EAQS Peds - OB mix

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An adolescent who has just been found to have type 1 diabetes asks a nurse about exercise. What is the best response by the nurse?

"Extra snacks are needed before exercise."

Which statement by a mother indicates the need for additional teaching about safety guidelines for infants and toddlers?

"I will give my child hard candies for chewing."

The registered nurse is teaching the mother of an infant about the prevention of sudden infant death syndrome (SIDS). Which statement by the mother indicates effective learning?

"I will position my baby on the back while sleeping."

The nurse is caring for an adolescent with hemophilia. Which statement by the client indicates a need for further teaching?

"I'll use a straight razor when I start shaving."

During labor a client states that she does not want eyedrops or ointment placed in her baby's eyes immediately after birth. How should the nurse respond?

"Let's talk about why you don't want the medicine to be put into your baby's eyes."

A 17-year-old mother is to sign the consent for her son's myringotomy. What should the nurse say to the mother about this procedure?

"Tell me what you know about this procedure."

A primigravida client asks the PN, "How will I know that I will be going into labor soon?" Which sign should the PN provide that is a common sign?

Burst of energy

An 8-year-old child is being prepared for surgery the next day. How should the nurse present preoperative instructions to this child?

By focusing on simple anatomical diagrams

A nurse is conducting a health class for adolescents. What modifiable risk factor, most closely associated with the development of coronary heart disease (CHD) in both men and women, should the nurse discuss?

Cigarette smoking

The PN is reviewing the informational packets with a client who is at risk for preeclampsia. Which information is most important for the PN reinforce with the client?

Notify the clinic if any vision changes are experienced

An 18-year-old primigravida at 36 weeks' gestation is admitted with a diagnosis of mild preeclampsia. What is the nurse's most important goal for this client?

Reducing her Blood pressure

How should a nurse screen the newborn of a diabetic mother for hypoglycemia?

Testing heel blood with the use of a glucose-oxidase strip

After interacting with a preschooler, the nurse concludes that the child has normal development according to Fowler's spiritual development. Which behavior of the child supports the nurse's conclusion?

The child imitates the adults as they pray

A client is admitted with a marginal placenta previa. What should the nurse have available?

Two units of typed and screened blood

Which physiological cause(s) for constipation during pregnancy should the PN explain to a client in the first trimester (Select all that apply) a. Displacement of the colon b. Tightening of the anal sphincter c. Change in nutrient absorption d. Shifting of liver placement e. Decrease in peristalsis f. Increase in bile production

a. Displacement of the colon e. Decrease in peristalsis

A client who had tocolytic therapy for preterm labor is being discharged. What instructions should the nurse include in the teaching plan?

limit daily activities

A woman at 22 weeks' gestation is admitted with heavy bleeding and severe abdominal cramping. When told that no fetal heart sounds can be detected, the client says to the nurse, "We wanted this baby so badly." How should the nurse respond?

"It must be difficult to lose this baby that was important to you both."

After an incomplete abortion, a client tells a nurse that although her health care provider explained what an incomplete abortion was, she did not understand. What is the best response by the nurse?

"It's when the fetus is expelled but other parts of the pregnancy remain in the uterus."

A 17-year-old child was recently found to have type 2 diabetes mellitus. What information will the nurse include when providing education to the family?

"The most important interventions are good nutrition and portion control."

Which reading of a newborn's pulse may indicate an abnormality in the function of the cardiovascular system? a. 100 bpm b. 120 bpm c. 130 bpm d. 140 bpm

100 bpm

A client is to undergo amniocentesis at 38 weeks' gestation to determine fetal lung maturity. What lecithin/sphingomyelin ratio (L/S ratio) is adequate for the nurse to conclude that the fetus' lungs are mature enough to sustain extrauterine life?

2:1

A nurse is caring for several pregnant clients in the prenatal clinic. Which client causes the most concern because of her predisposition to placenta previa?

30 years old, gravida 6, para 5

A primiparous client asks the PN how much her NB baby boy should sleep every day. What information should the PN provide?

A NB sleeps most of the day and gradually will have increasing periods of wakefulness

When entering the room of a client in active labor to answer the call light, the nurse sees that she ashen gray, dyspneic, and clutching her chest. What should the nurse do after pressing the emergency light in the client's room?

Administer oxygen by face mask

A woman in active labor arrives at the birthing unit. She tells the nurse that she was found to have a chlamydial infection the last time she visited the clinic but that she stopped taking the antibiotic after 3 days because she "felt better." What would the nurse anticipate as part of the plan of care, in light of this history?

Administration of antibiotics before delivery

Which condition is more common in adolescent girls than boys? a. Obesity b. Dental caries c. Anorexia nervosa d. Acquired Immunodeficiency syndrome (AIDS)

Anorexia nervosa

A multiparous client's membrane rupture after 8 hours of labor. Which action should the PN implements at this time?

