Nursing Elites

1. A client tells the nurse that she thinks she's pregnant. Which signs or symptoms provide the best indication that the client is pregnant?

• A. Morning sickness.
• B. Breast tenderness.
• C. Amenorrhea.
• D. Hegar's sign.

Correct answer: D

Rationale: Hegar's sign, which is a softening of the lower uterine segment, is considered a probable sign of pregnancy as it indicates changes in the cervix and uterus that occur during pregnancy. Amenorrhea, the absence of menstruation, is a common early sign of pregnancy but can also be due to other factors. Morning sickness, nausea and vomiting, can be a sign of early pregnancy but is not as specific as Hegar's sign. Breast tenderness is a common symptom in early pregnancy due to hormonal changes, but it is not as definitive as Hegar's sign in indicating pregnancy.

2. A healthcare provider is assessing a newborn immediately following a vaginal birth. For which of the following findings should the provider intervene?

• A. Molding
• B. Vernix Caseosa
• C. Acrocyanosis
• D. Sternal retractions

Correct answer: D

Rationale: Sternal retractions in a newborn indicate respiratory distress and require immediate intervention. This finding suggests the newborn is having difficulty breathing and needs prompt attention to ensure adequate oxygenation. Molding, the overlapping of fetal skull bones during birth, is a normal and expected process that does not require intervention. Vernix Caseosa, the protective white substance on the skin, and Acrocyanosis, the bluish discoloration of extremities, are both common and benign findings in newborns that do not necessitate immediate action. Therefore, the healthcare provider should focus on addressing sternal retractions to manage the respiratory distress effectively.

3. A client in labor requests nonpharmacological pain management. Which of the following nursing actions promotes client comfort?

• A. Assisting the client into a squatting position
• B. Having the client lie in a supine position
• C. Applying fundal pressure during contractions
• D. Encouraging the client to void every 6 hours

Correct answer: A

Rationale: Assisting the client into a squatting position promotes comfort during labor. This position can help relieve pain by utilizing gravity, allowing the pelvic outlet to widen, and potentially facilitating the progress of labor. Lying in a supine position (Choice B) can hinder labor progression and increase discomfort. Applying fundal pressure (Choice C) can be inappropriate and may cause harm as it is not routinely recommended during labor. Encouraging the client to void every 6 hours (Choice D) is important for bladder management but does not directly address pain relief during labor.

4. Jill bears the genetic code for Von Willebrand disease, but she has never developed the illness herself. Jill would be considered:

• A. a carrier of the recessive gene that causes the disease.
• B. susceptible to the disease after adolescence.
• C. an acceptor of the recessive gene that causes the disease.
• D. susceptible to the disease in late adulthood.

Correct answer: A

Rationale: Jill is a carrier of the recessive gene for Von Willebrand disease. Being a carrier means that she has one copy of the gene but does not show symptoms of the disease. Carriers can pass on the gene to their offspring. Choice B is incorrect as being a carrier does not mean she is susceptible to developing the disease after adolescence. Choice C is incorrect as 'acceptor' is not a term used in genetics in this context. Choice D is incorrect as susceptibility to the disease is not related to late adulthood in carriers of a recessive gene.

5. Are babies with fetal alcohol syndrome (FAS) often larger than normal, and so are their brains?

• A. TRUE
• B. FALSE
• C. Sometimes
• D. Always

Correct answer: B

Rationale: The correct answer is B: FALSE. Babies with fetal alcohol syndrome (FAS) are typically smaller than normal, with smaller brains and developmental issues. Choice A is incorrect because babies with FAS are not larger than normal. Choice C is incorrect as it does not accurately reflect the typical characteristics of babies with FAS. Choice D is incorrect as babies with FAS are not always larger than normal.

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