Nursing Elites

1. During a nonstress test for a pregnant client, a nurse uses an acoustic vibration device. The client inquires about its purpose. Which response should the nurse provide?

• A. It is used to stimulate uterine contractions.
• B. It will decrease the incidence of uterine contractions.
• C. It lulls the fetus to sleep.
• D. It awakens a sleeping fetus.

Correct answer: D

Rationale: The acoustic vibration device is utilized during a nonstress test to awaken a sleeping fetus. This action helps ensure more accurate test results by eliciting fetal movements and heart rate accelerations, which are indicators of fetal well-being. Choices A, B, and C are incorrect because the primary purpose of the acoustic vibration device during a nonstress test is not to stimulate uterine contractions, decrease uterine contractions, or lull the fetus to sleep. Instead, it is specifically used to awaken a sleeping fetus to assess fetal well-being.

2. A client who is pregnant is scheduled for a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply)

• A. Decreased fetal movement
• B. Intrauterine growth restriction (IUGR)
• C. Postmaturity
• D. All of the Above

Correct answer: D

Rationale: A contraction stress test (CST) is performed to assess how the fetus responds to the stress of contractions. Indications for this test include decreased fetal movement, intrauterine growth restriction (IUGR), and postmaturity. These conditions may warrant the need for a CST to evaluate fetal well-being and determine appropriate management. Therefore, all of the above options are correct indications for a contraction stress test. Options A, B, and C are incorrect because they are all valid reasons for performing a CST in a pregnant client.

3. A nurse in a clinic receives a phone call from a client who would like information about pregnancy testing. Which of the following information should the nurse provide to the client?

• A. You should wait 4 weeks after conception to be tested for pregnancy.
• B. You should be off any medications for 24 hours prior to the pregnancy test.
• C. You should not eat or drink for at least 8 hours prior to the pregnancy test.
• D. You should use your first morning urination specimen for a home pregnancy test.

Correct answer: D

Rationale: For the most accurate results, a home pregnancy test should be done using the first morning urine, which contains the highest concentration of hCG.

4. When caring for clients in a prenatal clinic, a nurse should report which client's weight gain to the provider?

• A. 1.8 kg (4 lb) weight gain in the first trimester
• B. 3.6 kg (8 lb) weight gain in the first trimester
• C. 6.8 kg (15 lb) weight gain in the second trimester
• D. 11.3 kg (25 lb) weight gain in the third trimester

Correct answer: B

Rationale: A weight gain of 3.6 kg (8 lb) in the first trimester is excessive and should be reported to the provider for further evaluation. Excessive weight gain in the first trimester can be a sign of potential issues that need monitoring and intervention to ensure the well-being of both the mother and the baby. Choices A, C, and D represent weight gains that are within normal ranges for the respective trimesters and do not raise immediate concerns for reporting to the provider.

5. A client who is at 10 weeks of gestation reports abdominal pain and moderate vaginal bleeding, with a tentative diagnosis of inevitable abortion. Which of the following nursing interventions should be included in the plan of care?

• A. Administer oxygen via nasal cannula.
• B. Offer the option to view products of conception.
• C. Instruct the client to increase potassium-rich foods in the diet.
• D. Maintain the client on bed rest.

Correct answer: B

Rationale: In cases of inevitable abortion, offering the option to view products of conception can assist in emotional healing and closure for the client. This can provide a sense of acknowledgment and closure for the loss experienced, aiding in the grieving process. Administering oxygen via nasal cannula (choice A) is not directly related to the emotional and psychological support needed during an inevitable abortion. Instructing the client to increase potassium-rich foods (choice C) may not be a priority in this situation. Maintaining the client on bed rest (choice D) may be indicated in some cases but does not address the emotional aspect of the situation.

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