Nursing Elites

1. A client has experienced a fetal demise following a vaginal delivery at term. What should the nurse advise the client?

• A. “You can bathe and dress your baby if you’d like to.”
• B. “If you don’t hold the baby, it will make letting go much harder.”
• C. “You should name the baby so he/she can have an identity.”
• D. “I’m sure you will be able to have another baby when you’re ready.”

Correct answer: A

Rationale: After a fetal demise, allowing the parents to bathe and dress their baby can offer them a sense of closure and help them in their grieving process. This act can provide a tangible way for the parents to bond with their baby and create lasting memories. Option B is incorrect because each individual may have different emotional needs and holding the baby may not be appropriate or helpful for everyone. Option C, while well-intentioned, may not be suitable for all parents as naming the baby could be emotionally challenging. Option D is insensitive as it overlooks the grieving process of losing a baby by suggesting a replacement.

2. The healthcare provider is preparing to administer phytonadione (vitamin K) to a newborn. Which statement made by the parents indicates understanding why the healthcare provider is administering this medication?

• A. Improve insufficient dietary intake
• B. Stimulate the immune system
• C. Help an immature liver
• D. Prevent hemorrhagic disorders

Correct answer: D

Rationale: The correct answer is D because phytonadione (vitamin K) is administered to newborns to prevent hemorrhagic disease due to their low levels of vitamin K, which is essential for blood clotting. Choice A is incorrect as vitamin K administration is not related to improving dietary intake. Choice B is incorrect as vitamin K doesn't stimulate the immune system. Choice C is incorrect as vitamin K is not given to help an immature liver, but rather to prevent hemorrhagic disorders.

3. Most victims of _____ die of respiratory infections in their 20s.

• A. Tay-Sachs disease
• B. cystic fibrosis
• C. Turner syndrome
• D. Klinefelter syndrome

Correct answer: B

Rationale: Individuals with cystic fibrosis have a genetic disorder that causes mucus to be thick and sticky, leading to blockages in the lungs and digestive system. This mucus buildup makes them more susceptible to severe respiratory infections, which can ultimately result in premature death in their 20s. Tay-Sachs disease (Choice A) is a genetic disorder that affects the nervous system, not typically causing respiratory infections. Turner syndrome (Choice C) and Klinefelter syndrome (Choice D) are chromosomal disorders that do not directly lead to the respiratory issues observed in cystic fibrosis.

4. A multiparous client at 36 hours postpartum reports increased bleeding and cramping. On examination, the nurse finds the uterine fundus 2 centimeters above the umbilicus. Which action should the nurse take first?

• A. Increase the intravenous fluid to 150 ml/hr.
• B. Call the healthcare provider.
• C. Encourage the client to void.
• D. Administer ibuprofen 800 milligrams by mouth.

Correct answer: C

Rationale: Encouraging the client to void is the priority action in this scenario. A distended bladder can prevent the uterus from contracting properly, leading to increased bleeding and a high uterine fundus. By encouraging the client to void, the nurse can help the uterus contract effectively, reducing bleeding. Increasing intravenous fluids or administering ibuprofen would not address the immediate concern of a distended bladder affecting uterine contraction. While it may be necessary to involve the healthcare provider, addressing the bladder distention promptly is crucial to prevent further complications.

5. A healthcare provider is assessing a preterm newborn who is at 32 weeks of gestation. Which of the following finding should the healthcare provider expect?

• A. Minimal arm recoil
• B. Popliteal angle of less than 90°
• C. Creases over the entire sole
• D. Sparse lanugo

Correct answer: A

Rationale: When assessing a preterm newborn at 32 weeks of gestation, healthcare providers should expect minimal arm recoil. This finding is common in preterm infants due to lower muscle tone. Choice B, a popliteal angle of less than 90°, is incorrect for this age group. Creases over the entire sole (Choice C) typically develop at term age, not at 32 weeks of gestation. Sparse lanugo (Choice D) is a normal finding in preterm infants but is not specific to those at 32 weeks of gestation.

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