Nursing Elites

1. A laboring client is experiencing late decelerations. Which position should she be placed in?

• A. left lateral
• B. lithotomy
• C. semi-Fowler's
• D. right lateral

Correct answer: A

Rationale: The correct answer is the left lateral position. Placing the laboring client in the left lateral position is beneficial because it promotes blood flow to the placenta. Late decelerations indicate potential issues with fetal oxygenation, and changing the position to left lateral can help improve placental perfusion. Choices B, C, and D are incorrect because lithotomy, semi-Fowler's, and right lateral positions do not specifically address the need for improved blood flow to the placenta in cases of late decelerations.

2. When a couple experiencing infertility presents for a fertility workup, which of the following procedures should the nurse prepare the couple to have first?

• A. Hysterosalpingography
• B. Semen analysis
• C. Endometrial biopsy
• D. Transvaginal ultrasound

Correct answer: B

Rationale: Semen analysis is the most appropriate initial diagnostic test for a couple experiencing infertility. It is the least invasive of the listed tests, and since male factor infertility contributes to around 35% of cases, assessing semen parameters early is crucial. Hysterosalpingography is a radiographic test to evaluate tubal patency and uterine cavity abnormalities. Endometrial biopsy assesses endometrial receptivity post-ovulation. Transvaginal ultrasound is mainly used in infertility treatment to monitor follicle development, oocyte maturity, and luteal phase defects. Choices A, C, and D are more invasive, require specialized expertise, and are costlier. If semen analysis yields normal results, further tests may be warranted.

3. What type of immunity do vaccines provide?

• A. active
• B. passive
• C. transplacental
• D. active and passive

Correct answer: A

Rationale: Vaccines provide active immunity by stimulating the immune system to produce antibodies against specific pathogens. Choice B, passive immunity, is acquired from ready-made antibodies, not through vaccination. Choice C, transplacental immunity, is a form of passive immunity transferred from mother to infant, not acquired through vaccines. Therefore, the correct answer is active immunity.

4. While assisting with data collection on a client, a nurse hears a bruit over the abdominal aorta. What action should the nurse prioritize based on this finding?

• A. Document the finding
• B. Palpate the area for a mass
• C. Notify the healthcare provider
• D. Percuss the abdomen to check for tympany

Correct answer: C

Rationale: Detection of a bruit over the aorta during abdominal assessment may indicate the presence of an aneurysm. The nurse's priority action should be to notify the healthcare provider to further evaluate the situation. Palpating the area or percussing the abdomen could potentially increase the risk of an aneurysm rupture. While documenting the finding is important, the priority is to ensure timely intervention by involving the healthcare provider.

5. The nurse is assessing an 18-month-old. Which of these statements made by the parent or caregiver would require follow-up?

• A. I'm worried that my child is not using two-word phrases yet.
• B. My child has recently taken a few steps but does not seem stable when standing.
• C. My child seems to have developed separation anxiety when I leave.
• D. I'm letting my child use a spoon to eat.

Correct answer: B

Rationale: The correct answer is 'My child has recently taken a few steps but does not seem stable when standing.' By 18 months of age, children should have taken their first steps and stand well. If a child hasn't made progress by this age, a physical therapy evaluation may be necessary. It is normal for an 18-month-old to start using a spoon to eat. However, the use of two-word phrases is not typically expected until 2 years of age. Separation anxiety is a common developmental phase that typically occurs between 6 and 18 months, so it does not require immediate follow-up. Therefore, the statement about the child not being stable when standing raises a red flag and necessitates further evaluation.

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