FINAL EXAM OB
In a patient not receiving anticoagulants, which of the following lab values with indicate the patient is at increased risk for bleeding? Select all that apply.
INR of 4.0 PT 45 seconds
A woman with severe preeclampsia has been receiving a magnesium sulfate by IV infusion. The nurse assesses the woman and documents. The following findings temperature 37.1, pulse 90 respirations 20 blood pressure 165/112 the nurse calls the physician anticipating an order for.
IV hydralazine
you are educating a patient on doxorubicin, an anti-tumor anabiotic. What education is important for this patient understand while taking this medication.
Importance of monitoring the ejection fraction or pulmonary function test
The RN at a preconception counseling center counsel as a adult male during an infertility evaluation which of these has the greatest implications for the man's care
Impotence related to daily alcohol consumption
A client who was diagnosed with HIV is prescribed raltegravir an integrase inhibitor for their ART therapy for the disease process. What nursing implications should we include during education session regarding their new medication treatment
Instructed patient to report a new onset of muscle pain or weakness
Gravid patient who is also a type one diabetic is in her third trimester of pregnancy she has for glycemic control and her latest serum glucose is 849. The nurse knows that this patient should be assessed immediately for which condition.
Intrauterine fetal death caused by metabolic acidosis
During their kids stage of meningitis a three year old, becomes restless and irritable with the IV pumps, beeping and call light, which of the following would be appropriate to institute
Keeping extraneous noise to a minimum within the room
A nurse is reviewing laboratory results for a patient with cirrhosis and notes the ammonia is 90 which dietary selection will the nurse suggest to the patient
Macaroni and cheese
The nurse provides patient teaching to a 10 week gravid patient who is being seen in the clinic today which information is priority for the nurse to provide
Methods to relieve back, aches in pregnancy
A female college student is planning to become sexually active the woman request something that will prevent ovulation to combine ovulation, suppression with her effectiveness in contraception which method of birth control should the nurse choose
Oral hormonal base contraceptive
The client is hospitalized with pneumocystis jiroveci pneumonia. The client reports shortness of breath with activity and extreme fatigue. What intervention is best to promote comfort
Pace activities, allowing for adequate rest.
A 62-year-old man confides in the nurse that he is concerned about his sexual function. What is the nurses best response
Please share with me more about your concerns
Which vital sign changes with the nurse highlight for a pregnant woman's obstetrician to review
Pre-pregnancy, BP 100/60 and third trimester BP 145/92
A student nurse asked his instructor. What types of conditions can cause IUGR. The instructor provides a list of conditions that may cause this which condition below is not a risk factor for the development of IUGR
Pregnant woman has a hemoglobin level 13.6.
gravida woman in her third trimester of pregnancy is in a car accident in lacerate her left radial artery from breaking glass and is bleeding profusely was Sarah vital signs is most concerning to the nurse related to blood loss
Pulse 138, respirations 28 blood pressure 106/62
A female client is receiving a unit of packed red blood cells which action taken by the nurse should be considered high priority if the client experiences tingling in the fingers and back pain
Stop the infusion
when the nurse is administering a vesiant chemotherapeutic agent intravenously an important consideration is to
Stop the infusion if swelling is observed at the site
A patient has a positive serum beta HCG on Monday of 250 on Friday. She calls the physicians office complaining of vaginal bleeding and cramping the physician. Instruct the patient to return for a repeat serum Beta. The repeat level is 489 what can the nurse conclude from this report?
The beta hCG should be about 1000 at this point a level of 489 is worrisome regarding viability of the pregnancy
A client diagnosed with aids is receiving anti-retroviral therapy a Triplea labs revealed the CD4 T cell count is 525. How should the nurse interpret this result?
The drug therapy is effective
A patient who has kept a menstrual chart for six months as the nurse to help her determine when she's ovulating the patient's insurance cycle have been 27 to 31 days in link over the past six months. What should the nurse say?
The patient is likely ovulating somewhere between days 13 to 17 of the menstrual cycle
A patient diagnosed with HIV infection has now developed the cryptosporidiosis opportunistic infection, which outcome would be appropriate for the nurse to include in the plan of care
The patient will maintain intact, peroneal skin
A couple receives there any sentences report and ask the nurse to help them interpret the results. The report states that they carry a child who's chromosomal composition is 46XY. How are the nurse interpret this result
The woman is caring, a male child with normal chromosomes
A nurse is educating a patient who is prescribed lactulose the patient states I do not want to take this medication because it causes diarrhea. How should the nurse respond
This medication helps to get rid of the ammonia in your body
A male patient is being admitted with acute pancreatitis. The physician is writing orders for the care. What does the nurse expect to be included in these orders? Select all that apply
administer IV fluids Give morphine 2 mg IV Q2 hours for pain NPO status
A nurse assesses patients on the medical surgical unit which patient is at greatest risk for development of carcinoma in the liver
A 66-year-old who has a history of cirrhosis
The oncology nurse informs a new frad that the cancer patient they are caring for has a documented staging of cancer that is listed as T2N1M0. The RN knows that this is indicators of what findings.
