Nursing Elites

1. A client has postpartum psychosis. Which of the following actions is the nurse's priority?

• A. Reinforce the importance of taking antipsychotics as prescribed
• B. Ask the client if they have thoughts of harming themselves or their infant
• C. Monitor the infant for signs of failure to thrive
• D. Check the client's medical record for a history of bipolar disorder

Correct answer: B

Rationale: In a situation where a client has postpartum psychosis, the priority action for the nurse is to ask the client if they have thoughts of harming themselves or their infant. This is crucial to assess the risk of harm and ensure the safety of the client and the infant. While reinforcing the importance of taking antipsychotics as prescribed is essential for treatment, safety concerns take precedence. Monitoring the infant for signs of failure to thrive is important for the infant's well-being but is not the priority when the immediate safety of the client and infant is at risk. Checking the client's medical record for a history of bipolar disorder is relevant for understanding the client's medical history but is not the priority when addressing current safety concerns.

2. A client who is pregnant states that her last menstrual period was April 1st. What is the client's estimated date of delivery?

• A. January 8
• B. January 15
• C. February 8
• D. February 15

Correct answer: A

Rationale: To calculate the estimated date of delivery, add 7 days to the first day of the last menstrual period (April 1st), which gives April 8th. Then, count forward 9 months from April 8th, leading to January 8th as the estimated date of delivery. Choice A is correct. Choice B is incorrect because it is exactly 9 months from the last menstrual period without accounting for the additional 7 days. Choices C and D are incorrect as they fall in February, which is beyond the 9-month period from the last menstrual period.

3. When caring for a client receiving nifedipine for prevention of preterm labor, the nurse should monitor the client for which of the following manifestations?

• A. Blood-tinged sputum
• B. Dizziness
• C. Pallor
• D. Somnolence

Correct answer: B

Rationale: Corrected Question: When caring for a client receiving nifedipine for prevention of preterm labor, the nurse should monitor the client for which of the following manifestations? Rationale: Nifedipine, a calcium channel blocker, causes vasodilation, potentially leading to a decrease in blood pressure and side effects such as dizziness. Monitoring for dizziness is essential to ensure the client's safety and well-being during treatment. Choices A, C, and D are incorrect as they are not typically associated with nifedipine use for preventing preterm labor. Blood-tinged sputum may indicate other conditions like pulmonary issues, pallor could suggest anemia or circulatory problems, and somnolence is not a common side effect of nifedipine.

4. During a client's active labor, a healthcare provider notes that the presenting part is at 0 station. What is the correct interpretation of this clinical finding?

• A. The fetal head is in the left occiput posterior position.
• B. The largest fetal diameter has passed through the pelvic outlet.
• C. The posterior fontanel is palpable.
• D. The lowermost portion of the fetus is at the level of the ischial spines.

Correct answer: D

Rationale: At 0 station, the lowermost portion of the fetus is at the level of the ischial spines, indicating that the presenting part of the baby has engaged in the pelvis. This position is a significant milestone in labor progress and suggests that the baby is descending into the birth canal for delivery. Choices A, B, and C are incorrect. Choice A refers to the fetal head position, choice B describes the largest fetal diameter passing through the pelvic outlet (which is not related to station), and choice C refers to the palpability of the posterior fontanel (which is not relevant to station in labor).

5. A client at 32 weeks of gestation with placenta previa is actively bleeding. Which medication should the provider likely prescribe?

• A. Betamethasone
• B. Indomethacin
• C. Nifedipine
• D. Methylergonovine

Correct answer: A

Rationale: In cases of placenta previa with active bleeding at 32 weeks of gestation, Betamethasone is prescribed to accelerate fetal lung maturity in anticipation of potential preterm delivery. This medication helps in reducing the risk of respiratory distress syndrome in the newborn, which is crucial in managing such high-risk pregnancies. Indomethacin is a nonsteroidal anti-inflammatory drug not indicated in this scenario and may be contraindicated due to its effects on platelet function and potential risk of bleeding. Nifedipine is a calcium channel blocker used for conditions like preterm labor or hypertension, not specifically for placenta previa with active bleeding. Methylergonovine is a uterotonic drug used to prevent or control postpartum hemorrhage, not indicated for placenta previa with active bleeding.

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