Nursing Elites

1. A client is in the first trimester of pregnancy and lacks immunity to rubella. When should the client receive rubella immunization?

• A. Shortly after giving birth
• B. In the third trimester
• C. Immediately
• D. During the next attempt to get pregnant

Correct answer: A

Rationale: Rubella immunization is recommended shortly after giving birth for a pregnant individual who lacks immunity. This timing ensures the client is protected from rubella in future pregnancies. Administering the vaccine postpartum allows the body to develop immunity without posing any risk to the developing fetus during pregnancy. Option B is incorrect because administering the rubella vaccine in the third trimester can potentially expose the developing fetus to the live virus, which is not recommended. Option C is incorrect as there is a preferred timing for rubella immunization in this scenario. Option D is incorrect as waiting until the next attempt to get pregnant does not protect the current pregnancy from rubella exposure.

2. When assessing a newborn with respiratory distress syndrome who received synthetic surfactant, which parameter should the nurse monitor to evaluate the newborn's condition?

• A. Oxygen saturation
• B. Body temperature
• C. Serum bilirubin
• D. Heart rate

Correct answer: A

Rationale: In a newborn with respiratory distress syndrome who has received synthetic surfactant, monitoring oxygen saturation is crucial to evaluate the effectiveness of the treatment. Oxygen saturation levels provide valuable information about the newborn's respiratory status and the adequacy of gas exchange. Changes in oxygen saturation can indicate improvements or deterioration in the newborn's condition following the administration of synthetic surfactant. Monitoring oxygen saturation helps the nurse assess the newborn's response to treatment and make timely interventions if needed. Body temperature, serum bilirubin, and heart rate are important parameters to monitor in newborns for other conditions but are not specific indicators of the effectiveness of synthetic surfactant in treating respiratory distress syndrome.

3. A client has a new prescription for chlamydia. Which of the following statements should the nurse provide?

• A. This infection is treated with one dose of azithromycin.
• B. If your sexual partner has no symptoms, no medication is needed.
• C. You should avoid sexual relations for 3 days.
• D. You need to return in 6 months for retesting.

Correct answer: A

Rationale: The correct treatment for chlamydia is a one-time dose of azithromycin. It is crucial for the client to understand the correct medication regimen for effective treatment. Choice B is incorrect because treatment is necessary for the partner even if asymptomatic. Choice C is incorrect because sexual relations should be avoided until treatment is completed. Choice D is incorrect as retesting should generally occur 3 months after treatment.

4. A woman in a women's health clinic is receiving teaching about nutritional intake during her 8th week of gestation. The healthcare provider should advise the woman to increase her daily intake of which of the following nutrients?

• A. Calcium
• B. Vitamin E
• C. Iron
• D. Vitamin D

Correct answer: C

Rationale: During pregnancy, the recommended daily iron intake is higher compared to non-pregnant women. Pregnant women should aim for 27 mg/day of iron, while non-pregnant women require 15 mg/day if under 19 years old and 18 mg/day if between 19 and 50 years old. Iron is essential during pregnancy to support the increased blood volume and ensure the proper oxygen supply to the fetus. Calcium is important for bone health but does not need a significant increase during early pregnancy. Vitamin E and Vitamin D are important but do not have specific increases recommended during the 8th week of gestation.

5. When providing care for a client in preterm labor at 32 weeks of gestation, which medication should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?

• A. Calcium gluconate
• B. Indomethacin
• C. Nifedipine
• D. Betamethasone

Correct answer: D

Rationale: Betamethasone is the correct medication to anticipate the provider prescribing to hasten fetal lung maturity in clients at risk for preterm labor. It is a corticosteroid that helps promote lung maturation in the preterm fetus by stimulating the production of surfactant, which is essential for lung function. This medication is commonly given to pregnant individuals at risk of preterm delivery between 24 and 34 weeks of gestation to reduce the risk of respiratory distress syndrome in the newborn. Calcium gluconate, Indomethacin, and Nifedipine are not used to hasten fetal lung maturity in preterm labor; they serve different purposes in maternal and fetal care.

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