Nursing Elites

1. A pregnant woman in her first trimester is experiencing watery vaginal discharge. What should the nurse tell her?

• A. Inform her that it is normal.
• B. Advise her to see a doctor immediately.
• C. Suggest using panty liners.
• D. Suggest a change in diet.

Correct answer: A

Rationale: Informing the pregnant woman that watery vaginal discharge is normal during the first trimester is crucial to providing reassurance and reducing anxiety. This discharge, known as leukorrhea, is common during pregnancy due to increased estrogen levels and increased blood flow to the pelvic area. It helps maintain a healthy balance of bacteria in the vagina and protects the birth canal from infection. Advising the woman to see a doctor immediately may cause unnecessary alarm, while suggesting the use of panty liners can help manage the discharge comfortably. Suggesting a change in diet is not relevant to addressing watery vaginal discharge in this scenario.

2. A client with no prenatal care arrives at the labor unit screaming, 'The baby is coming!' The nurse performs a vaginal examination that reveals the cervix is 3 centimeters dilated and 75% effaced. What additional information is most important for the LPN/LVN to obtain?

• A. Gravidity and parity.
• B. Time and amount of last oral intake.
• C. Date of last normal menstrual period.
• D. Frequency and intensity of contractions.

Correct answer: C

Rationale: Obtaining the date of the last normal menstrual period is crucial in estimating the gestational age of the fetus. This information helps in determining the progression of labor and the management of delivery. It also assists healthcare providers in assessing the overall health of the mother and the fetus. Choices A, B, and D are important in labor assessment, but in this scenario, the most crucial information needed is the date of the last normal menstrual period to estimate the gestational age.

3. The caregiver observes a mother giving her 11-month-old ferrous sulfate (iron drops), followed by 2 ounces of orange juice. What should the caregiver do next?

• A. Tell the mother to follow the iron drops with infant formula instead of orange juice.
• B. Suggest placing the iron drops in the orange juice and then feeding the infant.
• C. Instruct the mother to feed the infant nothing for 30 minutes after giving the iron drops.
• D. Give the mother positive feedback about the way she administered the medication.

Correct answer: D

Rationale: The high vitamin C content in orange juice aids in the absorption of iron. Providing positive feedback to the mother for administering the iron drops with orange juice is appropriate as it enhances iron absorption, benefiting the infant. Encouraging and acknowledging correct medication administration can help reinforce good practices and build confidence in the caregiver. Choices A, B, and C are incorrect because they do not align with the beneficial practice of administering iron drops with orange juice, which enhances iron absorption. Changing the method of administration based on incorrect assumptions or instructing to withhold feeding after giving iron drops is unnecessary and not evidence-based.

4. A 28-year-old client in active labor complains of cramps in her leg. What intervention should be implemented?

• A. Massage the calf and foot.
• B. Extend the leg and dorsiflex the foot.
• C. Lower the leg off the side of the bed.
• D. Elevate the leg above the heart.

Correct answer: B

Rationale: During active labor, if a client complains of leg cramps, extending the leg and dorsiflexing the foot can help relieve the muscle cramps by stretching the affected muscles. This intervention promotes circulation and can alleviate discomfort associated with leg cramps.

5. After a full-term vaginal delivery, a postpartum client's white blood cell count is 15,000/mm3. What action should the nurse take first?

• A. Check the differential, as the WBC count can be normal for this client.
• B. Assess the client's temperature, pulse, and respirations every 4 hours.
• C. Notify the healthcare provider, as this finding may indicate infection.
• D. Assess the client's perineal area for signs of a perineal hematoma.

Correct answer: A

Rationale: In postpartum clients, a white blood cell count of 15,000/mm3 can be within normal limits due to physiological changes that occur after childbirth. Checking the differential count would provide a more detailed analysis of the specific types of white blood cells present, helping to differentiate between normal postpartum changes and potential infection. This action allows the nurse to gather more information before escalating the situation to the healthcare provider or initiating other assessments. Assessing vital signs and the perineal area are important aspects of postpartum care but may not be the priority in this scenario where the white blood cell count can be influenced by normal physiological changes.

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