Nursing Elites

1. A nurse is assisting with an in-service for newly licensed nurses about neonatal abstinence syndrome in newborns. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?

• A. The newborn will have decreased muscle tone.
• B. The newborn will have a continuous high-pitched cry.
• C. The newborn will sleep for 2 to 3 hours after a feeding.
• D. The newborn will have mild tremors when disturbed.

Correct answer: B

Rationale: The correct answer is B. A continuous high-pitched cry is a characteristic sign of neonatal abstinence syndrome, indicating withdrawal from drugs. Choices A, C, and D are incorrect because decreased muscle tone, sleeping for 2 to 3 hours after a feeding, and mild tremors when disturbed are not specific indicators of neonatal abstinence syndrome.

2. A client who is at 8 weeks of gestation tells the nurse, 'I am not sure I am happy about being pregnant.' Which of the following responses should the nurse make?

• A. I will inform the provider that you are having these feelings.
• B. It is normal to have these feelings during the first few months of pregnancy.
• C. You should be happy that you are going to bring new life into the world.
• D. I am going to make an appointment with the counselor for you to discuss these thoughts.

Correct answer: B

Rationale: During the first few months of pregnancy, it is common for individuals to experience mixed feelings due to hormonal changes and the significant life adjustments that come with pregnancy. The nurse's response should acknowledge the client's feelings as normal and provide reassurance rather than dismissive or directive statements. By acknowledging the normalcy of these emotions, the nurse validates the client's experience and offers support during this critical time. Choices A, C, and D are less appropriate. Choice A focuses on informing the provider without addressing the client's emotions directly. Choice C disregards the client's current feelings and imposes a specific emotional response. Choice D jumps to scheduling a counseling appointment without first acknowledging the client's emotions or providing immediate support and validation.

3. During a client's active labor, a healthcare provider notes that the presenting part is at 0 station. What is the correct interpretation of this clinical finding?

• A. The fetal head is in the left occiput posterior position.
• B. The largest fetal diameter has passed through the pelvic outlet.
• C. The posterior fontanel is palpable.
• D. The lowermost portion of the fetus is at the level of the ischial spines.

Correct answer: D

Rationale: At 0 station, the lowermost portion of the fetus is at the level of the ischial spines, indicating that the presenting part of the baby has engaged in the pelvis. This position is a significant milestone in labor progress and suggests that the baby is descending into the birth canal for delivery. Choices A, B, and C are incorrect. Choice A refers to the fetal head position, choice B describes the largest fetal diameter passing through the pelvic outlet (which is not related to station), and choice C refers to the palpability of the posterior fontanel (which is not relevant to station in labor).

4. During an assessment of a newborn following a vacuum-assisted delivery, which of the following findings should the healthcare provider be informed about?

• A. Poor sucking
• B. Blue discoloration of the hands and feet
• C. Soft, edematous area on the scalp
• D. Facial edema

Correct answer: A

Rationale: Poor sucking in a newborn following a vacuum-assisted delivery could indicate potential issues with feeding or neurological function, which need to be promptly addressed by the healthcare provider to ensure the well-being of the infant. It is essential for the healthcare provider to be informed about poor sucking to facilitate further evaluation and intervention. Choices B, C, and D are not typically associated with vacuum-assisted delivery and do not pose immediate concerns that require urgent attention.

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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