Nursing Elites

1. A nurse is providing teaching to a client about the Papanicolaou (Pap) test. Which of the following information should the nurse include in the teaching?

• A. A Pap test is recommended every 3 years for women aged 21-29 and every 3-5 years for women aged 30-65.
• B. Pap tests are recommended following removal of the ovaries.
• C. Avoid having sexual intercourse for 24 hours prior to the Pap test.
• D. Viral infections cannot be detected by a Pap test.

Correct answer: C

Rationale: Clients should avoid sexual intercourse for 24 hours prior to the Pap test to ensure accurate results, as it can affect the sample. This is important for obtaining reliable results. Choice A is incorrect because a yearly Pap test is not the standard recommendation for all age groups; instead, it is typically every 3 years for women aged 21-29 and every 3-5 years for women aged 30-65. Choice B is incorrect because Pap tests are not necessarily discontinued following removal of the ovaries; they may still be needed based on the individual's health history and provider recommendations. Choice D is incorrect because while Pap tests are primarily used to detect abnormal cervical cells and cervical cancer, they do not detect viral infections.

2. A nurse is admitting a client who is in labor and at 38 weeks of gestation to the maternal newborn unit. The client has a history of herpes simplex virus 2 (HSV-2). Which of the following questions is most appropriate for the nurse to ask the client?

• A. Have your membranes ruptured?
• B. How far apart are your contractions?
• C. Do you have any active lesions?
• D. Are you positive for beta strep?

Correct answer: C

Rationale: The most appropriate question for the nurse to ask the client in this scenario is whether they have any active lesions. Active lesions from HSV-2 during labor increase the risk of neonatal transmission, which would necessitate a cesarean section to prevent the infant from contracting the virus during delivery. Asking about the presence of active lesions is crucial to determine the appropriate management and precautions needed to protect the newborn. Choices A, B, and D are not as pertinent in this situation and do not directly address the potential risk of neonatal transmission of HSV-2.

3. A nurse is providing education on the use of corticosteroids. Which of the following should be included?

• A. Monitor for signs of hyperglycemia
• B. Avoid abrupt discontinuation
• C. Long-term use may have risks
• D. Monitor for signs of dehydration

Correct answer: A

Rationale: The correct answer is to monitor for signs of hyperglycemia when educating on corticosteroids. Corticosteroids can increase blood glucose levels, making it essential to watch for hyperglycemia, especially in diabetic patients. Choice B is incorrect because corticosteroids should not be abruptly stopped due to the risk of adrenal insufficiency. Choice C is incorrect as corticosteroids are associated with various adverse effects, making long-term use risky. Choice D is incorrect as dehydration is not typically a primary concern directly related to corticosteroid use.

4. A postpartum client with AB negative blood whose newborn is B positive requires what intervention?

• A. Administer Rh immune globulin within 72 hours of delivery
• B. Administer Rh immune globulin at the 6-week postpartum visit
• C. No Rh immune globulin is needed since this is the second pregnancy
• D. Both mother and baby need Rh immune globulin

Correct answer: A

Rationale: The correct intervention is to administer Rh immune globulin within 72 hours of delivery. This is essential to prevent the mother from forming antibodies against Rh-positive blood, which could cause complications in future pregnancies. Choice B is incorrect as the administration should be immediate postpartum. Choice C is incorrect as Rh immune globulin is needed for each Rh-incompatible pregnancy. Choice D is incorrect as only the mother, who is Rh-negative, needs Rh immune globulin.

5. A nurse is observing bonding between the client and her newborn. Which of the following actions by the client requires the nurse to intervene?

• A. Holding the newborn in an en face position
• B. Asking the father to change the newborn's diaper
• C. Requesting the nurse to take the newborn to the nursery so she can rest
• D. Viewing the newborn’s actions as uncooperative

Correct answer: D

Rationale: The correct answer is D because viewing the newborn’s actions as uncooperative indicates a negative interaction with the newborn and suggests impaired bonding, which requires intervention. Choices A, B, and C are not indicative of impaired bonding. Holding the newborn in an en face position is a positive way to bond with the baby. Asking the father to change the diaper shows involvement of both parents in caring for the newborn, which is beneficial for bonding. Requesting the nurse to take the newborn to the nursery so the mother can rest is a normal request and does not necessarily indicate impaired bonding.

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