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 at 39 weeks of gestation in a prenatal clinic asks about signs preceding labor. Which of the following should the nurse identify as a sign that precedes labor?

• A. Decreased vaginal discharge
• B. A surge of energy
• C. Urinary retention
• D. Weight gain of 0.5 to 1.5 kg

Correct answer: B

Rationale: A surge of energy is a common sign that precedes labor. This burst of energy, often referred to as the 'nesting instinct,' is believed to occur as the body prepares for labor, prompting the individual to undertake tasks to prepare for the arrival of the baby. Decreased vaginal discharge is not a typical sign preceding labor. Urinary retention is not a sign that precedes labor and may indicate another issue. Weight gain of 0.5 to 1.5 kg is not a specific sign of impending labor.

3. A client at 42 weeks of gestation is having an ultrasound. For which of the following conditions should the nurse prepare for an amnioinfusion? (Select all that apply)

• A. Oligohydramnios
• B. Hydramnios
• C. Fetal cord compression
• D. Polyhydramnios

Correct answer: A

Rationale: In this scenario, the correct answer is "Oligohydramnios". Oligohydramnios, which refers to low amniotic fluid volume, may necessitate amnioinfusion to address the deficiency. Fetal cord compression is another indication for amnioinfusion as it can help alleviate pressure on the umbilical cord. Hydramnios or polyhydramnios, conversely, involve an excess of amniotic fluid and do not typically require amnioinfusion. Therefore, choices B, C, and D are incorrect in this context.

4. 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.

5. While assisting with the care of an infant with a high bilirubin level receiving phototherapy, which finding should the nurse prioritize for reporting to the charge nurse?

• A. Conjunctivitis
• B. Bronze skin discoloration
• C. Sunken fontanels
• D. Maculopapular skin rash

Correct answer: C

Rationale: Sunken fontanels should be prioritized for reporting as they indicate dehydration, which is a critical concern in infants undergoing phototherapy. Dehydration can lead to serious complications, making it essential for the nurse to promptly inform the charge nurse for appropriate intervention and management. Conjunctivitis, bronze skin discoloration, and maculopapular skin rash are important findings to note, but in this scenario, sunken fontanels take precedence due to the potential severity of dehydration in infants.

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