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. A nurse concludes that the parent of a newborn is not showing positive indications of parent-infant bonding. The parent appears very anxious and nervous when asked to bring the newborn to the other parent. Which of the following actions should the nurse use to promote parent-infant bonding?

• A. Hand the parent the newborn and suggest that they change the diaper.
• B. Ask the parent why they are so anxious and nervous.
• C. Tell the parent that they will grow accustomed to the newborn.
• D. Provide reinforcement about infant care when the parent is present.

Correct answer: D

Rationale: Providing reinforcement about infant care when the parent is present can help alleviate anxiety and promote positive parent-infant bonding. By offering guidance and support while the parent is interacting with the newborn, the nurse can help build the parent's confidence and strengthen the bond between the parent and the infant. Choice A is not ideal as it does not address the parent's anxiety and may increase stress levels. Choice B focuses on the parent's emotions without providing direct support for bonding. Choice C is dismissive and does not offer practical assistance in fostering bonding between the parent and the infant.

3. A client is in labor and reports increasing rectal pressure. She is experiencing contractions 2 to 3 minutes apart, each lasting 80 to 90 seconds, and a vaginal examination reveals that her cervix is dilated to 9 cm. The client is in which of the following phases of labor?

• A. Active
• B. Transition
• C. Latent
• D. Descent

Correct answer: B

Rationale: The client is in the transition phase of labor, characterized by cervical dilatation of 8 to 10 cm and contractions every 2 to 3 minutes, each lasting 45 to 90 seconds. In this phase, the cervix is nearly fully dilated, preparing the client for the pushing stage. The active phase of labor typically involves cervical dilatation from 4 to 7 cm, whereas the latent phase is the early phase of labor when the cervix dilates from 0 to 3 cm. Descent is not a phase of labor but rather refers to the movement of the fetus through the birth canal during the second stage of labor.

4. A healthcare provider is assisting with the care for a client who reports manifestations of preterm labor. Which of the following findings are risk factors for this condition? (Select all that apply)

• A. Urinary tract infection
• B. Multifetal pregnancy
• C. Oligohydramnios
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D: All of the Above. Multiple risk factors can contribute to preterm labor, including urinary tract infection, multifetal pregnancy, and oligohydramnios. These factors can lead to the uterus being irritated or overstimulated, potentially triggering early labor. Urinary tract infections can cause inflammation and contractions, multifetal pregnancies have a higher risk of preterm labor due to increased uterine stretching, and oligohydramnios can lead to poor fetal growth and premature contractions. Therefore, clients presenting with these conditions require close monitoring and management to prevent preterm birth. Choices A, B, and C are all correct risk factors for preterm labor, making option D the correct answer.

5. A nurse in a prenatal clinic overhears a newly licensed nurse discussing conception with a client. Which of the following statements by the newly licensed nurse requires intervention by the nurse?

• A. Fertilization takes place in the outer third of the fallopian tube.
• B. Implantation occurs between 6 to 10 days after conception.
• C. Sperm remain viable in the woman's reproductive tract for 2 to 3 days.
• D. Bleeding or spotting can accompany implantation.

Correct answer: B

Rationale: The correct answer is B because implantation typically occurs between 6 to 10 days after conception, not 2 to 3 days. It is crucial for the nurse to intervene and provide accurate information to ensure the client receives correct education about conception. Choice A is correct as fertilization does occur in the outer third of the fallopian tube. Choice C is also accurate as sperm can remain viable in the woman's reproductive tract for 2 to 3 days. Choice D is correct as bleeding or spotting can indeed accompany implantation.

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