Nursing Elites

1. A woman in a women's health clinic is receiving teaching about nutritional intake during her 8th week of gestation. The healthcare provider should advise the woman to increase her daily intake of which of the following nutrients?

• A. Calcium
• B. Vitamin E
• C. Iron
• D. Vitamin D

Correct answer: C

Rationale: During pregnancy, the recommended daily iron intake is higher compared to non-pregnant women. Pregnant women should aim for 27 mg/day of iron, while non-pregnant women require 15 mg/day if under 19 years old and 18 mg/day if between 19 and 50 years old. Iron is essential during pregnancy to support the increased blood volume and ensure the proper oxygen supply to the fetus. Calcium is important for bone health but does not need a significant increase during early pregnancy. Vitamin E and Vitamin D are important but do not have specific increases recommended during the 8th week of gestation.

2. A newborn is small for gestational age (SGA). Which of the following findings is associated with this condition?

• A. Moist skin
• B. Protruding abdomen
• C. Gray umbilical cord
• D. Wide skull sutures

Correct answer: D

Rationale: Wide skull sutures are a common finding in newborns who are small for gestational age (SGA) due to reduced intrauterine growth. This occurs because the skull bones do not grow at the same rate as the brain, leading to wider sutures. Moist skin, a protruding abdomen, and a gray umbilical cord are not typically associated with being small for gestational age.

3. A client reports unrelieved episiotomy pain 8 hours following a vaginal birth. Which of the following actions should the nurse take?

• A. Apply an ice pack to the affected area.
• B. Offer a warm sitz bath.
• C. Provide a squeeze bottle of antiseptic solution.
• D. Place a hot pack on the perineum.

Correct answer: A

Rationale: The correct answer is to apply an ice pack to the affected area. Ice packs help reduce swelling, inflammation, and provide pain relief post-episiotomy. Applying heat, as in a hot pack or warm sitz bath, can increase swelling and discomfort. Providing antiseptic solution in a squeeze bottle is not the first-line intervention for managing episiotomy pain, as the priority is pain relief and comfort.

4. A healthcare professional is assessing a newborn immediately following a scheduled cesarean delivery. Which of the following assessments is the healthcare professional's priority?

• A. Respiratory distress
• B. Hypothermia
• C. Accidental lacerations
• D. Acrocyanosis

Correct answer: A

Rationale: The correct answer is A: Respiratory distress. Assessing for respiratory distress is the priority when evaluating a newborn after a cesarean delivery. Newborns born via cesarean section are at higher risk for respiratory complications, making it crucial to monitor their breathing and ensure proper oxygenation immediately after birth. Choice B, hypothermia, is important too but assessing breathing takes precedence to ensure adequate oxygen supply. Choices C and D, accidental lacerations and acrocyanosis, are not the immediate priorities following a cesarean delivery.

5. During an assessment of a client in labor who received epidural anesthesia, which finding should the nurse identify as a complication of the epidural block?

• A. Vomiting
• B. Tachycardia
• C. Respiratory depression
• D. Hypotension

Correct answer: D

Rationale: Hypotension is a common complication of epidural anesthesia due to the vasodilation effect of the medication. Epidural anesthesia can lead to vasodilation, causing a decrease in blood pressure. This hypotension may result in decreased perfusion to vital organs and compromise maternal and fetal well-being. Tachycardia is less likely as a complication of epidural anesthesia since it tends to have a vasodilatory effect. Respiratory depression is more commonly associated with other forms of anesthesia, such as general anesthesia, rather than epidural anesthesia. Vomiting is not typically a direct complication of epidural anesthesia and is more commonly seen with other factors such as pain or medications given during labor.

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