Nursing Elites

1. A client who is 32 weeks pregnant and has a diagnosis of placenta previa is receiving teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit physical activity
• B. Monitor fetal movements daily
• C. Call the healthcare provider if contractions begin
• D. All of the above

Correct answer: D

Rationale: Clients diagnosed with placenta previa are at an increased risk of bleeding and preterm labor. Therefore, it is essential for them to limit physical activity to prevent complications. Monitoring fetal movements daily helps in assessing the well-being of the fetus. Additionally, notifying the healthcare provider if contractions begin is crucial as it could be a sign of preterm labor. Therefore, all of the instructions (limiting physical activity, monitoring fetal movements, and calling the healthcare provider if contractions begin) are necessary for managing placenta previa effectively. Choices A, B, and C are all correct instructions for a client with placenta previa.

2. A nurse is providing teaching to a client who has chronic kidney disease. Which of the following client statements indicates an understanding of the teaching?

• A. I will decrease my intake of foods that are high in phosphorus
• B. I will increase my intake of foods that are high in potassium
• C. I will decrease my intake of foods that are high in iron
• D. I will increase my intake of calcium supplements

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease should limit their intake of phosphorus because high phosphorus levels can lead to bone disease and cardiovascular problems. Increasing foods high in potassium (choice B) is not recommended as it can be harmful to individuals with kidney disease. Decreasing intake of foods high in iron (choice C) is not specifically indicated for chronic kidney disease. Increasing calcium supplements (choice D) may not be necessary and can potentially lead to hypercalcemia in individuals with kidney disease.

3. A nurse is performing a newborn assessment and notes a soft, swollen area on the newborn's scalp that does not cross the suture line. Which of the following should the nurse document?

• A. Cephalohematoma
• B. Caput succedaneum
• C. Subdural hematoma
• D. Molding

Correct answer: A

Rationale: The correct answer is A, cephalohematoma. A cephalohematoma is a collection of blood between the periosteum and the skull that does not cross the suture line. It is caused by trauma during birth and typically resolves on its own. Choice B, caput succedaneum, is characterized by diffuse edema over a newborn's scalp that crosses suture lines. Choice C, subdural hematoma, is a more serious condition involving bleeding between the dura mater and the brain. Choice D, molding, refers to the shaping of the fetal head during passage through the birth canal. Therefore, the nurse should document cephalohematoma in this scenario as it aligns with the description of a soft, swollen area on the newborn's scalp that does not cross the suture line.

4. A nurse is developing discharge care plans for a client who has osteoporosis. To prevent injury, the nurse should instruct the client to:

• A. Perform weight-bearing exercises
• B. Avoid crossing the legs beyond the midline
• C. Avoid sitting in one position for prolonged periods
• D. Splint the affected area

Correct answer: A

Rationale: The correct answer is A: Perform weight-bearing exercises. Weight-bearing exercises strengthen bones and help prevent fractures, which is crucial for clients with osteoporosis. Choices B, C, and D are incorrect. Avoiding crossing the legs beyond the midline and avoiding sitting in one position for prolonged periods are general recommendations for preventing musculoskeletal issues but are not specific to osteoporosis. Splinting the affected area is not a standard practice for managing osteoporosis and preventing fractures.

5. A charge nurse is discussing the use of applying ice to a client’s injured knee with a newly licensed nurse. Which of the following is a benefit of this treatment?

• A. Systemic analgesic effect
• B. Increase in metabolism
• C. Decreased capillary permeability
• D. Vasodilation

Correct answer: C

Rationale: The correct answer is C: Decreased capillary permeability. Ice application helps decrease capillary permeability, which in turn reduces swelling and inflammation at the injury site. This vasoconstriction effect helps to limit the extent of the injury. Choices A, B, and D are incorrect. Applying ice locally does not produce a systemic analgesic effect but rather a localized numbing effect. It does not increase metabolism but rather slows down metabolic processes in the affected area. Additionally, ice application causes vasoconstriction, not vasodilation.

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