Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 24-year-old pregnant woman asks the nurse if it is safe to drink alcohol during pregnancy. Which of the following is the most appropriate response?
A. Small amounts of alcohol are safe during the second trimester."
"Small amounts of alcohol are safe during the second trimester." is incorrect because no amount of alcohol is considered safe during pregnancy. Even small amounts can affect fetal development and increase the risk of fetal alcohol spectrum disorders (FASD).
B. "Alcohol is only harmful in the first trimester."
"Alcohol is only harmful in the first trimester." is incorrect because alcohol exposure can be harmful at any stage of pregnancy, not just the first trimester. While organogenesis occurs early, alcohol can still affect fetal growth, brain development, and neurobehavioral outcomes throughout pregnancy.
C. "Alcohol should be avoided completely during pregnancy."
"Alcohol should be avoided completely during pregnancy." is correct. The safest recommendation is complete abstinence from alcohol. This approach eliminates the risk of alcohol-related complications and supports optimal fetal development. Health authorities, including the CDC and ACOG, advise that no level of alcohol is safe during pregnancy.
D. "Beer is safer than hard liquor while pregnant."
"Beer is safer than hard liquor while pregnant." is incorrect because all types of alcoholic beverages pose a risk to the developing fetus, regardless of alcohol content or type. There is no safe form of alcohol during pregnancy.
This question is an excerpt from Nurse Dive's nursing test bank - Ati dmmsn 650 OB/Pediatrics Proctored Exams. Take the full exam now
Full Explanation
A. "Small amounts of alcohol are safe during the second trimester." is incorrect because no amount of alcohol is considered safe during pregnancy. Even small amounts can affect fetal development and increase the risk of fetal alcohol spectrum disorders (FASD).
B. "Alcohol is only harmful in the first trimester." is incorrect because alcohol exposure can be harmful at any stage of pregnancy, not just the first trimester. While organogenesis occurs early, alcohol can still affect fetal growth, brain development, and neurobehavioral outcomes throughout pregnancy.
C. "Alcohol should be avoided completely during pregnancy." is correct. The safest recommendation is complete abstinence from alcohol. This approach eliminates the risk of alcohol-related complications and supports optimal fetal development. Health authorities, including the CDC and ACOG, advise that no level of alcohol is safe during pregnancy.
D. "Beer is safer than hard liquor while pregnant." is incorrect because all types of alcoholic beverages pose a risk to the developing fetus, regardless of alcohol content or type. There is no safe form of alcohol during pregnancy.
Similar Questions
A nurse is assisting with the delivery of a newborn when the head is delivered, but the shoulders become stuck behind the maternal pubic bone. Which of the following is the nurse's priority action?
A. Pull the baby out forcefully by the head with forceps
Pull the baby out forcefully by the head with forceps is incorrect because forceful traction can cause severe injury to the baby, including brachial plexus injury, clavicle fracture, or intracranial hemorrhage. This is not recommended for shoulder dystocia.
B. Apply gentle upward traction on the baby's head
Apply gentle upward traction on the baby's head is incorrect because while gentle traction is part of standard delivery, upward traction alone is usually insufficient to resolve shoulder dystocia and may risk injury if used improperly.
C. Wait for the mother to push the shoulders out naturally
Wait for the mother to push the shoulders out naturally is incorrect because shoulder dystocia is an obstetric emergency. Delaying intervention can lead to hypoxia, birth asphyxia, or fetal injury, so immediate maneuvers are required.
D. Place the mother in McRoberts maneuver position and apply suprapubic pressure
Place the mother in McRoberts maneuver position and apply suprapubic pressure is correct. The McRoberts maneuver involves flexing the mother’s hips tightly toward her abdomen, which flattens the sacral promontory and increases the pelvic diameter. Simultaneously, suprapubic pressure helps dislodge the impacted anterior shoulder. This is the first-line, evidence-based intervention for shoulder dystocia and reduces the risk of fetal and maternal complications.
Full Explanation
A. Pull the baby out forcefully by the head with forceps is incorrect because forceful traction can cause severe injury to the baby, including brachial plexus injury, clavicle fracture, or intracranial hemorrhage. This is not recommended for shoulder dystocia.
B. Apply gentle upward traction on the baby's head is incorrect because while gentle traction is part of standard delivery, upward traction alone is usually insufficient to resolve shoulder dystocia and may risk injury if used improperly.
C. Wait for the mother to push the shoulders out naturally is incorrect because shoulder dystocia is an obstetric emergency. Delaying intervention can lead to hypoxia, birth asphyxia, or fetal injury, so immediate maneuvers are required.
D. Place the mother in McRoberts maneuver position and apply suprapubic pressure is correct. The McRoberts maneuver involves flexing the mother’s hips tightly toward her abdomen, which flattens the sacral promontory and increases the pelvic diameter. Simultaneously, suprapubic pressure helps dislodge the impacted anterior shoulder. This is the first-line, evidence-based intervention for shoulder dystocia and reduces the risk of fetal and maternal complications.