A larger primary tumor that has extended into regional lymph nodes with no distant metastasis
Which of these is most likely to result in a low sperm count in men
A man who rides motorcycles in motocross tournament each weekend and trains every other day
The nurse is preparing to hang an IV infusion of 1 g vancomycin and 250 mL of normal saline for a patient diagnosed with MRSA. The medication is to infuse over 1.5 hours at what rate in milliliter per hour does the nurse said the IV pump.
167
A nurse works in urology clinic were men often come in asking to be prescribed ED drugs which patient belay would most likely to benefit from the use of a patent vasodilating erectile dysfunction medication's
55-year-old man with coronary artery disease
The 16-year-old female client is diagnosed with idiopathic thrombocytopenia purpura which question would be important for the nurse to ask during the admission interview
How heavy are your menstrual periods?
After teaching a patient who has been diagnosed with hepatitis A, the nurse assesses the patients understanding which statement by the patient indicates a correct understanding of the teaching
I may have been exposed when we ate shrimp last week
A nurse is educating family members caring for a client who was diagnosed with thrombocytopenia, which statement by the family member requires further education
I will check their temperature rectally for an adequate temperature reading
which client exhibit the most significant risk factors for the development of preeclampsia
An African-American, who is 18 years old and pregnant with twins
The nurse is preparing a patient for a paracentesis. The nurse should remember to.
Ask the patient to void
A client with HIV has a viral load of 150,000 which action should the nurse take first
Assess the client for adherence to the drug regimen
The nursing assistant states a client who has pancreatic cancer is complaining of abdominal pain. What is the next step for the nurse to take?
Assess the client pain using a pain scale
A nurse cares for a patient who is hemorrhaging from bleeding, esophageal, varices and has an esophagogastric tube. What action would the nurse take first?
Assess the patient for airway patency.
The unlicensed assistive personnel relays these vital signs for your patient who has meningitis temperature 101 heart rate 115 blood pressure 100/73 and 98% room air with a new one set of pain in the left hand. What nursing action is priority for this patient
Assess the presence of the peripheral pulse and temperature of the affected extremity
The nurse is caring for a patient who is experiencing status epilepticus the nurse should expect to administer which medication
Ativan
A new nurse is giving a blood transfusion to a patient which statement by the new nurse indicates a need for further instruction
I will complete the red blood cell transfusion within six hours
Which choice best represents the triad symptoms found in preeclampsia
BP over 140/90, proteinuria, generalized edema
A patient with acute pancreatitis is reporting, excessive, thirst, excessive, avoiding, and BOARD vision the highest priority action of the nurse is
Check the patient's blood glucose
which of these meals would provide the most absorbable iron
Cheeseburger
The RN has just received the change of shift report for the medical unit which client should the nurse see first
Client with portosystemic encephalopathy, who has become increasingly difficult to arouse
The nurse is working in the emergency department and the call comes in that there has been a motor vehicle accident with injuries. The patient is 16 years old and has a blood pressure of 225/157 heart rate of 42 respirations of 14 EMS will arrive in five minutes. What will the nurse anticipate treatment for?
Cushing's triad
A nurse administers lactulose to a client with cirrhosis of the liver which response leads the nurse to determine that the lactulose is effective
Decreased ammonia
A Primi gravida at 32 and five weeks gestation was diagnosed with severe preeclampsia 10 days ago, and she was admitted to the hospital for Ivy magnesium sulfate therapy after three days of ivy, magnesium sulfate therapy she has developed some physical complaint which complaint is most concerning in relation to magnesium sulfate toxicity
Decreased reflexes and weakness
A client has been diagnosed with tuberculosis. What action by the nurse takes highest priority.
Educating the client on adherence to the treatment regimen
Chemotherapeutic agent known to cause alopecia is prescribed for a client. To maintain a client self-esteem, The nurse plans to
Encourage the client to purchase a wig or hot and wear it once hair loss begins
A client is hospitalized for chemotherapy and has a hemoglobin of 6.1. The client is symptomatic but refuses a blood transfusion. What medication is the nurse prepared to administer
Epogen
A nursing student observes a birth during clinicals at the hospital in a surprise to hear the primary nurse reports that the length of the umbilical cord is 105 cm in length what are the nursing student access for in relation to the cord length?
