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 healthcare professional is assessing a newborn immediately following a scheduled cesarean delivery. Which of the following assessments is the healthcare professional's priority?

• A. Respiratory distress
• B. Hypothermia
• C. Accidental lacerations
• D. Acrocyanosis

Correct answer: A

Rationale: The correct answer is A: Respiratory distress. Assessing for respiratory distress is the priority when evaluating a newborn after a cesarean delivery. Newborns born via cesarean section are at higher risk for respiratory complications, making it crucial to monitor their breathing and ensure proper oxygenation immediately after birth. Choice B, hypothermia, is important too but assessing breathing takes precedence to ensure adequate oxygen supply. Choices C and D, accidental lacerations and acrocyanosis, are not the immediate priorities following a cesarean delivery.

3. 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.

4. A healthcare professional in the emergency department is caring for a client who presents with severe abdominal pain in the left lower quadrant. The provider suspects a ruptured ectopic pregnancy. Which of the following signs indicates to the healthcare professional that the client has blood in the peritoneum?

• A. Chvostek's sign
• B. Cullen's sign
• C. Chadwick's sign
• D. Goodell's sign

Correct answer: B

Rationale: Cullen's sign, which presents as bruising around the umbilicus, indicates the presence of blood in the peritoneum. This sign is significant in cases of a ruptured ectopic pregnancy as it suggests intraperitoneal bleeding, prompting immediate medical attention. Chvostek's sign is related to facial muscle spasm and is not indicative of peritoneal bleeding. Chadwick's sign refers to a bluish discoloration of the cervix and vagina during pregnancy, not related to peritoneal bleeding. Goodell's sign is a softening of the cervix, which is a sign of pregnancy, and not specific to peritoneal bleeding.

5. A client in active labor is irritable, reports the urge to have a bowel movement, vomits, and states, 'I've had enough. I can't do this anymore.' Which of the following stages of labor is the client experiencing?

• A. Second stage
• B. Fourth stage
• C. Transition phase
• D. Latent phase

Correct answer: C

Rationale: The client in active labor displaying irritability, the urge to have a bowel movement, nausea, vomiting, and expressing frustration indicates that they are in the transition phase of labor. This phase typically occurs just before entering the second stage of labor, marked by intense contractions and cervical dilation from 8 to 10 centimeters. During this phase, the client may feel overwhelmed, exhausted, and may express a sense of losing control. It is a crucial phase indicating that the client is close to delivering the baby. Choice A, the second stage of labor, is characterized by complete cervical dilation and the birth of the baby, not the symptoms described in the scenario. Choice B, the fourth stage, is the period following the delivery of the placenta, not the phase before giving birth. Choice D, the latent phase, is the early phase of labor where contractions are mild and occur at irregular intervals, not the phase described in the scenario.

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