Nursing Elites

1. The healthcare provider prescribes terbutaline (Brethine) for a client in preterm labor. Before initiating this prescription, it is most important for the LPN/LVN to assess the client for which condition?

• A. Gestational diabetes.
• B. Elevated blood pressure.
• C. Urinary tract infection.
• D. Swelling in lower extremities.

Correct answer: A

Rationale: The correct answer is A: Gestational diabetes. Terbutaline (Brethine) is known to cause hyperglycemia, so it is crucial to assess for gestational diabetes before administering it. Assessing for elevated blood pressure (choice B), urinary tract infection (choice C), or swelling in lower extremities (choice D) is not directly related to the potential side effect of terbutaline in causing hyperglycemia.

2. 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.

3. At 35 weeks gestation, a client complains of 'pain whenever the baby moves.' The nurse notes a temperature of 101.2 F (38.4 C) with severe abdominal or uterine tenderness on palpation. What condition do these findings indicate?

• A. Round ligament strain.
• B. Chorioamnionitis.
• C. Abruptio placentae.
• D. Viral infection.

Correct answer: B

Rationale: The client's symptoms of fever and abdominal tenderness, along with the gestational age, are classic signs of chorioamnionitis, an infection of the amniotic fluid. Chorioamnionitis is a serious condition that requires prompt recognition and treatment to prevent maternal and fetal complications. Round ligament strain (Choice A) typically presents with sharp, stabbing pain on the sides of the abdomen and is not associated with fever or uterine tenderness. Abruptio placentae (Choice C) presents with sudden-onset vaginal bleeding and severe abdominal pain, often with a board-like uterus. Viral infections (Choice D) may present with a variety of symptoms, but the combination of fever, abdominal tenderness, and gestational age in this scenario points more towards chorioamnionitis.

4. A client addicted to heroin and newly pregnant asks a nurse about ensuring her baby's health while on methadone. What should the nurse advise?

• A. Sign up for group therapy sessions.
• B. Discontinue the methadone right away.
• C. Start prenatal care as soon as possible.
• D. Describe genetic testing protocol.

Correct answer: C

Rationale: Initiating prenatal care promptly is essential for monitoring the well-being of both the mother and the fetus, particularly in high-risk pregnancies involving substance use. Early prenatal care allows for timely interventions, education, and support to promote a healthier pregnancy and birth outcomes. Choice A is incorrect because while group therapy may be beneficial, initiating prenatal care is more crucial at this stage. Choice B is incorrect as abrupt discontinuation of methadone can be harmful and should be managed under medical supervision. Choice D is incorrect as genetic testing is not the immediate priority in this scenario.

5. A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in this client’s nursing care plan?

• A. Keep airway equipment at the bedside.
• B. Allow liberal family visitation.
• C. Monitor blood pressure, pulse, and respirations q4h.
• D. Assess temperature q1h.

Correct answer: A

Rationale: In a client with eclampsia, the priority intervention is to keep airway equipment at the bedside to manage potential convulsions effectively. This proactive measure is essential to ensure rapid response and intervention in case of convulsions, which can occur in clients with eclampsia.

Similar Questions