Nursing Elites

1. During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have

• A. lower Apgar scores.
• B. lower birth weights.
• C. respiratory distress.
• D. a higher rate of congenital anomalies.

Correct answer: B

Rationale: Smoking during pregnancy is associated with intrauterine growth restriction, leading to lower birth weights. This occurs due to the harmful effects of smoking on fetal development, which can result in reduced nutrient and oxygen supply to the fetus, impacting its overall growth and leading to lower birth weights. Choices A, C, and D are incorrect as smoking during pregnancy primarily affects fetal growth and development, leading to lower birth weights rather than lower Apgar scores, respiratory distress, or a higher rate of congenital anomalies.

2. A newborn's parents tell the nurse that their baby is already trying to walk. How should the nurse respond?

• A. Encourage the parents to report this to the healthcare provider.
• B. Acknowledge the parents' observation.
• C. Schedule the newborn for further neurological testing.
• D. Explain the newborn’s normal stepping reflex.

Correct answer: D

Rationale: When parents report that their newborn is trying to walk, the nurse should understand that newborns exhibit a stepping reflex, which is a normal developmental response. Explaining this reflex to the parents helps them understand that it is a typical behavior seen in newborns rather than true attempts to walk. Encouraging the parents to report this to the healthcare provider (Choice A) may cause unnecessary concern since the stepping reflex is a normal part of newborn development. Acknowledging the parents' observation (Choice B) is a good communication strategy but providing education on the normal reflex is essential. Scheduling the newborn for further neurological testing (Choice C) is not indicated in this scenario as the stepping reflex is a typical finding in newborns.

3. A woman who gave birth 48 hours ago is bottle-feeding her infant. During assessment, the nurse determines that both breasts are swollen, warm, and tender upon palpation. What action should the LPN/LVN take?

• A. Apply cold compresses to both breasts for comfort.
• B. Instruct the client to run warm water on her breasts.
• C. Wear a loose-fitting bra to prevent nipple irritation.
• D. Express small amounts of milk to relieve pressure.

Correct answer: A

Rationale: After childbirth, engorgement of the breasts can occur, leading to swelling and discomfort. Applying cold compresses helps reduce swelling and provides comfort for engorged breasts. This action can also help with pain relief and promote milk flow regulation. Instructing the client to run warm water on her breasts (Choice B) is incorrect as warm water can increase blood flow and exacerbate swelling. Wearing a loose-fitting bra (Choice C) may provide some comfort, but it does not address the swelling effectively. Expressing small amounts of milk (Choice D) may provide temporary relief but does not address the underlying issue of engorgement.

4. A neonate with congenital adrenal hypoplasia (CAH) presents with ambiguous genitalia. What is the primary nursing consideration when supporting the parents of a child with this anomaly?

• A. Discuss the need for cortisol and aldosterone replacement therapy after discharge
• B. Support the parents in their decision regarding the sex assignment of their child
• C. Offer information about ultrasonography and genotyping to determine sex assignment
• D. Explain that corrective surgical procedures consistent with sex assignment can be delayed

Correct answer: B

Rationale: Supporting the parents in their decision regarding the sex assignment of their child is crucial as it respects the parental role in making this important decision and helps provide emotional support during a challenging time. The primary focus should be on helping the parents navigate the complexities and implications of determining the sex assignment for their child with ambiguous genitalia.

5. When can a woman who thinks she may be pregnant use a home pregnancy test to diagnose pregnancy?

• A. A home pregnancy test can be used right after your first missed period.
• B. These tests are most accurate after you have missed your second period.
• C. Home pregnancy tests often give false positives and should not be trusted.
• D. The test can provide accurate information when used right after ovulation.

Correct answer: A

Rationale: The correct answer is A. Home pregnancy tests detect hCG, a hormone produced during pregnancy, and are most accurate after the first missed period when hCG levels are higher. Testing too early may result in a false negative. Waiting until after the first missed period increases the reliability of the test results. Choice B is incorrect as waiting until after the second missed period is unnecessary and may delay seeking appropriate healthcare. Choice C is incorrect as home pregnancy tests are generally reliable when used correctly. Choice D is incorrect because ovulation occurs before the period, and testing immediately after ovulation may not provide accurate results.

Similar Questions