Nursing Elites

1. What maternal behavior is typically observed when a new mother first receives her infant?

• A. She eagerly reaches for the infant, undresses the infant, and examines the infant completely.
• B. Her arms and hands receive the infant and she then traces the infant's profile with her fingertips.
• C. Her arms and hands receive the infant and she then cuddles the infant to her own body.
• D. She eagerly reaches for the infant and then holds the infant close to her own body.

Correct answer: B

Rationale: When a new mother first receives her infant, a typical maternal behavior is to use her arms and hands to receive the infant and then trace the infant's profile with her fingertips. This action is a gentle way of bonding with the newborn and aids in recognizing the infant's features. Choices A, C, and D are incorrect as they do not accurately describe the common behavior of tracing the infant's profile, which is a significant part of the initial interaction between a mother and her newborn.

2. The client is 24 hours postpartum and is being discharged. The nurse explains that vaginal discharge will change from red to pink and then to white. If the client starts having red bleeding after the color changes, what should the nurse instruct the client to do?

• A. Reduce activity level and notify the healthcare provider.
• B. Go to bed and assume a knee-chest position.
• C. Massage the uterus and go to the emergency room.
• D. Do not worry as this is a normal occurrence.

Correct answer: A

Rationale: If the client experiences red bleeding after the color changes, it may indicate possible hemorrhage or retained placental fragments, which require immediate attention. Instructing the client to reduce activity level and notify the healthcare provider is crucial for prompt evaluation and management of potential complications.

3. The healthcare provider prescribes Amoxicillin 500mg PO every 8hrs for a child who weighs 22 pounds. The available suspension is labeled Amoxicillin Suspension 250mg/5ml. The recommended maximum dose is 50mg/kg/24hr. How many mL should the nurse administer in a single dose based on the child’s weight?

• A. 10mL
• B. 15mL
• C. 7.5mL
• D. 5mL

Correct answer: A

Rationale: To calculate the dose for the child weighing 22 pounds, first convert the weight to kg: 22 lbs ÷ 2.2 = 10 kg. The maximum dose based on weight would be 10 kg × 50 mg/kg/24hr = 500 mg/24hr. Since the medication is prescribed every 8 hours, the dose for each administration would be 500 mg ÷ 3 doses = 166.67 mg. As the available suspension is 250mg/5ml, the nurse should administer 166.67 mg ÷ 250 mg/mL = 0.67 mL per dose. However, since it's not practical to administer a fraction of a milliliter, the nurse should round up to the nearest appropriate dose, which is 10mL.

4. A 6-year-old with heart failure (HF) gained 2 pounds in the last 24 hours. Which intervention is more important for the nurse to implement?

• A. Graph the daily weight for the past week.
• B. Decrease IV flow rate.
• C. Assess bilateral lung sounds.
• D. Restrict intake of oral fluids.

Correct answer: C

Rationale: Assessing bilateral lung sounds is crucial in this scenario as it can provide essential information about potential fluid accumulation in the lungs, indicating worsening heart failure. This assessment can guide immediate interventions to prevent further deterioration in the patient's condition.

5. The healthcare provider prescribes oxytocin 2 milliunits/minute to induce labor for a client at 41-weeks gestation. The nurse initiates an infusion of Ringer’s Lactate solution 1000 mL with oxytocin 10 units. How many mL/hour should the nurse program the infusion pump?

• A. 12 mL/hour
• B. 2 mL/hour
• C. 22 mL/hour
• D. 42 mL/hour

Correct answer: A

Rationale: To calculate the infusion rate in mL/hour, first, convert 2 milliunits/minute to milliunits/hour by multiplying by 60 to get 120 milliunits/hour. Then, calculate the mL/hour using the formula: milliunits/hour (120) × total volume (1000 mL) ÷ units in IV solution (10 units) = 1200 mL/hour. Therefore, the nurse should program the infusion pump to deliver 12 mL/hour to provide the prescribed dose of oxytocin. Choice B is incorrect as it does not reflect the correct calculation. Choice C is incorrect as it is not derived from the correct formula. Choice D is incorrect as it is not the result of the accurate calculation based on the provided information.

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