Nursing Elites

1. When reinforcing teaching with a group of new parents about proper techniques for bottle feeding, which of the following instructions should be provided?

• A. Burp the newborn at the end of the feeding
• B. Hold the newborn close in a supine position
• C. Keep the nipple full of formula throughout the feeding
• D. Refrigerate any unused formula

Correct answer: C

Rationale: The correct technique for bottle feeding includes keeping the nipple full of formula throughout the feeding to prevent air from entering the baby's stomach. This helps reduce the risk of the baby swallowing air, which can lead to discomfort and colic. Therefore, maintaining a full nipple during feeding is essential for the baby's comfort and digestion. Option A is incorrect as burping should be done during the feeding to prevent excessive air intake. Option B is incorrect as the baby should be held semi-upright, not in a supine position, to reduce the risk of choking and ear infections. Option D is irrelevant to the feeding process and does not contribute to the baby's well-being.

2. A client who is at 6 weeks of gestation is being educated about common discomforts of pregnancy. Which of the following findings should the individual include? (Select all that apply)

• A. Breast tenderness
• B. Urinary frequency
• C. Epistaxis
• D. All of the above

Correct answer: D

Rationale: During early pregnancy, common discomforts include breast tenderness due to hormonal changes, urinary frequency caused by increased blood flow to the kidneys, and epistaxis (nosebleeds) due to increased blood volume and hormonal changes. Educating the client about these discomforts helps them understand what to expect during this stage. Choice D, 'All of the above,' is the correct answer because all the listed findings are common discomforts experienced during early pregnancy. Choices A, B, and C are individually correct as well, as breast tenderness, urinary frequency, and epistaxis are all common discomforts that pregnant individuals may encounter.

3. A client who received carboprost for postpartum hemorrhage is being assessed by a nurse. Which of the following findings is an adverse effect of this medication?

• A. Hypertension
• B. Hypothermia
• C. Constipation
• D. Muscle weakness

Correct answer: A

Rationale: The correct answer is A: Hypertension. Carboprost is a vasoconstrictor medication used to control postpartum hemorrhage by contracting the uterus. One of the adverse effects of carboprost is hypertension due to its vasoconstrictive properties. Hypertension can occur as a result of increased peripheral vascular resistance. Choices B, C, and D are incorrect. Hypothermia, constipation, and muscle weakness are not typically associated with the administration of carboprost. It is crucial for the nurse to monitor the client's blood pressure closely while on carboprost to promptly detect and manage hypertension.

4. During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On data collection, a nurse finds the uterus to be firm, midline, and at the level of the umbilicus. Which of the following findings should the nurse interpret this data as being?

• A. Evidence of a possible vaginal hematoma
• B. An indication of a cervical or perineal laceration
• C. A normal postpartum discharge of lochia
• D. Abnormally excessive lochia rubra flow

Correct answer: C

Rationale: The nurse should interpret this data as a normal postpartum discharge of lochia. Lochia is the normal vaginal discharge after childbirth, and the gush of dark red blood upon ambulation is typical due to the pooling of blood in the vagina when lying down, which is then released upon standing. The firm, midline uterus at the level of the umbilicus indicates normal involution of the uterus postpartum. Therefore, this scenario is consistent with the expected postpartum physiological changes rather than complications like hematoma, lacerations, or abnormal excessive bleeding. Choices A, B, and D are incorrect because the described findings are more indicative of normal postpartum processes rather than complications such as vaginal hematoma, lacerations, or excessive bleeding.

5. A caregiver is learning about newborn safety. Which of the following statements by a parent indicates an understanding of the teaching?

• A. I will dress my baby in flame-retardant clothing.
• B. I will ensure a bib on my baby at night to keep her clothing dry.
• C. I will warm my baby's formula using the lowest setting in the microwave.
• D. I will cover the crib mattress with plastic to prevent staining.

Correct answer: A

Rationale: The correct answer is A. Dressing a baby in flame-retardant clothing is crucial to prevent injuries, especially in case of accidental exposure to fire sources. This safety measure can provide an added layer of protection for the newborn. The other options do not directly address newborn safety concerns or best practices. Option B focuses on keeping clothing dry, which is not a primary safety concern. Option C poses a risk of overheating the formula, which can be dangerous for the baby. Option D, covering the crib mattress with plastic, may pose a suffocation hazard to the baby.

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