Nursing Elites

1. 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.

2. Which of the following statements about Rh incompatibility is true?

• A. Rh incompatibility occurs most commonly during a woman’s first pregnancy.
• B. Rh incompatibility is an untreatable condition that leaves a woman infertile for the rest of her life.
• C. Rh incompatibility is an abnormality that is transmitted from generation to generation and carried by a sex chromosome.
• D. Rh incompatibility occurs due to antibodies transmitted to a fetus during subsequent deliveries causing brain damage or death.

Correct answer: D

Rationale: Rh incompatibility occurs when the mother's antibodies attack the fetus's red blood cells, leading to serious complications, usually in subsequent pregnancies. Choice A is incorrect because Rh incompatibility often occurs in subsequent pregnancies, not necessarily the first one. Choice B is incorrect as Rh incompatibility does not render a woman infertile but can lead to complications during pregnancies. Choice C is incorrect as Rh incompatibility is not carried by a sex chromosome but involves the Rh factor on red blood cells.

3. _________ are problems that stem from the interaction of heredity and environmental factors.

• A. Multifactorial problems
• B. Cognitive problems
• C. Horizon problems
• D. Coronal problems

Correct answer: A

Rationale: Multifactorial problems are conditions that result from the interplay of genetic and environmental factors. These conditions, such as diabetes or heart disease, are not solely determined by genetics or environment but are influenced by a combination of both factors. Choice B, cognitive problems, refers to difficulties related to thinking, learning, and memory and are not specifically linked to genetic and environmental interactions. Choices C and D, horizon problems and coronal problems, are nonsensical terms and do not relate to the interaction of heredity and environmental factors.

4. According to a study in 2013 by van Gameren-Oosterom, individuals with Down syndrome:

• A. are unlikely to die from cardiovascular problems by middle age.
• B. have no specific characteristic features.
• C. show deficits in cognitive development.
• D. are likely to have only 46 chromosomes.

Correct answer: C

Rationale: The correct answer is C. According to a study in 2013 by van Gameren-Oosterom, individuals with Down syndrome often exhibit deficits in cognitive development. This is a common characteristic of Down syndrome, along with other health challenges. Choice A is incorrect because individuals with Down syndrome are at a higher risk of cardiovascular problems, contrary to being unlikely to die from them. Choice B is incorrect as Down syndrome is associated with specific characteristic features such as distinctive facial characteristics, making the statement that they have no specific features incorrect. Choice D is incorrect as individuals with Down syndrome have an extra copy of chromosome 21, resulting in a total of 47 chromosomes, not 46.

5. The nurse has received a report regarding a client in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment?

• A. Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm above the ischial spines.
• B. Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines.
• C. Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm below the ischial spines.
• D. Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm below the ischial spines.

Correct answer: B

Rationale: The correct interpretation of the assessment provided is that the cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines. In the given assessment, the measurements are ordered as dilation, effacement, and station. Choice A is incorrect as it wrongly places the presenting part below the ischial spines. Choice C is incorrect because it places the presenting part below the ischial spines. Choice D is also incorrect as it incorrectly states that the presenting part is below the ischial spines, even though it correctly mentions the dilation and effacement of the cervix.

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