1538 test 1 prep questions
have blood pressure checked regularly
when talking with a patient about taking conjugated estrogen and medroxyprogesterone (Prempro), the health care professional should include which of the following instructions?
Doppler study
The health care provider is concerned about a client's fetus having appropriate blood flow through the fetal vessels. Which diagnostic test does the nurse anticipate to confirm a diagnosis?
Complete cervical dilation (dilatation) and time of fetal birth
The nurse is documenting the length of time in the second stage of labor. Which data will the nurse use to complete the documentation?
progesterone oxytocin prostaglandins
The nurse is instructing on maternal hormones which may impact the onset of labor. Which hormones are included in the discussion? Select all that apply.
Risk for injury: postpartum hemorrhage related to uterine atony
The nurse is preparing a nursing care plan for an immediate postpartum client. Which nursing diagnosis should the nurse prioritize?
black cohosh
a health care professional is caring for a patient who is receiving human chorionic gonadotropin to stimulate ovulation. the health care professional should advise the patient against taking which of the following herbal preparations?
elevated blood pressure
a nurse is assessing a client who is pregnant for preeclampsia. which of the following findings should indicate to the nurse that the client requires further evaluation for this disorder?
24 hours after the newborn's first protein feeding
Neonatal screening is done before the infant leaves the hospital. Blood is drawn through a heel stick and tested for several disorders that can cause lifelong disabilities. When is the ideal time to collect this specimen?
administrating a selective serotonin reuptake inhibitor
The nurse suspects that a mother who delivered her infant 2 weeks ago is experiencing postpartum depression. What is the first line of treatment for this client?
amenorrhea
absence of periods
triple/quad test
drawn from maternal blood test for genetic abnormalities - alpha fetoprotein test - higher or lower AFP - bad performed in the 2nd trimester
multigravida
multiple pregnancies
ectopic pregnancy pathophysiology
pregnancy outside of the uterus risk factors: - salpingitis - pelvic inflammatory disease - artificial insemination/IVF
apply breast milk to the nipples before each feeding. start breastfeeding with the nipple that is less sore. change the infant's position on the nipples.
a nurse is caring for a client who is 2 days postpartum, is breastfeeding and reports nipple soreness. which of the following measures should the nurse suggest to reduce discomfort during breastfeeding? select all that apply.
quickening
a nurse is caring for a client who is at 18 weeks of gestation. the client tells the nurse that she felt fluttering movements in her abdomen 3 days ago. the nurse should interpret this finding as which of the following?
assist the client to breathe into a paper bag
a nurse is caring for a client who is in the first stage of labor and is using pattern paced breathing. the client says she feels lightheaded and her fingers are tingling. which of the following actions should the nurse take?
insert a gloved hand into the vagina to relieve pressure on the cord.
a nurse is caring for a client who is in the first stage of labor. the nurse observes the umbilical cord protruding from the vagina. which of the following actions should the nurse perform first?
counterpressure
a nurse is caring for a patient who is in labor and has pain in her lower back because the fetal head is in a posterior position. which of the following nonpharmacological pain management techniques is likely to be most effective in relieving this type of pain?
let's talk about the available options and go from there.
a nurse is caring for a postpartum client who tells the nurse that she does not want any more children. the client asks which birth control method the nurse would recommend. which of the following responses should the nurse make?
red meat and organ meat
a nurse is caring for an antepartum client who has iron deficiency anemia. when teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?
slightly above the umbilicus
a nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation. at which location should the nurse expect to palpate the fundus?
it is normal to have a white vaginal discharge
a nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy. which of the following client statements indicates understanding of the teaching?
acetaminophen
a nurse is teaching a client who is in her first trimester of pregnancy about over the counter medications that are a pregnancy risk category B. which of the following medications should the nurse include?
give him a sponge bath until his cord stump falls off.
a nurse is teaching the parents of a term newborn how to bathe him. which of the following instructions should the nurse include?
take the missed dose along with the next dose
a patient taking oral contraceptives calls her health care professional because she forgot to take one of her pills. which of the following instructions should the health care professional provide?
the newborn has 6 wet diapers and 3 stools per day after day 4.
a patient who is 1 day postpartum tells the nurse that she is concerned about her newborn receiving enough nourishment from breastfeeding. the nurse should explain that she should look for which of the following as a sign of adequate nutrition?
The client reduces her smoking by 50 percent by the next clinic visit.
During the initial assessment of a 22-year-old pregnant client, the nurse learns that the client usually smokes 2 packs of cigarettes per day. The nurse is planning an education session about lifestyle changes during pregnancy. Which goal would be the most realistic and individualized for this client during this initial clinic visit?
Descent
Which cardinal movement of delivery is the nurse correct to document by station?
dysmenorrhea
causes: - often normal - fibroids - endometriosis
amenorrhea
causes: - pregnancy - breastfeeding - extreme weight loss - stress - medical conditions
uterine growth
2nd and 3rd trimesters: majority of growth at 1 pound a week fundal growth - 22 weeks at the umbilicus
Provide oxygen supplementation. Observe respiratory status frequently. Ensure the newborn's warmth.
