Nursing Elites

1. A postpartum client is experiencing heavy lochia and a boggy uterus. What should be the nurse's initial action?

• A. Administer a uterotonic medication
• B. Encourage the client to void
• C. Perform fundal massage
• D. Increase the client's fluid intake

Correct answer: C

Rationale: The correct initial action for a postpartum client experiencing heavy lochia and a boggy uterus is to perform fundal massage. Fundal massage helps to firm the uterus and reduce bleeding by promoting uterine contractions, which can assist in preventing postpartum hemorrhage. Administering uterotonic medication may be necessary in some cases but should not be the initial action. Encouraging the client to void and increasing fluid intake can be important interventions but are not the priority in this situation where immediate uterine firmness is needed to control bleeding.

2. What comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?

• A. He is always hungry.
• B. He tires out during feedings.
• C. He is fussy for several hours every day.
• D. He sleeps all the time.

Correct answer: B

Rationale: Observing a 1-month-old tiring out during feedings should alert the nurse to the possibility of a congenital heart defect. This symptom may indicate that the infant is expending excess energy to compensate for a heart issue, leading to fatigue during feeding. Choices A, C, and D do not directly relate to a congenital heart defect. Being always hungry, fussy, or sleeping a lot are not specific signs of a congenital heart defect in a 1-month-old.

3. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?

• A. The child should be allowed to play because doing so can foster healthy self-esteem
• B. The risk for fractures is increased because GH deficiency results in fragile bones
• C. Activity could aggravate insulin sensitivity, causing hyperglycemia
• D. Activity would aggravate the child's joints, already overtasked by obesity

Correct answer: A

Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.

4. When discussing heart conditions, a healthcare provider explains a condition in which the lungs retain extra fluid due to left ventricular impairment. What is this condition?

• A. Whooping cough
• B. Pneumonia
• C. Asthma
• D. Pulmonary edema

Correct answer: D

Rationale: Pulmonary edema is the correct answer. It is a condition characterized by the retention of extra fluid in the lungs, often due to left ventricular impairment. This fluid buildup can lead to symptoms such as shortness of breath, coughing, and difficulty breathing. Whooping cough (Choice A), pneumonia (Choice B), and asthma (Choice C) are not conditions related to the retention of fluid in the lungs due to left ventricular impairment. Whooping cough is a bacterial respiratory infection, pneumonia is an infection that inflames the air sacs in one or both lungs, and asthma is a chronic respiratory condition characterized by airway inflammation and constriction.

5. To prevent diarrhea in children, a vaccine is available against which of the following?

• A. Adenovirus
• B. Rotavirus
• C. Enterovirus
• D. All of the above

Correct answer: B

Rationale: The correct answer is B - Rotavirus. Rotavirus vaccine is available to prevent diarrhea in children. Rotavirus is a common cause of severe diarrhea in infants and young children globally, and vaccination has been shown to be effective in reducing the burden of this disease. Choices A and C are incorrect because there is no specific vaccine available for Adenovirus or Enterovirus to prevent diarrhea in children. Choice D is incorrect because while vaccines are available for some viruses that can cause diarrhea in children, not all mentioned in the choices have a specific vaccine available.

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