ExamPlug

1. Under the 2022 AAP guideline, phototherapy thresholds are determined by: A. The infant's age in hours, gestational age and the presence of neurotoxicity risk factors B. Only the infant's weight C. Only the mother's age D. Only skin color Correct Answer: A. The infant's age in hours, gestational age and the presence of neurotoxicity risk factors Rationale: Hour-specific nomograms adjusted for gestational age and risk factors guide treatment. Weight, maternal age and color a...

1. Central cyanosis in a newborn is: A. Normal for the first week B. Limited to the hands and feet C. Bluish color of the lips, tongue and trunk, indicating low oxygen saturation, and requires immediate evaluation D. Caused by cold hands only Correct Answer: C. Bluish color of the lips, tongue and trunk, indicating low oxygen saturation, and requires immediate evaluation Rationale: Central cyanosis signals hypoxemia from respiratory or cardiac causes. Peripheral cyanosis is limited to e...

1. Transition from fetal to neonatal life is generally completed over: A. The first several hours, with some changes continuing for days to weeks B. The first 5 seconds C. The first year D. It never occurs Correct Answer: A. The first several hours, with some changes continuing for days to weeks Rationale: Major cardiopulmonary changes occur quickly, but shunt closure and metabolic adaptation continue. Transition is not instantaneous or a year long. 2. Stimuli that help initiate the newb...

1. Neonatal hypocalcemia may occur in the first days of life, especially in infants who are: A. Preterm, infants of diabetic mothers or those who had birth asphyxia B. Term breastfed infants with no risk factors C. Over 1 year old D. Postmature only Correct Answer: A. Preterm, infants of diabetic mothers or those who had birth asphyxia Rationale: Abrupt loss of maternal calcium supply and immature parathyroid function contribute. It can cause jitteriness and seizures. 2. Excessive heat f...

1. Fetal pulmonary vascular resistance is high because: A. The lungs are fully aerated B. The foramen ovale is closed C. The fetus breathes air D. The lungs are filled with fluid and the vessels are constricted in a low-oxygen environment Correct Answer: D. The lungs are filled with fluid and the vessels are constricted in a low-oxygen environment Rationale: Fluid-filled, unexpanded lungs and low oxygen keep pulmonary vessels constricted, directing blood through the fetal shunts. Aeratio...

1. In the first Leopold maneuver, a soft, irregular mass in the uterine fundus suggests: A. The fetal head, indicating breech B. The fetal buttocks, indicating a cephalic presentation C. A transverse lie D. Twins Correct Answer: B. The fetal buttocks, indicating a cephalic presentation Rationale: The head feels hard, round and ballotable. A soft, irregular fundal part is typically the breech. 2. A fetus in a persistent occiput posterior (OP) position commonly causes: A. Intense back pai...

1. Fetal factors thought to help trigger labor include: A. Decreased fetal growth only B. Fetal hiccups C. Fetal sleep cycles D. Rising fetal cortisol and placental corticotropin-releasing hormone Correct Answer: D. Rising fetal cortisol and placental corticotropin-releasing hormone Rationale: Placental CRH has been called a placental clock. Hiccups and sleep cycles do not trigger labor. 2. Effacement describes: A. Opening of the cervix in centimeters B. Descent of the fetus C. Membra...

1. Signs of hypovolemic shock in postpartum hemorrhage that may appear late in healthy pregnant patients include: A. Bradycardia first B. Hypertension C. Increased urine output D. Hypotension, because compensation maintains blood pressure until significant loss Correct Answer: D. Hypotension, because compensation maintains blood pressure until significant loss Rationale: Tachycardia is an earlier sign. Shock index helps detect hidden loss. 2. The most common cause of postpartum hemorrha...

1. Signs of impending labor include: A. Decreased Braxton Hicks contractions B. Weight gain of 3 kg in a week C. Bloody show, lightening, a burst of energy and possible rupture of membranes D. Absent fetal movement Correct Answer: C. Bloody show, lightening, a burst of energy and possible rupture of membranes Rationale: Weight often decreases slightly as fluid shifts before labor. Absent fetal movement is a warning sign requiring evaluation. 2. A transverse lie at term in active labor m...

1. The most common and favorable fetal presentation is: A. Frank breech B. Shoulder C. Brow D. Cephalic vertex with the occiput leading Correct Answer: D. Cephalic vertex with the occiput leading Rationale: About 95% of term fetuses present vertex, which provides the smallest diameter through the pelvis. Breech, shoulder and brow presentations increase the risk of complications. 2. Maternal white blood cell count in labor: A. Always falls B. Is unaffected C. May rise to 20,000 to 25,0...

