MATERNITY ****ING FINAL

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Which assessment findings by the nurse would require obtaining a blood glucose level on the newborn? A) Jitteriness B) Sucking on fingers C) Lusty cry D) Axillary temperature of 98°F

Which nonspecific immune mechanism helps the ability of antibodies and phagocytic cells to clear pathogens from an organism? A) Complement B) Coagulation C) Inflammatory response D) Phagocytosis

Which of the following behaviors noted in the postpartum client would require the nurse to assess further? A) Responds hesitantly to infant cries. B) Expresses satisfaction about the sex of the baby. C) Friends and family visit the client and give advice. D) Talks to and cuddles with the infant frequently.

Which of the following conditions would predispose a client for thrombophlebitis? A) Severe anemia B) Cesarean delivery C) Anorexia D) Hypocoagulability

7) A nurse who tells family members the sex of a newborn baby without first consulting the parents would have committed which of the following? A) A breach of privacy B) Negligence C) Malpractice D) A breach of ethics

Before becoming pregnant, a patient had a BMI of 28.5 and weighed 150 lbs. What should be the minimum weight of this patient upon delivery?

165 LBS

1) The nurse is reviewing a list of families scheduled for community health visits. To visit these families according to the family life cycle each is in, in which order from first to last should the nurse visit these families? 1. Family with a 12-month-old child 2. Family whose oldest child is in the 5th grade 3. Family whose oldest child is attending college 4. Family whose youngest child just got a driver's license 5. Family whose youngest child got married last weekend 6. Family whose male partner retired from full-time employment

1, 2, 4, 3, 5, 6

1) A patient requiring back surgery wants to take family/medical leave to recover but is not sure if she is eligible. What should the nurse review as eligibility requirements for this coverage? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Work more than 25 hours per week 2. Have been in the job for at least 1 year 3. Be expected to return to work within 4 weeks 4. Be willing to accept a lower-paying position upon return 5. Have provisions to self-pay for health insurance while off from work

1, 2

1) An older patient is demonstrating a new onset of confusion and forgetfulness. While reviewing the patient's medical records, the nurse suspects these new manifestations are drug-induced. Which medications did the nurse identify as causing changes in cognitive functioning in this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Antihistamine for allergies 2. Antidepressant for nerve pain 3. Antibiotic for bronchial infection 4. Anticoagulant for atrial fibrillation 5. Antihypertensive for high blood pressure

1, 2

1) The nurse determines that a patient in the clinic has a learning disability. What did the nurse assess to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Dyslexia 2. Dysgraphia 3. Hearing loss 4. Osteoarthritis 5. Bilateral cataracts

1, 2

A premature newborn is unable to suck at the breast. The nurse plans care for the mother, who is going to hand-express milk. Arrange the steps for milk expression in the correct order. 1. Roll the thumb and fingers simultaneously forward. 2. Position the thumb at 12:00 and the forefinger and middle finger at 6:00 around the areola. 3. Repeat the sequence multiple times to completely drain the breasts. 4. Stretch the areola back toward the chest wall without lifting the fingers off the breast.

2, 4, 1, 3

The nurse is preparing to instruct the parents of a newborn on the care of the umbilical cord. In which order should the nurse provide these instructions? 1. Check the cord for color 2. Wash hands with soap and water 3. Fold diaper below umbilical cord 4. Clean cord and base of cord with cotton swab 5. Check the cord for odor or oozing of green material

2, 4, 1, 5, 3

The nurse is instructing a pregnant patient on the importance of increasing her dietary intake of vitamin E. Which foods should the nurse recommend to meet this dietary need? Select all that apply. 1. Milk 2. Eggs 3. Liver 4. Green salads 5. Whole grain bread

2, 4, 5

A patient weighing 80 k g with a body mass index of 29.8 is 6 weeks pregnant. What should be this patient's maximum weight at the time of delivery?

89kg

The nurse knows that the Bishop scoring system for cervical readiness includes which of the following? Select all that apply. A) Fetal station B) Fetal lie C) Fetal presenting part D) Cervical effacement E) Cervical softness

A, D, E

A pregnant patient is diagnosed with premature separation of the placenta. The nurse provides the patient with the following diagram. What amount of placenta separation is this patient experiencing? (PICTURE) A) Central B) Marginal C) Complete D) Anticipated

A telephone triage nurse gets a call from a postpartum client who is concerned about jaundice. The client's newborn is 37 hours old. What data point should the nurse gather first? A) Stool characteristics B) Fluid intake C) Skin color D) Bilirubin level

1) A nurse is performing an assessment on a family with a father and mother who both work. What type of family does she record this family as being? A) A traditional nuclear family B) A dual-career/dual-earner family C) An extended family D) An extended kin family

1) A 7-year-old client tells the nurse that "Grandpa, Mommy, Daddy, and my brother live at my house." The nurse identifies this as what type of family? A) Binuclear B) Extended C) Gay or lesbian D) Traditional

1) A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (I U D) for 2 years. What is the most likely cause for the client's complaint? A) Primary dysmenorrhea B) Secondary dysmenorrhea C) Menorrhagia D) Hypermenorrhea

7) The nursing instructor explains to the class that according to the 1973 Supreme Court decision in Roe v. Wade, abortion is legal if induced: A) Before the 30th week of pregnancy. B) Before the period of viability. C) To provide tissue for therapeutic research. D) Can be done any time if mother, doctor, and hospital all agree.

A 25-year-old primigravida is at 20 weeks' gestation. The nurse takes her vital signs and notifies the healthcare provider immediately because of which finding? A) Pulse 88/minute B) Rhonchi in both bases C) Temperature 37.4°C (99.3°F) D) Blood pressure 122/78 m m H g

1) A female client is disappointed to learn that intrauterine contraception is not an option. For what reason is this form of contraception contraindicated for this client? A) Diabetes B) Breast cancer C) Endometriosis D) Uterine surgery

A pregnant patient's first day of her last menstrual period was 6/14. What would be this patient's estimated date of birth?

March 21

Put the following components specific to a postpartum examination in the proper sequential order: 1. L-lochia 2. E-emotional 3. H-Homans'/hemorrhoids 4. B-breasts 5. E-episiotomy/lacerations

4, 1, 5, 3, 2

1) The nurse is working with a group of recent immigrants from a country in which female genital mutilation (F G M) is practiced. In order to be effective in teaching about gynecologic care in the U.S., the nurse must keep which issues in mind? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Women might undergo F G M willingly to support the status quo of society. B) Women might undergo the procedure to be considered for marriage. C) Women who immigrate to other countries feel a sense pride once the procedure has been performed. D) Women might undergo the procedure to gain greater sexual pleasure. E) Women might undergo the procedure to lose their virginity.

A, B

1) Why is it important for the nurse to understand the type of family that a client comes from? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Family structure can influence finances. B) Some families choose to conceive or adopt without a life partner. C) The nurse can anticipate which problems a client will experience based on the type of family the client has. D) Understanding if the client's family is nuclear or blended will help the nurse teach the client the appropriate information. E) The values of the family will be predictable if the nurse knows what type of family the client is a part of.

A, B

A new mother is concerned because the anterior fontanelle swells when the newborn cries. Explaining normal findings concerning the fontanelles, the nurse states which of the following? Select all that apply. A) The fontanelles can swell with crying. B) The fontanelles might be depressed. C) The fontanelles can pulsate with the heartbeat. D) The fontanelles might bulge. E) The fontanelles can swell when stool is passed.

A,C,E

A nurse is providing education to a client who is 2 hr postpartum and has perineal laceration. Which of the following information should the nurse include? Select all that apply. A. Use the perineal squeeze bottle to cleanse the perineum B. Sit on the perineum while resting in bed C. Apply a topical anesthetic cream or spray to the perineum D. Wipe the perineum thoroughly with a back and forth motion E. Apply cold or ice packs to the perineum

A,C,E

The nurse is caring for the newborn of a drug-addicted mother. Which assessment findings would be typical for this newborn? Select all that apply. A) Hyperirritability B) Decreased muscle tone C) Exaggerated reflexes D) Low pitched cry E) Transient tachypnea

A,C,E

Many newborns exposed to H I V/A I D S show signs and symptoms of disease within days of birth that include which of the following? Select all that apply. A) Swollen glands B) Hard stools C) Smaller than average spleen and liver D) Rhinorrhea E) Interstitial pneumonia

A,D,E

1) A nurse is teaching a class on the different types of uterine bleeding. The nurse explains that which of the following is one of the causes of abnormal uterine bleeding? A) Iron-deficiency anemia B) Polyps C) Heavy periods every 2 months D) Spotting between periods

1) A nurse is working in a clinic where clients from several cultures are seen. As a first step toward the goal of personal cultural competence, the nurse will do which of the following? A) Enhance cultural skills. B) Gain cultural awareness. C) Seek cultural encounters. D) Acquire cultural knowledge.

1) A female client comes into the clinic for a pregnancy test because she took the morning after pill immediately after having unprotected intercourse 3 days ago and has not had a menstrual period. What should the nurse respond to this client? A) "I'll make sure you have one during this visit." B) "You should wait for two weeks before having a pregnancy test." C) "It's unlikely that you are pregnant. Wait a few days and then take a pregnancy test." D) "How long did you wait to take the morning after pill after having unprotected intercourse?"

1) A female client presents in the emergency department (E D) after being sexually assaulted at a party. Which assessment finding indicates that the client may have been drugged? A) Attending the party with a large group of friends B) Accepting a beverage from a stranger at the party C) Dancing and kissing several men during the party D) Drinking large amounts of alcohol during the party

1) A client comes to the reproductive health clinic and reports that she woke up in a strange room this morning, her perineal area is sore, and she can't clearly remember what happened the previous evening. The client says she is afraid that she was a victim of a drug-facilitated sexual assault. Which statement should the nurse include when discussing this possibility with the client? A) "Drinking alcohol can lead to uninhibited sexual behavior, which is not the same as rape." B) "Some men use drugs mixed into a drink to subdue a potential victim prior to a rape." C) "It is rare that a woman doesn't remember what happened if she is actually raped." D) "We need to check for forensic evidence of rape before we can be sure what happened."

The nurse is planning an in-service educational program to talk about disseminated intravascular coagulation (D I C). The nurse should identify which conditions as risk factors for developing D I C? Select all that apply. A) Diabetes mellitus B) Abruptio placentae C) Fetal demise D) Multiparity E) Preterm labor

B, C

1) A patient receiving chemotherapy for breast cancer writes in a journal during the treatments and reads devotional material. Which phase of psychologic adjustment should the nurse identify that this patient is experiencing? A) Shock B) Denial C) Reaction D) Recovery

1) A patient with osteoporosis wants a medication that does not need to be taken every day. What should the nurse expect to be prescribed for this patient? A) Teriparatide (Forteo) B) Alendronate (Fosamax) C) Zoledronic acid (Zometa®) D) Salmon calcitonin (Miacalcin®)

1) A 24-year-old patient with an intellectual disability at 30 weeks' gestation asks when it is safe to have an abortion. How should the nurse respond to this patient? A) "Have you been hiding your pregnancy?" B) "The safe time to end a pregnancy has passed." C) "Is it safe for me to assume that you don't want to have this baby?" D) "I guess you didn't realize that an abortion should have occurred months ago."

1) A 38-year-old female is scheduled for a laparoscopic-assisted vaginal hysterectomy (L A V H) for severe endometriosis with the removal of both ovaries. What should the nurse expect to be prescribed for this patient postoperatively? A) Corticosteroid therapy B) Mineralocorticoid therapy C) Estrogen replacement therapy D) Progesterone replacement therapy

1) A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take both hormones, what is the nurse's best reply? A) "Hot flashes respond better when replacement includes both hormones." B) "You are having very severe symptoms, so you need more hormones replaced." C) "There is an increased risk of tissue abnormality inside the uterus if only one is given." D) "Your blood pressure can become elevated if only one hormone is used."

A nurse is teaching a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the nurse include? Select all that apply. A) Avoid any lifting B) Perform kegel exercises twice a day C) Perform the pelvic rock exercise every day D) Use proper body mechanics E) Avoid constrictive clothing

C, D

Lacerations of the cervi × or vagina may be present when bright red vaginal bleeding persists in the presence of a well-contracted uterus. The incidence of lacerations is higher among which of the following childbearing women? Select all that apply. A) Over the age of 35 B) Have not had epidural block C) Have had an episiotomy D) Have had a forceps-assisted or vacuum-assisted birth E) Nulliparous

C, D, E

The nurse is working with parents who have just experienced the birth of their first child at 34 weeks. Which statement(s) by the parents indicate that additional teaching is needed? Select all that apply. A) "Our baby will be in an incubator to keep him warm." B) "Breathing might be harder for our baby because he is early." C) "The growth of our baby will be faster than if he were term." D) "Tube feedings will be required because his stomach is small." E) "Because he came early, he will not produce urine for 2 days."

C, D, E

A client is having contractions that last 20-30 seconds and that are occurring every 8-20 minutes. The client is requesting something to help relieve the discomfort of contractions. What should the nurse suggest? A) That a mild analgesic be administered B) An epidural C) A local anesthetic block D) Nonpharmacologic methods of pain relief

The nurse has assessed four newborns' respiratory rates immediately following birth. Which respiratory rate would require further assessment by the nurse? A) 60 breaths per minute B) 70 breaths per minute C) 64 breaths per minute D) 20 breaths per minute

1) The nurse is teaching an in-service educational presentation about working with battered women. The nurse should explain that it is often frustrating for nurses to work with battered women for which reasons? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) There is little the nurse can really do to help. B) Healthcare policies and practices are not supportive of abused women. C) Both husband and wife must agree to therapy. D) These women might return to the abusive situation. E) Women often believe that they are the cause of the abuse.

D, E

The client at 24 weeks' gestation is experiencing painless vaginal bleeding after intercourse. The physician has ordered a transvaginal ultrasound examination. Which statements by the client indicate an understanding of why this exam has been requested? Select all that apply. A) "This ultrasound will show the baby's gender." B) "This ultrasound might cause the miscarriage of my baby." C) "This ultrasound carries a risk of creating a uterine infection." D) "This ultrasound can determine the location of my placenta." E) "This ultrasound might detect whether the placenta is detaching prematurely."

D, E

A patient who is 12 weeks pregnant is counseled to increase her protein intake by an additional 40 grams per day. If each gram of protein is 4 calories, how many additional calories per day should this patient ingest to reach the recommended 300 calories more per day during the pregnancy?

140 CALORIES

1) While conducting a health interview, the nurse suspects that a middle-aged female client has undiagnosed learning disabilities. What did the nurse observe to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Difficulty reading instructions 2. Illegible signature on treatment forms 3. Difficulty tying shoes when eyeglasses are not being worn 4. Inability to hear normal conversation through the right ear 5. Inability to select correct paper money to pay the insurance co-pay

1, 2, 5

A pregnant patient in the early stages of labor asks for assistance to sit in the whirlpool tub. What are the advantages of using this intervention for the laboring patient? Select all that apply. 1. Increases relaxation 2. Increases pain threshold 3. Reduces postural hypotension 4. Promotes maternal-infant bonding 5. Reduces the need for pain medication

1, 2, 5

1) While visiting the home of a single patient who is raising school-age children, the nurse becomes concerned that the quality of care for the children after school is less than adequate. What did the nurse observe that led to this conclusion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Children fighting in the front yard 2. Youngest child failing spelling and arithmetic 3. Middle child received an A on a writing assignment 4. Youngest child received a black eye from a child in school 5. Oldest child riding the bicycle in the street without a helmet

1, 2, 4, 5

The nurse learns that a patient who is 8 weeks pregnant continues to smoke 10 cigarettes a day. In which order should the nurse provide a 5 to 15 minute intervention about smoking with this patient? 1. Ask about tobacco use 2. Advise to quit smoking 3. Assist in attempt to quit 4. Arrange for follow-up care 5. Assess willingness to quit

1, 2, 5, 3, 4

1) A female patient with amenorrhea is suspected to have pituitary dysfunction. For which health problems should the nurse explain that the patient will most likely be evaluated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Cancer 2. Adenoma 3. Head trauma 4. Turner syndrome 5. Polycystic ovarian syndrome

1, 2, 3

1) The community nurse is conducting health assessments at the homeless shelter and notes that the majority of clients are female. What should the nurse identify as reasons for the percentage of women who are homeless? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Unemployment 2. Substance abuse 3. Recent prison release 4. Lack of family support 5. Inadequate child support

1, 2, 3, 4

A pregnant patient's healthcare provider is using the Hadlock method to determine gestational age and growth of the fetus. Which measurements will be used to make this fetal determination? Select all that apply. 1. Femur length 2. Biparietal diameter 3. Head circumference 4. Abdominal circumference 5. Crown to rump measurement

1, 2, 3, 4

The nurse is assessing a pregnant client in the second trimester of pregnancy during a scheduled prenatal visit. Which questions are appropriate during the assessment process? Select all that apply. 1. "Do you feel bloated?" 2. "Do you have hemorrhoids?" 3. "Are you experiencing heartburn?" 4. "Are you experiencing constipation?" 5. "Are you experiencing nausea and vomiting?"

1, 2, 3, 4

1) During a routine prenatal visit the nurse suspects that a patient in the 14th week of gestation is affected by environmental pollution. What assessment findings caused the nurse to come to this conclusion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Headache 2. Scratchy throat 3. Chest wheezing 4. Abdominal pain 5. Itchy burning eyes

1, 2, 3, 5

A patient asks if seafood is permitted during pregnancy. Which foods should the nurse encourage the patient to consume during this time? Select all that apply. 1. Shrimp 2. Catfish 3. Salmon 4. Swordfish 5. Canned light tuna

1, 2, 3, 5

The nurse is preparing material to present to a group of patients in the second trimester of their pregnancies. Which topics should the nurse include in this presentation? Select all that apply. 1. Clothing 2. Infant feeding 3. Fetal movement 4. Exercise and rest 5. Skin and breast care

1, 2, 3, 5

1) The nurse is concerned that a patient is at risk for developing vulvovaginal candidiasis (V V C). What assessment information caused the nurse to have this concern? Select all that apply. 1. 16 weeks pregnant 2. +3 glucose in the urine 3. Elevated blood pressure 4. Type 2 diabetes mellitus 5. Edematous lower extremities

1, 2, 4

1) While reviewing data, the nurse determines that a patient is at risk for pelvic inflammatory disease. Which information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Age 23 2. Douches weekly 3. Smokes cigarettes 1 ppd 4. I U D inserted 2 months ago 5. Received H P V vaccination

1, 2, 4

A patient in the first trimester of pregnancy is experiencing ptyalism. What should the nurse suggest to help this patient? Select all that apply. 1. Use chewing gum 2. Suck on hard candy 3. Snack on soda crackers 4. Use an astringent mouthwash 5. Brush the teeth with baking soda

1, 2, 4

1) A pregnant patient is concerned about the development of several urinary tract infections (U T Is) over the last few months of her pregnancy. What should the nurse explain as reasons for the development of these infections in this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Decrease in bladder tone 2. Hyperemic bladder mucosa 3. Urethral stricture and loss of micturition reflex 4. Ureters elongate and are displaced by the uterus 5. Distal ureters hypertrophy leading to ureteral stenosis

1, 2, 4, 5

1) The nurse is planning care for a client who is the victim of rape. Which psychosocial nursing diagnoses does the nurse include in the client's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Fear 2. Fatigue 3. Powerlessness 4. Risk for infection 5. Readiness for enhanced knowledge

1, 3

1) A patient is being assessed for recurrent vulvovaginal candidiasis (V V C) infections. What should the nurse instruct this patient to do to help reduce the incidence of infection? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Avoid douching 2. Use vaginal sprays 3. Wear cotton underwear 4. Avoid tight-fitting clothing 5. Apply cornstarch to the vulva

1, 3, 4

1) At the end of a routine examination, a 68-year-old female asks the nurse what she should observe to determine if she should obtain custody of her two preschool-age grandchildren. What factors should the nurse tell this patient to look for? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Parental divorce 2. Long work hours 3. Drug or alcohol abuse 4. Intimate partner violence 5. Use of public transportation

1, 3, 4

1) The nurse is caring for a client diagnosed with cystitis. When teaching the client about self-care techniques, which foods or beverages will the nurse advise the client to avoid? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Caffeine 2. Dairy products 3. Alcohol 4. Carbonated beverages 5. Acidic fruit juices

1, 3, 4

1) The nurse is concerned that a clinic patient is at risk for experiencing poverty. Which information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Of African-American descent 2. Attends church on Sunday mornings 3. Completed only up to 10th grade 4. Raising 2 children under the age of 10 alone 5. Works as a clothing assistant in a retail store

1, 3, 4

1) A college student is distraught after being diagnosed with pediculosis pubis. What should the nurse instruct this student to do to help prevent future infections? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Both partners need to be treated 2. Take the prescribed medication for 10 days 3. Avoid all sexual contact until treated and cured 4. Wash bed linens in hot water and dry in a dryer for 20 minutes 5. Testing for other sexually transmitted infections is recommended

1, 3, 4, 5

1) During a routine physical examination a female patient asks the nurse what can be done to prevent the development of breast cancer. What should the nurse review with the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Exercise regularly 2. Discuss starting tamoxifen 3. Reduce the intake of red meat 4. Maintain a normal body weight 5. Reduce the intake of dietary fat

1, 3, 4, 5

1) The nurse is reviewing data collected during a health history and physical assessment and suspects that the patient could be experiencing polycystic ovarian syndrome (P C O S). What information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Body mass index 31 2. Hair loss and warm moist skin 3. Periods occur every 3 to 4 months 4. Fasting capillary blood glucose 123 m g/d L 5. Inability to become pregnant after 2 years of unprotected intercourse

1, 3, 4, 5

1) The nurse is preparing teaching materials for female clients who wish to perform breast self-examination. In which order should the nurse ensure that the teaching materials present the process of inspection? 1. Compare the breasts 2. Study the skin surface 3. Analyze for symmetry 4. Study the shape and direction 5. Look at color, thickening, edema, and venous patterns

1, 3, 4, 5, 2

1) The nurse is preparing instructions for a patient newly diagnosed with genital herpes. What should the nurse encourage to promote healing of the lesions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Take sitz baths 2. Use vaginal sprays 3. Wear cotton underwear 4. Douche after intercourse 5. Wear loose fitting clothing

1, 3, 5

The nurse is preparing to provide a newborn with an injection of vitamin K. In which order should the nurse complete the following steps? 1. Cleanse skin with alcohol and allow to dry 2. Aspirate and then inject the medication slowly 3. Insert a 25-gauge 5/8 inch needle at a 90 degree angle 4. Remove the needle and massage with an alcohol swab 5. Bunch skin over mid-anterior lateral aspect of the thigh

1, 5, 3, 2, 4

The nurse is admitting a client to the labor and delivery unit. Which aspect of the client's history requires notifying the physician? A) Blood pressure 120/88 B) Father a carrier of sickle-cell trait C) Dark red vaginal bleeding D) History of domestic abuse

A patient is labor is prescribed to receive nalbuphine 10 m g/70 k g intravenously now. The patient weighs 198 l b s. How many m g of medication should the nurse provide this patient? (Round to the nearest tenth decimal point.)

12.9mg

A patient in preterm labor is prescribed magnesium sulfate 6 grams intravenous infusion now, followed by 5 grams per hour. The pharmacy prepares an infusion of 500 m L lactated Ringer's solution with 100 grams of magnesium sulfate. If the patient receives the loading dose and 3 hours of the medication, how many total m L of the infusion did the patient receive?

150 mL

1) A patient experiencing menopause asks what complementary and alternative therapy can be taken to reduce the symptoms. After reviewing the patient's health history, for which problems should the nurse encourage the patient to avoid taking phytoestrogens? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Allergy to soy 2. Currently taking tamoxifen 3. Treated for breast cancer 5 years ago 4. Surgery for uterine fibroids in her 20s 5. Experiences insomnia several times a week

2, 3, 4

7) The nurse is preparing a report on the number of births by three service providers at the facility (certified nurse-midwives, family practitioners, and obstetricians). What is this an example of? A) Inferential statistics B) Descriptive statistics C) Evidence-based practice D) Secondary use of data

1) A patient seeks medical attention after being exposed to blood during a gang fight several weeks ago. For which types of hepatitis should the nurse anticipate that this patient will be tested? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. A 2. B 3. C 4. D 5. E

2, 3, 4

29) The nurse is ensuring that a patient has provided informed consent before agreeing to an amniocentesis. In which order should the nurse validate that informed consent was provided by the patient? 1. Information provides risk and benefits 2. Information provided clearly and concisely 3. Information included treatment alternatives 4. Information explaining the right to refuse treatment 5. Information reviews consequences if no treatment provided

2, 1, 3, 5, 4

1) During an interview the nurse learns that a patient's sister was recently diagnosed with endometrial cancer. What should the nurse review to reduce the patient's risk for developing the same disease process? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Smoking cessation 2. Maintain a normal body mass index 3. Consider birth control without estrogen 4. Limit the intake of alcohol to one drink per day 5. Increase exercise to 30 minutes most days of the week

2, 3

1) The nurse is providing care for a female client who is the victim of sexual assault. Which sexually transmitted infections (S T Is) does the nurse anticipate medication prescriptions to prevent? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Syphilis 2. Gonorrhea 3. Chlamydia 4. Bacterial vaginosis 5. Herpes simplex virus

2, 3, 4

1) A female comes into the emergency department seeking treatment for possible rape. The patient recalls having a cocktail with friends at a local club but woke up in an alley three blocks away from the business. For which date rape drugs should the nurse prepare to have this patient tested? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Atropine 2. Ketamine 3. Scopolamine 4. Flunitrazepam 5. Gamma hydroxybutyrate

2, 3, 4, 5

1) A female patient experiencing menopause is concerned that periodic lapses of memory are symptoms of Alzheimer disease. What should the nurse review with the patient to reduce the risk of developing Alzheimer disease (A D)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Increase rest 2. Stop smoking 3. Exercise regularly 4. Eat a healthy diet 5. Maintain mental activity

2, 3, 4, 5

1) A patient in her late 40s asks the nurse what she should expect when entering menopause. In which order should the nurse identify changes that the patient will experience during menopause? 1. Amenorrhea 2. Anovulation 3. Reduced fertility 4. Changes in menstrual flow 5. Menstrual cycle irregularities

2, 3, 4, 5, 1

1) The nurse suspects that a newly admitted patient is experiencing manifestations of hepatitis A. What assessment findings did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Rash 2. Fever 3. Jaundice 4. Joint pain 5. Gray-colored stool

2, 3, 5

1) The nurse in the community clinic is preparing educational materials to be used for teaching patients with sexually transmitted infections. What information should the nurse include regarding the medications metronidazole or tinidazole? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Take this medication until symptoms disappear 2. Abstain from all alcohol while taking these medications 3. Stop taking oral contraceptives while taking these medications 4. Abstain from all alcohol for 72 hours after completing tinidazole 5. Abstain from all alcohol for 24 hours after completing metronidazole

2, 4, 5

1) The nurse is providing care to a female client in the acute phase of recovery following a sexual assault. Which nursing actions are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Clarifying feelings 2. Creating a safe environment 3. Supporting advocacy efforts 4. Establishing a trusting relationship 5. Providing care for significant others

2, 5

1) A female patient comes into the clinic because of concerns about a sore that was present on her labia but spontaneously healed. During the interview the patient asks what could occur if the infection is syphilis. In what order should the nurse explain the course of this sexually transmitted infection? 1. Latent period with no lesions 2. Development of a chancre sore 3. Skin eruptions and sore throat occur 4. Tertiary stage with various symptoms 5. Development of a fever, weight loss, and malaise

2, 5, 3, 1, 4

The nurse is preparing to conduct a nonstress test with a pregnant patient. In which order should the nurse complete the steps of the procedure? 1. Obtain baseline measurement for 20 minutes 2. Place the patient in the semi-Fowler's position 3. Place the pressure transducer over the uterine fundus 4. Give the patient a handheld marker to indicate when fetal movement is felt 5. Place the ultrasound transducer from the external fetal monitor over the F H R

2, 5, 3, 1, 4

A breastfeeding mother is instructed to increase her daily caloric intake an additional 500 calories each day. If her daily intake of protein is 65 grams at 4 calories per gram, how many calories will this patient need to ingest to reach the recommended daily intake?

240 CALORIES

A patient using the calendar rhythm method of birth control asks for assistance to calculate her most fertile period. She states that her shortest cycle is 22 days and her longest cycle is 40 days. Using this information, which day should the nurse identify as being the end of the patient's fertile period?

The nurse is assessing a drug-dependent newborn. Which symptom would require further assessment by the nurse? A) Occasional watery stools B) Spitting up after feeding C) Jitteriness and irritability D) Nasal stuffiness

1) When assessing a client asking about birth control, the nurse knows that the client would not be a good candidate for Depo-Provera (D M P A) if which of the following is true? A) She wishes to get pregnant within 3 months. B) She is a nursing mother. C) She has a vaginal prolapse. D) She weighs 200 pounds.

The nurse is preparing to gavage-feed a preterm infant. Put the steps in the order in which the nurse should provide this feeding. 1. Check p H of the gastric aspirate 2. Elevate the syringe 6-8 inches above the infant's head 3. Measure from the tip of the nose to the earlobe to the xiphoid process 4. Clear the tubing with 2-3 m L of air 5. Lubricate the tube by dipping it into sterile water

3, 5, 1, 2, 4

1) The nurse is assisting with the collection of evidence for a female client who is the victim of sexual assault. Which actions by the nurse are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Drawing blood to test for gonorrhea 2. Placing each piece of clothing in a plastic bag 3. Pulling hair from the head and pubic region as evidence 4. Collecting a urine sample if drug-facilitated rape is suspected 5. Obtaining informed consent prior to photographing the injured areas

3, 4, 5

The nurse is assessing a pregnant client who reports nasal stuffiness and congestion. Which term will the nurse use to document this data in the medical record? A) Rales B) Epistaxis C) Rhinitis of pregnancy D) Pregnancy-induced asthma

1) The nurse is preparing an educational seminar for a group of middle-aged healthy women on health screening recommendations. What information should the nurse include during this educational session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Get a Pap test every 3 years 2. Schedule mammograms every 5 years 3. Get testing for H I V before the age of 60 4. Have a screening for colorectal cancer 5. Have blood pressure measured every year if 140/90

3, 4

The nurse has completed a community presentation about the changes of pregnancy, and knows that the lesson was successful when a community member states that which of the following is one probable or objective change of pregnancy? A) "Enlargement of the uterus" B) "Hearing the baby's heart rate" C) "Increased urinary frequency" D) "Nausea and vomiting"

28) The nurse is reviewing the Quality and Safety Education for Nurses (Q S E N) competencies while preparing an in-service program to address safety in the neonatal intensive care unit. In which order should the nurse present these competencies? 1. Safety 2. Informatics 3. Patient-centered care 4. Quality improvement 5. Evidence-based practice 6. Teamwork and collaboration

3, 6, 5, 4, 1, 2

The nurse is assessing an obese pregnant client during a routine prenatal visit. Which is the priority assessment for this client? A) Complete blood count (C B C) B) Basic metabolic panel (B M P) C) Blood pressure D) Fetal heart rate

The nurse is aware that a fetus that is not in any stress would respond to a fetal scalp stimulation test by showing which change on the monitor strip? A) Late decelerations B) Early decelerations C) Accelerations D) Fetal dysrhythmia

What is the most significant cause of neonatal morbidity and mortality? A) Amenorrhea B) Posttraumatic stress disorder C) Prematurity D) Endometriosis

The nurse has completed an initial physical assessment for a client admitted to the birthing unit. Which action should the nurse take next? A) Obtain the client's social history B) Document the physical assessment findings C) Report findings to the physician D) Perform interventions for pain management

1) The nurse is participating in the collection of evidence from a victim of rape. In which order should the evidence be collected from this victim? 1. Oral swabs are obtained 2. Blood samples are drawn for syphilis 3. Hair samples and fingernail scrapings taken 4. Clothing is removed and bagged for evidence 5. Swabs of body stains and secretions are taken

4, 5, 1, 3, 2

26) Nursing research is vital to do which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Expand the science of nursing. B) Foster evidence-based practice. C) Improve client care. D) Visually depict nursing management. E) Plan and organize care.

