High Risk Antepartum
a woman with a dx of ectopic pregnancy is to receive medical intervention rather than a surgical interruption. which of the following IM meds would the nurse expect to administer a. decadron (dexamethasone) b. amethopterin (methotrexate) b. pergonal (metotropin) d. prometrium (progesterone)
B
in analyzing the need for health teaching in a client, G5 P4004 with gestational diabetes, the nurse should ask which of the following questions a. how old were you at your first pregnancy b. do you exercise regularly c. is your partner diabetic d. do you work outside of the home
B
a nurse is counseling a preeclamptic client about her diet. which should the nurse encourage the woman to do a. restrict Na+ intake b. increase intake of fluids c. eat a well balanced diet d. avoid simple sugars
C
a woman has been diagnosed with ruptured ectopic pregnancy. which of the following signs/symptoms is characteristic of the dx a. dark brown rectal bleeding b. severe nausea and vomiting c. sharp unilateral pain d. marked hyperthermia
C
A patient, 32 weeks pregnant with severe headache, is admitted to the hospital with preeclampsia. in addition to obtaining baseline vital signs and placing the client on best rest, the physician ordered the following 4 items. which of the orders whoulc the nurse perform first a. assess DTR b. obtain CBC c. assess baseline weight d. obtain routine urinalysis
A
a type 1 diabetic is being seen for preconception counseling. the nurse should emphasize that during the first trimester the woman may experience which of the following a. need for less insulin than she normally injects b. an increased risk for hyperglycemic episodes c. signs and symptoms of hydramnios d. a need to be hospitalized for fetal testing
A (need less insulin during first trimester than they did preconception)
a gestational diabetic, who requires insulin therapy to control her blood glucose levels telephones triage complaining of dizziness and headache. which of the following actions should the nurse take at this time a. have client proceed to office to see physician b. advise client to drink a glass of juice and then call back c. instruct client to inject herself with regular insulin d. tell the client immediately to telephone medical doctor
B
a woman is to recieve methotrexate IM for an ectopic pregnancy. the nurse should teach the woman about which side effects (select all that apply) a. nausea and vomiting b. abdominal pain c. fatigue d. light headedness e. breast tenderness
A, B, C, D
a nurse who is caring for a pregnant diabetic should carefully monitor the client for which of the following (select all that apply) a. UTI b. multiple gestation c. metabolic acidosis d. pathological hypotension e. hypolipedemia
A, C (hyper not hypotension, hyper not hypolipedemia)
a 12 week gravid client presents in the ER wit abdominal cramps and scant dark red bleeding. which of the following signs/symptoms should the nurse assess the client for (select all that apply) a. tachycardia b. referred shoulder pain c. headache d. fetal heart dysrhythmias e. hypertension
A,C,D,E
a client, 32 weeks gestation with placenta previa, is on total bed rest. the physical expects her to be hospitalized on bed rest until her cesarean senction which is schedules for 38 weeks. to prevent complication while in the hospital the nurse should do which of the following (select all that apply) a. perform passive ROM exercises b. restrict fluid intake c. decorate the room with pictures of the family d. encourage the client to eat a high fiber diet e. teach the client deep breathing exercises
A,C,D,E
a 24 week gravid client is being seen in the prenatal clinic. she states, "i have had a terrible headache for the past 2 days." which of the following is the most appropriate action for the nurse to perform next a. inquire whether or not the client has allergies b. take the womans blood pressure. c. assess the womans fundal height d. ask the woman about stressors at work
B
a 29 week gestation woman diagnosed with severe preeclampisa is noted to have blood prssure of 170/112, 4+ proteinuria and a weight gain of 10lbs over the past 2 days. which of the following signs/symptoms would the nruse also expect to see a. fundal height of 32cm b. papilledema c. pateller reflexes of +2 d. nystagmus
B
a client has been admitted with a dx of hyperemesis gravidum. which of the following lab values would be consistent with the diagnosis a. po2 90, pco2 35, hco3 19, ph 7.30 b.po2 100, pco2 30, hco3 21, ph 7.50 c.po2 60, pco2 50, hco3 28, ph 7.30 d.po2 90, pco2 45, hco3 30, ph 7.50
D (metabolic alkalosis)
a gravid client with 4+ proteinuria and 4+ reflexes is admitted to the hospital. the nurse must closely monitor the woman for which of the following a. grand mal seizure b. high platelet count c. explosive diarrhea d. fractured pelvis
A
the nurse is evaluating the effectiveness of bed rest for a client with mild preeclampsia. which of the following signs/symptoms would the nurse determine is a positive finding a. weight loss b. 2+ proteinuria c. decreased in plasma protein d. 3+ patellar reflexes
A
