Nursing Elites

1. A client with hyperemesis gravidarum is receiving dietary teaching. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will eat foods that appeal to my taste instead of trying to balance my meals.
• B. I will avoid having a snack at bedtime.
• C. I will have 8 ounces of hot tea with each meal.
• D. I will pair my sweets with a starch instead of eating them alone.

Correct answer: A

Rationale: In hyperemesis gravidarum, where there is severe nausea and vomiting during pregnancy, it is essential for the client to eat foods that appeal to their taste to prevent further nausea. Balancing meals may not be a priority initially if the client is struggling to keep any food down. Choice B is unrelated to managing hyperemesis gravidarum. Choice C, having hot tea with each meal, may not necessarily address the issue of taste preferences. Choice D, pairing sweets with a starch, is not as relevant as choosing foods appealing to taste for managing hyperemesis gravidarum.

2. 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.

3. A healthcare professional in a provider's office is reviewing the medical record of a client who is in her first trimester of pregnancy. Which of the following findings should the healthcare professional identify as a risk factor for the development of preeclampsia?

• A. Singleton pregnancy
• B. BMI of 20
• C. Maternal age of 32 years
• D. Pregestational diabetes mellitus

Correct answer: D

Rationale: Pregestational diabetes mellitus is a significant risk factor for the development of preeclampsia in pregnant individuals. Preeclampsia is more common in women with preexisting conditions such as diabetes, hypertension, renal disease, lupus, or rheumatoid arthritis. Singleton pregnancy, a BMI of 20, or maternal age of 32 years are not considered significant risk factors for developing preeclampsia.

4. A newborn who was born at 38 weeks of gestation, weighs 3,200 g, and is in the 60th percentile for weight should be classified as which of the following?

• A. Low birth weight
• B. Appropriate for gestational age
• C. Small for gestational age
• D. Large for gestational age

Correct answer: B

Rationale: The classification of a newborn as appropriate for gestational age is determined by considering the weight and gestational age. In this case, the newborn's weight falls within the normal range for the gestational age, indicating that the newborn is appropriately sized for the length of time spent in the womb. Choice A, 'Low birth weight,' is incorrect as the newborn's weight is within the normal range. Choice C, 'Small for gestational age,' is incorrect because the newborn's weight is not below the 10th percentile for gestational age. Choice D, 'Large for gestational age,' is incorrect as the newborn's weight is not above the 90th percentile, rather falling within the 60th percentile which is considered normal.

5. A healthcare provider is assisting with the care for a client who has a prescription for magnesium sulfate. The provider should recognize that which of the following are contraindications for the use of this medication? (Select all that apply)

• A. Fetal distress
• B. Cervical dilation greater than 6 cm
• C. Vaginal bleeding
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Magnesium sulfate should not be used in cases of fetal distress, vaginal bleeding, or cervical dilation greater than 6 cm. These conditions can be exacerbated by the administration of magnesium sulfate, leading to further complications for the client. Choice A, fetal distress, is a contraindication because magnesium sulfate can further affect the fetal heart rate. Choice B, cervical dilation greater than 6 cm, is a contraindication as magnesium sulfate can potentially suppress uterine contractions, prolonging labor. Choice C, vaginal bleeding, is a contraindication as magnesium sulfate can further increase bleeding tendencies.

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