Before drying off the newborn after birth, which assessment finding should the healthcare professional document to ensure an accurate gestational rating on the Ballard gestational assessment tool?

• A. Amount and area of vernix coverage
• B. Creases on the sole
• C. Size of the areola
• D. Body surface temperature

Correct answer: A

Rationale: To ensure an accurate gestational rating on the Ballard gestational assessment tool, healthcare professionals should document the amount and area of vernix coverage before drying the newborn. Drying the baby after birth could disturb the vernix, potentially affecting the gestational age assessment. Assessing and documenting the vernix coverage beforehand enables a more precise evaluation using the Ballard gestational assessment tool. Choices B, C, and D are incorrect as they are not directly related to gestational rating on the Ballard assessment tool.

2. A healthcare provider is educating a new mother on discharge. They told the mother to look for the following danger signs.

• A. Poor Feeding
• B. High Temperature
• C. Convulsions
• D. All of the Above

Correct answer: D

Rationale: It is crucial for new mothers to be aware of potential danger signs after discharge. Poor feeding, high temperature, and convulsions are all critical symptoms that should prompt immediate medical attention. Poor feeding may indicate issues with feeding or underlying health problems. High temperature could be a sign of infection or illness. Convulsions are a serious symptom that could indicate neurological problems or other medical emergencies. By being vigilant and recognizing these signs early, the mother can help ensure the well-being of her newborn. Therefore, the correct answer is 'All of the Above' as all these signs require prompt medical attention to ensure the baby's health and safety.

3. When using the Ballard gestational assessment tool on a newborn, which of the following tests should be performed after the first hour of birth, allowing the newborn to recover from the stress of birth?

• A. Arm recoil
• B. Square window sign
• C. Scarf sign
• D. Popliteal angle

Correct answer: A

Rationale: The correct answer is Arm recoil. Arm recoil is slower in healthy but fatigued newborns after birth, making it best elicited after the first hour of birth when the baby has had time to recover from the stress of birth. This assessment helps evaluate neuromuscular maturity in newborns and is more accurate when performed after the initial recovery period. The other choices, Square window sign, Scarf sign, and Popliteal angle, are not specifically assessed using the Ballard gestational assessment tool and do not relate to the recovery period after birth.

4. Which of the following statements regarding 2-rescuer child CPR is correct?

• A. The chest should be compressed with one hand, and a compression-to-ventilation ratio of 30:2 should be used.
• B. The chest should not be allowed to fully recoil in between compressions.
• C. A compression-to-ventilation ratio of 15:2 should be used if an advanced airway is in place.
• D. Compress the chest with one or two hands to a depth equal to one-third the diameter of the chest.

Correct answer: D

Rationale: During 2-rescuer child CPR, it is important to compress the chest with one or two hands to a depth equal to one-third the diameter of the chest. This technique ensures effective chest compressions are being delivered to help circulate blood and oxygenate the child's body. Choice A is incorrect because both hands should be used for chest compressions in 2-rescuer CPR. Choice B is incorrect as allowing the chest to fully recoil between compressions is essential to create negative pressure and facilitate blood flow back to the heart. Choice C is incorrect as the standard compression-to-ventilation ratio for child CPR is 30:2, regardless of whether an advanced airway is in place.

5. A 30-year-old woman has severe lower abdominal pain and light vaginal bleeding. She tells you that her last menstrual period was 2 months ago. On the basis of these findings, you should suspect:

• A. a normal pregnancy.
• B. a ruptured ovarian cyst.
• C. an ectopic pregnancy.
• D. a spontaneous abortion.

Correct answer: C

Rationale: Severe lower abdominal pain, light vaginal bleeding, and a history of missed periods are concerning for an ectopic pregnancy. The absence of a normal menstrual period along with these symptoms raises suspicion for an ectopic pregnancy, which requires immediate medical attention due to the risk of rupture and life-threatening complications. A normal pregnancy would typically present with different symptoms such as a positive pregnancy test and typical signs of early pregnancy. A ruptured ovarian cyst may present with similar symptoms but typically lacks the history of missed periods. A spontaneous abortion usually involves heavier bleeding and tissue passage, which is not described in this scenario.

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