Nursing Elites

1. A nurse is providing discharge teaching to a client who is postpartum and has a prescription for ibuprofen for perineal pain. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Take the medication only at bedtime.
• C. Take the medication with food.
• D. Take the medication with caffeine.

Correct answer: C

Rationale: The correct answer is C: 'Take the medication with food.' Ibuprofen can cause gastrointestinal upset, so it is essential for the client to take the medication with food to minimize this side effect. Choice A, 'Take the medication on an empty stomach,' is incorrect because ibuprofen should be taken with food to prevent stomach irritation. Choice B, 'Take the medication only at bedtime,' is incorrect as there is no specific timing requirement for ibuprofen administration related to bedtime. Choice D, 'Take the medication with caffeine,' is incorrect as there is no benefit in combining ibuprofen with caffeine, and caffeine could potentially worsen gastrointestinal side effects.

2. A nurse is caring for a newborn who is large for gestational age (LGA). Which of the following findings should the nurse expect?

• A. Hyperbilirubinemia
• B. Hypoglycemia
• C. Hypercalcemia
• D. Hypothermia

Correct answer: B

Rationale: Newborns who are large for gestational age (LGA) are at risk for hypoglycemia due to increased insulin production. Hyperbilirubinemia (Choice A) is more commonly associated with ABO or Rh incompatibility. Hypercalcemia (Choice C) is not a common finding in LGA newborns. Hypothermia (Choice D) may occur in newborns who are small for gestational age (SGA) due to a lack of subcutaneous fat for insulation, but it is not typically associated with LGA newborns.

3. A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take?

• A. Swaddle the newborn tightly
• B. Provide frequent tactile stimulation
• C. Position the newborn in a prone position
• D. Offer large feedings every 4 hours

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a newborn with neonatal abstinence syndrome is to swaddle the newborn tightly. Swaddling helps to provide comfort and reduce irritability in these newborns. Choice B, providing frequent tactile stimulation, may exacerbate the symptoms of neonatal abstinence syndrome by overstimulating the newborn. Choice C, positioning the newborn in a prone position, is not recommended as it increases the risk of sudden infant death syndrome (SIDS). Choice D, offering large feedings every 4 hours, is not appropriate as newborns with neonatal abstinence syndrome may have feeding difficulties and need smaller, more frequent feedings.

4. A nurse is teaching a client who is at 20 weeks of gestation about the glucose tolerance test. Which of the following instructions should the nurse include?

• A. You should eat a low-carbohydrate diet for 3 days before the test.
• B. You will need to fast for 12 hours before the test.
• C. You should expect the test to take about 1 hour.
• D. You will need to limit fluid intake to water before the test.

Correct answer: C

Rationale: The correct answer is C. During a glucose tolerance test, the client is required to drink a glucose solution, and blood samples are taken at specific intervals, typically over a period of 1 to 3 hours. In this case, the nurse should inform the client to expect the test to take about 1 hour. Choices A, B, and D are incorrect because there is no specific instruction to eat a low-carbohydrate diet for 3 days before the test, fast for 12 hours before the test, or limit fluid intake to water before the test in a standard glucose tolerance test.

5. A client who is 2 days postpartum and breastfeeding reports nipple soreness. Which of the following instructions should the nurse provide?

• A. Avoid using a breast pump.
• B. Apply breast milk to the nipples after feedings.
• C. Feed the newborn less frequently.
• D. Use a nipple shield during feedings.

Correct answer: B

Rationale: The correct instruction for the nurse to provide is to advise the client to apply breast milk to the nipples after feedings. Breast milk has healing properties and can help soothe sore nipples. Option A is incorrect because avoiding the use of a breast pump does not directly address nipple soreness. Option C is incorrect as feeding the newborn less frequently can lead to engorgement and further complications. Option D is incorrect as using a nipple shield during feedings may not address the underlying issue of soreness and can sometimes even worsen the situation.

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