Nursing Elites

1. Following a traumatic delivery, an infant receives an initial Apgar score of 3. Which intervention is most important for the nurse to implement?

• A. Page the pediatrician STAT
• B. Continue resuscitative efforts
• C. Repeat the Apgar assessment in 5 minutes
• D. Inform the parents of the infant's condition

Correct answer: B

Rationale: In a situation where an infant receives a low Apgar score of 3 following a traumatic delivery, the most crucial intervention for the nurse to implement is to continue resuscitative efforts. A low Apgar score indicates that the newborn is in distress and requires immediate medical attention to support breathing, heart rate, muscle tone, reflex irritability, and color. Continuing resuscitative efforts is essential to provide life-saving interventions promptly. Paging the pediatrician may cause a delay in crucial interventions, repeating the Apgar assessment in 5 minutes is not appropriate as immediate action is needed to stabilize the infant, and informing parents should not take precedence over providing immediate medical care to the newborn.

2. 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.

3. Daisy was always unusually short for her age. She was unable to conceive a child after marriage, and upon visiting a doctor, she was prescribed estrogen replacement therapy. Daisy is most likely suffering from:

• A. Phenylketonuria (PKU).
• B. Cystic fibrosis.
• C. Turner syndrome.
• D. Huntington’s disease (HD).

Correct answer: C

Rationale: Daisy's symptoms of short stature and infertility, along with the prescription of estrogen replacement therapy, are indicative of Turner syndrome. Turner syndrome is a genetic condition in which a female is partially or completely missing one X chromosome. This results in short stature, infertility, and other physical characteristics. Phenylketonuria (PKU) is a metabolic disorder caused by a mutation in the gene responsible for the breakdown of the amino acid phenylalanine. Cystic fibrosis is a genetic disorder affecting the respiratory and digestive systems. Huntington's disease (HD) is a neurodegenerative disorder that affects muscle coordination and leads to cognitive decline.

4. What is the primary rationale for thoroughly drying the infant immediately after birth?

• A. Stimulates crying and lung expansion.
• B. Removes maternal blood from the skin surface.
• C. Reduces heat loss from evaporation.
• D. Increases blood supply to the hands and feet.

Correct answer: C

Rationale: The primary rationale for thoroughly drying the infant immediately after birth is to reduce heat loss from evaporation. This helps maintain the infant's body temperature and prevent hypothermia. Choice A (Stimulates crying and lung expansion) is incorrect because drying the infant is not primarily done to stimulate crying but rather to prevent heat loss. Choice B (Removes maternal blood from the skin surface) is incorrect as the main reason is to prevent heat loss, not to remove maternal blood. Choice D (Increases blood supply to the hands and feet) is also incorrect as drying the infant is not intended to increase blood supply but rather to regulate body temperature.

5. A client has active genital herpes simplex virus type 2. Which of the following medications should the nurse plan to administer?

• A. Metronidazole
• B. Penicillin
• C. Acyclovir
• D. Gentamicin

Correct answer: C

Rationale: Acyclovir is the antiviral medication specifically used to treat herpes simplex virus infections, including genital herpes caused by herpes simplex virus type 2. Metronidazole (Choice A) is an antibiotic used for different types of infections, but not for viral infections like herpes. Penicillin (Choice B) is an antibiotic effective against bacterial infections, not viruses like herpes. Gentamicin (Choice D) is an antibiotic mainly used to treat bacterial infections, not viral infections like herpes.

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