Assess the FHR and pattern

An 18-year-old high school student arrives at the local blood drive center to donate blood for the first time. As the site is being prepared for needle insertion, the student becomes agitated, starts to hyperventilate, and complains of dizziness and tingling of the hands. What should the nurse instruct the student to do?

Breathing into cupped hands

A client who had a cesarean birth is unable to void 3 hours after the removal of an indwelling catheter. How can the nurse evaluate whether the client's bladder is distended?

By palpating the client's suprapubic area gently

A nurse is caring for a 15-year-old client who is undergoing chemotherapy for leukemia. The nurse expects that adolescents with health problems are most concerned about:

Feeling different regarding changes in body image

A client gives birth to a full-term male with an 8/9 Apgar score. What should the immediate nursing care of this newborn include?

Identifying the infant, assessing respiration, and keeping him warm

A client in the 38th week of gestation exhibits a slight increase in blood pressure. The health care provider advises her to remain in bed at home in a side-lying position. The client asks why this is important. What is the nurse's response regarding the advantage of this position?

It increases blood flow to the fetus

A nurse is assessing a newborn for signs of hyperbilirubinemia (pathological jaundice). What clinical finding confirms this complication?

Jaundice that develops in the first 12 to 24 hours

A nurse is teaching a prenatal class about smoking during pregnancy. What neonatal consequence of maternal smoking should the nurse include in the teaching?

Low birth weight

A breastfeeding mother experiences redness and pain in the left breast, a temperature of 100.8° F (38.2° C), chills, and malaise. What condition does the nurse suspect?

Mastitis

A young adult female comes to the health clinic to confirm a positive home pregnancy test. After determining the client's LMP as August 5, what expected date of birth should the PN calculate

May 12

An infant who weighs 4550 grams is delivered using forceps-assisted vaginal delivery. What action is most important for the PN to implement?

Monitor signs of hypoglycemia

A client who is in the first trimester is being discharged after a week of hospitalization for hyperemesis gravidarum. She is to be maintained at home with rehydration infusion therapy. What is the priority nursing activity for the home health nurse?

Monitoring the client for signs of electrolyte imbalances

A health care provider determines that a fetus is in a breech presentation. For which complication should the nurse monitor the client?

Nonreassuring fetal signs, indicating prolapse of the cord

A client in labor is being prepared for a cesarean birth. What is the most important nursing intervention before anesthesia is administered?

Obtaining informed consent

Which client should a nurse suspect is at increased risk for postpartum hemorrhage?

One who gives birth to an infant weighing 9 lb 8 oz

While auscultating the lungs of a client admitted with severe preeclampsia, the nurse identifies crackles. What inference does the nurse make when considering the presence of crackles in the lungs?

Pulmonary edema has developed.

What is the most important parameter for the nurse to monitor during the first 24 hours after the birth of an infant at 36 weeks' gestation?

Respiratory distress

In which type of play does a child experience pleasure by swinging?

Sense pleasure play

Which gross motor skill can be observed in a 7-month-old infant?

Sits alone without support

The PN places a NB who is 4 hours old with an axillary temperature of 97.2 F under the radiant heat warmer. Which rationale supports the PN's action?

The NB's thin layer of subcutaneous fat provides poor insulation

Which client is a candidate for the administration of human immune globulin (RhoGam) after delivery?

The Rh-negative mother who delivers a Rh-positive baby

The nurse is evaluating the dietary plan of a 6-month-old infant. Which action by the infant's mother needs correction?

The mother gives low-fat milk to the infant in a bottle

After repeating VS for a NB who is 5 hours old, the PN obtains an axillary temperature of 97.2F and places the NB under a radiant warmer. Which additional finding should the PN observe in the NB?

Tremors of the hands during crying

During a follow-up appointment, a client at 21 weeks' gestation is found to have hyperemesis gravidarum. The client says, "Why is this happening to me? I don't know whether I can continue like this." What is the best response by the nurse?

"This must be physically and emotionally challenging for you."

A new mother exclaims to the nurse, "My baby looks like a Conehead!" How should the nurse respond?

"This often happens as the baby's head moves down the birth canal—the bones move for easier passage."

A 6-month-old infant is admitted to the pediatric unit with a diagnosis of failure to thrive. The birthweight was 7 lb. Judging from growth and development charts, how many pounds does the nurse conclude that the infant should weigh? a. 12 b. 14 c. 18 d. 22

14

Which information is most important for a large-for-gestational-age (LGA) infant of a diabetic mother (IDM)?

Blood glucose level less than 40 mg/dL

A nurse who is caring for a client in labor uses nitrazine paper to test the pH of the client's leaking vaginal fluid. What color will the nitrazine paper turn if the leakage is amniotic fluid?

