Nursing Elites

1. The embryo and fetus develop within a protective _______ in the uterus.

• A. amniotic sac
• B. umbilical cord
• C. neural tube
• D. embryonic disk

Correct answer: A

Rationale: The correct answer is A, the amniotic sac. The amniotic sac is a fluid-filled structure that surrounds and protects the developing embryo and fetus in the uterus. It provides a cushion against external pressure, allows for movement and growth, and helps maintain a stable environment for the developing fetus. Choices B, C, and D are incorrect. The umbilical cord connects the fetus to the placenta and serves as a conduit for nutrients and waste; the neural tube is a structure that forms the central nervous system in early embryonic development; and the embryonic disk is a structure that forms during gastrulation, one of the early stages of embryonic development.

2. _____ is a life-threatening disease, characterized by high blood pressure that may afflict women late in the second or early in the third trimester.

• A. Rubella
• B. Syphilis
• C. Preeclampsia
• D. Phenylketonuria

Correct answer: C

Rationale: Preeclampsia is a serious pregnancy complication characterized by high blood pressure that typically occurs in the second half of pregnancy. If left untreated, it can lead to severe complications for both the mother and the baby. Rubella (choice A) is a viral infection that can harm the developing fetus but is not directly related to high blood pressure in pregnancy. Syphilis (choice B) is a sexually transmitted infection that can affect pregnancy but does not specifically cause high blood pressure. Phenylketonuria (choice D) is a genetic disorder that affects metabolism and is not associated with high blood pressure in pregnancy.

3. A healthcare provider is assessing a preterm newborn who is at 32 weeks of gestation. Which of the following finding should the healthcare provider expect?

• A. Minimal arm recoil
• B. Popliteal angle of less than 90°
• C. Creases over the entire sole
• D. Sparse lanugo

Correct answer: A

Rationale: When assessing a preterm newborn at 32 weeks of gestation, healthcare providers should expect minimal arm recoil. This finding is common in preterm infants due to lower muscle tone. Choice B, a popliteal angle of less than 90°, is incorrect for this age group. Creases over the entire sole (Choice C) typically develop at term age, not at 32 weeks of gestation. Sparse lanugo (Choice D) is a normal finding in preterm infants but is not specific to those at 32 weeks of gestation.

4. Which FHR finding is the most concerning to the nurse providing care to a laboring client?

• A. Accelerations with fetal movement.
• B. Early decelerations.
• C. Average FHR of 126 beats per minute.
• D. Late decelerations.

Correct answer: D

Rationale: Late decelerations are caused by uteroplacental insufficiency, resulting in fetal hypoxemia. They are considered ominous if persistent, indicating compromised oxygen supply to the fetus. Accelerations with fetal movement (Choice A) are reassuring signs of fetal well-being. Early decelerations (Choice B) are typically benign, associated with head compression during contractions. An average FHR of 126 beats per minute (Choice C) falls within the normal range for fetal heart rate and is not concerning. Therefore, the most concerning FHR finding in a laboring client is late decelerations (Choice D).

5. A client is preparing to administer methylergonovine 0.2 mg orally to a client who is 2 hr postpartum and has a boggy uterus. For which of the following assessment findings should the nurse withhold the medication?

• A. Blood pressure 142/92 mm Hg
• B. Urine output 100 mL in 1 hr
• C. Pulse 58/min
• D. Respiratory rate 14/min

Correct answer: A

Rationale: The correct answer is A. Methylergonovine can increase blood pressure, so it should be withheld if the client has hypertension. A blood pressure reading of 142/92 mm Hg indicates hypertension and is a contraindication for administering methylergonovine. Choices B, C, and D are within normal limits and not contraindications for administering this medication. Urine output, pulse rate, and respiratory rate are not factors that determine the appropriateness of administering methylergonovine in this situation.

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