Nursing Elites

1. A nurse is teaching clients in a prenatal class about the importance of taking folic acid during pregnancy. The nurse should instruct the clients to consume an adequate amount of folic acid from various sources to prevent which of the following fetal abnormalities?

• A. Neural tube defect
• B. Trisomy 21
• C. Cleft lip
• D. Atrial septal defect

Correct answer: A

Rationale: The nurse should educate clients that inadequate folic acid intake is associated with an increased risk of neural tube defects in newborns. Consuming an adequate amount of folic acid from sources like fortified cereals, oranges, artichokes, liver, broccoli, and asparagus can help prevent this serious fetal abnormality. Trisomy 21 (Choice B) is caused by an extra chromosome 21 and is not preventable by folic acid intake. Cleft lip (Choice C) and atrial septal defect (Choice D) are not directly linked to folic acid intake during pregnancy.

2. A client who is at 24 weeks of gestation and reports daily mild headaches is being cared for by a nurse. Which of the following instructions should the nurse include in the plan of care?

• A. Administer ibuprofen 400 mg twice daily.
• B. Recommend that the client perform conscious relaxation techniques daily.
• C. Give the client ginseng tea with each meal.
• D. Instruct the client to soak in a bath with a water temperature of 105°F for 15 minutes daily.

Correct answer: B

Rationale: Mild headaches during pregnancy can be common and are often related to stress and tension. Recommending conscious relaxation techniques daily can help to relieve tension, reduce stress, and alleviate headaches without the need for medication, which is safer during pregnancy. Choice A is incorrect as ibuprofen is not recommended during pregnancy due to potential risks to the fetus. Choice C is incorrect because ginseng tea is not recommended during pregnancy as it may have adverse effects. Choice D is incorrect as soaking in a hot bath with a water temperature of 105°F can raise the body temperature, which is not safe during pregnancy.

3. Which of the following medications should the provider prescribe for a client with gonorrhea?

• A. Ceftriaxone
• B. Fluconazole
• C. Metronidazole
• D. Zidovudine

Correct answer: A

Rationale: Ceftriaxone is the preferred medication to treat gonorrhea, a bacterial infection. It is essential to promptly treat gonorrhea to prevent complications such as pelvic inflammatory disease, infertility, and the spread of the infection to others. Fluconazole is used for fungal infections, Metronidazole treats certain bacterial and parasitic infections, and Zidovudine is an antiretroviral medication used in HIV treatment; none of these are appropriate for gonorrhea.

4. A client is learning how to check basal temperature to determine ovulation. When should the client check her temperature?

• A. On days 13 to 17 of her menstrual cycle
• B. Every morning before arising
• C. 1 hour following intercourse
• D. Before going to bed every night

Correct answer: B

Rationale: The basal body temperature should be taken every morning before arising as it provides the most accurate reading. This time ensures consistency and eliminates variations that may occur throughout the day due to activities or environmental factors. Choice A is incorrect because ovulation can vary among individuals, and checking temperature on specific days may not align with the actual ovulation day. Choice C is incorrect as there is no direct correlation between intercourse and basal body temperature. Choice D is incorrect because taking the temperature before going to bed does not provide a consistent baseline reading.

5. A client in labor is having contractions 4 minutes apart. Which of the following patterns should the nurse expect on the fetal monitoring tracing?

• A. Contractions that last for 60 seconds each with a 4-minute rest between contractions
• B. A contraction that lasts 4 minutes followed by a period of relaxation
• C. Contractions that last for 60 seconds each with a 3-minute rest between contractions
• D. Contractions that last 45 seconds each with a 3-minute rest between contractions

Correct answer: C

Rationale: The correct answer is C. When contractions are 4 minutes apart, it means there are 4 minutes from the start of one contraction to the start of the next. If each contraction lasts 60 seconds, there will be a 3-minute rest period between contractions. This allows for adequate uterine relaxation and recovery before the next contraction begins. Choice A is incorrect because it suggests a 4-minute rest between contractions, which is not accurate. Choice B is incorrect as contractions lasting 4 minutes continuously without rest would be concerning. Choice D is incorrect as it suggests 45-second contractions instead of 60-second contractions.

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