Nursing Elites

1. A client at 8 weeks of gestation with iron deficiency anemia is prescribed iron supplements. Which beverage should the nurse reinforce the client to take the supplements with for better absorption?

• A. Ice water
• B. Low-fat or whole milk
• C. Tea or coffee
• D. Orange juice

Correct answer: D

Rationale: The correct answer is 'Orange juice.' Orange juice is recommended to be taken with iron supplements because vitamin C present in orange juice enhances iron absorption, improving the effectiveness of the supplement. It is essential to take iron supplements with a source of vitamin C to optimize iron absorption and address iron deficiency anemia. Ice water (Choice A), low-fat or whole milk (Choice B), and tea or coffee (Choice C) are not ideal choices to take with iron supplements as they do not contain vitamin C, which is crucial for enhancing iron absorption.

2. A client who is at 8 weeks of gestation tells the nurse, 'I am not sure I am happy about being pregnant.' Which of the following responses should the nurse make?

• A. I will inform the provider that you are having these feelings.
• B. It is normal to have these feelings during the first few months of pregnancy.
• C. You should be happy that you are going to bring new life into the world.
• D. I am going to make an appointment with the counselor for you to discuss these thoughts.

Correct answer: B

Rationale: During the first few months of pregnancy, it is common for individuals to experience mixed feelings due to hormonal changes and the significant life adjustments that come with pregnancy. The nurse's response should acknowledge the client's feelings as normal and provide reassurance rather than dismissive or directive statements. By acknowledging the normalcy of these emotions, the nurse validates the client's experience and offers support during this critical time. Choices A, C, and D are less appropriate. Choice A focuses on informing the provider without addressing the client's emotions directly. Choice C disregards the client's current feelings and imposes a specific emotional response. Choice D jumps to scheduling a counseling appointment without first acknowledging the client's emotions or providing immediate support and validation.

3. A client who is at 22 weeks of gestation reports concern about the blotchy hyperpigmentation on her forehead. Which of the following actions should the nurse take?

• A. Tell the client to follow up with a dermatologist.
• B. Explain to the client this is an expected occurrence.
• C. Instruct the client to increase her intake of vitamin D.
• D. Inform the client she might have an allergy to her skin care products.

Correct answer: B

Rationale: Chloasma, also known as the mask of pregnancy, is a blotchy, brown hyperpigmentation of the skin over the cheeks, nose, and forehead. It is most common in dark-skinned women and is caused by an increase in melanotropin during pregnancy. This condition typically appears after 16 weeks of gestation and gradually increases until delivery for 50 to 70% of women. The nurse should reassure the client that this is an expected occurrence, which usually fades after delivery. Therefore, explaining to the client that this is an expected occurrence is the appropriate action in this situation. Options A, C, and D are incorrect because chloasma is a common skin change during pregnancy and does not require a referral to a dermatologist, an increase in vitamin D intake, or suspicion of an allergy to skin care products.

4. A healthcare professional is discussing risk factors for urinary tract infections with a newly licensed nurse. Which of the following conditions should the healthcare professional include in the teaching? (Select all that apply)

• A. Epidural anesthesia
• B. Urinary bladder catheterization
• C. Frequent pelvic examinations
• D. All of the Above

Correct answer: D

Rationale: Urinary tract infections can be influenced by various factors. Epidural anesthesia, urinary bladder catheterization, and frequent pelvic examinations are all associated with an increased risk of UTIs. Epidural anesthesia can introduce bacteria into the urinary tract, urinary bladder catheterization can serve as a pathway for bacteria to enter the bladder, and frequent pelvic examinations can disrupt the natural flora and introduce bacteria. Therefore, it is crucial for healthcare professionals to be aware of these risk factors to help prevent and manage UTIs effectively. Choice D, 'All of the Above,' is the correct answer as all the listed conditions are significant risk factors for urinary tract infections. Choices A, B, and C are incorrect because each of them, when present, can contribute to the development of UTIs. It is essential for healthcare professionals to educate patients and colleagues about these risk factors to minimize the occurrence of UTIs.

5. A client is in the first trimester of pregnancy and lacks immunity to rubella. When should the client receive rubella immunization?

• A. Shortly after giving birth
• B. In the third trimester
• C. Immediately
• D. During the next attempt to get pregnant

Correct answer: A

Rationale: Rubella immunization is recommended shortly after giving birth for a pregnant individual who lacks immunity. This timing ensures the client is protected from rubella in future pregnancies. Administering the vaccine postpartum allows the body to develop immunity without posing any risk to the developing fetus during pregnancy. Option B is incorrect because administering the rubella vaccine in the third trimester can potentially expose the developing fetus to the live virus, which is not recommended. Option C is incorrect as there is a preferred timing for rubella immunization in this scenario. Option D is incorrect as waiting until the next attempt to get pregnant does not protect the current pregnancy from rubella exposure.

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