Nursing Elites

1. A healthcare professional is discussing risk factors for urinary tract infections with a newly licensed nurse. Which of the following conditions should the healthcare professional include in the teaching? (Select all that apply)

• A. Epidural anesthesia
• B. Urinary bladder catheterization
• C. Frequent pelvic examinations
• D. All of the Above

Correct answer: D

Rationale: Urinary tract infections can be influenced by various factors. Epidural anesthesia, urinary bladder catheterization, and frequent pelvic examinations are all associated with an increased risk of UTIs. Epidural anesthesia can introduce bacteria into the urinary tract, urinary bladder catheterization can serve as a pathway for bacteria to enter the bladder, and frequent pelvic examinations can disrupt the natural flora and introduce bacteria. Therefore, it is crucial for healthcare professionals to be aware of these risk factors to help prevent and manage UTIs effectively. Choice D, 'All of the Above,' is the correct answer as all the listed conditions are significant risk factors for urinary tract infections. Choices A, B, and C are incorrect because each of them, when present, can contribute to the development of UTIs. It is essential for healthcare professionals to educate patients and colleagues about these risk factors to minimize the occurrence of UTIs.

2. When advising a woman considering pregnancy on nutritional needs to reduce the risk of giving birth to a newborn with a neural tube defect, what information should the nurse include?

• A. Limit alcohol consumption.
• B. Increase intake of iron-rich foods.
• C. Consume foods fortified with folic acid.
• D. Avoid foods containing aspartame.

Correct answer: C

Rationale: The correct answer is C: Consume foods fortified with folic acid. Folic acid plays a crucial role in preventing neural tube defects. It is advised to consume foods fortified with folic acid or take a supplement containing at least 400 micrograms of folic acid daily. This nutrient is essential for the developing fetus and can significantly reduce the risk of neural tube defects when taken before and during early pregnancy. Choices A, B, and D are incorrect. While limiting alcohol consumption is important during pregnancy, it is not directly related to reducing the risk of neural tube defects. Increasing intake of iron-rich foods is essential for preventing anemia but is not specifically linked to neural tube defects. Avoiding foods containing aspartame is generally recommended, but it is not directly related to reducing the risk of neural tube defects.

3. A client in an obstetrical clinic is discussing using an IUD for contraception with a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?

• A. An IUD should be replaced annually during a pelvic exam.
• B. I cannot get an IUD until after I've had a child.
• C. I should plan on regaining fertility 5 months after the IUD is removed.
• D. I will check to ensure the strings of the IUD are still present after my periods.

Correct answer: D

Rationale: Checking for the presence of IUD strings after each period is crucial to ensure the IUD is correctly positioned and functioning. This practice helps in confirming the effectiveness of the contraceptive method and timely detection of any displacement or issues with the IUD. Choice A is incorrect as IUDs have varying durations of effectiveness, but they do not need to be replaced annually as a routine. Choice B is incorrect as women can get an IUD even if they haven't had a child. Choice C is incorrect as fertility typically returns shortly after IUD removal, not necessarily after a specific timeframe like 5 months.

4. A nurse is caring for several clients. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following clients?

• A. A client who is experiencing fetal death at 32 weeks of gestation
• B. A client who is experiencing preterm labor at 26 weeks of gestation
• C. A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation
• D. A client who has a post-term pregnancy at 42 weeks of gestation

Correct answer: B

Rationale: Tocolytic therapy is used to suppress premature labor. It is appropriate to administer it to a client experiencing preterm labor at 26 weeks of gestation to help delay delivery and improve neonatal outcomes. Administering tocolytic therapy to a client experiencing fetal death, Braxton-Hicks contractions, or post-term pregnancy is not indicated and may not be safe or effective in these situations. Fetal death at 32 weeks indicates a non-viable pregnancy, Braxton-Hicks contractions are normal and not indicative of preterm labor, and post-term pregnancy at 42 weeks does not require tocolytic therapy.

5. 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).

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