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Fluid and Electrolyte Balance: Multiple Choice Questions and Answers, Quizzes of Nursing

A series of multiple choice questions and answers related to fluid and electrolyte balance, covering topics such as hypovolemia, hypervolemia, electrolyte imbalances, and glucose regulation. It provides a valuable resource for students studying nursing or related healthcare fields, offering a comprehensive assessment of their understanding of these essential concepts.

Typology: Quizzes

2023/2024

Uploaded on 10/30/2024

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laura-alsleben 🇺🇸

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Fluid and Electrolyte (15 Questions on Test)
Fluid Imbalance
1. A nurse is performing an assessment on a client who has hypovolemia due to vomiting
and diarrhea. The nurse should expect which of the following findings? (Select all that
apply)
a. Hyperthermia
b. Bradycardia
c. Orthostatic hypotension
d. Tachycardia (Distended neck veins)
e. Decreased skin turgor
2. The nurse is reviewing the data on the client who has hypovolemia. The nurse should
identify which of the following findings is a manifestation of hypovolemia? (Select all
that apply)
a. Increased Hct
b. Increased blood pressure
c. Decreased urine output
d. Urine specific gravity
e. Increased sodium level
3. The nurse is planning care for the client who is admitted to an acute care facility with
dehydration. What actions should the nurse include in the plan? (All these are in order)
a. Monitor vital signs
b. Administer oxygen as prescribed
c. Check labs
Urinalysis
CBC
Electrolytes
d. Alert provider if urine output is less than 30 mL/hr
e. Weight daily & at same time
f. Observe for nausea and vomiting
g. B/P assessment for postural hypotension
h. Encourage client to change positions slowly, use call light, ask for assistance
i. Check neurologic status
j. Observe level of gain stability
k. Check heart rhythm
l. Maintain IV access
m. Provide oral & IV rehydration therapy as prescribed
n. Encourage fluids as tolerated
4. A nurse is teaching a class about fluid imbalances. Sort the following manifestations into
either hypovolemia or hypervolemia.
a. Breath sounds with crackles
b. Weight gain
c. Decreased urine specific gravity
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Fluid and Electrolyte (15 Questions on Test)

Fluid Imbalance

  1. A nurse is performing an assessment on a client who has hypovolemia due to vomiting and diarrhea. The nurse should expect which of the following findings? (Select all that apply) a. Hyperthermia b. Bradycardia c. Orthostatic hypotension d. Tachycardia (Distended neck veins) e. Decreased skin turgor
  2. The nurse is reviewing the data on the client who has hypovolemia. The nurse should identify which of the following findings is a manifestation of hypovolemia? (Select all that apply) a. Increased Hct b. Increased blood pressure c. Decreased urine output d. Urine specific gravity e. Increased sodium level
  3. The nurse is planning care for the client who is admitted to an acute care facility with dehydration. What actions should the nurse include in the plan? (All these are in order) a. Monitor vital signs b. Administer oxygen as prescribed c. Check labs  Urinalysis  CBC  Electrolytes d. Alert provider if urine output is less than 30 mL/hr e. Weight daily & at same time f. Observe for nausea and vomiting g. B/P assessment for postural hypotension h. Encourage client to change positions slowly, use call light, ask for assistance i. Check neurologic status j. Observe level of gain stability k. Check heart rhythm l. Maintain IV access m. Provide oral & IV rehydration therapy as prescribed n. Encourage fluids as tolerated
  4. A nurse is teaching a class about fluid imbalances. Sort the following manifestations into either hypovolemia or hypervolemia. a. Breath sounds with crackles b. Weight gain c. Decreased urine specific gravity

