Nursing Elites

1. Four clients at full term present to the labor and delivery unit at the same time. Which client should a nurse assess first?

• A. Multipara with contractions occurring every three minutes
• B. Multipara scheduled for non-stress test and biophysical profile
• C. Primipara with vaginal show and leaking membranes
• D. Primipara with burning on urination and urinary frequency

Correct answer: C

Rationale: A primipara with vaginal show and leaking membranes requires immediate assessment as she may be in active labor or at risk of infection. The vaginal show and leaking membranes suggest potential rupture of membranes and the start of labor. Assessing her first ensures prompt management and monitoring. The other options, while important, do not indicate immediate or emergent needs. Contractions every three minutes in a multipara can be managed with ongoing monitoring; non-stress tests and biophysical profiles can be scheduled and are not acute needs. Burning on urination and urinary frequency in a primipara may indicate a urinary tract infection, which is important but not as urgent as assessing for active labor or rupture of membranes.

2. An individual’s phenotype reflects both genetic and environmental influences.

• A. phenotype
• B. chromosome
• C. allele
• D. genotype

Correct answer: A

Rationale: The correct answer is A: phenotype. A phenotype is the observable characteristics of an individual, which result from the interaction of their genotype with the environment. This interaction between genetics and the environment determines how genes are expressed and how traits are manifested in an individual. Choices B, C, and D are incorrect because chromosomes, alleles, and genotypes are components of an individual's genetic makeup, but they do not directly reflect the observable traits influenced by both genetics and the environment.

3. A client who is pregnant and follows a vegan diet asks a nurse for guidance on foods high in calcium. Which of the following foods has the highest amount of calcium?

• A. ½ cup cubed avocado
• B. 1 large banana
• C. 1 medium potato
• D. 1 cup cooked broccoli

Correct answer: D

Rationale: The correct answer is D: 1 cup of cooked broccoli. Broccoli is an excellent source of calcium, making it a suitable choice for a vegan diet. Avocado (Choice A), banana (Choice B), and potato (Choice C) are not significant sources of calcium compared to broccoli. Avocado and banana are primarily sources of other nutrients like healthy fats and potassium, respectively. Potato is a good source of vitamin C and potassium but not calcium. Therefore, for a pregnant client following a vegan diet and seeking calcium-rich foods, cooked broccoli is the most appropriate choice.

4. A client has active genital herpes simplex virus type 2. Which of the following medications should the nurse plan to administer?

• A. Metronidazole
• B. Penicillin
• C. Acyclovir
• D. Gentamicin

Correct answer: C

Rationale: Acyclovir is the antiviral medication specifically used to treat herpes simplex virus infections, including genital herpes caused by herpes simplex virus type 2. Metronidazole (Choice A) is an antibiotic used for different types of infections, but not for viral infections like herpes. Penicillin (Choice B) is an antibiotic effective against bacterial infections, not viruses like herpes. Gentamicin (Choice D) is an antibiotic mainly used to treat bacterial infections, not viral infections like herpes.

5. The client who is 40 weeks gestation seems upset and tells the nurse that the physician told her she needs to have a nonstress test. The client asks why she needs the test. The nurse’s best response would be:

• A. This is a test to see if your stress level is affecting your baby’s growth and well-being.
• B. This is a test to see if your baby will be able to withstand the stress of labor.
• C. This is a test to assess your baby’s well-being now that you are due to deliver soon.
• D. This is a test to let us know if your baby needs to be delivered to avoid a bad outcome.

Correct answer: C

Rationale: The correct response is C because the nonstress test is specifically used to assess the baby's well-being close to the due date. It helps determine if the baby is receiving enough oxygen and nutrients in the womb. Choice A is incorrect as the test does not assess the mother's stress level but focuses on fetal well-being. Choice B is incorrect as the test does not predict the baby's ability to withstand labor. Choice D is incorrect because the test does not solely indicate if the baby needs to be delivered to avoid a bad outcome; rather, it assesses the current well-being of the baby.

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