Nursing Elites

1. A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make?

• A. It's a minor inconvenience, which you should ignore.
• B. In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone.
• C. There is no way to predict how long it will last in each individual client.
• D. It occurs during the first trimester and near the end of the pregnancy.

Correct answer: D

Rationale: Urinary frequency is common during the first trimester and again at the end of pregnancy when the baby drops into the pelvis, putting pressure on the bladder.

2. A client who received carboprost for postpartum hemorrhage is being assessed by a nurse. Which of the following findings is an adverse effect of this medication?

• A. Hypertension
• B. Hypothermia
• C. Constipation
• D. Muscle weakness

Correct answer: A

Rationale: The correct answer is A: Hypertension. Carboprost is a vasoconstrictor medication used to control postpartum hemorrhage by contracting the uterus. One of the adverse effects of carboprost is hypertension due to its vasoconstrictive properties. Hypertension can occur as a result of increased peripheral vascular resistance. Choices B, C, and D are incorrect. Hypothermia, constipation, and muscle weakness are not typically associated with the administration of carboprost. It is crucial for the nurse to monitor the client's blood pressure closely while on carboprost to promptly detect and manage hypertension.

3. When providing care for a client in preterm labor at 32 weeks of gestation, which medication should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?

• A. Calcium gluconate
• B. Indomethacin
• C. Nifedipine
• D. Betamethasone

Correct answer: D

Rationale: Betamethasone is the correct medication to anticipate the provider prescribing to hasten fetal lung maturity in clients at risk for preterm labor. It is a corticosteroid that helps promote lung maturation in the preterm fetus by stimulating the production of surfactant, which is essential for lung function. This medication is commonly given to pregnant individuals at risk of preterm delivery between 24 and 34 weeks of gestation to reduce the risk of respiratory distress syndrome in the newborn. Calcium gluconate, Indomethacin, and Nifedipine are not used to hasten fetal lung maturity in preterm labor; they serve different purposes in maternal and fetal care.

4. A nurse in a clinic receives a phone call from a client who would like information about pregnancy testing. Which of the following information should the nurse provide to the client?

• A. You should wait 4 weeks after conception to be tested for pregnancy.
• B. You should be off any medications for 24 hours prior to the pregnancy test.
• C. You should not eat or drink for at least 8 hours prior to the pregnancy test.
• D. You should use your first morning urination specimen for a home pregnancy test.

Correct answer: D

Rationale: For the most accurate results, a home pregnancy test should be done using the first morning urine, which contains the highest concentration of hCG.

5. A client in active labor has 7 cm of cervical dilation, 100% effacement, and the fetus at 1+ station. The client's amniotic membranes are intact, but she suddenly expresses the need to push. What should the nurse do?

• A. Assist the client into a comfortable position.
• B. Observe the perineum for signs of crowning.
• C. Have the client pant during the next contractions.
• D. Help the client to the bathroom to void.

Correct answer: C

Rationale: Having the client pant during contractions is crucial to prevent premature pushing, particularly when the cervix is not fully dilated. Premature pushing can lead to cervical swelling and may impede the progress of labor. It is important to allow the cervix to fully dilate before active pushing to prevent complications. Assisting the client into a comfortable position (Choice A) may not address the urge to push and can lead to premature pushing. Observing the perineum for signs of crowning (Choice B) is important but does not address the immediate need to prevent premature pushing. Helping the client to the bathroom to void (Choice D) does not address the urge to push and may not be appropriate at this stage of labor.

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