Nursing Elites

1. A client is being educated by a healthcare provider about the physiological changes that occur during pregnancy. The client is at 10 weeks of gestation and has a BMI within the expected reference range. Which of the following client statements indicates an understanding of the teaching?

• A. I should gain more than 15 to 20 pounds during my pregnancy.
• B. I will likely need to use alternative positions for sexual intercourse.
• C. I'm glad I had a breast reduction years ago so they will not enlarge with my pregnancy.
• D. I'm glad I have a light complexion and will not get any stretch marks.

Correct answer: B

Rationale: During pregnancy, weight gain is expected. The client's understanding is demonstrated by acknowledging the need for alternative sexual positions due to the physiological changes, such as weight gain and a growing abdomen. This statement reflects comprehension of the teaching provided by the healthcare provider.

2. A healthcare professional is providing information to a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the healthcare professional include? (Select all that apply)

• A. Avoid any lifting
• B. Perform Kegel exercises twice a day
• C. Perform the pelvic rock exercise every day
• D. Avoid standing for prolonged periods

Correct answer: C

Rationale: Performing the pelvic rock exercise daily can help relieve backache during pregnancy by strengthening the back and abdominal muscles, providing support to the spine. This exercise is beneficial in maintaining proper posture and reducing strain on the back. Avoiding standing for prolonged periods can also help alleviate backache by reducing pressure on the spine and supporting muscles. Kegel exercises primarily focus on strengthening the pelvic floor muscles and may not directly help with backache during pregnancy. Avoiding any lifting is overly restrictive and not necessary, as long as proper lifting techniques are followed.

3. A healthcare professional in a provider's office is reviewing the medical record of a client who is in her first trimester of pregnancy. Which of the following findings should the healthcare professional identify as a risk factor for the development of preeclampsia?

• A. Singleton pregnancy
• B. BMI of 20
• C. Maternal age of 32 years
• D. Pregestational diabetes mellitus

Correct answer: D

Rationale: Pregestational diabetes mellitus is a significant risk factor for the development of preeclampsia in pregnant individuals. Preeclampsia is more common in women with preexisting conditions such as diabetes, hypertension, renal disease, lupus, or rheumatoid arthritis. Singleton pregnancy, a BMI of 20, or maternal age of 32 years are not considered significant risk factors for developing preeclampsia.

4. When assessing newborn reflexes, what action should be taken to elicit the Moro reflex?

• A. Perform a sharp hand clap near the infant.
• B. Hold the newborn vertically allowing one foot to touch the table surface.
• C. Place a finger at the base of the newborn's toes.
• D. Turn the newborn's head quickly to one side.

Correct answer: A

Rationale: The correct answer is A: Perform a sharp hand clap near the infant. The Moro reflex, also known as the startle reflex, is elicited by a sudden stimuli such as a sharp hand clap near the infant. This reflex is characterized by the infant's arms extending and then flexing with a distinctive 'startle' motion. It is a normal and expected reflex in newborns, typically disappearing by 3-6 months of age. Choices B, C, and D are incorrect because they do not elicit the Moro reflex; holding the newborn vertically (choice B) or placing a finger at the base of the newborn's toes (choice C) are associated with other reflexes, while turning the newborn's head quickly to one side (choice D) is related to the tonic neck reflex.

5. A newborn who was born at 38 weeks of gestation, weighs 3,200 g, and is in the 60th percentile for weight should be classified as which of the following?

• A. Low birth weight
• B. Appropriate for gestational age
• C. Small for gestational age
• D. Large for gestational age

Correct answer: B

Rationale: The classification of a newborn as appropriate for gestational age is determined by considering the weight and gestational age. In this case, the newborn's weight falls within the normal range for the gestational age, indicating that the newborn is appropriately sized for the length of time spent in the womb. Choice A, 'Low birth weight,' is incorrect as the newborn's weight is within the normal range. Choice C, 'Small for gestational age,' is incorrect because the newborn's weight is not below the 10th percentile for gestational age. Choice D, 'Large for gestational age,' is incorrect as the newborn's weight is not above the 90th percentile, rather falling within the 60th percentile which is considered normal.

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