Nursing Elites

1. 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.

2. When should a nurse on a labor and delivery unit instruct a newly licensed nurse to don gloves for a procedure?

• A. Assisting a mother with breastfeeding
• B. Performing a newborn's initial bath
• C. Administering the measles, mumps, rubella vaccine
• D. Performing umbilical cord care

Correct answer: B

Rationale: The correct answer is B: Performing a newborn's initial bath. Gloves should be worn during this procedure to protect against exposure to body fluids, such as amniotic fluid or blood. Assisting a mother with breastfeeding (Choice A) does not typically require gloves unless there are specific reasons for infection control. Administering vaccines (Choice C) and performing umbilical cord care (Choice D) are procedures that may require hand hygiene but not necessarily gloves, unless there is active bleeding or potential exposure to body fluids. The initial bath involves direct contact with body fluids, making it crucial to wear gloves for protection.

3. Four clients at full term present to the labor and delivery unit at the same time. Which client should a nurse assess first?

• A. Multipara with contractions occurring every three minutes
• B. Multipara scheduled for non-stress test and biophysical profile
• C. Primipara with vaginal show and leaking membranes
• D. Primipara with burning on urination and urinary frequency

Correct answer: C

Rationale: A primipara with vaginal show and leaking membranes requires immediate assessment as she may be in active labor or at risk of infection. The vaginal show and leaking membranes suggest potential rupture of membranes and the start of labor. Assessing her first ensures prompt management and monitoring. The other options, while important, do not indicate immediate or emergent needs. Contractions every three minutes in a multipara can be managed with ongoing monitoring; non-stress tests and biophysical profiles can be scheduled and are not acute needs. Burning on urination and urinary frequency in a primipara may indicate a urinary tract infection, which is important but not as urgent as assessing for active labor or rupture of membranes.

4. Females with Turner syndrome:

• A. possess more thymine than cytosine.
• B. are taller than average.
• C. produce little estrogen.
• D. are more likely to give birth to twins.

Correct answer: C

Rationale: Turner syndrome is a chromosomal disorder in females characterized by short stature and underdeveloped ovaries, resulting in low estrogen production. This leads to symptoms such as delayed puberty and infertility. Choice A is incorrect because the chromosomal abnormality in Turner syndrome does not affect the thymine-cytosine ratio. Choice B is incorrect as females with Turner syndrome are typically shorter than average. Choice D is incorrect as Turner syndrome does not increase the likelihood of giving birth to twins.

5. When assessing a woman in the first stage of labor, which clinical finding will alert the nurse that uterine contractions are effective?

• A. Dilation of the cervix.
• B. Descent of the fetus to –2 station.
• C. Rupture of the amniotic membranes.
• D. Increase in bloody show.

Correct answer: A

Rationale: During the first stage of labor, effective uterine contractions lead to cervical dilation. Dilation of the cervix is a key indicator that uterine contractions are progressing labor. Descent of the fetus to -2 station (Choice B) is related to the fetal position in the pelvis and not a direct indicator of uterine contraction effectiveness. Rupture of the amniotic membranes (Choice C) signifies the rupture of the fluid-filled sac surrounding the fetus and does not directly reflect uterine contraction effectiveness. An increase in bloody show (Choice D) can be a sign of impending labor, but it is not a direct indicator of uterine contraction effectiveness.

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