A, B, C

7) The Quality and Safety Education for Nurses (Q S E N) project focused on competencies in which areas? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Client-centered care B) Teamwork and collaboration C) Evidence-based practice D) Family planning E) Injury and violence prevention

A, B, C

At birth, an infant weighed 8 pounds 4 ounces. Three days later, the newborn is being discharged. The parents note that the baby now weighs 7 pounds 15 ounces. The nurse explains that the change in the newborn's weight is which of the following? A) Excessive B) Within normal limits C) Less than expected D) Unusual

When caring for a laboring client with oligohydramnios, what should the nurse be aware of? Select all that apply. A) Increased risk of cord compression B) Decreased variability C) Labor progress is often more rapid than average D) Presence of periodic decelerations E) During gestation, fetal skin and skeletal abnormalities can occur

A, B, D, E

The nurse is reviewing the process of pumping the breasts with a new mother. In which order should the nurse provide this information? 1. Fill glass or bottles 3/4 full 2. Massage the breasts and relax 3. Sit up straight or lean forward 4. Wash hands with soap and water 5. Pump each breast for 10 to 20 minutes

4, 2, 3, 5, 1

How does the nurse assess for Homans' sign? A) Extending the foot and inquiring about calf pain. B) Extending the leg and inquiring about foot pain. C) Flexing the knee and inquiring about thigh pain. D) Dorsiflexing the foot and inquiring about calf pain.

1) The nurse is preparing to meet with a female patient to review the most appropriate contraceptive method. In which order should the nurse complete the steps of this process? 1. Emphasize actions if pregnancy occurs 2. Instruct on the use of the selected method 3. Review side effects and warning symptoms 4. Assess for medical contraindications to specific methods 5. Learn about lifestyle, attitudes, religious beliefs and plans for children

4, 5, 2, 3, 1

The nurse is caring for a jaundiced infant receiving bank light phototherapy in an isolette. Which finding requires an immediate intervention? A) Eyes are covered, no clothing on, diaper in place B) Axillary temperature 99.7°F C) Infant removed from the isolette for breastfeeding D) Loose bowel movement

What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing? A) Pap smear B) Hepatitis B screening (H Bs A g) C) Fundal height measurement D) Complete blood count

1) The nurse is identifying a plan to help a rape victim work through the phases of recovery. In which order should the nurse perform the following actions to help this victim? 1. Clarify the victim's feelings 2. Establish a trusting relationship 3. Acknowledge the victim's success 4. Provide advocacy as requested by the victim 5. Allow the victim to grieve and express feelings

5, 4, 2, 1, 3

1) A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: A) Oral acyclovir B) Ceftriaxone I M C) Azithromycin P O D) Penicillin G I M

1) A client describes breast swelling and tenderness. What piece of data would be most important for the nurse to gather initially? A) Timing of the symptoms B) Birth control method C) Method of breast self-examination D) Diet history

1) A client in the women's clinic asks the nurse, "How is the cervical mucus method of contraception different from the rhythm method?" The appropriate response by the nurse is that the cervical mucus method is which of the following? A) More effective for women with irregular cycles B) Not acceptable to women of many different religions C) Harder to work with than the rhythm method D) Requires an artificial substance or device

29) The manager of a maternal-child care area is preparing information to share with nursing staff regarding the leading causes of infant death in the United States. In which order, from most to least frequent, should the manager provide this information? 1. S I D S 2. Low birth weight 3. Unintentional injuries 4. Maternal complications 5. Congenital malformation

5, 2, 1, 4, 3

The mother of a newly circumcised infant is concerned about caring for the infant at home. What should the nurse instruct the mother about the infant's care? Place the following actions in the order that should be instructed to the mother. 1. Pat dry 2. Rinse area with warm water 3. Fasten diaper snuggly over the penis 4. Apply small amount of petroleum jelly 5. Squeeze water over the circumcision site

5, 2, 1, 4, 3

1) The nurse is helping a victim of domestic violence create a safety plan. In which order should the nurse recommend that the steps of the plan be completed? 1. Decide where to go regardless of the day or time 2. Establish a code word that is shared with family and friends 3. Have money, identification, and bank account information prepared 4. Determine a planned escape route with emergency telephone numbers 5. Pack a change of clothes, toilet articles, and keys stored away from the home

5, 3, 1, 2, 4

1) A female patient is anxious about having a pelvic examination. To help reduce the patient's fears in which order should the nurse explain that the examination will be performed? 1. The speculum is inserted 2. The speculum is removed 3. The perineum is inspected 4. The rectal examination is performed 5. The healthcare provider applies gloves 6. The bimanual examination is performed

5, 3, 1, 2, 6, 4

1) A patient is concerned about contracting herpes genitalis from a sexual partner and asks the nurse what to expect if the infection is present. In which order should the nurse explain the infection to the patient? 1. Emotional trigger occurs 2. Lesions spontaneously appear 3. Take oral acyclovir as prescribed 4. Virus enters a dormant phase with no lesions 5. Development of single or multiple blister-like vesicles

5, 3, 4, 1, 2

During an educational session the nurse learns that legislation was written to support breastfeeding mothers. In which order did the titles of this legislation occur? 1. Establish standards for safe and effective breast pumps 2. Include breastfeeding equipment as medical care for taxes 3. Require businesses with 50 or more employees to give lactating women breaks 4. Give tax incentives to businesses that establish a private place for breastfeeding 5. Protect lactating women from being fired or discriminated against in the workplace

5, 4, 1, 2, 3

The nurse is demonstrating to a patient the proper steps for breastfeeding a newborn. Put these steps in the logical order that would assist the patient in placing the newborn to her breast. 1. Tickle the newborn's lips with the nipple. 2. Allow the newborn to latch on to the nipple. 3. The newborn opens her mouth wide. 4. Have the newborn face the mother tummy to tummy. 5. Position the newborn so the nose is at the level of the nipple.

5, 4, 1, 3, 2

If a woman has the pre-existing condition of diabetes, the nurse knows that she would be prone to what high-risk factor when pregnant? A) Vasospasm B) Postpartum hemorrhage C) Episodes of hypoglycemia and hyperglycemia D) Cerebrovascular accident (C V A)

1) A female client with an intrauterine device calls the clinic because she is unable to locate the strings after her last menstrual period. What should the nurse counsel this client? A) Schedule an appointment immediately B) Wait a few days and recheck for the strings C) Take a tub bath and then recheck for the strings D) Perform a douche and then recheck for the strings

1) A female college student comes into the student health clinic, concerned about being pregnant from unprotected intercourse the evening before. What should the school nurse counsel this student? A) "Take Plan B One Step now." B) "Take 1 pill of Plan B now and the second pill in 5 days." C) "Take one half of Plan B One Step now and the second half in 3 days." D) "Wait 5 days and take 1 pill of Plan B followed by the second pill in 2 days."

1) A female patient schedules an appointment for a gynecologic examination. Which finding should indicate to the nurse that the patient is experiencing a vaginal infection? A) Foul odor from used tampons B) Scant menstrual flow at the end of the cycle C) Abdominal bloating a few days prior to menstruation D) Saturating a tampon every 2 hours during menstruation

1) A patient and her partner are being treated for trichomoniasis. What should the nurse emphasize when teaching the couple about this infection? A) Avoid intercourse until symptom free B) Ensure a repeat test is completed in 3 months C) Limit alcohol intake while taking metronidazole D) Have annual screening for recurrence of the infection

1) A patient schedules an appointment to be seen in the community clinic for dysuria, urgency, frequency, blood in the urine, and low back pain. For which health problem should the nurse provide care for this patient? A) Cystitis B) Pyelonephritis C) Glomerulonephritis D) Asymptomatic bacteriuria

1) A patient with female genital mutilation is being prepared for a gynecologic examination. What cultural implications should the nurse keep in mind when assisting with this examination? A) Maintain a nonjudgmental attitude B) The procedure was performed by choice C) The patient is at increased risk for genital infection D) The procedure was performed to increase sexual satisfaction

1) A premenopausal female received a recommendation by her healthcare provider to have a bone mineral density (B M D) test done. What should the nurse identify as being the reason for the test at this time in the patient's life? A) History of an eating disorder B) Takes N S A I Ds for osteoarthritis C) Lives with a spouse who smokes cigarettes D) Surgery for carpal tunnel syndrome last year

1) A premenopausal patient is experiencing vaginal dryness. What pharmacological intervention should the nurse suggest for this patient's symptom? A) Local low-dose vaginal estrogen B) Testosterone replacement therapy C) Menopausal hormone therapy with testosterone D) Menopausal hormone therapy with estrogen alone

1) A woman has come to the emergency department with multiple bruises on her body and a small laceration over her upper lip. She says she fell down the stairs while doing housework. Which observation would most cause the nurse to suspect that the client has been a victim of battering? A) The client is hesitant to provide details about how the injuries occurred. B) The client was accompanied to the emergency department by her mother instead of her partner. C) The client has sought care quickly after the incident. D) The client does not seem to be in pain.

1) Abdominal hysterectomy is generally recommended for which condition? A) Severe endometriosis B) Removal of the ovaries C) Suspected or confirmed cancer removal D) Abnormal uterine bleeding

1) After a pelvic examination, a patient is scheduled for tests to diagnose pelvic inflammatory disease. Which finding from the physical examination suggested to the nurse practitioner that further testing is required? A) Cervical tenderness B) Greenish vaginal discharge C) Open sores along the vagina D) Condylomata acuminata on the vulva

1) An older person contacts the emergency medical service at 11 P M to report that she has been left sitting in her wheelchair all day after her caregiver left in the morning to buy groceries. What type of elder abuse is this person experiencing? A) Abandonment B) Physical abuse C) Financial abuse D) Psychological abuse

1) Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following? A) There is less trauma to the mother. B) More childbirth education classes are available. C) They are instrumental in providing change in the birth environment at work. D) They advocate for more home healthcare agencies.

1) The 12-year-old client reports that menarche occurred 5 months ago. She has had bleeding every day this month, and is very worried. The nurse should explain that the most common cause of this bleeding is which of the following? A) Dysfunctional uterine bleeding (D U B) B) Diabetes mellitus (D M) C) Pregnancy D) Von Willebrand's disease

1) The client has been a victim of a violent, sadistic rape. She is crying and asks the nurse, "Why would someone do something like that?" The nurse should explain that which of the following is the primary purpose of sadistic rape? A) Take pleasure from the victim's struggle and pain B) Express feelings of rage C) Feel a sense of power or mastery D) Relieve intolerable anxiety

1) The client reports relief from headaches when she rubs the temples on each side of her head. The nurse understands that this is a form of which of the following? A) Acupressure B) Acupuncture C) Reflexology D) Hydrotherapy

1) The client's Pap smear result is A S C-U S. Which statement is the best way for the nurse to explain this A S C-U S result? A) "Abnormal cells of an unknown cause." B) "Cancer has invaded the upper cervix." C) "High-grade squamous intraepithelial lesion (H S I L), which includes C I N." D) "The focus of the Pap smear is the detection of high-risk pregnancy." E) "The cervical cells are abnormal and the reason why is severe dysplasia and carcinoma in situ."

1) The nurse is admitting a Hispanic woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which question would be most important for the nurse to ask? A) "What other treatments have you used for your abdominal pain?" B) "In what country were you were born?" C) "When you talk to family members, how close do you stand?" D) "How would you describe your role within your family?"

1) The nurse is caring for a female client with a history of pelvic inflammatory disease (P I D) who reports having difficulty conceiving after unprotected sex for over 2 years. Which deviation from the norm does the nurse recognize is most likely the cause of the client's infertility? A) Non-patent fallopian tube B) Unfavorable cervical mucus C) Absence of ovulation D) Abnormal endometrial preparation

1) The nurse is caring for a postpartal client of Hmong descent who immigrated to the United States 5 years ago. The client asks for the regular hospital menu because American food tastes best. The nurse assesses this response to be related to which of the following cultural concepts? A) Acculturation B) Ethnocentrism C) Enculturation D) Stereotyping

1) The nurse is completing the health history for a client desiring the Essure method of permanent sterilization. What should the nurse specifically ask when assessing this client? A) "Are you allergic to any metals?" B) "How many children do you have?" C) "When was your last menstrual period?" D) "Is your spouse aware of the procedure?"

1) The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago. Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make? A) "Your lack of menses might be related to your rapid weight loss." B) "It is common and normal for runners to stop having any menses." C) "Increase your intake of iron-rich foods to reestablish menses." D) "Adolescents rarely have regular menses, even if they used to be regular."

1) The nurse is preparing a program about osteoporosis for a group of community members. What should the nurse emphasize as being the greatest risk factor for the development of this disorder? A) Family history B) Caucasian race C) Sedentary lifestyle D) Low lifetime intake of calcium

1) The nurse is providing care to a client who is the victim of sexual assault. Which assessment finding does the nurse anticipate during the disorganization phase of rape trauma syndrome? A) Anxiety B) Insomnia C) Dyspepsia D) Depression

1) The nurse is providing care to a female client who is the victim of domestic violence. Which referral by the nurse is most appropriate? A) Group therapy B) Physical therapy C) Nutrition therapy D) Occupational therapy

1) The nurse is teaching a class to the community on mind-based therapies. A class participant gives an example of a friend with leukemia who was taught by her complementary therapist to concentrate on making antibodies that will fight and kill the cancer cells in the bloodstream. How would the nurse identify this technique? A) Guided imagery B) Qigong C) Biofeedback D) Homeopathy

1) The nurse is telling a new client how advanced technology has permitted the physician to do which of the following? A) Treat the fetus and monitor fetal development. B) Deliver at home with a nurse-midwife and doula. C) Have the father act as the coach and cut the umbilical cord. D) Breastfeed a new baby on the delivery table.

1) The nurse is working with a woman who is undergoing chemotherapy for breast cancer. The client states, "First, the cancer seemed unreal. Now I feel like I can cope." What is the nurse's best response? A) "Women with breast cancer often go through several stages of adjustment." B) "Women with breast cancer cope better than their partners cope." C) "Women with breast cancer seek multiple opinions before starting treatment." D) "Women with breast cancer become angry after treatment begins."

1) The nurse notes that a lesbian client who recently found a breast lump on self-examination has not had a mammogram for 10 years. When asked about this delay the client states that she was not made to feel comfortable during the last mammogram. What should the nurse recognize is the underlying problem that this client is describing? A) Social barrier B) Emotional barrier C) Fear of finding a health problem D) Discomfort with the examination

1) The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? A) Age 30, treated for P I D B) Age 25, monogamous C) Age 20, pregnant D) Age 27, uses a diaphragm

1) The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? A) Age 37, multiple partners B) Age 22, abstains from sexual intercourse C) Age 32, pregnant with twins D) Age 27, uses female condom

1) The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection? A) 16-year-old sexually active girl, using no contraceptive B) 22-year-old mother of two, developed dyspareunia C) 35-year-old woman on oral contraceptives D) 48-year-old woman with hot flashes and night sweats

1) The pregnant client employed at a factory asks the nurse whether exposure to chemicals can cause harm to her fetus. The nurse should advise the client that exposure to which substance can lead to neurological damage? A) Lead B) Latex C) Formaldehyde D) Benzene

1) There have been a number of historical trends that have contributed to the existing wage gap, including which of the following? A) There was a perception that men were the sole breadwinners. B) Women who were competitive in the work environment were viewed positively. C) Women in past generations generally were not limited to certain occupations. D) Increase in societal importance of women's intellectual traits.

1) What is the most important aspect of care for the nurse to remember when screening a woman for partner abuse? A) Ensuring privacy and confidentiality B) Conveying warmth and empathy C) Asking specific, direct questions about abuse D) Clarifying her myths about battering

1) When analyzing data collected during a sexual history, the nurse notes that a patient has limited information about contraception. What should the nurse do to address this patient's need? A) Provide the patient with the information B) Suggest that the patient talk with the nurse practitioner C) Schedule an appointment for the patient to see the midwife D) Discuss the implications if contraception is not used correctly

1) Which action by the nurse is appropriate when providing care to a female client who is the victim of domestic violence? A) Providing adequate time for the client to tell her story B) Reporting the incident to the police to protect the client C) Telling the spouse about the client's accusations of abuse D) Stressing to the client that the abuse could have been avoided

1) Which client in the gynecology clinic should the nurse see first? A) 32-year-old taking gonadotropins, reporting extremity edema B) 15-year-old, no menses for past 4 months C) 18-year-old seeking information on contraception methods D) 31-year-old, taking progestins, reports increasing dyspareunia

1) Which is a known characteristic of domestic violence batterers? A) Feeling inferior to others B) Working in a low-paying job C) Having a low socioeconomic status D) Being diagnosed with posttraumatic stress disorder

1The nurse notes purplish stretch marks on the pregnant client's breasts during the physical assessment. Which term will the nurse use when documenting this finding in the medical record? A) Striae B) Colostrum C) Linea nigra D) Chadwick's sign

7) The nurse manager is examining the descriptive statistics of increasing teen pregnancy rates in the community. Which inferential statistical research question would the nurse manager find most useful in investigating the reasons for increased frequency of teen pregnancy? A) What providers do pregnant teens see for prenatal care? B) What are the ages of the parents of pregnant teens in the community? C) Do pregnant teens drink caffeinated beverages? D) What do pregnant teens do for recreation?

A 26-year-old client is having her initial prenatal appointment. The client reports to the nurse that she suffered a pelvic fracture in a car accident 3 years ago. The client asks whether her pelvic fracture might affect her ability to have a vaginal delivery. What response by the nurse is best? A) "It depends on how your pelvis healed." B) "You will need to have a cesarean birth." C) "Please talk to your doctor about that." D) "You will be able to delivery vaginally."

A 27-year-old married woman is 16 weeks pregnant and has an abnormally low maternal serum alpha-fetoprotein test. Which statement indicates that the couple understands the implications of this test result? A) "We have decided to have an abortion if this baby has Down syndrome." B) "If we hadn't had this test, we wouldn't have to worry about this baby." C) "I'll eat plenty of dark green leafy vegetables until I have the ultrasound." D) "The ultrasound should be normal because I'm under the age of 35."

A 28-year-old woman has been an insulin-dependent diabetic for 10 years. At 36 weeks' gestation, she has an amniocentesis. A lecithin/sphingomyelin (L/S) ratio test is performed on the sample of her amniotic fluid. Because she is a diabetic, what would an obtained 2:1 ratio indicate for the fetus? A) The fetus may or may not have immature lungs. B) The amniotic fluid is contaminated. C) The fetus has a neural tube defect. D) There is blood in the amniotic fluid.

A 3-month-old baby who was born at 25 weeks has been exposed to prolonged oxygen therapy. The nurse explains to the parents that due to oxygen therapy, their infant is at a greater risk for which of the following? A) Visual impairment B) Hyperthermia C) Central cyanosis D) Sensitive gag reflex

A 38-year-old client in her second trimester states a desire to begin an exercise program to decrease her fatigue. What is the most appropriate nursing response? A) "Fatigue should resolve in the second trimester, but walking daily might help." B) "Avoid a strenuous exercise regimen at your age. Drink coffee to combat fatigue." C) "Avoid an exercise regimen due to your pregnancy. Try to nap daily." D) "Fatigue will increase as pregnancy progresses, but running daily might help."

A Navajo client who is 36 weeks pregnant meets with a traditional healer as well as her physician. What does the nurse understand this to mean? A) The client is seeking spiritual direction. B) The client does not trust her physician. C) The client will not adapt well to mothering. D) The client is experiencing complications of pregnancy.

A cesarean section is ordered for a pregnant client. Because the client is to receive general anesthesia, what is the primary danger with which the nurse is concerned? A) Fetal depression B) Vomiting C) Maternal depression D) Uterine relaxation

A client admitted to the birthing unit with placenta previa asks the nurse, "What is the cause of my condition?" Which statement should be included in the nurse's response? A) "The placenta is improperly implanted in the lower uterus." B) "The placenta has separated prematurely." C) "The placenta has grown too large." D) "The placenta has prolapsed and is being compressed."

A client delivered 30 minutes ago. Which postpartal assessment finding would require close nursing attention? A) A soaked perineal pad since the last 15-minute check B) An edematous perineum C) The client experiencing tremors D) A fundus located at the umbilicus

A client is admitted to the birth setting in early labor. She is 3 c m dilated, -2 station, with intact membranes, and F H R of 150 b p m. Her membranes rupture spontaneously, and the F H R drops to 90 b p m with variable decelerations. What would the nurse's initial response be? A) Perform a vaginal exam B) Notify the physician C) Place the client in a left lateral position D) Administer oxygen at 2 L per nasal cannula

A client who is at 7 weeks of gestation is experiencing nausea and vomiting in the morning. Which of the following information should the nurse include? A) Eat crackers or plain toast before getting out of bed B) Awaken during the night to eat a snack C) Skip breakfast and eat lunch after nausea has subsided D) Eat a large evening meal

A laboring client's obstetrician has suggested amniotomy as a method for creating stronger contractions and facilitating birth. The client asks, "What are the advantages of doing this?" What should the nurse cite in response? A) Contractions elicited are similar to those of spontaneous labor. B) Amniotomy decreases the chances of a prolapsed cord. C) Amniotomy reduces the pain of labor and makes it easier to manage. D) The client will not need an episiotomy.

When a breastfeeding mother complains that her breasts are leaking milk, the nurse can offer which effective intervention? A) Decrease the number of minutes the newborn is at the breast per feeding. B) Decrease the mother's fluid intake. C) Place absorbent pads in the bra. D) Administer oxytocin.

A newborn delivered at term is being discharged. The parents ask the nurse how to keep their baby warm. The nurse knows additional teaching is necessary if a parent states which of the following? A) "A quick cool bath will help wake up my son for feedings." B) "I can check my son's temperature under his arm." C) "My baby should be dressed warmly, with a hat." D) "Cuddling my son will help to keep him warm."

A nurse in a prenatal clinic is providing education to a client who is at 8 weeks of gestation. The client states, "I don't like milk." Which of the following foods should the nurse recommend as a good source of calcium? A) Dark green leafy vegetables B) Deep red or orange vegetables C) White breads and rice D) Meat, poultry, and fish

A nurse is caring for a client having contractions every 8 min that are 30 to 40 seconds in duration. The clients cervix is 2 cm dilated, 50% effaced, and the fetus is at a -2 station with a FHR around 140/min. Which of the following stages and phases of labor is this client experiencing? A. 1st stage, laten phase B. 1st stage, active phase C. 1st stage, transition phase D. 2nd stage of labor

A nurse is caring for a client who is at 32 weeks of gestation and has a placenta previa. The nurse notes that the client is actively bleeding. Which of the following medications should the nurse expect the provider will prescribe? A) Betamethasone B) Indomethacin C) Nifedipine D) Methylergonovine

A nurse is caring for a client who is in active labor and reports severe back pain. During assessment, the fetus is noted to be in the occiput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progress? A) Hands and knees B) Lithotomy C) Trendelenburg D) Supine with a rolled towel under one hip

A nurse is caring for a client who is pregnant and reviewing manifestations of complications the client should promptly report to the provider. Which of the following complications should the nurse include? A) Vaginal bleeding B) Swelling of the ankles C) Heartburn after bleeding D) Lightheadedness when lying on back

A nurse is checking the postpartum orders. The doctor has prescribed bed rest for 6-12 hours. The nurse knows this is an appropriate order if the client had which type of anesthesia? A) Spinal B) Pudendal C) General D) Epidural

A nurse is performing a fundal assessment for a client who is 2 days postpartum and observes the perineal pad for lochia. The pad is saturated approximately 12 cm with lochia that is bright red and contains small clots. Which of the following findings should the nurse document? A. Moderate lochia rubra B. Excessive lochia serosa C. Light lochia rubra D. Scant lochia serosa

A nursing instructor is demonstrating an assessment on a newborn using the Ballard gestational assessment tool. The nurse explains that which of the following tests should be performed after the first hour of birth, when the newborn has had time to recover from the stress of birth? A) Arm recoil B) Square window sign C) Scarf sign D) Popliteal angle

A nursing instructor is demonstrating how to perform a heel stick on a newborn. To obtain an accurate capillary hematocrit reading, what does the nursing instructor tell the student do? A) Rub the heel vigorously with an isopropyl alcohol swab prior to obtaining blood. B) Use a previous puncture site. C) Cool the heel prior to obtaining blood. D) Use a sterile needle and aspirate.

A patient pregnant with twins late in the 3rd trimester has an ultrasound that shows the position of the fetuses as follows. What should the nurse expect will be planned for this patient? (PICTURE) A) Cesarean birth B) Vaginal delivery C) Spinal block during labor

A postpartum client calls the nursery to report that her newborn's umbilical cord stump is draining, and has a foul odor. What is the nurse's best response? A) "Take your newborn to the pediatrician." B) "Cover the cord stump with gauze." C) "Apply Betadine around the cord stump." D) "This is normal during healing."

A postpartum client has inflamed hemorrhoids. Which nursing intervention would be appropriate? A) Encourage sitz baths. B) Position the client in the supine position. C) Avoid stool softeners. D) Decrease fluid intake.

A pregnant client who was of normal pre-pregnancy weight is now 30 weeks pregnant. She asks the nurse what appropriate weight gain for her should be. What is the nurse's best response? A) "25-35 pounds" B) "30-40 pounds" C) "17-18 pounds" D) "Less than 15 pounds"

A pregnant patient is observed lying in bed in the following position. Which health problem is this patient prone to developing? A) Vena caval syndrome B) Physiologic anemia of pregnancy C) Physiologic leukocytosis D) Low iron level

A woman gave birth last week to a fetus at 18 weeks' gestation after her first pregnancy. She is in the clinic for follow-up, and notices that her chart states she has had one abortion. The client is upset over the use of this word. How can the nurse best explain this terminology to the client? A) "Abortion is the obstetric term for all pregnancies that end before 20 weeks." B) "Abortion is the word we use when someone has miscarried." C) "Abortion is how we label babies born in the second trimester." D) "Abortion is what we call all babies who are born dead."

A woman has been having contractions since 4 a.m. At 8 a.m., her cervi × is dilated to 5 c m. Contractions are frequent, and mild to moderate in intensity. Cephalopelvic disproportion (C P D) has been ruled out. After giving the mother some sedation so she can rest, what would the nurse anticipate preparing for? A) Oxytocin induction of labor B) Amnioinfusion C) Increased intravenous infusion D) Cesarean section

A woman is admitted to the birth setting in early labor. She is 3 c m dilated, -2 station, with intact membranes and F H R of 150 beats/min. Her membranes rupture spontaneously, and the F H R drops to 90 beats/min with variable decelerations. What would the initial response from the nurse be? A) Perform a vaginal exam. B) Notify the physician. C) Place the client in a left lateral position. D) Administer oxygen at 2 L per nasal cannula.

The nurse is caring for a newborn who was recently circumcised. Which nursing intervention is appropriate following the procedure? A) Keep the infant N P O for 4 hours following the procedure. B) Observe for urine output. C) Wrap dry gauze tightly around the penis. D) Clean with cool water with each diaper change.

After being in labor for several hours with no progress, a client is diagnosed with C P D (cephalopelvic disproportion), and must have a cesarean section. The client is worried that she will not be able to have any future children vaginally. After sharing this information with her care provider, the nurse would anticipate that the client would receive what type of incision? A) Transverse B) Infraumbilical midline C) Classic D) Vertical

After teaching a pregnant client about the effects of smoking on pregnancy, the nurse knows that the client needs further education when she makes which statement? A) "I am at increased risk for preeclampsia." B) "I am at increased risk for preterm birth." C) "I am at increased risk for placenta previa." D) "I am at increased risk for abruptio placentae."

An analgesic medication has been administered intramuscularly to a client in labor. How would the nurse evaluate if the medication was effective? A) The client dozes between contractions. B) The client is moaning during contractions. C) The contractions decrease in intensity. D) The contractions decrease in frequency.

At 32 weeks' gestation, a woman is scheduled for a second nonstress test (following one she had at 28 weeks' gestation). Which statement by the client would indicate an adequate understanding of this procedure? A) "I can't get up and walk around during the test." B) "I'll have an I V started before the test." C) "I can still smoke before the test." D) "I need to have a full bladder for this test."

At birth, an infant weighed 6 pounds 12 ounces. Three days later, he weighs 5 pounds 2 ounces. What conclusion should the nurse draw regarding this newborn's weight? A) This weight loss is excessive. B) This weight loss is within normal limits. C) This weight gain is excessive. D) This weight gain is within normal limits.

Before drying off the newborn after birth, which assessment finding should the nurse document to ensure an accurate gestational rating on the Ballard gestational assessment tool? A) Amount and area of vernix coverage B) Creases on the sole C) Size of the areola D) Body surface temperature

By inquiring about the expectations and plans that a laboring woman and her partner have for the labor and birth, the nurse is primarily doing which of the following? A) Recognizing the client as an active participant in her own care. B) Attempting to correct any misinformation the client might have received. C) Acting as an advocate for the client. D) Establishing rapport with the client.

During a pelvic examination of a pregnant patient the following area is identified as being softened. How should the nurse document this finding? A) Ladin sign B) Braun von Fernwald sign C) Piskacek's sign D) Goodell sign

During an intrapartum vaginal examination the following is palpated. In which type of presentation is this fetus? (PICTURE) A) Breech B) Shoulder C) Occiput face D) Occiput brow

During newborn resuscitation, how does the nurse evaluate the effectiveness of bag-and-mask ventilations? A) The rise and fall of the chest B) Sudden wakefulness C) Urinary output D) Adequate thermoregulation

In planning care for a new family immediately after birth, which procedure would the nurse most likely withhold for 1 hour to allow time for the family to bond with the newborn? A) Eye prophylaxis medication B) Drying the newborn C) Vital signs D) Vitamin K injection

In planning care for the fetal alcohol syndrome (F A S) newborn, which intervention would the nurse include? A) Allow extra time with feedings. B) Assign different personnel to the newborn each day. C) Place the newborn in a well-lit room. D) Monitor for hyperthermia.

On assessment, a laboring client is noted to have cardiovascular and respiratory collapse and is unresponsive. What should the nurse suspect? A) An amniotic fluid embolus B) Placental abruption C) Placenta accreta D) Retained placenta

The charge nurse is looking at the charts of laboring clients. Which client is in greatest need of further intervention? A) Woman at 7 c m, fetal heart tones auscultated every 90 minutes B) Woman at 10 c m and pushing, external fetal monitor applied C) Woman with meconium-stained fluid, internal fetal scalp electrode in use D) Woman in preterm labor, external monitor in place

The client at 14 weeks' gestation has undergone a transvaginal ultrasound to assess cervical length. The ultrasound revealed cervical funneling. How should the nurse explain these findings to the client? A) "Your cervix has become cone-shaped and more open at the end near the baby." B) "Your cervix is lengthened, and you will deliver your baby prematurely." C) "Your cervix is short, and has become wider at the end that extends into the vagina." D) "Your cervix was beginning to open but now is starting to close up again."

The client gave birth to a 7 pound, 14 ounce female 30 minutes ago. The placenta has not yet delivered. Manual removal of the placenta is planned. What should the nurse prepare to do? A) Start an I V of lactated Ringer's. B) Apply anti-embolism stockings. C) Bottle-feed the infant. D) Send the placenta to pathology.

The client tells the nurse that she has come to the hospital so that her baby's position can be changed. The nurse would begin to organize the supplies needed to perform which procedure? A) A version B) An amniotomy C) Leopold maneuvers D) A ballottement

The community nurse is working with a client from Southeast Asia who has delivered her first child. Her mother has come to live with the family for several months. The nurse understands that the main role of the grandmother while visiting is to do which of the following? A) Help the new mother by allowing her to focus on resting and caring for the baby. B) Teach her son-in-law the right way to be a father because this is his first child. C) Make sure that her daughter does not become abusive towards the infant. D) Pass on cultural values and beliefs to the newborn grandchild.

The fetal heart rate baseline is 140 beats/min. When contractions begin, the fetal heart rate drops suddenly to 120, and rapidly returns to 140 before the end of the contraction. Which nursing intervention is best? A) Assist the client to change position. B) Apply oxygen to the client at 2 liters per nasal cannula. C) Notify the operating room of the need for a cesarean birth. D) Determine the color of the leaking amniotic fluid.

The home care nurse is examining a 3-day-old infant. The child's skin on the sternum is yellow when blanched with a finger. The parents ask the nurse why jaundice occurs. What is the best response from the nurse? A) "The liver of an infant is not fully mature, and doesn't conjugate the bilirubin for excretion." B) "The infant received too many red blood cells after delivery because the cord was not clamped immediately." C) "The yellow color of your baby's skin indicates that you are breastfeeding too often." D) "This is an abnormal finding related to your baby's bowels not excreting bilirubin as they should."

The home health nurse is visiting a client at 18 weeks who is pregnant with twins. Which nursing action is most important? A) Teach the client about foods that are good sources of protein. B) Assess the client's blood pressure in her upper right arm. C) Determine whether the pregnancy is the result of infertility treatment. D) Collect a cervicovaginal fetal fibronectin (fF N) specimen.

