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 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. A nurse in a prenatal clinic overhears a newly licensed nurse discussing conception with a client. Which of the following statements by the newly licensed nurse requires intervention by the nurse?

• A. Fertilization takes place in the outer third of the fallopian tube.
• B. Implantation occurs between 6 to 10 days after conception.
• C. Sperm remain viable in the woman's reproductive tract for 2 to 3 days.
• D. Bleeding or spotting can accompany implantation.

Correct answer: B

Rationale: The correct answer is B because implantation typically occurs between 6 to 10 days after conception, not 2 to 3 days. It is crucial for the nurse to intervene and provide accurate information to ensure the client receives correct education about conception. Choice A is correct as fertilization does occur in the outer third of the fallopian tube. Choice C is also accurate as sperm can remain viable in the woman's reproductive tract for 2 to 3 days. Choice D is correct as bleeding or spotting can indeed accompany implantation.

4. When should a provider order a maternal serum alpha-fetoprotein (MSAFP) screening for pregnant clients?

• A. A client who has mitral valve prolapse
• B. A client who has been exposed to AIDS
• C. All pregnant clients
• D. A client who has a history of preterm labor

Correct answer: C

Rationale: Maternal serum alpha-fetoprotein (MSAFP) screening is recommended for all pregnant clients to assess the risk of neural tube defects. It is a routine screening test used to detect increased levels of alpha-fetoprotein in maternal blood, which may indicate a higher risk for conditions such as neural tube defects in the developing fetus. Therefore, all pregnant clients, regardless of their medical history or risk factors, should undergo MSAFP screening as part of routine prenatal care. Choices A, B, and D are incorrect because the MSAFP screening is not specific to certain medical conditions or histories; it is a standard screening procedure for all pregnant individuals to evaluate neural tube defect risk in the fetus.

5. A client is receiving postpartum discharge teaching after being vaccinated for varicella due to lack of immunity. Which statement by the client indicates understanding?

• A. I will need a second vaccination at my postpartum visit.
• B. I need a second vaccination at my postpartum visit.
• C. I was given the vaccine to protect myself from varicella.
• D. I will be tested in 3 months to confirm my immunity status.

Correct answer: B

Rationale: The correct answer is B because the client needs a second varicella vaccination at the postpartum visit to ensure immunity. Option A is incorrect as it implies a future need for a second vaccination without a clear action plan. Option C is incorrect as the varicella vaccine is primarily for the client's protection, not others. Option D is not the appropriate action as waiting to be tested for immunity delays the necessary second vaccination.

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