1. Internal rotation during labor allows the fetal head to: A. Be born B. Exit the pelvis without turning C. Return to its original position after birth D. Turn so the sagittal suture aligns with the anteroposterior diameter of the pelvic outlet Correct Answer: D. Turn so the sagittal suture aligns with the anteroposterior diameter of the pelvic outlet Rationale: The outlet's widest diameter is anteroposterior. Restitution, the return to alignment with the shoulders, happens after the...

1. The android pelvis increases the risk of: A. Arrest of descent and persistent occiput posterior positions B. Precipitous birth C. Placenta previa D. Polyhydramnios Correct Answer: A. Arrest of descent and persistent occiput posterior positions Rationale: Its heart-shaped inlet and narrow forepelvis limit space. Placental location and amniotic fluid volume are unrelated to pelvic shape. 2. The false pelvis is located: A. Below the ischial spines B. Above the linea terminalis and supp...

1. Interprofessional collaboration is associated with: A. Worse outcomes B. Improved patient outcomes, fewer errors and greater staff satisfaction C. Increased errors D. Lower satisfaction Correct Answer: B. Improved patient outcomes, fewer errors and greater staff satisfaction Rationale: Evidence links teamwork to quality. Collaboration also reduces burnout. 2. Communication failures have been identified by the Joint Commission as: A. A rare cause of harm B. Unrelated to patient safety...

1. Interprofessional communication competence can be developed through: A. Experience alone without reflection B. Avoiding teams C. Reading only D. Education, simulation, feedback and practice Correct Answer: D. Education, simulation, feedback and practice Rationale: Simulation allows safe practice. Feedback improves skills. 2. The IPEC competency area of Roles and Responsibilities emphasizes: A. Avoiding other professions B. Doing every task oneself C. Following hierarchy without ques...

1. Conflict that is never addressed in a team often leads to: A. Better teamwork B. Resentment, poor communication and safety risks C. Improved outcomes D. Higher trust Correct Answer: B. Resentment, poor communication and safety risks Rationale: Unresolved conflict grows. Timely, constructive resolution is better. 2. Workplace violence from patients or visitors requires: A. Prevention programs, reporting systems and support for staff B. Acceptance as part of the job C. No response D....

1. A communication breakdown that results in a wrong-site surgery is an example of: A. A near miss B. A sentinel event C. A minor error D. A billing error Correct Answer: B. A sentinel event Rationale: Sentinel events cause death or severe harm. Universal Protocol aims to prevent wrong-site surgery. 2. A communication climate where questions are welcomed leads to: A. Less clarity B. More clarification and fewer errors C. More errors D. Lower engagement Correct Answer: B. More clarif...

1. Documentation and verbal communication are complementary because: A. Documentation replaces all conversation B. Verbal communication is never needed C. Documentation provides a record, while verbal communication allows clarification and urgency D. They conflict Correct Answer: C. Documentation provides a record, while verbal communication allows clarification and urgency Rationale: Urgent issues need direct conversation. Records support continuity. 2. Communication accommodation mean...

1. A critical lab value that seems inconsistent with the patient's condition, such as potassium 7.0 in a well-appearing patient, should prompt the nurse to: A. Ignore it B. Treat it without notifying anyone C. Assess the patient, consider specimen problems such as hemolysis and notify the provider promptly D. Wait until morning Correct Answer: C. Assess the patient, consider specimen problems such as hemolysis and notify the provider promptly Rationale: Spurious results occur but mus...

1. Psychological safety in a team, as described by Amy Edmondson, is: A. A locked unit B. A shared belief that it is safe to speak up, ask questions and admit mistakes without fear of punishment C. An absence of all conflict D. Strict hierarchy Correct Answer: B. A shared belief that it is safe to speak up, ask questions and admit mistakes without fear of punishment Rationale: Teams with psychological safety learn and report errors more. Leaders shape it. 2. A CRICO Strategies analysis ...

1. Interprofessional care for older adults is important because: A. Nurses should work alone B. It increases costs only C. Older adults have simple needs D. Geriatric problems are multifactorial and benefit from nursing, medicine, pharmacy and therapy input Correct Answer: D. Geriatric problems are multifactorial and benefit from nursing, medicine, pharmacy and therapy input Rationale: Team care improves outcomes. Falls programs depend on multiple disciplines. 2. Age-related changes in ...