d. Flat neck vein e. Sunken eyeballs

  1. A nurse on a medical-surgical unit is caring for a group of clients. The nurse should identify that which of the following clients is at risk for hypovolemia? a. A client who has nasogastric suctioning b. A client who has chronic constipation c. A client who has syndrome of inappropriate antidiuretic hormone d. A client who took a toxic dose of sodium bicarbonate antacids
  2. A nurse is planning care for a client who has hypernatremia. Which of the following actions should the nurse anticipate including in the plan of care? a. Implement a fluid restriction b. Infuse hypotonic IV fluids c. Increase sodium intake d. Administer sodium polystyrene sulfonate (Kayexalate)
  3. A charge nurse is leading a staff education session about caring for a client who has hypocalcemia. Which of the following statements by a staff nurse indicates the need for further teaching? a. "I should monitor for hand spasms during blood pressure cuff inflation." b. "Clients who have a vitamin D deficiency are at risk for hypocalcemia." c. "Clients who have hypocalcemia are at risk for pathologic fractures." d. "I should implement seizure precautions for a client who has hypocalcemia."
  4. A nurse on a medical-surgical unit is caring for a group of clients. For which of the following clients should the nurse expect a prescription for fluid restriction? a. A client who has a new diagnosis of adrenal insufficiency b. A client who has heart failure c. A client who is receiving treatment for diabetic ketoacidosis d. A client who has abdominal ascites Electrolyte imbalance
  5. The nurse is caring for a client who has a positive Chvostek’s sign. The nurse should identify that this finding is a manifestation of which of the following electrolyte imbalances? (Select all that apply) a. Hypocalcemia b. Hypomagnesemia c. Hypernatremia d. Hypernatremia e. Hyperkalemia
  1. A nurse is teaching a class about electrolyte imbalances. Match the electrolyte imbalance to the clinical manifestation. A. Hypocalcemia 1. Dry swollen tongue B. Hypomagnesemi a 2. Hypertension C. Hypernatremia 3. Tingling around mouth D. Hyperkalemia 4. Muscle weakness Fluid & Electrolyte Answer Key
  2. B, C, E
  3. A, C, E
  4. Skip
  5. Hyper-A, B, C, ; Hypo-D, E
  6. A
  7. B
  8. C
  9. B Electrolytes
  10. A, B
  11. Skip
  1. Skip
  2. A-1, B-4, C-2, D-
  3. A, B, C
  4. A-3, B-2, C-1, D-

Nutrition – Glucose Regulation (8 Questions on Test)

Nutrition

  1. A nurse is preparing a presentation about basic nutrients for a group of high school athletes. The nurse should include that which of the following provides the body with the most energy? a. Fat b. Protein c. Glycogen d. Carbohydrates *
  2. A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include? (Select all that apply) a. Older are more prone to dehydration than younger adults * b. The recommended intake of daily fiber decreases in older adults * c. Many older adults need calcium supplementation * d. Older adults need more calcium than they did when they were younger e. Older adults should consume a diet low in carbohydrates
  3. A nurse is caring for a client who weighs 80kg (176lbs) and is 1.6m (5ft 3in) tall. Calculate the body mass index (BMI) and determine whether this client’s BMI is: a. A healthy weight b. Underweight c. Overweight d. Obese * i. 31.25 BMI
  4. A nurse is caring for a client who is at high risk for aspiration. Which of the following actions should the nurse take? a. Giving the client thin liquids b. Instructing the client to tuck their chin when swallowing * c. Having the client use a straw d. Encouraging the client to lie down and rest after meals

b. Antiseptic cleaner * c. Reagent strips * d. Reusable lancet e. Cotton balls *

  1. Which of the following statements by Mrs. Lewis indicates an understanding of the blood glucose testing process? a. “I will check my blood sugar as soon as I finish my breakfast in the mornings” b. “I will wash my hands with soap and water before checking my blood sugar” * c. “I will plan to monitor my blood sugar weekly” d. “I will use the tip of my finger when testing my blood sugar”
  2. The nurse is evaluating their discussion regarding nonnutritive sweetener. The nurse identifies the client understands the teaching when they select which of the following choices of sweeteners to use? a. Sucrose b. Aspartame * c. Mannitol d. Xylitol e. Sucralose *
  3. The nurse is reinforcing dietary teaching with the client. Which of the following information should the nurse include? a. Carbohydrates counting is vital to the meal planning approach * b. Use hydrogenated oils for cooking c. Choose whole grains for choices of fiber * d. Never estimate portion sizes, always have an exact measuring tool *
  4. The nurse is reviewing the teaching session with the client. Which of the following client statements indicates understanding? a. “I will avoid having snacks” b. “I can’t eat anything containing sugar” c. “I will eat a variety of different foods to get my daily carbohydrates” * d. “I will not eat more than 2,800mg of sodium a day” 10.A nurse is assessing a client who has hypoglycemia. Which of the following findings should the nurse expect? a. Fruity breath odor b. Diaphoresis c. Ketones in urine * d. Polyuria 11.A nurse is caring for a client who has diabetes mellitus and reports feeling shaky and weak. The client’s blood glucose is 53 mg/dL. Which of the following actions should the nurse take? a. Provide subcutaneous insulin for the client b. Offer the client 120 mL (4oz) fruit juice * c. Give the client IV potassium d. Administer IV sodium bicarbonate