A nurse is caring for a newborn with transient tachypnea. What nursing interventions should the nurse perform while providing supportive care to the newborn? Select all that apply.
anticonvulsants
a nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive. the nurse recognizes that which of the following client medications can interfere with the effectiveness of the COC?
anticonvulsants
a nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive. the nurse recognizes that which of the following client medications can interfere with the effectiveness of the COC? a. antihypertensives. b. anticonvulsants. c. antioxidants. d. antiemetics.
transmission of the disease will not occur when my lesions are gone
a nurse is teaching a client who has a new diagnosis of genital herpes. which of the following statements by the client indicates the need for further teaching?
you can receive an influenza vaccination during pregnancy.
a nurse is teaching a client who is at 23 weeks of gestation about immunizations. which of the following statements should the nurse include in the teaching?
Clear liquids but no solid food
The 29-year-old client presents at 5:30 a.m. with labor pains. Her history reveals G4, three previous vaginal births, and gynecoid pelvis. At 9 a.m. her assessment reveals 80% effaced and dilated at 3 cm. What nourishment can the nurse provide if the client mentions she hasn't eaten since 5 p.m. yesterday and is hungry?
hyperkalemia
a health care professional should question the use of ethinyl estradiol and drospirenone (Yasmin) by women who have renal disease for risk of which of the following?
seizure activity hypertension bradycardia
a healthcare professional is caring for a patient who is receiving IV methylergonovine (methergine) to stop postpartum hemorrhage. the health care professional should monitor the patient for which of the following adverse effects? select all that apply.
i'll feed my baby every 2 hours
a home health nurse is teaching a client who is breastfeeding about managing breast engorgement. which of the following client statements indicates an understanding of the teaching?
i'll feed my baby every 2 hours.
a home health nurse is teaching a client who is breastfeeding about managing breast engorgement. which of the following client statements indicates understanding of the teaching? a. i'll let my baby drain one breast at each feeding. b. i'll try drinking an herbal tea to reduce the engorgement. c. i'll apply cold compresses 20 minutes before each feeding. d. i'll feed my baby every 2 hours.
8
a newborn delivered vaginally at term 1 min ago cried loudly at delivery, has a heart rate of 140 bpm, has well flexed arms and legs, grimaces when the nurse rubs the soles of his feet, and is pink with mild acrocyanosis. what apgar score should the nurse assign?
obtain info about the client's recent sexual experiences.
a nurse in a clinic is caring for a female client who was exposed to gonorrhea. which of the following actions should the nurse take?
obtain info about the client's recent sexual experiences.
a nurse in a clinic is caring for a female client who was exposed to gonorrhea. which of the following actions should the nurse take? a. instruct the client about preventing reinfection by using a diaphragm. b. tell the client to expect some joint pain. c. obtain info about the client's recent sexual experiences. d. collect a urine specimen from the client.
this infection is treated with one dose of azithromycin
a nurse in a community clinic is counseling a client who received a positive test result for chlamydia. which of the following statements should the nurse provide?
linea nigra chloasma striae gravidarum
a nurse in a prenatal clinic is completing a skin assessment of a client who is in the second trimester. which of the following findings should the nurse expect? select all that apply.
hypertension
a nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. the nurse should recognize that which of the following is the most common risk factor for abruption?
two arteries and one vein
a nurse in labor and delivery is caring for a client. following delivery of the placenta, the nurse examines the umbilical cord. which of the following vessels should the nurse expect to observe in the umbilical cord?
two arteries and one vein.
a nurse in labor and delivery is caring for a client. following delivery of the placenta, the nurse examines the umbilical cord. which of the following vessels should the nurse expect to observe in the umbilical cord? a. two veins and one artery. b. one artery and one vein. c. two arteries and one vein. d. two arteries and two veins.
you should try to pant as the delivery proceeds
a nurse in the emergency department is admitting a client who is at 40 weeks of gestation, has ruptured membranes, and the nurse observes the newborn's head is crowning. the client tells the nurse she wants to push. which of the following statements should the nurse make?
place the client in the lateral position
a nurse in the labor and delivery unit is caring for a client who is undergoing external fetal monitoring. the nurse observes that the fetal heart rate begins to slow after the start of a contraction and the lowest rate occurs at the peak of the contraction. which of the following actions should the nurse take first?
ambulate twice daily
a nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the providers orders. which of the following orders requires clarification?
placenta previa
a nurse is admitting a client who is at 36 weeks gestation and has painless, bright red vaginal bleeding. the nurse should recognize this finding as an indication of which of the following conditions?
placenta previa
a nurse is admitting a client who is at 36 weeks gestation and has painless, bright red vaginal bleeding. the nurse should recognize this finding as an indication of which of the following conditions? a. abruptio placentae. b. placenta previa. c. precipitous labor. d. threatened abortion.
pelvic pain
a nurse is assessing a client for postpartum infection. which of the following findings should indicate to the nurse that the client requires further evaluation for endometritis?
pelvic pain.
a nurse is assessing a client for postpartum infection. which of the following findings should indicate to the nurse that the client requires further evaluation for endometritis? a. moderate amount of dark red lochia with a blood odor. b. a localized area of breast tenderness. c. pelvic pain. d. hematuria.
additional interventions are not indicated at this time.