Fetal asphyxia, which can lead to IUFD
A gravid woman with a BMI of 16 ask the nurse how much total weight she should gain during her pregnancy. What should the nurse say?
For your prepregnancy weight and BMI you should gain about 28 to 40 pounds
A client is brought to the emergency department with an INR of 9. which of the following blood products with the nurse expect to be prescribed to replace volume and clotting factors
Fresh frozen plasma
A 45-year-old male was recently diagnosed with lymphocytic leukemia. He currently receives chemotherapy. which of the following statements by new nurse, would the preceptor need to question
Try eating the raw sushi in the famous Japanese restaurants. It will not be heavy on your stomach.
The nurse witnesses a patient fall to the floor and experience a tonic clonic seizure with the loss of consciousness. What action should the nurse take first
Turn the patient on their side
The nurse teaches a patient with hepatitis A, who is prescribed Ribavarin, which statement with the nurse, include in this, patient's discharge education
Use a pill organizer to ensure you take this medication as prescribed
A patient is newly prescribe rifampin to treat active tuberculosis. What instruction is important to teach this patient.
Use additional birth control forms, such as condoms while on this medication
While taking oral contraceptives to prevent pregnancy, a patient requires treatment with antibiotic for a dental infection. What information if any does the nurse need to provide this patient
Use supplemental birth control during the cycle that you are on antibiotics
The oncology nurse should use which intervention to prevent DIC
Using strict aseptic techniques to prevent infection
A patient whose primary language is Spanish, but understands some English is receiving education regarding her oral chemotherapy. What is the most effective way to assess whether the patient understood the instructions
Utilize the teacher back method
The nurse is reviewing the electrolyte value of a patient with bacterial meningitis and I said the serum sodium is 140. How does that I was interpret this
Within normal limits will continue to monitor laboratory testing for downward trend
You walk by room or a new graduate nurse is educating a patient on their new diagnosis of pancreatic cancer which statement by the nurse would you need to correct?
You have no reason to worry pancreatic cancer is very common and easy to treat
The nurse is reviewing physician orders for a newly admitted patient which of these orders needs further clarification before they can be carried out. Select all that apply.
administer a prenatal vitamin QD Administer betamethasone, 12.0 mg now. Begin a magnesium sulfate infusion at 1.00 g/h.
The nurse is assessing an adult, diagnosed with bacterial meningitis, which clinical manifestation would support this diagnosis
after lying the patient flat on their back and lifting their head to bring their chin to chest caused flexion of their hips and knees
Patient recently diagnosed with meningitis, is scheduled to have a lumbar puncture later in the day. What I'm normal neurological findings would require the nurse to notify the healthcare provider prior to the lumbar puncture.
alteration of cranial nerve of VI
And those is caring for a client that has had a strike what intervention should the nurse having place? Select all that apply.
assign assistive personnel to feed the client place the bedside table on the unaffected side Perform neurological assessment every four hours
A client is receiving monthly doses of chemotherapy for treatment of stage three colon cancer, which laboratory results. Should the nurse report to the oncologist before the next dose of chemotherapy is administered.
platelet count of 40,000 White blood cell count of 2300 Temperature of 101.2.
client has impaired tissue, integrity, and a wound positive for MRSA the nurse has taught the client about that changes to improve wound healing. What diet selections from the client indicates he has a good understanding of foods, high in protein.
chicken breast Protein boost supplement Beans
A client is taking ethambutol for tuberculosis what instructions does the nurse provide the client regarding this drug?
contact the healthcare provider if it pre-existing gout becomes worse Take this medication with a full glass of water Report any changes in vision immediately to the healthcare provider
The patient is receiving IV vancomycin for a diagnosis of MRSA. The nurse receives the vancomycin trough level of 8.7 a few hours prior to the next house. What would the nurse his first response be?
contact the physician to determine if the dose need to increased
A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline, and IV Lasix, which of the following nursing finding require immediate intervention
crackles assess throughout the lung fields
And caring for a gravid woman, who is HIV positive or has aids. The nurse knows that which of the following actions would minimize the chances of maternal to child transmission of the virus select all that apply
dry, thoroughly, and bathe quickly after birth Expect to administer zidovudine to the newborn during the postpartum period and up to six weeks after Continued to administer antiretroviral therapy to the woman during pregnancy
which of the following physical findings with lead the nurse to suspect that a client with severe preeclampsia has developed help syndrome
elevated liver enzymes Petechiae
Pregnant patients who are also obese or more likely to develop maternal health complications, which complications are most common in the obese patients
gestational hypertension and gestational diabetes
A nurse plans to care for a patient with the new onset of seizures who is coming to the floor for the emergency department which intervention with the nurse include in this clients plan of care select all that apply.
