Nursing Elites

1. What is the central layer of the embryo from which the bones and muscles develop?

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

Correct answer: B

Rationale: The correct answer is mesoderm. The mesoderm is the middle layer of the embryo that gives rise to the bones, muscles, and other connective tissues. The neural tube (choice A) develops into the nervous system, not bones and muscles. The ectoderm (choice C) forms the skin and nervous system, not bones and muscles. The umbilical cord (choice D) is a structure that connects the developing fetus to the placenta; it is not a layer of the embryo that gives rise to bones and muscles.

2. A newborn is being assessed following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method?

• A. Hypoglycemia
• B. Polycythemia
• C. Facial Palsy
• D. Bronchopulmonary dysplasia

Correct answer: C

Rationale: Facial palsy is a known complication of forceps-assisted birth. During forceps delivery, pressure applied to the facial nerve can result in facial palsy. The newborn may present with weakness or paralysis of the facial muscles on one side. Hypoglycemia (Choice A) is not directly related to forceps-assisted birth. Polycythemia (Choice B) is a condition characterized by an increased number of red blood cells and is not typically associated with forceps delivery. Bronchopulmonary dysplasia (Choice D) is a lung condition that primarily affects premature infants who require mechanical ventilation and prolonged oxygen therapy, not a direct outcome of forceps-assisted birth.

3. A client comes to the clinic for her first prenatal visit and reports that July 10 was the first day of her last menstrual period. Using Nagele’s Rule, the nurse calculates the estimated date of birth for the client to be _________.

• A. 4/17.
• B. 4/10.
• C. 5/10.
• D. 5/17.

Correct answer: A

Rationale: Nagele's Rule is a common method used to estimate the due date. To calculate it, subtract 3 months and add 7 days to the first day of the last menstrual period. In this case, if the last menstrual period started on July 10, subtracting 3 months (April) and adding 7 days gives an estimated due date of April 17. This is the correct answer. Choices B, C, and D are incorrect because they do not follow the Nagele's Rule calculation method.

4. A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began one hour ago. The nurse's assessment reveals approximately 30ML of bright red vaginal bleeding, fetal heart rate of 130 - 140 beats per minute, no contractions, and no complaints of pain. What is the most likely cause of this client's bleeding?

• A. Abruptio Placenta
• B. Placenta Previa
• C. Normal bloody show indicating induction of labor
• D. A ruptured blood vessel in the vaginal vault

Correct answer: B

Rationale: Placenta previa, a condition where the placenta covers the cervix, can cause painless, bright red vaginal bleeding in the third trimester. In this scenario, the absence of contractions and pain, along with the presence of significant bright red bleeding, is more indicative of placenta previa rather than abruptio placenta or a ruptured vessel. A normal bloody show typically occurs closer to the onset of labor and is not associated with the amount of bleeding described in the question.

5. Once the testes have developed in the embryo, they begin to produce male sex hormones, or _____.

• A. androgens
• B. genotypes
• C. blastocysts
• D. teratogens

Correct answer: A

Rationale: Androgens are male sex hormones, such as testosterone, produced by the testes after they have developed in the embryo. Androgens are responsible for the development of male secondary sexual characteristics. Genotypes refer to an individual's genetic makeup, not hormones. Blastocysts are early stage embryos, not male sex hormones. Teratogens are substances that can interfere with fetal development, not male sex hormones produced by the testes.

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