a nurse is assessing a client who is 3 days postpartum and is breastfeeding. the nurse notes that the fundus is 3 fingerbreadths below the umbilicus, lochia rubra is moderate, and the breasts are hard and warm to palpation. which of the following interpretations of these findings should the nurse make?
fundus 3 fingerbreadths above the umbilicus
a nurse is assessing a client who is 8 hr postpartum and multiparous. which of the following findings should alert the nurse to the client's need to urinate?
elevated blood pressure
a nurse is assessing a client who is pregnant for preeclampsia. which of the following findings should indicate to the nurse that the client requires further evaluation for this disorder? a. increased urine output. b. vaginal discharge. c. elevated blood pressure. d. joint pain.
the symphysis pubis and the top of the fundus
a nurse is assessing a patient at a routine antepartum visit. for a rough estimate of the number of gestational weeks the patient is at, the nurse should measure the number of cm between which two anatomical landmarks?
a nonreactive test
a nurse is caring for a client during a nonstress test. at the end of a 30 min period of observation, the nurse notes the following findings: the FHR baseline is 120/min with minimal variability and no accelerations. there are two decelerations of 15 bpm in the fetal heart rate during a period of fetal movement, each lasting 20 seconds. which of the following interpretations of these findings should the nurse make?
a nonreactive test
a nurse is caring for a client during a nonstress test. at the end of a 30 min period of observation, the nurse notes the following findings: the FHR baseline is 120/min with minimal variability and no accelerations. there are two decelerations of 15/min in the FHR during a period of fetal movement, each lasting 20 seconds. which of the following interpretations of these findings should the nurse make? a. a negative test. b. a nonreactive test. c. a positive test. d. a reactive test.
at the level of the umbilicus
a nurse is caring for a client who experienced a vaginal delivery 12 hr ago. when palpating the client's abdomen, at which of the following positions should the nurse expect to find the uterine fundus?
at the level of the umbilicus.
a nurse is caring for a client who experienced a vaginal delivery 12 hr ago. when palpating the client's abdomen, which of the following positions should the nurse expect to find the uterine fundus? a. at the level of the umbilicus. b. 2 cm above the umbilicus. c. one fingerbreadth above the symphysis pubis. d. to the right of the umbilicus.
document fundal height. observe the lochia during palpation of fundus. determine whether the fundus is midline. administer methylergonovine maleate if uterus is boggy.
a nurse is caring for a client who had a vaginal delivery 2 hr ago. which of the following actions should the nurse anticipate in the care of this client? select all that apply.
unilateral, cramp like abdominal pain
a nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks gestation. which of the following manifestations should the nurse expect to identify as consistent with the diagnosis?
unilateral, cramp like abdominal pain.
a nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks of gestation. which of the following manifestations should the nurse expect to identify as consistent with the diagnosis? a. severe n/v. b. large amount of vaginal bleeding. c. unilateral, cramp like abdominal pain. d. uterine enlargement greater than expected for gestational age.
discontinue the medication infusion
a nurse is caring for a client who has preeclampsia and is being treated with mag sulfate IV. the client's resp rate is 10/*min and deep tendon reflexes are absent. which of the following actions should the nurse take?
discontinue the medication infusion.
a nurse is caring for a client who has preeclampsia and is being treated with mag sulfate IV. the client's respiratory rate is 10/min and deep tendon reflexes are absent. which of the following actions should the nurse take? a. discontinue the medication infusion. b. prepare for an emergency cesarean birth. c. assess maternal blood glucose. d. place the client in trendelenburg position.
document the findings and continue to monitor the client.
a nurse is caring for a client who is 1 hr postpartum and observes a large amount of lochia rubra and several small clots on the client's perineal pad. the fundus is midline and firm at the umbilicus. which of the following actions should the nurse take? a. document the findings and continue to monitor the client. b. notify the client's provider. c. increase the frequency of fundal massage. d. encourage the client to empty her bladder.
document the findings and continue to monitor the client
a nurse is caring for a client who is 1 hr postpartum and observes a large amount of lochia rubria and several small clots on the client's perineal pad. the fundus is midline and firm at the umbilicus. which of the following actions should the nurse take?
fundus firm, at the level of the umbilicus
a nurse is caring for a client who is 12 hr postpartum following a vaginal delivery. which of the following findings should the nurse expect?
fundus firm, at the level of the umbilicus.
a nurse is caring for a client who is 12 hr postpartum following a vaginal delivery. which of the following findings should the nurse expect? a. fundus soft, 1 cm to the right of the umbilicus. b. fundus firm, at the level of the umbilicus. c. fundus present, to the left of the umbilicus. d. fundus soft, 2 cm above the umbilicus.
apply breast milk to the nipples before each feeding. start breastfeeding with the nipple that is less sore. change the infant's position on the nipples.
a nurse is caring for a client who is 2 days postpartum, is breastfeeding, and reports sore nipples. which of the following measures should the nurse suggest to reduce discomfort during breastfeeding? select all that apply. a. apply breast milk to the nipples before each feeding. b. place breast pads inside the nursing bra. c. massage the breasts and nipples prior to feeding. d. start breastfeeding with the nipple that is less sore. e. change the infant's position on the nipples.
fundus palpable to right of midline
a nurse is caring for a client who is 2 hr postpartum following a vaginal birth. which of the following findings indicates the client's bladder is distended?
red and painful area in one breast.
