Nursing Elites

1. A client has active genital herpes simplex virus type 2. Which of the following medications should the nurse plan to administer?

• A. Metronidazole
• B. Penicillin
• C. Acyclovir
• D. Gentamicin

Correct answer: C

Rationale: Acyclovir is the antiviral medication specifically used to treat herpes simplex virus infections, including genital herpes caused by herpes simplex virus type 2. Metronidazole (Choice A) is an antibiotic used for different types of infections, but not for viral infections like herpes. Penicillin (Choice B) is an antibiotic effective against bacterial infections, not viruses like herpes. Gentamicin (Choice D) is an antibiotic mainly used to treat bacterial infections, not viral infections like herpes.

2. A client who is 24 weeks gestation arrives at the clinic reporting swollen hands. On examination, the nurse notes the client has had a rapid weight gain over six weeks. Which action should the nurse implement next?

• A. Review the client's previous blood pressures in the chart.
• B. Obtain the client's blood pressure.
• C. Observe and time the client's contractions.
• D. Examine the client for pedal edema.

Correct answer: B

Rationale: Swollen hands and rapid weight gain could be signs of preeclampsia, so the next step is to check the client's blood pressure. Elevated blood pressure is a key indicator in assessing for preeclampsia in pregnancy. Reviewing the client's previous blood pressures may provide additional context but obtaining the current blood pressure is crucial for immediate assessment. Observing and timing contractions are not relevant in this scenario as the client is not presenting with signs of active labor. Examining for pedal edema is important in assessing for fluid retention, but obtaining the blood pressure takes precedence in this case due to the potential seriousness of preeclampsia.

3. A newborn who was born post-term is being assessed by a nurse. Which of the following findings should the nurse expect?

• A. A Rh-negative mother who has an Rh-positive infant
• B. A Rh-positive mother who has an Rh-negative infant
• C. A Rh-positive mother who has an Rh-positive infant
• D. A Rh-negative mother who has an Rh-negative infant

Correct answer: A

Rationale: The correct answer is A: 'A Rh-negative mother who has an Rh-positive infant.' In cases where the newborn is born post-term, the mismatched Rh factor between the mother (Rh-negative) and the infant (Rh-positive) can lead to hemolytic disease of the newborn. This condition occurs when maternal antibodies attack fetal red blood cells, causing hemolysis. This can result in jaundice, anemia, and other serious complications for the infant. Choices B, C, and D are incorrect because they do not reflect the mismatched Rh factor scenario that poses a risk for hemolytic disease of the newborn.

4. A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began one hour ago. The nurse's assessment reveals approximately 30ML of bright red vaginal bleeding, fetal heart rate of 130 - 140 beats per minute, no contractions, and no complaints of pain. What is the most likely cause of this client's bleeding?

• A. Abruptio Placenta
• B. Placenta Previa
• C. Normal bloody show indicating induction of labor
• D. A ruptured blood vessel in the vaginal vault

Correct answer: B

Rationale: Placenta previa, a condition where the placenta covers the cervix, can cause painless, bright red vaginal bleeding in the third trimester. In this scenario, the absence of contractions and pain, along with the presence of significant bright red bleeding, is more indicative of placenta previa rather than abruptio placenta or a ruptured vessel. A normal bloody show typically occurs closer to the onset of labor and is not associated with the amount of bleeding described in the question.

5. A client has bacterial vaginosis. Which of the following medications should the nurse expect to administer?

• A. Metronidazole
• B. Fluconazole
• C. Acyclovir
• D. Clindamycin

Correct answer: A

Rationale: Metronidazole is the correct choice for treating bacterial vaginosis as it is the first-line medication recommended for this condition. Metronidazole works by disrupting the DNA structure of bacteria, making it an effective treatment. Choice B, Fluconazole, is an antifungal medication primarily used for treating fungal infections, not bacterial vaginosis. Choice C, Acyclovir, is an antiviral medication used to treat viral infections, not bacterial vaginosis. Choice D, Clindamycin, is also used to treat bacterial infections but is not the first-line treatment for bacterial vaginosis, making it an incorrect choice in this scenario.

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