Nursing Elites

1. A client with pregestational type 1 diabetes mellitus is being taught by a nurse about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should aim to maintain my fasting blood glucose between 100 and 120.
• B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or higher.
• C. I will continue taking my insulin if I experience nausea and vomiting.
• D. I will avoid exercise if my blood glucose exceeds 250.

Correct answer: C

Rationale: The correct answer is C. It is essential for a client with pregestational type 1 diabetes mellitus to continue taking insulin as prescribed even if they experience nausea and vomiting. This is crucial to prevent fluctuations in blood glucose levels that could lead to serious complications. Choice A is incorrect because the fasting blood glucose target for pregnant women with diabetes is usually lower. Choice B is incorrect as engaging in exercise when blood glucose is high is not recommended. Choice D is incorrect as avoiding exercise is not the appropriate approach when blood glucose levels are elevated.

2. While observing the electronic fetal heart rate monitor tracing for a client at 40 weeks of gestation in labor, a nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

• A. Early decelerations
• B. Accelerations
• C. Late decelerations
• D. Variable decelerations

Correct answer: D

Rationale: Variable decelerations can indicate umbilical cord compression, which is a concern that may arise due to the umbilical cord being compressed during labor. This compression can lead to reduced blood flow and oxygen delivery to the fetus, necessitating close monitoring and potentially interventions to alleviate the pressure on the cord. Early decelerations are typically benign and mirror the contractions, indicating fetal head compression. Accelerations are reassuring patterns that show a healthy response to fetal movement. Late decelerations are concerning as they suggest uteroplacental insufficiency, indicating potential oxygen deprivation to the fetus.

3. A healthcare provider is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider's orders. Which of the following orders requires clarification?

• A. Assess deep tendon reflexes every hour.
• B. Obtain a daily weight.
• C. Continuous fetal monitoring
• D. Ambulate twice daily

Correct answer: D

Rationale: The correct answer is D. Ambulating twice daily is not recommended for a client with severe preeclampsia. Clients with severe preeclampsia are at risk for seizures and should be on bed rest to prevent complications. Ambulation can increase blood pressure and the risk of seizure activity in these clients. Assessing deep tendon reflexes, obtaining a daily weight, and continuous fetal monitoring are all appropriate and important interventions for a client with severe preeclampsia to monitor for signs of worsening condition and fetal well-being.

4. A client in a prenatal clinic is receiving education from a nurse and mentions, 'I don't like milk.' Which of the following foods should the nurse recommend as a good source of calcium?

• A. Dark green leafy vegetables
• B. Deep red or orange vegetables
• C. White bread and rice
• D. Meat, poultry, and fish

Correct answer: A

Rationale: Dark green leafy vegetables are rich in calcium, making them an excellent alternative source for individuals who dislike or cannot consume dairy products. Calcium is crucial for bone health, particularly during pregnancy, to support the developing fetus and maintain the mother's bone strength. Therefore, recommending dark green leafy vegetables ensures the client receives an adequate intake of calcium despite not liking milk. Choice B, deep red or orange vegetables, are not typically high in calcium. Choice C, white bread and rice, are not significant sources of calcium. Choice D, meat, poultry, and fish, are good sources of protein but do not provide as much calcium as dark green leafy vegetables.

5. A client has a new prescription for chlamydia. Which of the following statements should the nurse provide?

• A. This infection is treated with one dose of azithromycin.
• B. If your sexual partner has no symptoms, no medication is needed.
• C. You should avoid sexual relations for 3 days.
• D. You need to return in 6 months for retesting.

Correct answer: A

Rationale: The correct treatment for chlamydia is a one-time dose of azithromycin. It is crucial for the client to understand the correct medication regimen for effective treatment. Choice B is incorrect because treatment is necessary for the partner even if asymptomatic. Choice C is incorrect because sexual relations should be avoided until treatment is completed. Choice D is incorrect as retesting should generally occur 3 months after treatment.

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