Nursing Elites

1. When should a provider order a maternal serum alpha-fetoprotein (MSAFP) screening for pregnant clients?

• A. A client who has mitral valve prolapse
• B. A client who has been exposed to AIDS
• C. All pregnant clients
• D. A client who has a history of preterm labor

Correct answer: C

Rationale: Maternal serum alpha-fetoprotein (MSAFP) screening is recommended for all pregnant clients to assess the risk of neural tube defects. It is a routine screening test used to detect increased levels of alpha-fetoprotein in maternal blood, which may indicate a higher risk for conditions such as neural tube defects in the developing fetus. Therefore, all pregnant clients, regardless of their medical history or risk factors, should undergo MSAFP screening as part of routine prenatal care. Choices A, B, and D are incorrect because the MSAFP screening is not specific to certain medical conditions or histories; it is a standard screening procedure for all pregnant individuals to evaluate neural tube defect risk in the fetus.

2. A nurse is assisting the nurse manager with an educational session about ways to prevent TORCH infections during pregnancy with a group of newly licensed nurses. Which of the following statements by one of the session participants indicates understanding?

• A. Seeking an immunization against rubella early in pregnancy.
• B. Receiving prophylactic treatment for cytomegalovirus if detected during pregnancy.
• C. Clients should avoid crowded places during pregnancy.
• D. Clients should avoid consuming undercooked meat while pregnant.

Correct answer: D

Rationale: The correct answer is D. To prevent TORCH infections during pregnancy, it is essential for clients to avoid consuming undercooked meat, as it can be a potential source of toxoplasmosis. This infection, along with others in the TORCH group, can pose risks to the fetus, making it crucial for pregnant individuals to follow proper food safety practices. Choices A, B, and C are incorrect because seeking an immunization against rubella, receiving prophylactic treatment for cytomegalovirus, and avoiding crowded places are not directly related to preventing TORCH infections through food safety measures.

3. A client at 32 weeks of gestation with placenta previa is actively bleeding. Which medication should the provider likely prescribe?

• A. Betamethasone
• B. Indomethacin
• C. Nifedipine
• D. Methylergonovine

Correct answer: A

Rationale: In cases of placenta previa with active bleeding at 32 weeks of gestation, Betamethasone is prescribed to accelerate fetal lung maturity in anticipation of potential preterm delivery. This medication helps in reducing the risk of respiratory distress syndrome in the newborn, which is crucial in managing such high-risk pregnancies. Indomethacin is a nonsteroidal anti-inflammatory drug not indicated in this scenario and may be contraindicated due to its effects on platelet function and potential risk of bleeding. Nifedipine is a calcium channel blocker used for conditions like preterm labor or hypertension, not specifically for placenta previa with active bleeding. Methylergonovine is a uterotonic drug used to prevent or control postpartum hemorrhage, not indicated for placenta previa with active bleeding.

4. A client is in labor and reports increasing rectal pressure. She is experiencing contractions 2 to 3 minutes apart, each lasting 80 to 90 seconds, and a vaginal examination reveals that her cervix is dilated to 9 cm. The client is in which of the following phases of labor?

• A. Active
• B. Transition
• C. Latent
• D. Descent

Correct answer: B

Rationale: The client is in the transition phase of labor, characterized by cervical dilatation of 8 to 10 cm and contractions every 2 to 3 minutes, each lasting 45 to 90 seconds. In this phase, the cervix is nearly fully dilated, preparing the client for the pushing stage. The active phase of labor typically involves cervical dilatation from 4 to 7 cm, whereas the latent phase is the early phase of labor when the cervix dilates from 0 to 3 cm. Descent is not a phase of labor but rather refers to the movement of the fetus through the birth canal during the second stage of labor.

5. A nurse is teaching clients in a prenatal class about the importance of taking folic acid during pregnancy. The nurse should instruct the clients to consume an adequate amount of folic acid from various sources to prevent which of the following fetal abnormalities?

• A. Neural tube defect
• B. Trisomy 21
• C. Cleft lip
• D. Atrial septal defect

Correct answer: A

Rationale: The nurse should educate clients that inadequate folic acid intake is associated with an increased risk of neural tube defects in newborns. Consuming an adequate amount of folic acid from sources like fortified cereals, oranges, artichokes, liver, broccoli, and asparagus can help prevent this serious fetal abnormality. Trisomy 21 (Choice B) is caused by an extra chromosome 21 and is not preventable by folic acid intake. Cleft lip (Choice C) and atrial septal defect (Choice D) are not directly linked to folic acid intake during pregnancy.

Similar Questions