which of the following clients is at highest risk for developing a hypertensive illness a. G1 P0000, age 44 with hx of DM b. G2 P0101, age 27 with hx of rheumatic fever c. G3 P1102, age 25 with hx of scoliosis d. G3 P1011, age 20 with hx of celiac disease
A
in anticipatiion of a complication that may develop in the second half of pregnancy, the nurse teaches an 18 week gravid client to call the office if she experiences which of the following a. headache and decreased otuput b. puffy feet c. hemorrhoids and vaginal discharge d. backache
A (preeclampsia signs)
a 32 week gestation client was last seen in the prenatal clinic at 28 weeks gestation. which of the following changes should the nurse bring to the attention of the certified nurse midwife a. weight change from 128 to 138 b. pulse rate change from 88 to 92 c. blood pressure change from 120/80 to 118/78 d. respiratory rate change from 16 to 20
A (recommended weight gain during second and third trimesters is approximately 1 lb per week)
a 26 week gestation woman is diagnosed with severe preeclampsia with HELLP syndrome. the nurse will assess for which of the following signs/symptoms a. low serum creatinine b. high serum protein c. bloody stools d. epigastric pain
D (high serum creatinine, low serum protein, NOT bloody stools)
an insuling dependet diabetic woman will require higher doses of insulin as whcih of the following pregnancy hormone increases a.estrogen b. progesterone c. human chorionic gonadotropin d. human placental lactogen
D (insulin antagonist)
a gravid client, 27 weeks gestation has been diagnosed with gestational diabetes. which of the following therapies will most likely be ordered for this client a. oral hypoglycemic agents b. diet control with exercise c. regular insulin injections d. inhaled insulin
B
a clients 32 week clinic assessment was bp: 90/60 T 98.6 P92 R 20 weight 145lb and urine negative for protein. which of the following findings at the 34 week appointment should the nurse highlight for the midwife a. bp: 110/70 t: 99.2 P: 88 R: 20 b. weight 155lbs, urine protein +2 c. urine protein trace, bp: 88/56 d. weight 147lbs, T: 99 P:76 R:18
B (10lb weight gain in 2 weeks and significant protein in urine)
a gravid client is admitted with a dx of 3rd trimester bleeding. it is priority for the nurse to assess for a change in which of the following vital signs a. temperature b. pulse c. RR d. bp
B (bv increases in 3rd trimester so bp can be maintained for long period of time where as pulse does rise)
a nurse is caring for 4 prenatal clients in the clinic. which of the clients is high risk for palcenta previa (select all that apply) a. jogger with low BMI b. primigravida who smokes 1 pack/day c. infertility client who is carryign in vitro triplets d. RN who works 12 hour shifts e. police officer on foot patrol
B, C (3 placenta nourishing fraternal triplets, because of the amount of space needed for placenta, it is not unusual for one to implant near or over cervical os. the uterine lining of women who smoke is not well profused, so might implant on or near cervical os)
the nurse is caring for a 32 week G8 P7007 with placenta previa. which of the followign interventions would the nurse expect to perform (select all that apply) a. daily contraction stress tests b. blood type and cross match c. bed rest with passive ROM exercises d. daily serum electorlyte assessments e. weekly biophysical profiles
B,C,E
A client is admitted to the hospital with severe preeclampsia. the nurse is assessing for clonus. which of the following actions should the nurse perform a. strike the womans patellar tendon b. palpate the womans ankle c. dorsiflex the womans foot d. position the womans feet flat on the floor
C
a client with mild preeclampsia who has been advised to be on bed rest at home asks why doing so is necessary. which of the following is the best response for the nruse to give the client. a. bed rest will help you to conserve energy for your labor b. bed rest will help to relieve your nausea and anorexia c. reclining will increase the amount of oxygen that your baby gets d. the position change will prevent the placenta from seperating
C
the nurse has assessed 4 primigravid clients in the prenatal clinic. which of the women would the nurse refer to the nurse midwife for further assessment a. 10 weeks getation, complains of fatigue with nausea and vomiting b. 26 weeks gestation, complains of ankle edema and chloasma c. 32 weeks gestation, complains of epigastric pain and facial edema d. 37 weeks gestation, complains of bleeding gums and urinary frequency
C
the nurse is caring for a type 1 diabetic client who wishes to become pregnant notes that the clients A1C is 15% today and fasting bg was 100. which of the following interpretations by the nurse is correct in relation to these labs a. hyper for 3 months, hyper today b. normo for 3 months, normo today c. hyper for 3 months, normo today d. normo for 3 months, hyper today
C
the nurse is grading a womans reflexes. which of the following grades would indicate reflexes that are slightly brisker than normal a. +1 b. +2 c. +3 d. +4
C
