Nursing Elites

1. A healthcare provider is assisting with the care of a newborn immediately following birth. Which of the following nursing interventions is the highest priority?

• A. Initiating breastfeeding
• B. Performing the initial bath
• C. Giving a vitamin K injection
• D. Covering the newborn's head with a cap

Correct answer: D

Rationale: Covering the newborn's head with a cap is the highest priority immediately following birth to prevent heat loss. Newborns are at risk of hypothermia due to their immature thermoregulation, making it crucial to maintain their body temperature. By covering the newborn's head with a cap, heat loss through the head is minimized, helping to keep the baby warm and stable in the immediate post-birth period. Initiating breastfeeding, performing the initial bath, and giving a vitamin K injection are important interventions but are not as high a priority as ensuring the newborn's thermal stability.

2. A client who received carboprost for postpartum hemorrhage is being assessed by a nurse. Which of the following findings is an adverse effect of this medication?

• A. Hypertension
• B. Hypothermia
• C. Constipation
• D. Muscle weakness

Correct answer: A

Rationale: The correct answer is A: Hypertension. Carboprost is a vasoconstrictor medication used to control postpartum hemorrhage by contracting the uterus. One of the adverse effects of carboprost is hypertension due to its vasoconstrictive properties. Hypertension can occur as a result of increased peripheral vascular resistance. Choices B, C, and D are incorrect. Hypothermia, constipation, and muscle weakness are not typically associated with the administration of carboprost. It is crucial for the nurse to monitor the client's blood pressure closely while on carboprost to promptly detect and manage hypertension.

3. A nurse in a health clinic is reinforcing teaching about contraceptive use with a group of clients. Which of the following client statements demonstrates understanding?

• A. Using a water-soluble lubricant with condoms can help prevent breakage and ensure effectiveness in preventing pregnancy and STIs.
• B. A diaphragm should be removed 2 hours after intercourse.
• C. Oral contraceptives can worsen a case of acne.
• D. A contraceptive patch is replaced once a month.

Correct answer: A

Rationale: The correct answer is A because using a water-soluble lubricant with condoms can help prevent breakage and ensure effectiveness in preventing pregnancy and sexually transmitted infections (STIs). This statement demonstrates the client's understanding of the importance of proper condom use to maximize protection. Choice B is incorrect because a diaphragm should be left in place for at least 6 hours after intercourse to ensure contraceptive effectiveness. Choice C is incorrect as oral contraceptives are known to improve acne in some cases. Choice D is incorrect because a contraceptive patch is typically replaced weekly, not monthly.

4. A client in active labor is being prepared for epidural analgesia. Which of the following actions should the nurse take?

• A. Have the client sit upright on the bed with legs crossed.
• B. Administer a 500 mL bolus of lactated Ringer's solution prior to induction.
• C. Inform the client that the anesthetic effect will last for approximately 2 hours.
• D. Obtain a 30-minute electronic fetal monitoring (EFM) strip prior to induction.

Correct answer: D

Rationale: Obtaining a 30-minute electronic fetal monitoring (EFM) strip prior to epidural analgesia is crucial to establish a baseline for fetal heart rate and uterine activity. This baseline helps in monitoring fetal well-being during labor and assessing the effect of analgesia on the baby. It enables the healthcare team to identify any changes in the fetal heart rate pattern and uterine contractions, ensuring the safety of both the mother and the baby. Choices A, B, and C are incorrect because having the client sit upright with legs crossed is not necessary for epidural placement, administering a bolus of lactated Ringer's solution is not typically done before epidural analgesia, and the duration of the anesthetic effect varies and is not accurately 2 hours.

5. A client is postpartum and has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect?

• A. Decreased platelet count
• B. Increased erythrocyte sedimentation rate (ESR)
• C. Decreased megakaryocytes
• D. Increased WBC

Correct answer: A

Rationale: Idiopathic thrombocytopenic purpura (ITP) is characterized by an autoimmune response that leads to a decreased platelet count. This condition increases the risk of bleeding due to the low platelet levels. Monitoring the platelet count is crucial in managing ITP, as it helps determine the risk of bleeding and guides treatment decisions. Therefore, the correct finding to expect in a client with ITP is a decreased platelet count. Choice B, an increased erythrocyte sedimentation rate (ESR), is not typically associated with ITP. Choice C, decreased megakaryocytes, may be seen in conditions like aplastic anemia but are not a typical finding in ITP. Choice D, an increased white blood cell count (WBC), is not a characteristic feature of ITP.

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