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 pregnant client is learning about Kegel exercises in the third trimester. Which statement signifies understanding of the teaching?

• A. These exercises facilitate preventing constipation.
• B. These exercises aid pelvic muscle stretching during birth.
• C. They assist in decreasing backaches.
• D. They can prevent additional stretch marks.

Correct answer: B

Rationale: Kegel exercises are beneficial during pregnancy to help strengthen pelvic muscles, which is crucial for childbirth. Pelvic muscle stretching during birth is a key aspect of labor, making choice B the correct statement indicating understanding of the teaching. Choices A, C, and D are incorrect because Kegel exercises primarily focus on strengthening pelvic floor muscles to support the uterus, bladder, and bowel, aiding in labor and delivery. They are not directly related to preventing constipation, decreasing backaches, or preventing stretch marks.

3. A client in active labor has 7 cm of cervical dilation, 100% effacement, and the fetus at 1+ station. The client's amniotic membranes are intact, but she suddenly expresses the need to push. What should the nurse do?

• A. Assist the client into a comfortable position.
• B. Observe the perineum for signs of crowning.
• C. Have the client pant during the next contractions.
• D. Help the client to the bathroom to void.

Correct answer: C

Rationale: Having the client pant during contractions is crucial to prevent premature pushing, particularly when the cervix is not fully dilated. Premature pushing can lead to cervical swelling and may impede the progress of labor. It is important to allow the cervix to fully dilate before active pushing to prevent complications. Assisting the client into a comfortable position (Choice A) may not address the urge to push and can lead to premature pushing. Observing the perineum for signs of crowning (Choice B) is important but does not address the immediate need to prevent premature pushing. Helping the client to the bathroom to void (Choice D) does not address the urge to push and may not be appropriate at this stage of labor.

4. A healthcare provider in a clinic is reinforcing teaching with a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency?

• A. Iron deficiency anemia
• B. Poor bone formation
• C. Macrosomic fetus
• D. Neural tube defects

Correct answer: D

Rationale: The correct answer is D: Neural tube defects. Folic acid deficiency during pregnancy can lead to neural tube defects in the fetus, affecting the brain, spine, or spinal cord development. Iron deficiency anemia (choice A) is not directly related to folic acid deficiency. Poor bone formation (choice B) is more associated with calcium and vitamin D deficiencies. Macrosomic fetus (choice C) refers to a baby with excessive birth weight and is not a typical outcome of folic acid deficiency in pregnancy. Therefore, it is crucial for individuals of childbearing age to take recommended folic acid supplements to prevent neural tube defects.

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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