a nurse is caring for a client who is 3 days postpartum and is attempting to breastfeed. which of the following findings indicate mastitis? a. swelling in both breasts. b. cracked and bleeding nipples. c. red and painful area in one breast. d. a white patch on a nipple.
massage the client's fundus
a nurse is caring for a client who is 4 hr postpartum following a vaginal birth. the client has saturated a perineal pad within 10 min. which of the following actions should the nurse take first?
uterine atony
a nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz. the nurse should recognize that this client is at risk for which of the following postpartum complications?
uterine atony
a nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz. the nurse should recognize that this client is at risk for which of the following postpartum complications? a. puerperal infection. b. retained placental fragments. c. thrombophlebitis. d. uterine atony.
elevate her leg.
a nurse is caring for a client who is 7 days postpartum and calls the clinic to report pain and redness of her left calf. besides seeing her provider, which of the following interventions should the nurse suggest? a. flex her knee while resting. b. massage the area. c. elevate her leg. d. apply cold compresses.
changes in the cervix.
a nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not". which of the following should the nurse recognize as a sign of true labor? a. rupture of the membranes. b. changes in the cervix. c. station of the presenting part. d. pattern of contractions.
changes in the cervix
a nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is not really sure if she is in labor or not. which of the following should the nurse recognize as a sign of true labor?
painless red vaginal bleeding
a nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. which of the following findings support this diagnosis?
painless red vaginal bleeding.
a nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. which of the following findings support this diagnosis? a. painless red vaginal bleeding. b. increasing abdominal pain with a nonrelaxed uterus. c. abdominal pain with scant red vaginal bleeding. d. intermittent abdominal pain following passage of blood mucus.
frank breach
a nurse is caring for a client who is at 39 weeks of gestation and is in active labor. the nurse locates the fetal heart tones above the client's umbilicus at midline. the nurse should suspect that the fetus is in which of the following positions?
reduce her intake of iron.
a nurse is caring for a client who is breastfeeding her newborn and asks the nurse about the changes she should make in her diet. which of the following dietary changes should the nurse suggest? a. increase her caloric intake by 600 kcal/day. b. increase her fluid intake to 2.5 L/day. c. reduce her intake of iron. d. avoid shellfish.
an IUD
a nurse is caring for a client who is considering several methods of contraception. which of the following methods of contraception should the nurse identify as being most reliable?
history of breast cancer
a nurse is caring for a client who is experiencing menopausal symptoms and asks the nurse about menopausal hormone therapy. the nurse should inform the client that HT is not recommended due to which of the following findings in the client's medical history?
uteroplacental insufficiency
a nurse is caring for a client who is in labor and has an external fetal monitor. the nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?
uteroplacental insufficiency.
a nurse is caring for a client who is in labor and has an external fetal monitor. the nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following? a. uteroplacental insufficiency. b. maternal bradycardia. c. umbilical cord compression. d. fetal head compression.
variable decelerations are due to umbilical cord compression
a nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluid. the nurse observes variable decelerations in the fetal heart rate on the monitor strip. which of the following is a correct interpretation of this finding?
assist the client to the bathroom to void
a nurse is caring for a client who is postpartum and finds the fundus slightly boggy and displaced to the right. based on these findings, which of the followign actions should the nurse take?
fundus firm to palpation
a nurse is caring for a client who is postpartum and received methylergonovine. which of the following findings indicates that the medication was effective?
fundus firm to palpation.
a nurse is caring for a client who is postpartum and received methylergonovine. which of the following findings indicates that the medication was effective? a. fundus firm to palpation. b. increase in blood pressure. c. increase in lochia. d. report of absent breast pain.
blood pressure 80/56 mmHg
a nurse is caring for a client who is receiving opioid epidural analgesia during labor. which of the following findings is the nurse's priority?
fetal breathing. fetal motion. amniotic fluid volume.
a nurse is caring for a client who is to undergo a biophysical profile. the client asks the nurse what is being evaluated during the test. which of the following should the nurse include? select all that apply. a. fetal breathing. b. fetal motion. c. fetal neck translucency. d. amniotic fluid volume. e. fetal gender.
fetal breathing. fetal motion. amniotic fluid volume.
a nurse is caring for a client who is to undergo a biophysical profile. the client asks the nurse what is being evaluated during this test. which of the following should the nurse include? select all that apply.
flu like symptoms
a nurse is caring for a male client who has a new diagnosis of genital herpes. which of the following findings should the nurse expect?
dryness with intercourse
a nurse is caring for a middle adult female client who reports that her menstrual periods have become irregular and she has been having hot flashes. the nurse should expect the client to have which of the following manifestations associated with early menopause?
let's talk about the available options and go from there.
a nurse is caring for a postpartum client who tells the nurse that she does not want any more children. the client asks which birth control method the nurse would recommend. which of the following responses should the nurse make? a. it's your choice, of course, but birth control pills are the most reliable. b. your provider usually recommends a diaphragm and spermicidal cream. c. i'd consider an intrauterine device. you won't have to worry about pregnancy. d. let's talk about the available options and go from there.
apply petroleum jelly to the penis for the first 24 hr. apply gentle pressure from a sterile gauze to control slight bleeding. apply the diaper loosely over the penis.
