Nursing Elites

1. A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding indicates that preterm labor is occurring?

• A. Estriol is not found in maternal saliva.
• B. Irregular, mild uterine contractions occur every 12 to 15 minutes.
• C. Fetal fibronectin is present in vaginal secretions.
• D. The cervix is effacing and dilated to 2 cm.

Correct answer: D

Rationale: The correct answer is D. Cervical changes such as effacement and dilation to 2 cm are strong indicators of imminent preterm labor. These changes, combined with regular contractions, can signify labor at any gestation. Estriol can be detected in maternal plasma as early as 9 weeks of gestation. Levels of salivary estriol have been linked to preterm birth. Irregular, mild contractions occurring every 12 to 15 minutes without cervical change are generally not concerning. While the presence of fetal fibronectin in vaginal secretions between 24 and 36 weeks of gestation may predict preterm labor, its predictive value is limited (20%-40%). Therefore, cervical changes provide more reliable information regarding the risk of preterm labor.

2. According to a survey by Adhikari and Liu in the year 2013, at birth, women have:

• A. close to 100,000 ova.
• B. around 300,000 to 400,000 ova.
• C. around 100 to 200 ova.
• D. only 500 ova.

Correct answer: B

Rationale: Women are born with approximately 300,000 to 400,000 ova, which gradually decrease in number as they age. Choice A ('close to 100,000 ova.') is incorrect as the actual number is much higher. Choice C ('around 100 to 200 ova.') is incorrect as it underestimates the quantity significantly. Choice D ('only 500 ova.') is incorrect as it greatly underestimates the number of ova present at birth.

3. A client has experienced a fetal demise following a vaginal delivery at term. What should the nurse advise the client?

• A. “You can bathe and dress your baby if you’d like to.”
• B. “If you don’t hold the baby, it will make letting go much harder.”
• C. “You should name the baby so he/she can have an identity.”
• D. “I’m sure you will be able to have another baby when you’re ready.”

Correct answer: A

Rationale: After a fetal demise, allowing the parents to bathe and dress their baby can offer them a sense of closure and help them in their grieving process. This act can provide a tangible way for the parents to bond with their baby and create lasting memories. Option B is incorrect because each individual may have different emotional needs and holding the baby may not be appropriate or helpful for everyone. Option C, while well-intentioned, may not be suitable for all parents as naming the baby could be emotionally challenging. Option D is insensitive as it overlooks the grieving process of losing a baby by suggesting a replacement.

4. What is the typical sex chromosome pattern for males?

• A. XX
• B. XYY
• C. XY
• D. XXY

Correct answer: C

Rationale: The correct answer is C: XY. In males, the typical sex chromosome pattern consists of one X chromosome and one Y chromosome. Choice A (XX) is the sex chromosome pattern for females. Choice B (XYY) is a chromosomal disorder where males have an extra Y chromosome. Choice D (XXY) is the sex chromosome pattern associated with Klinefelter syndrome, a condition where males have an extra X chromosome.

5. A client who delivered a healthy newborn an hour ago asked the nurse when she can go home. Which information is most important for the nurse to provide the client?

• A. After the baby no longer demonstrates acrocyanosis
• B. After the baby receives the vitamin K injection
• C. When ambulating to avoid causing dizziness
• D. When there is no significant vaginal bleeding

Correct answer: D

Rationale: The most critical information for the nurse to provide the client is ensuring that there is no significant vaginal bleeding before discharge. This is vital to prevent complications such as postpartum hemorrhage. Options A, B, and C are important aspects of postpartum care, but assessing and managing vaginal bleeding takes precedence due to its potential seriousness.

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