Nursing Elites

1. During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination, you advised her against a home delivery. Which of the following findings disqualifies her for a home delivery?

• A. Her OB score is G5P3
• B. She has some palmar pallor
• C. Her blood pressure is 130/80
• D. Her baby is in cephalic presentation

Correct answer: A

Rationale: The correct answer is A. An OB score of G5P3 indicates that the client has had five pregnancies and three live births, making her ineligible for a home delivery. Typically, women with fewer pregnancies are considered better candidates for home deliveries due to lower risks. Additionally, primigravidas are usually advised to deliver at a medical facility for their first pregnancy.

2. Which principle is CONTRARY to planning a home visit?

• A. A home visit should have a clear purpose or objective
• B. The plan should be centered around the family's health needs
• C. A home visit should strictly follow RHU guidelines
• D. Involving a responsible family member in continuing care planning is essential

Correct answer: C

Rationale: When planning a home visit, it is crucial for the visit to be tailored to the specific needs of the family. While guidelines are important, they should not restrict the flexibility and practicality of the plan. The plan should adapt to the family's unique circumstances, resources available, and the nurse's assessment, rather than being rigidly bound by preset guidelines.

3. Tertiary prevention is needed in which stage of the natural history of disease?

• A. Pre-pathogenesis
• B. Pathogenesis
• C. Predromal
• D. Terminal

Correct answer: D

Rationale: Tertiary prevention focuses on actions taken to prevent complications and further deterioration among individuals already diagnosed with a disease. It is implemented during the terminal stage of a disease when efforts are made to prevent disability, restore function, and improve quality of life. This stage is crucial for managing the disease's progression and enhancing the patient's well-being.

4. When preparing a primigravida for breastfeeding, which of the following will you do?

• A. Explain that lactation usually begins 1 to 3 days after delivery
• B. Teach her nipple stretching exercises if her nipples are flat or inverted
• C. Advise against washing her nipples excessively before and after each breastfeeding
• D. Inform her that putting the baby to breast can help reduce post-delivery blood loss

Correct answer: D

Rationale: Putting the baby to breast can help reduce post-delivery blood loss as suckling stimulates the release of oxytocin, causing uterine contractions. Lactation typically starts 1 to 3 days after delivery, not immediately. Nipple stretching exercises are recommended for flat or inverted nipples, not everted ones. Excessive washing of the nipples can dry them out, increasing the risk of fissures.

5. To maintain the cleanliness of the bag and its contents, what should the nurse do?

• A. Wash their hands before and after providing care to family members
• B. Use only items from the bag when caring for family members
• C. Wear an apron to protect their uniform and fold it with the right side out before returning it to the bag
• D. Fold the lining on which the bag was placed at the end of the visit, ensuring the contaminated side is facing outward

Correct answer: A

Rationale: The most crucial step in maintaining cleanliness when caring for family members and handling the bag and its contents is to wash the nurse's hands before and after providing care. This practice helps prevent the spread of germs and maintains proper hygiene standards, reducing the risk of contamination. Washing hands is a fundamental infection control measure that all healthcare professionals should adhere to in their daily practice.

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