A 3-year-old child is diagnosed with neuroblastoma after presenting with a mass in the abdomen, abnormal eye movements, and swelling of the face. Which of the following is the most common site of origin for neuroblastoma in children?
A. Liver
Liver is incorrect because the liver is not the primary site of neuroblastoma. While the liver can become involved through metastasis, the tumor originates elsewhere along the sympathetic chain.
B. Brain
Brain is incorrect because neuroblastoma develops from peripheral sympathetic tissue, not the central nervous system. Brain tumors in children are a separate category of malignancies.
C. Kidneys
Kidneys is incorrect. Although neuroblastoma can present as an abdominal mass that seems near the kidneys, the tumor originates from the adrenal glands, not the renal tissue itself. Wilms’ tumor, not neuroblastoma, arises from the kidneys in children.
D. Adrenal glands
Adrenal glands is correct. Approximately 40% of neuroblastomas originate in the adrenal medulla, located above the kidneys. Other tumors may arise along the sympathetic chain, including the chest, neck, and pelvis. The adrenal origin explains why children may present with abdominal masses, abdominal pain, or systemic symptoms. Metastatic spread can cause periorbital ecchymosis (“raccoon eyes”), proptosis, and facial edema, as seen in this child, reflecting tumor spread to orbital bones and lymphatic structures.
Full Explanation
A. Liver is incorrect because the liver is not the primary site of neuroblastoma. While the liver can become involved through metastasis, the tumor originates elsewhere along the sympathetic chain.
B. Brain is incorrect because neuroblastoma develops from peripheral sympathetic tissue, not the central nervous system. Brain tumors in children are a separate category of malignancies.
C. Kidneys is incorrect. Although neuroblastoma can present as an abdominal mass that seems near the kidneys, the tumor originates from the adrenal glands, not the renal tissue itself. Wilms’ tumor, not neuroblastoma, arises from the kidneys in children.
D. Adrenal glands is correct. Approximately 40% of neuroblastomas originate in the adrenal medulla, located above the kidneys. Other tumors may arise along the sympathetic chain, including the chest, neck, and pelvis. The adrenal origin explains why children may present with abdominal masses, abdominal pain, or systemic symptoms. Metastatic spread can cause periorbital ecchymosis (“raccoon eyes”), proptosis, and facial edema, as seen in this child, reflecting tumor spread to orbital bones and lymphatic structures.
The nurse teaches a pregnant patient about the signs of pregnancy. The patient demonstrates understanding when she states that a positive sign of pregnancy is:
A. quickening experienced by the patient.
Quickening experienced by the patient is incorrect because quickening (the first perception of fetal movement by the mother) is considered a presumptive sign of pregnancy, not a positive sign. While it suggests pregnancy, it can be mistaken for gastrointestinal activity.
B. patient reports of a positive pregnancy test.
Patient reports of a positive pregnancy test is incorrect because this is a probable sign of pregnancy. Laboratory tests detecting human chorionic gonadotropin (hCG) are more reliable than presumptive signs, but they can occasionally give false positives (e.g., due to certain medications or medical conditions).
C. Braxton Hicks contractions felt by the patient.
Braxton Hicks contractions felt by the patient is incorrect because these are also presumptive or possible signs of pregnancy. They indicate uterine activity, but they do not confirm the presence of a fetus.
D. fetal movement palpated by the provider.
Fetal movement palpated by the provider is correct. This is considered a positive sign of pregnancy, as only a developing fetus can cause these movements to be felt by an examiner. Other positive signs include visualization of the fetus on ultrasound and auscultation of the fetal heartbeat. Positive signs provide definitive confirmation of pregnancy, distinguishing them from presumptive or probable signs.
Full Explanation
A. Quickening experienced by the patient is incorrect because quickening (the first perception of fetal movement by the mother) is considered a presumptive sign of pregnancy, not a positive sign. While it suggests pregnancy, it can be mistaken for gastrointestinal activity.
B. Patient reports of a positive pregnancy test is incorrect because this is a probable sign of pregnancy. Laboratory tests detecting human chorionic gonadotropin (hCG) are more reliable than presumptive signs, but they can occasionally give false positives (e.g., due to certain medications or medical conditions).
C. Braxton Hicks contractions felt by the patient is incorrect because these are also presumptive or possible signs of pregnancy. They indicate uterine activity, but they do not confirm the presence of a fetus.
D. Fetal movement palpated by the provider is correct. This is considered a positive sign of pregnancy, as only a developing fetus can cause these movements to be felt by an examiner. Other positive signs include visualization of the fetus on ultrasound and auscultation of the fetal heartbeat. Positive signs provide definitive confirmation of pregnancy, distinguishing them from presumptive or probable signs.