Nursing Elites

1. Immediately after birth, a newborn infant is suctioned, dried, and placed under a radiant warmer. The infant has spontaneous respirations, and the nurse assesses an apical heart rate of 80 beats/minute and respirations of 20 breaths/minute. What action should the nurse take next?

• A. Initiate positive pressure ventilation.
• B. Intervene after the one-minute Apgar assessment.
• C. Initiate CPR on the infant.
• D. Assess the infant's blood glucose level.

Correct answer: A

Rationale: A heart rate below 100 bpm in a newborn indicates bradycardia and requires intervention. Positive pressure ventilation should be initiated to improve oxygenation and help increase the infant's heart rate. This intervention is crucial to support the newborn's transition to extrauterine life and prevent further complications.

2. The healthcare provider prescribes magnesium sulfate 6 grams intravenously (IV) to be infused over 20 minutes for a client with preterm labor. The IV bag contains magnesium sulfate 20 grams in dextrose 5% in water 500 mL. How many mL/hour should the nurse set the infusion pump?

• A. 150 mL/hour
• B. 250 mL/hour
• C. 50 mL/hour
• D. 275 mL/hour

Correct answer: A

Rationale: To calculate the infusion rate, first, determine the total volume to be infused (6 grams of magnesium sulfate) over a specific time frame (20 minutes). Then, calculate the concentration of magnesium sulfate in the IV bag to determine the mL/hour rate. The IV bag contains 20 grams of magnesium sulfate in 500 mL of solution, which means there are 4 grams of magnesium sulfate per 100 mL. Since 6 grams are required, the nurse should set the pump to deliver 150 mL/hour to infuse the prescribed dose over 20 minutes. Choice B, 250 mL/hour, is incorrect because it miscalculates the amount of magnesium sulfate infused per hour. Choice C, 50 mL/hour, is incorrect as it is too slow to deliver the required dose in the specified time frame. Choice D, 275 mL/hour, is incorrect as it overestimates the infusion rate and would deliver the dose too quickly.

3. At 20 weeks gestation, a client is scheduled for an ultrasound. In preparing the client for the procedure, the nurse should explain that the primary reason for conducting this diagnostic study is to obtain which information?

• A. Sex and size of the fetus.
• B. Chromosomal abnormalities.
• C. Fetal growth and gestational age.
• D. Lecithin-sphingomyelin ratio.

Correct answer: C

Rationale: The primary reason for an ultrasound at 20 weeks gestation is to assess fetal growth, gestational age, and anatomical development. This evaluation helps ensure the fetus is developing appropriately and can detect any potential issues that may require intervention. Choices A, B, and D are incorrect because at 20 weeks, the primary focus of the ultrasound is not to determine the sex of the fetus, detect chromosomal abnormalities, or assess the lecithin-sphingomyelin ratio. While these factors may be evaluated in pregnancy, they are not the primary reasons for an ultrasound at 20 weeks gestation.

4. After a client delivered vaginally 2 days ago, what information should you share with her if she wants to resume using her diaphragm for birth control?

• A. The diaphragm is the most effective form of contraception.
• B. The diaphragm must be refitted after childbirth.
• C. Vaseline lubricant should be used when inserting the diaphragm.
• D. The diaphragm should be inserted 2 to 4 hours before intercourse.

Correct answer: B

Rationale: After childbirth, the diaphragm must be refitted to ensure a proper fit and effectiveness. Changes in the body post-delivery can affect the fit of the diaphragm, making it necessary to get refitted. Choice A is incorrect because while the diaphragm can be effective, it is not the most effective form of contraception. Choice C is incorrect because oil-based lubricants like Vaseline can damage latex diaphragms. Choice D is incorrect because the diaphragm should be inserted no more than 2 hours before intercourse, not 2 to 4 hours.

5. A loading dose of terbutaline (Brethine) 250 mcg IV is prescribed for a client in preterm labor. Brethine 20 mg is added to 1,000 mL of D5W. How many milliliters of the solution should the nurse administer?

• A. 45
• B. 15 mL
• C. 4
• D. 13

Correct answer: D

Rationale: To calculate the amount of terbutaline to administer, first convert the dose to the same unit. 250 mcg = 0.25 mg. Next, set up a proportion: 20 mg is to 1000 mL as 0.25 mg is to X mL. Cross multiply and solve for X: 20 × X = 0.25 × 1000. X = (0.25 × 1000) / 20 = 12.5 mL. Therefore, the nurse should administer 13 mL of the solution. Choice A is incorrect as it does not reflect the correct calculation. Choice B is incorrect as it does not consider the accurate conversion and calculation. Choice C is incorrect as it is not the result of the correct proportion calculation.

Similar Questions