Nursing Elites

1. A new parent is receiving discharge teaching about car seat safety from a nurse. Which statement by the parent indicates an understanding of the teaching?

• A. “I should position my baby’s car seat at a 45-degree angle in the car.”
• B. “I should place the car seat rear-facing until my baby is 12 months old.”
• C. “I should place the harness snugly in a slot above my baby’s shoulders.”
• D. “I should position the retainer clip at the top of my baby’s abdomen.”

Correct answer: A

Rationale: The correct answer is A. Positioning the car seat at a 45-degree angle is crucial to prevent the baby's head from falling forward, which can obstruct the airway. Choice B is incorrect because the recommendation is to keep the car seat rear-facing until the baby reaches the height or weight limit set by the car seat manufacturer, typically beyond 12 months. Choice C is incorrect as the harness should be snugly placed at or below the baby's shoulders, not above. Choice D is incorrect as the retainer clip should be positioned at armpit level to secure the harness straps properly.

2. Which of the following statements is a symptom of cystic fibrosis in children?

• A. Cystic fibrosis leads to uncontrollable muscle movements and personality changes.
• B. Cystic fibrosis leads to the excessive production of thick mucus that clogs the pancreas and lungs.
• C. Cystic fibrosis causes red blood cells to clump together, obstructing small blood vessels and decreasing the oxygen supply.
• D. Cystic fibrosis causes the central nervous system to degenerate, resulting in death.

Correct answer: B

Rationale: The correct answer is B. Cystic fibrosis is a genetic disorder that causes the body to produce thick, sticky mucus. This mucus can clog the airways in the lungs and obstruct the pancreas, leading to severe respiratory and digestive problems. Choice A is incorrect because uncontrollable muscle movements and personality changes are not typical symptoms of cystic fibrosis. Choice C is incorrect because cystic fibrosis does not directly cause red blood cells to clump together and obstruct small blood vessels. Choice D is incorrect because cystic fibrosis primarily affects the respiratory and digestive systems, not the central nervous system.

3. Following an amniocentesis, a nurse is caring for a client. The nurse should observe the client for which of the following complications?

• A. Hyperemesis
• B. Proteinuria
• C. Hypoxia
• D. Hemorrhage

Correct answer: D

Rationale: After an amniocentesis, the nurse should monitor the client for potential complications, with hemorrhage being a significant concern due to the invasive nature of the procedure. Hyperemesis (severe vomiting), proteinuria (excessive protein in the urine), and hypoxia (low oxygen levels) are not typically associated with amniocentesis and are less likely to occur compared to hemorrhage, which is a more common complication that requires prompt recognition and intervention.

4. A client is receiving oxytocin by continuous IV infusion for labor induction. Which of the following interventions should the nurse include in the plan?

• A. Increase the infusion rate every 30 to 60 minutes.
• B. Maintain the client in a supine position.
• C. Titrate the infusion rate by 4 milliunits/min.
• D. Limit IV intake to 4 L per 24 hours.

Correct answer: A

Rationale: The correct answer is to increase the infusion rate every 30 to 60 minutes. This approach allows for the careful monitoring and adjustment of oxytocin administration during labor induction. Choice B is incorrect because maintaining the client in a supine position can decrease blood flow to the placenta and compromise fetal oxygenation. Choice C is incorrect as titrating the infusion rate by 4 milliunits/min is not a standard practice for oxytocin administration. Choice D is incorrect as limiting IV intake to 4 L per 24 hours is not specifically related to the administration of oxytocin for labor induction.

5. Do neural tube defects cause an elevation in the alpha-fetoprotein (AFP) level in the mother’s blood?

• A. Yes
• B. No
• C. Possibly
• D. Never

Correct answer: A

Rationale: Yes, neural tube defects can cause an elevation in AFP levels in the mother’s blood. AFP levels are often used as a screening marker during pregnancy to detect neural tube defects. Choice B is incorrect because an elevation in AFP levels can indeed occur in the presence of neural tube defects. Choice C is not the best option as it leaves room for uncertainty when the relationship between neural tube defects and AFP elevation is well-established. Choice D is incorrect as neural tube defects are known to influence AFP levels in the maternal blood.

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