Nursing Elites

1. When obtaining a health history from a client, a nurse in a woman’s health clinic should identify which of the following findings as increasing the client’s risk for developing pelvic inflammatory disease (PID)?

• A. Recurrent Cystitis
• B. Frequent Alcohol Use
• C. Use of Oral Contraceptives
• D. Chlamydia Infection

Correct answer: D

Rationale: Chlamydia infection is a significant risk factor for developing pelvic inflammatory disease (PID). PID is often caused by untreated sexually transmitted infections (STIs) like Chlamydia and Gonorrhea that ascend from the vagina to the upper reproductive organs. Recurrent cystitis (choice A) is more related to urinary tract infections, frequent alcohol use (choice B) is not directly linked to PID, and the use of oral contraceptives (choice C) does not increase the risk of developing PID.

2. Following a traumatic delivery, an infant receives an initial Apgar score of 3. Which intervention is most important for the nurse to implement?

• A. Page the pediatrician STAT
• B. Continue resuscitative efforts
• C. Repeat the Apgar assessment in 5 minutes
• D. Inform the parents of the infant's condition

Correct answer: B

Rationale: In a situation where an infant receives a low Apgar score of 3 following a traumatic delivery, the most crucial intervention for the nurse to implement is to continue resuscitative efforts. A low Apgar score indicates that the newborn is in distress and requires immediate medical attention to support breathing, heart rate, muscle tone, reflex irritability, and color. Continuing resuscitative efforts is essential to provide life-saving interventions promptly. Paging the pediatrician may cause a delay in crucial interventions, repeating the Apgar assessment in 5 minutes is not appropriate as immediate action is needed to stabilize the infant, and informing parents should not take precedence over providing immediate medical care to the newborn.

3. What should be the primary focus of nursing care in the transitional phase of labor for a client who anticipates an unmedicated delivery?

• A. Assessing the strength of uterine contractions
• B. Re-evaluating the need for medication
• C. Reminding her to push 3 times with each contraction
• D. Assisting her to maintain control

Correct answer: D

Rationale: During the transitional phase of labor, which is the most intense phase, the primary focus of nursing care for a client who anticipates an unmedicated delivery should be assisting her to maintain control. This is essential to help her manage the intense pain and anxiety associated with this phase without the use of medication. Assessing the strength of uterine contractions (Choice A) is important but not the primary focus during the transitional phase. Re-evaluating the need for medication (Choice B) is not applicable as the client anticipates an unmedicated delivery. Reminding her to push 3 times with each contraction (Choice C) is more related to the pushing stage of labor and not the transitional phase.

4. What causes cystic fibrosis?

• A. Sex-linked abnormality.
• B. Abnormality in the 21st pair of chromosomes.
• C. Recessive gene.
• D. Single segment found only on the Y chromosome.

Correct answer: C

Rationale: Cystic fibrosis is a genetic disorder caused by inheriting two copies of a recessive gene, one from each parent. This means that both parents must carry at least one copy of the faulty gene for a child to inherit the condition. Choice A is incorrect because cystic fibrosis is not linked to the sex chromosomes. Choice B is incorrect as cystic fibrosis is not caused by an abnormality in the 21st pair of chromosomes but by a specific gene mutation. Choice D is also incorrect as cystic fibrosis is not related to the Y chromosome, which is specific to males.

5. A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for an induction of labor with misoprostol?

• A. A client who has active genital herpes
• B. A client who has gestational diabetes mellitus
• C. A client who has a previous uterine incision
• D. A client who has placenta previa

Correct answer: B

Rationale: Misoprostol can be used for induction in clients with gestational diabetes mellitus. Choice A, a client with active genital herpes, is not a candidate for misoprostol induction due to the risk of viral shedding and transmission. Choice C, a client with a previous uterine incision, may be at risk for uterine rupture with misoprostol use. Choice D, a client with placenta previa, is not an appropriate candidate for misoprostol induction due to the risk of increased bleeding associated with the condition.

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