Nursing Elites

1. A client who is at 24 weeks of gestation is scheduled for a 1-hour glucose tolerance test. Which of the following statements should the nurse include in her teaching?

• A. You will need to drink the glucose solution 1 hour prior to the test.
• B. Limit your carbohydrate intake for 24 hours prior to the test.
• C. A blood glucose of 130 to 140 mg/dL is considered a positive screening result.
• D. You will need to fast for 8 hours prior to the test.

Correct answer: C

Rationale: The correct statement to include in the teaching for a client scheduled for a 1-hour glucose tolerance test at 24 weeks of gestation is that a blood glucose level of 130 to 140 mg/dL is considered a positive screening result. This range indicates a potential issue with glucose metabolism and would prompt the need for a follow-up 3-hour glucose tolerance test to confirm the diagnosis of gestational diabetes mellitus. Choices A, B, and D are incorrect. In a 1-hour glucose tolerance test, the glucose solution is typically consumed within a specific timeframe before the test, not necessarily 1 hour prior. There is usually no specific requirement to limit carbohydrate intake for 24 hours prior to the test. Fasting for 8 hours prior to the test is more common for a fasting glucose test, not a 1-hour glucose tolerance test.

2. When discussing intermittent fetal heart monitoring with a newly licensed nurse, which statement should a nurse include?

• A. Count the fetal heart rate for 15 seconds to determine the baseline.
• B. Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor.
• C. Count the fetal heart rate after a contraction to determine baseline changes.
• D. Auscultate the fetal heart rate every 30 minutes during the second stage of labor.

Correct answer: C

Rationale: When discussing intermittent fetal heart monitoring, it is crucial to count the fetal heart rate after a contraction to determine baseline changes. This practice allows for the assessment of variations in the fetal heart rate pattern associated with uterine contractions. Monitoring the fetal heart rate after contractions provides valuable insights into fetal well-being and potential distress. Option A is incorrect because determining the baseline involves assessing the fetal heart rate over a more extended period. Option B is incorrect as auscultation every 5 minutes during the active phase of the first stage of labor is too frequent for intermittent monitoring. Option D is incorrect as auscultating the fetal heart rate every 30 minutes during the second stage of labor is too infrequent for proper monitoring of fetal well-being.

3. A nurse is assisting with an in-service for newly licensed nurses about neonatal abstinence syndrome in newborns. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?

• A. The newborn will have decreased muscle tone.
• B. The newborn will have a continuous high-pitched cry.
• C. The newborn will sleep for 2 to 3 hours after a feeding.
• D. The newborn will have mild tremors when disturbed.

Correct answer: B

Rationale: The correct answer is B. A continuous high-pitched cry is a characteristic sign of neonatal abstinence syndrome, indicating withdrawal from drugs. Choices A, C, and D are incorrect because decreased muscle tone, sleeping for 2 to 3 hours after a feeding, and mild tremors when disturbed are not specific indicators of neonatal abstinence syndrome.

4. A client at 36 weeks of gestation is suspected of having placenta previa. Which of the following findings support this diagnosis?

• A. Painless red vaginal bleeding
• B. Increasing abdominal pain with a non-relaxed uterus
• C. Abdominal pain with scant red vaginal bleeding
• D. Intermittent abdominal pain following the passage of bloody mucus

Correct answer: A

Rationale: Painless red vaginal bleeding is a hallmark sign of placenta previa. In this condition, the placenta partially or completely covers the cervical opening, leading to painless, bright red bleeding due to the separation of the placenta from the uterine wall. Other types of bleeding, such as those associated with abdominal pain or mucus passage, are more indicative of conditions like placental abruption rather than placenta previa. Therefore, choices B, C, and D are incorrect as they describe findings more consistent with placental abruption rather than placenta previa.

5. A healthcare professional is assisting with the care of a client who is receiving IV magnesium sulfate. Which of the following medications should the healthcare professional anticipate administering if magnesium sulfate toxicity is suspected?

• A. Nifedipine
• B. Pyridoxine
• C. Ferrous sulfate
• D. Calcium gluconate

Correct answer: D

Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity. In cases of magnesium sulfate toxicity, calcium gluconate is administered to counteract the effects of magnesium and restore calcium levels. Magnesium toxicity can lead to symptoms such as muscle weakness, respiratory depression, and cardiac arrhythmias. Calcium gluconate helps in reversing these effects by competing with magnesium and preventing its adverse manifestations. Nifedipine is a calcium channel blocker used for conditions like hypertension and angina, not for magnesium toxicity. Pyridoxine is vitamin B6 and is not the antidote for magnesium toxicity. Ferrous sulfate is an iron supplement and is not used to treat magnesium sulfate toxicity.

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