Nursing Elites

1. A client with hyperemesis gravidarum is being cared for by a nurse. Which of the following laboratory tests should the nurse anticipate?

• A. Urine Ketones
• B. Rapid plasma reagin
• C. Prothrombin time
• D. Urine culture

Correct answer: A

Rationale: Urine ketones should be anticipated as a laboratory test for a client with hyperemesis gravidarum because it helps assess the severity of dehydration and malnutrition, which are common complications of this condition. Choice B, rapid plasma reagin, is a test for syphilis and is not relevant to hyperemesis gravidarum. Choice C, prothrombin time, is a measure of blood clotting function and is not typically indicated for hyperemesis gravidarum. Choice D, urine culture, is used to identify bacteria in the urine and is not directly related to assessing dehydration and malnutrition in clients with hyperemesis gravidarum.

2. A client who is receiving prenatal care is at her 24-week appointment. Which of the following laboratory tests should the nurse plan to conduct?

• A. Group B strep culture
• B. 1-hour glucose tolerance test
• C. Rubella titer
• D. Blood type and Rh

Correct answer: B

Rationale: The correct answer is B: 1-hour glucose tolerance test. At around 24-28 weeks of gestation, a pregnant individual is typically screened for gestational diabetes. The 1-hour glucose tolerance test helps in identifying elevated blood sugar levels during pregnancy. Choice A, Group B strep culture, is not typically performed at the 24-week appointment but later in the third trimester to screen for Group B streptococcus colonization. Choice C, Rubella titer, is usually checked early in pregnancy to determine immunity to rubella. Choice D, Blood type and Rh, is important for determining the client's blood type and Rh status, but it is usually done earlier in pregnancy and not specifically at the 24-week appointment.

3. A client is receiving oxytocin by continuous IV infusion for labor induction. Which of the following interventions should the nurse include in the plan?

• A. Increase the infusion rate every 30 to 60 minutes.
• B. Maintain the client in a supine position.
• C. Titrate the infusion rate by 4 milliunits/min.
• D. Limit IV intake to 4 L per 24 hours.

Correct answer: A

Rationale: The correct answer is to increase the infusion rate every 30 to 60 minutes. This approach allows for the careful monitoring and adjustment of oxytocin administration during labor induction. Choice B is incorrect because maintaining the client in a supine position can decrease blood flow to the placenta and compromise fetal oxygenation. Choice C is incorrect as titrating the infusion rate by 4 milliunits/min is not a standard practice for oxytocin administration. Choice D is incorrect as limiting IV intake to 4 L per 24 hours is not specifically related to the administration of oxytocin for labor induction.

4. According to a study conducted in 2013 by Fellman, what affects the chances of having twins?

• A. Increase when a woman conceives at a younger age.
• B. Increase with parental age.
• C. Decrease with the frequency of intercourse before conception.
• D. Decrease with the use of fertility drugs.

Correct answer: B

Rationale: The correct answer is B. According to the study by Fellman in 2013, the chances of having twins actually increase with parental age. Choice A is incorrect as the study does not specify a younger age for conceiving to increase the chances of twins. Choice C is incorrect as the frequency of intercourse before conception is not a highlighted factor in the study. Choice D is also incorrect as the study does not discuss the impact of fertility drugs on the likelihood of having twins.

5. What nursing action should the nurse implement for a 3-hour-old male infant who presents with cyanotic hands and feet, an axillary temperature of 96.5°F (35.8°C), a respiratory rate of 40 breaths per minute, and a heart rate of 165 beats per minute?

• A. Administer oxygen by mouth at 2L/min
• B. Gradually warm the infant under a radiant heat source
• C. Notify the pediatrician of the infant's vital signs
• D. Perform a heel-stick to maintain blood glucose levels

Correct answer: B

Rationale: The correct nursing action is to gradually warm the infant under a radiant heat source. The infant is presenting with signs of cold stress, indicated by cyanotic extremities and a low body temperature. Gradual warming is crucial to stabilize the infant's temperature and prevent further complications. Administering oxygen, notifying the pediatrician, or performing a heel-stick are not the priority actions in this scenario and may not address the immediate need to raise the infant's body temperature.

Similar Questions