Nursing Elites

1. A parent is receiving discharge teaching from a nurse regarding caring for their newborn after a circumcision. Which instruction should the nurse include?

• A. Apply slight pressure with a sterile gauze pad for mild bleeding.
• B. Inspect the circumcision site every 6 to 8 hours.
• C. Avoid using baby wipes containing alcohol to cleanse the penis with each diaper change.
• D. Clean the circumcision site daily using a warm, wet washcloth.

Correct answer: A

Rationale: The correct answer is to apply slight pressure with a sterile gauze pad for mild bleeding. This helps to stop bleeding. If the bleeding persists, the parent should contact the healthcare provider for further guidance. While inspecting the circumcision site is important, checking every 6 to 8 hours might be too frequent and could disrupt healing. Using baby wipes containing alcohol can irritate the sensitive skin, so it is advised to avoid them. Cleaning the circumcision site daily is crucial, but excessive cleaning by removing yellow exudate daily is not necessary unless advised by the healthcare provider.

2. A newborn is noted to have secretions bubbling out of the nose and mouth after delivery. What is the nurse's priority action?

• A. Suction the nose with a bulb syringe.
• B. Suction the mouth with a bulb syringe.
• C. Use a suction catheter with low negative pressure.
• D. Turn the newborn on their side.

Correct answer: B

Rationale: The priority action for the nurse is to suction the mouth with a bulb syringe. Suctioning the mouth first is crucial to prevent aspiration and ensure the airway is clear, which takes precedence over suctioning the nose. This intervention helps maintain a patent airway and promotes adequate breathing in the newborn. Using a suction catheter with low negative pressure may not be appropriate as the newborn needs a gentle suction method like a bulb syringe. Turning the newborn on their side is important if there is a risk of aspiration, but clearing the mouth of secretions should be the priority to establish a clear airway.

3. A client in an obstetrical clinic is discussing using an IUD for contraception with a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?

• A. An IUD should be replaced annually during a pelvic exam.
• B. I cannot get an IUD until after I've had a child.
• C. I should plan on regaining fertility 5 months after the IUD is removed.
• D. I will check to ensure the strings of the IUD are still present after my periods.

Correct answer: D

Rationale: Checking for the presence of IUD strings after each period is crucial to ensure the IUD is correctly positioned and functioning. This practice helps in confirming the effectiveness of the contraceptive method and timely detection of any displacement or issues with the IUD. Choice A is incorrect as IUDs have varying durations of effectiveness, but they do not need to be replaced annually as a routine. Choice B is incorrect as women can get an IUD even if they haven't had a child. Choice C is incorrect as fertility typically returns shortly after IUD removal, not necessarily after a specific timeframe like 5 months.

4. A client who is pregnant and has phenylketonuria (PKU) is receiving teaching from a nurse. Which of the following foods should the nurse instruct the client to eliminate from her diet?

• A. Peanut butter
• B. Potatoes
• C. Apple juice
• D. Broccoli

Correct answer: A

Rationale: Individuals with phenylketonuria (PKU) have difficulty breaking down phenylalanine, an amino acid found in protein-rich foods like peanut butter. Therefore, clients with PKU should avoid foods high in phenylalanine, such as peanut butter, to prevent adverse effects on their health. Choices B, C, and D are not typically high in phenylalanine and do not pose the same risk to individuals with PKU as peanut butter.

5. A client who is at 39 weeks of gestation and is in active labor has fetal heart tones located above the umbilicus at midline. The fetus is likely in which of the following positions?

• A. Cephalic
• B. Transverse
• C. Posterior
• D. Frank breech

Correct answer: D

Rationale: Fetal heart tones above the umbilicus at midline are indicative of a breech presentation, specifically a frank breech position. In a frank breech position, the baby's buttocks are presenting first, which aligns with the fetal heart tones being above the umbilicus. This position indicates that the baby is not in the normal head-down position for birth, which can impact the delivery process and may require specific interventions. Cephalic presentation (Choice A) is the normal head-down position for birth, transverse lie (Choice B) is when the baby is positioned horizontally in the uterus, and posterior position (Choice C) refers to the baby's back being positioned towards the mother's back.

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