Nursing Elites

1. A newborn is 24 hours old, and a healthcare provider is caring for them. Which of the following laboratory findings should the healthcare provider report to the provider?

• A. Hgb 20 g/dL
• B. Bilirubin 2 mg/dL
• C. Platelets 200,000/mm3
• D. WBC count 32,000/mm3

Correct answer: D

Rationale: The correct answer is D: WBC count 32,000/mm3. A WBC count of 32,000/mm3 is significantly elevated in a newborn and could indicate an infection, which needs immediate attention and intervention. High white blood cell counts in newborns can be concerning as they may suggest an ongoing infection or other underlying issues that require prompt medical evaluation and treatment. Choices A, B, and C are within normal ranges for a newborn and would not typically warrant immediate reporting to the provider. Hgb levels of 20 g/dL (Choice A) are high for newborns, but this is not as concerning as a significantly elevated WBC count. Bilirubin levels of 2 mg/dL (Choice B) are within normal limits for a newborn and do not indicate immediate issues. Platelet count of 200,000/mm3 (Choice C) is also within the normal range for a newborn and would not require immediate reporting.

2. Which of the following is a fatal genetic neurologic disorder whose onset is in middle age?

• A. Tay-Sachs disease
• B. Duchenne muscular dystrophy
• C. Hemophilia
• D. Huntington’s disease

Correct answer: D

Rationale: Huntington's disease is a fatal genetic neurologic disorder characterized by progressive nerve cell degeneration in the brain. It typically manifests in middle age with symptoms such as involuntary movements, cognitive decline, and psychiatric disturbances. Tay-Sachs disease (Choice A) is a genetic disorder that primarily affects the nervous system in early childhood, not middle age. Duchenne muscular dystrophy (Choice B) is a genetic disorder that primarily affects muscle function and usually presents in early childhood. Hemophilia (Choice C) is a genetic disorder related to blood clotting, and its onset is not typically in middle age.

3. 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.

4. A charge nurse is teaching a group of staff nurses about fetal monitoring during labor. Which of the following findings should the charge nurse instruct the staff members to report to the provider?

• A. Contraction durations of 95 to 100 seconds
• B. Contraction frequency of 2 to 3 minutes apart
• C. Absent early deceleration of fetal heart rate
• D. Fetal heart rate is 140/min

Correct answer: A

Rationale: The correct answer is A. Contraction durations of 95 to 100 seconds are prolonged, indicating uterine hyperstimulation, which can lead to fetal distress and requires immediate intervention. Reporting this finding to the provider is crucial to ensure timely management and prevent adverse outcomes. Choice B, contraction frequency of 2 to 3 minutes apart, is within the normal range and does not raise immediate concerns. Choice C, absent early deceleration of fetal heart rate, is a reassuring finding suggesting fetal well-being. Choice D, a fetal heart rate of 140/min, is also normal for a fetus and does not typically require immediate reporting unless it deviates significantly from the baseline or is accompanied by other concerning signs.

5. A client is experiencing preterm labor and has a prescription for 4 doses of dexamethasone 6 mg IM every 12 hours. The available concentration is dexamethasone 10 mg/mL. How many mL of dexamethasone should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use trailing zero.)

• A. 0.6 mL
• B. ---
• C. ---
• D. ---

Correct answer: A

Rationale: Calculation: (6 mg/dose) / (10 mg/mL) = 0.6 mL per dose. The correct answer is 0.6 mL. This calculation is obtained by dividing the dose needed (6 mg) by the concentration available (10 mg/mL). The resulting value is 0.6 mL per dose. Choices B, C, and D are not applicable as the correct answer has been calculated accurately.

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