The introduction of a new baby into the family is often the beginning of which of the following? A) Sibling rivalry B) Inconsistent childrearing C) Toilet training D) Weaning

The kosher diet followed by many Jewish people forbids the eating of what foods? A) Pig products and shellfish B) Dairy products C) All animal products D) Dairy products and eggs

The laboring client is complaining of tingling and numbness in her fingers and toes, dizziness, and spots before her eyes. The nurse recognizes that these are clinical manifestations of which of the following? A) Hyperventilation B) Seizure auras C) Imminent birth D) Anxiety

The laboring client presses the call light and reports that her water has just broken. What would the nurse's first action be? A) Check fetal heart tones. B) Encourage the mother to go for a walk. C) Change bed linens. D) Call the physician.

The laboring client's fetal heart rate baseline is 120 beats per minute. Accelerations are present to 135 beats/min. During contractions, the fetal heart rate gradually slows to 110, and is at 120 by the end of the contraction. What nursing action is best? A) Document the fetal heart rate. B) Apply oxygen via mask at 10 liters. C) Prepare for imminent delivery. D) Assist the client into Fowler's position.

The mother of a 16-week-old infant is concerned because she cannot feel the posterior fontanelle on her infant. Which response by the nurse would be most appropriate? A) "It is normal for the posterior fontanelle to close by 8 to 12 weeks after birth." B) "Bring your infant to the clinic immediately." C) "This is due to overriding of the cranial bones during labor." D) "Your baby must be dehydrated."

The mother of a 2-day-old male has been informed that her child has sepsis. The mother is distraught and says, "I should have known that something was wrong. Why didn't I see that he was so sick?" What is the nurse's best reply? A) "Newborns have immature immune function at birth, and illness is very hard to detect." B) "Your mothering skills will improve with time. You should take the newborn class." C) "Your baby didn't get enough active acquired immunity from you during the pregnancy." D) "The immunity your baby gets in utero doesn't start to function until he is 4 to 8 weeks old."

The mother of a 3-day-old infant calls the clinic and reports that her baby's skin is turning slightly yellow. What should the nurse explain to the mother? A) Physiologic jaundice is normal, and peaks at this age. B) The newborn's liver is not working as well as it should. C) The baby is yellow because the bowels are not excreting bilirubin. D) The yellow color indicates that brain damage might be occurring.

The mother of a premature newborn questions why a gavage feeding catheter is placed in the mouth of the newborn and not in the nose. What is the nurse's best response? A) "Most newborns are nose breathers." B) "The tube will elicit the sucking reflex." C) "A smaller catheter is preferred for feedings." D) "Most newborns are mouth breathers."

The nurse administered oxytocin 20 units at the time of placental delivery. Why was this primarily done? A) To contract the uterus and minimize bleeding B) To decrease breast milk production C) To decrease maternal blood pressure D) To increase maternal blood pressure

The nurse assesses four newborns. Which of the following assessment findings would place a newborn at risk for developing physiologic jaundice? A) Cephalohematoma B) Mongolian spots C) Telangiectatic nevi D) Molding

The nurse assesses the newborn's ears to be parallel to the outer and inner canthus of the eye. The nurse documents this finding to be which of the following? A) A normal position B) A possible chromosomal abnormality C) Facial paralysis D) Prematurity

The nurse at the prenatal clinic has four calls to return. Which call should the nurse return first? A) Client at 32 weeks, reports headache and blurred vision. B) Client at 18 weeks, reports no fetal movement in this pregnancy. C) Client at 16 weeks, reports increased urinary frequency. D) Client at 40 weeks, reports sudden gush of fluid and contractions.

The nurse auscultates the F H R and determines a rate of 112 beats/min. Which action is appropriate? A) Inform the maternal client that the rate is normal. B) Reassess the F H R in 5 minutes because the rate is low. C) Report the F H R to the doctor immediately. D) Turn the maternal client on her side and administer oxygen.

The nurse evaluates the diet of a pregnant client and finds that it is low in zinc. The nurse knows that zinc intake should increase during pregnancy to promote protein metabolism. Which food should the nurse suggest in order to increase intake of zinc? A) Shellfish B) Bananas C) Yogurt D) Cabbage

The nurse has completed a community education session on growth patterns of infants. Which statement by a participant indicates that additional teaching is needed? A) "Newborns should regain their birth weight by 1 week of age." B) "Breastfed and formula-fed babies have different growth rates." C) "Formula-fed infants regain their birth weight earlier than breastfed infants." D) "Healthcare providers consider breastfeeding to be the 'gold standard' for neonatal nutrition."

1) The client is undergoing lab work and ultrasound for a possible diagnosis of polycystic ovarian syndrome (P C O S). Which problem does the nurse expect to find in the client's history? A) Multiple first-trimester fetal losses B) Dyspareunia C) Vulvitis D) Oligomenorrhea

The nurse has received end-of-shift reports in the high-risk maternity unit. Which client should the nurse see first? A) The client at 26 weeks' gestation with placenta previa experiencing blood on toilet tissue after a bowel movement B) The client at 30 weeks' gestation with placenta previa whose fetal monitor strip shows late decelerations C) The client at 35 weeks' gestation with grade I abruptio placentae in labor who has a strong urge to push D) The client at 37 weeks' gestation with pregnancy-induced hypertension whose membranes ruptured spontaneously

The nurse is answering phone calls at the pediatric clinic. Which call should the nurse return first? A) Mother of a 2-week-old infant who doesn't make eye contact when talked to B) Father of a 1-week-old infant who sleeps through the noise of an older sibling C) Father of a 6-day-old infant who responds more to mother's voice than to father's voice D) Mother of a 3-week-old infant who has begun to suck on the fingers of the right hand

The nurse is assessing the baseline fetal heart rate for a client in labor. What action should the nurse take first? A) Measure the fetal heart rate for 10 minutes B) Round the heart rate to increments of 5 beats/minute C) Exclude periods of marked variation D) Calculate the mean (average) heart rate

The nurse is caring for a 2-hour-old newborn whose mother is diabetic. The nurse assesses that the newborn is experiencing tremors. Which nursing action has the highest priority? A) Obtain a blood calcium level. B) Take the newborn's temperature. C) Obtain a bilirubin level. D) Place a pulse oximeter on the newborn.

The nurse is caring for a client in labor who has a history of physical dependence on narcotics. Which consideration should the nurse take with regard to the administration of naloxone (Narcan)? A) Inducing withdrawal symptoms B) Prolonging respiratory depression C) Exacerbating pruritis D) Increasing the risk for fetal depression

The nurse is caring for a client with fetal heart rate monitoring, and the fetus is discovered to have tachycardia. Which complication should the nurse anticipate in the fetus? A) Infection B) Umbilical cord compression C) Vagus nerve stimulation D) Hypoxemia

The nurse is caring for a laboring client with thrombocytopenia. During labor, it is determined that the client requires a cesarean delivery. The nurse is preparing the client for surgery, and should instruct the client that the recommended method of anesthesia is which of the following? A) General anesthesia B) Epidural anesthesia C) Spinal anesthesia D) Regional anesthesia

The nurse is caring for four newborns who have recently been admitted to the newborn nursery. Which labor event puts the newborn at risk for an alteration of health? A) The infant's mother has group B streptococcal (G B S) disease. B) The infant's mother had an I V of lactated Ringer's solution. C) The infant's mother had a labor that lasted 12 hours. D) The infant's mother had a cesarean birth with her last child.

The nurse is caring for several pregnant clients. Which client should the nurse anticipate is most likely to have a newborn at risk for mortality or morbidity? A) 37-year-old, with a history of multiple births and preterm deliveries who works in a chemical factory B) 23-year-old of low socioeconomic status, unmarried C) 16-year-old who began prenatal care at 30 weeks D) 28-year-old with a history of gestational diabetes

The nurse is caring for the newborn of a diabetic mother whose blood glucose level is 39 m g/d L. What should the nurse include in the plan of care for this newborn? A) Offer early feedings with formula or breast milk. B) Provide glucose water exclusively. C) Evaluate blood glucose levels at 12 hours after birth. D) Assess for hyperthermia.

The nurse is caring for the newborn of a diabetic mother. Which of the following should be included in the nurse's plan of care for this newborn? A) Offer early feedings. B) Administer an intravenous infusion of glucose. C) Assess for hypercalcemia. D) Assess for hyperbilirubinemia immediately after birth.

The nurse is collecting information during the health history assessment for the client profile during the initial prenatal visit. Which question is appropriate when assessing the current pregnancy? A) "What was the date of your last menstrual period?" B) "How many times have you been pregnant?" C) "What were your children's birth weights?" D) "How many living children do you have?"

The nurse is completing the discharge teaching of a young first-time mother. Which statement by the mother requires immediate intervention? A) "I will put my baby to bed with his bottle so he doesn't get hungry during the night." B) "My baby will probably have a bowel movement each breastfeeding, and will wet often." C) "Nursing every 2 to 3 hours is normal, for a total of 8 to 12 feedings every day." D) "I will drink fenugreek tea from my grandmother to prevent my milk from coming in."

The nurse is evaluating the effectiveness of phototherapy on a newborn. Which evaluation indicates a therapeutic response to phototherapy? A) The newborn maintains a normal temperature B) An increase of serum bilirubin levels C) Weight loss D) Skin blanching yellow

The nurse is explaining to a new prenatal client that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the client makes which statement about the reason for the exam? A) "It will help us know how big a baby I can deliver vaginally." B) "Doing this exam is a part of prenatal care at this clinic." C) "My sister had both of her babies by cesarean." D) "I am pregnant with my first child."

The nurse is inducing the labor of a client with severe preeclampsia. As labor progresses, fetal intolerance of labor develops. The induction medication is turned off, and the client is prepared for cesarean birth. Which statement should the nurse include in her preoperative teaching? A) "Because of your preeclampsia, you are at higher risk for hypotension after an epidural anesthesia." B) "Because of your preeclampsia, you might develop hypertension after a spinal anesthesia." C) "Because of your preeclampsia, your baby might have decreased blood pressure after birth." D) "Because of your preeclampsia, your husband will not be allowed into the operating room."

A nurse in a clinic is teaching a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency? A) Iron deficiency anemia B) Poor bone formation C) Macrosomic fetus D) Neural tube defects

The nurse is instructing parents of a newborn about voiding and stool characteristics. Which of the following would be considered an abnormal pattern? A) Large amounts of uric acid crystals in the first days of life B) At least 6 to 10 wet diapers a day after the first few days of life C) 1 to 2 stools a day for a formula-fed baby D) Urine that is straw to amber color without foul smell

The nurse is making an initial assessment of the newborn. Which of the following data would be considered normal? A) Chest circumference 31.5 c m, head circumference 33.5 c m B) Chest circumference 30 c m, head circumference 29 c m C) Chest circumference 38 c m, head circumference 31.5 c m D) Chest circumference 32.5 c m, head circumference 36 c m

The nurse is observing a student nurse who is caring for a neonate undergoing intensive phototherapy. Which action by the student nurse indicates an understanding of how to provide this care? A) Urine specific gravity is assessed at each voiding. B) Eye coverings are left off to help keep the baby calm. C) Temperature is checked every 6 hours. D) The infant is taken out of the isolette for diaper changes.

The nurse is performing a vaginal exam on a client who was admitted to the birthing unit after her membranes ruptured, and discovers a cord prolapse. Which intervention is priority at this time? A) Pushing the presenting fetal part upward B) Administering oxygen C) Initiating intravenous fluid D) Inserting an indwelling bladder catheter

The nurse is performing an assessment on an infant whose mother states that she feeds the infant in a supine position by propping the bottle. Based on this information, what would the nurse include in the assessment? A) Otoscopic exam of the eardrum B) Bowel sounds C) Vital signs D) Skin assessment

The nurse is planning an educational session for pregnant vegans. What information should the nurse include? A) Eating beans and rice provides complete protein needs. B) Soy is not a good source of protein for vegans. C) Rice contains a high level of vitamin B12. D) Vegan diets are excessively high in iron.

The nurse is preparing a class on breastfeeding for pregnant women in their first trimester. The women are from a variety of cultural backgrounds, and all speak English well. Which statement should the nurse include in this presentation? A) "Although some cultures believe colostrum is not good for the baby, it provides protection from infections and helps the digestive system to function." B) "Some women are uncomfortable with exposing their breasts to nurse their infant, but it really isn't a big deal. You will get used to it." C) "No religion prescribes a feeding method, so you all can choose whatever method makes the most sense to you." D) "In most cultures, it is culturally acceptable to speak about intimate matters in front of their families."

The nurse is preparing a client for amniocentesis. Which statement would indicate that the client clearly understands the risks of amniocentesis? A) "I might go into labor early." B) "It could produce a congenital defect in my baby." C) "Actually, there are no real risks to this procedure." D) "The test could stunt my baby's growth."

The nurse is preparing a prenatal class about infant feeding methods. The maternal nutritional requirements for breastfeeding and formula-feeding will be discussed. What statement should the nurse include? A) "Breastfeeding requires a continued high intake of protein and calcium." B) "Formula-feeding mothers should protect their health with a lot of calcium." C) "Producing breast milk requires calories, but any source of food is fine." D) "Formula-feeding mothers need a high protein intake to avoid fatigue."

The nurse is preparing for a postpartum home visit. The client has been home for a week, is breastfeeding, and experienced a third-degree perineal tear after vaginal delivery. The nurse should assess the client for which of the following? A) Dietary intake of fiber and fluids B) Dietary intake of folic acid and prenatal vitamins C) Return of hemoglobin and hematocrit levels to baseline D) Return of protein and albumin to predelivery levels

The nurse is preparing new parents for discharge with their newborn. The father asks the nurse why the baby's head is so pointed and puffy-looking. What is the best response by the nurse? A) "His head is molded from fitting through the birth canal. It will become more round." B) "We refer to that as 'cone head,' which is a temporary condition that goes away." C) "It might mean that your baby sustained brain damage during birth, and could have delays." D) "I think he looks just like you. Your head is much the same shape as your baby's."

The nurse is preparing teaching material for a pregnant patient with the following type of placenta previa. What information should the nurse provide the patient about this health problem? (PICTURE) A) Internal o s is partially covered by the placenta B) Internal o s is covered completely by the placenta C) Edge of the placenta is at the margin of the internal o s D) Placenta is implanted in the lower segment but does not reach the o s

The nurse is preparing to assess the fetus of a laboring client. Which assessment should the nurse perform first? A) Perform Leopold maneuvers to determine fetal position. B) Count the fetal heart rate between, during, and for 30 seconds following a uterine contraction (U C). C) Dry the maternal abdomen before using the Doppler. D) The diaphragm should be cooled before using the Doppler.

The nurse is presenting a preconception counseling class. The nurse instructs the participants that niacin intake should increase during pregnancy to promote metabolic coenzyme activity. The nurse will know that teaching has been effective if a client suggests which food as a source of niacin? A) Fish B) Apples C) Broccoli D) Milk

The nurse is responding to phone calls. Whose call should the nurse return first? A) A client at 37 weeks' gestation reports no fetal movement for 24 hours. B) A client at 29 weeks' gestation reports increased fetal movement. C) A client at 32 weeks' gestation reports decreased fetal movement X 2 days. D) A client at 35 weeks' gestation reports decreased fetal movement X 4 hours.

The pregnant client and her partner are both 40 years old. The nurse is explaining the options of chorionic villus sampling (C V S) and amniocentesis for genetic testing. The nurse should correct the client if she makes which statement? A) "Amniocentesis results are available sooner than C V S results are." B) "C V S carries a higher risk of limb abnormalities." C) "Amniocentesis cannot detect a neural tube defect." D) "C V S is performed through my belly or my cervix."

The nurse is reviewing charts of clients who underwent cesarean births by request in the last two years. The hospital is attempting to decrease costs of maternity care. What findings contribute to increased healthcare costs in clients undergoing cesarean birth by request? A) Increased abnormal placenta implantation in subsequent pregnancies B) Decreased use of general anesthesia with greater use of epidural anesthesia C) Prolonged anemia, requiring blood transfusions every few months D) Coordination of career projects of both partners leading to increased income

The nurse is reviewing the F H R monitor for a client in labor. The rhythm strip yields the following result: How should the nurse interpret this pattern? A) Moderate variability B) Minimal variability C) Absent variability D) Marked variability

The nurse is scheduling a client for an external cephalic version (E C V). Which finding in the client's chart requires immediate intervention? A) Previous birth by cesarean B) Frank breech ballotable C) 37 weeks, complete breech D) Failed E C V last week

The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected findings? A) 12 weeks' gestation, with fetal heart tones heard by Doppler fetoscope B) 22 weeks' gestation, client reports no fetal movement felt yet C) 16 weeks' gestation, fundus three finger-breadths above umbilicus D) Marked edema

The nurse is teaching a class on vaginal birth after cesarean (V B A C). Which statement by a participant indicates that additional information is needed? A) "Because the scar on my belly goes down from my navel, I am not a candidate for a V B A C." B) "My first baby was in a breech position, so for this pregnancy, I can try a V B A C if the baby is head-down." C) "Because my hospital is so small and in a rural area, they won't let me attempt a V B A C." D) "The rate of complications from V B A C is lower than the rate of complications from a cesarean."

The nurse is teaching a group of new parents about their infants. The infants are all 4 weeks of age or younger. Which statement should the nurse include? A) "Your baby will respond to you the most if you look directly into his eyes and talk to him." B) "Each baby is different. Don't try to compare your infant's behavior with any other child's behavior." C) "If the sound level around your baby is high, the baby will wake up and be fussy or cry." D) "If your baby is a cuddler, it is because you rocked and talked to her during your pregnancy."

The nurse is teaching a prenatal class about feeding methods. A father-to-be asks the nurse which method, breast or formula, leads to the fastest infant growth and weight gain. Which response by the nurse is best? A) "In the first 3 to 4 months breastfed babies tend to gain weight faster." B) "In the first 3 to 4 months there is no difference in weight gain." C) "In the first 3 to 4 months bottle-fed babies grow faster." D) "In the first 3 to 4 months growth isn't as important as your comfort with the method."

The nurse is teaching the parents of an infant with an inborn error of metabolism how to care for the infant at home. What information does teaching include? A) Specially prepared formulas B) Cataract problems C) Low glucose concentrations D) Administration of thyroid medication

The nurse knows that a baby born to a mother who had oligohydramnios could show signs of which of the following? A) Respiratory difficulty B) Hypertension C) Heart murmur D) Decreased temperature

The nurse knows that a contraindication to the induction of labor is which of the following? A) Placenta previa B) Isoimmunization C) Diabetes mellitus D) Premature rupture of membranes

The nurse on the birthing unit is caring for a client who has an amputated cervix and is about to undergo a cerclage procedure. Which type of cerclage procedure should the nurse anticipate? A) Abdominal cerclage B) Rescue cerclage C) Emergency cerclage D) Elective cerclage

The nurse prepares to admit to the nursery a newborn whose mother had meconium-stained amniotic fluid. The nurse knows this newborn might require which of the following? A) Initial resuscitation B) Vigorous stimulation at birth C) Phototherapy immediately D) An initial feeding of iron-enriched formula

The nurse wishes to demonstrate to a new family their infant's individuality. Which assessment tool would be most appropriate for the nurse to use? A) Brazelton Neonatal Behavioral Assessment Scale B) New Ballard Score C) Dubowitz gestational age scale D) Ortolani maneuver

The nurse would expect a physician to prescribe which medication to a postpartum client with heavy bleeding and a boggy uterus? A) Methylergonovine maleate (Methergine) B) Rh immune globulin (R h o G A M) C) Terbutaline (Brethine) D) Docusate (Colace)

The parents of a newborn are receiving discharge teaching. The nurse explains that the infant should have several wet diapers per day. Which statement by the parents indicates that further education is necessary? A) "Our baby was born with kidneys that are too small." B) "A baby's kidneys don't concentrate urine well for several months." C) "Feeding our baby frequently will help the kidneys function." D) "Kidney function in an infant is very different from that in an adult."

The parents of a newborn have just been told their infant has tetralogy of Fallot. The parents do not seem to understand the explanation given by the physician. What statement by the nurse is best? A) "With this defect, not enough of the blood circulates through the lungs, leading to a lack of oxygen in the baby's body." B) "The baby's aorta has a narrowing in a section near the heart that makes the left side of the heart work harder." C) "The blood vessels that attach to the ventricles of the heart are positioned on the wrong sides of the heart." D) "Your baby's heart doesn't circulate blood well because the left ventricle is smaller and thinner than normal."

The pediatric clinic nurse is reviewing lab results with a 2-month-old infant's mother. The infant's hemoglobin has decreased since birth. Which statement by the mother indicates the need for additional teaching? A) "My baby isn't getting enough iron from my breast milk." B) "Babies undergo physiologic anemia of infancy." C) "This results from dilution because of the increased plasma volume." D) "Delaying the cord clamping did not cause this to happen."

The nurse caring for a postterm newborn would not perform what intervention? A) Providing warmth B) Frequently monitoring blood glucose C) Observing respiratory status D) Restricting breastfeeding

The pregnant client at 41 weeks is scheduled for labor induction. She asks the nurse whether induction is really necessary. What response by the nurse is best? A) "Babies can develop postmaturity syndrome, which refers to a number of complications that can occur after 42 weeks of pregnancy." B) "When infants are born 2 or more weeks after their due date, they have meconium in the amniotic fluid." C) "Sometimes the placenta ages excessively, and we want to take care of that problem before it happens." D) "The doctor wants to be proactive in preventing any problems with your baby if he gets any bigger."

The prenatal clinic nurse is caring for a 15-year-old client who is at 8 weeks' gestation. The client asks the nurse why she is supposed to gain so much weight. What is the best response by the nurse? A) "Gaining 25-35 pounds is recommended for healthy fetal growth." B) "It's what your certified nurse-midwife recommended for you." C) "Inadequate weight gain delays lactation after delivery." D) "Weight gain is important to ensure that you get enough vitamins."

The prenatal clinic nurse is explaining test results to a client who has had an assessment for fetal well-being. Which statement indicates that the client understands the test results? A) "The normal Doppler velocimetry wave result indicates my placenta is getting enough blood to the baby." B) "The reactive nonstress test means that my baby is not growing because of a lack of oxygen." C) "Because my contraction stress test was positive, we know that my baby will tolerate labor well." D) "My biophysical profile score of 6 points to everything being normal and healthy for my baby."

The primiparous client has told the nurse that she is afraid she will develop hemorrhoids during pregnancy because her mother did. Which statement would be best for the nurse to make? A) "It is not unusual for women to develop hemorrhoids during pregnancy." B) "Most women don't have any problem until after they've delivered." C) "If your mother had hemorrhoids, you will get them, too." D) "If you get hemorrhoids, you probably will need surgery to get rid of them."

The student nurse attempts to take a newborn's vital signs, but the newborn is crying. What nursing action would be appropriate? A) Place a gloved finger in the newborn's mouth. B) Take the vital signs. C) Wait until the newborn stops crying. D) Place a hot water bottle in the isolette.

The student nurse notices that a newborn weighs less today compared with the newborn's birth weight three days ago. The nursing instructor explains that newborns lose weight following birth due to which of the following? A) A shift of intracellular water to extracellular spaces. B) Loss of meconium stool. C) A shift of extracellular water to intracellular spaces. D) The sleep-wake cycle.

Two hours after delivery, a client's fundus is boggy and has risen to above the umbilicus. What is the first action the nurse would take? A) Massage the fundus until firm B) Express retained clots C) Increase the intravenous solution D) Call the physician

Upon the client's admission to the birthing unit, the nurse performs a careful assessment to determine whether the client has a history of physical dependence on narcotics. For which complication related to analgesic administration is the nurse preparing? A) Respiratory depression B) Urinary retention C) Fetal depression D) Pruritis

What condition is due to poor peripheral circulation? A) Acrocyanosis B) Mottling C) Harlequin sign D) Jaundice

What is one of the most common initial signs of nonreassuring fetal status? A) Meconium-stained amniotic fluid B) Cyanosis C) Dehydration D) Arrest of descent

What is the major adverse side effect of epidural anesthesia? A) Maternal hypotension B) Decrease in variability of the F H R C) Vertigo D) Decreased or absent respiratory movements

What is the most significant maternal risk factor for preterm birth? A) Previous preterm birth B) Smoking C) Stress D) Substance abuse

What would be a normal cervical dilatation rate in a first-time mother ("primip")? A) 1.5 c m per hour B) Less than 1 c m cervical dilatation per hour C) 1 c m per hour D) Less than 0.5 c m per hour

Which of the following is a benefit of delayed umbilical cord clamping for the preterm infant? A) Fewer infants require blood transfusion for anemia B) Fewer infants require blood transfusion for high blood pressure C) Increase in the incidence of intraventricular hemorrhage D) Increase in incidence of infant breastfeeding

Which of the following is a localized, easily identifiable soft area of the infant's scalp, generally resulting from a long and difficult labor or vacuum extraction? A) Caput succedaneum B) Cephalohematoma C) Molding D) Depressed fontanelles

Which statement is best to include when teaching a pregnant adolescent about her nutritional needs in pregnancy? A) "It is important to eat iron-rich foods like meat every day." B) "Calcium and milk aren't needed until the third trimester." C) "Folic acid intake is the key to having a healthy baby." D) "You just need to pay attention to what you eat now."

While caring for a client admitted to the birthing unit, the nurse suspects that the client may be experiencing a uterine rupture. Which assessment finding should the nurse expect to appear first? A) Nonreassuring fetal heart rate B) Constant abdominal pain C) Loss of fetal station D) Cessation of contractions

While caring for a client in labor, the nurse notes the following F H R pattern: Which action should the nurse perform? A) Continue to monitor the client B) Fetal scalp stimulation C) Palpate contraction strength D) Discontinue oxytocin

While caring for a client in labor, the nurse notes the following persistent rhythm on the fetal heart rate monitor: Which action should the nurse take first? A) Notify the provider. B) Prepare for expedient delivery. C) Reposition the client. D) Discontinue oxytocin therapy.

1) What issues should the nurse consider when counseling a client on contraceptive methods? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Cultural perspectives on menstruation and pregnancy B) Effectiveness of the method C) Future childbearing plans D) Whether the client is a vegetarian E) Age at menarche

A, B, C

While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts with "Why are you asking me all these questions? What difference does it make?" Which statement would best answer the client's questions? A) "We ask these questions to detect anything that happened in your past that might affect the pregnancy." B) "We ask these questions to see whether you can have prenatal visits less often than most clients do." C) "We ask these questions to make sure that our paperwork and records are complete and up to date." D) "We ask these questions to look for any health problems in the past that might affect your parenting."

While performing a uterine assessment on a client in the birthing unit, the nurse notes a loss of fetal station and a change in uterine shape. The client reports constant abdominal pain, uterine tenderness, and is exhibiting signs of shock. Which condition should the nurse suspect? A) Uterine rupture B) Anaphylactoid syndrome of pregnancy C) Circumvallate placenta D) Breech presentation

In caring for the premature newborn, the nurse must assess hydration status continually. Assessment parameters should include which of the following? Select all that apply. A) Volume of urine output B) Weight C) Blood p H D) Head circumference E) Bowel sounds

A, B

The nurse has taken a detailed social history from a client admitted to the birthing unit. Which insights may the nurse gain as a result of this assessment? Select all that apply. A) Social habits B) Psychologic factors C) Presence of H I V D) Readiness for discharge E) Need for bed rest

A, B

The nurse is assessing the comfort of the parents during the third stage of labor. Which finding(s) indicate that the parents feel comfortable during this stage? Select all that apply. A) Talking to the newborn B) Verbally expressing feelings of pride C) Requesting to dim the lights D) Preferring limited contact with the newborn initially E) Immediately placing phone calls

A, B

The nurse is caring for a client who has experienced premature rupture of membranes. For which maternal implication(s) should the nurse monitor? Select all that apply. A) Infection B) Preterm labor C) Dyspnea D) Discomfort E) Uterine distention

A, B

1) During a wellness visit, a 50-year-old female experiencing menopause says that she jogs three times a week and feels like her symptoms are becoming worse. What should the nurse recommend to help with the discomfort of menopause? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Yoga B) Tai chi C) Meditation D) Weight lifting E) Kegel exercises

A, B, C

1) During the assessment phase of a family, the community nurse recognizes that culture influences childrearing and childbearing in which of the following ways? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Beliefs about the importance of children B) Beliefs and attitudes about pregnancy C) Norms regarding infant feeding D) Acculturation is important in rearing children E) Time orientation to the future is very important

A, B, C

1) In assessing a family, the community nurse uses a family assessment tool, which provides an organized framework to collect data concerning which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Access to laundry and grocery facilities B) Access to health care C) Sharing of religious beliefs and values D) Acculturation to traditional lifestyles E) Ability to include a new spouse into the family unit

A, B, C

1) In working with immigrants in an inner-city setting, the nurse recognizes that acculturation of immigrants often brings with it which of the following benefits? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Improved socioeconomic status B) Use of preventive care services C) Better nutrition D) Increase in substance abuse over time E) More physician visits due to language barriers

A, B, C

1) Lesbian, transgendered, and bisexual women are at greater risk for health and social disparities, including which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Increased suicide risk B) Increased risk of homelessness C) Lack of screening for female-related cancers D) Lack of screening for lung cancers E) Increased divorce rates

A, B, C

1) The nurse is discharging a client after hospitalization for pelvic inflammatory disease (P I D). Which statements indicate that teaching was effective? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "I might have infertility because of this infection." B) "It is important for me to finish my antibiotics." C) "Tubal pregnancy could occur after P I D." D) "My P I D was caused by a yeast infection." E) "I am going to have an I U D placed for contraception."

A, B, C

A cesarean section is ordered for the laboring client with whom the nurse has worked all shift. The client will receive general anesthesia. The nurse knows that potential complications of general anesthesia include which of the following? Select all that apply. A) Fetal depression that is directly proportional to the depth and duration of the anesthesia B) Poor fetal metabolism of anesthesia, which inhibits use with preterm infants C) Uterine relaxation D) Increased gastric motility E) Itching of the face and neck

A, B, C

A client is admitted to the labor and delivery unit in active labor. What nursing diagnoses might apply to the client with suspected abruptio placentae? Select all that apply. A) Fluid Volume, Deficient, related to hypovolemia secondary to excessive blood loss B) Tissue Perfusion: Peripheral, Ineffective, related to blood loss secondary to uterine atony following birth C) Anxiety related to concern for own personal status and the baby's safety D) Knowledge, Deficient related to lack of information about inherited genetic defects E) Alteration in Respiratory Function related to blood loss

A, B, C

A nurse is teaching a client who is at 6 weeks of gestation about common discomforts of pregnancy. Which of the following findings should the nurse include? Select all that apply. A) Breast tenderness B) Urinary frequency C) Epistaxis D) Dysuria E) Epigastric pain

A, B, C

The nurse is caring for a client who is about to receive an amnioinfusion. For which complication(s) should the nurse monitor the client?. Select all that apply. A) Umbilical cord prolapse B) Amniotic fluid embolism C) Uterine rupture D) Amnionitis E) Abruptio placentae

A, B, C

The nurse is performing an assessment on a client admitted to the birthing unit. Which assessment finding(s) contraindicate(s) an epidural block? Select all that apply. A) Maternal refusal B) Local infection of the skin on the lower back C) Coagulation disorder D) Long-term N S A I D use E) Previous back surgery

A, B, C

The prenatal period should be used to expose the prospective parents to up-to-date, evidence-based information about which of the following topics? Select all that apply. A) Breastfeeding B) Pain relief C) Obstetric complications and procedures D) Toddler care E) Antepartum adjustment

A, B, C

What self-care measures would a nurse recommend for a client in her first trimester to reduce the discomfort of nausea and vomiting? Select all that apply. A) Avoid odors or causative factors. B) Have small but frequent meals. C) Drink carbonated beverages. D) Drink milk before arising in the morning. E) Eat highly seasoned food.

