Nursing Elites

1. The client is 30 weeks pregnant and experiencing preterm labor. Which medication should the nurse anticipate administering to promote fetal lung maturity?

• A. Betamethasone (Celestone).
• B. Magnesium sulfate.
• C. Terbutaline (Brethine).
• D. Ampicillin.

Correct answer: A

Rationale: Betamethasone (Celestone) is the medication of choice to promote fetal lung maturity in cases of preterm labor. It helps accelerate surfactant production in the fetal lungs, reducing the risk of respiratory distress syndrome. Administering betamethasone to the mother can improve the baby's lung function and overall outcome if preterm birth occurs. Magnesium sulfate is commonly used to prevent seizures in preeclampsia or eclampsia. Terbutaline is a tocolytic agent used to suppress preterm labor contractions. Ampicillin is an antibiotic used for various bacterial infections but does not promote fetal lung maturity.

2. What is the best nursing intervention for a pregnant woman with hyperemesis gravidarum?

• A. Administer prescribed IV solution.
• B. Give oral rehydration solution.
• C. Encourage small, frequent meals.
• D. Offer ginger tea to reduce nausea.

Correct answer: A

Rationale: The best nursing intervention for a pregnant woman with hyperemesis gravidarum is to administer the prescribed IV solution. Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that can lead to dehydration and electrolyte imbalances. Administering IV fluids helps in managing dehydration, replenishing electrolytes, and providing the necessary hydration for both the mother and the fetus. Giving oral rehydration solution (Choice B) may not be sufficient for severe cases of hyperemesis gravidarum where IV fluids are required. Encouraging small, frequent meals (Choice C) may not be effective as the woman may not be able to tolerate oral intake. Offering ginger tea (Choice D) is not the most appropriate intervention for hyperemesis gravidarum, as it may not provide adequate hydration or electrolyte balance needed in severe cases.

3. The healthcare provider prescribes terbutaline (Brethine) for a client in preterm labor. Before initiating this prescription, it is most important for the LPN/LVN to assess the client for which condition?

• A. Gestational diabetes.
• B. Elevated blood pressure.
• C. Urinary tract infection.
• D. Swelling in lower extremities.

Correct answer: A

Rationale: The correct answer is A: Gestational diabetes. Terbutaline (Brethine) is known to cause hyperglycemia, so it is crucial to assess for gestational diabetes before administering it. Assessing for elevated blood pressure (choice B), urinary tract infection (choice C), or swelling in lower extremities (choice D) is not directly related to the potential side effect of terbutaline in causing hyperglycemia.

4. A client with no prenatal care arrives at the labor unit screaming, 'The baby is coming!' The nurse performs a vaginal examination that reveals the cervix is 3 centimeters dilated and 75% effaced. What additional information is most important for the LPN/LVN to obtain?

• A. Gravidity and parity.
• B. Time and amount of last oral intake.
• C. Date of last normal menstrual period.
• D. Frequency and intensity of contractions.

Correct answer: C

Rationale: Obtaining the date of the last normal menstrual period is crucial in estimating the gestational age of the fetus. This information helps in determining the progression of labor and the management of delivery. It also assists healthcare providers in assessing the overall health of the mother and the fetus. Choices A, B, and D are important in labor assessment, but in this scenario, the most crucial information needed is the date of the last normal menstrual period to estimate the gestational age.

5. A loading dose of terbutaline (Brethine) 250 mcg IV is prescribed for a client in preterm labor. Brethine 20 mg is added to 1,000 mL of D5W. How many milliliters of the solution should the nurse administer?

• A. 45
• B. 15 mL
• C. 4
• D. 13

Correct answer: D

Rationale: To calculate the amount of terbutaline to administer, first convert the dose to the same unit. 250 mcg = 0.25 mg. Next, set up a proportion: 20 mg is to 1000 mL as 0.25 mg is to X mL. Cross multiply and solve for X: 20 × X = 0.25 × 1000. X = (0.25 × 1000) / 20 = 12.5 mL. Therefore, the nurse should administer 13 mL of the solution. Choice A is incorrect as it does not reflect the correct calculation. Choice B is incorrect as it does not consider the accurate conversion and calculation. Choice C is incorrect as it is not the result of the correct proportion calculation.

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