Nursing Elites

1. During a Leopold maneuver, a healthcare professional determines that the fetus is in an RSA position. Which fetal presentation should be documented in the client's medical record?

• A. Vertex
• B. Shoulder
• C. Breech
• D. Mentum

Correct answer: C

Rationale: The correct answer is C: "Breech." The RSA position indicates that the fetus is in a breech presentation. In a breech presentation, the buttocks or feet are positioned to be delivered first, which can impact the mode of delivery and require close monitoring during labor and birth. Choice A (Vertex) refers to the head-first presentation, which is considered the normal and most common presentation for birth. Choice B (Shoulder) does not represent a specific fetal presentation. Choice D (Mentum) refers to the chin presentation, which is also not relevant in this scenario.

2. A client who is at 12 weeks of gestation is reviewing a new prescription of ferrous sulfate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will take this pill with my breakfast.
• B. I will take this medication with a glass of milk.
• C. I plan to drink more orange juice while taking this pill.
• D. I plan to add more calcium-rich foods to my diet while taking this medication.

Correct answer: C

Rationale: The correct answer is C. Taking iron supplements with orange juice, which contains vitamin C, enhances the absorption of iron, making the treatment more effective. Choices A, B, and D are incorrect because taking ferrous sulfate with milk, calcium-rich foods, or breakfast may hinder iron absorption due to interactions with calcium or other substances that compete with iron absorption.

3. A healthcare professional is providing information to a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the healthcare professional include? (Select all that apply)

• A. Avoid any lifting
• B. Perform Kegel exercises twice a day
• C. Perform the pelvic rock exercise every day
• D. Avoid standing for prolonged periods

Correct answer: C

Rationale: Performing the pelvic rock exercise daily can help relieve backache during pregnancy by strengthening the back and abdominal muscles, providing support to the spine. This exercise is beneficial in maintaining proper posture and reducing strain on the back. Avoiding standing for prolonged periods can also help alleviate backache by reducing pressure on the spine and supporting muscles. Kegel exercises primarily focus on strengthening the pelvic floor muscles and may not directly help with backache during pregnancy. Avoiding any lifting is overly restrictive and not necessary, as long as proper lifting techniques are followed.

4. When a client states, 'My water just broke,' what is the nurse's priority intervention?

• A. Perform Nitrazine testing.
• B. Assess the fluid.
• C. Check cervical dilation.
• D. Begin FHR monitoring.

Correct answer: D

Rationale: The correct answer is D: Begin FHR monitoring. The priority intervention when a client's water breaks is to assess the fetal well-being due to the risk of umbilical cord prolapse. Monitoring the fetal heart rate (FHR) will help the nurse ensure the fetus's well-being. Performing Nitrazine testing (choice A) or assessing the fluid (choice B) may provide information about the rupture of membranes but does not directly address fetal well-being. Checking cervical dilation (choice C) is important but not the priority when the client's water has broken.

5. A nurse is caring for a client who is at 40 weeks of gestation and is in early labor. The client has a platelet count of 75,000/mm3 and is requesting pain relief. Which of the following treatment modalities should the nurse anticipate?

• A. Epidural analgesia
• B. Naloxone hydrochloride
• C. Attention-focusing
• D. Pudendal nerve block

Correct answer: C

Rationale: Attention-focusing and distraction techniques are types of nonpharmacological care that are effective in relieving labor pain.

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