Nursing Elites

1. During the third trimester of pregnancy, which of the following findings should a nurse recognize as an expected physiologic change?

• A. Gradual lordosis
• B. Increased abdominal muscle tone
• C. Posterior neck flexion
• D. Decreased mobility of pelvic joints

Correct answer: A

Rationale: During pregnancy, gradual lordosis is a common adaptation to the growing fetus. Lordosis refers to an increased lumbar curve in the spine, which helps to shift the center of gravity forward, supporting the enlarging uterus. This change is necessary to maintain balance and reduce strain on the back muscles as the pregnancy progresses. Increased abdominal muscle tone, posterior neck flexion, and decreased mobility of pelvic joints are not typical physiological changes during pregnancy. Increased abdominal muscle tone is not expected as the abdominal muscles tend to stretch and separate to accommodate the growing fetus. Posterior neck flexion is not a common finding and decreased mobility of pelvic joints is not an expected change and can cause discomfort.

2. A healthcare provider is preparing to administer vitamin K by IM injection to a newborn. The medication should be administered into which of the following muscles?

• A. Vastus lateralis
• B. Ventrogluteal
• C. Dorsogluteal
• D. Deltoid

Correct answer: A

Rationale: Vitamin K is typically administered in the vastus lateralis muscle of a newborn to prevent bleeding disorders. The vastus lateralis muscle is the preferred site for IM injections in infants due to its size and accessibility, allowing for easy and safe administration. The ventrogluteal and dorsogluteal sites are more commonly used in adults due to better muscle mass and less risk of injury to nearby structures. The deltoid muscle is typically used for older children and adults for IM injections, as it is a well-developed muscle suitable for injections in these populations.

3. When reinforcing teaching with new parents on bathing a newborn, a nurse observes a bluish-brown marking across the newborn's lower back. Which of the following statements should the nurse make concerning the variation?

• A. This is more commonly seen in newborns who have dark skin.
• B. This is a finding indicating hyperbilirubinemia.
• C. This is a forceps mark from an operative delivery.
• D. This is related to prolonged birth or trauma during delivery.

Correct answer: A

Rationale: A bluish-brown marking across the lower back is more commonly seen in newborns with dark skin. These markings are known as Mongolian spots and are benign. They are not related to hyperbilirubinemia, forceps marks, or trauma during delivery. Choice B is incorrect because hyperbilirubinemia presents as jaundice, not as a bluish-brown marking. Choice C is incorrect because forceps marks would have a different appearance and location. Choice D is incorrect as Mongolian spots are not related to prolonged birth or trauma during delivery.

4. A healthcare professional is preparing to administer magnesium sulfate 2 g/hr IV to a client who is in preterm labor. Available is 20 g of magnesium sulfate in 500 mL of dextrose 5% in water (D5W). How many mL/hr should the IV infusion pump be set to administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 60
• B. 30
• C. 50
• D. 80

Correct answer: C

Rationale: To administer magnesium sulfate 2 g/hr IV, the healthcare professional should set the IV infusion pump to administer 50 mL/hr. The calculation is as follows: 20 g / 500 mL = 2 g / X mL, X = 50 mL/hr. Choice A (60 mL/hr) is incorrect as it does not match the calculated rate. Choice B (30 mL/hr) is incorrect as it is half of the calculated rate. Choice D (80 mL/hr) is incorrect as it is higher than the calculated rate.

5. 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.

Similar Questions