a nurse is caring for a term newborn who has just had a circumcision using the gomco clamp technique. which of the following instructions should the nurse include when teaching the parents to care for the site? select all that apply.
the client requires a rubella immunization following delivery
a nurse is caring for an antepartum client whose lab findings indicate a negative rubella titer. which of the following is the correct interpretation of this data?
report of headache
a nurse is completing the admission assessment of a client who is at 38 weeks of gestation and has severe preeclampsia. which of the following is an expected finding?
report of headache.
a nurse is completing the admission assessment of a client who is at 38 weeks of gestation and has severe preeclampsia. which of the following is an expected finding? a. tachycardia. b. absence of clonus. c. polyuria. d. report of headache.
they are more direct when discussing issues.
a nurse is engaging in relationship counseling with a male client. which of the following is a characteristic of men that the nurse should consider when beginning the nurse-client relationship?
before i can help you, i need to know more about your sexual activity.
a nurse is leading a discussion about contraception with a group of 14 year old clients. after the presentation, a client asks the nurse which method would be best for her to use. which of the following responses should the nurse make?
the LPN plans to inject the needle 2" below the acromion process.
a nurse is observing a LPN preparing to administer 2 mL penicillin G injection to a client. which of the following actions by the LPN require intervention by the nurse? a. the LPN determines if the client has a history of allergies to cephalosporin. b. the LPN selects a 21 gauge, 1.5" needle. c. the LPN plans to inject the needle 2" below the acromion process. d. the LPN states that she will aspirate for blood prior to injecting the medication.
flat areola
a nurse is performing a gestational age assessment using the new ballard score for newborn maturity rating. which of the following findings indicates that the newborn is preterm?
redness at the base
a nurse is performing umbilical cord care for a term newborn. which of the following findings requires further assessment and intervention?
a 38 year old client who reports smoking one pack of cigarettes every day
a nurse is reviewing contraception options for four clients. the nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives?
transmission of the disease will not occur when my lesions are gone.
a nurse is teaching a client who has a new diagnosis of genital herpes. which of the following statements by the client indicates the need for further teaching? a. transmission of the disease will not occur when my lesions are gone. b. abstaining from sexual activity reduces the risk of transmission of the disease. c. the use of condoms will reduce the risk of transmission. d. antiviral medications will not cure the infection.
ask about the client's exposure to any past of present STIs
a nurse is teaching a group of newly licensed nurses on effective techniques for counseling clients about sexually transmitted infections. which of the following statements should the nurse include in the teaching?
female condoms can help prevent transmission of sexually transmitted infections.
a nurse is teaching a group of teenage clients about the use of condoms for the prevention of STIs. which of the following statements should the nurse include in the teaching? a. use a natural membrane condom rather than a polyurethane condom. b. you may use a condom more than once. c. use an oil based lubricant when you use a condom. d. female condoms can help prevent transmission of STIs.
the presenting part is 1 cm above the ischial spines
a nurse on the labor and delivery unit is caring for a client following a vaginal examination by the provider which is documented at -1. which of the following interpretations of this finding should the nurse make?
discontinue the infusion of iv oxytocin
a nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. uterine contractions occur every 2 min, last 90 sec, and are strong to palpation. the baseline FHR is 150/min, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. which of the following actions should the nurse take?
discontinue the infusion of the IV oxytocin.
a nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. uterine contractions occur every 2 min, last 90 sec, and are strong to palpation. the baseline fetal heart rate is 150 bpm, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. which of the following actions should the nurse take? a. decrease the rate of infusion of the maintenance IV solution. b. discontinue the infusion of the IV oxytocin. c. increase the rate of the infusion of the IV oxytocin. d. slow the client's rate of breathing.
maternal hypotension and fetal bradycardia
A client in labor has administered an epidural anesthesia. Which assessment findings should the nurse prioritize?
Endometritis
A woman is 2 weeks postpartum when she calls the clinic and tells the nurse that she has a fever of 101°F (38.3°C). She reports abdominal pain and a "bad smell" to her lochia. The nurse recognizes that these symptoms are associated with which condition?
November 8, 2017
A woman reports that her last menstrual period (LMP) occurred February 1, 2017. Using the Naegele rule, what would be her estimated date of delivery (EDD)?
To reduce the risk of heat loss, the bath should be performed by the nurse, not the parents, within 2 to 4 hours of birth.
Which statement is false regarding bathing the newborn?
multipara
carried multiple pregnancies to viability
polycystic ovarian syndrome pathophysiology
elevated testosterone in women genetic
bimanual/two hand exam
evaluation of the womb by entering the vaginal cavity not an RN assessment potential pregnancy confirmation
primigravida
first pregnancy
probable signs of pregnancy
goodell's sign chadwick's sign hegar's sign positive pregnancy test
penicillin G injection
must be administered deep into a large muscle.
hyperemesis gravidarum interventions
rehydrate (oral and IV as needed) pharmacological
hyperemesis gravidarum s/s
severe n/v weight loss dehydration
fetal tachycardia
During a follow-up visit to the prenatal clinic, a pregnant client asks the nurse about using a hot tub to help with her backache. The nurse recommends against the use based on the understanding that what can occur?
the lowermost portion of the fetus is at the level of the ischial spines.
a nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. which of the following is the correct interpretation of this clinical finding?
preeclampsia
a nurse is assessing a patient who is at 20 weeks of gestation. she instructs the patient to be sure to report headaches, blurred vision, and swelling of her hands because these are indications of which of the following complications of pregnancy?
poorly ossified bones of the cranial vault
A nurse is educating a group of nursing students about the molding of the fetal skull during the birth process. What would the nurse include as the usual cause of molding?
