Nursing Elites

1. A caregiver is learning about newborn safety. Which of the following statements by a parent indicates an understanding of the teaching?

• A. I will dress my baby in flame-retardant clothing.
• B. I will ensure a bib on my baby at night to keep her clothing dry.
• C. I will warm my baby's formula using the lowest setting in the microwave.
• D. I will cover the crib mattress with plastic to prevent staining.

Correct answer: A

Rationale: The correct answer is A. Dressing a baby in flame-retardant clothing is crucial to prevent injuries, especially in case of accidental exposure to fire sources. This safety measure can provide an added layer of protection for the newborn. The other options do not directly address newborn safety concerns or best practices. Option B focuses on keeping clothing dry, which is not a primary safety concern. Option C poses a risk of overheating the formula, which can be dangerous for the baby. Option D, covering the crib mattress with plastic, may pose a suffocation hazard to the baby.

2. A healthcare professional is assessing a late preterm newborn. Which of the following clinical manifestations is an indication of hypoglycemia?

• A. Hypertonia
• B. Increased feeding
• C. Hyperthermia
• D. Respiratory distress

Correct answer: D

Rationale: The correct answer is D, respiratory distress, as it is a clinical manifestation of hypoglycemia in newborns. Other signs of hypoglycemia include an abnormal cry, jitteriness, lethargy, poor feeding, apnea, and seizures. Hypertonia, increased feeding, and hyperthermia are not typically associated with hypoglycemia in newborns. Hypertonia is more indicative of neurological issues, increased feeding is not a common sign of hypoglycemia, and hyperthermia is not a typical symptom of low blood sugar.

3. During a teaching session with a client in labor, a nurse is explaining episiotomy. Which of the following information should the nurse include?

• A. An episiotomy is a perineal incision made by the provider to facilitate delivery of the fetus
• B. A fourth-degree episiotomy extends into the rectal area and is not recommended
• C. An episiotomy is an incision made by the provider to facilitate delivery of the fetus
• D. A mediolateral episiotomy is preferred over a median episiotomy for most deliveries

Correct answer: C

Rationale: The correct answer is C because an episiotomy is an intentional incision made by the healthcare provider to widen the vaginal opening during delivery. This procedure is performed to facilitate the birth of the baby and prevent uncontrolled tearing of the perineum. It is important for the nurse to educate the client on the purpose and implications of episiotomy to ensure informed decision-making and proper postpartum care. Choice A is incorrect because an episiotomy is not a perineal tear but a deliberate incision. Choice B is incorrect because a fourth-degree episiotomy extending into the rectal area is not a standard practice and can lead to complications. Choice D is incorrect because a mediolateral episiotomy is not universally considered easier to repair than a median episiotomy; the choice of incision type depends on the healthcare provider's preference and clinical situation.

4. A client is scheduled for a cesarean birth based on fetal lung maturity. Which finding indicates that the fetal lungs are mature?

• A. Absence of Phosphatidylglycerol (PG)
• B. Biophysical profile score of 8
• C. Lecithin/sphingomyelin (L/S) ratio of 2:1
• D. Reactive nonstress test

Correct answer: C

Rationale: An L/S ratio of 2:1 indicates fetal lung maturity, as it signifies the presence of surfactant in the amniotic fluid, which helps with lung expansion and prevents collapse at the end of expiration. The absence of PG indicates immaturity of the fetal lungs, as PG appears in the amniotic fluid during the later stages of lung maturation. Biophysical profile scores and nonstress tests are assessments of fetal well-being and do not directly indicate fetal lung maturity. Therefore, choice C is the correct answer.

5. A client at 42 weeks of gestation is having an ultrasound. For which of the following conditions should the nurse prepare for an amnioinfusion? (Select all that apply)

• A. Oligohydramnios
• B. Hydramnios
• C. Fetal cord compression
• D. Polyhydramnios

Correct answer: A

Rationale: In this scenario, the correct answer is "Oligohydramnios". Oligohydramnios, which refers to low amniotic fluid volume, may necessitate amnioinfusion to address the deficiency. Fetal cord compression is another indication for amnioinfusion as it can help alleviate pressure on the umbilical cord. Hydramnios or polyhydramnios, conversely, involve an excess of amniotic fluid and do not typically require amnioinfusion. Therefore, choices B, C, and D are incorrect in this context.

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