Nursing Elites

1. When assessing a newborn infant with low set ears, short palpebral fissures, flat nasal bridge, and an indistinct philtrum, a priority maternal assessment by the nurse should be to ask about

• A. Alcohol use during pregnancy
• B. Usual nutritional intake
• C. Family genetic disorders
• D. Maternal and paternal ages

Correct answer: A

Rationale: The correct answer is A: Alcohol use during pregnancy. The physical features mentioned are indicative of fetal alcohol syndrome, a condition caused by maternal alcohol consumption during pregnancy. It is crucial for the nurse to inquire about alcohol use as it can help in diagnosing and managing the infant's condition. Choices B, C, and D are incorrect as they are not directly associated with the physical findings described in the newborn, which specifically point towards a potential history of alcohol exposure during pregnancy.

2. Which of the following is a key component of community-based participatory research?

• A. Conducting research in a laboratory setting
• B. Involving community members in the research process
• C. Focusing solely on quantitative data
• D. Ignoring community input

Correct answer: B

Rationale: The correct answer is B: 'Involving community members in the research process.' Community-based participatory research emphasizes the active involvement of community members in all aspects of the research process, from identifying research questions to interpreting and disseminating results. Choice A is incorrect because community-based participatory research typically takes place in real-world settings, not in laboratories. Choice C is incorrect because community-based participatory research values a mix of quantitative and qualitative data. Choice D is incorrect because community input is essential in this research approach.

3. During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy. The client's last child has a history of low-birth-weight (LBW). Which additional finding is most important for the nurse to consider?

• A. Cigarette smoking.
• B. African American ethnicity.
• C. Poor nutritional status.
• D. Limited maternal education.

Correct answer: A

Rationale: The correct answer is A: Cigarette smoking. Cigarette smoking is a significant risk factor for low birth weight. Smoking during pregnancy reduces the amount of oxygen available to the baby, leading to LBW. Choice B, African American ethnicity, while it may be a risk factor, is not as directly linked to LBW as cigarette smoking. Choice C, poor nutritional status, can contribute to LBW but is not as significant as cigarette smoking in this case. Choice D, limited maternal education, is an important social determinant of health but is not as directly related to LBW as cigarette smoking.

4. You attended a home delivery with the Rural Health midwife. The newborn is premature. Which of the following should be included in premature infant care at home?

• A. establishing and maintaining good respiration
• B. proper management of feeding
• C. minimum handling of the baby
• D. regulation of body temperature

Correct answer: D

Rationale: Corrected Rationale: Regulation of body temperature is crucial for the survival of a premature infant. Premature infants have difficulty regulating their body temperature, making it essential to keep them warm. While establishing and maintaining good respiration and proper feeding management are important aspects of infant care, they are not as critical as regulating body temperature for premature infants. Additionally, while minimizing handling to reduce stress can be beneficial, it is not as vital as temperature regulation for premature infants.

5. The nurse is caring for an acutely ill 10-year-old client. Which of the following assessments would require the nurse's immediate attention?

• A. Rapid bounding pulse
• B. Temperature of 38.5 degrees Celsius
• C. Profuse diaphoresis
• D. Slow, irregular respirations

Correct answer: D

Rationale: The correct answer is D, slow, irregular respirations. In an acutely ill child, this assessment can indicate impending respiratory failure or neurological compromise, necessitating immediate intervention. Rapid bounding pulse (choice A) may indicate tachycardia but is not as immediately concerning as compromised respirations. A temperature of 38.5 degrees Celsius (choice B) is elevated but may not be the most urgent concern unless accompanied by other symptoms. Profuse diaphoresis (choice C) can indicate increased sympathetic activity but is not as critical as respiratory compromise.

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