Amniocentesis
A sonogram on a woman in the first trimester of her pregnancy shows abnormal fetal findings. The nurse prepares to provide the woman with information concerning which diagnostic procedure?
endorphins
A client in the first stage of labor is admitted to a health care center. The nurse caring for the client instructs her to rock on a birth ball. The nurse informs her that this causes the release of certain natural substances, which reduces the pain. To which substance is the nurse referring?
"Be sure to change your pajamas to prevent you from chilling."
A client who gave birth 5 days ago reports profuse sweating during the night. What should the nurse recommend to the client in this regard?
reduces the risk of ovarian cancer. relieves hot flashes. prevents osteoporosis.
a health care professional is caring for a patient who is about to begin taking transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. the health care professional should explain to the patient that the drug combination includes which of the following therapeutic effects? select all that apply.
dilated pupils dizziness distended bladder fever
a health care professional administers oxybutynin (Ditropan) to a patient to treat neurogenic bladder. which of the following assessment findings should the health care professional recognize as an adverse effect? select all that apply.
female condoms can help prevent transmission of sexually transmitted viruses
a nurse is teaching a group of teenage clients about the use of condoms for the prevention of STIs. which of the following statements should the nurse include in the teaching?
polycystic ovarian syndrome s/s
amenorrhea acne hirsutism (hair in typically male areas - face, neck, chin)
presumptive signs of pregnancy
amenorrhea quickening n/v urinary frequency
non-stress test
biophysical profile tests for fetal well being during pregnancy assess for fetal accelerations - reactive = normal and good - non-reactive = abnormal and bad
primipara
carried one pregnancy to viability
toxic shock syndrome pathophysiology
caused by improper use of tampons - replace every 4 to 6 hours - rotate between pads and tampons bacteria leading to a cytokine storm (overreaction of the immune system)
Explain this is normal.
A new mother is learning how to change the diaper on her newborn and becomes concerned after observing a rash on the trunk of the infant. Which response should the nurse prioritize?
higher oxygen content of the circulating blood
A nurse is analyzing a journal article that explains the changes at birth from fetal to newborn circulation. The nurse can point out the closure of the ductus arteriosus is related to which event after completing the article?
reduce her intake of iron
a nurse is caring for a client who is breastfeeding her newborn and asks the nurse about the changes she should make in her diet. which of the following dietary changes should the nurse suggest?
naegele's rule
LMP + 1 year - 3 months + 7 days
Social support
The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother?
Over the right upper quadrant on the abdomen
The nurse in the newborn nursery is placing a 30-minute-old newborn on a radiant warmer for thermoregulation. Where should she apply the temperature probe to be most accurate?
ask about the client's exposure to any past or present STIs.
a nurse is teaching a group of newly licensed nurses on effective techniques for counseling clients about sexually transmitted infections. which of the following statements should the nurse include in the teaching? a. use close ended questions when obtaining the health history. b. a client's reproductive health history is not needed for counseling purposes. c. ask about the client's exposure to any past or present STIs. d. refer the client to genetic counseling if he has had an STI.
anovaginal fistula pathophysiology
abnormal tunneling between vagina and anus may occur after perineal tear repair or in older age
heart rate
after administering terbutaline (brethine) to a patient to inhibit preterm labor, the health care professional should assess which of the following?
gtpal history assessment
gravidity (number of times pregnant) term (term births 36-40 weeks) parity (number of pregnancies carried to viability (20-24 weeks) abortion (pregnancies lost due to abortion or miscarriage) living (living children)
toxic shock syndrome s/s
hyperthermia hypotension progresses to coma and/or multiple system organ failure
toxic shock syndrome interventions
immediate removal of the tampon teat the underlying infection hospitalization likely (ICU)
ectopic pregnancy s/s
lower abdominal pain vaginal pain fever rupture (medical emergency) - hypotension (shock) - rebound tachycardia
qualifying accelerations
peak at least 15/min above the FHR and last at least 15 seconds.
abortion
pregnancies lost due to abortion or miscarriage
follicular maturation
prior to administering human chorionic gonadotropin to a patient to stimulate ovulation, the health care professional should give her menotropins, or hMG, to promote:
Evaporative
The newborn has been placed in skin-to-skin contact with his mother. A blanket covers all of his body except his head. His hair is still wet with amniotic fluid, etc. What is the most likely type of heat loss this baby may experience?
Fill a tub with warm water and add a mild soap. Using a soft washcloth, wash the newborn all over. Comb the hair to remove any dried blood. Take the newborn's axillary temperature. Cover the head with a cap, apply a diaper and dress the newborn. Swaddle in a warm blanket and place in an open crib.
The nurse is bathing a newborn for the first time. Place in order how the nurse would perform these tasks during the bathing procedure. Use all options.
Staphylococcus aureus
The nurse is teaching a client with newly diagnosed mastitis about her condition. The nurse would inform the client that she most likely contracted the disorder from which organism?
