Nursing Elites

1. What is the most critical physiological change required of newborns at birth?

• A. Transition from fetal to neonatal breathing
• B. Body temperature maintenance
• C. Stabilization of fluid and electrolytes
• D. Closure of fetal shunts in the heart

Correct answer: A

Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The most critical physiological change required of newborns at birth is the initiation of breathing. This transition is crucial for the newborn to start exchanging oxygen and carbon dioxide outside the womb, marking the beginning of their independent respiratory function. Choices B, C, and D are important aspects of newborn care but are not as immediately critical as the establishment of breathing for oxygenation and removal of carbon dioxide, which is essential for the newborn's survival and adaptation to extrauterine life.

2. The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?

• A. Advise bed rest until 1 week after the icteric phase.
• B. Teach infection control measures to family members.
• C. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
• D. Reassure the mother that hepatitis A cannot be transmitted to other family members.

Correct answer: B

Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.

3. Which sign is indicative of developmental dysplasia of the hip in infants?

• A. Ortolani sign
• B. Romberg sign
• C. Trendelenburg sign
• D. Gower's sign

Correct answer: A

Rationale: The Ortolani sign is a specific maneuver used during physical examination to detect hip instability or dislocation in infants. A positive Ortolani sign, where the hip is felt to slip back into the socket, is indicative of developmental dysplasia of the hip, a condition that can lead to long-term disability if not treated early. Romberg sign is used to assess sensory ataxia, Trendelenburg sign indicates weakness of the hip abductor muscles, and Gower's sign is seen in children with proximal muscle weakness climbing up their own body from a supine position due to conditions like muscular dystrophy.

4. The nurse is caring for an adolescent who is overweight. Which of the following psychological effects of being overweight during adolescence will the nurse consider when planning care for the adolescent?

• A. Poor body image
• B. Sexual promiscuity
• C. Feelings of contempt for thin peers
• D. Lack of independence

Correct answer: A

Rationale: Adolescents who are overweight often struggle with poor body image, which can lead to low self-esteem and mental health issues. Addressing body image concerns and promoting healthy lifestyle changes are important aspects of care. Choices B, C, and D are incorrect. Sexual promiscuity is not a direct psychological effect of being overweight; feelings of contempt for thin peers are not a common or recommended psychological response; lack of independence is a broad term that does not specifically relate to the psychological effects of being overweight.

5. Apgar scoring is conducted at 1 minute and 5 minutes after birth. It is used to determine:

• A. Major body systems’ responses at birth
• B. Future intelligence of the newborn
• C. Level of parent and newborn interaction
• D. Gestational age of the newborn

Correct answer: A

Rationale: The Apgar score assesses a newborn's physical condition immediately after birth by evaluating heart rate, respiratory effort, muscle tone, reflex response, and color. Therefore, the correct answer is A. The other choices are incorrect because B) the Apgar score does not predict future intelligence, C) it does not measure parent and newborn interaction, and D) it is not used to determine gestational age.

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