Nursing Elites

1. What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?

• A. Assessing FHR and maternal vital signs.
• B. Performing a venipuncture for hemoglobin and hematocrit levels.
• C. Placing clean disposable pads to collect any drainage.
• D. Monitoring uterine contractions.

Correct answer: A

Rationale: The highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to assess the fetal heart rate (FHR) and maternal vital signs. This assessment is crucial in determining the extent of blood loss and its impact on both the mother and the fetus. Ensuring the well-being of both the mother and the fetus is the top priority in this situation. While obtaining hemoglobin and hematocrit levels is important, it can be done after the initial assessment. Placing clean disposable pads is necessary for managing any drainage but does not take precedence over assessing vital signs. Monitoring uterine contractions is important but is not the highest priority when compared to assessing the FHR and maternal vital signs.

2. A client has bacterial vaginosis. Which of the following medications should the nurse expect to administer?

• A. Metronidazole
• B. Fluconazole
• C. Acyclovir
• D. Clindamycin

Correct answer: A

Rationale: Metronidazole is the correct choice for treating bacterial vaginosis as it is the first-line medication recommended for this condition. Metronidazole works by disrupting the DNA structure of bacteria, making it an effective treatment. Choice B, Fluconazole, is an antifungal medication primarily used for treating fungal infections, not bacterial vaginosis. Choice C, Acyclovir, is an antiviral medication used to treat viral infections, not bacterial vaginosis. Choice D, Clindamycin, is also used to treat bacterial infections but is not the first-line treatment for bacterial vaginosis, making it an incorrect choice in this scenario.

3. A newborn is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan?

• A. Apply a thin layer of lotion to the newborn's skin every 8 hours.
• B. Give the newborn 1 oz of glucose water every 4 hours.
• C. Ensure the newborn's eyes are closed beneath the shield.
• D. Dress the newborn in a thin layer of clothing during therapy.

Correct answer: C

Rationale: During phototherapy using a lamp, it is crucial to protect the newborn's eyes from the light to prevent damage. Closing the newborn's eyes beneath the shield is essential for this purpose. Applying lotion to the skin (Choice A) is not recommended as it can intensify the effects of the phototherapy. Giving glucose water (Choice B) is unrelated to the phototherapy process and is not indicated. Dressing the newborn in clothing (Choice D) may hinder the effectiveness of the phototherapy by blocking the light exposure to the skin.

4. A healthcare provider is assessing a newborn upon admission to the nursery. Which of the following should the provider expect?

• A. Bulging Fontanels
• B. Nasal Flaring
• C. Length from head to heel of 40 cm (15.7 in)
• D. Chest circumference 2 cm (0.8 in) smaller than the head circumference

Correct answer: D

Rationale: Upon admission to the nursery, a healthcare provider should expect the newborn's chest circumference to be slightly smaller than the head circumference. This is a normal finding in newborns due to their physiological development. Bulging fontanels (Choice A) can indicate increased intracranial pressure, which is abnormal. Nasal flaring (Choice B) is a sign of respiratory distress and is also an abnormal finding. While a length from head to heel of 40 cm (15.7 in) (Choice C) falls within the normal range for newborns, it is not a specific expectation upon admission to the nursery. Therefore, the correct expectation for a newborn upon admission is for the chest circumference to be slightly smaller than the head circumference.

5. The nurse is caring for a multiparous client who is 8 centimeters dilated, 100% effaced, and the fetal head is at 0 station. The client is shivering and states extreme discomfort with the urge to bear down. Which intervention should the nurse implement?

• A. Administer IV pain medication
• B. Perform a vaginal exam
• C. Reposition to side-lying
• D. Encourage pushing with each contraction

Correct answer: C

Rationale: Repositioning the client to a side-lying position is the most appropriate intervention in this scenario. This position can help relieve pressure on the cervix and reduce the urge to push prematurely, allowing the cervix to continue dilating. Administering IV pain medication may not address the underlying cause of the discomfort, and pushing prematurely can lead to cervical trauma. Performing a vaginal exam is not necessary at this point as the client is already 8 centimeters dilated, and the fetal head is at 0 station.

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