Nursing Elites

1. During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination, you advised her against a home delivery. Which of the following findings disqualifies her for a home delivery?

• A. Her OB score is G5P3
• B. She has some palmar pallor
• C. Her blood pressure is 130/80
• D. Her baby is in cephalic presentation

Correct answer: A

Rationale: The correct answer is A. An OB score of G5P3 indicates that the client has had five pregnancies and three live births, making her ineligible for a home delivery. Typically, women with fewer pregnancies are considered better candidates for home deliveries due to lower risks. Additionally, primigravidas are usually advised to deliver at a medical facility for their first pregnancy.

2. Why is a primigravida instructed to offer her breast to the baby for the first time within 30 minutes after delivery?

• A. To initiate the occurrence of milk letdown
• B. To stimulate milk production by the mammary acini
• C. To provide the baby with colostrum
• D. To allow the mother to practice breastfeeding in the presence of healthcare providers

Correct answer: C

Rationale: Offering the breast to the baby early after delivery ensures that the baby receives colostrum, the initial milk produced by the mammary glands rich in antibodies and essential nutrients, which are crucial for the newborn's health and immune system. This early breastfeeding also helps establish the mother-infant bond and promotes successful breastfeeding in the long term.

3. The number of cases of Dengue fever usually increases towards the end of the rainy season. This pattern of occurrence of Dengue fever is best described as:

• A. Epidemic occurrence
• B. Cyclical variation
• C. Sporadic occurrence
• D. Secular occurrence

Correct answer: B

Rationale: Cyclical variation best describes the periodic fluctuation in the number of Dengue fever cases in the community, typically increasing towards the end of the rainy season and then decreasing during drier periods. This pattern suggests a recurring cycle rather than a sudden outbreak (epidemic), random occurrence (sporadic), or gradual long-term change (secular occurrence).

4. Which of the following diseases is targeted for eradication through the Expanded Program on Immunization (EPI)?

• A. Hepatitis B
• B. Diphtheria
• C. Poliomyelitis
• D. Tuberculosis

Correct answer: C

Rationale: Poliomyelitis is the correct answer as it is one of the diseases targeted for eradication through the Expanded Program on Immunization (EPI). The EPI aims to control and eliminate vaccine-preventable diseases globally, with a specific focus on polio due to its severe consequences and the feasibility of eradication through vaccination campaigns.

5. When preparing a primigravida for breastfeeding, which of the following will you do?

• A. Explain that lactation usually begins 1 to 3 days after delivery
• B. Teach her nipple stretching exercises if her nipples are flat or inverted
• C. Advise against washing her nipples excessively before and after each breastfeeding
• D. Inform her that putting the baby to breast can help reduce post-delivery blood loss

Correct answer: D

Rationale: Putting the baby to breast can help reduce post-delivery blood loss as suckling stimulates the release of oxytocin, causing uterine contractions. Lactation typically starts 1 to 3 days after delivery, not immediately. Nipple stretching exercises are recommended for flat or inverted nipples, not everted ones. Excessive washing of the nipples can dry them out, increasing the risk of fissures.

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