Nursing Elites

1. A healthcare provider is reinforcing teaching with a client about a new prescription for medroxyprogesterone. Which of the following information should the provider include in the teaching? (Select all that apply)

• A. Weight fluctuations can occur.
• B. Irregular vaginal spotting can occur.
• C. You should increase your intake of calcium.
• D. All of the above

Correct answer: D

Rationale: When educating a client about medroxyprogesterone, it is important to include information about potential side effects and recommendations. Weight fluctuations and irregular vaginal spotting are common side effects of medroxyprogesterone. Additionally, increasing calcium intake is often advised to counteract the potential bone density loss associated with this medication. Therefore, all the statements provided are correct, making option D the correct answer. Choices A, B, and C are all essential pieces of information that the healthcare provider should convey to the client regarding medroxyprogesterone.

2. A healthcare professional is assisting with the care for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this 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

Correct answer: D

Rationale: Severe shoulder pain is a common finding in clients with a ruptured ectopic pregnancy due to referred pain from diaphragmatic irritation caused by blood in the abdominal cavity. This pain is known as Kehr's sign and is often experienced in the shoulder due to irritation of the phrenic nerve. Choices A, B, and C are incorrect. A ruptured ectopic pregnancy typically presents with symptoms such as abdominal pain, vaginal bleeding, and signs of shock, rather than no alteration in menses, a fetus in the uterus, or elevated blood progesterone levels.

3. When reinforcing discharge teaching to the parents of a newborn regarding circumcision care, which statement made by a parent indicates an understanding of the teaching?

• A. The circumcision will heal within a couple of days.
• B. I should not 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.

Correct answer: C

Rationale: The correct answer is C because cleaning the penis with each diaper change is essential for preventing infection and promoting healing after circumcision. This practice helps maintain good hygiene and reduces the risk of complications. Removing the yellow mucus or giving a tub bath too soon can interfere with the healing process and increase the likelihood of infection. Choice A is incorrect because circumcision healing usually takes about a week or more, not just a couple of days. Choice B is incorrect because parents should gently clean the area, including removing any discharge or debris as part of proper care. Choice D is incorrect because tub baths should be avoided until the circumcision is fully healed to prevent infection.

4. A client who is at 36 weeks of gestation and has a prescription for a nonstress test is being taught by a nurse. Which of the following statements should the nurse include in the teaching?

• A. You will receive IV fluid before this test.
• B. The procedure will take approximately 10 to 15 minutes.
• C. You will be offered orange juice to drink during the test.
• D. You will need to sign an informed consent form before each test.

Correct answer: C

Rationale: The correct statement the nurse should include in the teaching is that the client will be offered orange juice to drink during the nonstress test. This is because offering the client orange juice, or another beverage high in glucose, will help stimulate the fetus during the procedure, aiding in obtaining accurate results. Choice A is incorrect because IV fluid is not typically administered before a nonstress test. Choice B is incorrect as the procedure usually takes around 20 to 40 minutes. Choice D is incorrect as informed consent is typically obtained once for the procedure, not before each individual test.

5. A healthcare professional is providing information to a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the healthcare professional include? (Select all that apply)

• A. Avoid any lifting
• B. Perform Kegel exercises twice a day
• C. Perform the pelvic rock exercise every day
• D. Avoid standing for prolonged periods

Correct answer: C

Rationale: Performing the pelvic rock exercise daily can help relieve backache during pregnancy by strengthening the back and abdominal muscles, providing support to the spine. This exercise is beneficial in maintaining proper posture and reducing strain on the back. Avoiding standing for prolonged periods can also help alleviate backache by reducing pressure on the spine and supporting muscles. Kegel exercises primarily focus on strengthening the pelvic floor muscles and may not directly help with backache during pregnancy. Avoiding any lifting is overly restrictive and not necessary, as long as proper lifting techniques are followed.

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