Nursing Elites

1. In a prenatal clinic, a client in the first trimester of pregnancy has a health record that includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply)

• A. Client has delivered one newborn at term
• B. Client has experienced no preterm labor
• C. Client has had two prior pregnancies
• D. ALL OF THE ABOVE - has one living child

Correct answer: D

Rationale: The client's health record data is interpreted as follows: G3 (gravida 3 - total number of pregnancies), T1 (term births - number of full-term deliveries), P0 (preterm births - number of preterm deliveries), A1 (abortions/miscarriages - total number of miscarriages or abortions), L1 (living children - total number of living children). Therefore, the client has had three pregnancies, one full-term delivery, no preterm labor, one miscarriage/abortion, and one living child. The correct interpretation is that the client has delivered one newborn at term, experienced no preterm labor, had two prior pregnancies, and has one living child. Therefore, choice D is correct. Choices A, B, and C are incorrect as they do not provide a comprehensive interpretation of all aspects of the client's health record data.

2. A healthcare provider is discussing the differences between true labor and false labor with a group of expectant parents. Which of the following characteristics should the healthcare provider include when discussing true labor?

• A. Contractions become stronger with walking.
• B. Discomfort can be relieved with a back massage.
• C. Contractions become irregular with a change in activity.
• D. Discomfort is felt above the umbilicus.

Correct answer: A

Rationale: During true labor, contractions typically become stronger and more regular with activity, such as walking. This is a key characteristic that helps differentiate true labor from false labor. In false labor, contractions often remain irregular and do not intensify with changes in activity. Choice B is incorrect because discomfort in true labor is not typically relieved with a back massage. Choice C is incorrect as contractions in true labor become stronger and more regular with activity rather than irregular. Choice D is incorrect because discomfort in true labor is usually felt in the lower abdomen and pelvis, not above the umbilicus.

3. A client at 38 weeks of gestation with a diagnosis of preeclampsia has the following findings. Which of the following should the nurse identify as inconsistent with preeclampsia?

• A. 1+ pitting sacral edema
• B. 3+ protein in the urine
• C. Blood pressure 148/98 mm Hg
• D. Deep tendon reflexes of +1

Correct answer: D

Rationale: Deep tendon reflexes of +1 are inconsistent with preeclampsia. Preeclampsia typically presents with hyperreflexia, not diminished reflexes. Diminished reflexes may indicate other neurological conditions, thus making this finding inconsistent with preeclampsia. Choices A, B, and C are consistent with preeclampsia. Pitting sacral edema, protein in the urine, and elevated blood pressure are common findings in preeclampsia due to fluid retention, kidney involvement, and hypertension associated with the condition.

4. A nurse is assisting the nurse manager with an educational session about ways to prevent TORCH infections during pregnancy with a group of newly licensed nurses. Which of the following statements by one of the session participants indicates understanding?

• A. Seeking an immunization against rubella early in pregnancy.
• B. Receiving prophylactic treatment for cytomegalovirus if detected during pregnancy.
• C. Clients should avoid crowded places during pregnancy.
• D. Clients should avoid consuming undercooked meat while pregnant.

Correct answer: D

Rationale: The correct answer is D. To prevent TORCH infections during pregnancy, it is essential for clients to avoid consuming undercooked meat, as it can be a potential source of toxoplasmosis. This infection, along with others in the TORCH group, can pose risks to the fetus, making it crucial for pregnant individuals to follow proper food safety practices. Choices A, B, and C are incorrect because seeking an immunization against rubella, receiving prophylactic treatment for cytomegalovirus, and avoiding crowded places are not directly related to preventing TORCH infections through food safety measures.

5. Which of the following medications should the provider prescribe for a client with gonorrhea?

• A. Ceftriaxone
• B. Fluconazole
• C. Metronidazole
• D. Zidovudine

Correct answer: A

Rationale: Ceftriaxone is the preferred medication to treat gonorrhea, a bacterial infection. It is essential to promptly treat gonorrhea to prevent complications such as pelvic inflammatory disease, infertility, and the spread of the infection to others. Fluconazole is used for fungal infections, Metronidazole treats certain bacterial and parasitic infections, and Zidovudine is an antiretroviral medication used in HIV treatment; none of these are appropriate for gonorrhea.

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