Nursing Elites

1. A client is being educated by a healthcare provider about potential adverse effects of implantable progestins. Which of the following adverse effects should the healthcare provider include? (Select all that apply)

• A. Nausea
• B. Irregular vaginal bleeding
• C. Weight gain
• D. All of the Above

Correct answer: D

Rationale: When educating a client about implantable progestins, it is important to discuss potential adverse effects. Nausea, irregular vaginal bleeding, and weight gain are common side effects associated with implantable progestins. Therefore, clients should be informed about these possibilities to ensure they are aware of what to expect and when to seek medical attention if needed. Choice D, 'All of the Above,' is the correct answer because all of the listed adverse effects (nausea, irregular vaginal bleeding, and weight gain) should be included in the client education. Choices A, B, and C are incorrect because they individually do not encompass all the potential adverse effects that the healthcare provider should discuss with the client.

2. When providing care for a client in preterm labor at 32 weeks of gestation, which medication should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?

• A. Calcium gluconate
• B. Indomethacin
• C. Nifedipine
• D. Betamethasone

Correct answer: D

Rationale: Betamethasone is the correct medication to anticipate the provider prescribing to hasten fetal lung maturity in clients at risk for preterm labor. It is a corticosteroid that helps promote lung maturation in the preterm fetus by stimulating the production of surfactant, which is essential for lung function. This medication is commonly given to pregnant individuals at risk of preterm delivery between 24 and 34 weeks of gestation to reduce the risk of respiratory distress syndrome in the newborn. Calcium gluconate, Indomethacin, and Nifedipine are not used to hasten fetal lung maturity in preterm labor; they serve different purposes in maternal and fetal care.

3. A client is in labor, and a nurse observes late decelerations on the electronic fetal monitor. What should the nurse identify as the first action that the registered nurse should take?

• A. Assist the client into the left-lateral position
• B. Apply a fetal scalp electrode
• C. Insert an IV catheter
• D. Perform a vaginal exam

Correct answer: A

Rationale: Late decelerations indicate uteroplacental insufficiency. The initial action should be to assist the client into the left-lateral position to optimize maternal blood flow and oxygenation to the fetus, thereby improving uteroplacental blood flow and fetal oxygenation. This position helps reduce pressure on the vena cava, enhancing blood return to the heart and improving circulation to the placenta. Applying a fetal scalp electrode (Choice B) is not the first action indicated for late decelerations. Inserting an IV catheter (Choice C) and performing a vaginal exam (Choice D) are not primary interventions for addressing late decelerations related to uteroplacental insufficiency.

4. A healthcare professional is assisting with the care for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this condition?

• A. No alteration in menses
• B. Transvaginal ultrasound indicating a fetus in the uterus
• C. Blood progesterone greater than the expected reference range
• D. Report of severe shoulder pain

Correct answer: D

Rationale: Severe shoulder pain is a common finding in clients with a ruptured ectopic pregnancy due to referred pain from diaphragmatic irritation caused by blood in the abdominal cavity. This pain is known as Kehr's sign and is often experienced in the shoulder due to irritation of the phrenic nerve. Choices A, B, and C are incorrect. A ruptured ectopic pregnancy typically presents with symptoms such as abdominal pain, vaginal bleeding, and signs of shock, rather than no alteration in menses, a fetus in the uterus, or elevated blood progesterone levels.

5. A client is being educated by a healthcare provider about the changes she should expect when planning to become pregnant. Identify the correct sequence of maternal changes. A. Amenorrhea B.Lightening C. Goodell's sign D. Quickening

• A. A,B,C,D
• B. D,B,A,C
• C. A,D,B,C
• D. A,C,D,B

Correct answer: D

Rationale: The correct sequence of maternal changes during pregnancy is as follows: Amenorrhea (absence of menstrual periods), Goodell's sign (softening of the cervix), Quickening (first fetal movements felt by the mother), and Lightening (baby descending into the pelvis). These changes occur at different stages of pregnancy and are important indicators of fetal development and maternal adaptation. Choice A is correct as it is the initial change indicating possible pregnancy. Choices B, C, and D follow in the correct order of occurrence during pregnancy. Choices B, C, and D are incorrect as they do not follow the correct sequence of maternal changes.

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