Nursing Elites

1. When caring for a client in labor, which of the following infections can be treated during labor or immediately following birth? (Select all that apply)

• A. Gonorrhea
• B. Chlamydia
• C. HIV
• D. All of the Above

Correct answer: D

Rationale: Infections such as gonorrhea, chlamydia, and HIV can be treated during labor or immediately following birth to prevent transmission to the newborn. It is crucial to identify and treat these infections promptly to reduce the risk of vertical transmission to the infant. Therefore, all the given options are correct as they can be treated during labor or immediately following birth to prevent transmission to the newborn. Other choices are incorrect because only gonorrhea, chlamydia, and HIV can be effectively treated during labor or immediately after birth to prevent vertical transmission.

2. What is the most appropriate statement for a nurse to make to a client who has recently experienced a perinatal death?

• A. It must be a comfort to know you have another child.
• B. I'm sad for you.
• C. There is usually something wrong with the baby.
• D. You will always have an angel in heaven.

Correct answer: B

Rationale: Option B, 'I'm sad for you,' is the most appropriate response for the nurse to make to the client who has experienced a perinatal death. This statement conveys empathy and compassion, acknowledging the client's grief and validating their emotions. It opens the door for the client to express their feelings and facilitates further communication and support from the nurse. Choices A, C, and D are not appropriate in this context. Choice A may come across as dismissive of the client's grief by redirecting the focus to another child. Choice C suggests blame or fault, which is not helpful or accurate in most cases of perinatal death. Choice D, while well-intentioned, may not be comforting to all clients and could impose a specific belief system on the client's experience.

3. When educating a pregnant client about potential complications, which manifestation should the nurse emphasize reporting to the provider promptly?

• A. Vaginal bleeding
• B. Swelling of the ankles
• C. Heartburn after eating
• D. Lightheadedness when lying on back

Correct answer: A

Rationale: Vaginal bleeding during pregnancy is a concerning sign that could indicate serious complications like miscarriage or placental issues. Prompt reporting to the healthcare provider is crucial for timely evaluation and management to ensure the best outcomes for both the mother and the baby. Swelling of the ankles (choice B), heartburn after eating (choice C), and lightheadedness when lying on the back (choice D) are common discomforts during pregnancy but are not typically associated with serious complications that require immediate attention.

4. A healthcare provider is assisting with the care of a newborn immediately following birth. Which of the following nursing interventions is the highest priority?

• A. Initiating breastfeeding
• B. Performing the initial bath
• C. Giving a vitamin K injection
• D. Covering the newborn's head with a cap

Correct answer: D

Rationale: Covering the newborn's head with a cap is the highest priority immediately following birth to prevent heat loss. Newborns are at risk of hypothermia due to their immature thermoregulation, making it crucial to maintain their body temperature. By covering the newborn's head with a cap, heat loss through the head is minimized, helping to keep the baby warm and stable in the immediate post-birth period. Initiating breastfeeding, performing the initial bath, and giving a vitamin K injection are important interventions but are not as high a priority as ensuring the newborn's thermal stability.

5. A client who is at 24 weeks of gestation is scheduled for a 1-hour glucose tolerance test. Which of the following statements should the nurse include in her teaching?

• A. You will need to drink the glucose solution 1 hour prior to the test.
• B. Limit your carbohydrate intake for 24 hours prior to the test.
• C. A blood glucose of 130 to 140 mg/dL is considered a positive screening result.
• D. You will need to fast for 8 hours prior to the test.

Correct answer: C

Rationale: The correct statement to include in the teaching for a client scheduled for a 1-hour glucose tolerance test at 24 weeks of gestation is that a blood glucose level of 130 to 140 mg/dL is considered a positive screening result. This range indicates a potential issue with glucose metabolism and would prompt the need for a follow-up 3-hour glucose tolerance test to confirm the diagnosis of gestational diabetes mellitus. Choices A, B, and D are incorrect. In a 1-hour glucose tolerance test, the glucose solution is typically consumed within a specific timeframe before the test, not necessarily 1 hour prior. There is usually no specific requirement to limit carbohydrate intake for 24 hours prior to the test. Fasting for 8 hours prior to the test is more common for a fasting glucose test, not a 1-hour glucose tolerance test.

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