Nursing Elites

1. Four clients at full term present to the labor and delivery unit at the same time. Which client should a nurse assess first?

• A. Multipara with contractions occurring every three minutes
• B. Multipara scheduled for non-stress test and biophysical profile
• C. Primipara with vaginal show and leaking membranes
• D. Primipara with burning on urination and urinary frequency

Correct answer: C

Rationale: A primipara with vaginal show and leaking membranes requires immediate assessment as she may be in active labor or at risk of infection. The vaginal show and leaking membranes suggest potential rupture of membranes and the start of labor. Assessing her first ensures prompt management and monitoring. The other options, while important, do not indicate immediate or emergent needs. Contractions every three minutes in a multipara can be managed with ongoing monitoring; non-stress tests and biophysical profiles can be scheduled and are not acute needs. Burning on urination and urinary frequency in a primipara may indicate a urinary tract infection, which is important but not as urgent as assessing for active labor or rupture of membranes.

2. Which neonatal complications are associated with hypertension in the mother?

• A. Intrauterine growth restriction (IUGR) and prematurity.
• B. Seizures and cerebral hemorrhage.
• C. Hepatic or renal dysfunction.
• D. Placental abruption and DIC.

Correct answer: A

Rationale: Neonatal complications associated with maternal hypertension are primarily due to placental insufficiency. The correct answer is A, which includes Intrauterine Growth Restriction (IUGR) and prematurity. These complications arise from inadequate blood flow to the fetus, leading to growth restriction and premature birth. Choices B, seizures, and cerebral hemorrhage are more commonly maternal complications rather than neonatal ones. Choice C, hepatic or renal dysfunction, pertains to maternal complications of hypertensive disorders in pregnancy, not neonatal issues. Choice D, placental abruption, and Disseminated Intravascular Coagulation (DIC) are conditions linked to maternal morbidity and mortality, not neonatal complications.

3. 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.

4. A 16-year-old gravida 1 para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She's not presently convulsing. Which intervention should the nurse plan to include in this client's nursing care plan?

• A. Allow liberal family visitation
• B. Keep an airway at the bedside
• C. Assess temperature every hour
• D. Monitor blood pressure, pulse, and respiration every 4 hours

Correct answer: B

Rationale: Keeping an airway at the bedside is crucial for a client with eclampsia, as there is a high risk of seizures that can obstruct the airway. Allowing liberal family visitation (choice A) may not be a priority at this time and can be overwhelming for the client. Assessing temperature every hour (choice C) is not directly related to managing eclampsia. Monitoring blood pressure, pulse, and respiration every 4 hours (choice D) is important but not as immediate as ensuring airway patency.

5. Which of the following statements is true of mutations?

• A. Mutations can only occur by chance.
• B. Mutations produce sperm and ova cells.
• C. Mutations occur through radiation or other environmental influences.
• D. Mutations help adenine combine with guanine to form the single spiral structure of DNA.

Correct answer: C

Rationale: The correct answer is C. Mutations can occur due to environmental influences such as radiation, chemicals, or other external factors, leading to changes in the DNA sequence. Choice A is incorrect because mutations can also occur due to errors in DNA replication, not solely by chance. Choice B is incorrect as mutations affect the DNA sequence itself, not the production of specific cells. Choice D is incorrect because mutations involve changes in the DNA sequence and do not specifically involve the formation of the DNA structure.

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