Nursing Elites

1. A client with preeclampsia is receiving magnesium sulfate by continuous IV infusion. Which finding should the nurse report to the provider?

• A. Blood pressure 148/94 mm Hg
• B. Respiratory rate 14/min
• C. Urinary output 20 mL/hr
• D. 2+ deep tendon reflexes

Correct answer: C

Rationale: In a client with preeclampsia receiving magnesium sulfate, a urinary output of 20 mL/hr is a concerning finding as it may indicate renal impairment or magnesium toxicity. Adequate urinary output is crucial for eliminating excess magnesium and preventing toxicity. The nurse should report this finding to the provider for further evaluation. A blood pressure of 148/94 mm Hg is elevated but expected in a client with preeclampsia. A respiratory rate of 14/min is within the normal range. 2+ deep tendon reflexes are a common finding in clients receiving magnesium sulfate and are not a cause for concern unless they progress to hyperreflexia or clonus.

2. A healthcare provider is teaching a prenatal class about immunizations that newborns receive following birth. Which of the following immunizations should the provider include in the teaching?

• A. Hepatitis B
• B. Rotavirus
• C. Pneumococcal
• D. Varicella

Correct answer: A

Rationale: The correct answer is Hepatitis B. Newborns receive the Hepatitis B vaccine shortly after birth to provide protection against the virus. Rotavirus, Pneumococcal, and Varicella vaccines are typically administered at later stages of infancy or childhood, not immediately after birth. Rotavirus vaccine helps prevent severe diarrhea, Pneumococcal vaccine protects against infections like pneumonia and meningitis, and Varicella vaccine prevents chickenpox. However, these vaccines are not part of the routine immunizations given to newborns immediately after birth.

3. What is the central layer of the embryo from which the bones and muscles develop?

• A. neural tube
• B. mesoderm
• C. ectoderm
• D. umbilical cord

Correct answer: B

Rationale: The correct answer is mesoderm. The mesoderm is the middle layer of the embryo that gives rise to the bones, muscles, and other connective tissues. The neural tube (choice A) develops into the nervous system, not bones and muscles. The ectoderm (choice C) forms the skin and nervous system, not bones and muscles. The umbilical cord (choice D) is a structure that connects the developing fetus to the placenta; it is not a layer of the embryo that gives rise to bones and muscles.

4. _____ are environmental agents that can harm the embryo or fetus.

• A. Mutations
• B. Autosomes
• C. Teratogens
• D. Androgens

Correct answer: C

Rationale: Teratogens are environmental agents, such as drugs, chemicals, or infections, that can cause harm to a developing embryo or fetus. Mutations (Choice A) refer to changes in the DNA sequence and are not environmental agents. Autosomes (Choice B) are chromosomes that are not involved in determining an individual's sex and are not environmental agents that harm the embryo or fetus. Androgens (Choice D) are a group of hormones that are more related to male sexual development and function, not environmental agents that harm the embryo or fetus.

5. A client experiencing preterm labor is being taught about terbutaline by a nurse. Which statement by the client indicates an understanding of the teaching?

• A. “The medication could cause me to experience heart palpitations.”
• B. “This medication could cause me to experience blurred vision.”
• C. “This medication could cause me to experience ringing in my ears.”
• D. “This medication could cause me to experience frequent urination.”

Correct answer: A

Rationale: The correct answer is A. Terbutaline is a beta-adrenergic agonist used to stop preterm labor. One of its common side effects is heart palpitations due to its action on beta receptors in the heart. Choices B and C are incorrect because blurred vision and ringing in the ears are not common side effects of terbutaline. Choice D is irrelevant to the side effects of terbutaline.

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