A, B, C

1) A 17-year-old high school student comes into the nurse's office to find out what to do about severe menstrual cramps. What should the nurse recommend to this student? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Rest B) Good nutrition C) Regular exercise D) Application of heat E) D & C of the uterus

A, B, C, D

1) A 40-year-old patient is being seen in the clinic for gynecological changes. Which approaches should the nurse use when completing this patient's health interview? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Avoid writing B) Clarify terms used C) Maintain eye contact D) Analyze body language E) Use simple yes-no questions

A, B, C, D

1) A client at 10 weeks' gestation is scheduled for a surgical abortion. Which approaches may be used to dilate the cervix for the procedure? Note: Credit will be given only if all correct choices and no incorrect choices are elected. Select all that apply. A) Misoprostol B) Mifepristone C) Metal dilators D) Sterile seaweed E) Paracervical block

A, B, C, D

1) Pesticide exposure can be linked to a variety of adverse health outcomes, including which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Increased risk of cancer B) Endocrine abnormalities C) Liver damage D) Birth defects E) Cardiovascular diseases

A, B, C, D

During a labor and delivery class, a client asks the nurse, "Why would I be placed under general anesthesia during delivery?" What should the nurse include in the response? Select all that apply. A) Perceived lack of time for regional anesthesia B) Contraindications for regional anesthesia C) Failure of regional anesthesia D) Refusal of regional anesthesia E) Provider preference over regional anesthesia

A, B, C, D

The nurse is caring for a client undergoing fetal heart rate monitoring, and the F H R is greater than 162 beats/min for 12 Select all that apply. A) Maternal anxiety B) Fetal asphyxia C) Prematurity D) Fetal anemia E) Maternal hypotension

A, B, C, D

The nurse is performing a comprehensive assessment on a client admitted to the birthing unit with abruptio placentae. Which finding(s) contribute(s) to this condition? Select all that apply. A) History of domestic violence B) Presence of uterine fibroids C) Alcohol consumption during pregnancy D) Hypertension E) Gestational diabetes mellitus

A, B, C, D

The nurse is performing an assessment on a client in the birthing unit who has acquired cervical insufficiency. Which other finding(s) may contribute to the client's condition? Select all that apply. A) Inflammation B) Infection C) Cervical trauma D) Cone biopsy E) H P V positivity

A, B, C, D

The nurse is reviewing the contents of the birthing unit's emergency pack for use in case of a precipitous birth. Which item(s) should the nurse ensure is (are) included in the pack? Select all that apply. A) Sterile drape B) Bulb syringe C) Two sterile clamps D) Sterile gloves E) Forceps

A, B, C, D

The nurse on the birthing unit is collecting the obstetric history of a client at risk for cervical insufficiency. Which findings increase the client's risk for this condition? Select all that apply. A) Multiple gestations B) Previous preterm births C) Progressively earlier births with each subsequent pregnancy D) Cervical manipulation E) Prolonged labors

A, B, C, D

Which serum markers are assessed when conducting a quadruple screen? Select all that apply. A) Alpha-fetoprotein (A F P) B) Human chorionic gonadotropin (h C G) C) Unconjugated estriol (U E) D) Inhibin-A E) Glycated hemoglobin

A, B, C, D

1) The public health nurse is working with a student nurse. The student nurse asks which of the six groups of people they have seen today are considered to be families. How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "The married heterosexual couple without children" B) "The gay couple with two adopted children" C) "The unmarried heterosexual couple with two biological children" D) "The lesbian couple not living together that have no children" E) "The married heterosexual couple with three children, living with grandparents"

A, B, C, E

For what common side effects of epidural anesthesia should the nurse watch? Select all that apply. A) Elevated maternal temperature B) Urinary retention C) Nausea D) Long-term back pain E) Local itching

A, B, C, E

Upon assessing the F H R tracing, the nurse determines that there is fetal tachycardia. The fetal tachycardia would be caused by which of the following? Select all that apply. A) Early fetal hypoxia B) Prolonged fetal stimulation C) Fetal anemia D) Fetal sleep cycle E) Infection

A, B, C, E

1) Psychologic elder abuse includes, but is not limited to, which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Verbal assaults B) Humiliation C) Desertion D) Intimidation E) Failure to provide reasonable care

A, B, D

1) The client with polycystic ovarian syndrome (P C O S) has been prescribed metformin (Glucophage). The nurse tells the client that the medication will do which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "Decrease your excessive hair growth." B) "Make it easier to lose weight." C) "Increase your acne." D) "Improve your chances of pregnancy." E) "Make your menstrual periods irregular."

A, B, D

A newborn who has not voided by 48 hours after birth should be assessed for which of the following? Select all that apply. A) Restlessness B) Pain C) Kidney distention D) Adequacy of fluid intake E) Lethargy

A, B, D

Marked changes that occur in the cardiopulmonary system at birth include which of the following? Select all that apply. A) Closure of the foramen ovale B) Closure of the ductus venosus C) Mean blood pressure of 31 to 61 m m H g in full-term resting newborns D) Increased systemic vascular resistance and decreased pulmonary vascular resistance E) Opening of the ductus arteriosus

A, B, D

Risk factors for tachysystole include which of the following? Select all that apply. A) Cocaine use B) Placental abruption C) Low-dose oxytocin titration regimens D) Uterine rupture E) Smoking

A, B, D

The client is undergoing an emergency cesarean birth for fetal bradycardia. The client's partner has not been allowed into the operating room. What can the nurse do to alleviate the partner's emotional distress? Select all that apply. A) Allow the partner to wheel the baby's crib to the newborn nursery. B) Allow the partner to be near the operating room where the newborn's first cry can be heard. C) Have the partner wait in the client's postpartum room. D) Encourage the partner to be in the nursery for the initial assessment. E) Teach the partner how to take the client's blood pressure.

A, B, D

The nurse tells a mother that the doctor is preparing to circumcise her newborn. The mother expresses concern that the infant will be uncomfortable during the procedure. The nurse explains that the physician will numb the area before the procedure. Additional methods of comfort often used during the procedure include which of the following? Select all that apply. A) Providing a pacifier B) Stroking the head C) Restraining both arms and legs D) Talking to the infant E) Giving the infant a sedative before the procedure

A, B, D

1) A 30-year-old patient who experiences severe premenstrual syndrome every month asks for nonpharmacologic suggestions to treat this disorder. What should the nurse recommend? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Eat more frequent meals B) Engage in aerobic activity C) Limit alcohol to two drinks per day D) Restrict the intake of chocolate and coffee E) Increase the intake of fruits and vegetables

A, B, D, E

1) The nurse is discussing the use of contraception with a client who has just become sexually active. What factors should the nurse include when educating the client on contraceptive methods? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Contraindications in the client's health history B) Religious or moral beliefs C) Partner's belief in the effectiveness of the choice D) Personal preferences to use method E) Future childbearing plans

A, B, D, E

1) The nurse is preparing an educational session for high school female students on self-care during menstruation. What should the nurse include regarding care when using a tampon? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Wash hands before inserting a tampon B) Wash hands after inserting the tampon C) Change the tampon every 8 to 12 hours D) Use tampons with the minimum amount of absorbency E) Avoid touching the part that will be inserted into the vagina

A, B, D, E

Remedies for back pain in pregnancy that are supported by research evidence and may safely be taught to any pregnant woman by the nurse include which of the following? Select all that apply. A) Pelvic tilt B) Water aerobics C) Sit-ups D) Proper body mechanics E) Good posture is important because it allows more room for the stomach to function.

A, B, D, E

The nurse is caring for a newborn with jaundice. The parents question why the newborn is not under phototherapy lights. The nurse explains that the fiber-optic blanket is beneficial because of which of the following? Select all that apply. A) Lights can stay on all the time. B) The eyes do not need to be covered. C) The lights will need to be removed for feedings. D) Newborns do not get overheated. E) Weight loss is not a complication of this system.

A, B, D, E

The nurse is planning an early-pregnancy class session on nutrition. Which information should the nurse include? Select all that apply. A) Protein is important for fetal development. B) Iron helps both mother and baby maintain the oxygen-carrying capacity of the blood. C) Calcium prevents constipation at the end of pregnancy. D) Zinc facilitates synthesis of R N A and D N A. E) Vitamin A promotes development of the baby's eyes.

A, B, D, E

1) In learning about Duvall's life-cycle stages ascribed to traditional families, the nursing student recognizes that developmental tasks of each stage include which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Adjusting to new roles as mother and father B) Working out authority and socialization roles with the school C) Becoming a single parent with custodial responsibilities D) Becoming a couple and dating E) Adjusting to the loss of a spouse

A, B, E

1) The 22-year-old client is scheduled for her first gynecologic examination. What can the nurse do to make the client more comfortable during this exam? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Create a trusting atmosphere. B) Show the client what the speculum looks like. C) Avoid telling the client what the exam involves. D) Ask the client why she has delayed her first Pap test this long. E) Provide a mirror for the client.

A, B, E

During labor, the client at 4 c m suddenly becomes short of breath, cyanotic, and hypoxic. The nurse must prepare or arrange immediately for which of the following? Select all that apply. A) Intravenous access B) Cesarean delivery C) Immediate vaginal delivery D) McRoberts maneuver E) A crash cart

A, B, E

Fetal factors that possibly indicate electronic fetal monitoring include which of the following? Select all that apply. A) Meconium passage B) Multiple gestation C) Preeclampsia D) Grand multiparity E) Decreased fetal movement

A, B, E

The client and her partner are carriers of sickle cell disease. They are considering prenatal diagnosis with either amniocentesis or chorionic villus sampling (C V S). Which statements indicate that further teaching is needed on these two diagnostic procedures? Select all that apply. A) "Chorionic villus sampling carries a lower risk of miscarriage." B) "Amniocentesis can be done earlier in my pregnancy than C V S." C) "Neither test will conclusively diagnose sickle cell disease in our baby." D) "The diagnosis comes sooner if we have C V S, not amniocentesis." E) "Amniocentesis is more accurate in diagnosis than the C V S."

A, B, E

The client presents to the labor and delivery unit stating that her water broke 2 hours ago. Indicators of normal labor include which of the following?. Select all that apply. A) Fetal heart rate of 130 with average variability B) Blood pressure of 130/80 C) Maternal pulse of 160 D) Protein of +1 in urine E) Odorless, clear fluid on underwear

A, B, E

The nurse is administering erythromycin (Ilotycin) ointment to a newborn. What factors are associated with administration of this medication? Select all that apply. A) The medication should be instilled in the lower conjunctival sac of each eye. B) The eyelids should be massaged gently to distribute the ointment. C) The medication must be given immediately after delivery. D) The medication does not cause any discomfort to the infant. E) The medication can interfere with the baby's ability to focus.

A, B, E

The nurse is teaching the pregnant client about the symptoms of preeclampsia. Which clinical manifestations will the nurse include in the teaching session? Select all that apply. A) Dizziness B) Blurred vision C) Abdominal pain D) Vaginal bleeding E) Severe headache

A, B, E

To maintain a healthy temperature in the newborn, which of the following actions should be taken? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Keep the newborn's clothing and bedding dry. B) Reduce the newborn's exposure to drafts. C) Do not use the radiant warmer during procedures. D) Do not wrap the newborn. E) Encourage the mother to snuggle with the newborn under blankets.

A, B, E

Which statements by a breastfeeding class participant indicate that teaching by the nurse was effective? Select all that apply. A) "Breastfed infants get more skin-to-skin contact and sleep better." B) "Breastfeeding raises the level of a hormone that makes me feel good." C) "Breastfeeding is complex and difficult, and I probably won't succeed." D) "Breastfeeding is worthwhile, even if it costs more overall." E) "Breastfed infants have fewer digestive and respiratory illnesses."

A, B, E

1) Before performing Leopold maneuvers, what would the nurse do? Select all that apply. A) Have the client empty her bladder. B) Place the client in Trendelenburg position. C) Have the client lie on her back with her feet on the bed and knees bent. D) Turn the client to her left side. E) This is not the optimal position for the client when performing Leopold maneuvers.

A, C

The pregnant client states she does not want "to take all these supplements." What recommendations could the nurse make for the client? Select all that apply. A) "Folic acid has been found to be essential for minimizing the risk of neural tube defects." B) "You do not have to take these supplements if you think you are healthy enough." C) "Most women do not have adequate intake of iron pre-pregnancy, and iron needs increase with pregnancy." D) "These medications do the same thing. I will call your physician to cancel one of your medications." E) "You should take the folic acid, but the vitamins are not that important."

A, C

What are the primary complications of placenta accreta? Select all that apply. A) Maternal hemorrhage B) Insomnia C) Failure of the placenta to separate following birth of the infant D) Autonomic dysreflexia E) Shoulder dystocia

A, C

1) A client is being prepared to take the oral mifepristone-vaginal misoprostol treatment for an abortion. For which reasons should the nurse instruct the client to contact the healthcare provider within 24 hours? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Nausea B) Itchy skin C) Weakness D) Stomach pain E) Bloody discharge

A, C, D

1) The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected? Select all that apply. A) The client's chest circumference has increased by 6 cm during the pregnancy. B) The client has a narrowed subcostal angle. C) The client is using thoracic breathing. D) The client may have epistaxis. E) The client has a productive cough.

A, C, D

1) The nurse is presenting a session on intimate partner violence. Which statement by a client indicates a need for further education? A) "My daughter is not to blame for the violence in her marriage." B) "Everyone experiences anger and hitting in a relationship." C) "Abusers can be either husbands or boyfriends or girlfriends." D) "The 'honeymoon period' follows an episode of violence."

1) The nurse is reviewing the spermicidal agent nonoxynol-9 (N-9) with a client planning to use the barrier method to prevent pregnancy. What should the nurse emphasize when teaching about this preparation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) It does not cause toxicity. B) It is inserted after intercourse. C) It has no systemic side effects. D) It can be purchased over-the-counter. E) It reduces the risk of sexually transmitted infections.

A, C, D

1) The nurse suspects that a client is experiencing adverse effects from the progestin within a combined oral contraceptive. What did the nurse assess to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Pruritus B) Headache C) Hirsutism D) Weight gain E) Hypertension

A, C, D

A postpartum mother questions whether the environmental temperature should be warmer in the baby's room at home. The nurse responds that the environmental temperature should be warmer for the newborn. This response is based on which newborn characteristics that affect the establishment of thermal stability? Select all that apply. A) Newborns have less subcutaneous fat than do adults. B) Infants have a thick epidermis layer. C) Newborns have a large body surface to weight ratio. D) Infants have increased total body water. E) Newborns have more subcutaneous fat than do adults.

A, C, D

Postpartum nutritional status is determined primarily by assessing which of the following? Select all that apply. A) Dietary history B) Menstrual history C) Mother's weight D) Hemoglobin levels E) Mother's height

A, C, D

The nurse encourages a new mother to feed the newborn as soon as the newborn shows interest. The nurse bases this recommendation on which benefits of early feedings? Select all that apply. A) Early feedings stimulate peristalsis. B) Colostrum is thinner than mature milk. C) Early feedings enhance maternal-infant bonding. D) Early feedings promote the passage of meconium. E) Colostrum contains a high number of calories.

A, C, D

The nurse initiates newborn admission procedures and evaluates the newborn's need to remain under observation by assessing which of the following? Select all that apply. A) Respiratory rate B) Skin texture C) Airway clearance D) Ability to feed E) Head weight

A, C, D

The nurse is teaching the parents of a newborn who has been exposed to H I V how to care for the newborn at home. Which instructions should the nurse emphasize? Select all that apply. A) Use proper hand-washing technique. B) Provide three feedings per day. C) Place soiled diapers in a sealed plastic bag. D) Cleanse the diaper changing area with a 1:10 bleach solution after each diaper change. E) Take the temperature rectally.

A, C, D

1) During an assessment, the nurse determines that a female patient is at risk for developing osteoporosis. Which information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Body weight of 120 lb B) Plays tennis twice a week C) Smokes 2 packs per day of cigarettes D) Ingests 2 to 3 cocktails every day E) Mother diagnosed with osteoporosis

A, C, D, E

1) If a woman returns to an abusive situation, the nurse should encourage her to develop an exit, or safety, plan for herself and her children, if she has any. What should the plan include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Identify friends and family who know about the situation and will help her. B) Call the police if violence begins. C) Pack a change of clothes for herself and the children. D) Have a plan for where she will go. E) Have a planned escape route.

A, C, D, E

Antibiotics have been ordered for a newborn with an infection. Which interventions would the nurse prepare to implement? Select all that apply. A) Obtain skin cultures. B) Restrict parental visits. C) Evaluate bilirubin levels. D) Administer oxygen as ordered. E) Observe for signs of hypoglycemia.

A, C, D, E

The nurse is caring for a client and her spouse during the third stage of labor. Which action(s) support initial parental-newborn attachment at this time? Select all that apply. A) Minimizing assessments B) Delaying ophthalmic antibiotics for 2 hours C) Dimming the room lights D) Talking quietly E) Providing privacy

A, C, D, E

The nurse is conducting an initial prenatal assessment for a pregnant client. Which screenings should the nurse prepare the client for during this visit? Select all that apply. A) Complete blood count (C B C) B) Glucose tolerance test (G T T) C) A B O and Rh typing D) H I V screening E) Urinalysis

A, C, D, E

The nurse should inform the parents of a newborn that they should call their healthcare provider when which of the following occurs? Select all that apply. A) Continual rise in temperature B) Decreased frequency of stools C) Absence of breathing longer than 20 seconds D) Lethargy E) Refusal of two feedings in a row

A, C, D, E

When general anesthesia is necessary for a cesarean delivery, what should the nurse be prepared to do? Select all that apply. A) Administer an antacid to the client. B) Place a wedge under the client's thigh. C) Apply cricoid pressure to the client during anesthesia intubation. D) Preoxygenate the client for 3-5 minutes before anesthesia. E) Place a Foley catheter in the client's bladder.

A, C, D, E

Which of the following are important behaviors to assess in the neurologic assessment? Select all that apply. A) State of alertness B) Active posture C) Quality of muscle tone D) Cry E) Motor activity

A, C, D, E

1) Among women who have been sexually assaulted, which of the following are the most frequently diagnosed sexually transmitted infections (S T Is)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Bacterial vaginosis B) H I V C) Chlamydia D) Syphilis E) Gonorrhea

A, C, E

The nurse understands that a client's pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks' gestation? Select all that apply. A) The joints of the pelvis have relaxed, causing a waddling gait. B) The cervix is firm and blue-purple in color. C) The uterus vasculature contains one sixth of the total maternal blood volume. D) Gastric emptying time is delayed, and the client complains of constipation and bloating. E) Supine hypotension occurs when the client lies on her back.

A,C,D,E

1) The nurse manager is consulting with a certified nurse-midwife about a client. What is the role of the C N M? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth. B) Give primary care for high-risk clients who are in hospital settings. C) Give primary care for healthy newborns. D) Obtain a physician consultation for any technical procedures at delivery. E) Be educated in two disciplines of nursing.

A, C, E

1) When a woman seeks care for an injury, the nurse should be alert to which clues of abuse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Defensive injuries B) Immediate reporting of symptoms or seeking care for injuries C) Lack of eye contact D) Providing too much detailed information about the injury E) Vague complaints without accompanying pathology

A, C, E

25) The nurse is serving on a panel to evaluate the hospital staff's reliance on evidence-based practice in their decision-making processes. Which practices characterize the basic competencies related to evidence-based practice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Recognizing which clinical practices are supported by good evidence B) Recognizing and including clinical practice supported by intuitive evidence C) Using data in clinical work to evaluate outcomes of care D) Including quality-improvement measures in clinical practice E) Appraising and integrating scientific bases into practice

A, C, E

The newborn's cry should have which of the following characteristics? Select all that apply. A) Medium pitch B) Shrillness C) Strength D) High pitch E) Lusty

A, C, E

Women with eating disorders who become pregnant are at risk for a variety of complications including which of the following? Select all that apply. A) Premature birth B) Too many nutrients available for the fetus C) Miscarriage D) High birth weight E) Perinatal mortality

A, C, E

A new mother is concerned about a mass on the newborn's head. The nurse assesses this to be a cephalohematoma based on which characteristics? Select all that apply. A) The mass appeared on the second day after birth. B) The mass appears larger when the newborn cries. C) The head appears asymmetrical. D) The mass appears on only one side of the head. E) The mass overrides the suture line.

A, D

The nurse is admitting a client who was diagnosed with hydramnios. The client asks why she has developed this condition. The nurse should explain that hydramnios is sometimes associated with which of the following? Select all that apply. A) Rh sensitization B) Postmaturity syndrome C) Renal malformation or dysfunction D) Maternal diabetes E) Large-for-gestational-age infants

A, D

1) A female patient asks what can be done to control vaginal odor. How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Wear cotton underwear B) Use a mild vaginal deodorant C) Schedule douching to occur weekly D) Cleanse from front to back when toileting E) Use soap and water to cleanse the perineum

A, D, E

The nurse is caring for a postpartum client who is experiencing afterpains following the birth of her third child. Which comfort measure should the nurse implement to decrease her pain? Select all that apply. A) Offer a warm water bottle for her abdomen. B) Call the physician to report this finding. C) Inform her that this is not normal, and she will need an oxytocic agent. D) Administer a mild analgesic to help with breastfeeding. E) Administer a mild analgesic at bedtime to ensure rest.

A, D, E

1) In assessing a new family coming to the clinic, the nurse determines they are an extended kin family because the family exhibits what as characteristics of an extended kin network family? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) A sharing of a social support network B) Each family establishes their own sources of goods and services C) Elderly parents share housing D) Children are members of two nuclear families E) A sharing of goods and services

A, E

The nurse is preparing an educational in-service presentation about jaundice in the newborn. What content should the nurse include in this presentation? Select all that apply. A) Physiologic jaundice occurs after 24 hours of age. B) Pathologic jaundice occurs after 24 hours of age. C) Phototherapy increases serum bilirubin levels. D) The need for phototherapy depends on the bilirubin level and age of the infant. E) Kernicterus causes irreversible neurological damage.

A, E

The pregnant teen who was prescribed prenatal vitamins at her initial prenatal visit states that she does not like to take them. How should Select all that apply. A) "Folic acid has been found to be essential for minimizing the risk of neural tube defects." B) "You do not have to take these supplements if you think you are healthy enough." C) "These medications do the same thing. I will call your doctor to cancel one of your medications." D) "You can trust your doctor to know what you need." E) "You need the supplements because your dietary intake may not be adequate for fetal development."

A, E

The nurse is cross-training maternal-child health unit nurses to provide home-based care for parents after discharge. Which statements indicate that additional teaching is required? Select all that apply. A) "The behavioral assessment should be done as soon after birth as possible." B) "The behavioral assessment can be performed without input from parents." C) "The behavioral assessment might be incomplete in a 1-hour home visit." D) "The behavioral assessment includes orientation and motor activity." E) "The behavioral assessment can detect neurological impairments."

A,B

Which of the following are potential disadvantages to breastfeeding? Select all that apply. A) Pain with breastfeeding B) Leaking milk C) Equal feeding responsibilities with fathers D) Vaginal wetness E) Embarrassment

A,B,E

A nurse is instructing nursing students about the procedure for vitamin K administration. What information should be included? Select all that apply. A) Gently massage the site after injection. B) Use a 22-gauge, 1-inch needle. C) Inject in the vastus lateralis muscle. D) Cleanse the site with alcohol prior to injection. E) Inject at a 45-degree angle.

A,C,D

1) A client is concerned about her risk for breast cancer. Following the initial history, the nurse identifies which of the following as a high risk factor for breast cancer? A) History of late menarche and early menopause B) Sister who has had breast cancer C) Mother with fibrocystic breast disease D) Multiparity

1) A client who has been using transdermal hormonal contraception comes in for a routine wellness visit. Which finding should cause the nurse to question if the client should continue to use this form of contraception? A) Body weight of 179 lb B) Skin breakdown at the site of the patch C) Drinks 2 cups of caffeinated coffee a day D) Bicycles at the gym three evenings a week

1) A couple who came to the United States two years ago with their two children are seeing the nurse in the community clinic. The nurse knows their family is acculturating when the mother makes which statement? A) "The children are much less well-behaved than they used to be." B) "Our diet now includes hamburgers and French fries." C) "We celebrate the same holidays that we used to at home." D) "When the children leave the house, I worry about them."

1) A menopausal woman tells her nurse that she experiences discomfort from vaginal dryness during sexual intercourse, and asks, "What should I use as a lubricant?" The nurse should recommend which of the following? A) Petroleum jelly B) A water-soluble lubricant C) Body cream or body lotion D) Less-frequent intercourse

1) A nursing student investigating potential career goals is strongly considering becoming a nurse practitioner (N P). The major focus of the N P is on which of the following? A) Leadership B) Physical and psychosocial clinical assessment C) Independent care of the high-risk pregnant client D) Tertiary prevention

1) A patient with a rectocele is experiencing progressive pain and constipation. What should the nurse expect to be indicated for this patient? A) Enemas B) Surgery C) Laxatives D) Antibiotics

1) After reviewing approaches for contraception with a female client, the nurse is concerned that barrier methods will not achieve the client's goal to prevent pregnancy. What did the client say to cause the nurse to draw this conclusion? A) "My partner doesn't mind wearing condoms." B) "I don't want to have to put anything in myself." C) "We should use a condom even with a diaphragm." D) "I know that spermicides are inserted before intercourse."

1) An older female patient is concerned about the finances needed to run her home. What event in this person's life should the nurse realize is causing her financial concern? A) Change in the number of prescribed medications B) Recent death of spouse after a long and costly illness C) Participation in activities at the community center D) Relocation of older children to another city

1) Extended use of combined oral contraceptives (C O Cs) reduces the side effects of C O Cs such as which of the following? A) Cramping B) Hypertension C) Breast tenderness D) Bloating

1) The clinic nurse is returning phone calls. Which call should the nurse return first? A) The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month B) The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day C) The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control D) The call from a 34-year-old requesting information on douching after intercourse

1) The nurse at a women's clinic is reviewing a new client health information questionnaire. Which question does she find to be insulting and discriminatory toward lesbian clients? A) Who should be contacted in case of emergency? B) What method of birth control do you use? C) How often do you drink alcohol? D) Do you feel safe in your relationship?

1) The nurse has presented a community education class on recommended health screenings for women. Which statement about the Pap smear by a class member indicates that additional teaching is necessary? A) "It is recommended for women 21 years of age and older." B) "It diagnoses cervical cancer." C) "Intercourse at a young age is a risk factor for an abnormal Pap smear." D) "Detects abnormal cells."

1) The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? A) Encourage oral fluids B) Administer cefotetan Ⅳ C) Enforce bed rest D) Remove I U C, if present

1) The nurse is planning teaching for a patient diagnosed with hepatitis A. What should the nurse emphasize when instructing the patient about this disease process? A) It is a chronic illness B) It is not a chronic illness C) A vaccination is not available D) It occurs in East and South Asia

1) The nurse is preparing an education session for women on the prevention of urinary tract infections (U T Is). Which statement should be included? A) Lower urinary tract infections rarely occur in women. B) The most common causative organism of cystitis is E. coli. C) Wiping from back to front after a B M will help prevent a U T I. D) Back pain often develops with a lower urinary tract infection.

1) The nurse is preparing an educational seminar about the frequency of intimate partner violence against females. Using the chart below, which age group should the nurse identify as experiencing the most intimate partner violence in 2010? A) 12-17 B) 18-24 C) 25-34 D) 35-49

1) The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes? A) "I should douche daily to prevent infection." B) "I could have another breakout during my period." C) "I am more likely to develop cancer of the cervix." D) "I should use sodium bicarbonate on the lesions to relieve discomfort."

1) The nurse is reviewing laboratory testing completed for a patient with suspected pelvic inflammatory disease. Which test result should the nurse identify as supporting this diagnosis? A) Decreased hematocrit level B) Elevated sedimentation rate C) Decreased hemoglobin level D) Elevated white blood cell count

1) The nurse is seeing clients in the women's clinic. Which client should be treated with ceftriaxone I M and doxycycline orally? A) A pregnant client with gonorrhea and a yeast infection B) A nonpregnant client with gonorrhea and chlamydia C) A pregnant client with syphilis D) A nonpregnant client with chlamydia and trichomoniasis

1) The nurse is teaching a community education class on complementary and alternative therapies. To assess learning, the nurse asks, "In traditional Chinese medicine, what is the invisible flow of energy in the body that maintains health and ensures physiologic functioning?" Which answer indicates that teaching was successful? A) Meridians B) Chi C) Yin D) Yang

1) The nurse is working with a client whose religious beliefs differ from those of the general population. What is the best nursing intervention to use to meet the specific spiritual needs of this family? A) Ask how important the client's religious and spiritual beliefs are when making decisions about health care. B) Show respect while allowing time and privacy for religious rituals. C) Ask for the client's opinion on what caused the illness. D) Identify healthcare practices forbidden by religious or spiritual beliefs.

1) The nurse manager in a hospital with a large immigrant population is planning an in-service. Aware of how ethnocentrism affects nursing care, the nurse manager asks, "The belief that one's own values and beliefs are the only or the best values has which of the following results?" A) It implies newcomers to the United States should adopt the norms and values of the country. B) It can create barriers to communication through misunderstanding. C) It leads to an expectation that all clients will exhibit pain the same way. D) It improves the quality of care provided to culturally diverse client bases.

1) The nurse receives a phone call from a 25-year-old woman experiencing breast tenderness in the week prior to her menses, with palpable breast nodularity, without nipple discharge. What is the best response by the nurse? A) "Please make an appointment at the breast cancer center as soon as possible." B) "How much salty food do you regularly consume?" C) "As long as you don't have nipple discharge, it isn't a serious condition." D) "Eliminate caffeine and chocolate from your diet."

1) The nurse recognizes that what are the most common disabilities in women? A) Asthma and headaches B) Arthritis or rheumatism C) Adverse kidney and nervous system functioning D) Cardiovascular diseases

1) The nurse who is taking a sexual history from a client should do which of the following? A) Ask questions that the client can answer with "yes" or "no." B) Ask mostly open-ended questions. C) Have the client fill out a comprehensive questionnaire and review it after the client leaves. D) Try not to make much direct eye contact.

1) The nurse working at a homeless shelter is studying case statistics. Of the total homeless population served at the shelter, which group would the nurse's statistics likely uncover as the fastest-growing group? A) Unemployed women B) Families with children C) The mentally ill D) The elderly

1) Which myth regarding rape will the community health nurse include in a teaching session within the community? A) Rape is a type of sexual assault. B) Women lie about rape as an act of revenge. C) Both men and women can be victims of rape. D) Rape is one of the most underreported violent crimes.

1) Which of the following best describes a nuclear family? A) An unmarried woman who chooses to conceive or adopt without a life partner. B) Children live in a household with both biologic parents and no other relatives or persons. C) A couple shares household and childrearing responsibilities with parents, siblings, or other relatives. D) The head of the household is widowed, divorced, abandoned, separated, or most often, the mother remains unmarried.

1) While attending a community fair the nurse is surprised to learn the number of women who are homemakers, teachers, and nurses. What impact should the nurse recognize that this has on these individuals' income? A) Potential for longer lifespan B) Overall lower income than men C) Reduced risk for chronic illnesses D) Increased risk for health problems

7) A fetus has been diagnosed with myelomeningocele. Which of the following surgeries would be performed to correct this condition? A) Tubal ligation B) Intrauterine fetal surgery C) Cesarean section D) Sterilization

7) A maternity client is in need of surgery. Which healthcare member is legally responsible for obtaining informed consent for an invasive procedure? A) The nurse B) The physician C) The unit secretary D) The social worker

7) A nurse is providing guidance to a group of parents of children in the infant-to-preschool age group. After reviewing statistics on the most common cause of death in this age group, the nurse includes information about prevention of which of the following? A) Cancer by reducing the use of pesticides in the home B) Accidental injury by reducing the risk of pool and traffic accidents C) Heart disease by incorporating heart-healthy foods into the child's diet D) Pneumonia by providing a diet high in vitamin C from fruits and vegetables

7) The nurse is explaining the difference between descriptive statistics and inferential statistics to a group of student nurses. To illustrate descriptive statistics, what would the nurse use as an example? A) A positive correlation between breastfeeding and infant weight gain B) The infant mortality rate in the state of Oklahoma C) A causal relationship between the number of sexual partners and sexually transmitted infections D) The total number of spontaneous abortions in drug-abusing women as compared with non-drug-abusing women

7) The nurse is reviewing care of clients on a mother-baby unit. Which situation should be reported to the supervisor? A) A 2-day-old infant has breastfed every 2-3 hours and voided four times. B) An infant was placed in the wrong crib after examination by the physician. C) The client who delivered by cesarean birth yesterday received oral narcotics. D) A primiparous client who delivered today is requesting discharge within 24 hours.

A Chinese woman who is 12 weeks pregnant reports to the nurse that ginseng and bamboo leaves help reduce her anxiety. How should the nurse respond to this client? A) Advise the client to give up the bamboo leaves but to continue taking ginseng. B) Advise the client to discuss all herbal remedies with the provider. C) Tell the client that the provider thinks the remedies have no scientific foundation. D) Assess where the client obtains her remedy, and investigate the source.

A client at 16 weeks' gestation has a hematocrit of 35%. Her prepregnancy hematocrit was 40%. Which statement by the nurse best explains this change? A) "Because of your pregnancy, you're not making enough red blood cells." B) "Because your blood volume has increased, your hematocrit count is lower." C) "This change could indicate a serious problem that might harm your baby." D) "You're not eating enough iron-rich foods like meat."

