Nursing Elites

1. A healthcare provider is discussing the differences between true labor and false labor with a group of expectant parents. Which of the following characteristics should the healthcare provider include when discussing true labor?

• A. Contractions become stronger with walking.
• B. Discomfort can be relieved with a back massage.
• C. Contractions become irregular with a change in activity.
• D. Discomfort is felt above the umbilicus.

Correct answer: A

Rationale: During true labor, contractions typically become stronger and more regular with activity, such as walking. This is a key characteristic that helps differentiate true labor from false labor. In false labor, contractions often remain irregular and do not intensify with changes in activity. Choice B is incorrect because discomfort in true labor is not typically relieved with a back massage. Choice C is incorrect as contractions in true labor become stronger and more regular with activity rather than irregular. Choice D is incorrect because discomfort in true labor is usually felt in the lower abdomen and pelvis, not above the umbilicus.

2. A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make?

• A. It's a minor inconvenience, which you should ignore.
• B. In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone.
• C. There is no way to predict how long it will last in each individual client.
• D. It occurs during the first trimester and near the end of the pregnancy.

Correct answer: D

Rationale: Urinary frequency is common during the first trimester and again at the end of pregnancy when the baby drops into the pelvis, putting pressure on the bladder.

3. An adolescent is being taught about levonorgestrel contraception by a school nurse. What information should the nurse include in the teaching?

• A. You should take the medication within 72 hours following unprotected sexual intercourse.
• B. Do not take this medication if you are on an oral contraceptive.
• C. If you do not start your period within 5 days of taking this medication, you will need a pregnancy test.
• D. One dose of this medication will prevent pregnancy for 14 days after taking it.

Correct answer: A

Rationale: Levonorgestrel is an emergency contraceptive that works by inhibiting ovulation to prevent conception. It is most effective when taken as soon as possible within 72 hours following unprotected sexual intercourse. Therefore, the nurse should instruct the adolescent to take the medication promptly to maximize its effectiveness. Choice B is incorrect because levonorgestrel can be used even if the individual is on oral contraceptives. Choice C is incorrect as the efficacy of levonorgestrel is not determined by the onset of menstruation. Choice D is incorrect because levonorgestrel is a single-dose emergency contraceptive and does not provide protection for 14 days after ingestion.

4. A client who is breastfeeding and has mastitis is receiving teaching from the nurse. Which of the following responses should the nurse make?

• A. Limit the amount of time the infant nurses on each breast.
• B. Nurse the infant only on the unaffected breast until resolved.
• C. Completely empty each breast at each feeding or use a pump.
• D. Wear a tight-fitting bra until lactation has ceased.

Correct answer: C

Rationale: The correct response is to completely empty each breast at each feeding or use a pump to prevent milk stasis, which can exacerbate mastitis. By ensuring proper drainage of the affected breast, the client can help alleviate symptoms and promote healing. Choice A is incorrect because limiting feeding time can lead to inadequate drainage, potentially worsening the condition. Choice B is incorrect as it can cause engorgement in the unaffected breast, leading to further complications. Choice D is incorrect as wearing a tight-fitting bra can worsen symptoms by putting pressure on the affected breast, hindering proper drainage and exacerbating mastitis.

5. While assisting with the care of an infant with a high bilirubin level receiving phototherapy, which finding should the nurse prioritize for reporting to the charge nurse?

• A. Conjunctivitis
• B. Bronze skin discoloration
• C. Sunken fontanels
• D. Maculopapular skin rash

Correct answer: C

Rationale: Sunken fontanels should be prioritized for reporting as they indicate dehydration, which is a critical concern in infants undergoing phototherapy. Dehydration can lead to serious complications, making it essential for the nurse to promptly inform the charge nurse for appropriate intervention and management. Conjunctivitis, bronze skin discoloration, and maculopapular skin rash are important findings to note, but in this scenario, sunken fontanels take precedence due to the potential severity of dehydration in infants.

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