have oxygen and section equipment at the bed side Ensure the client has patent IV access
Which statements about hepatitis are accurate? Select all that apply.
hepatitis D only occurs with hepatitis B to cause viral replication Hepatitis A is spread through the fecal oral route Hepatitis B can be transmitted through unprotected sexual intercourse
The nurse is preparing to schedule a woman for a Pap test. Which instructions by the nurse are appropriate for a woman who will be having a pap test. Select all that apply.
if you are having your menstrual period, you should reschedule your Pap smear Do not have vaginal intercourse for at least 24 hours before this test
The healthcare provider has prescribed IV mannitol for a child who has had a head injury. Which two choices are the best indicators of the drug has been effective.
improved level consciousness Decrease, intracranial pressure
The new nurse is educating clients on education regarding cancer, risk and self-care, which of the following statements are true regarding various types of cancers? Select all that apply.
inflammatory processes such as Crohn's disease, inflammatory bowel, Gerd, and hepatitis B, and C increased risk for cancer Colon cancer risks may be decreased if a client takes aspirin daily Women who have early menses, late menopause, nulliparity, or have any later in life pregnancy are at risk for breast cancer
The home health nurse is making an initial home visit to a client currently living with family members after being hospitalized with pneumonia, and a newly diagnosed AIDS. Which statement by the nurse best acknowledges the clients fear of discovery of his aids by his family.
is there somewhere private in the home where we can go and talk?
what are these are examples of presumptive signs of pregnancy
nausea and vomiting amenorrhea
Which of these patients being seen at the HIV clinic should the nurse assess first
patient who has had 12 liquid stools in the last 24 hours
A nurse is caring for patients in the Neuro ICU. After receiving the head off report which patient does the nurse see first.
patient with a Glasgow, coma, scale, score that was 10 and now is eight
A client with HIV is admitted to the hospital with fever, night sweats and severe cough. Laboratory results include a CD4 count of 180 and a negative tuberculosis skin test four days ago. What action should the nurse take first
place the client under airborne precautions
The nurse is caring for a gravid patient in her third trimester who has underlying cardiac disease the patient verbalizes complains of shortness of breath on assessment the nurse notes the following heart rate 110 irregular respiratory rate 26 crackles throughout lungs lower extremity edema. What is the highest priority response for the nurse at this time?
position patient on left side to maximize, fetal oxygenation and call the physician because this is cardiac decompensation
The nurse is admitting a patient to labor and delivery who is suspected to have preeclampsia. The patient is also suspected to be in her third trimester. The patient begins to have a grandma seizure place directions below in the order that they should be implemented.
provide safety to prevent patient injury Initiate a magnesium sulfate infusion Prepare patient for emergency delivery A certain the patient's exact due date
A client who has aids is experiencing extreme fatigue today which activities can the nurse postpone or eliminate for the client
providing education on nutrition therapy ambulating in the hall Providing a complete bed Bath
A nurse is caring for a client admitted for non-Hodgkin's lymphoma and chemotherapy. The client reports nausea, flank pain, and muscle cramps. What action by the nurse is most important.
request an order for serum electrolytes and uric acid
A deficiency in any of the anti-clotting factors such as proteins C, protein S, an anti-thrombin three increases the patient's risk for which disorders? select all that apply
stroke Myocardial infarction Pulmonary embolism
A registered nurse is caring for a patient with neutropenia. What tasks can be delegated to the unlicensed assistive personnel assigned to work with the RN? Select all that apply.
taking vital signs every shift Reporting a temperature of more than 100.4 to the RN Change the bedding daily
The parents of a four month old child, who was recently diagnosed with RSV are receiving discharge instructions from the nurse which information should the nurse include
wash hands thoroughly after caring for the child allow the child to rest, and that throughout the day Bronchodilators may be used as needed for wheezing Use a bulb syringe to clear the nose before giving a bottle Make sure your child completes the full course of anabiotic therapy
A client with cancer is admitted to a short-term rehab facility. The nurse prepares to administer the client, their chemo medication which action by the nurse is appropriate.
wear adequate PPE when handling the chemo medication