A client at 37 weeks' gestation has a mildly elevated blood pressure. Her antenatal testing demonstrates three contractions in 10 minutes, no decelerations, and accelerations four times in 1 hour. What would this test be considered? A) Positive nonstress test B) Negative contraction stress test C) Positive contraction stress test D) Negative nonstress test

A client in labor is found to have meconium-stained amniotic fluid upon rupture of membranes. At delivery, the nurse finds the infant to have depressed respirations and a heart rate of 80. What does the nurse anticipate? A) Delivery of the neonate on its side with head up, to facilitate drainage of secretions. B) Direct tracheal suctioning by specially trained personnel. C) Preparation for the immediate use of positive pressure to expand the lungs. D) Suctioning of the oropharynx when the newborn's head is delivered.

A client presents to the antepartum clinic with a history of a 20-pound weight loss. Her pregnancy test is positive. She is concerned about gaining the weight back, and asks the nurse if she can remain on her diet. What is the nurse's best response? A) "As long as you supplement your diet with the prenatal vitamin, the amount of weight you gain in pregnancy is not significant." B) "I understand that gaining weight after such an accomplishment might not appeal to you but weight gain during pregnancy is important for proper fetal growth." C) "Dieting during pregnancy is considered child neglect." D) "Excessive weight gain in pregnancy is due to water retention, so weight loss following birth will not be an issue."

A client received epidural anesthesia during the first stage of labor. The epidural is discontinued immediately after delivery. This client is at increased risk for which problem during the fourth stage of labor? A) Nausea B) Bladder distention C) Uterine atony D) Hypertension

A client was admitted to the labor area at 5 c m with ruptured membranes about 14 hours ago. What assessment data would be most beneficial for the nurse to collect? A) Blood pressure B) Temperature C) Pulse D) Respiration

A client who is at 8 weeks of gestation tells the nurse "I am not sure I am happy about being pregnant." Which of the following responses should the nurse make? A) "I will inform the provider that you are having these feelings." B) "It is normal to have these feelings during the first few months of pregnancy." C) "You should be happy that you are going to bring new life into the world." D) "I am going to make an appointment with the counselor for you to discuss these thoughts."

A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice? A) Lightening of the nipples and areolas B) Reddish streaks called striae on her abdomen C) A decrease in hair thickness D) Small purplish dots on her face and arms

A fetal weight is estimated at 4490 grams in a client at 38 weeks' gestation. Counseling should occur before labor regarding which of the following? A) Mother's undiagnosed diabetes B) Likelihood of a cesarean delivery C) Effectiveness of epidural anesthesia with a large fetus D) Need for early delivery

A mother who is H I V-positive has given birth to a term female. What plan of care is most appropriate for this infant? A) Test with an H I V serologic test at 8 months. B) Begin prophylactic A Z T (Zidovudine) administration. C) Provide 4 to 5 large feedings throughout the day. D) Encourage the mother to breastfeed the child.

A new mother is holding her 2-hour-old son. The delivery occurred on the due date. His Apgar score was 9 at both 1 and 5 minutes. The mother asks the nurse why her son was so wide awake right after birth, and now is sleeping so soundly. What is the nurse's best response? A) "Don't worry. Babies go through a lot of these little phases." B) "Your son is in the sleep phase. He'll wake up soon." C) "Your son is exhausted from being born, and will sleep 6 more hours." D) "Your breastfeeding efforts have caused excessive fatigue in your son."

A new mother who is breastfeeding tells the nurse that her infant is spitting up frequently, has very loose stools and copious gas, and feeds for only short periods of time. The nurse suspects a feeding intolerance and, after questioning the mother about her diet, suggests that she do which of the following? A) Stop breastfeeding and switch to formula. B) Eliminate dairy products from her diet. C) Supplement breastfeeding with a soy-based formula. D) Offer the baby water between feedings.

A nurse examining a prenatal client recognizes that a lag in progression of measurements of fundal height from week to week and month to month could signal what condition? A) Twin pregnancy B) Intrauterine growth restriction C) Hydramnios Breech position

A nurse in a prenatal clinic is caring for four clients. Which of the following clients's weight gain should the nurse report to the provider? A) 1.8kg (4lb) 1st trimester B) 3.6kg (8lb) 1st trimester C) 6.8kg (15lb) 2nd trimester D) 11.3 (25lb) 3rd trimester

A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states "I missed one menstrual cycle and cannot be pregnant because I have an IUD." The nurse should suspect which of the following? A) Missed abortion B) Ectopic pregnancy C) Severe preeclampsia D) Hydatidiform mole

A nurse is assessing a postpartum client for fundal height, location, and consistency. The fundus is noted to be displaced laterally to the right, and there is uterine atony. The nurse should identify which of the following conditions as the cause for uterine atony? A. Poor involution B. Urinary retention C. Hemorrhage D. Infection

A nurse is caring for a client who is 40 weeks of gestation and reports having large gush of fluid from the vagina while walking from the bathroom. Which of the following actions should the nurse take first? A. Examine the amniotic fluid for meconium B. Check the FHR C. Dry the client and make them comfortable D. Apply a tocotransducer

A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation between hypertonic contractions. The nurse should identify that this contraction pattern increases the risk for which of the following complications? A) Prolonged labor B) Reduced fetal oxygen supply C) Delayed cervical dilation D) Increased maternal stress

A nurse is completing an admission assessment for a client who is 39 weeks of gestation and reports fluid leaking from the vagina for 2 days. Which of the following conditions is the client at risk for developing? A. Cord prolapse B. Infection C. Postpartum hemorrhage D. Hydramnios

A nurse is completing postpartum discharge teaching to a client who had no immunity to varicella and was given the varicella vaccine. Which of the following statements by the client indicates an understanding of the teaching? A. "I will need to use contraception for 3 months before considering pregnancy" B. "I need a second vaccination at my postpartum visit. C. "I was given the vaccine because my baby is O-positive" D. "I will be tested in 3 months to see if I have developed immunity."

A nurse is evaluating the diet plan of a breastfeeding mother, and determines that her intake of fruits and vegetables is inadequate. The nurse explains that the nutritional composition of the mother's breast milk can be adversely affected by this nutritional inadequacy. Which strategy should the nurse recommend to the mother? A) Stop breastfeeding B) Provide newborn supplements to the newborn C) Offer whole milk D) Supplement with skim milk

A nurse is evaluating the diet plan of a breastfeeding mother. Which beverage is most likely to cause intolerance in the infant? A) Orange juice B) Milk C) Decaffeinated tea D) Water

A patient at 28 weeks' gestation asks the nurse why she has backaches. To help explain the changes, the nurse shows her a picture of the shape of her back. Which picture should the nurse use? A) A B) B C) C D) D

A postpartum mother is concerned that her newborn has not had a stool since birth. The newborn is 18 hours old. What is the nurse's best response? A) "I will call your pediatrician immediately." B) "Passage of the first stool within 48 hours is normal." C) "Your newborn might not have a stool until the third day." D) "Your newborn must be dehydrated."

A pregnant client who swims 3-5 times per week asks the nurse whether she should stop this activity. What is the appropriate nursing response? A) "You should decrease the number of times you swim per week." B) "Continuing your exercise program would be beneficial." C) "You should discontinue your exercise program immediately." D) "You should consider a less strenuous type of exercise."

A pregnant patient is having pelvic measurements made. Which approach should the examiner use to determine this patient's estimated length of the pubic ramus? A) A B) B C) C D) D

A pregnant patient is scheduled to have the procedure depicted in the diagram performed. What should the nurse explain is the purpose for this procedure? (PICTURE) A) Correct marginal placenta previa B) Prevent preterm cervical dilatation and pregnancy loss C) Reduce the risk of developing central abruptio placentae D) Assist the fetus to rotate into the appropriate position for delivery

A pregnant teenage client is diagnosed with iron-deficiency anemia. Which nutrient should the nurse encourage her to take to increase iron absorption? A) Vitamin A B) Vitamin C C) Vitamin D D) Vitamin E

A prenatal educator is asking a partner about normal psychologic adjustment of an expectant mother during the second trimester of pregnancy. Which answer by the partner would indicate a typical expectant mother's response to pregnancy? A) "She is very body-conscious, and hates every little change." B) "She daydreams about what kind of parent she is going to be." C) "I haven't noticed anything. I just found out she was pregnant." D) "She has been having dreams at night about misplacing the baby."

A woman has been admitted for an external version. She has completed an ultrasound exam and is attached to the fetal monitor. Prior to the procedure, why will terbutaline be administered? A) To provide analgesia B) To relax the uterus C) To induce labor D) To prevent hemorrhage

A woman in labor asks the nurse to explain the electronic fetal heart rate monitor strip. The fetal heart rate baseline is 150 with accelerations to 165, variable decelerations to 140, and moderate long-term variability. Which statement indicates that the client understands the nurse's teaching? A) "The most important part of fetal heart monitoring is the absence of variable decelerations." B) "The most important part of fetal heart monitoring is the presence of variability." C) "The most important part of fetal heart monitoring is the fetal heart rate baseline." D) "The most important part of fetal heart monitoring is the depth of decelerations."

An H I V-positive mother delivered 2 days ago. The infant will be placed in foster care. The nurse is planning discharge teaching for the foster parents on how to care for the newborn at home. Which instructions should the nurse include? A) Do not add food supplements to the baby's diet. B) Place soiled diapers in a sealed plastic bag. C) Wash soiled linens in cool water with bleach. D) Shield the baby's eyes from bright lights.

Before applying a cord clamp, the nurse assesses the umbilical cord. The mother asks why the nurse is doing this. What should the nurse reply? A) "I'm checking the blood vessels in the cord to see whether it has one artery and one vein." B) "I'm checking the blood vessels in the cord to see whether it has two arteries and one vein." C) "I'm checking the blood vessels in the cord to see whether it has two veins and one artery." D) "I'm checking the blood vessels in the cord to see whether it has two arteries and two veins."

Carbohydrates provide the body's primary source of energy as well as fiber necessary for proper bowel functioning. If the carbohydrate intake is not adequate, the body will use which of the following for energy? A) Iron B) Protein C) Vitamin C D) Vitamin D

During labor, the fetus was in a brow presentation, but after a prolonged labor, the fetus converted to face presentation and was delivered vaginally with forceps assist. What should the nurse explain to the parents? A) The infant will need to be observed for meconium aspiration. B) Facial edema and head molding will subside in a few days. C) The infant will be given prophylactic antibiotics. D) Breastfeeding will need to be delayed for a day or two.

During the examination of a patient who is pregnant 24 weeks, the healthcare provider performs the maneuver in the diagram below. What is being measured on this patient? A) Subpubic angle B) Transverse diameter C) Anteroposterior sagittal diameter D) Height and angle of the symphysis pubis

During the nursing assessment of a woman with ruptured membranes, the nurse suspects a prolapsed umbilical cord. What would the nurse's priority action be? A) To help the fetal head descend faster B) To use gravity and manipulation to relieve compression on the cord C) To facilitate dilation of the cervix with prostaglandin gel D) To prevent head compression

Dystocia encompasses many problems in labor. What is the most common? A) Meconium-stained amniotic fluid B) Dysfunctional uterine contractions C) Cessation of contractions D) Changes in the fetal heart rate

Every time the nurse enters the room of a postpartum client who gave birth 3 hours ago, the client asks something else about her birth experience. What action should the nurse take? A) Answer questions quickly and try to divert her attention to other subjects. B) Review the documentation of the birth experience and discuss it with her. C) Contact the physician to warn him the client might want to file a lawsuit, based on her preoccupation with the birth experience. D) Submit a referral to Social Services because of possible obsessive behavior.

Forceps are being used to deliver the fetus of a laboring patient, as identified in the diagram. In which direction should the healthcare provider use the forceps to guide the fetus for delivery? (PICTURE) A) Upward and outward B) Downward and outward C) Midline and towards the left D) Midline and toward the right

If oligohydramnios occurs in the first part of pregnancy, the nurse knows that there is a danger of which of the following? A) Major congenital anomalies B) Fetal adhesions C) Maternal diabetes D) Rh sensitization

In succenturiate placenta, one or more accessory lobes of fetal villi have developed on the placenta, with vascular connections of fetal origin. What is the gravest maternal danger? A) Cord prolapse B) Postpartum hemorrhage C) Paroxysmal hypertension D) Brachial plexus injury

In utero, what is the organ responsible for gas exchange? A) Umbilical vein B) Placenta C) Inferior vena cava D) Right atrium

Mild or chronic anemia in an infant may be treated adequately by which of the following? A) Transfusions with O-negative or typed and cross-matched packed red cells B) Iron supplements or iron-fortified formulas C) Steroid therapy D) Antibiotics or antivirals

Narcotic analgesia is administered to a laboring client at 10:00 a.m. The infant is delivered at 12:30 p.m. What would the nurse anticipate that the narcotic analgesia could do? A) Be used in place of preoperative sedation B) Result in neonatal respiratory depression C) Prevent the need for anesthesia with an episiotomy D) Enhance uterine contractions

Nurses who are interacting with expectant families from a different culture or ethnic group can provide more effective, culturally sensitive nursing care by doing what? A) Recognizing that ultimately it is the family's right to make a woman's healthcare choices. B) Obtaining a medical interpreter of the language the client speaks. C) Evaluating whether the client's healthcare beliefs have any positive consequences for her health. D) Accepting personal biases, attitudes, stereotypes, and prejudices.

Of all the clients who have been scheduled to have a biophysical profile, the nurse should check with the physician to clarify the order for which client? A) A gravida with intrauterine growth restriction B) A gravida with mild hypotension of pregnancy C) A gravida who is postterm D) A gravida who complains of decreased fetal movement for 2 days

One day after giving birth vaginally, a client develops painful vesicular lesions on her perineum and vulva. She is diagnosed with a primary herpes simplex 2 infection. What is the expected care for her neonate? A) Meticulous hand washing and antibiotic eye ointment administration. B) Intravenous acyclovir (Zovirax) and contact precautions. C) Cultures of blood and C S F and serial chest x-rays every 12 hours. D) Parental rooming-in and four intramuscular injections of penicillin.

Placing the baby at mother's breast facilitates early latch and promotes successful breastfeeding. When should breastfeeding be initiated? A) 6 to 12 hours after birth B) Within 1 hour of birth C) 24 hours after birth D) 48 hours after birth

Slowly removing some amniotic fluid is a treatment for hydramnios. What consequence can occur with the withdrawal of fluid? A) Preterm labor B) Prolapsed cord C) Preeclampsia D) Placenta previa

The adolescent client reports to the clinic nurse that her period is late, but her home pregnancy test is negative. What should the nurse explain that these findings most likely indicate? A) "This means you are not pregnant." B) "You might be pregnant, but it might be too early for your home test to be accurate." C) "We don't trust home tests. Come to the clinic for a blood test." D) "Most people don't use the tests correctly. Did you read the instructions?"

The breastfeeding mother is concerned that her milk production has decreased. The nurse knows that further client teaching is needed based on which statement? A) "I am drinking a minimum of 8 to 10 glasses of liquid a day." B) "I have started cutting back on my protein intake." C) "At least three times a day, I drink a glass of milk." D) "My calorie intake is higher than during the pregnancy."

The client at 38 weeks' gestation has been diagnosed with oligohydramnios. Which statement indicates that teaching about the condition has been effective? A) "My gestational diabetes might have caused this problem to develop." B) "When I go into labor, I should come to the hospital right away." C) "This problem was diagnosed with blood and urine tests." D) "Women with this condition usually do not have a cesarean birth."

The client at 39 weeks' gestation is undergoing a cesarean birth due to breech presentation. General anesthesia is being used. Which situation requires immediate intervention? A) The baby's hands and feet are blue at 1 minute after birth. B) The fetal heart rate is 70 prior to making the skin incision. C) Clear fluid is obtained from the baby's oropharynx. D) The neonate cries prior to delivery of the body.

The client delivered 30 minutes ago. Her blood pressure and pulse are stable. Vaginal bleeding is scant. The nurse should prepare for which procedure? A) Abdominal hysterectomy B) Manual removal of the placenta C) Repair of perineal lacerations D) Foley catheterization

The client has been pushing for two hours, and is exhausted. The fetal head is visible between contractions. The physician informs the client that a vacuum extractor could be used to facilitate the delivery. Which statement indicates that the client needs additional information about vacuum extraction assistance? A) "A small cup will be put onto the baby's head, and a gentle suction will be applied." B) "I can stop pushing and just rest if the vacuum extractor is used." C) "The baby's head might have some swelling from the vacuum cup." D) "The vacuum will be applied for a total of ten minutes or less."

The client is in the second stage of labor. The fetal heart rate baseline is 170, with minimal variability present. The nurse performs fetal scalp stimulation. The client's partner asks why the nurse did that. What is the best response by the nurse? A) "I stimulated the top of the fetus's head to wake him up a little." B) "I stimulated the top of the fetus's head to try to get his heart rate to accelerate." C) "I stimulated the top of the fetus's head to calm the fetus down before birth." D) "I stimulated the top of the fetus's head to find out whether he is in distress."

The client presents for cervical ripening in anticipation of labor induction tomorrow. What should the nurse include in her plan of care for this client? A) Apply an internal fetal monitor. B) Monitor the client using electronic fetal monitoring. C) Withhold oral intake and start intravenous fluids. D) Place the client in an upright, sitting position.

The client with blood type O R h-negative has given birth to an infant with blood type O R h-positive. The infant has become visibly jaundiced at 12 hours of age. The mother asks why this is happening. What is the best response by the nurse? A) "The R h o G A M you received at 28 weeks' gestation did not prevent alloimmunization." B) "Your body has made antibodies against the baby's blood that are destroying her red blood cells." C) "The red blood cells of your baby are breaking down because you both have type O blood." D) "Your baby's liver is too immature to eliminate the red blood cells that are no longer needed."

The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings? A) Document the findings on the prenatal chart. B) Have the physician see the client today. C) Instruct the client to avoid direct sunlight. D) Analyze previous thyroid hormone lab results.

The community nurse is meeting a new mother for the first time. The client delivered her first child 5 days ago after a 12-hour labor. Neither the mother nor the infant had any complications during the birth or postpartum period. Which statement by the client would indicate to the nurse that the client is experiencing postpartum blues? A) "I am so happy and blessed to have my new baby." B) "One minute I'm laughing and the next I'm crying." C) "My husband is helping out by changing the baby at night." D) "Breastfeeding is going quite well now that the engorgement is gone."

The community nurse is working with poor women who are formula-feeding their infants. Which statement indicates that the nurse's education session was effective? A) "I should use only soy-based formula for the first year." B) "I should follow the instructions for mixing the powdered formula exactly." C) "It is okay to add more water to the formula to make it last longer." D) "The mixed formula can be left on the counter for a day."

The laboring client and her partner have arrived at the birthing unit. Which step of the admission process should be undertaken first? A) The sterile vaginal exam B) Welcoming the couple C) Auscultation of the fetal heart rate D) Checking for ruptured membranes

The laboring client brought a written birth plan indicating that she wanted to avoid pain medications and an epidural. She is now at 6 c m and states, "I can't stand this anymore! I need something for pain! How will an epidural affect my baby?" What is the nurse's best response? A) "The narcotic in the epidural will make both you and the baby sleepy." B) "It is unlikely that an epidural will decrease your baby's heart rate." C) "Epidurals tend to cause low blood pressure in babies after birth." D) "I can't get you an epidural, because of your birth plan."

The nurse is completing the gestational age assessment on a newborn while in the mother's postpartum room. During the assessment, the mother asks what aspects of the baby are being checked. What is the nurse's best response? A) "I'm checking to make sure the baby has all of its parts." B) "This assessment looks at both physical aspects and the nervous system." C) "This assessment checks the baby's brain and nerve function." D) "Don't worry. We perform this check on all the babies."

The nurse is conducting an initial prenatal appointment for a client who believes she is pregnant. Which is considered a positive sign of pregnancy? A) Linea nigra B) Fetal heartbeat C) Breast tenderness D) Urinary frequency

The laboring client is at 7 c m, with the vertex at a +1 station. Her birth plan indicates that she and her partner took Lamaze prenatal classes, and they have planned on a natural, unmedicated birth. Her contractions are every 3 minutes and last 60 seconds. She has used relaxation and breathing techniques very successfully in her labor until the last 15 minutes. Now, during contractions, she is writhing on the bed and screaming. Her labor partner is rubbing the client's back and speaking to her quietly. Which nursing diagnosis should the nurse incorporate into the plan of care for this client? A) Fear/Anxiety related to discomfort of labor and unknown labor outcome B) Pain, Acute, related to uterine contractions, cervical dilatation, and fetal descent C) Coping: Family, Compromised, related to labor process D) Knowledge, Deficient, related to lack of information about normal labor process and comfort measures

The laboring client is having moderately strong contractions lasting 60 seconds every 3 minutes. The fetal head is presenting at a -2 station. The cervix is 6 c m and 100% effaced. The membranes spontaneously ruptured prior to admission, and clear fluid is leaking. Fetal heart tones are in the 140s with accelerations to 150. Which nursing action has the highest priority? A) Encourage the husband to remain in the room. B) Keep the client on bed rest at this time. C) Apply an internal fetal scalp electrode. D) Obtain a clean-catch urine specimen.

The laboring client participated in childbirth preparation classes that strongly discouraged the use of medications and intervention during labor. The client has been pushing for two hours, and is exhausted. The physician requests that a vacuum extractor be used to facilitate the birth. The client first states that she wants the birth to be normal, then allows the vacuum extraction. Following this, what should the nurse assess the client for after the birth? A) Elation, euphoria, and talkativeness B) A sense of failure and loss C) Questions about whether or not to circumcise D) Uncertainty surrounding the baby's name

The need for forceps has been determined. The client's cervix is dilated to 10 c m, and the fetus is at +2 station. What category of forceps application would the nurse anticipate? A) Input B) Low C) Mid D) Outlet

The neonate was born 5 minutes ago. The body is bluish. The heart rate is 150. The infant is crying strongly. The infant cries when the sole of the foot is stimulated. The arms and legs are flexed, and resist straightening. What should the nurse record as this infant's Apgar score? A) 7 B) 8 C) 9 D) 10

The nurse anticipates that the physician will most likely order a cervicovaginal fetal fibronectin test for which client? A) The client at 34 weeks' gestation with gestational diabetes B) The client at 32 weeks' gestation with regular uterine contractions C) The client at 37 weeks' multi-fetal gestation D) The client at 20 weeks' gestation with ruptured amniotic membranes

The nurse assesses a sleeping 1-hour-old, 39-weeks'-gestation newborn. The assessment data that would be of greatest concern would be which of the following? A) Temperature 97.9°F B) Respirations 68 breaths/minute C) Stable vital signs 45 minutes ago D) Heart rate 156 beats/min

The nurse begins a prenatal assessment on a 25-year-old primigravida at 20 weeks' gestation and immediately contacts the healthcare provider because of which finding? A) Pulse 88/minute B) Respirations 30/minute C) Temperature 37.4°C (99.3°F) D) Blood pressure 118/82 m m H g

The nurse expects an initial weight loss for the average postpartum client to be which of the following? A) 5 to 8 pounds B) 10 to 12 pounds C) 12 to 15 pounds D) 15 to 20 pounds

The nurse has just assisted the father in bathing the newborn 2 hours after birth. The nurse explains that the newborn must remain in the radiant warmer. This is based on which assessment data? A) Heart rate 120 B) Temperature 96.8°F C) Respiratory rate 50 D) Temperature 99.6°F

The nurse has received the end-of-shift report on the postpartum unit. Which client should the nurse see first? A) Woman who is 2nd day post-cesarean, moderate lochia serosa B) Woman day of delivery, fundus firm 2 c m above umbilicus C) Woman who had a cesarean section, 1st postpartum day, 4 c m diastasis recti abdominis D) Woman who had a cesarean section, 1st postpartum day, hypoactive bowel sounds all quadrants

The nurse is admitting a client to the birthing unit. What question should the nurse ask to gain a better understanding of the client's psychosocial status? A) "How did you decide to have your baby at this hospital?" B) "Who will be your labor support person?" C) "Have you chosen names for your baby yet?" D) "What feeding method will you use for your baby?"

The nurse is admitting a client with possible hydramnios. When is hydramnios most likely suspected? A) Hydramnios is most likely suspected when there is less amniotic fluid than normal for gestation. B) Hydramnios is most likely suspected when the fundal height increases disproportionately to the gestation. C) Hydramnios is most likely suspected when the woman has a twin gestation. D) Hydramnios is most likely suspected when the quadruple screen comes back positive.

The nurse is assessing a 2-hour-old newborn delivered by cesarean at 38 weeks. The amniotic fluid was clear. The mother had preeclampsia. The newborn has a respiratory rate of 80, is grunting, and has nasal flaring. What is the most likely cause of this infant's condition? A) Meconium aspiration syndrome B) Transient tachypnea of the newborn C) Respiratory distress syndrome D) Prematurity of the neonate

The nurse is assessing a primiparous client who indicates that her religion is Judaism. Why is this information pertinent for the nurse to assess? A) Religious and cultural background can impact what a client eats during pregnancy. B) It provides a baseline from which to ask questions about the client's religious and cultural background. C) Knowing the client's beliefs and behaviors regarding pregnancy is not important. D) Clients sometimes encounter problems in their pregnancies based on what religion they practice.

The nurse is assisting a mother to bottle-feed her newborn, who has been crying. The nurse suggests that prior to feeding, the mother should do which of the following? A) Offer a pacifier B) Burp the newborn C) Unwrap the newborn D) Stroke the newborn's spine and feet

The nurse is explaining pelvic measurements to a patient who is 20 weeks pregnant. On the diagram, which measurement should the nurse identify as being the smallest for the fetus to pass during delivery? A) A B) B C) C D) D

The nurse is planning care for four infants who were born on this shift. The infant who will require the most detailed assessment is the one whose mother has which of the following? A) A history of obsessive-compulsive disorder (O C D) B) Chlamydia C) Delivered six other children by cesarean section D) A urinary tract infection (U T I)

The nurse is preparing a class for expectant fathers. Which information should the nurse include? A) Siblings adjust readily to the new baby. B) Sexual activity is safe for normal pregnancy. C) The expectant mother decides the feeding method. D) Fathers are expected to be involved in labor and birth.

The nurse is preparing an educational session on phenylketonuria for a family whose neonate has been diagnosed with the condition. Which statement by a parent indicates that teaching was effective? A) "This condition occurs more frequently among Japanese people." B) "We must be very careful to avoid most proteins to prevent brain damage." C) "Carbohydrates can cause our baby to develop cataracts and liver damage." D) "Our baby's thyroid gland isn't functioning properly."

The nurse is preparing to assess the pregnant client's fundal height during a routine prenatal visit. Which nursing action is appropriate in this situation? A) Telling the client not to eat or drink for one hour after the procedure B) Asking the client to empty her bladder prior to the procedure C) Obtaining informed consent for the procedure D) Assessing blood pressure after the procedure

The nurse is reviewing amniocentesis results. Which of the following would indicate that client care was appropriate? A) The client who is R h-positive received R h immune globulin after the amniocentesis. B) The client was monitored for 30 minutes after completion of the test. C) The client began vaginal spotting before leaving for home after the test. The client identified that she takes insulin before each meal and at bedtime

The nurse is teaching a new mother how to encourage a sleepy baby to breastfeed. Which of the following instructions would not be included in that teaching? A) Providing skin-to-skin contact B) Swaddling the newborn in a blanket C) Unwrapping the newborn D) Allowing the newborn to feel and smell the mother's breast

The nurse is teaching a newborn care class to parents who are about to give birth to their first babies. Which statement by a parent indicates that teaching was effective? A) "My baby will be able to focus on my face when she is about a month old." B) "My baby might startle a little if a loud noise happens near him." C) "Newborns prefer sour tastes." D) "Our baby won't have a sense of smell until she is older."

The nurse is training a nurse new to the labor and delivery unit. They are caring for a laboring client who will have a forceps delivery. Which action or assessment finding requires intervention? A) Regional anesthesia is administered via pudendal block. B) The client is instructed to push between contractions. C) Fetal heart tones are consistently between 110 and 115. D) The client's bladder is emptied using a straight catheter.

The nurse is working with a mother who has just delivered her third child at 33 weeks' gestation. The mother says to the nurse, "This baby doesn't turn her head and suck like the older two children did. Why?" What is the best response by the nurse? A) "Every baby is different. This is just one variation of normal that we see on a regular basis." B) "This baby might not have a rooting or sucking reflex because she is premature." C) "When she is wide awake and alert, she will probably root and suck even if she is early." D) "She might be too tired from the birthing process and need a couple of days to recover."

The nurse is working with a new mother who delivered yesterday. The mother has chosen to breastfeed her infant. Which demonstration of skill is the best indicator that the client understands breastfeeding? A) She puts the infant to breast when he is asleep to help wake him up. B) She takes off her gown to achieve skin-to-skin contact. C) She leans toward the infant so that he turns his head to access the nipple. D) The infant is crying when he is brought to the breast.

The nurse notes that a 36-hour-old newborn's serum bilirubin level has increased from 14 m g/d L to 16.6 m g/d L in an 8-hour period. What nursing intervention would be included in the plan of care for this newborn? A) Continue to observe B) Begin phototherapy C) Begin blood exchange transfusion D) Stop breastfeeding

The nurse receives a phone call from a client who claims she is pregnant. The client reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10. What would the client's estimated date of delivery (E D D) be if she is pregnant? A) Nov. 13 B) Jan. 17 C) Jan. 10 D) Dec. 3

The nurse should anticipate the labor pattern for a fetal occiput posterior position to be which of the following? A) Shorter than average during the latent phase B) Prolonged as regards the overall length of labor C) Rapid during transition D) Precipitous

The nurse suspects clubfoot in the newborn and assesses for the condition by doing which of the following? A) Adducting the foot and listening for a click. B) Moving the foot to midline and determining resistance. C) Extending the foot and observing for pain. D) Stimulating the sole of the foot.

The nursing instructor is conducting a class about attachment behaviors. Which statement by a student indicates the need for further instruction? A) "The en face position promotes bonding and attachment." B) "Ideally, initial skin-to-skin contact occurs after the baby has been assessed and bathed." C) "In reciprocity, the interaction of mother and infant is mutually satisfying and synchronous." D) "The needs of the mother and of her infant are balanced during the phase of mutual regulation."

The physician has determined the need for forceps. The nurse should explain to the client that the use of forceps is indicated because of which of the following? A) Her support person is exhausted B) Premature placental separation C) To shorten the first stage of labor D) To prevent fetal distress

The physician/C N M opts to use a vacuum extractor for a delivery. What does the nurse understand? A) There is little risk with vacuum extraction devices. B) There should be further fetal descent with the first two "pop-offs." C) Traction is applied between contractions. D) The woman often feels increased discomfort during the procedure.

The pregnant client at 14 weeks' gestation is in the clinic for a regular prenatal visit. Her mother also is present. The grandmother-to-be states that she is quite uncertain about how she can be a good grandmother to this baby because she works full time. Her own grandmother was retired, and was always available when needed by a grandchild. What is the nurse's best response to this concern? A) "Don't worry. You'll be a wonderful grandmother. It will all work out fine." B) "What are your thoughts on what your role as grandmother will include?" C) "As long as there is another grandmother available, you don't have to worry." D) "Grandmothers are supposed to be available. You should retire from your job."

The pregnant client has asked the nurse what kinds of medications cause birth defects. Which statement would best answer this question? A) "Birth defects are very rare. Don't worry; your doctor will watch for problems." B) "To be safe, don't take any medication without talking to your doctor." C) "Too much vitamin C is one of the most common issues." D) "Almost all medications will cause birth defects in the first trimester."

The prenatal clinic nurse is designing a new prenatal intake information form for pregnant clients. Which question is best to include on this form? A) Where was the father of the baby born? B) Do genetic diseases run in the family of the baby's father? C) What is the name of the baby's father? D) Are you married to the father of the baby?

The school nurse is planning a class about nutrition for pregnant teens, several of whom have been diagnosed with iron-deficiency anemia. In order to increase iron absorption, the nurse would encourage the teens to consume more of what beverage? A) Gatorade B) Orange juice C) Milk D) Green tea

The special care nursery nurse is working with parents of a 3-day-old infant who was born with myelomeningocele and has developed an infection. Which statement from the mother is unexpected? A) "If I had taken better care of myself, this wouldn't have happened." B) "I've been sleeping very well since I had the baby." C) "This is probably the doctor's fault." D) "If I hadn't seen our baby's birth, I wouldn't believe she is ours."

