Nursing Elites

1. A client with pregestational type 1 diabetes mellitus is being taught by a nurse about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should aim to maintain my fasting blood glucose between 100 and 120.
• B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or higher.
• C. I will continue taking my insulin if I experience nausea and vomiting.
• D. I will avoid exercise if my blood glucose exceeds 250.

Correct answer: C

Rationale: The correct answer is C. It is essential for a client with pregestational type 1 diabetes mellitus to continue taking insulin as prescribed even if they experience nausea and vomiting. This is crucial to prevent fluctuations in blood glucose levels that could lead to serious complications. Choice A is incorrect because the fasting blood glucose target for pregnant women with diabetes is usually lower. Choice B is incorrect as engaging in exercise when blood glucose is high is not recommended. Choice D is incorrect as avoiding exercise is not the appropriate approach when blood glucose levels are elevated.

2. A healthcare provider is instructing a client who is taking an oral contraceptive about manifestations to report. Which of the following manifestations should the healthcare provider include?

• A. Reduced menstrual flow
• B. Breast tenderness
• C. Shortness of breath
• D. Increased appetite

Correct answer: C

Rationale: Shortness of breath is a symptom that can indicate a serious side effect of oral contraceptives, such as a potential blood clot in the lungs. This condition requires immediate medical attention to prevent complications. Choices A, B, and D are not typically associated with serious side effects of oral contraceptives and are considered normal or common side effects that do not require urgent medical attention.

3. A client at 28 weeks of gestation received terbutaline. Which of the following findings should the nurse expect?

• A. Fetal heart rate 100/min
• B. Weakened uterine contractions
• C. Enhanced production of fetal lung surfactant
• D. Maternal blood glucose 63 mg/dL

Correct answer: B

Rationale: Terbutaline is a tocolytic medication that works by relaxing the uterine muscles, leading to weakened uterine contractions. This effect helps to prevent preterm labor. Therefore, the nurse should expect weakened uterine contractions in a client who has received terbutaline at 28 weeks of gestation. Choices A, C, and D are incorrect. Terbutaline administration would not directly affect the fetal heart rate, enhance fetal lung surfactant production, or cause maternal hypoglycemia.

4. A woman in a women's health clinic is receiving teaching about nutritional intake during her 8th week of gestation. The healthcare provider should advise the woman to increase her daily intake of which of the following nutrients?

• A. Calcium
• B. Vitamin E
• C. Iron
• D. Vitamin D

Correct answer: C

Rationale: During pregnancy, the recommended daily iron intake is higher compared to non-pregnant women. Pregnant women should aim for 27 mg/day of iron, while non-pregnant women require 15 mg/day if under 19 years old and 18 mg/day if between 19 and 50 years old. Iron is essential during pregnancy to support the increased blood volume and ensure the proper oxygen supply to the fetus. Calcium is important for bone health but does not need a significant increase during early pregnancy. Vitamin E and Vitamin D are important but do not have specific increases recommended during the 8th week of gestation.

5. A healthcare provider is assessing fetal heart tones for a pregnant client. The provider has determined the fetal position as left occipital anterior. To which of the following areas of the client's abdomen should the provider apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart?

• A. Left upper quadrant
• B. Right upper quadrant
• C. Left lower quadrant
• D. Right lower quadrant

Correct answer: C

Rationale: When the fetal position is left occipital anterior, the point of maximum intensity of the fetal heart is best heard in the left lower quadrant of the client's abdomen. Placing the ultrasound transducer in the left lower quadrant allows for optimal detection of fetal heart tones in this specific fetal position. Choice A (Left upper quadrant) is incorrect as it is not where the fetal heart tones are best heard in this scenario. Choice B (Right upper quadrant) is also incorrect as it is not the recommended area for assessing fetal heart tones in a left occipital anterior position. Choice D (Right lower quadrant) is incorrect as the focus should be on the left side due to the fetal position mentioned.

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