Nursing Elites

1. 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.

2. A healthcare professional is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the healthcare professional include in the plan of care?

• A. Dress the newborn in lightweight clothing.
• B. Avoid using lotion or ointment on the newborn's skin.
• C. Keep the newborn supine throughout treatment.
• D. Measure the newborn's temperature every 8 hours.

Correct answer: B

Rationale: When a newborn is receiving phototherapy, it is important to avoid using lotions or ointments on their skin as these products can lead to skin irritation and burns under the phototherapy lights. Dressing the newborn in lightweight clothing helps ensure proper exposure to the phototherapy lights. Keeping the newborn supine during treatment helps maximize exposure to the light. However, the key consideration in this scenario is to prevent skin irritation and burns by avoiding lotions or ointments.

3. What is the purpose of amniocentesis?

• A. To induce abortion
• B. To detect genetic abnormalities in the fetus
• C. To determine the baby's gender
• D. To monitor fetal growth

Correct answer: B

Rationale: Amniocentesis is a diagnostic procedure used to detect genetic abnormalities in the fetus, such as chromosomal disorders like Down syndrome. It is not performed to induce abortion. The primary purpose of amniocentesis is to assess the genetic health of the fetus, not to determine the baby's gender (Choice C). While amniocentesis can provide information about the baby's health and development, it is not primarily used for monitoring fetal growth (Choice D). Therefore, the correct answer is B.

4. A newborn who was born post-term is being assessed by a nurse. Which of the following findings should the nurse expect?

• A. A Rh-negative mother who has an Rh-positive infant
• B. A Rh-positive mother who has an Rh-negative infant
• C. A Rh-positive mother who has an Rh-positive infant
• D. A Rh-negative mother who has an Rh-negative infant

Correct answer: A

Rationale: The correct answer is A: 'A Rh-negative mother who has an Rh-positive infant.' In cases where the newborn is born post-term, the mismatched Rh factor between the mother (Rh-negative) and the infant (Rh-positive) can lead to hemolytic disease of the newborn. This condition occurs when maternal antibodies attack fetal red blood cells, causing hemolysis. This can result in jaundice, anemia, and other serious complications for the infant. Choices B, C, and D are incorrect because they do not reflect the mismatched Rh factor scenario that poses a risk for hemolytic disease of the newborn.

5. A primiparous woman presents in labor with the following labs: hemoglobin 10.9 g/dL, hematocrit 29%, hepatitis surface antigen positive, Group B Streptococcus positive, and rubella non-immune. Which intervention should the nurse implement?

• A. Transfuse 2 units of packed red blood cells.
• B. Give measles, mumps, rubella vaccine 0.5 mL.
• C. Administer ampicillin 2 grams intravenously.
• D. Inject hepatitis B immune globulin 0.5 milliliters.

Correct answer: C

Rationale: The correct intervention in this scenario is to administer ampicillin 2 grams intravenously. This is crucial to prevent Group B Streptococcus infection in the newborn during delivery. Option A, transfusing packed red blood cells, is not indicated based on the hemoglobin and hematocrit levels provided. Option B, giving measles, mumps, rubella vaccine, is not necessary at this time. Option D, injecting hepatitis B immune globulin, is not appropriate for the conditions presented in the question.

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