The student nurse has performed a gestational age assessment of an infant, and finds the infant to be at 32 weeks. On which set of characteristics is the nurse basing this assessment? A) Lanugo mainly gone, little vernix across the body B) Prominent clitoris, enlarging minora, anus patent C) Full areola, 5 to 10 m m bud, pinkish-brown in color D) Skin opaque, cracking at wrists and ankles, no vessels visible

The student nurse notices that the newborn seems to focus on the mother's eyes. The nursing instructor explains that this newborn behavior is which of the following? A) Habituation B) Orientation C) Self-quieting D) Reactivity

The visiting nurse evaluates a 2-day-old breastfed newborn at home and notes that the baby appears jaundiced. When explaining jaundice to the parents, what would the nurse tell them? A) "Jaundice is uncommon in newborns." B) "Some newborns require phototherapy." C) "Jaundice is a medical emergency." D) "Jaundice is always a sign of liver disease."

To promote infant security in the hospital, the nurse instructs the parents of a newborn to do which of the following? A) Keep the baby in the room at all times. B) Check the identification of all personnel who transport the newborn. C) Place a "No Visitors" sign on the door. D) Keep the baby in the nursery at all times.

Upon delivery of the newborn, what nursing intervention most promotes parental attachment? A) Placing the newborn under the radiant warmer. B) Placing the newborn on the mother's abdomen. C) Allowing the mother a chance to rest immediately after delivery. D) Taking the newborn to the nursery for the initial assessment.

What indications would lead the nurse to suspect sepsis in a newborn? A) Respiratory distress syndrome developing 48 hours after birth B) Temperature drops from 97.4°F to 97.0 2°F hours after 2 hours of warming. C) Irritability and flushing of the skin at 8 hours of age D) Bradycardia and tachypnea developing when the infant is 36 hours old

What is required for any woman receiving oxytocin (Pitocin)? A) C P R B) Continuous electronic fetal monitoring C) Administering oxygen by mask D) Nonstress test

What is the primary carbohydrate in mammalian milk that plays a crucial role in the nourishment of the newborn? A) Colostrum B) Lactose C) Lactoferrin D) Secretory I g A

What type of forceps are designed to be used with a breech presentation? A) Midforceps B) Piper C) Low D) High

What would the nurse do to accurately assess a pregnant client's food intake? A) Assess her most recent laboratory values. B) Ask her to complete a nutritional questionnaire. C) Observe for signs of hunger. D) Ask about her cooking facilities.

Which of the following functions primarily to provide low-income women and children who are at risk for medical or nutritional problems with nutritious foods to supplement their diets, nutrition education and counseling, and screening and referrals to other health, welfare, and social programs? A) A B M B) W I C C) I L C A D) L L L I

Which of the following is important for the development of the central nervous system of the fetus? A) Calcium and phosphorus B) Essential fatty acids C) Iron D) Vitamin D

Which of the following tests provides information about the fetal number? A) Amniocentesis B) Standard second-trimester sonogram C) Beta h C G D) Maternal serum alpha-fetoprotein

1) Which questions are appropriate for the nurse to ask during a cultural assessment of a client who is new to the clinic? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) What genetic and other biological differences affect caregiving? B) Which family member must be consulted for decisions about care? C) What type of healthcare provider is the most appropriate? D) Does the client have beliefs or traditions that might impact the care plan? E) Are communications patterns established?

B, C, D

Absolute contraindications to exercise while pregnant include which of the following? Select all that apply. A) Abruptio placentae B) Placenta previa after 26 weeks' gestation C) Preeclampsia-eclampsia D) Cervical insufficiency (cerclage) E) Intrauterine growth restriction (I U G R)

B, C, D

Nonreassuring fetal status often occurs with a tachysystole contraction pattern. Intrauterine resuscitation measures may become warranted and can include which of the following measures? Select all that apply. A) Position the woman on her right side. B) Apply oxygen via face mask. C) Call the anesthesia provider for support. D) Increase intravenous fluids by at least 500 m L bolus. E) Call the physician/C N M to the bedside.

B, C, D

The nurse knows that which of the following are advantages of spinal block? Select all that apply. A) Intense blockade of sympathetic fibers B) Relative ease of administration C) Maternal compartmentalization of the drug D) Immediate onset of anesthesia E) Larger drug volume

B, C, D

Under which circumstances would the nurse remove prostaglandin from the client's cervix? Select all that apply. A) Contractions every 5 minutes B) Nausea and vomiting C) Uterine tachysystole D) Cardiac tachysystole E) Baseline fetal heart rate of 140-148

B, C, D

1) During a follow-up wellness visit, the nurse determines that a female client is experiencing favorable outcomes after starting combined oral contraceptives. What data did the nurse use to determine this? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Reduced appetite B) Reduced menstrual flow C) Fewer menstrual cramps D) No pain with ovulation E) Cycle is regular at 28 days

B, C, D, E

The nurse is teaching new parents how to dress their newborn. Which statements indicate that teaching has been effective? Select all that apply. A) "We should keep our home air-conditioned so the baby doesn't overheat." B) "It is important that we dry the baby off as soon as we give him a bath or shampoo his hair." C) "When we change the baby's diaper, we should change any wet clothing or blankets, too." D) "If the baby's body temperature gets too low, he will warm himself up without any shivering." E) "Our baby will have a much faster rate of breathing if he is not dressed warmly enough."

B, C, D, E

The nurse knows that the maternal risks associated with postterm pregnancy include which of the following? Select all that apply. A) Polyhydramnios B) Maternal hemorrhage C) Maternal anxiety D) Forceps-assisted delivery E) Perineal damage

B, C, D, E

A nurse is providing care for a client who has a marginal abruptio placentae. Which of the following findings are risk factors for developing the condition? Select all that apply. A) Fetal position B) Blunt abdominal trauma C) Cocaine use D) Maternal age E) Cigarette smoking

B, C, E

Maternal risks of occiput posterior (O P) malposition include which of the following? Select all that apply. A) Blood loss greater than 1000 m L B) Postpartum infection C) Anal sphincter injury D) Higher rates of vaginal birth E) Instrument delivery

B, C, E

What signs would indicate that a pregnant client's urinalysis culture was abnormal? Select all that apply. A) p H 4.6-8 B) Alkaline urine C) Cloudy appearance D) Negative for protein and red blood cells E) Hemoglobinuria

B, C, E

Which of the following would be considered normal newborn urinalysis values? Select all that apply. A) Color bright yellow B) Bacteria 0 C) Red blood cells (R B C) 0 D) White blood cells (W B C) more than 4-5/h p f E) Protein less than 5-10 m g/d L

B, C, E

1) The nurse interviews a 28-year-old client with a new medical diagnosis of endometriosis. Which question asked by the nurse is appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "Are you having hot flashes?" B) "Are you experiencing pain during intercourse?" C) "Is a vaginal discharge present?" D) "Are you having pain during your period?" E) "Have you noticed any skin rashes?"

B, D

1) During a pelvic examination, a patient is diagnosed with a Bartholin gland cyst. For which treatment should the nurse prepare this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Pelvic ultrasound B) Antibiotic therapy C) Exploratory laparotomy D) Incision and drainage of the cyst E) Culture and sensitivity of the discharge

B, D, E

Amniotomy as a method of labor induction has which of the following advantages? Select all that apply. A) The danger of a prolapsed cord is decreased. B) There is usually no risk of hypertonus or rupture of the uterus. C) The intervention can cause a decrease in pain. D) The color and composition of amniotic fluid can be evaluated. E) The contractions elicited are similar to those of spontaneous labor.

B, D, E

Benefits of skin-to-skin care as a developmental intervention include which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Routine discharge B) Stabilization of vital signs C) Increased periods of awake-alert state D) Decline in episodes of apnea and bradycardia E) Increased growth parameters

B, D, E

Risk factors for labor dystocia include which of the following? Select all that apply. A) Tall maternal height B) Labor induction C) Small-for-gestational-age (S G A) fetus D) Malpresentation E) Prolonged latent phase

B, D, E

The nurse is caring for a newborn 30 minutes after birth. After assessing respiratory function, the nurse would report which findings as abnormal? Select all that apply. A) Respiratory rate of 66 breaths per minute B) Periodic breathing with pauses of 25 seconds C) Synchronous chest and abdomen movements D) Grunting on expiration E) Nasal flaring

B, D, E

A pregnant client who is a lacto-vegetarian asks the nurse for assistance with her diet. What instruction should the nurse give? Select all that apply. A) "Protein is important; therefore, the addition of one serving of meat a day is necessary." B) "A daily supplement of vitamin B12 is important." C) "The high fiber in a vegetarian diet is dangerous for pregnant women." D) "Eggs are important to add to your diet. Eat six eggs per week." E) "Milk products contain protein, but they are very low in iron."

B, E

The nurse determines the gestational age of an infant to be 40 weeks. Which characteristics are most likely to be observed? Select all that apply. A) Lanugo abundant over shoulders and back B) Plantar creases over entire sole C) Pinna of ear springs back slowly when folded. D) Vernix well distributed over entire body E) Testes are pendulous, and the scrotum has deep rugae

B, E

The nurse is working with a new mother who follows Muslim traditions. Which expectations and actions are appropriate for this client? Select all that apply. A) Make sure she gets a kosher diet. B) Expect that most visitors will be women. C) Uncover only the necessary skin when assessing. D) The father will take an active role in infant care. E) She will prefer a male physician.

B,C

A N I C U nurse plans care for a preterm newborn that will provide opportunities for development. Which interventions support development in a preterm newborn in a N I C U? Select all that apply. A) Schedule care throughout the day. B) Silence alarms quickly. C) Place a blanket over the top portion of the incubator. D) Do not offer a pacifier. E) Dim the lights.

B,C,E

Nursing interventions that foster the process of becoming a mother include which of the following? Select all that apply. A) Encouraging detachment from the nurse-patient relationship B) Promoting maternal-infant attachment C) Building awareness of and responsiveness to infant interactive capabilities D) Instruct about promoting newborn independence E) Preparing the woman for the maternal social role

B,C,E

Which of the following symptoms would be an indication of postpartum blues? Select all that apply. A) Overeating B) Anger C) Mood swings D) Constant sleepiness E) Crying

B,C,E

During the first several postpartum weeks, the new mother must accomplish certain physical and developmental tasks, including which of the following? Select all that apply. A) Establish a therapeutic relationship with her physician B) Adapt to altered lifestyles and family structure resulting from the addition of a new member C) Restore her intellectual abilities D) Restore physical condition E) Develop competence in caring for and meeting the needs of her infant

B,D,E

Which of the following are considered risk factors for development of severe hyperbilirubinemia? Select all that apply. A) Northern European descent B) Previous sibling received phototherapy C) Gestational age 27 to 30 weeks D) Exclusive breastfeeding E) Infection

B,D,E

1) A client asks her nurse, "Is it okay for me to take a tub bath during the heavy part of my menstruation?" What is the nurse's correct response? A) "Tub baths are contraindicated during menstruation." B) "You should shower and douche daily instead." C) "Either a bath or a shower is fine at that time." D) "You should bathe and use a feminine deodorant spray during menstruation."

1) A client asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy?" What is the nurse's best response? A) "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred." B) "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." C) "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur." D) "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."

1) A client who wants to use the vaginal sponge method of contraception shows that she understands the appropriate usage when she makes which statement? A) "I need to use a lubricant prior to insertion." B) "I need to add spermicidal cream prior to intercourse." C) "I need to moisten it with water prior to use." D) "I need to leave it in no longer than 6 hours."

1) A client who was raped is extremely upset when a pregnancy test confirms that she is pregnant, and requests information regarding pregnancy termination. Which statement is best for the nurse to make? A) "Abortion is morally wrong, and should not be undertaken." B) "Hypertension is a risk with any abortion." C) "Surgical abortion in the first trimester is technically easier and safer than abortion in the second trimester." D) "The most accurate method to determine gestational age are the results of a pregnancy test."

1) A patient in the 2nd trimester of pregnancy is diagnosed with bacterial vaginosis. Which medication regimen should the nurse expect to be prescribed for this patient? A) Metronidazole 500 m g orally one dose B) Metronidazole 250 m g orally once a day for 7 days C) Metronidazole 500 m g orally twice a day for 7 days D) Metronidazole 250 m g orally twice a day for 14 days

1) A patient is being instructed on adverse effects of gonorrhea. For which reason should the nurse instruct the patient to contact the healthcare provider? A) Dysuria B) Urinary frequency C) Sharp abdominal pain D) Purulent, greenish-yellow vaginal discharge

1) A woman with polycystic ovarian syndrome (P C O S) is prescribed clomiphene citrate for the treatment of infertility. Which statement does the nurse understand is true? A) The woman has abnormal ovaries B) The woman has low prolactin levels C) The woman's pituitary gland is intact D) The woman's thyroid gland is normal

1) An older female patient with a known intellectual disability is newly diagnosed with osteoporosis and admitted with a fractured hip after falling in the home. What should the nurse realize could have contributed to this patient's health problem? A) Importance of resting during the day B) Need to reduce the amount of physical activity C) Understanding home environmental safety needs D) Reducing the oral intake of protein and carbohydrates

1) During a health interview focused on sexual history, a female patient makes a statement about douching and intercourse. What should the nurse do in response to this statement? A) Recommend the frequency of douching B) Explain the proper procedure to douche C) Take the time now to educate the patient about the practice D) Document that the patient has misunderstandings about the use of douches

1) The client diagnosed with endometriosis asks the nurse whether there are any long-term health risks associated with this condition. The nurse should include which statement in the client teaching about endometriosis? A) "There are no other health risks associated with endometriosis." B) "Pain with intercourse rarely occurs as a long-term problem." C) "You are at increased risk for ovarian and breast cancer." D) "Most women with this condition develop severe migraines."

During a routine assessment of a pregnant patient the nurse observes the following on the patient's abdomen. How should the nurse document this finding? A) Striae B) Chloasma C) Linea nigra D) Vascular spider nevi

1) The client reports using an alternative therapy that involves the manipulation of soft tissues. This therapy has reduced the client's stress, diminished pain, and increased circulation. Which therapy has this client most likely received? A) Guided imagery B) Homeopathy C) Massage therapy D) Reflexology

1) The community health nurse manager is reviewing the charts of female elderly clients. Which issue are these clients most likely to experience? A) Adequate financial resources to purchase medications B) Senior services that provide transportation to healthcare appointments C) Multiple medications prescribed by different physicians D) Medicare that covers healthcare costs so no out-of-pocket expenses occur

1) The emergency department nurse is admitting a client who has been sexually assaulted. The nurse is explaining how the physical evidence will be collected. Which statement by the client indicates that teaching has been effective? A) "All the evidence will be kept in a locked cupboard until the police arrive." B) "You collect urine samples to make sure the rapist did not get me pregnant." C) "The evidence you collect might be able to identify the rapist." D) "Blood samples are taken to help identify whether the rapist had H I V."

1) The nurse has been talking to a woman about the reorganization phase following a rape. Which response would indicate that the client understands this phase? A) "By using denial and suppression in this phase, I will eventually be able to accept what has happened to me." B) "During this time, I won't talk much about the rape, because I am examining my inward feelings regarding the rape." C) "During this time, I will repeatedly replay the role of the victim until I come to terms with the experience." D) "My perception of a normal sexual relationship will be similar to my perception prior to the rape."

1) The nurse has received the shift change report on infants born within the previous 4 hours. Which newborn should the nurse see first? A) 37-week male, respiratory rate 45 B) 8 pound 1 ounce female, pulse 150 C) Term male, nasal flaring D) 4-hour-old female who has not voided

1) The nurse in the clinic instructs a client who is using the natural method of contraception to begin counting the first day of her cycle as which day? A) The day her menstrual period ceases B) The first day after her menstrual period ceases C) The first day of her menstrual period D) The day of ovulation

1) The nurse in the community should use a family assessment tool to obtain what type of information? A) How long the family has lived at its current address B) What other health insurance the family has had in the past C) How the family meets its nutritional needs and obtains food D) What eye color the family desires in its unborn child

1) The nurse is about to tell a client that her Pap smear result was abnormal. Which statement should the nurse include? A) "The Pap smear is used to diagnose cervical cancer." B) "A loop electrosurgical excision procedure (L E E P) is needed." C) "Colposcopy to further examine your cervix is the next step." D) "Your cervix needs to be treated with cryotherapy."

1) The nurse is assessing a client who reports seeing an acupuncturist on a weekly basis to treat back pain. The nurse understands that acupuncture is an example of what? A) A risky practice without evidence of efficacy B) A folk remedy C) A complementary therapy D) An alternative therapy

1) The nurse is caring for a client diagnosed with endometriosis. Which statement by the client would require a need for perhaps another treatment option? A) "I am having many hot flashes since I had the Lupron injection." B) "The pain I experience with intercourse is becoming more severe." C) "I have vaginal dryness, reduced libido, and my clitoris has become larger since taking danazol. Is this normal?" D) "I've noticed I have not had my period on a regular basis since being on the G n R H analogs."

1) The nurse is conducting a health maintenance assessment for a new female client who recently moved to the city. Which finding would indicate the need for further assessment for intimate partner violence? A) A miscarriage two years ago noted during the reproductive history. B) A sprained ankle one year ago noted during the health history interview. C) A history of delaying treatment for a concussion and fractured extremity. D) A scar noted on the abdomen from a previous surgery during the physical examination.

1) The nurse is developing a teaching plan for a client undergoing a tubal ligation. What information should be included in the plan? A) The surgical procedure is easily reversible. B) Laparotomy is performed following a vaginal birth. C) Minilaparotomy is performed in the postpartum period soon after a vaginal birth. D) Tubal ligation can be done at any time the woman is either pregnant or not pregnant.

1) The nurse is helping a victim of domestic abuse to develop a safety plan. Which client action would require intervention by the nurse? A) Asking a neighbor to call police if violence begins B) Establishing a code word for danger with family and friends C) Keeping a bag packed in the home in case the need to leave arises D) Having a planned escape route and emergency phone numbers if violence occurs

1) The nurse is making an initial assessment of the newborn. The findings include a chest circumference of 32.5 c m and a head circumference of 33.5 c m. Based on these findings, which action should the nurse take first? A) Notify the physician. B) Elevate the newborn's head. C) Document the findings in the chart. D) Assess for hypothermia immediately.

1) The nurse is planning a community education presentation on battering. Which statement about battering should the nurse include? A) Battering occurs in a small percentage of the population. B) Battering is mainly a lower-class, blue-collar problem. C) Battered women are at greatest risk for severe violence when they leave the batterer. D) If the batterer stops drinking, the violence usually stops.

1) The nurse is planning a community education program on the role of complementary and alternative therapies during pregnancy. Which statement about alternative and complementary therapies should the nurse include? A) "They bring about cures for illnesses and diseases." B) "They are invasive but effective for achieving health." C) "They emphasize prevention and wellness." D) "They prevent pregnancy complications."

1) The nurse is planning a community educational presentation for people living below the poverty level. The nurse knows that which of the following is the largest population in this socioeconomic category? A) Adults in communal living situations B) Young married couples under the age of 20 C) Single women with children D) Single adults

1) The nurse is planning care for a newborn. Which nursing intervention would best protect the newborn from the most common form of heat loss? A) Placing the newborn away from air currents B) Pre-warming the examination table C) Drying the newborn thoroughly D) Removing wet linens from the isolette

1) The nurse is preparing educational materials at a family planning clinic. The client who is an appropriate candidate for using emergency contraception would be one who reports which of the following? A) Forgetting to start her pill pack yesterday B) Unprotected intercourse during her menses C) That a condom broke yesterday in the middle of her cycle D) Increased dysmenorrhea since I U C insertion

1) The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (V V C), and knows the client understands when she makes which of the following statements? A) "I need to apply the miconazole for 10 days." B) "I need to douche daily." C) "I need to add yogurt to my diet." D) "I need to wear nylon panties."

1) The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect? A) Shortens newborn length of stay B) Decreases use of home health agencies C) Decreases healthcare costs D) Decreases the number of emergency department visits

1) The nurse is teaching a class about domestic violence to enhance education within the community. Which statement regarding the cycle of violence should the nurse include in the presentation? A) "The tension-building phase lasts a few hours." B) "The batterer often feels remorse during the tension-building phase." C) "The acute battery incident is often triggered by an external event, such as the loss of a job." D) "The acute battery incident often finds the victim hoping the relationship will change for the better."

1) The nurse is teaching a client who has been diagnosed with vulvitis. Which statement by the client indicates that the nurse's instruction has not been effective? A) "I should stop having sexual intercourse." B) "Non-deodorized tampons could make this condition recur." C) "Wearing pantyhose daily will improve the problem." D) "A different brand of soap might eliminate the irritation."

1) The nurse is teaching a group of women about menopause at a community clinic. The nurse tells them that the best indicator of menopause is which of the following symptoms? A) No menses for 8 consecutive months B) Hot flashes and night sweats C) F S H levels rise and ovarian follicles cease to produce estrogen D) Diagnosed with osteoporosis 4 months ago

1) The nurse manager is preparing an educational in-service for staff nurses about elder abuse. The nurse manager develops a hypothetical situation: A wheelchair-bound client who lives with her daughter has experienced hunger because she cannot reach the cupboards to make lunch. Which category of elder abuse does this example describe? A) Psychologic abuse B) Physical abuse C) Neglect D) Financial abuse

1) The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? A) "She could become pregnant." B) "She could have severe vaginal itching." C) "He could get an infection in the tube that carries the urine out." D) "It could cause us to develop a rash."

1) The nurse suspects that a female patient is experiencing amenorrhea because of ovarian failure. For which situation should the nurse assess this patient? A) Severe stress B) Recent head trauma C) Treatment for cancer D) Antianxiety medication

1) The nurse walks in to find the client crying after the physician informed her of her diagnosis of human papilloma virus (H P V). Which statement by the nurse conveys an attitude of acceptance toward the client with a sexually transmitted infection? A) "Don't worry about it. In a few weeks, with treatment, the lesions will disappear." B) "You seem upset. I'll get the doctor." C) "You seem upset. Can I help answer any questions?" D) "I think you need to see a therapist."

1) The postpartum nurse is caring for a client who gave birth to full-term twins earlier today. The nurse will know to assess for symptoms of which of the following? A) Increased blood pressure B) Hypoglycemia C) Postpartum hemorrhage D) Postpartum infection

1) The transcultural nursing theory was developed in 1961 by Dr. Madeleine Leininger. Its foundation is in which of the following? A) The framework categorizes a family's progression over time B) The family life cycle of a traditional nuclear family C) Anthropology and nursing D) Holistic health beliefs

1) What is the term for when children alternate between two homes, spending varying amounts of time with each parent in a situation called co-parenting and usually involving joint custody? A) Blended or reconstituted nuclear family B) Extended kin network family C) Binuclear family D) Extended family

1) When a woman who has been raped is admitted to the emergency department, the nurse caring for the woman knows that which of the following is the priority nursing intervention? A) Explaining exactly what will need to be done to preserve legal evidence B) Assuring the woman that everything will be all right C) Creating a safe, secure environment for her D) Contacting family members

1) When the nurse is teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size how often? A) Every five years routinely B) When weight gain or loss beyond five pounds has occurred C) After each birth D) Only after significant weight loss

1) Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (P I D)? A) C B C (complete blood count) with differential B) Venereal Disease Research Laboratory (V D R L) C) Throat culture for Streptococcus A D) R P R (Rapid Plasma Reagin)

1) Which of the following federal departments actively investigates and prosecutes individuals who cross state lines to avoid paying child support, and now intercepts delinquent parents' income tax refunds? A) U.S. Department of Health and Human Services B) U.S. Department of Labor C) U.S. Department of Justice D) U.S. Equal Employment Opportunity Commission

1) Which of the following systems provides a uniform format and classification of terminology based on current understanding of cervical disease? A) Levonorgestrel intrauterine B) P A L M-C O E I N C) Bethesda D) B S E

1) Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? A) Foul-smelling discharge B) Ectopic pregnancy C) Preterm labor D) A colicky large intestine

7) Client safety goals, which are evaluated and updated regularly, are requirements for what? A) Clinical practice guidelines B) Scope of practice C) Accreditation D) Standards of care

7) For prenatal care, the client is attending a clinic held in a church basement. The client's care is provided by registered nurses and a certified nurse-midwife. What is this type of prenatal care? A) Secondary care B) Tertiary care C) Community care D) Unnecessarily costly care

7) The current emphasis on federal healthcare reform has yielded what unexpected benefit? A) Assessment of the details of the family's income and expenditures B) Case management to limit costly, unnecessary duplication of services C) Many healthcare providers and consumers are becoming more aware of the vitally important role nurses play in providing excellent care to clients and families D) Education of the family about the need for keeping regular well-child visit appointments

7) While a child is being admitting to the hospital, the parent receives information about the pediatric unit's goals, including the statement that the unit practices family-centered care. The parent asks why that is important. The nurse responds that what communication dynamic is characteristic of the family-centered care paradigm? A) The mother is the principal caregiver in each family. B) The child's physician is the key person in ensuring that the health of a child is maintained. C) The family serves as the constant influence and continuing support in the child's life. D) The father is the leader in each home; thus, all communications should include him.

A 2-day-old newborn is asleep, and the nurse assesses the apical pulse to be 88 beats/min. What would be the most appropriate nursing action based on this assessment finding? A) Call the physician. B) Administer oxygen. C) Document the finding. D) Place the newborn under the radiant warmer.

A client dilated to 5 c m has just received an epidural for pain. She complains of feeling lightheaded and dizzy within 10 minutes after the procedure. Her blood pressure was 120/80 before the procedure and is now 80/52. In addition to the bolus of fluids she has been given, which medication is preferred to increase her B P? A) Epinephrine B) Terbutaline C) Ephedrine D) Epifoam

A client from Mexico has just delivered a son, and the nurse offers to assist in putting the baby to breast. Although the client indicated before the birth that she wanted to breastfeed, she is very hesitant, and says she would like to bottle-feed for the first few days. After talking to her, the nurse understands that her primary reason for wanting to delay breastfeeding is based on what cultural belief? A) Breast milk causes skin rashes. B) It is harmful to breastfeed immediately. C) Colostrum is bad for the baby. D) Thin milk causes diarrhea.

A client in her second trimester is complaining of spotting. Causes for spotting in the second trimester are diagnosed primarily through the use of which of the following? A) A non-stress test B) A vibroacoustic stimulation test C) An ultrasound D) A contraction stress test

A client is admitted to the labor and delivery unit with a history of ruptured membranes for 2 hours. This is her sixth delivery; she is 40 years old, and smells of alcohol and cigarettes. What is this client at risk for? A) Gestational diabetes B) Placenta previa C) Abruptio placentae D) Placenta accreta

A client is admitted to the labor and delivery unit with contractions that are regular, are 2 minutes apart, and last 60 seconds. She reports that her labor began about 6 hours ago, and she had bloody show earlier that morning. A vaginal exam reveals a vertex presenting, with the cervix 100% effaced and 8 c m dilated. The client asks what part of labor she is in. The nurse should inform the client that she is in what phase of labor? A) Latent phase B) Active phase C) Transition phase D) Fourth stage

A client is consulting a certified nurse-midwife because she is hoping for a vaginal birth after cesarean (V B A C) with this pregnancy. Which statement indicates that the client requires more information about V B A C? A) "I can try a vaginal birth because my uterine incision is a low segment transverse incision." B) "The vertical scar on my skin doesn't mean that the scar on my uterus goes in the same direction." C) "There is about a 90% chance of giving birth vaginally after a cesarean." D) "Because my hospital has a surgery staff on call 24 hours a day, I can try a V B A C there."

A client who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the client needs additional information? A) "Because we heard the baby's heartbeat, I am undoubtedly pregnant." B) "Because I have had a positive pregnancy test, I am undoubtedly pregnant." C) "My last period was 2 months ago, which means I'm 2 months along." D) "The increased size of my uterus means that I am finally pregnant."

A client who wishes to have an unmedicated birth is in the transition stage. She is very uncomfortable and turns frequently in the bed. Her partner has stepped out momentarily. How can the nurse be most helpful? A) Talk to the client the entire time. B) Turn on the television to distract the client. C) Stand next to the bed with hands on the railing next to the client. D) Sit silently in the room away from the bed.

A client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client the recommended weight gain is during pregnancy? A) 25-35 pounds, regardless of a client's prepregnant weight B) More than 25-35 pounds for an overweight woman C) Up to 40 pounds for an underweight woman D) The same for a normal weight woman as for an overweight woman

A client's labor has progressed so rapidly that a precipitous birth is occurring. What should the nurse do? A) Go to the nurse's station and immediately call the physician. B) Run to the delivery room for an emergency birth pack. C) Stay with the client and ask auxiliary personnel for assistance. D) Hold back the infant's head forcibly until the physician arrives for the delivery.

A laboring client's obstetrician has suggested amniotomy as a method for inducing labor. Which assessment(s) must be made just before the amniotomy is performed? A) Maternal temperature, B P, and pulse B) Estimation of fetal birth weight C) Fetal presentation, position, station, and heart rate D) Biparietal diameter

A laboring mother has recurrent late decelerations. At birth, the infant has a heart rate of 100, is not breathing, and is limp and bluish in color. What nursing action is best? A) Begin chest compressions. B) Begin direct tracheal suctioning. C) Begin bag-and-mask ventilation. D) Obtain a blood pressure reading.

A mother states that her breasts leak between feedings. Which of the following can contribute to the letdown reflex in breastfeeding mothers? A) Pain with breastfeeding B) Number of hours passed since last feeding C) The newborn's cry D) Maternal fluid intake

A new father asks the nurse to describe what his baby will experience while sleeping and awake. What is the best response? A) "Babies have several sleep and alert states. Keep watching and you'll notice them." B) "You might have noticed that your child was in an alert awake state for an hour after birth." C) "Newborns have two stages of sleep: deep or quiet sleep and rapid eye movement sleep." D) "Birth is hard work for babies. It takes them a week or two to recover and become more awake."

A new grandfather is marveling over his 12-hour-old newborn grandson. Which statement indicates that the grandfather needs additional education? A) "I can't believe he can already digest fats, carbohydrates, and proteins." B) "It is amazing that his whole digestive tract can move things along at birth." C) "Incredibly, his stomach capacity was already a cupful when he was born." D) "He will lose some weight but then miraculously regain it by about 10 days."

A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea; vomiting; and scant, prune-colored discharge. The client has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect? A) Hyperemesis gravidarum B) Threatened abortion C) Hydatidiform mole D) Preterm labor

A nurse explains to new parents that their newborn has developed respiratory distress syndrome (R D S). Which of the following signs and symptoms would not be characteristic of R D S? A) Grunting respirations B) Nasal flaring C) Respiratory rate of 40 during sleep D) Chest retractions

A nurse is caring for a client who is at 42 weeks of gestation and in active labor. Which of the following findings is the fetus at risk for developing? A) Intrauterine growth restriction B) Hyperglycemia C) Meconium aspiration D) Polyhydramnios

A nurse is caring for a client who is in active labor, irritable, and reports the urge to have a bowel movement. The client vomits and states, "I've had enough. I can't do this anymore." Which of the following stages of labor is the client experiencing? A. 2nd stage B. 4th stage C. Transition stage D. Latent stage

A nurse is caring for several postpartum clients. Which client is demonstrating a problem attaching to her newborn? A) The client who is discussing how the baby looks like her father B) The client who is singing softly to her baby C) The client who continues to touch her baby with only her fingertips D) The client who picks her baby up when the baby cries

A patient is scheduled to have the following type of incision for a cesarean birth. What advantage should the nurse explain to the patient that this type of incision has? (PICTURE) A) Easier to repair B) Less blood loss C) Expedites delivery of multiple fetuses D) Less likely to rupture with future pregnancies

A pregnant client confides to the nurse that she is eating laundry starch daily. The nurse should assess the client for which of the following? A) Alopecia B) Weight loss C) Iron deficiency anemia D) Fecal impaction

A woman has been in labor for 16 hours. Her cervi × is dilated to 3 c m and is 80% effaced. The fetal presenting part is not engaged. The nurse would suspect which of the following? A) Breech malpresentation B) Fetal demise C) Cephalopelvic disproportion (C P D) D) Abruptio placentae

A young adolescent is transferred to the labor and delivery unit from the emergency department. The client is in active labor, but did not know she was pregnant. What is the most important nursing action? A) Determine who might be the father of the baby for paternity testing. B) Ask the client what kind of birthing experience she would like to have. C) Assess blood pressure and check for proteinuria. D) Obtain a Social Services referral to discuss adoption.