Performing a heel stick Accucheck Changing a diaper
Under which circumstances should gloves be worn in the newborn nursery? Select all that apply.
"Tell me how you handled labor pain in your past deliveries."
When collecting data to devise a labor plan for a multiparous woman, which question best allows the nurse to develop individualized strategies?
uterine subinvolution
Which complication is most likely responsible for a late postpartum hemorrhage?
uterine atony
Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage?
a positive test
findings for a client having a contraction stress test that indicates that late decelerations occured with 50% or more of the contractions, even if fewer than 3 contractions occurred in a 10 min period.
prenatal diet
increase 500 calories per day increase unsaturated fatty acids
menopause
no more ovulation
hyperemesis gravidarum pathophysiology
not morning sickness (morning sickness is typically only in the 1st trimester)
gravidity
number of pregnancies
parity
number of pregnancies carried to viability (36-40 weeks)
gestational diabetes interventions
oral antidiabetic agents insulin
dysmenorrhea
painful periods
ectopic pregnancy interventions
prior to emergency: - induced miscarriage (methotrexate) during emergency: - surgery (stop the bleeding)
amniocentesis
removal of amniotic fluid tests for genetic abnormalities and sex of the baby - down syndrome - turner syndrome performed at 14-16 weeks complications: - preterm labor - miscarriage - chorioamnionitis
percutaneous umbilical cord sampling/fetal blood sampling
removal of blood from the umbilical cord test if serious risk of genetic defects exists performed when all other tests are inconclusive complications: - hemorrhage - cord damage - miscarriage
anovaginal fistula s/s
stool leaking from vagina
anovaginal fistula interventions
surgical repair
a negative test
the findings for a client having a contraction stress where at least three uterine contractions occured in a 10 min period with no late or significant variable decelerations.
ingestion of the medication with nitrates causes hypotension
the nurse is planning an educational program on sildenafil to a group of older male clients. which of the following information should the nurse include in the educational program?
ingestion of the medication with nitrates causes hypotension.
the nurse is planning an educational program on sildenafil to a group of older male clients. which of the following information should the nurse include in the educational program? a. swallow the medication with grapefruit juice to improve the action. b. ingestion of the medication with nitrates causes hypotension. c. take the medication 2 hr prior to sexual activity. d. consume a high fat meal to increase the medication absorption.
polycystic ovarian syndrome interventions
weight loss progesterone surgery
perform weight bearing exercises
when talking with a patient about using leuprolide (Lupron) to treat endometriosis, the health care professional should include which of the following instructions?
vaginal dryness
when talking with a patient who is receiving leuprolide (lupron) to treat endometriosis, the health care professional should advise the patient to expect which of the following side effects?
Assist the client to semi-Fowler position, assess the fetal heart rate, start an IV bolus of 500 ml, and administer oxygen via face mask.
A client has just had an epidural placed. Before the procedure, her vital signs were as follows: BP 120/70, P90 bmp, R18 per min, and O2 sat 98%. Now, 3 minutes after the procedure, the client says she feels lightheaded and nauseous. Her vital signs are BP 80/40, P100 bmp, R20 per min, and O2 sat 96%. Which interventions should the nurse perform?
diabetes
A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia?
"Within 1 to 3 weeks, your diaphragm should return to normal, and your breathing will feel like it did before your pregnancy."
A client who had a vaginal birth 2 days ago asks the nurse when she will be able to breathe normally again. Which response by the nurse is accurate?
Establish a baseline of present health. Determine the gestational age of the fetus. Monitor for fetal development and maternal well-being. Identify women at risk for complications.
A nurse is conducting a program about the importance of prenatal care for a group of women in a community health clinic. Which information would the nurse include when describing the purpose of prenatal care? Select all that apply.
"We will turn the mobile on that's hanging on our baby's crib."
A nurse teaches new parents how to soothe a crying newborn. Which statement, by the parents, indicates to the nurse the teaching was effective?
Mother states she wanted a boy this time, not another girl.
Healthy bonding behaviors are important to note when the nurse is assessing the new family. What statement or action would the nurse consider a warning sign that the mother and infant were not attaching as they should?
bladder or kidney infection
Which possible complication associated with back pain can lead to premature contractions?
hypertension
a nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. the nurse should recognize that which of the following is the most common risk factor for abruption? a. cocaine use. b. hypertension. c. blunt force trauma. d. cigarette smoking.
bethanechol
a health care professional is caring for a male patient who has hyperthyroidism that has not responded to treatment. the health care professional should recognize that this thyroid disorder is a contraindication for which of the following genitourinary system drugs?
erectile dysfunction for which he takes sildenafil (viagra)
a health care professional is caring for a patient who has benign prostatic hypertrophy and is taking tamsulosin (flomax). the health care professional should question the use of the drug if the patient also has which of the following?
assist the client to turn onto her side.
a nurse is caring for a client who is at 40 weeks gestation and is in active labor. the client has 6 cm of cervical dilation and 100% effacement. the nurse obtains the client's blood pressure reading as 82/52 mmHg. which of the following nursing interventions should the nurse perform?
the LPN plans to inject the needle 2 in below the acromion process.
