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 client at 32 weeks of gestation with placenta previa is actively bleeding. Which medication should the provider likely prescribe?

• A. Betamethasone
• B. Indomethacin
• C. Nifedipine
• D. Methylergonovine

Correct answer: A

Rationale: In cases of placenta previa with active bleeding at 32 weeks of gestation, Betamethasone is prescribed to accelerate fetal lung maturity in anticipation of potential preterm delivery. This medication helps in reducing the risk of respiratory distress syndrome in the newborn, which is crucial in managing such high-risk pregnancies. Indomethacin is a nonsteroidal anti-inflammatory drug not indicated in this scenario and may be contraindicated due to its effects on platelet function and potential risk of bleeding. Nifedipine is a calcium channel blocker used for conditions like preterm labor or hypertension, not specifically for placenta previa with active bleeding. Methylergonovine is a uterotonic drug used to prevent or control postpartum hemorrhage, not indicated for placenta previa with active bleeding.

3. A healthcare professional is preparing to administer prophylactic eye ointment to a newborn to prevent ophthalmia neonatorum. Which of the following medications should the healthcare professional anticipate administering?

• A. Ofloxacin
• B. Nystatin
• C. Erythromycin
• D. Ceftriaxone

Correct answer: C

Rationale: Erythromycin eye ointment is the medication of choice for preventing ophthalmia neonatorum, an eye infection in newborns caused by exposure to gonorrhea or chlamydia during birth. Erythromycin helps prevent the transmission of these bacteria from the mother to the baby during delivery, protecting the newborn's eyes from potential infection. Ofloxacin, Nystatin, and Ceftriaxone are not indicated for preventing ophthalmia neonatorum. Ofloxacin is a fluoroquinolone antibiotic used for treating eye infections in adults, Nystatin is an antifungal medication used for fungal infections, and Ceftriaxone is a cephalosporin antibiotic used for various bacterial infections, but not for preventing ophthalmia neonatorum.

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 nurse on the labor and delivery unit is caring for a client who is having a difficult, prolonged labor with severe backache. Which of the following contributing causes should the nurse identify?

• A. Fetal attitude is in general flexion.
• B. Fetal lie is longitudinal.
• C. Maternal pelvis is gynecoid.
• D. Fetal position is persistent occiput posterior.

Correct answer: D

Rationale: The correct answer is D. In a persistent occiput posterior position, the baby's head presses against the mother's spine, causing prolonged labor and severe backache. This position can lead to difficulties in labor progress and increase discomfort for the mother. Choices A, B, and C are incorrect as they do not directly relate to the client's difficult, prolonged labor with severe backache. Fetal attitude, fetal lie, and maternal pelvis type may affect labor, but in this scenario, the persistent occiput posterior fetal position is the primary contributing cause for the client's symptoms.

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