Nursing Elites

1. A nurse is caring for a client who is 8 hours postpartum following a vaginal birth. The client reports passing large clots and heavy bleeding. Which of the following actions should the nurse take?

• A. Massage the fundus
• B. Administer methylergonovine
• C. Increase the IV fluid rate
• D. Notify the healthcare provider

Correct answer: A

Rationale: Heavy bleeding and the passage of large clots after childbirth can indicate uterine atony. The nurse should first attempt to massage the fundus to stimulate uterine contractions and control the bleeding. Massaging the fundus helps the uterus to contract and may help prevent further bleeding. Administering methylergonovine (Choice B) is not the initial intervention for uterine atony. Increasing the IV fluid rate (Choice C) may not address the underlying cause of the bleeding. Notifying the healthcare provider (Choice D) can be done after attempting initial interventions like fundal massage.

2. A healthcare professional is preparing to administer a hepatitis B vaccine. Which of the following should the healthcare professional verify?

• A. Client's allergy to eggs
• B. Client's vaccination history
• C. Client's weight
• D. Client's blood pressure

Correct answer: B

Rationale: The correct answer is B: Client's vaccination history. Before administering the hepatitis B vaccine, it is essential to verify the client's vaccination history to ensure they are due for the vaccine. This helps in preventing unnecessary vaccinations and ensures the appropriate timing and dosage. Option A, the client's allergy to eggs, is not directly related to administering the hepatitis B vaccine. Option C, the client's weight, and option D, the client's blood pressure, are not factors that need to be specifically verified before administering the hepatitis B vaccine.

3. A postpartum client with AB negative blood whose newborn is B positive requires what intervention?

• A. Administer Rh immune globulin within 72 hours of delivery
• B. Administer Rh immune globulin at the 6-week postpartum visit
• C. No Rh immune globulin is needed since this is the second pregnancy
• D. Both mother and baby need Rh immune globulin

Correct answer: A

Rationale: The correct intervention is to administer Rh immune globulin within 72 hours of delivery. This is essential to prevent the mother from forming antibodies against Rh-positive blood, which could cause complications in future pregnancies. Choice B is incorrect as the administration should be immediate postpartum. Choice C is incorrect as Rh immune globulin is needed for each Rh-incompatible pregnancy. Choice D is incorrect as only the mother, who is Rh-negative, needs Rh immune globulin.

4. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory findings should the nurse expect?

• A. Decreased serum amylase
• B. Decreased serum lipase
• C. Elevated blood glucose
• D. Elevated calcium levels

Correct answer: C

Rationale: In acute pancreatitis, the nurse should expect elevated blood glucose levels. This is due to impaired insulin production by the inflamed pancreas. While serum amylase and lipase levels are typically elevated in acute pancreatitis, blood glucose levels are also affected due to the pancreatic dysfunction. Therefore, choices A and B are incorrect. Elevated calcium levels are not typically associated with acute pancreatitis, making choice D incorrect.

5. A healthcare provider is assessing a client for allergies before administering propofol. Which of the following allergies is a contraindication to the medication?

• A. Eggs
• B. Milk
• C. Shrimp
• D. Peanuts

Correct answer: A

Rationale: The correct answer is A: Eggs. Propofol is contraindicated in clients with egg allergies because it contains egg lecithin, which can trigger allergic reactions in sensitive individuals. Milk, shrimp, and peanuts are not contraindications for propofol administration.

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