a nurse is observing an LPN preparing to administer a 2 mL penicillin G injection to a client. which of the following actions by the LPN require intervention by the nurse?
positive pregnancy signs
audible fetal heart sounds ultrasound visualization leopold maneuvers
menopause
causes: - 45 - 55 years of age - hysterectomy - illness
nullipara
never carried a pregnancy to viability
nulligravida
never pregnant
gestational diabetes pathophysiology
new onset or previous diabetes
pre labor ultrasound
test for cephalopelvic disproportion the birth canal cannot physically allow a vaginal birth causes: - small birth canal - large fetus - multiples (twins, triplets, etc.) - c-section likely
stress test
tests for fetal ability to handle labor - administration of oxytocin assess fetal heart rate when term - positive = bad - negative = good
pregnancy test
tests for human chorionic gonadotropin (HCG) blue (positive) also used to assess for testicular cancer in men
gestation diabetes s/s
the 3 P's of hyperglycemia elevated serum fasting glucose - tested multiple times throughout pregnancy
a reactive test
the fetus has a minimum of 2 accelerations in a 20 min period, each lasting at least 15 seconds and peaking at least 15/min above the FHR baseline.
a nonreactive test
the findings for a client having a contraction stress test that does not produce two or more qualifying accelerations within a 20 min period. qualifying actions peak at least 15/min above the FHR baseline and last at least 15 seconds
prenatal screening tests
triple/quad test amniocentesis non stress test stress test percutaneous umbilical cord sampling/fetal blood sampling pre labor ultrasound
multiples pregnancy
twins, triplets, etc. may lead to gallstone formation in mother risk for preterm labor
do not take the drug with high fat foods
when talking with a patient about taking sildenafil (Viagra) to treat erectile dysfunction, the health care professional should include which of the following instructions?
oxytocin
which of the following drugs should a primary care provider prescribe to induce labor in a woman who is at 42 weeks of gestation?
red and painful area in one breast
a nurse is caring for a client who is 3 days postpartum and is attempting to breastfeed. which of the following findings indicate mastitis?
prolonged labor hydramnios uterine infection
A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply.
On her side with the weight of the uterus on the bed
A pregnant client reports difficulty sleeping well. Which suggestion for sleeping should the nurse prioritize to assist this client?
applying ice packs
a nurse is assessing a patient who is 1 day postpartum and is not breastfeeding. the nurse notes the patient's breasts are engorged. which of the following actions is appropriate for the patient to take?
ovarian hyperstimulation syndrome
a health care professional is caring for a patient who is about to begin clomiphene (Clomid) therapy to treat infertility. the health care professional should monitor the patient for which of the following adverse effects?
prolactin level
a health care professional is caring for a patient who is about to begin taking cabergoline to treat infertility. the healthcare professional should explain to the patient the need to monitor which of the following laboratory tests?
vaginal bleeding
a health care professional is caring for a patient who is about to begin taking conjugated equine estrogen (Premarin). the health care professional should tell the patient to report which of the following indications of a serious adverse reaction?
prostate specific antigen
a health care professional is caring for a patient who is about to begin taking finasteride (Proscar) to treat benign prostatic hypertrophy. the health care professional should explain to the patient the need to monitor which of the following laboratory tests?
cover the area of applicating with clothing. wash your hands after applying the gel. do not shower for several hours after applying the gel.
a health care professional is caring for a patient who is about to begin using transdermal testosterone gel (AndroGel) to treat delayed puberty. when talking with the patient, which of the following instructions should the health care professional include? select all that apply.
avoid driving and activities that require alertness. increase fluid intake. stay close to the bathroom after taking the drug.
a health care professional is caring for a patient who is taking bethanechol (Urecholine) for urinary retention. when advising the patient about taking the drug, which of the following instructions should the health care professional include? select all that apply.
use additional birth control
a health care professional is caring for a patient who is taking combination oral contraceptive ethinyl estradiol and drospirenone (Yasmin) and is about to begin taking rifampin (Rifadin) to treat tuberculosis. because of a likely drug interaction, the health care professional should tell the patient to:
blood clots
a health care professional should question the use of conjugated equine estrogen (Vagifem) by a patient who has a history of which of the following?
smokes half a pack of cigarettes a day
a health care professional should question the use of the combination oral contraceptive ethinyl estradiol and drospirenone by a patient who:
elevate her leg
a nurse is caring for a client who is 7 days postpartum and calls the clinic to report pain and redness of her left calf. besides seeing her provider, which of the following interventions should the nurse suggest?
disseminated intravascular coagulation
a nurse on the obstetric unit is caring for a client who experienced abruptio placentae. the nurse observes petechiae and bleeding around the IV access site. the nurse should recognize that this client is at risk for which of the following complications?
have the patient urinate prior to insertion. remove the pouch when active labor begins. monitor for uterine hyperstimulation. monitor the patient's temperature.
a primary care provider has prescribed dinoprostone (Cervadil) vaginal insert to promote cervical ripening in a patient who is at 40 weeks of gestation. when administering dinoprostone, which of the following actions should the health care professional take? select all that apply.
a small piece of tissue from the fetal placenta will be removed and analyzed
a woman is to undergo chorionic villus sampling as part of a risk assessment for genetic disorders. what statement would the nurse include when describing this test to the woman?
