Nursing Elites

1. A healthcare provider is assisting with the care for a client who reports manifestations of preterm labor. Which of the following findings are risk factors for this condition? (Select all that apply)

• A. Urinary tract infection
• B. Multifetal pregnancy
• C. Oligohydramnios
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D: All of the Above. Multiple risk factors can contribute to preterm labor, including urinary tract infection, multifetal pregnancy, and oligohydramnios. These factors can lead to the uterus being irritated or overstimulated, potentially triggering early labor. Urinary tract infections can cause inflammation and contractions, multifetal pregnancies have a higher risk of preterm labor due to increased uterine stretching, and oligohydramnios can lead to poor fetal growth and premature contractions. Therefore, clients presenting with these conditions require close monitoring and management to prevent preterm birth. Choices A, B, and C are all correct risk factors for preterm labor, making option D the correct answer.

2. A nurse is providing education about family bonding to parents who recently adopted a newborn. The nurse should make which of the following suggestions to aid the family's 7-year-old child in accepting the new family member?

• A. Allow the sibling to hold the newborn during a bath.
• B. Make sure the sibling kisses the newborn each night.
• C. Obtain a gift from the newborn to present to the sibling.
• D. Switch the sibling's room with the nursery.

Correct answer: C

Rationale: To help a 7-year-old child accept a new family member, it is important to involve them in the process. Obtaining a gift from the newborn to present to the sibling is a thoughtful gesture that can make the older child feel included and valued in the family dynamic. This strategy fosters a sense of connection and understanding between the siblings, promoting acceptance and bonding. Choices A, B, and D are incorrect as they do not directly involve the older sibling in a positive and inclusive manner. Allowing the sibling to hold the newborn during a bath or making them kiss the newborn might not resonate well with the 7-year-old and could potentially create negative feelings. Switching the sibling's room with the nursery is a major change that may not necessarily promote acceptance and bonding, and it could lead to feelings of displacement or confusion.

3. A pregnant client is learning about Kegel exercises in the third trimester. Which statement signifies understanding of the teaching?

• A. These exercises facilitate preventing constipation.
• B. These exercises aid pelvic muscle stretching during birth.
• C. They assist in decreasing backaches.
• D. They can prevent additional stretch marks.

Correct answer: B

Rationale: Kegel exercises are beneficial during pregnancy to help strengthen pelvic muscles, which is crucial for childbirth. Pelvic muscle stretching during birth is a key aspect of labor, making choice B the correct statement indicating understanding of the teaching. Choices A, C, and D are incorrect because Kegel exercises primarily focus on strengthening pelvic floor muscles to support the uterus, bladder, and bowel, aiding in labor and delivery. They are not directly related to preventing constipation, decreasing backaches, or preventing stretch marks.

4. A nurse is admitting a term newborn following a cesarean birth. The nurse observes that the newborn's skin is slightly yellow. This finding indicates the newborn is experiencing a complication related to which of the following?

• A. Maternal/newborn blood group incompatibility
• B. Absence of vitamin K
• C. Physiologic jaundice
• D. Maternal cocaine abuse

Correct answer: A

Rationale: The yellow skin observed in the newborn suggests jaundice. Maternal/newborn blood group incompatibility is a common cause of jaundice in newborns. This occurs when the mother and baby have different blood types, leading to the baby's immune system attacking the red blood cells, causing jaundice. Physiologic jaundice, which is a normal process due to the breakdown of red blood cells in newborns, typically presents after the first 24 hours of life. Absence of vitamin K leads to bleeding issues, not jaundice. Maternal cocaine abuse does not directly cause jaundice in newborns.

5. A client is reinforcing discharge teaching with a client who has premature rupture of membranes at 26 weeks of gestation. Which of the following instructions should the client include?

• A. Use a condom with sexual intercourse
• B. Avoid bubble bath solution when taking a tub bath
• C. Wipe from front to back when performing perineal hygiene
• D. Keep a daily record of fetal kick counts

Correct answer: D

Rationale: Keeping a daily record of fetal kick counts is crucial for clients with premature rupture of membranes at 26 weeks of gestation as it helps monitor fetal well-being. This activity enables the client to assess the frequency and strength of fetal movements, which can provide important information about the fetus' health and development. Other options such as using a condom with sexual intercourse, avoiding bubble bath solution, and wiping from front to back are important for general perinatal care but are not specifically related to managing premature rupture of membranes.

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