Nursing Elites

1. Which intervention is most helpful in relieving postpartum uterine contractions or 'afterpains'?

• A. Lying prone with a pillow on the abdomen.
• B. Using a breast pump.
• C. Massaging the abdomen.
• D. Giving oxytocic medications.

Correct answer: A

Rationale: Lying prone with a pillow on the abdomen is the most helpful intervention in relieving postpartum uterine contractions or 'afterpains.' This position provides counter-pressure and support to the uterus, helping to alleviate discomfort and promote uterine involution. Choice B, using a breast pump, is not effective in relieving afterpains as it focuses on milk expression. Massaging the abdomen (Choice C) may help with discomfort but does not provide the same level of support as lying prone with a pillow. Giving oxytocic medications (Choice D) is not typically the first-line intervention for afterpains unless there are specific medical indications.

2. A pregnant client receives Rho(D) immune globulin after an amniocentesis. The day following, she reports a temperature of 99.8°F (37.67°C). Which action should the nurse implement?

• A. Schedule a visit with the healthcare provider today.
• B. Verify the compatibility of the administered Rho(D) immune globulin.
• C. Encourage the client to increase her intake of oral fluids.
• D. Instruct the client to maintain bedrest for 24 hours.

Correct answer: C

Rationale: A mild increase in temperature post-amniocentesis is common, and encouraging the client to increase oral fluid intake is the appropriate action. Increasing fluid intake can help reduce mild fever, promote recovery, and prevent dehydration. It is important for the nurse to educate the client on the importance of staying hydrated to support her overall well-being during this time.

3. During an examination for possible cryptorchidism in an infant, what technique should be used?

• A. Place the infant in a warm room and use a calm approach.
• B. Hold the scrotum and palpate gently.
• C. Cleanse the penis with an antiseptic-soaked pad.
• D. Position the infant in a warm room to prevent muscle contraction.

Correct answer: D

Rationale: When examining an infant for cryptorchidism, it is important to position the infant in a warm room to prevent muscle contraction, which could cause the testes to retract. Placing the infant in a side-lying position may not be necessary for this specific examination. Holding the penis or retracting the foreskin is not relevant to the assessment for cryptorchidism. Cleansing the penis with an antiseptic pad is not indicated for this examination.

4. The healthcare provider is reviewing the serum laboratory findings for a 5-day-old infant with congenital adrenal hyperplasia. Which laboratory result should be reported to the healthcare provider immediately?

• A. Bilirubin of 1.5 mg/dl.
• B. Glucose of 80 mg/dl.
• C. Potassium of 4.5 mEq/L.
• D. Sodium of 119 mEq/L.

Correct answer: D

Rationale: Low sodium levels in congenital adrenal hyperplasia can indicate salt-wasting crisis, which is a life-threatening emergency requiring immediate medical attention. Monitoring sodium levels is crucial to prevent complications such as dehydration and shock in these patients.

5. The healthcare provider is providing preconception counseling. Which supplement should the provider recommend to help prevent the occurrence of anencephaly?

• A. Folic Acid.
• B. Calcium.
• C. Iron.
• D. Vitamin D.

Correct answer: A

Rationale: Folic acid supplementation before and during early pregnancy is crucial for reducing the risk of neural tube defects, including anencephaly. Anencephaly is a severe birth defect in which a baby is born without parts of the brain and skull. Folic acid plays a key role in neural tube development and can significantly lower the chances of such defects when taken prior to conception and in early pregnancy.

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