Nursing Elites

1. A nurse concludes that the parent of a newborn is not showing positive indications of parent-infant bonding. The parent appears very anxious and nervous when asked to bring the newborn to the other parent. Which of the following actions should the nurse use to promote parent-infant bonding?

• A. Hand the parent the newborn and suggest that they change the diaper.
• B. Ask the parent why they are so anxious and nervous.
• C. Tell the parent that they will grow accustomed to the newborn.
• D. Provide reinforcement about infant care when the parent is present.

Correct answer: D

Rationale: Providing reinforcement about infant care when the parent is present can help alleviate anxiety and promote positive parent-infant bonding. By offering guidance and support while the parent is interacting with the newborn, the nurse can help build the parent's confidence and strengthen the bond between the parent and the infant. Choice A is not ideal as it does not address the parent's anxiety and may increase stress levels. Choice B focuses on the parent's emotions without providing direct support for bonding. Choice C is dismissive and does not offer practical assistance in fostering bonding between the parent and the infant.

2. A client is learning how to check basal temperature to determine ovulation. When should the client check her temperature?

• A. On days 13 to 17 of her menstrual cycle
• B. Every morning before arising
• C. 1 hour following intercourse
• D. Before going to bed every night

Correct answer: B

Rationale: The basal body temperature should be taken every morning before arising as it provides the most accurate reading. This time ensures consistency and eliminates variations that may occur throughout the day due to activities or environmental factors. Choice A is incorrect because ovulation can vary among individuals, and checking temperature on specific days may not align with the actual ovulation day. Choice C is incorrect as there is no direct correlation between intercourse and basal body temperature. Choice D is incorrect because taking the temperature before going to bed does not provide a consistent baseline reading.

3. A client who is at 24 weeks of gestation is scheduled for a 1-hour glucose tolerance test. Which of the following statements should the nurse include in her teaching?

• A. You will need to drink the glucose solution 1 hour prior to the test.
• B. Limit your carbohydrate intake for 24 hours prior to the test.
• C. A blood glucose of 130 to 140 mg/dL is considered a positive screening result.
• D. You will need to fast for 8 hours prior to the test.

Correct answer: C

Rationale: The correct statement to include in the teaching for a client scheduled for a 1-hour glucose tolerance test at 24 weeks of gestation is that a blood glucose level of 130 to 140 mg/dL is considered a positive screening result. This range indicates a potential issue with glucose metabolism and would prompt the need for a follow-up 3-hour glucose tolerance test to confirm the diagnosis of gestational diabetes mellitus. Choices A, B, and D are incorrect. In a 1-hour glucose tolerance test, the glucose solution is typically consumed within a specific timeframe before the test, not necessarily 1 hour prior. There is usually no specific requirement to limit carbohydrate intake for 24 hours prior to the test. Fasting for 8 hours prior to the test is more common for a fasting glucose test, not a 1-hour glucose tolerance test.

4. A healthcare provider in a clinic is reinforcing teaching with 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. Macrosomic fetus
• D. Neural tube defects

Correct answer: D

Rationale: The correct answer is D: Neural tube defects. Folic acid deficiency during pregnancy can lead to neural tube defects in the fetus, affecting the brain, spine, or spinal cord development. Iron deficiency anemia (choice A) is not directly related to folic acid deficiency. Poor bone formation (choice B) is more associated with calcium and vitamin D deficiencies. Macrosomic fetus (choice C) refers to a baby with excessive birth weight and is not a typical outcome of folic acid deficiency in pregnancy. Therefore, it is crucial for individuals of childbearing age to take recommended folic acid supplements to prevent neural tube defects.

5. A healthcare professional in a provider's office is reviewing the medical record of a client who is in her first trimester of pregnancy. Which of the following findings should the healthcare professional identify as a risk factor for the development of preeclampsia?

• A. Singleton pregnancy
• B. BMI of 20
• C. Maternal age of 32 years
• D. Pregestational diabetes mellitus

Correct answer: D

Rationale: Pregestational diabetes mellitus is a significant risk factor for the development of preeclampsia in pregnant individuals. Preeclampsia is more common in women with preexisting conditions such as diabetes, hypertension, renal disease, lupus, or rheumatoid arthritis. Singleton pregnancy, a BMI of 20, or maternal age of 32 years are not considered significant risk factors for developing preeclampsia.

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