Elimination, Sleep, & Rest (7 Questions on Test)

Urine Elimination

  1. A nurse is teaching a client who has recurrent UTI’s. Which of the following instructions should the nurse include? (Select all that apply) a. Urinate after sexual intercourse* b. Drink at least 1L a fluid each day c. Clean peritoneum from the front to back* d. Wear nylon undergarments e. Avoid bubble baths*
  2. a nurse is teaching a newly licensed nurse about urine specimen collection. Match the following tests to the procedure. A. Random urinalysis 1. Collect urine for a 24-hour period B. Clean-catch midstream for culture and sensitivity (C&S) 2. Obtain a non-sterile urine specimen C. Timed urine specimen 3. Obtain A sterile urine specimen from an indwelling urinary catheter D. Catheter urine specimen for C&S 4. Clean the urethral meatus prior to obtaining the urine specimen A-2, B-4, C-1, D-
  3. This is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take? (Select all that apply) a. Empty the client’s urinary drainage bag when it is 3/4 full b. Keep the urinary drainage bag below the level of the client's bladder* c. Assess the clients need for the indwelling urinary catheter daily* d. Rest the urinary collection bag on the floor when the client is sitting in the chair e. Maintain a closed system of the client’s urinary catheter*
  4. A nurse is teaching a client who reports stress urinary incontinence. Which of the following instructions should the nurse include? (Select all that apply) a. Maintain adequate fluid intake b. Empty the bladder completely with each void c. Avoid bladder irritants (alcohol and caffeine) d. Preform pelvic muscle exercises (Kegel) 3 to 4 times each day (all are correct)
  5. A nurse is preparing to initiate a bladder retaining program for a client who has urge incontinence. Which of the following actions should the nurse take? (Select all that apply) a. Restrict the client’s intake of fluid during the daytime b. Have the client record urination times * c. Gradually increase the time of the client’s urination intervals * d. Remind the client to hold urine until the next scheduled urination time *

a. Cognitive restoration occurs (REM) b. Light sleep (NREM) c. 75% of time sleeping (NREM) d. Loss of muscle tonal curves (REM) e. Vivid dreams occur (REM)

  1. A nurse in an acute care facility is caring for a client who is having difficulty sleeping at night. What action should the nurse take to promote sleep? a. Provide a quiet hospital environment b. Limit waking the client during the night c. Soothing back rub d. Assisting client with regular bedtime routine (all are correct)
  2. A nurse is assessing a client who reports insomnia. Which of the following findings can contribute to the client’s insomnia? (Select all that apply) a. Irregular schedule * b. Stress * c. Warm bath d. Alcohol intake * e. Morning walk
  3. The nurse is educating the client about ways to improve sleep. Which of the following recommendations should the nurse include? (Select all that apply) a. Practice muscle relaxation techniques * b. Exercise each morning * c. Take two 30-minute naps each day d. Avoid heavy meals before bed * e. Limit fluid intake at least 1 hour before bedtime
  4. A nurse is instructing a client who has narcolepsy. Which of the following client statements indicates an understanding of the instructions? a. “I will add plenty of carbohydrates to my meal” b. “I will take a short nap when I feel sleepy” * c. “I will increase my heat in my office, so I stay warm” d. “I will limit alcohol intake to 1 drink per day”

Maternal Child (10 Questions on Test)

