Nursing Elites

1. When can a woman who thinks she may be pregnant use a home pregnancy test to diagnose pregnancy?

• A. A home pregnancy test can be used right after your first missed period.
• B. These tests are most accurate after you have missed your second period.
• C. Home pregnancy tests often give false positives and should not be trusted.
• D. The test can provide accurate information when used right after ovulation.

Correct answer: A

Rationale: The correct answer is A. Home pregnancy tests detect hCG, a hormone produced during pregnancy, and are most accurate after the first missed period when hCG levels are higher. Testing too early may result in a false negative. Waiting until after the first missed period increases the reliability of the test results. Choice B is incorrect as waiting until after the second missed period is unnecessary and may delay seeking appropriate healthcare. Choice C is incorrect as home pregnancy tests are generally reliable when used correctly. Choice D is incorrect because ovulation occurs before the period, and testing immediately after ovulation may not provide accurate results.

2. The healthcare provider is preparing to suture a 10-year-old with a lacerated forehead. Both parents and the 12-year-old sibling are at the child’s bedside. Which instruction best supports the family?

• A. While waiting for the healthcare provider, only one family member may stay with the child.
• B. All family members should leave while the healthcare provider sutures the child’s forehead.
• C. It is best if the sibling goes to the waiting room until the suturing is completed.
• D. Please decide among yourselves who will stay when the healthcare provider begins suturing.

Correct answer: D

Rationale: Choice D is the best instruction as it involves the family in the decision-making process, allowing them to choose who will stay with the child during the suturing procedure. This approach supports the family's comfort and participation in the child's care, promoting a sense of control and family-centered care. Choices A, B, and C do not promote family involvement and may lead to feelings of exclusion or lack of control among the family members.

3. The client delivered hours ago and has a boggy uterus displaced above and to the right of the umbilicus. What action should the nurse take?

• A. Inspect the perineal pad.
• B. Encourage voiding.
• C. Monitor vital signs.
• D. Notify the healthcare provider.

Correct answer: B

Rationale: A boggy uterus that is displaced above and to the right of the umbilicus may indicate a full bladder, which can impede uterine contraction and lead to hemorrhage. Encouraging the client to void helps relieve pressure on the uterus, promoting better contraction and preventing postpartum hemorrhage.

4. During a routine first-trimester prenatal exam, a pregnant client tells the nurse that she has noticed an increase in vaginal discharge that is white, thin, and watery. Which action should the nurse implement?

• A. Recommend explaining the normal physiological changes during pregnancy.
• B. Notify the healthcare provider of the complaint.
• C. Inform her that this is a normal physiological change.
• D. Prepare to provide education on vaginal health.

Correct answer: C

Rationale: The increased vaginal discharge described by the pregnant client, which is white, thin, and watery, is a common physiological change during pregnancy. It is typically normal and attributed to hormonal fluctuations. The nurse should reassure the client that this type of discharge is expected during pregnancy and does not typically indicate an issue requiring medical intervention or treatment.

5. Why is complete bedrest necessary for a pregnant client with mitral stenosis Class III?

• A. Complete bedrest decreases oxygen needs and demands on the heart muscle tissue.
• B. We want your baby to be healthy, and this is the only way we can ensure that will happen.
• C. I know you're upset. Would you like to talk about some activities you could do while in bed?
• D. Labor is difficult, and you need to use this time to rest before assuming child-caring duties.

Correct answer: A

Rationale: Complete bedrest is necessary for a pregnant client with mitral stenosis Class III to reduce the workload on the heart, lower oxygen consumption, and prevent complications associated with cardiac conditions like mitral stenosis. By remaining in bed, the client can help maintain cardiac function and promote a safer pregnancy outcome. Choice B is incorrect as it does not provide a specific reason related to the client's medical condition. Choice C is not addressing the medical necessity of bedrest for this particular client. Choice D is irrelevant and does not explain the importance of bedrest for a pregnant client with mitral stenosis Class III.

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