After nalbuphine hydrochloride (Nubain) is administered, labor progresses rapidly, and the baby is born less than 1 hour later. The baby shows signs of respiratory depression. Which medication should the nurse be prepared to administer to the newborn? A) Fentanyl (Sublimaze) B) Butorphanol tartrate (Stadol) C) Naloxone (Narcan) D) Pentobarbital (Nembutal)

Approximately what percentage of the newborn's body weight is water? A) 5% to 10% B) 90% to 95% C) 70% to 75% D) 50% to 60%

At 1 minute after birth, the infant has a heart rate of 100 beats per minute, and is crying vigorously. The limbs are flexed, the trunk is pink, and the feet and hands are cyanotic. The infant cries easily when the soles of the feet are stimulated. How would the nurse document this infant's Apgar score? A) 7 B) 8 C) 9 D) 10

During a nonstress test, the nurse notes that the fetal heart rate decelerates about 15 beats during a period of fetal movement. The decelerations occur twice during the test, and last 20 seconds each. The nurse realizes these results will be interpreted as which of the following? A) A negative test B) A reactive test C) A nonreactive test D) An equivocal test

During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, an RN finds the client's uterus to be firm and midline & at the level of the umbilicus. Which of the following findings should the nurse interpret this data as being? A. Evidence of a possible vaginal hematoma B. An indication of a cervical or perineal laceration C. A normal postural discharge of lochia D. Abnormally excessive lochia rubra flow

During an assessment of a 12-hour-old newborn, the nurse notices pale pink spots on the nape of the neck. The nurse documents this finding as which of the following? A) Nevus vasculosus B) Nevus flammeus C) Telangiectatic nevi D) A Mongolian spot

During discharge planning for a drug-dependent newborn, the nurse explains to the mother how to do which of the following? A) Place the newborn in a prone position. B) Limit feedings to three a day to decrease diarrhea. C) Place the infant supine and operate a home apnea-monitoring system. D) Wean the newborn off the pacifier.

During her first months of pregnancy, a client tells the nurse, "It seems like I have to go to the bathroom every 5 minutes." The nurse explains to the client that this is because of which of the following? A) The client probably has a urinary tract infection. B) Bladder capacity increases throughout pregnancy. C) The growing uterus puts pressure on the bladder. D) Some women are very sensitive to body function changes.

If the physician indicates a shoulder dystocia during the delivery of a macrosomic fetus, how would the nurse assist? A) Call a second physician to assist. B) Prepare for an immediate cesarean delivery. C) Assist the woman into McRoberts maneuver. D) Utilize fundal pressure to push the fetus out.

In early-pregnancy class, the nurse emphasizes the importance of 8-10 glasses of fluid per day. How many of these should be water? A) 1 to 2 B) 2 to 4 C) 4 to 6 D) 3 to 5

Induction of labor is planned for a 31-year-old client at 39 weeks due to insulin-dependent diabetes. Which nursing action is most important? A) Administer 100 mcg of misoprostol (Cytotec) vaginally every 2 hours. B) Place dinoprostone (Prepidil) vaginal gel and ambulate client for 1 hour. C) Begin Pitocin (oxytocin) 4 hours after 50 mcg misoprostol (Cytotec). D) Prepare to induce labor after administering a tap water enema.

It is 1 week before a pregnant client's due date. The nurse notes on the chart that the client's pulse rate was 74-80 before pregnancy. Today, the client's pulse rate at rest is 90. What action should the nurse should take? A) Chart the findings. B) Notify the physician of tachycardia. C) Prepare the client for an electrocardiogram (E K G). D) Prepare the client for transport to the hospital.

Major perineal trauma (extension to or through the anal sphincter) is more likely to occur if what type of episiotomy is performed? A) Mediolateral B) Episiorrhaphy C) Midline D) Medical

New parents decide not to have their newborn circumcised. What should the nurse teach regarding care for the uncircumcised infant? A) The foreskin will be retractable at 2 months. B) Retract the foreskin and clean thoroughly. C) Avoid retracting the foreskin. D) Use soap and Betadine to cleanse the penis daily.

On the first postpartum day, the nurse teaches the client about breastfeeding. Two hours later, the mother seems to remember very little of the teaching. The nurse understands this memory lapse to be related to which of the following? A) The taking-hold phase B) Postpartum hemorrhage C) The taking-in period D) Epidural anesthesia

Persistent early decelerations are noted. What would the nurse's first action be? A) Turn the mother on her left side and give oxygen. B) Check for prolapsed cord. C) Do nothing. This is a benign pattern. D) Prepare for immediate forceps or cesarean delivery.

Screening for gestational diabetes mellitus (G D M) is typically completed between which of the following weeks of gestation? A) 36 and 40 weeks B) Before 20 weeks C) 24 and 28 weeks D) 30 and 34 weeks

Specific cellular immunity is mediated by T lymphocytes, which enhance the efficiency of the phagocytic response. What do cytotoxic activated T cells do? A) Enable T or B cells to respond to antigens B) Repress responses to specific B or T lymphocytes to antigens C) Kill foreign or virus-infected cells D) Remove pathogens and cell debris

The client at 30 weeks' gestation is admitted with painless late vaginal bleeding. The nurse understands that expectant management includes which of the following? A) Limiting vaginal exams to only one per 24-hour period. B) Evaluating the fetal heart rate with an internal monitor. C) Monitoring for blood loss, pain, and uterine contractibility. D) Assessing blood pressure every 2 hours.

The client demonstrates understanding of the implications for future pregnancies secondary to her classic uterine incision when she states which of the following? A) "The next time I have a baby, I can try to deliver vaginally." B) "The risk of rupturing my uterus is too high for me to have any more babies." C) "Every time I have a baby, I will have to have a cesarean delivery." D) "I can only have one more baby."

The client has been pushing for 2 hours and is exhausted. The physician is performing a vacuum extraction to assist the birth. Which finding is expected and normal? A) The head is delivered after eight "pop-offs" during contractions. B) A cephalohematoma is present on the fetal scalp. C) The location of the vacuum is apparent on the fetal scalp after birth. D) Positive pressure is applied by the vacuum extraction during contractions.

The client has delivered her first child at 37 weeks. The nurse would describe this to the client as what type of delivery? A) Preterm B) Postterm C) Early term D) Near term

The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she has not had a menstrual cycle for 3 months, and her breasts are getting bigger. What response by the nurse is best? A) "Lack of menses and breast enlargement are presumptive signs of pregnancy." B) "The changes you are describing are definitely indicators that you are pregnant." C) "Lack of menses can be caused by many things. We need to do a pregnancy test." D) "You're probably not pregnant, but we can check it out if you like."

The client is at 6 weeks' gestation, and is spotting. The client had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order which intervention? A) A urine pregnancy test B) The client to be seen next week for a full examination C) An antiserum pregnancy test D) An ultrasound

The client is being admitted to the birthing unit. As the nurse begins the assessment, the client's partner asks why the fetus's heart rate will be monitored. After the nurse explains, which statement by the partner indicates a need for further teaching? A) "The fetus's heart rate will vary between 110 and 160." B) "The heart rate is monitored to see whether the fetus is tolerating labor." C) "By listening to the heart, we can tell the gender of the fetus." D) "After listening to the heart rate, you will contact the midwife."

The client is recovering from a delivery that included a midline episiotomy. Her perineum is swollen and sore. Ten minutes after an ice pack is applied, the client asks for another. What is the best response from the nurse? A) "I'll get you one right away." B) "You only need to use one ice pack." C) "You need to leave it off for at least 20 minutes and then reapply." D) "I'll bring you an extra so that you can change it when you are ready."

The client requires vacuum extraction assistance. To provide easier access to the fetal head, the physician cuts a mediolateral episiotomy. After delivery, the client asks the nurse to describe the episiotomy. How does the nurse respond? A) "The episiotomy goes straight back toward your rectum." B) "The episiotomy is from your vagina toward the urethra." C) "The episiotomy is cut diagonally away from your vagina." D) "The episiotomy extends from your vagina into your rectum."

The client with a normal pregnancy had an emergency cesarean birth under general anesthesia 2 hours ago. The client now has a respiratory rate of 30, pale blue nail beds, a pulse rate of 110, and a temperature of 102.6°F, and is complaining of chest pain. The nurse understands that the client most likely is experiencing which of the following? A) Pulmonary embolus B) Pneumococcal pneumonia C) Pneumonitis D) Gastroesophageal reflux disease

The client with an abnormal quadruple screen is scheduled for an ultrasound. Which statement indicates that the client understands the need for this additional antepartal fetal surveillance? A) "After the ultrasound, my partner and I will decide how to decorate the nursery." B) "During the ultrasound we will see which of us the baby looks like most." C) "The ultrasound will show whether there are abnormalities with the baby's spine." D) "The blood test wasn't run correctly, and now we need to have the sonogram."

The community nurse is working with a client whose only child is 8 months old. Which statement does the nurse expect the mother to make? A) "I have a lot more time to myself than I thought I would have." B) "My confidence level in my parenting is higher than I anticipated." C) "I am constantly tired. I feel like I could sleep for a week." D) "My baby likes everyone, and never fusses when she's held by a stranger."

The labor and delivery nurse is assigned to four clients in early labor. Which electronic fetal monitoring finding would require immediate intervention? A) Early decelerations with each contraction B) Variable decelerations that recover to the baseline C) Late decelerations with minimal variability D) Accelerations

The laboring client with meconium-stained amniotic fluid asks the nurse why the fetal monitor is necessary, as she finds the belt uncomfortable. Which response by the nurse is most important? A) "The monitor is necessary so we can see how your labor is progressing." B) "The monitor will prevent complications from the meconium in your fluid." C) "The monitor helps us to see how the baby is tolerating labor." D) "The monitor can be removed, and oxygen given instead."

The nurse assesses the gestational age of a newborn and informs the parents that the newborn is premature. Which of the following assessment findings is not congruent with prematurity? A) Cry is weak and feeble B) Clitoris and labia minora are prominent C) Strong sucking reflex D) Lanugo is plentiful

The nurse assessing a pregnant African American woman in the first trimester understands that a cultural practice is which of the following? A) Use of herbs like dandelion during pregnancy to increase lactation B) Drinking ginseng tea for faintness C) Eating clay to supply dietary minerals D) Consulting a spiritual advisor to ensure a healthy pregnancy and birth

The nurse attempts to elicit the Moro reflex on a newborn, and assesses movement of the right arm only. Based on this finding, the nurse immediately assesses for which of the following? A) Ortolani maneuver B) Palmar grasping reflex C) Clavicle D) Tonic neck reflex

The nurse determines the fundus of a postpartum client to be boggy. Initially, what should the nurse do? A) Document the findings. B) Catheterize the client. C) Massage the uterine fundus until it is firm. D) Call the physician immediately.

The nurse has instructed a new mother on quieting activities for her newborn. The nurse knows that the mother understands when she overhears the mother telling the father to do what? A) Hold the newborn in an upright position. B) Massage the hands and feet. C) Swaddle the newborn in a blanket. D) Make eye contact while talking to the newborn.

The nurse has just palpated contractions and compares the consistency to that of the forehead in order to estimate the firmness of the fundus. What would the intensity of these contractions be identified as? A) Mild B) Moderate C) Strong D) Weak

The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take? A) Reassure the client that this is a normal finding in multigravidas. B) Suggest that she should feel for movement with her fingertips. C) Schedule an appointment for her with her physician for that same day. D) Tell her gently that her fetus is probably dead.

The nurse in a prenatal clinic finds that four clients have called with complaints related to their pregnancies. Which call should the nurse return first? A) Pregnant woman at 7 weeks' gestation reporting nasal stuffiness B) Pregnant woman at 38 weeks' gestation experiencing rectal itching and hemorrhoids C) Pregnant woman at 15 weeks' gestation with nausea and vomiting and a 15-pound weight loss D) Pregnant woman at 32 weeks' gestation treating constipation with prune juice

The nurse is caring for a client at 30 weeks' gestation who is experiencing preterm premature rupture of membranes (P P R O M). Which statement indicates that the client needs additional teaching? A) "If I were having a singleton pregnancy instead of twins, my membranes would probably not have ruptured." B) "If I develop a urinary tract infection in my next pregnancy, I might rupture membranes early again." C) "If I want to become pregnant again, I will have to plan on being on bed rest for the whole pregnancy." D) "If I have amniocentesis, I might rupture the membranes again."

The nurse is caring for a client experiencing a uterine rupture. Which outcome demonstrates that the plan of care has been effective for the client? A) The mother remains hemodynamically stable throughout emergency cesarean birth. B) The mother has additional knowledge regarding the problems, implications, and treatment plans. C) The F H R remains in normal range with supportive measures. D) The family is able to cope successfully with fetal or neonatal anomalies, if they exist.

The nurse is caring for an infant born at 37 weeks that weighs 1750 g (3 pounds 10 ounces). The head circumference and length are in the 25th percentile. What statement would the nurse expect to find in the chart? A) Preterm appropriate for gestational age, symmetrical I U G R B) Term small for gestational age, symmetrical I U G R C) Preterm small for gestational age, asymmetrical I U G R D) Preterm appropriate for gestational age, asymmetrical I U G R

The nurse is caring for an infant who was delivered in a car on the way to the hospital and who has developed cold stress. Which finding requires immediate intervention? A) Increased skin temperature and respirations B) Blood glucose level of 45 C) Room-temperature I V running D) Positioned under radiant warmer

The nurse is completing a newborn care class. The nurse knows that teaching has been effective if a new parent states which of the following? A) "My baby might open her arms wide and pull her legs up to her tummy if she is passing gas." B) "When I hold my baby upright with one of his feet on the floor, his feet will automatically remain still." C) "When I put my finger in the palm of my daughter's hand, she will curl her fingers and hold on." D) "I can get my baby to turn his head toward the right if I lift his right arm over his head."

The nurse is instructing a new mother on circumcision care with a Plastibell. The nurse knows the mother understands when she states that the Plastibell should fall off within how long? A) 2 days B) 10 days C) 8 days D) 14 days

The nurse is listening to the fetal heart tones of a client at 37 weeks' gestation while the client is in a supine position. The client states, "I'm getting lightheaded and dizzy." What is the nurse's best action? A) Assist the client to sit up. B) Remind the client that she needs to lie still to hear the baby. C) Help the client turn onto her left side. D) Check the client's blood pressure.

The nurse is measuring the fundal height of a patient who is at 28 weeks' gestation using the following method. What would be considered a normal finding? A) 22 c m B) 24 c m C) 28 c m D) 30 c m

The nurse is observing a new graduate perform a postpartum assessment. Which action requires intervention by the nurse? A) Asking the client to void and donning clean gloves B) Listening to bowel sounds and then asking when her last bowel movement occurred C) Offering the patient pre-medication 2 hours before the assessment D) Completing the assessment and explaining the results to the client

The nurse is planning an educational presentation on hyperbilirubinemia for nursery nurses. Which statement is most important to include in the presentation? A) Conjugated bilirubin is eliminated in the conjugated state. B) Unconjugated bilirubin is neurotoxic, and cannot cross the placenta. C) Total bilirubin is the sum of the direct and indirect levels. D) Hyperbilirubinemia is a decreased total serum bilirubin level.

The nurse is planning care for a preterm newborn. Which nursing diagnosis has the highest priority? A) Tissue Integrity, Impaired B) Infection, Risk for C) Gas Exchange, Impaired D) Family Processes, Dysfunctional

The nurse is preparing a client in her second trimester for a three-dimensional ultrasound examination. Which statement indicates that teaching has been effective? A) "If the ultrasound is normal, it means my baby has no abnormalities." B) "The nuchal translucency measurement will diagnose Down syndrome." C) "I might be able to see who the baby looks like with the ultrasound." D) "Measuring the length of my cervix will determine whether I will deliver early."

The nurse is presenting a class of important "dos and don'ts" during pregnancy, including travel considerations. What method of travel does the nurse recommend as most appropriate for a client in her 25th week of pregnancy? A) Automobile B) Airplane C) Train D) None; this client should not travel

The nurse is providing care to a pregnant client diagnosed with a urinary tract infection (U T I) during a routine prenatal visit. What will the nurse educate the client about based on this data? A) Gestational hypertension B) Gestational diabetes mellitus C) Preterm labor D) Anemia

The nurse is providing care to a pregnant client who is experiencing an increase in white, thick, and "cottage-cheese-like" vaginal discharge. Based on this data, which diagnosis does the nurse anticipate for this client? A) Syphilis B) Gonorrhea C) Moniliasis D) Chlamydia

The nurse is providing discharge teaching to a woman who delivered her first child 2 days ago. The nurse understands that additional information is needed if the client makes which statement? A) "I should expect a lighter flow next week." B) "The flow will increase if I am too active." C) "My bleeding will remain red for about a month." D) "I will be able to use a pantiliner in a day or two."

The nurse is providing prenatal care to an obese client who asks, "How much weight should I gain during my pregnancy?" Which response by the nurse is appropriate? A) "You should gain 15 to 25 pounds." B) "You should gain 25 to 35 pounds." C) "You should gain 11 to 20 pounds." D) "You should gain 28 to 40 pounds."

A nurse is caring for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this condition? A) No alteration in menses B) Transvaginal ultrasound indication a fetus in the uterus C) Blood progesterone greater than the expected reference range D) Report of sever shoulder pain

The nurse is providing preoperative teaching to a client for whom a cesarean birth under general anesthesia is scheduled for the next day. Which statement by the client indicates that she requires additional information? A) "General anesthesia can be accomplished with inhaled gases." B) "General anesthesia usually involves administering medication into my I V." C) "General anesthesia will provide good pain relief after the birth." D) "General anesthesia takes effect faster than an epidural."

The nurse is teaching a class on infant care to new parents. Which statement by a parent indicates that additional teaching is needed? A) "The white spots on my baby's nose are called milia, and are harmless." B) "The whitish cheeselike substance in the creases is vernix, and will be absorbed." C) "The red spots with a white center on my baby are abnormal acne." D) "Jaundice is a yellowish discoloration of skin that if noticed on the 1st day of life should be reported to the physician."

The nurse is teaching an early pregnancy class for clients in the first trimester of pregnancy. Which statement by a client requires immediate intervention by the nurse? A) "When my nausea is bad, I will drink some ginger tea." B) "The fatigue I am experiencing will improve in the second trimester." C) "It is normal for my vaginal discharge to be green." D) "I will urinate less often during the middle of my pregnancy."

The nurse is using the New Ballard Score to assess the gestational age of a newborn delivered 4 hours ago. The infant's gestational age is 33 weeks based on early ultrasound and last menstrual period. The nurse expects the infant to exhibit which of the following? A) Full sole creases, nails extending beyond the fingertips, scarf sign showing the elbow beyond the midline B) Testes located in the upper scrotum, rugae covering the scrotum, vernix covering the entire body C) Ear cartilage folded over, lanugo present over much of the body, slow recoil time D) 1 c m breast bud, peeling skin and veins not visible, rapid recoil of legs and arms to extension

The nurse is working with a student nurse during assessment of a 2-hour-old newborn. Which action indicates that the student nurse understands neonatal assessment? A) The student nurse listens to bowel sounds, then assesses the head for skull consistency and size and tension of fontanelles. B) The student nurse checks for Ortolani's sign, then palpates the femoral pulse, then assesses respiratory rate. C) The student nurse determines skin color, then describes the shape of the chest and looks at structures and flexion of the feet. D) The student nurse counts the number of cord vessels, then assesses genitals, then sclera color and eyelids.

The nurse knows that a lecithin/sphingomyelin (L/S) ratio finding of 2:1 in amniotic fluid means which of the following? A) Fetal lungs are still immature. B) The fetus has a congenital anomaly. C) Fetal lungs are mature. D) The fetus is small for gestational age.

The nurse knows that in some cases, breastfeeding is not advisable. Which mother should be counseled against breastfeeding? A) A mother with a poorly balanced diet B) A mother who is overweight C) A mother who is H I V positive D) A mother who has twins

The nurse teaches the parents of an infant who was recently circumcised to observe for bleeding. What should the parents be taught to do if bleeding does occur? A) Wrap the diaper tightly. B) Clean with warm water with each diaper change. C) Apply gentle pressure to the site with gauze. D) Apply a new petroleum ointment gauze dressing.

The parents of a newborn male ask the nurse whether they should circumcise their son. What is the best response by the nurse? A) "Circumcision should be undertaken to prevent problems in the future." B) "Circumcision might decrease the child's risk of developing a urinary tract infection." C) "Circumcision can sometimes cause complications. What questions do you have?" D) "Circumcision is painful, and should be avoided unless you are Jewish."

The parents of a preterm newborn wish to visit their baby in the N I C U. A statement by the nurse that would not support the parents as they visit their newborn is which of the following? A) "Your newborn likes to be touched." B) "Stroking the newborn will help with stimulation." C) "Visits must be scheduled between feedings." D) "Your baby loves her pink blanket."

The postpartum client is about to go home. The nurse includes which subject in the teaching plan? A) Replacement of fluids B) Striae C) Diastasis of the recti muscles D) R E E D A scale

The pregnant client cannot tolerate milk or meat. What would the nurse recommend to the client to assist in meeting protein needs? A) Wheat bread and pasta B) Ice cream and peanut butter C) Eggs and tofu D) Beans and potatoes

The pregnant client in her second trimester states, "I didn't know my breasts would become so large. How do I find a good bra?" The best answer for the nurse to give would be which of the following? A) "Avoid cotton fabrics and get an underwire bra; they fit everyone best." B) "Just buy a bra one cup size bigger than usual, and it will fit." C) "Look for wide straps and cups big enough for all of your breast tissue." D) "There isn't much you can do for comfort. Try not wearing a bra at all."

The prenatal client in her third trimester tells the clinic nurse that she works 8 hours a day as a cashier and stands when at work. What response by the nurse is best? A) "No problem. Your baby will be fine." B) "Do you get regular breaks for eating?" C) "Your risk of poor pregnancy outcomes may be higher." D) "Standing might increase ankle swelling."

The student nurse is to perform Leopold maneuvers on a laboring client. Which assessment requires intervention by the staff nurse? A) The client is assisted into supine position, and the position of the fetus is assessed. B) The upper portion of the uterus is palpated, then the middle section. C) After determining where the back is located, the cervix is assessed. D) Following voiding, the client's abdomen is palpated from top to bottom.

Two hours after an epidural infusion has begun, a client complains of itching on her face and neck. What should the nurse do? A) Remove the epidural catheter and apply a Band-Aid to the injection site. B) Offer the client a cool cloth and let her know the itching is temporary. C) Recognize that this is a common side effect, and follow protocol for administration of Benadryl. D) Call the anesthesia care provider to re-dose the epidural catheter.

What is the increased vascularization causing the softening of the cervix known as? A) Hegar sign B) Chadwick sign C) Goodell sign D) McDonald sign

When assisting with a transabdominal ultrasound sampling, which of the following would the nurse do? A) Obtain preliminary urinary samples. B) Have the woman empty her bladder before the test begins. C) Assist the woman into a supine position on the examining table. D) Instruct the woman to eat a fat-free meal 2 hours before the scheduled test time.

When counseling a newly pregnant client at 8 weeks' gestation with twins, the nurse teaches the woman about the need for increased caloric intake. What would the nurse tell the woman that the minimum recommended intake should be? A) 2500 k c a l and 120 grams protein B) 3000 k c a l and 150 grams protein C) 4000 k c a l and 135 grams protein D) 5000 k c a l and 190 grams protein

When is breastfeeding contraindicated? A) Infant has hypertension B) Mother has a history of treated tuberculosis C) Mother is H I V positive or has A I D S D) Mother has a history of treated herpes

Which of the following drugs and drug categories can cause multiple fetal central nervous system (C N S), facial, and cardiovascular anomalies? A) Category C: Zidovudine B) Category B: Penicillin C) Category X: Isotretinoin D) Category A: Vitamin C

Which of the following is the primary carbohydrate in the breastfeeding newborn? A) Glucose B) Fructose C) Lactose D) Maltose

Which of the following tests has become a widely accepted method of evaluating fetal status? A) Contraction stress test (C S T) B) M S A F P test C) Nonstress test (N S T) D) Nuchal translucency test

Which statement by a new mother 1 week postpartum indicates maternal role attainment? A) "I don't think I'll ever know what I'm doing." B) "This baby feels like a real stranger to me." C) "It works better for me to undress the baby and to nurse in the chair rather than the bed." D) "My sister took to mothering in no time. Why can't I?"

Which statement, if made by a pregnant client, would indicate that she understands health promotion during pregnancy? A) "I lie down after eating to relieve heartburn." B) "I try to limit my fluid intake to 3 or 4 glasses each day." C) "I elevate my legs while sitting at my desk." D) "I am avoiding exercise to stay well rested."

1) A nurse is providing a client with instructions regarding breast self-examination (B S E). Which of the following statements by the client would indicate that the teaching has been successful? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "I should perform B S E 1 week prior to the start of my period." B) "When I reach menopause, I will perform B S E every 2 months." C) "Knowing the density of my breast tissue is important." D) "I should inspect my breasts while standing with my arms down at my sides." E) "I should inspect my breasts while in a supine position with my arms at my sides."

C, D

The labor and birth nurse is admitting a client. The nurse's assessment includes asking the client whom she would like to have present for the labor and birth, and what the client would prefer to wear. The client's partner asks the nurse the reason for these questions. What would the nurse's best response be? Select all that apply. A) "These questions are asked of all women. It's no big deal." B) "I'd prefer that your partner ask me all the questions, not you." C) "A client's preferences for her birth are important for me to understand." D) "Many women have beliefs about childbearing that affect these choices." E) "I'm gathering information that the nurses will use after the birth."

C, D

1) A patient experiencing symptoms of menopause asks if there are any vitamin supplements she should take at this time. Which vitamins should the nurse suggest to this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Vitamin A B) Vitamin C C) Vitamin D D) Vitamin E E) Vitamin B complex

C, D, E

1) The nurse takes a telephone call from a women's health clinic patient. What information should cause the nurse to suspect that the patient is experiencing a cystocele? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Bloody urine B) Low back pain C) Onset of stress incontinence D) Feeling of fullness in the perineum E) Feels like something "fell out" of the vagina

C, D, E

A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of which of the following?. Select all that apply. A) Confirm fetal heart activity. B) Evaluate the cervix. C) Determine fetal presentation. D) Assess amniotic fluid volume. E) Determine fetal number.

C, D, E

An abbreviated systematic physical assessment of the newborn is performed by the nurse in the birthing area to detect any abnormalities. Normal findings would include which of the following? Select all that apply. A) Skin color: Body blue with pinkish extremities B) Umbilical cord: two veins and one artery C) Respiration rate of 30-60 irregular D) Temperature of above 36.5°C (97.8°F) E) Sole creases that involve the heel

C, D, E

Clinical risk factors for severe hyperbilirubinemia include which of the following? Select all that apply. A) African American ethnicity B) Female gender C) Cephalohematoma D) Bruising E) Assisted delivery with vacuum or forceps

C, D, E

True postterm pregnancies are frequently associated with placental changes that cause a decrease in uterine-placental-fetal circulation. Complications related to alterations in placenta functioning include which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Increased fetal oxygenation B) Increased placental blood supply C) Reduced nutritional supply D) Macrosomia E) Risk of shoulder dystocia

C, D, E

What should the healthcare provider consider when prescribing a medication to a woman who is breastfeeding? Select all that apply. A) Drug's potential effect on hormone production B) Amount of drug excreted into the mother's blood C) Drug's potential adverse effects to the infant D) Infant's age and health E) Mother's need for the medication

C, D, E

The nurse is assessing the newborn for symptoms of anemia. If the blood loss is acute, the baby may exhibit which of the following signs of shock? Select all that apply. A) Increased pulse B) High blood pressure C) Tachycardia D) Bradycardia E) Capillary filling time greater than 3 seconds

C, E

The nurse is preparing a class for mothers who have just recently delivered and their partners. One topic of the class is infant attachment. Which statement by a participant indicates an understanding of this concept? Select all that apply. A) "We should avoid holding the baby too much." B) "Looking directly into the baby's eyes might frighten him." C) "Talking to the baby is good because he'll recognize our voices." D) "Holding the baby so we have direct face-to-face contact is good." E) "We should only touch the baby with our fingertips for the first month."

C,D

1) A 38-year-old patient is concerned that a month after becoming a widow, her menstrual cycles stopped. What should the nurse suspect as being the cause for this patient's secondary amenorrhea? A) Ovarian failure B) Pituitary dysfunction C) Severe or prolonged stress such as that which occurs with an unexpected death can lead to hypothalamic dysfunction. Ovarian failure is related to exposure to radiation, chemotherapy, viral infection, and surgical removal of the ovary. Pituitary dysfunction is related to pituitary tumors or disease, use of antipsychotic medication, low prolactin levels, head trauma, and cancer. With an anatomic abnormality the patient would not have had a menstrual cycle. D) Hypothalamic dysfunction

1) A client is planning to use condoms with a spermicidal cream as contraception. What should the nurse include when reviewing this method with the client? A) Coat the condom with spermicide before using B) Insert the spermicide 1 hour before having intercourse C) Insert the cream high into the vagina and remain supine D) Wait 15 minutes after inserting the spermicide into the vagina

1) A client scheduled to have a Mirena levonorgestrel intrauterine system (L N g-I U C) inserted asks how this device stops conception. What should the nurse say in response to this client? A) "It stops ovulation." B) "It slows sperm motility." C) "It shortens the menstrual cycle." D) "It causes the lining of the uterus to waste away."

1) A couple asks the nurse what is the safest method of sterilization. What should the nurse reply? A) "Laparotomy tubal ligation." B) "Laparoscopy tubal ligation." C) "Minilaparotomy." D) "Vasectomy."

1) A female client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this client? A) Intrauterine device B) Vaginal sponge C) Combined oral contraceptives D) Transdermal hormonal contraception

1) A female is offered a position as a manager with a major city hotel that offers flexibility with childcare and family issues. What should this individual also investigate financially before accepting this position? A) Number of sick days B) Expectations to work holidays C) Number of overtime hours expected to work every month D) Wages that are commensurate with those of male employee managers

1) A home care nurse is looking over the charts of four elderly female clients. The nurse knows that which client has the highest risk for developing diabetes and heart disease? A) A woman who is 55 and white B) A woman who is 60 and from a middle-class background C) All women over 55 D) A woman over 65 who is African American

1) A lesbian female is surprised to learn of contracting the human papillomavirus. What should the nurse explain to this patient? A) "Are you telling me everything about your sexual orientation?" B) "It is rare for this infection to occur in women such as yourself." C) "Is it possible that your partner has been having intercourse with a man?" D) "Exposure to vaginal secretions can increase the risk of sexually transmitted infections."

1) A nonpregnant client is diagnosed with bacterial vaginosis (B V). What does the nurse expect to administer? A) Penicillin G 2 million units I M one time B) Zithromax 1 m g P O bid for 2 weeks C) Doxycycline 100 m g P O bid for a week D) Metronidazole 500 m g P O bid for a week

1) A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role? A) A registered nurse who is the manager of a large obstetrical unit B) A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections) C) A clinical nurse specialist working as a staff nurse on a mother-baby unit D) A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants

1) A patient is demonstrating manifestations of acute cervicitis. Which laboratory test should the nurse expect to be completed for this patient? A) Sedimentation rate B) Blood test for V D R L C) White blood cell count D) Vaginal smear for S T Is

1) A patient treated for a urinary tract infection a month ago is experiencing symptoms of the same infection. What should the nurse suspect is the reason for the reoccurrence of the infection? A) Using oral contraceptives B) Wearing cotton underwear C) Cleansing from front to back D) Stopped antibiotics after 3 days

1) A patient who is postmenopausal is encouraged to take calcium 1500 mg every day. How should the nurse instruct the patient to take this supplement? A) Take calcium 750 m g with breakfast and dinner B) Take the complete dose first thing in the morning C) Take the complete dose prior to bedtime every day D) Take calcium 500 m g three times a day with meals

1) A patient with amenorrhea has an elevated serum prolactin level. Which diagnostic test should the nurse expect will be prescribed for this patient? A) Laparoscopy B) Abdominal ultrasound C) C T scan of the abdomen D) Magnetic resonance imaging (M R I)

1) A sexually active female asks why an H I V test is needed since she uses condoms with spermicidal agents when having intercourse. How should the nurse respond to this client? A) "Condoms do not protect against contracting H I V." B) "Spermicides only control bacteria and not viruses." C) "All sexually active people are at risk for contracting H I V." D) "The spermicide can make your vaginal cells more susceptible to H I V."

1) Duvall's eight stages in the family life cycle of a traditional nuclear family have been used as the foundation for contemporary models that describe the developmental processes and role expectations for different family types. Which of the following is an example of Stage Ⅳ of this family life cycle? A) Families launching young adults (all children leave home) B) Families with preschool-age children (oldest child is between 2.5 and 6 years of age) C) Middle-aged parents (empty nest through retirement) D) Families with schoolchildren (oldest child is between 6 and 13 years of age)

1) The client with limited English language skills has a black eye and bruises across her face and arms. The client's husband has been acting as an interpreter for her, and answers all of the questions the nurse asks, often without talking to his wife first. The nurse suspects the client has been a victim of domestic abuse. What should the nurse do next? A) Ask the husband whether he has beaten his wife. B) Ask the husband to have a female friend come in with his wife. C) Provide written materials in English for the client to read at home. D) Ask the husband to step out of the room, and obtain an interpreter.