Identify options for family planning

  1. A nurse is performing a health assessment for a client who has been unable to conceive for 16 months. The nurse should recognize that which of the following are findings the nurse should report to the provider? (Select all that apply) a. Age greater than 30 b. Abnormal uterine contours * c. History of STI's * d. Tobacco use * e. Nutritional deficiencies
  1. A nurse is preparing to discuss assistive management options with a couple who has infertility. Match the assistive management procedure to information that the nurse should discuss. A. In vitro fertilization embryo transfer (IVF- ET) 1. Procedure used to place prepared sperm in the uterus at the time of ovulation B. Intrauterine insemination 2. A couple completes a process of IVF with the embryo placed in another person who will carry the pregnancy. This is a contract agreement with the carrier having no genetic investment with the embryo. C. Donor oocyte 3. Donated eggs are collected by a donor by an IVF procedure. The eggs are inseminated. The embryos are placed in the recipients uterus. Prior to implantation the recipient undergoes hormonal therapy to prepare the uterus. D. Gestational carrier (embryo host) 4. Procedure of collecting the clients eggs from the ovaries fertilizing the eggs in the laboratory with sperm and transferring the embryo to the uterus. E. Surrogate 5. A person is inseminated with sperm and carries the fetus until birth. A-4, B-1, C-3, D-2, E- Identify physiology changes in the maternal system during pregnancy

3. A nurse is discussing signs of pregnancy with a newly licensed nurse. Sort the following findings the

nurse should include into Presumptive, Probable, and Positive signs of pregnancy.

a. Hegar’s sign (probable)

b. Fetal movement (positive)

c. Positive pregnancy test (probably)

d. Amenorrhea (presumptive)

4. A nurse is caring for a client who is pregnant and states that their last menstrual period was

September 9th. What is the client’s estimated date of delivery?

a.

5. Sort the following items into psychological changes of Endocrine, Renal, and Musculoskeletal.

a. Large amounts of hCG (endocrine)

b. Pelvic joint relax (musculoskeletal)

12.A nurse in a prenatal clinic is caring for 4 clients. Which of the following clients’ weight gain should the nurse report to the provider? a. 1.8kg (4lb) weight gain and is in the 1st^ trimester b. 3.6kg (8lb) weight gain and is in the 1st^ trimester * c. 6.8kg (15lb) weight gain and is in the 2nd^ trimester d. 11.3kg (25lb) weight gain and is in the 3rd^ trimester 13.A nurse is discussing with a client who is 6 weeks gestation food sources high is dietary content for folate and iron. Sort the below food source to the appropriate nutrient. a. Beef liver (Iron) b. Leafy vegetables (Folate) c. Orange juice (Folate) d. Poultry (Iron)

14. A nurse in a clinic is teaching a client of childbearing age about recommended folic acid

supplements. Which of the following defects can occur in the fetus or neonate as a result of folic

acid deficiency?

a. Iron deficiency anemia

b. poor bone formation

c. abnormal fetal growth

d. natural tube defects *

15. A nurse in a prenatal clinic is providing education to a client who is 8 weeks of gestation. The client

states I don't like milk. Which of the following foods should the nurse recommend as a good source

of calcium?

a. Dark green leafy vegetables *

b. deep red and orange vegetables

c. white breads and rice

d. meat, poultry, and fish

Evidence-based practice for maternal / child assessments and care

16. A nurse is reviewing findings of a client’s biophysical profile (BPP). The nurse should expect which of

the following variables to be included in this test? (Select all that apply)

a. Fetal weight

b. Fetal breathing movement *

c. Fetal tone *

d. Fetal position

e. Amniotic fluid *

17.A nurse is caring for a client who is pregnant and undergoing a nonstress test. The client asks why

the nurse is using an acoustic vibration device. Which of the following responses should the nurse

make?

a. It is used to stimulate uterine contractions

b. It will decrease the incidence of uterine contractions

c. It lulls the fetus to sleep

d. It awakens a sleeping fetus *

18. A nurse is caring for a client who is pregnant and is to undergo a contraction stress test (CST). Which

of the following findings are indications for this procedure? (Select all that apply)

a. Decreased fetal movement *

b. Intrauterine growth restriction (IUGR) *

c. Postmaturity *

d. Placenta previa

e. Amniotic fluid emboli

19. A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the

following statements should the nurse include in the teaching?

a. You will lay on your right side during the procedure

b. You should not eat anything for 24 hours prior to the procedure

c. You should empty your bladder prior to the procedure *

d. The test is done to determine gestational age.

