Nursing Elites

1. The healthcare provider assesses a postpartum client who is 1 day post-delivery. Which finding would require immediate intervention?

• A. Lochia rubra with a few small clots
• B. Fundus firm and midline
• C. Temperature of 100.4°F (38°C)
• D. Saturated perineal pad in 15 minutes

Correct answer: D

Rationale: A saturated perineal pad in 15 minutes indicates excessive bleeding, which is abnormal postpartum. This finding could suggest hemorrhage, requiring immediate intervention to prevent further complications like hypovolemic shock. Monitoring and managing postpartum bleeding are crucial to ensure the client's safety and prevent serious consequences.

2. Adoley has been presented at the OPD with the following clinical manifestations: crying easily, short attention span, inability to sit still, fatigue but unable to sleep at night, excessive sweating, increased heart rate, and blood pressure. Which of the following will be the appropriate diagnosis for Adoley?

• A. Autism
• B. Hyperthyroidism
• C. Hypoglycemia
• D. Pneumonia

Correct answer: B

Rationale: The symptoms described in the case, such as excessive sweating, increased heart rate, and inability to sleep, are indicative of hyperthyroidism. Hyperthyroidism is characterized by an overactive thyroid gland, leading to symptoms like increased heart rate, sweating, and difficulty sleeping, which align with Adoley's clinical manifestations. Therefore, the appropriate diagnosis for Adoley would be hyperthyroidism.

3. The nurse is assessing a postpartum client's fundus. Where should the nurse expect to find the fundus 24 hours after delivery?

• A. At the level of the umbilicus
• B. 1 cm above the symphysis pubis
• C. At the level of the xiphoid process
• D. 2 cm below the umbilicus

Correct answer: A

Rationale: After delivery, the fundus is expected to be at the level of the umbilicus 24 hours postpartum. This position indicates that the uterus is involuting properly. Assessing the fundal height helps monitor the progress of uterine involution and can identify any potential complications like postpartum hemorrhage.

4. Atta, who weighs 20kg, has been prescribed amoxicillin 500 mg b.i.d. The drug information indicates a daily dose of amoxicillin at 50 mg/kg/day in two divided doses. What is the safest dose in milligrams for this child?

• A. 1000 mg
• B. 750 mg
• C. 500 mg
• D. 250 mg

Correct answer: A

Rationale: To calculate the safest dose of amoxicillin for Atta, we multiply the weight (20kg) by the daily dose (50 mg/kg/day) which equals 1000 mg/day. Since the dose is to be given in two divided doses, the safest dose for each administration would be 500 mg. Therefore, the correct answer is 1000 mg, as it aligns with the prescribed dose for this child based on weight and dosing guidelines. Choice B, 750 mg, is incorrect as it does not match the calculated daily dose. Choice C, 500 mg, is incorrect as it represents the safest dose for each administration, not the total daily dose. Choice D, 250 mg, is incorrect as it is below the calculated daily dose required for the child.

5. Which of the following signs is MOST indicative of inadequate breathing in an infant?

• A. Sunken fontanelles
• B. Heart rate of 130 beats/min
• C. Expiratory grunting
• D. Abdominal breathing

Correct answer: C

Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.

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