Nursing Elites

1. A patient has been diagnosed with hypothyroidism; the nurse tells the patient not to eat goitrogens. Which of the following is an example of a goitrogen?

• A. Orange
• B. Tomatoes
• C. Cabbage
• D. Grapes

Correct answer: C

Rationale: Cabbage is an example of a goitrogen. Goitrogens are substances that can interfere with thyroid function by inhibiting the uptake of iodine. Cabbage contains compounds that can have this effect and should be consumed in moderation by individuals with hypothyroidism.

2. The student nurse has performed a gestational age assessment of an infant and finds the infant to be at 32 weeks. On which set of characteristics is the nurse basing this assessment?

• A. Lanugo mostly gone, little vernix remaining on the body
• B. Prominent clitoris, enlarging labia minora, patent anus
• C. Full areola, 5 to 10 mm nipple bud, pinkish-brown areola
• D. Skin opaque, cracking at wrists and ankles, no visible vessels

Correct answer: B

Rationale: The correct answer is B. At 30 to 32 weeks' gestation, the clitoris is prominent, and the labia minora are enlarging. The labia majora are small and widely separated. As gestational age increases, the labia majora increase in size. At 36 to 40 weeks, they almost cover the clitoris. At 40 weeks and beyond, the labia majora cover the labia minora and clitoris. Choices A, C, and D do not align with the characteristic features seen at 32 weeks of gestation, making them incorrect.

3. After the baby's head delivers, how is it usually tilted?

• A. with the face up.
• B. anteriorly, with the chin up.
• C. posteriorly, to one side.
• D. posteriorly, face down.

Correct answer: C

Rationale: After the baby's head delivers, it is typically tilted posteriorly to one side to help facilitate the delivery of the shoulders. This positioning is important for the safe and smooth delivery of the baby.

4. When working with a new adolescent patient, which greeting by the nurse indicates awareness of the needs of the adolescent client?

• A. I will talk with your parents first, and then you can tell me why you are here.
• B. Please let me know what your concerns are, and if you have any questions.
• C. Before we begin, I will need to know if you are sexually active.
• D. I will do the physical exam first, and then we will talk about your history.

Correct answer: B

Rationale: The greeting 'Please let me know what your concerns are, and if you have any questions.' indicates awareness of the needs of the adolescent client. It encourages open communication, allows the adolescent to voice their concerns, and shows that their questions are welcomed and valued, fostering a trusting nurse-patient relationship. Choices A, C, and D do not prioritize the adolescent's perspective or promote open communication. Asking to talk to the parents first (Choice A) may hinder the adolescent's autonomy and trust. Inquiring about sexual activity (Choice C) may be necessary but should be approached with sensitivity and privacy. Doing the physical exam first (Choice D) before discussing the patient's history may not align with the adolescent's need for communication and understanding.

5. What intervention should the nurse encourage for a postpartum client complaining of perineal pain?

• A. Use of ice packs for the first 24 hours
• B. Application of heat packs immediately
• C. Avoiding the use of peri-bottles
• D. Using tampons to manage lochia

Correct answer: A

Rationale: The correct intervention for perineal pain in a postpartum client is the use of ice packs for the first 24 hours. Ice packs help reduce swelling and discomfort in the perineal area, especially during the initial post-delivery period. Applying heat packs can exacerbate swelling and discomfort. Avoiding peri-bottles may lead to poor perineal hygiene. Using tampons is contraindicated postpartum as it increases the risk of infection.

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