20. A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis.

The nurse should evaluate which of the following tests to assess fetal lung maturity?

a. Alpha-fetoprotein (AFP)

b. Lecithin/sphingomyelin (L/S) ratio *

c. Kleihauer-Betke test

d. Indirect Coombs test

21. A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided

lower quadrant abdominal pain and bright red vaginal bleeding. The client states “I missed one

menstrual cycle and cannot be pregnant because I have an intrauterine device”. The nurse should

suspect which of the following?

a. Missed abortion

b. Ectopic pregnancy *

c. Severe preeclampsia

d. Hydatidiform mole

22. A nurse is caring for a client who is experiencing a ruptured ectopic pregnancy. Which of the

following findings is expected with the condition?

a. No alteration in menses

b. Transvaginal ultrasound indicating a fetus in the uterus

c. Blood progesterone greater than the expected reference range

d. Report of severe shoulder pain *

variability. There is no slowing of the FHR from the baseline. This client is exhibiting manifestations

of which of the following? (Select all that apply)

a. Moderate variability *

b. FHR accelerations *

c. FHR decelerations

d. Normal baseline FRH *

e. Fetal tachycardia

29. A nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal

monitor. Which of the following is the first action the nurse should take?

a. Assist the client into the left-lateral position *

b. Apply a fetal scalp electrode

c. Insert an IV catheter

d. Perform a vaginal exam

30. A nurse is teaching a client about the benefits of internal fetal heart monitoring. Which of the

following statements should the nurse include? (Select all that apply)

a. It is considered a noninvasive procedure

b. It can detect abnormal fetal heart rate tones early *

c. It can determine that amount of amniotic fluid you have

d. It allows for accurate readings with maternal movement *

e. It can measure uterine contraction intensity *

31. A nurse is planning care for a newly admitted client who reports “I am in labor, and I have been

having vaginal bleeding for 2 weeks”. Which of the following should the nurse include in the plan of

care?

a. Inspect the introitus for a prolapsed cord

b. Perform a test to identify the ferning pattern

c. Monitor station of the presenting part

d. Defer vaginal examinations *

32. A nurse is caring for a client who is in the first stage of labor and is encouraging the client to void

every 2 hours. Which of the following statements should the nurse make?

a. A full bladder increases the risk for fetal trauma

b. A full bladder increases the risk for bladder infections

c. A distended bladder will be traumatized by frequent pelvic exams

d. A distended bladder reduces pelvis space needed for birth *

33. A nurse is caring for a client and partner during the second stage of labor. The client’s partner asks

the nurse to explain how to know when crowning occurs. Which of the following responses should

the nurse make?

a. The placenta will protrude from the vagina

b. Your partner will report a decrease in the intensity of contractions

c. The vaginal area will bulge as the baby’s head appears *

d. Your partner will report less rectal pressure

34. A nurse is caring for a client in the third stage of labor. Which of the following findings indicate

placental separation? (Select all that apply)

a. Lengthening of the umbilical cord

b. Swift gush of clear amniotic fluid *

c. Softening of the lower uterine segment

d. Appearance of dark blood from the vagina *

e. Fundus firm upon palpation *

35. A nurse is caring for a newborn who was born at 38 weeks of gestation, weighs 3,200 g, and is in the

60 th^ percentile for weight. Based on the weight and gestational age, the nurse should classify this

neonate as which of the following?

a. Low birth weight

b. Appropriate for gestational age *

c. Small for gestational age

d. Large for gestational age

36. A nurse is assessing the heart rate of a newborn immediately following birth. Auscultate the heart

rate using your stethoscope on the apex of the newborn’s heart

a. Apex *

b. Tricuspid

c. Pulmonic

d. Aortic

37. A nurse is completing an assessment. Which of the following data indicates the newborn is adapting

to extrauterine life? (Select all that apply)

a. Expiratory grunting

b. Inspiratory nasal flaring

c. Apnea for 10-seconds periods *

d. Crackles and wheezing *

38. A nurse is teaching a newly licensed nurse how to bathe a newborn and observes a bluish brown

marking across the newborn’s lower back. The nurse should include which of the following

information in the teaching?

a. This is more commonly seen in newborns who have dark skin *

b. This is a finding indicating hyperbilirubinemia

c. This is a forceps mark from an operative delivery

d. This is related to prolonged birth or trauma during delivery

39. A nurse is completing a newborn assessment and observes small pearly white nodules on the roof of

the newborn’s mouth. This finding is a characteristic of which of the following conditions?

