Nursing Elites

1. What is the most critical action in caring for the newborn immediately after birth?

• A. Keeping the airway clear.
• B. Fostering parent-newborn attachment.
• C. Drying the newborn and wrapping the infant in a blanket.
• D. Administering eye drops and vitamin K.

Correct answer: A

Rationale: The most critical action in caring for the newborn immediately after birth is keeping the airway clear. This is essential to ensure that the newborn can breathe effectively and prevent any respiratory distress. Fostering parent-newborn attachment, although important, is not the most critical action immediately after birth. Drying the newborn and wrapping the infant in a blanket is important for temperature regulation but is not as critical as maintaining a clear airway. Administering eye drops and vitamin K is typically done later and is not the most critical action immediately after birth.

2. A 38-week primigravida is admitted to labor and delivery after a non-reactive result on a non-stress test (NST). The nurse begins a contraction stress test (CST) with an oxytocin infusion. Which finding is most important for the nurse to report to the healthcare provider?

• A. A pattern of fetal late decelerations.
• B. Fetal heart rate accelerations with fetal movement.
• C. Absence of uterine contractions within 20 minutes.
• D. Spontaneous rupture of membranes.

Correct answer: A

Rationale: The correct answer is A: A pattern of fetal late decelerations. Late decelerations during a contraction stress test are concerning as they indicate uteroplacental insufficiency, which can pose a risk to fetal well-being. Reporting this finding to the healthcare provider is crucial for prompt intervention. Choice B, fetal heart rate accelerations with fetal movement, is a reassuring sign of fetal well-being and does not raise immediate concerns. Choice C, absence of uterine contractions within 20 minutes, may require further assessment but is not as critical as late decelerations. Choice D, spontaneous rupture of membranes, is important but not the most immediate concern during a contraction stress test.

3. A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. What is the nurse’s highest priority in this situation?

• A. Prepare the woman for imminent birth.
• B. Notify the woman’s primary healthcare provider.
• C. Document the characteristics of the fluid.
• D. Assess the fetal heart rate (FHR) and pattern.

Correct answer: D

Rationale: The correct answer is to assess the fetal heart rate (FHR) and pattern (Choice D). When a multiparous woman's membranes rupture after 8 hours of labor, the nurse's priority is to assess the fetal well-being. Rupture of membranes can lead to potential complications such as umbilical cord prolapse. Monitoring the fetal heart rate and pattern immediately after the rupture of membranes is crucial to ensure the fetus is not in distress. This assessment helps in determining the need for immediate interventions to safeguard the fetus. Documenting the characteristics of the fluid (Choice C) may be necessary but is of lower priority compared to assessing fetal well-being. While preparing the woman for imminent birth (Choice A) is important, assessing the fetal heart rate takes precedence to ensure the fetus is not compromised. Notifying the woman's primary healthcare provider (Choice B) is also important but not the highest priority at this moment.

4. A prenatal educator is teaching a class about false labor. Which of the following information should the educator include?

• A. Contractions will become more intense with walking
• B. There will be dilation and effacement of the cervix
• C. There will be bloody show
• D. Contractions will become temporarily regular

Correct answer: D

Rationale: The correct answer is D. False labor contractions, also known as Braxton Hicks contractions, are typically irregular and do not lead to cervical dilation or effacement. They are often described as sporadic and temporary, becoming temporarily regular. Choices A, B, and C are incorrect because false labor contractions do not intensify with activity, do not cause cervical changes like dilation and effacement, and are not associated with the presence of a bloody show.

5. Before meiosis, a sperm cell:

• A. contains 46 chromosomes.
• B. contains two X chromosomes.
• C. is significantly larger than an egg cell.
• D. contains both an X and a Y chromosome.

Correct answer: A

Rationale: Before meiosis, a sperm cell contains 46 chromosomes. This is because sperm cells, like other somatic cells, have a diploid number of chromosomes. During meiosis, the number of chromosomes is halved to 23 to combine with an egg cell during fertilization. Choice B is incorrect because a sperm cell carries either an X or a Y chromosome, not both (Choice D). Choice C is incorrect as sperm cells are generally smaller than egg cells, which is an adaptation that aids in motility and penetration of the egg during fertilization.

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