Nursing Elites

1. During a woman's first prenatal visit, the nurse reviews her health care record, noting a history of chickenpox as a child and syphilis as a teenager. Which action is most important for the nurse to take?

• A. Obtain blood and urine for prenatal screens.
• B. Schedule prenatal visits to occur monthly.
• C. Explain common complications of pregnancy.
• D. Obtain baseline blood pressure and weight.

Correct answer: A

Rationale: Obtaining blood and urine for prenatal screens is crucial in identifying any potential infections or conditions that may require monitoring throughout the pregnancy. Screening for infections such as syphilis is essential to ensure appropriate management and prevent adverse outcomes. This action helps in early detection and timely intervention, promoting the health and well-being of both the mother and the developing fetus. The other options, while important during prenatal care, are not as critical as obtaining prenatal screens to assess for any existing infections that could impact the pregnancy.

2. A primipara patient asks what is the best pet to have at home to share time with. Which pet is not recommended?

• A. Dog
• B. Cat
• C. Bird
• D. Fish

Correct answer: C

Rationale: Birds are not recommended as pets for a primipara patient due to potential health risks associated with bird droppings, feathers, and dander. These factors may pose a risk to the newborn's health and the mother's well-being. Additionally, some birds can be loud, which may disrupt the baby's sleep patterns. Therefore, it is advisable for primipara patients to consider pets like dogs, cats, or fish as they generally have lower associated risks in a household with a newborn. Dogs, cats, and fish are relatively safer options compared to birds for primipara patients due to their lower risk of transmitting infections, allergens, or causing disturbances that could affect the newborn or the mother.

3. A client receiving oxytocin (Pitocin) to augment early labor. Which assessment is most important for the nurse to obtain each time the infusion rate is increased?

• A. Pain level
• B. Blood pressure
• C. Infusion site
• D. Contraction pattern

Correct answer: D

Rationale: When a client is receiving oxytocin to augment labor, the most crucial assessment for the nurse to obtain each time the infusion rate is increased is monitoring the contraction pattern. Increasing the infusion rate of oxytocin can lead to stronger and more frequent contractions, which can have implications for both the mother and the baby. Monitoring the contraction pattern helps ensure the safe administration of oxytocin and allows for timely interventions if needed.

4. A couple has been trying to conceive for nine months without success. Which information obtained from the clients is most likely to have an impact on the couple's ability to conceive a child?

• A. Both partners have a daily exercise regimen that includes running four miles each morning.
• B. The couple has a history of having sexual intercourse 2 to 3 times per week.
• C. The woman's menstrual period occurs every 35 days.
• D. They use lubricants with each sexual encounter to decrease friction.

Correct answer: D

Rationale: Using lubricants during sexual encounters can potentially impact the couple's ability to conceive a child. Some lubricants may contain substances that are spermicidal or alter the vaginal environment, affecting sperm motility and fertility.

5. A 3-month-old with myelomeningocele and atonic bladder is catheterized every 4hrs to prevent urinary retention. The home health nurse notes that the child has developed episodes of sneezing, urticarial, watery eyes, and a rash in the diaper area. What action is most important for the nurse to take?

• A. Auscultate the lungs for respiratory pneumonia.
• B. Change to latex-free gloves when handling infant.
• C. Draw blood to analyze for streptococcal infection.
• D. Apply zinc oxide to perineum with each diaper change.

Correct answer: B

Rationale: Latex allergy is a concern in patients with myelomeningocele, so switching to latex-free gloves is important.

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