Blue

The nurse is helping an adolescent with iron-deficiency anemia make breakfast meal choices. Which foods should the nurse suggest? a. Apple fruit cup b. Bowl of raisin bran c. Cup of blueberry yogurt d. Slice of wheat bread toast with butter

Bowl of raisin bran

A nurse is caring for a client with preeclampsia who is receiving intravenous magnesium sulfate therapy. What antidote should the nurse have readily available?

Calcium gluconate

A client in labor is admitted to the birthing unit. Assessment reveals that the fetus is in a footling breech presentation. What should the nurse consider about breech presentations when caring for this client?

Cesarean birth probably will be necessary

A client is being prepared for an emergency cesarean birth because of fetal compromise. What is the most important preoperative nursing action?

Confirming the signed consent

A client at 35 weeks' gestation who has had no prenatal care arrives in labor and delivery and is found to be 20 percent effaced and 2 cm dilated, with her membranes intact and contractions 3 minutes apart. The nurse notices some ruptured blisterlike vesicles in the genital area. What should the nurse's next action be?

Contacting the health care provider about the need for a cesarean birth

The PN is discussing aspects of NB hygiene with the new parents as they prepare for discharge. Which information should the PN provide?

Create a draft-free environment when bathing the baby

A 14-week gestational client, who weighed 125 pounds before pregnancy, come into the health clinic for a prenatal appointment. The client's weight today is 129 pounds/ What action should the PN implement?

Document the finding in the medical record

A 3-day old newborn who weighed 7 pounds, 8 ounces at birth is breast feeding and now weighs 6 pound and 15 ounces. Which action should the PN take?

Document the weight loss

A client has a cesarean birth. What is the most important nursing intervention to prevent thromboembolism on the client's first postpartum day?

Encouraging frequent ambulation

A client who is 21 weeks pregnant loses the baby because of an incompetent cervix. Once the client's physical needs have been assessed and met, what is the best way for the nurse to meet the client's psychological needs?

Encouraging the client to see and hold the baby while still possible

A 28-year-old woman is recovering from her third consecutive spontaneous abortion in 2 years. What is the most therapeutic nursing intervention for this client at her follow-up appointment?

Encouraging the client to verbalize her feelings about the loss

Which medication is prescribed for the prevention of ophthalmia neonatorum?

Erythromycin (Ilotycin)

A nurse teaches a new mother about neonatal weight loss in the first 3 days of life. What does the nurse explain is the cause of this weight loss?

Excretion of accumulated excess fluids

What should the nurse advise the parents of a child who performs manual stimulation of his genitalia in public places?

Explain that genital stimulation is acceptable in private places

A primigravida is admitted with a ruptured fallopian tube resulting from a tubal pregnancy and surgery is performed to remove the fallopian tube. What should postoperative nursing care include?

Explaining that the client may still be capable of becoming pregnant

A client with type 1 diabetes is scheduled for an amniocentesis at 36 weeks' gestation. She asks the nurse why this is being done so late in her pregnancy. What should the nurse consider before responding?

Fetal lung maturity may be evaluated

A 15-year-old emancipated minor gave birth to a boy 36 hours ago and has requested a circumcision. What is the nurse's priority?

Getting an informed consent signed by the mother of the baby

A client in labor, who is at term, is admitted to the birthing room. The fetus is in the left occiput posterior position. The client's membranes rupture spontaneously. What observation requires the nurse to notify the practitioner?

Greenish amniotic fluid

What is the most important action by the PN in preventing neonatal infection?

Hand washing

A nurse is caring for a client who is admitted to the birthing unit with a diagnosis of abruptio placentae. For what complication associated with this problem should the nurse monitor this client?

Hypovolemic shock

A woman who had a home birth brings the infant to the well-baby clinic on the third day after the birth, and the infant weighs 5% less than at birth. What does the nurse suspect as the cause of this weight loss?

Imbalance between nutrient intake and fluid loss

The nurse is counseling a pregnant client with type 1 diabetes about medication changes as pregnancy progresses. Which medication will be needed in increased dosages during the second half of her pregnancy?

Insulin

A nurse is discussing insulin needs with an adolescent with recently diagnosed type 1 diabetes. What information is important for the nurse to include concerning insulin administration?

Insulin will be required throughout life

What signs and symptoms of withdrawal does the nurse identify in a postpartum client with a history of opioid abuse?

Irritability and muscle tremors

A 16-year-old male asks the nurse about the use of condoms. He states, "I've used condoms in the past, but I'm not sure I'm using them correctly." What should be included as part of the teaching about condoms?

The condom must be positioned after an erection has occurred

A nurse places a newly admitted client with worsening preeclampsia in a private room. Why is it important for this client to be in a nonstimulating environment?

The probability of tonic-clonic seizures is reduced

A nonstress test (NST) is scheduled for a client with mild preeclampsia. During the test, the client asks the nurse what it means when the fetal heart rate goes up every time the fetus moves. What should the nurse consider before responding?

These accelerations are a sign of fetal well-being


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