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 in a family planning clinic requests oral contraceptives. Which of the following findings in the client's history should be recognized as contraindications to oral contraceptives? (Select all that apply.)

• A. Cholecystitis
• B. Hypertension
• C. Migraine headaches
• D. All of the above

Correct answer: D

Rationale: Cholecystitis is a correct answer. A history of gallbladder disease, such as cholecystitis, is a contraindication for the use of oral contraceptives. Hypertension is a correct answer. Hypertension is also a contraindication for the use of oral contraceptives due to the increased risk of complications. Migraine headaches are a correct answer. A history of migraine headaches is a contraindication for the use of oral contraceptives, especially for those with aura. Selecting 'All of the above' is correct as all the mentioned conditions (cholecystitis, hypertension, and migraine headaches) are contraindications for oral contraceptives. Human papillomavirus and anxiety disorder are incorrect choices as they are not contraindications for the use of oral contraceptives.

3. A client is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown after childbirth. Which of the following conditions is associated with these manifestations?

• A. Postpartum fatigue
• B. Postpartum psychosis
• C. Letting-go phase
• D. Postpartum blues

Correct answer: D

Rationale: The correct answer is D, Postpartum blues. Postpartum blues, also known as baby blues, are common after childbirth and are characterized by symptoms like tearfulness, insomnia, lack of appetite, and a feeling of letdown. This condition is typically self-limiting and resolves without specific treatment. Postpartum fatigue (choice A) refers to extreme tiredness after childbirth but does not typically include symptoms like tearfulness and insomnia. Postpartum psychosis (choice B) is a severe condition that includes symptoms such as hallucinations and delusions, which are not present in the scenario. The letting-go phase (choice C) does not represent a specific postpartum condition related to the symptoms described.

4. A client with a BMI of 26.5 is seeking advice on weight gain during pregnancy at the first prenatal visit. Which of the following responses should the nurse provide?

• A. It would be best if you gained about 11 to 20 pounds.
• B. The recommendation for you is about 15 to 25 pounds.
• C. A gain of about 25 to 35 pounds is recommended for you.
• D. A gain of about 1 pound per week is the best pattern for you.

Correct answer: B

Rationale: For a client with a BMI of 26.5 (overweight), the recommended weight gain during pregnancy is 15 to 25 pounds. This range helps promote a healthy pregnancy outcome and reduces the risk of complications associated with excessive weight gain. Option A suggests a lower weight gain range, which may not be adequate for a client with a BMI of 26.5. Option C indicates a higher weight gain range, which could lead to complications for an overweight individual. Option D provides a general guideline for weight gain without considering the client's BMI, which is not personalized advice. Therefore, the most appropriate response is option B, offering a suitable weight gain recommendation for the client's BMI to support a healthy pregnancy journey.

5. A newborn was delivered vaginally and experienced a tight nuchal cord. Which of the following clinical manifestations should the nurse expect to observe?

• A. Bruising over the buttocks
• B. Hard nodules on the roof of the mouth
• C. Petechiae over the head
• D. Bilateral periauricular papillomas

Correct answer: C

Rationale: When a newborn experiences a tight nuchal cord during delivery, it can lead to petechiae, which are small red or purple spots on the skin caused by bleeding under the skin. These petechiae may appear over the head, face, and neck due to the pressure of the cord. It is essential for the nurse to recognize this as a possible consequence and monitor the newborn for any signs of complications. Bruising over the buttocks (Choice A) is not typically associated with a tight nuchal cord. Hard nodules on the roof of the mouth (Choice B) are more indicative of Epstein pearls or Bohn's nodules, which are considered normal findings in newborns. Bilateral periauricular papillomas (Choice D) are not related to a tight nuchal cord but are seen in congenital syphilis.

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