Nursing Elites

1. A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea, fatigue, and a moist cough. Which question is most important for the LPN/LVN to ask this client?

• A. Which symptom did you experience first?
• B. Are you consuming large amounts of salty foods?
• C. Have you traveled to a foreign country recently?
• D. Do you have a history of rheumatic fever?

Correct answer: D

Rationale: The correct answer is D. Rheumatic fever can lead to rheumatic heart disease, which may be exacerbated during pregnancy, causing symptoms like pedal edema and dyspnea. Asking about a history of rheumatic fever is crucial in this case to assess the potential impact on the client's current symptoms. Choices A, B, and C are less relevant in this scenario as they do not directly relate to the presenting symptoms and history of rheumatic fever.

2. A father watching the admission of his newborn to the nursery notices that eye ointment is placed in the infant's eyes. He asks what is the purpose of the ointment. The nurse would be correct in stating that the purpose of the ointment is:

• A. Prevent eye infection.
• B. Dilate the pupil so the red reflex can be visualized.
• C. Clear the infant's vision.
• D. Prevent herpes infection.

Correct answer: A

Rationale: The correct answer is A: Prevent eye infection. Eye ointment, usually containing erythromycin, is applied to prevent neonatal conjunctivitis, which can be caused by bacteria present in the birth canal. It is not used to dilate the pupil, clear the infant's vision, or prevent herpes infection.

3. A child with glomerulonephritis is asking for strawberries. What should the nurse do?

• A. Allow the child to eat strawberries.
• B. Restrict the child's diet.
• C. Give the child a low-protein diet.
• D. Increase the child's fluid intake.

Correct answer: B

Rationale: In glomerulonephritis, it is crucial to restrict the child's diet, particularly avoiding foods high in potassium like strawberries. Potassium restriction is essential because impaired kidney function in glomerulonephritis can lead to potassium retention, potentially causing hyperkalemia. Therefore, the nurse should restrict the child's diet to manage their condition effectively.

4. In which chromosome pattern is Duchenne disease inherited?

• A. Autosomal dominant
• B. Autosomal recessive
• C. X-linked recessive
• D. Mitochondrial

Correct answer: C

Rationale: Duchenne disease is caused by a mutation in the DMD gene located on the X chromosome, leading to an X-linked recessive inheritance pattern. Males are typically affected by this disorder as they have only one X chromosome, while females are carriers with one normal and one affected X chromosome.

5. In planning care for a client at 30-weeks gestation experiencing preterm labor, what maternal prescription is most important in preventing this fetus from developing respiratory syndrome?

• A. Betamethasone (Celestone) 12mg deep IM.
• B. Butorphanol 1mg IV push q2h PRN pain.
• C. Ampicillin 1g IV push q8h.
• D. Terbutaline (Brethine) 0.25mg subcutaneously q15 minutes x3.

Correct answer: A

Rationale: The administration of Betamethasone (Celestone) is crucial in cases of preterm labor to promote fetal lung maturation and reduce the risk of respiratory distress syndrome in the newborn. Betamethasone helps enhance the production of surfactant in the fetal lungs, improving their functionality and decreasing the likelihood of respiratory complications upon birth. Butorphanol is an analgesic and not indicated for preventing respiratory syndrome in preterm infants. Ampicillin is an antibiotic used for infection prevention and treatment, not for fetal lung maturation. Terbutaline is a tocolytic agent used to inhibit contractions, but it does not have a direct effect on fetal lung maturity.

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