Nursing Elites

1. Preconception counseling is crucial for the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?

• A. Frequent episodes of maternal hypoglycemia
• B. Congenital anomalies in the fetus
• C. Hydramnios
• D. Hyperemesis gravidarum

Correct answer: B

Rationale: Preconception counseling is essential as strict metabolic control before conception and in the early weeks of gestation helps reduce the risk of congenital anomalies. Frequent episodes of maternal hypoglycemia usually occur during the first trimester due to hormonal changes, affecting insulin production and use, rather than before conception. Hydramnios is more common in diabetic pregnancies, typically seen in the third trimester, not during early pregnancy. Hyperemesis gravidarum, although it may lead to hypoglycemic events, is related to decreased food intake and glucose transfer to the fetus, exacerbating hypoglycemia rather than being directly associated with poor glycemic control before and during early pregnancy.

2. What is the central layer of the embryo from which the bones and muscles develop?

• A. neural tube
• B. mesoderm
• C. ectoderm
• D. umbilical cord

Correct answer: B

Rationale: The correct answer is mesoderm. The mesoderm is the middle layer of the embryo that gives rise to the bones, muscles, and other connective tissues. The neural tube (choice A) develops into the nervous system, not bones and muscles. The ectoderm (choice C) forms the skin and nervous system, not bones and muscles. The umbilical cord (choice D) is a structure that connects the developing fetus to the placenta; it is not a layer of the embryo that gives rise to bones and muscles.

3. A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider?

• A. A client with a urinary output of 300 ml in 8 hours
• B. A client reporting abdominal cramping during breastfeeding
• C. A client receiving magnesium sulfate with absent deep tendon reflexes
• D. A client reporting lochia rubra requiring changing perineal pads every 3 hours

Correct answer: C

Rationale: The correct answer is C because in a client receiving magnesium sulfate, absent deep tendon reflexes can indicate magnesium toxicity, which requires immediate intervention to prevent serious complications. Choices A, B, and D are common postpartum occurrences that do not typically warrant immediate provider notification. A urinary output of 300 ml in 8 hours, abdominal cramping during breastfeeding, and frequent changing of perineal pads due to lochia rubra are within the expected range of postpartum recovery and do not indicate an urgent need for provider notification.

4. In the prenatal record, the nurse should record for the pregnant client who has a 3-year-old child at home, a term birth, a miscarriage at 10 weeks’ gestation, and a set of twins who died within 24 hours:

• A. Gravida 2, para 1.
• B. Gravida 3, para 3.
• C. Gravida 4, para 2.
• D. Gravida 5, para 4.

Correct answer: C

Rationale: The correct answer is C: 'Gravida 4, para 2.' Gravida refers to the total number of pregnancies, including the current one. In this case, the client has been pregnant a total of 4 times, so gravida is 4. Para is the number of pregnancies that have reached viability, which is 2 in this case. The client has had a term birth and a set of twins who died within 24 hours, totaling 2 pregnancies that reached viability. Choices A, B, and D are incorrect because they do not accurately reflect the client's obstetric history based on the information provided.

5. After a mother was diagnosed with gonorrhea immediately after delivery, what is an important goal of the nurse when providing care for her baby?

• A. Prevent the development of ophthalmia neonatorum.
• B. Lubricate the eyes.
• C. Prevent the development of infection.
• D. Teach about the risks of breastfeeding with gonorrhea.

Correct answer: A

Rationale: The correct answer is A: Prevent the development of ophthalmia neonatorum. When a mother has gonorrhea, the baby can be infected during delivery, leading to ophthalmia neonatorum, which can cause permanent blindness. Therefore, it is crucial for the nurse to prevent this condition by treating the baby's eyes with an antibiotic prophylactically after birth. Choice B, lubricating the eyes, is not the primary goal in this situation as preventing infection takes precedence. Choice C, preventing the development of infection, is too broad and does not specifically address the potential complication of ophthalmia neonatorum. Choice D, teaching about the risks of breastfeeding with gonorrhea, is important but not the immediate goal in this scenario where preventing ophthalmia neonatorum and potential blindness is the priority.

Similar Questions