45. A nurse is preparing to administer a vitamin K (phytonadione) injection to a newborn. What

explanation should the nurse give for why this medication is given?

a. It assists with blood clotting. Vitamin K is deficient in a newborn because the colon is sterile.

Until bacteria are present to stimulate vitamin K production, the newborn is at risk for

hemorrhagic disease.

46. A nurse is reviewing breastfeeding positions with the parent of a newborn. Which of the following

positions should the nurse discuss?

a. Over-the-shoulder

b. Supine

c. Chin-supported

d. Cradle *

47. A nurse is giving instructions to a parent about how to breastfeed their newborn. Which of the

following actions by the parent indicates understanding of the teaching?

a. The parent places a few drops of water on their nipple before feeding

b. The parent gently removes their nipple from the infant’s mouth to break the suction

c. When they are ready to breastfeed, the parent gently strokes the newborn’s neck with a

finger

d. When latched on, the infant’s nose, cheek, and chin are touching the breast *

48. A nurse is teaching a group of new parents about proper techniques for bottle feeding. Which of the

following instructions should the nurse provide?

a. Burp the newborn at the end of the feeding

b. Hold the newborn close in the supine position

c. Keep the nipple full of formula throughout the feeding *

d. Refrigerate any unused formula

49. A nurse is reviewing formula preparation with parents who plan to bottle-feed their newborn. Which

of the following information should the nurse include in the teaching? (Select all that apply)

a. Use a disinfectant wipe to clean the lip of the formula can

b. Store prepared formula in the refrigerator for up to 72 hours

c. Place used bottles in the dishwasher *

d. Check the nipple for appropriate flow of formula *

e. Use tap water to dilute concentrated formula *

50. A nurse is caring for a newborn. Which of the following actions by the newborn indicates readiness

to feed?

a. Spits up clear mucus

b. Attempts to place their hand in their mouth *

c. Turns the head toward sounds

d. Lies quietly with their eyes open

51. A nurse is providing discharge teaching to the parents of a newborn regarding circumcision care.

Which of the following statements made by a parent indicates an understanding of the teaching?

a. The circumcision will heal within a couple of days

b. I should remove the yellow mucus that will form

c. I will clean the penis with each diaper change *

d. I will give him a tub bath within a couple of days

52. A nurse is reviewing care of the umbilical cord with the parent of a newborn. Which of the following

instructions should the nurse include in the teaching?

a. Cover the cord with a small gauze square

b. Trickle clean water over the cord with each diaper change

c. Apply hydrogen peroxide to the cord twice a day

d. Keep the diaper folded below the cord *

53. As a nurse what are strategies that you could instruct the parents of a newborn about home safety?

a.

54. A nurse is reviewing car seat safety with the parents of a newborn. Which of the following

instructions should the nurse include in the teaching regarding car seat position?

a. Front seat, rear facing

b. front seat, forward facing

c. back seat, rear facing *

d. back seat, forward facing

55. A nurse is conducting an in service for newly licensed nurse about neonatal optimal withdraw

syndrome (NOWS) in newborns. Which of the following statements by a newly licensed nurse

indicates an understanding of the teaching?

a. The newborn will have decreased muscle tone

b. the newborn will have a continuous high-pitched cry *

c. the newborn will sleep for 2 to 3 hours after a feeding

d. the newborn will have mild tremors when disturbed

56. A nurse is caring for a newborn who is preterm and has respiratory distress syndrome. Which of the

following should the nurse monitor to evaluate the newborns condition following administration of

synthetic surfactant?

a.

57. A nurse is caring for a newborn who was born at 32 weeks of gestation the newborns birth weight is

1,100 g. Which of the following are expected findings in this newborn? (Select all that apply)

a. Lanugo *

b. long nails

c. weak grasp reflex *