Nursing Elites

1. The nurse is providing care for a newborn who was delivered vaginally assisted by forceps. The nurse observes red marks on the head with swelling that does not cross the suture line. Which condition should the nurse document in the medical record?

• A. Caput succedaneum
• B. Hydrocephalus
• C. Cephalhematoma
• D. Microcephaly

Correct answer: C

Rationale: The correct answer is Cephalhematoma. Cephalhematoma is a collection of blood between the skull bone and periosteum that does not cross the suture line. It often occurs due to birth trauma, such as forceps delivery, leading to localized swelling. Caput succedaneum (Choice A) is diffuse swelling of the scalp that may cross suture lines and is typically present at birth. Hydrocephalus (Choice B) is an abnormal accumulation of cerebrospinal fluid within the brain's ventricles. Microcephaly (Choice D) is a condition characterized by a smaller than average head size and may be present at birth or develop later in infancy.

2. A healthcare provider is assessing a newborn upon admission to the nursery. Which of the following should the provider expect?

• A. Bulging Fontanels
• B. Nasal Flaring
• C. Length from head to heel of 40 cm (15.7 in)
• D. Chest circumference 2 cm (0.8 in) smaller than the head circumference

Correct answer: D

Rationale: Upon admission to the nursery, a healthcare provider should expect the newborn's chest circumference to be slightly smaller than the head circumference. This is a normal finding in newborns due to their physiological development. Bulging fontanels (Choice A) can indicate increased intracranial pressure, which is abnormal. Nasal flaring (Choice B) is a sign of respiratory distress and is also an abnormal finding. While a length from head to heel of 40 cm (15.7 in) (Choice C) falls within the normal range for newborns, it is not a specific expectation upon admission to the nursery. Therefore, the correct expectation for a newborn upon admission is for the chest circumference to be slightly smaller than the head circumference.

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. Is a low sperm count or lack of sperm the most common infertility problem in men?

• A. TRUE
• B. FALSE
• C. Rarely
• D. Never

Correct answer: A

Rationale: A low sperm count or lack of sperm is indeed one of the most common causes of infertility in men. Factors such as hormonal imbalances, genetic issues, reproductive anatomy problems, and lifestyle factors can also contribute to male infertility. Choice B is incorrect because a low sperm count is a prevalent issue among men facing infertility, making it a common problem. Choices C and D are incorrect as they do not accurately reflect the prevalence of low sperm count as a cause of infertility in men.

5. A client is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?

• A. Hypotension
• B. Polyuria
• C. Bilateral crackles
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Bilateral crackles. Bilateral crackles indicate respiratory complications, which can occur as an adverse effect of an epidural block with opioid analgesics. Hypotension (Choice A) is a common side effect of epidural opioids but is not typically monitored via crackles. Polyuria (Choice B) is excessive urination and is not directly associated with epidural blocks. Hyperglycemia (Choice D) is high blood sugar levels and is not a typical adverse effect of epidural opioids.

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