Nursing Elites

1. A home care nurse is following up with a postpartum client. Which of the following is a risk factor that places this client at risk for postpartum depression?

• A. History of anxiety
• B. Socioeconomic status
• C. Hormonal changes with a rapid decline in estrogen and progesterone
• D. Support from family members

Correct answer: C

Rationale: Postpartum depression can be triggered by various factors, but one of the strongest predictors is a rapid drop in estrogen and progesterone levels following childbirth. These hormonal changes can affect mood regulation, making some women more vulnerable to depression during the postpartum period. Choices A, B, and D are not direct risk factors associated with postpartum depression. While a history of anxiety may contribute, it is not as directly linked to the hormonal changes that occur postpartum. Socioeconomic status and support from family members may influence the overall well-being of the mother but are not specific risk factors for postpartum depression.

2. A nurse is caring for a newborn diagnosed with necrotizing enterocolitis (NEC). Which of the following interventions should the nurse expect to implement?

• A. Withhold oral feedings
• B. Measure abdominal girth
• C. Position the newborn supine
• D. Apply cold compresses to the abdomen

Correct answer: B

Rationale: Measuring abdominal girth is crucial in monitoring for signs of abdominal distension, which is a key indicator of worsening necrotizing enterocolitis (NEC). It helps in assessing the progression of the condition. Positioning the newborn supine, as in choice C, can help relieve pressure on the abdomen but does not directly monitor the condition. Applying cold compresses, as in choice D, is not recommended for NEC as it can constrict blood vessels and potentially worsen the condition. Withholding oral feedings, as in choice A, is also important to rest the bowel and prevent further complications, but measuring abdominal girth is more directly related to monitoring the progression of NEC.

3. A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?

• A. Notify your provider if you experience restlessness or spasms of the face or neck.
• B. Take the medication only if you feel nauseous.
• C. Avoid drinking any fluids while taking this medication.
• D. Take the medication on an empty stomach.

Correct answer: A

Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can cause extrapyramidal symptoms, such as restlessness and muscle spasms, particularly of the face and neck. These symptoms should be reported to the provider immediately. Choice B is incorrect because metoclopramide is not meant to be taken only when feeling nauseous; it is used to treat nausea and vomiting. Choice C is incorrect because it is important to stay hydrated while taking metoclopramide. Choice D is incorrect because metoclopramide is usually taken before meals to improve gastric emptying, not necessarily on an empty stomach.

4. A client who is 28 weeks pregnant and has preeclampsia is being cared for by a nurse. Which of the following is the priority assessment?

• A. Level of consciousness
• B. Deep tendon reflexes
• C. Blood pressure
• D. Urinary output

Correct answer: C

Rationale: Blood pressure is the priority assessment in clients with preeclampsia because hypertension is the primary symptom of the condition. Elevated blood pressure increases the risk of complications such as eclampsia and placental abruption. Assessing the blood pressure helps in monitoring the severity of the preeclampsia and guiding appropriate interventions. While monitoring the client's level of consciousness, deep tendon reflexes, and urinary output are important, they are secondary assessments in the context of preeclampsia.

5. A nurse is caring for a client with chronic pain. Which of the following interventions should the nurse prioritize?

• A. Administer pain medications as prescribed
• B. Encourage physical activity
• C. Monitor for depression
• D. Educate about alternative therapies

Correct answer: A

Rationale: Administering pain medications as prescribed is a priority to manage chronic pain effectively. Pain medications help alleviate the client's discomfort and improve their quality of life. Encouraging physical activity, monitoring for depression, and educating about alternative therapies are important interventions but may not directly address the immediate need for pain relief in a client with chronic pain. Physical activity and alternative therapies can be beneficial as part of a holistic pain management plan, but addressing the pain directly should be the initial priority.

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