Nursing Elites

1. A client is postpartum and has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect?

• A. Decreased platelet count
• B. Increased erythrocyte sedimentation rate (ESR)
• C. Decreased megakaryocytes
• D. Increased WBC

Correct answer: A

Rationale: Idiopathic thrombocytopenic purpura (ITP) is characterized by an autoimmune response that leads to a decreased platelet count. This condition increases the risk of bleeding due to the low platelet levels. Monitoring the platelet count is crucial in managing ITP, as it helps determine the risk of bleeding and guides treatment decisions. Therefore, the correct finding to expect in a client with ITP is a decreased platelet count. Choice B, an increased erythrocyte sedimentation rate (ESR), is not typically associated with ITP. Choice C, decreased megakaryocytes, may be seen in conditions like aplastic anemia but are not a typical finding in ITP. Choice D, an increased white blood cell count (WBC), is not a characteristic feature of ITP.

2. A healthcare professional is assisting with the care of a client who is receiving IV magnesium sulfate. Which of the following medications should the healthcare professional anticipate administering if magnesium sulfate toxicity is suspected?

• A. Nifedipine
• B. Pyridoxine
• C. Ferrous sulfate
• D. Calcium gluconate

Correct answer: D

Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity. In cases of magnesium sulfate toxicity, calcium gluconate is administered to counteract the effects of magnesium and restore calcium levels. Magnesium toxicity can lead to symptoms such as muscle weakness, respiratory depression, and cardiac arrhythmias. Calcium gluconate helps in reversing these effects by competing with magnesium and preventing its adverse manifestations. Nifedipine is a calcium channel blocker used for conditions like hypertension and angina, not for magnesium toxicity. Pyridoxine is vitamin B6 and is not the antidote for magnesium toxicity. Ferrous sulfate is an iron supplement and is not used to treat magnesium sulfate toxicity.

3. A nurse in a health clinic is reinforcing teaching about contraceptive use with a group of clients. Which of the following client statements demonstrates understanding?

• A. Using a water-soluble lubricant with condoms can help prevent breakage and ensure effectiveness in preventing pregnancy and STIs.
• B. A diaphragm should be removed 2 hours after intercourse.
• C. Oral contraceptives can worsen a case of acne.
• D. A contraceptive patch is replaced once a month.

Correct answer: A

Rationale: The correct answer is A because using a water-soluble lubricant with condoms can help prevent breakage and ensure effectiveness in preventing pregnancy and sexually transmitted infections (STIs). This statement demonstrates the client's understanding of the importance of proper condom use to maximize protection. Choice B is incorrect because a diaphragm should be left in place for at least 6 hours after intercourse to ensure contraceptive effectiveness. Choice C is incorrect as oral contraceptives are known to improve acne in some cases. Choice D is incorrect because a contraceptive patch is typically replaced weekly, not monthly.

4. A client who is pregnant is scheduled for a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply)

• A. Decreased fetal movement
• B. Intrauterine growth restriction (IUGR)
• C. Postmaturity
• D. All of the Above

Correct answer: D

Rationale: A contraction stress test (CST) is performed to assess how the fetus responds to the stress of contractions. Indications for this test include decreased fetal movement, intrauterine growth restriction (IUGR), and postmaturity. These conditions may warrant the need for a CST to evaluate fetal well-being and determine appropriate management. Therefore, all of the above options are correct indications for a contraction stress test. Options A, B, and C are incorrect because they are all valid reasons for performing a CST in a pregnant client.

5. A healthcare provider is assessing fetal heart tones for a pregnant client. The provider has determined the fetal position as left occipital anterior. To which of the following areas of the client's abdomen should the provider apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart?

• A. Left upper quadrant
• B. Right upper quadrant
• C. Left lower quadrant
• D. Right lower quadrant

Correct answer: C

Rationale: When the fetal position is left occipital anterior, the point of maximum intensity of the fetal heart is best heard in the left lower quadrant of the client's abdomen. Placing the ultrasound transducer in the left lower quadrant allows for optimal detection of fetal heart tones in this specific fetal position. Choice A (Left upper quadrant) is incorrect as it is not where the fetal heart tones are best heard in this scenario. Choice B (Right upper quadrant) is also incorrect as it is not the recommended area for assessing fetal heart tones in a left occipital anterior position. Choice D (Right lower quadrant) is incorrect as the focus should be on the left side due to the fetal position mentioned.

Similar Questions