Nursing Elites

1. A client who experienced a cesarean birth due to dysfunctional labor expresses disappointment for not having a natural childbirth. Which response should the nurse make?

• A. Validate the client's feelings by saying, 'It sounds like you are feeling sad that things didn't go as planned.'
• B. Assure the client by stating, 'At least you know you have a healthy baby.'
• C. Encourage the client by suggesting, 'Maybe next time you can have a vaginal delivery.'
• D. Provide information by saying, 'You can resume sexual relations sooner than if you had delivered vaginally.'

Correct answer: A

Rationale: The correct response is to acknowledge and validate the client's feelings of disappointment. This empathetic approach demonstrates understanding and support for the client's emotional state, fostering a therapeutic nurse-client relationship. Options B, C, and D do not address the client's emotional needs or provide appropriate support in this situation.

2. A client at 22 weeks of gestation with uncontrolled gestational diabetes mellitus may require medication. Which of the following medications would the provider likely prescribe?

• A. Acarbose
• B. Repaglinide
• C. Glyburide
• D. Glipizide

Correct answer: C

Rationale: Glyburide is commonly prescribed for gestational diabetes mellitus when diet and exercise are insufficient to control blood sugar levels. It is considered safe and effective during pregnancy, making it a suitable choice for managing diabetes in pregnant individuals. Acarbose, Repaglinide, and Glipizide are not typically recommended for use in pregnancy due to potential risks to the fetus.

3. A healthcare provider in the emergency department is caring for a client who comes to the emergency department reporting severe abdominal pain in the left lower quadrant. The provider suspects a ruptured ectopic pregnancy. Which of the following signs indicates to the provider the presence of intra-abdominal bleeding?

• A. Chvostek's sign
• B. Cullen's sign
• C. Chadwick's sign
• D. Goodell's sign

Correct answer: B

Rationale: Cullen's sign is the presence of periumbilical ecchymosis indicating intra-abdominal bleeding, which can be associated with a ruptured ectopic pregnancy. Chvostek's sign is a facial spasm related to hypocalcemia. Chadwick's sign is a bluish discoloration of the cervix, vagina, and labia during early pregnancy. Goodell's sign is a softening of the cervix in early pregnancy.

4. A client at 37 weeks of gestation with placenta previa asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

• A. There is an increased risk of introducing infection.
• B. This could initiate preterm labor.
• C. This could result in profound bleeding.
• D. There is an increased risk of rupture of the membranes.

Correct answer: C

Rationale: Performing an internal examination in a client with placenta previa can lead to significant bleeding due to the proximity of the placenta to the cervical os. This bleeding can be severe and potentially life-threatening. Therefore, it is crucial to avoid any unnecessary manipulation that could disrupt the delicate balance and lead to hemorrhage.

5. A client with acute respiratory failure (ARF) may present with which of the following manifestations? (Select one that doesn't apply.)

• A. Severe dyspnea
• B. Decreased level of consciousness
• C. Headache
• D. Nausea

Correct answer: D

Rationale: In acute respiratory failure (ARF), the body is not getting enough oxygen, leading to respiratory distress. Symptoms of ARF typically include severe dyspnea (difficulty breathing), decreased level of consciousness due to hypoxia, and headache from inadequate oxygenation to the brain. Nausea is not a typical manifestation of ARF and would not be expected in this condition.

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