Nursing Elites

1. A client who is at 22 weeks gestation is being educated by a nurse about the amniocentesis procedure. Which of the following statements should the nurse make?

• A. You will lie on your right side during the procedure.
• B. You should not eat anything for 24 hours before the procedure.
• C. You should empty your bladder before the procedure.
• D. The test is performed to determine gestational age.

Correct answer: C

Rationale: The correct answer is C. The nurse should advise the client to empty her bladder before an amniocentesis to minimize the risk of bladder puncture during the procedure. This precaution helps ensure the safety and accuracy of the procedure by reducing potential complications related to bladder puncture. Choices A, B, and D are incorrect because lying on the right side, fasting for 24 hours, and determining gestational age are not relevant instructions for an amniocentesis procedure.

2. A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 minute and a frequency of 3 minutes. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min, and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take?

• A. Notify the provider of the findings.
• B. Position the client with one hip elevated.
• C. Ask the client if she needs pain medication.
• D. Have the client void.

Correct answer: B

Rationale: The priority action for the nurse in this situation is to position the client with one hip elevated. This position can help improve blood flow to the placenta and stabilize blood pressure, which is crucial for both the client and the fetus during labor. It can also help optimize fetal oxygenation by improving circulation. Notifying the provider of the findings may be necessary, but ensuring proper positioning of the client takes precedence to address the immediate physiological needs. Asking the client about pain medication or having the client void are important interventions but are not the priority in this scenario where the client is experiencing painful contractions and has low blood pressure.

3. When developing an educational program for adolescents about nutrition during the third trimester of pregnancy, which of the following statements should be included?

• A. Consume three to four servings of dairy each day.
• B. Increase daily caloric intake by 600 to 700 calories.
• C. Limit daily sodium intake to less than 1 gram.
• D. Increase protein intake to 40 to 50 grams per day.

Correct answer: A

Rationale: The correct statement to include when developing an educational program for adolescents about nutrition during the third trimester of pregnancy is to consume three to four servings of dairy each day. Adequate calcium intake is crucial for bone development during pregnancy and helps prevent complications related to inadequate calcium intake. Increasing daily caloric intake by 600 to 700 calories (Choice B) is not necessary during the third trimester; excessive caloric intake can lead to unnecessary weight gain. Limiting daily sodium intake to less than 1 gram (Choice C) is not suitable during pregnancy, as some sodium intake is necessary for maintaining fluid balance. Increasing protein intake to 40 to 50 grams per day (Choice D) is important during pregnancy, but the emphasis in this case should be on calcium from dairy sources for bone development.

4. A parent of a newborn is being taught about crib safety. Which statement by the client indicates understanding of the teaching?

• A. I will place my baby on his stomach when he is sleeping.
• B. I should remove extra blankets from my baby's crib.
• C. I should pad the mattress in my baby's crib so that he will be more comfortable when he sleeps.
• D. I should place my baby's crib next to the heater to keep him warm during the winter.

Correct answer: B

Rationale: The correct answer is B. Removing extra blankets from the crib is essential to prevent suffocation and reduce the risk of sudden infant death syndrome (SIDS). Extra blankets can pose a suffocation hazard to the baby during sleep. It is recommended to keep the crib free from loose bedding, pillows, and other soft items to provide a safe sleep environment for the newborn. Choices A, C, and D are incorrect. Placing the baby on his stomach (Choice A) increases the risk of SIDS. Padding the mattress (Choice C) can also pose a suffocation risk, and placing the crib next to a heater (Choice D) can lead to overheating, which is associated with an increased risk of SIDS.

5. A client has a new prescription for chlamydia. Which of the following statements should the nurse provide?

• A. This infection is treated with one dose of azithromycin.
• B. If your sexual partner has no symptoms, no medication is needed.
• C. You should avoid sexual relations for 3 days.
• D. You need to return in 6 months for retesting.

Correct answer: A

Rationale: The correct treatment for chlamydia is a one-time dose of azithromycin. It is crucial for the client to understand the correct medication regimen for effective treatment. Choice B is incorrect because treatment is necessary for the partner even if asymptomatic. Choice C is incorrect because sexual relations should be avoided until treatment is completed. Choice D is incorrect as retesting should generally occur 3 months after treatment.

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