a gravid client, G6 P5005, 24 weeks gestation has been admitted to the hospital for placenta previa. which of the following is an appropriate long term goal for this client. client will... a. state an understanding of need for complete bed rest b. have reactive nonstress test on day 2 of hospitalization c. symptom free until at least 37 weeks gestation d. call her children shortly after admission
C (long term goal)
a client has just been diagnosed with gestationaly diabetes. she cries, "oh no! i will never be able to give myself shots!" which of the following responses by the nurse is appropriate at this time a. i am sure you can learn for your baby b. i will work with you until you feel comfortable giving yourself insulin c. we will be giving you pills for the diabetes d. if you follow your diet and exercise you will probably need no insulin
D
a client has severe preeclampsia. the nurse would expect the primary health care practitioner to order tests to assess the fetus for which of the following a. severe anemia b. hypoprothrombinemia c. craniosynostosis d. intrauterine growth restriction
D
a nurse is caring for a 25 year old client who has just had a spontaneous first trimester abortion.which of the following comments by the nurse is appropriate a. you can try again very soon b. it is probably better this way c. at least you weren't very far along d. im here to talk if you would like
D
the nurse is caring for a client who was just admitted to the hospital to rule out ectopic pregnancy. which of the following orders is the most important to perform a. take clients temperature b. document time of clients last meal c. obtain urine for analysis and culture d. asses for complain of dizziness or weakness
D
which finding should the nurse expect when assessing a client with placenta previa a. severe occipital headache b. hx of thyroid cancer c. previos premature delivery d. painless vaginal bleeding
D
a woman 8 weeks pregnant is admitted to OB unit with dx of threatened abortion. which of the following tests would help to determine whether the woman is carrying a viable or nonviable pregnancy a. LH b. endometrial biopsy c. hysterosalpinogram d. serum progesterone level
D (high levels indicate viable baby, low levels indicate pregnancy loss)
a 25 year old client is admitted with the following hx: 12 weeks pregnant, vaginal bleeding, no FHB seen on ultrasound. the nurse would expect the doctor to write an order to prepare the client for which of the following a. cervical cerclage b. amniocentesis c. nonstress testing d. dilation and curettage
D (performed on a client with an incomplete abortion)
which of the following statements is appropriate for the nurse to say to a patient with a complete placenta previa a. during 1st phase of labor you will do slow chest breathing b. you should ambulate in the halls at least 2x/day c. doctor will deliver you once you reach 25 weeks d. important to inform me if you become constipated
D (straining=placental bleeding)
a woman is recovering at the gyno office following a late first trimester spontaneous abortion. at this time it is essential for the nurse to check which of the following a. maternal rubella titer b. past ob hx c. maternal blood type d. cervical patency
c
a client has been admited with a dx of hyperemesis gravidarum. which of the following orders written by PHP is highest priority to the nurse a. obtain CBC b. start IV with multivitamins c. check admission weight d. obtain urine for analysis
B
a client is admitted with dx of eclampsia. the fetal HR tracing shows moderate variabliity with early decelerations. which of the followign actions by nurse is appropriate a. tape tongue blade to head of bed b. pad side rails and head of bed c. provide client with needed stimulation d. provide client with grief counseling
B
a client, G2 P1001 telephones the office complaining of left sided pain. which of the following Q's by the triage nurse would help to determine whether the one sided pain is due to an ectopic pregnancy a. when did you have your pregnancy test done b. when was the first day of your LMP c. did you have any complications with your first pregnancy d. how old were you when you first got your period
B
an obese gravid woman is being seen in the prenatal clinic. the nurse will monitor this client carefully throughout her pregnancy because she is high risk for which of the following complication of pregnancy a. placenta previa b. gestational diabetes c. abruptio placentae d. preeclampsia e. chromosomal defects
B,D
a woman has just beed admitted to the ER after a head on car accident. her body appears to be uninjured. the nurse carefully monitors the woman for which complication of pregnancy (select all that apply) a. placenta previa b. transervse fetal lie c. placental abruption d. severe preeclampsia d. preterm labor
C,D (placenta previa related to site of placental implantation, TFL is malpresentation, preeclampia not occur as result of auto accident)
a client being seen in ED has admitted MD of third trimester bleeding, rule out placenta previa. each time a nurse passes by the clients room, the woman asks, "please tell me, do you think the baby will be all right." which of the following is an appropriate nursing DX a. hopelessness rt possible fetal loss b. anxiety rt inconclusive dx c. situational low self esteem rt blood loss d. potential for altered parenting rt inexperience
B