1) The community clinic nurse manager is working on a long-term budget. The manager understands that in the next few years, Medicaid is expected to pay for fewer births. This is, in part, because of which of the following? A) The U.S. economy is becoming stronger. B) More women are able to pay for private insurance. C) New public policies are providing other forms of payment. D) Rules for Medicaid have been changed.

1) The community nurse is planning to visit a family. The grandparents are helping the adult parents with child-rearing activities. For which type of family should the nurse plan care? A) Nuclear B) Blended C) Binuclear D) Extended

1) The elderly parent of an employee at an insurance company sustains a myocardial infarction and needs assistance for several weeks after returning home from the hospital. What option should the employee consider to cover her absence while caring for her parent? A) Sick days B) Personal days C) Vacation days D) Family medical leave

1) The labor and delivery nurse is caring for a laboring client who has asked for a priest to visit her during labor. The client's mother died during childbirth, and although there were no complications during her pregnancy, the client is fearful of her own death during labor. What would be the best way for the nurse to respond? A) "Nothing is going to happen to you. We'll take very good care of you during your birth." B) "Would you like to have an epidural so that you won't feel the pain of the contractions?" C) "The priest won't be able to prevent complications, and might get in the way of your providers." D) "Would you like me to contact someone from your parish or our hospital chaplain to come see you?"

1) The nurse is conducting a health maintenance assessment for a female client. Which neurologic data would cause the nurse to further assess for intimate partner abuse? A) Anxiety B) Depression C) Weight gain D) Tension headaches

1) The nurse is identifying complementary and alternative therapies for a patient with a history of liver disorders who is experiencing symptoms of menopause. Which herbal supplement should this patient be counseled to avoid? A) Ginger B) Ginseng C) Red clover D) Black cohosh

1) The nurse is interviewing a client who has admitted to being a victim of domestic violence. What is the most typical description of how the domestic violence developed in a relationship? A) "He changed overnight. Everything was fine, and all of a sudden he flipped out and beat me up; he nearly killed me." B) "It was severe from the beginning. As soon as we got married, he began hitting me and threatening to kill me." C) "We've both always dated other people. I thought that was understood. He was as emotionally abusive in the beginning as he is now." D) "I don't know when it started, really. It was gradual. First, just yelling, blaming, and shoving. Then the beatings started; and now they're more frequent."

1) The nurse is preparing a community presentation on family development. Which statement should the nurse include? A) The youngest child determines the family's current stage. B) A family does not experience overlapping of stages. C) Family development ends when the youngest child leaves home. D) The stages describe the family's progression over time.

1) The nurse is preparing a female client for a scheduled pelvic examination. During the health history interview, the client states, "My husband constantly criticizes me and calls me stupid. I am afraid that he will begin to hit me one of these days." Which type of intimate partner violence is the client experiencing based on the assessment data? A) Sexual abuse B) Physical abuse C) Economic abuse D) Emotional abuse

1) The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that which of the following is the primary use of a family assessment tool? A) Obtain a comprehensive medical history of family members. B) Determine to which clinic the client should be referred. C) Predict how a family will likely change with the addition of children. D) Understand the physical, emotional, and spiritual needs of members.

1) The nurse is preparing to assess the sexual history of a 35-year-old female patient. Which approach should the nurse first use to facilitate this data collection? A) Ask if the patient is sexually active B) Review the present method of birth control C) Determine the patient's number of children D) Talk about the patient's medical-surgical history

1) The nurse is providing care to a female client who presents in the emergency department (E D) with multiple bruises and lacerations. The nurse suspects the client is the victim of domestic violence. Which action by the nurse is appropriate? A) Reporting the incident to the police to enhance safety B) Documenting domestic violence in the medical record C) Avoiding photographs of the injuries to prevent embarrassment D) Communicating the level of confidentiality that can be expected

1) The nurse is teaching a client who is having the Skyla L N g-I U C device inserted for contraception. What should the nurse emphasize to the client about this device? A) This device will provide protection for 5 years B) This device will provide protection for 10 years C) This device should not be used with a copper allergy D) This device has a silver ring and could interfere with an M R I

1) The nurse suspects that a patient is experiencing bacterial vaginosis. What finding caused the nurse to make this clinical determination? A) Dysuria B) Vaginal itching C) Thick white vaginal discharge D) Fishy odor to vaginal discharge

1) The nurse working with a client who is seeking a family and medical leave knows that the employee must meet which eligibility requirement of the Family and Medical Leave Act (F M L A) of 1993? A) Work at least 40 hours per week B) Have been employed for at least 1 month C) Work for a company with fewer than 50 employees D) Parental leave for childbirth or adoption by her employer

1) The nurse works in a facility that cares for clients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation to recently hired nurses on the client population of the facility? A) "Our clients come from a broad range of backgrounds, but we have a good interpreter service." B) "Many of our clients come from backgrounds different from your own, but it doesn't cause problems for the nurses." C) "Because most of the doctors are bilingual, we don't have to deal with the differences in cultural backgrounds of our clients." D) "Understanding the common values and health practices of our diverse clients will facilitate better care and health outcomes."

1) When teaching a culturally diverse group of childbearing families about hospital birthing options, the culturally competent nurse does which of the following? A) Understands that the families have the same values as the nurse B) Teaches the families how childbearing takes place in the United States C) Insists that the clients answer questions instead of their husbands D) Incorporates the specific beliefs of the cultural groups that are attending the class

1) Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea? A) 17-year-old, has never had a menstrual cycle B) 16-year-old, had regular menses for 4 years, but has had no menses in 4 months C) 19-year-old, regular menses for 5 years that have suddenly become painful D) 14-year-old, irregular menses for 1 year, experiences cramping every cycle

7) The nurse at an elementary school is performing T B screenings on all of the students. Permission slips were returned for all but the children of one family. When the nurse phones to obtain permission, the parent states in clearly understandable English that permission cannot be given because the grandmother is out of town for 2 more weeks. Which cultural element is contributing to the dilemma that faces the nurse? A) Permissible physical contact with strangers B) Beliefs about the concepts of health and illness C) Religion and social beliefs D) Presence and influence of the extended family

7) The nurse manager is planning a presentation on ethical issues in caring for childbearing families. Which example should the nurse manager include to illustrate maternal-fetal conflict? A) A client chooses an abortion after her fetus is diagnosed with a genetic anomaly. B) A 39-year-old nulliparous client undergoes therapeutic insemination. C) A family of a child with leukemia requests cord-blood banking at a sibling's birth. D) A cesarean delivery of a breech fetus is court ordered after the client refuses.

7) The nurse reviewing charts for quality improvement notes that a client experienced a complication during labor. The nurse is uncertain whether the labor nurse took the appropriate action during the situation. What is the best way for the nurse to determine what the appropriate action should have been? A) Call the nurse manager of the labor and delivery unit and ask what the nurse should have done. B) Ask the departmental chair of the obstetrical physicians what the best nursing action would have been. C) Examine other charts to find cases of the same complication, and determine how it was handled in those situations. D) Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization.A

7) The registered nurse who has completed a master's degree program and passed a national certification exam has clinic appointments with clients who are pregnant or seeking well-woman care. What is the role of this nurse considered to be? A) Professional nurse B) Certified registered nurse (R N C) C) Clinical nurse specialist D) Nurse practitioner

A 38-week newborn is found to be small for gestational age (S G A). Which nursing intervention should be included in the care of this newborn? A) Monitor for feeding difficulties. B) Assess for facial paralysis. C) Monitor for signs of hyperglycemia. D) Maintain a warm environment.

A 7 pound 14 ounce girl was born to an insulin-dependent type Ⅱ diabetic mother 2 hours ago. The infant's blood sugar is 47 m g/d L. What is the best nursing action? A) To recheck the blood sugar in 6 hours B) To begin an I V of 10% dextrose C) To feed the baby 1 ounce of formula D) To document the findings in the chart

A client at 20 weeks' gestation has not decided on a feeding method for her infant. She asks the nurse for advice. The nurse presents information about the advantages and disadvantages of formula-feeding and breastfeeding. Which statements by the client indicate that the teaching was successful? A) "Formula-feeding gives the baby protection from infections." B) "Breast milk cannot be stored; it has to be thrown away after pumping." C) "Breastfeeding is more expensive than formula-feeding." D) "My baby will have a lower risk of food allergies if I breastfeed."

A client calls a providers office and reports having contractions for 2 hr that increased with activity and did not decrease with rest and hydration. The client denies leaking of vaginal fluid but did notice blood when wiping after voiding. Which of the following manifestations is the client experiencing? A. Braxton Hicks contractions B. Rupture of membranes C. Fetal decent D. True contractions

A client has just been admitted for labor and delivery. She is having mild contractions lasting 30 seconds every 15 minutes. The client wants to have a medication-free birth. When discussing medication alternatives, the nurse should be sure the client understands which of the following? A) In order to respect her wishes, no medication will be given. B) Pain relief will allow a more enjoyable birth experience. C) The use of medications allows the client to rest and be less fatigued. D) Maternal pain and stress can have a more adverse effect on the fetus than would a small amount of analgesia.

A client in her third trimester of pregnancy reports frequent leg cramps. What strategy would be most appropriate for the nurse to suggest? A) Point the toes of the affected leg B) Increase intake of protein-rich foods C) Limit activity for several days D) Flex the foot to stretch the calf

A new parent reports to the nurse that the baby looks cross-eyed several times a day. The nurse teaches the parents that this finding should resolve in how long? A) 2 months B) 2 weeks C) 1 year D) 4 months

A newborn is receiving phototherapy. Which intervention by the nurse would be most important? A) Measurement of head circumference B) Encouraging the mother to stop breastfeeding C) Stool blood testing D) Assessment of hydration status

A nurse is caring for a client who is in labor. With the use of Leopold maneuvers, it is noted that the fetus is in a breech presentation. For which of the following possible complications should the nurse observe? A) Precipitous labor B) Premature rupture of membranes C) Postmaturity syndrome D) Prolapsed umbilical cord

A nurse is caring for a newborn on a ventilator who has respiratory distress syndrome (R D S). The nurse informs the parents that the newborn is improving. Which data support the nurse's assessment? A) Decreased urine output B) Pulmonary vascular resistance increases C) Increased P C O2 D) Increased urination

A nurse is reviewing a new prescription for iron supplements with a client who is at 8 weeks of gestation and has iron deficiency anemia. Which of the following beverages should the nurse instruct the client to take the iron supplements with? A) Ice water B) Low-fat or whole milk C) Tea or coffee D) Orange juice

A nurse is reviewing postpartum nutrition needs with a group of clients who have begun breastfeeding their newborns. Which of the following statements by a member of the group indicates an understanding of the teaching? A) "I am glad I can have my morning coffee." B) "I should take folic acid to increase my milk supply." C) "I will continue adding 330 calories per day to my diet." D) "I will continue my calcium supplements because I don't like milk."

A postpartum client calls the nursery to report that her 3-day-old newborn has passed a green stool. What is the nurse's best response? A) "Take your newborn to the pediatrician." B) "There might be a possible food allergy." C) "Your newborn has diarrhea." D) "This is a normal occurrence."

A woman at 28 weeks' gestation is asked to keep a fetal activity record and to bring the results with her to her next clinic visit. One week later, she calls the clinic and anxiously tells the nurse that she has not felt the baby move for more than 30 minutes. Which of the following would be the nurse's most appropriate initial comment? A) "You need to come to the clinic right away for further evaluation." B) "Have you been smoking?" C) "When did you eat last?" D) "Your baby might be asleep."

A woman calls the clinic and tells a nurse that she thinks she might be pregnant. She wants to use a home pregnancy test before going to the clinic, and asks the nurse how to use it correctly. What information should the nurse give? A) The false-positive rate of these tests is quite high. B) If the results are negative, the woman should repeat the test in 2 weeks if she has not started her menstrual period. C) A negative result merely indicates growing trophoblastic tissue and not necessarily a uterine pregnancy. D) The client should follow up with a healthcare provider after taking the home pregnancy test.

A woman is in labor. The fetus is in vertex position. When the client's membranes rupture, the nurse sees that the amniotic fluid is meconium-stained. What should the nurse do immediately? A) Change the client's position in bed. B) Notify the physician that birth is imminent. C) Administer oxygen at 2 liters per minute. D) Begin continuous fetal heart rate monitoring.

After delivery, it is determined that there is a placenta accreta. Which intervention should the nurse anticipate? A) 2 L oxygen by mask B) Intravenous antibiotics C) Intravenous oxytocin D) Hysterectomy

After inserting prostaglandin gel for cervical ripening, what should the nurse do? A) Apply an internal fetal monitor. B) Insert an indwelling catheter. C) Withhold oral intake and start intravenous fluids. D) Place the client in a supine position with a right hip wedge.

After noting meconium-stained amniotic fluid and fetal heart rate decelerations, the physician diagnoses a depressed fetus. The appropriate nursing action at this time would be to do what? A) Increase the mother's oxygen rate. B) Turn the mother to the left lateral position. C) Prepare the mother for a higher-risk delivery. Increase the intravenous infusion rate

After several hours of labor, the electronic fetal monitor (E F M) shows repetitive variable decelerations in the fetal heart rate. The nurse would interpret the decelerations to be consistent with which of the following? A) Breech presentation B) Uteroplacental insufficiency C) Compression of the fetal head D) Umbilical cord compression

An expectant father has been at the bedside of his laboring partner for more than 12 hours. An appropriate nursing intervention would be which of the following? A) Insist that he leave the room for at least the next hour. B) Tell him he is not being as effective as he was, and that he needs to let someone else take over. C) Offer to remain with his partner while he takes a break. D) Suggest that the client's mother might be of more help.

As compared with admission considerations for an adult woman in labor, the nurse's priority for an adolescent in labor would be which of the following? A) Cultural background B) Plans for keeping the infant C) Support persons D) Developmental level

Before the newborn and mother are discharged from the birthing unit, the nurse teaches the parents about newborn screening tests that includes which of the following? A) Preeclampsia screening B) Congenital kidney disease screening C) Visual screening D) Hearing screening

During a postpartum examination of a client who delivered an 8-pound newborn 6 hours ago, the following assessment findings are noted: fundus firm and at the umbilicus, and moderate lochia rubra with a steady trickle of blood from the vagina. What is the assessment finding that would necessitate follow-up? A) Firm fundus B) Fundus at the umbilical level C) Moderate lochia rubra D) Steady trickle of blood

During an intrapartum vaginal examination the following is assessed. In which position should the patient be placed at this time? (PICTURE) A) Supine B) Side-lying C) Lithotomy D) Knee-chest

Each of the following pregnant women is scheduled for a 14-week antepartal visit. In planning care, the nurse would give priority teaching on amniotic fluid alpha-fetoprotein (A F P) screening to which client? A) 28-year-old with history of rheumatic heart disease B) 18-year-old with exposure to H I V C) 20-year-old with a history of preterm labor D) 35-year-old with a child with spina bifida

In the operating room, a client is being prepped for a cesarean delivery. The doctor is present. What is the last assessment the nurse should make just before the client is draped for surgery? A) Maternal temperature B) Maternal urine output C) Vaginal exam D) Fetal heart tones

Intercourse is contraindicated if the pregnancy is vulnerable because of which diagnosis? A) Gestational diabetes B) Cervical insufficiency (cerclage) C) Abruptio placentae D) Placenta previa

Intervention to reduce preterm birth can be divided into primary prevention and secondary prevention. What does secondary prevention include? A) Diagnosis and treatment of infections B) Cervical cerclage C) Progesterone administration D) Antibiotic treatment and tocolysis

Parents have been told their child has fetal alcohol syndrome (F A S). Which statement by a parent indicates that additional teaching is required? A) "Our baby's heart murmur is from this syndrome." B) "He might be a fussy baby because of this." C) "His face looks like it does due to this problem." D) "Cuddling and rocking will help him stay calm."

Prior to receiving lumbar epidural anesthesia, the nurse would anticipate placing the laboring client in which position? A) On her right side in the center of the bed with her back curved B) Lying prone with a pillow under her chest C) On her left side with the bottom leg straight and the top leg slightly flexed D) Sitting on the edge of the bed

The client at 30 weeks' gestation with her first child is upset. She tells the prenatal clinic nurse that she is excited to become a mother, and has been thinking about what kind of parent she will be. But her mother has told her that she doesn't want to be a grandmother because she doesn't feel old enough, while her husband has said that the pregnancy doesn't feel real to him yet, and he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family? A) Her husband will not attach with this child and will not be a good father. B) Her mother is rejecting the role of grandparent, and will not help out. C) The client is not progressing through the developmental tasks of pregnancy. D) The family members are adjusting to the role change at their own paces.

The client delivered her first child vaginally 7 hours ago. She has not voided since delivery. She has an I V of lactated Ringer's solution running at 100 m L/h r. Her fundus is firm and to the right of midline. What is the best nursing action? A) To massage the fundus vigorously B) To assess the client's pain level C) To increase the rate of the I V D) To assist the client to the bathroom

The client has delivered a 4200 g fetus. The physician performed a midline episiotomy, which extended into a third-degree laceration. The client asks the nurse where she tore. Which response is best? A) "The episiotomy extended and tore through your rectal mucosa." B) "The episiotomy extended and tore up near your vaginal mucous membrane." C) "The episiotomy extended and tore into the muscle layer." D) "The episiotomy extended and tore through your anal sphincter."

The client has stated that she wants to avoid an epidural and would like an unmedicated birth. Which nursing action is most important for this client? A) Encourage the client to vocalize during contractions. B) Perform vaginal exams only between contractions. C) Provide a C D of soft music with sounds of nature. D) Offer to teach the partner how to massage tense muscles.

The client is at 42 weeks' gestation. Which order should the nurse question? A) Obtain biophysical profile today. B) Begin nonstress test now. C) Schedule labor induction for tomorrow. D) Have the client return to the clinic in 1 week.

The client is carrying monochorionic-monoamniotic twins. The nurse teaches the client what this is, and the implications of this finding. The nurse knows that teaching is successful when the client states which of the following? A) "My babies came from two eggs." B) "About two thirds of twins have this amniotic sac formation." C) "My use of a fertility drug led to this issue." D) "My babies have a lower chance of surviving to term than fraternal twins do."

The client is having fetal heart rate decelerations. An amnioinfusion has been ordered to alleviate the decelerations. The nurse understands that the type of decelerations that will be alleviated by amnioinfusion is which of the following? A) Early decelerations B) Moderate decelerations C) Late decelerations D) Variable decelerations

The clinic nurse is compiling data for a yearly report. Which client would be classified as a primigravida? A) A client at 18 weeks' gestation who had a spontaneous loss at 12 weeks B) A client at 13 weeks' gestation who had an ectopic pregnancy at 8 weeks C) A client at 14 weeks' gestation who has a 3-year-old daughter at home D) A client at 15 weeks' gestation who has never been pregnant before

The multiparous client at term has arrived to the labor and delivery unit in active labor with intact membranes. Leopold maneuvers indicate the fetus is in a transverse lie with a shoulder presentation. Which physician order is most important? A) Artificially rupture membranes. B) Apply internal fetal scalp electrode. C) Monitor maternal blood pressure every 15 minutes. D) Alert surgical team of urgent cesarean.

The neonatal special care unit nurse is overseeing the care provided by a nurse new to the unit. Which action requires immediate intervention? A) The new nurse holds the infant after giving a gavage feeding. B) The new nurse provides skin-to-skin care. C) The new nurse provides care when the baby is awake. D) The new nurse gives the feeding with room-temperature formula.

The nurse admits into the labor area a client who is in preterm labor. What assessment finding would constitute a diagnosis of preterm labor? A) Cervical effacement of 30% or more B) Cervical change of 0.5 c m per hour C) 2 contractions in 30 minutes D) 8 contractions in 1 hour

The nurse assesses the newborn and notes the following behaviors: nasal flaring, facial grimacing, and excessive mucus. What is the nurse most concerned about? A) Neonatal jaundice B) Neonatal hypothermia C) Neonatal hyperthermia D) Respiratory distress

The nurse assesses the postpartum client who has not had a bowel movement by the third postpartum day. Which nursing intervention would be appropriate? A) Encourage the new mother, saying, "It will happen soon." B) Instruct the client to eat a low-fiber diet. C) Decrease fluid intake. D) Obtain an order for a stool softener.

The nurse examines the client's placenta and finds that the umbilical cord is inserted at the placental margin. The client comments that the placenta and cord look different than they did for her first two births. The nurse should explain that this variation in placenta and cord is called what? A) Placenta accreta B) Circumvallate placenta C) Succenturiate placenta D) Battledore placenta

The nurse has presented a session on pain relief options to a prenatal class. Which statement indicates that additional teaching is needed? A) "An epidural can be continuous or can be given in one dose." B) "A spinal is usually used for a cesarean birth." C) "Pudendal blocks are effective when a vacuum is needed." D) "Local anesthetics provide good labor pain relief."

The nurse is analyzing assessment findings on four newborns. Which finding might suggest a congenital heart defect? A) Apical heart rate of 140 beats per minute B) Respiratory rate of 40 C) Temperature of 36.5°C D) Visible, blue discoloration of the skin

The nurse is analyzing several fetal heart rate patterns. The pattern that would be of most concern to the nurse would be which of the following? A) Moderate variability B) Early decelerations C) Late decelerations D) Accelerations

The nurse is analyzing various strategies for teaching new mothers about newborn care. To enhance learning, which teaching method should the nurse implement? A) Select videos on various topics of newborn care. B) Organize a class that includes first-time mothers only. C) Have mothers return in 1 week, when they feel more rested. D) Schedule time for one-to-one teaching in the mother's room.

The nurse is assessing a newborn at 1 hour of age. Which finding requires an immediate intervention? A) Respiratory rate 60 and irregular in depth and rhythm B) Pulse rate 145, cardiac murmur heard C) Mean blood pressure 55 m m H g D) Pauses in respiration lasting 30 seconds

The nurse is assessing a newly pregnant client. Which finding does the nurse note as a normal psychosocial adjustment in this client's first trimester? A) An unlisted telephone number B) Reluctance to tell the partner of the pregnancy C) Parental disapproval of the woman's partner D) Ambivalence about the pregnancy

The nurse is assessing a pregnant client during a scheduled prenatal visit who reports dizziness and clamminess when lying in bed each morning. Which statement by the nurse is appropriate based on this data? A) "The doctor may order an amniocentesis to determine if the fetus is healthy." B) "This information indicates that you are developing gestational hypertension." C) "Be sure to sit up slowly and stay sitting for several minutes prior to getting up." D) "Try lying on your left side to enhance blood flow, which will help your symptoms."

The nurse is assessing the emotional state of a client following the delivery of her newborn. Which response by the client requires further follow up by the nurse? A) Excitability B) Crying C) Quiet D) Withdrawn

The nurse is beginning the postpartum teaching of a mother who has given birth to her first child. What aspect of teaching is most important? A) Describe the likely reaction of siblings to the new baby. B) Discuss adaptation to grandparenthood by her parents. C) Determine whether father-infant attachment is taking place. D) Assist the mother in identifying the baby's behavior cues.

The nurse is caring for a client in active labor. The membranes spontaneously rupture, with a large amount of clear amniotic fluid. Which nursing action is most important to undertake at this time? A) Assess the odor of the amniotic fluid. B) Perform Leopold maneuvers. C) Obtain an order for pain medication. D) Complete a sterile vaginal exam.

The nurse is caring for a client who recently emigrated from a Southeast Asian country. The mother has been resting since the birth, while her sister has changed the diapers and fed the infant. What is the most likely explanation for this behavior? A) The client is not attaching to her infant appropriately. B) The client is not going to be a good mother, and the baby is at risk. C) The client has no mother present to role-model behaviors. D) The client is exhibiting normal behavior for her culture.

The nurse is caring for a new breastfeeding mother who is from Pakistan. The nurse plans her care so that the newborn is offered the breast on which of the following? A) Day of birth B) First day after birth C) Second day after birth D) Third to fourth day after birth

The nurse is caring for a newborn in the special care nursery. The infant has hydrocephalus, and is positioned in a prone position. The nurse is especially careful to cleanse all stool after bowel movements. This care is most appropriate for an infant born with which of the following? A) Omphalocele B) Gastroschisis C) Diaphragmatic hernia D) Myelomeningocele

The nurse is caring for a pregnant client. The client's husband has come to the prenatal visit. Which question is best for the nurse to use to assess the father's adaptation to the pregnancy? A) "What kind of work do you do?" B) "What furniture have you gotten for the baby?" C) "How moody has your wife been lately?" D) "How are you feeling about becoming a father?"

The nurse is caring for a premature infant in the N I C U, and is going to attempt a bottle feeding with thawed breast milk. How long can thawed breast milk be stored in the refrigerator before the nurse must discard it? A) 4 hours B) 8 hours C) 12 hours D) 24 hours

The nurse is completing discharge teaching for a client who delivered 2 days ago. Which statement by the client indicates that further information is required? A) "Because I have a midline episiotomy, I should keep my perineum clean." B) "I can use an ice pack to relieve some the pain from the episiotomy." C) "I can take ibuprofen (Motrin) when my perineum starts to hurt." D) "The tear I have through my rectum is unrelated to my episiotomy."

The nurse is discharging a 15-year-old first-time mother. Which statement should the nurse include in the discharge teaching? A) "Call your pediatrician if the baby's temperature is below 98.6°F axillary." B) "Your baby's stools will change to a greenish color when your milk comes in." C) "You can wipe away any eye drainage that might form." D) "Your infant should wet a diaper at least 6 times per day."

The nurse is discussing parent-infant attachment with a prenatal class. Which statement indicates that teaching was successful? A) "I should avoid looking directly into the baby's eyes to prevent frightening the baby." B) "My baby will be very sleepy immediately after birth and should go to the nursery." C) "Newborns cannot focus their eyes, so it doesn't matter how I hold my new baby." D) "Giving my baby his first bath can really give me a chance to get to know him."

The nurse is evaluating the fundal height of a patient who is 20 weeks pregnant. Which height should the nurse expect to assess in this patient? A) A B) B C) C D) D

The nurse is explaining "quickening" to a client who is pregnant for the first time. Which client indicates the need for further education on this topic? A) "It will feel like butterflies in my stomach." B) "It might feel like I have gas." C) "It should occur during the second trimester of my pregnancy." D) "It is an indication that I am experiencing preterm labor."

The nurse is explaining the nutritional differences between breast milk and formula to an expectant couple. The mother-to-be asks whether breast milk is nutritionally superior to formula. What should the nurse reply? A) The vitamins and minerals in formula are more bioavailable to the infant. B) There is no cholesterol in breast milk. C) The only carbohydrate in breast milk is lactose. D) The ratio of whey to casein proteins in breast milk changes to meet the nutritional needs of the growing infant.

The nurse is instructing the parents of a newborn about car seat safety. Which statement indicates that the parents need additional information? A) "The baby should be in the back seat." B) "Newborns must be in rear-facing car seats." C) "We need instruction on how to use the car seat before installing it." D) "We can bring the baby home from the hospital without a car seat, as it is only a short drive."

The nurse is performing a postpartum assessment on a newly delivered client. When checking the fundus, there is a gush of blood. The client asks why that is happening. What is the nurse's best response? A) "We see this from time to time. It's not a big deal." B) "The gush is an indication that your fundus isn't contracting." C) "Don't worry. I'll make sure everything is fine." D) "Blood pooled in the vagina while you were in bed."

The nurse is planning visits to the homes of new parents and their newborns. Which client should the nurse see first? A) 3-day-old male who received hepatitis B vaccine prior to discharge B) 4-day-old female whose parents are both hearing-impaired C) 5-day-old male with light, sticky, yellow drainage on the circumcision site D) 6-day-old female with greenish discharge from the umbilical cord site

The nurse is preparing to assess a newborn's neurological status. Which finding would require an immediate intervention? A) At rest, the infant has partially flexed arms and the legs drawn up to the abdomen. B) When the corner of the mouth is touched, the infant turns the head that direction. C) The infant blinks when the exam light is turned on over the face and body. D) The right arm is flaccid while the infant brings the left arm and fist upward to the head.

The nurse is providing care to a client who is entering the second trimester of pregnancy. Which client statement does the nurse anticipate when assessing this client? A) "We picked out a name for a boy and for a girl." B) "We bought the baby's crib and car seat this past weekend." C) "I am so uncomfortable all the time and I can't seem to sleep at night." D) "I am angry with my husband for not showing more interest in my pregnancy."

The nurse is returning phone calls from clients. Which client does the nurse anticipate would not require a serum beta h C G? A) A client with a risk of ectopic pregnancy B) A client with spotting during pregnancy C) A client with previous pelvic inflammatory disease D) A client with a previous history of twins

The nurse is teaching a group of new parents about newborn behavior. Which statement made by a parent would indicate a need for additional information? A) "Sleep and alert states cycle throughout the day." B) "We can best bond with our child during an alert state." C) "About half of the baby's sleep time is in active sleep." D) "Babies sleep during the night right from birth."

The nurse is teaching a pregnant client the clinical manifestations associated with preterm labor. Which client statement indicates the need for further education? A) "Menstrual-like cramps are a sign of preterm labor." B) "A dull low backache is a sign of preterm labor." C) "Diarrhea is a sign of preterm labor." D) "Vomiting is a sign of preterm labor."

The nurse is working in an outpatient clinic. Which client's indications most warrant fetal monitoring in the third trimester? A) Gravida 4, para 3, 39 weeks, with a history of one spontaneous abortion at 8 weeks B) Gravida 1, para 0, 40 weeks, with a history of endometriosis and a prior appendectomy C) Gravida 3, para 2, with a history of gestational diabetes controlled by diet D) Gravida 2, para 1, 36 weeks, with a history of preterm labor or cervical insufficiency

The nurse is working with a client from Southeast Asia. The client tells the nurse that she should not put the baby to breast until her milk comes in and her breasts are warm, because "cold milk" (colostrum) is bad for the baby. After the nurse explains the benefits of colostrum, the client still insists that "cold milk" is bad. Which response by the nurse is best? A) "What kind of formula would you like to use?" B) "That idea is folklore. Colostrum is good for the baby." C) "Now that you are here, you need to feed your baby the right way." D) "Let's give the baby formula after you breastfeed."

The nurse is working with a pregnant 14-year-old. Which statement indicates that additional education is required? A) "Because I am still growing, I need more calories than a pregnant adult." B) "I need to eat fruit and vegetables every day to get enough vitamins." C) "My favorite food is pizza, and I eat it once a week." D) "Because I don't eat breakfast, I'll have to eat more at supper."

The nurse is working with an adolescent mother who tells the nurse, "I'm really scared that I won't take care of my baby correctly. My mother says I'll probably hurt the baby because I'm too young to be a mother." What is the best response by the nurse? A) "You are very young, and parenting will be a challenge for you." B) "Your mother was probably right. Be very careful with your baby." C) "Mothers have instincts that kick in when they get their babies home." D) "We can give the baby a bath together. I'll help you learn how to do it."

The nurse is working with new parents who have recently immigrated to the United States. The nurse is not familiar with the family's cultural background. Which approach is most appropriate when discussing the newborn? A) "You appear to be Muslim. Do you want your son circumcised?" B) "Let me explain newborn care here in the United States." C) "Your baby is a United States citizen. You must be very happy about that." D) "Could you explain your preferences regarding childrearing?"

The nurse will be bringing the parents of a neonate with sepsis to the neonatal intensive care nursery for the first time. Which statement is best? A) "I'll bring you to your baby and then leave so you can have some privacy." B) "Your baby is on a ventilator with 50% oxygen, and has an umbilical line." C) "I am so sorry this has all happened. I know how stressful this can be." D) "Your baby is working hard to breathe and lying quite still, and has an I V."

The parents of a newborn comment to the nurse that their infant seems to enjoy being held, and that holding the baby helps him calm down after crying. They ask the nurse why this happens. After explaining newborn behavior, the nurse assesses the parents' learning. Which statement indicates that teaching was effective? A) "Some babies are easier to deal with than others." B) "We are lucky to have a baby with a calm disposition." C) "Our baby spends more time in the active alert phase." D) "Cuddliness is a social behavior that some babies have."

The partner of a client at 16 weeks' gestation accompanies her to the clinic. The partner tells the nurse that the baby just doesn't seem real to him, and he is having a hard time relating to his partner's fatigue and food aversions. Which statement would be best for the nurse to make? A) "If you would concentrate harder, you'd be aware of the reality of this pregnancy." B) "My husband had no problem with this. What was your childhood like?" C) "You might need professional psychological counseling. Ask your physician." D) "Many men feel this way. Feeling the baby move in a few weeks will help make it real to you."

The primigravida at 22 weeks' gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the client why she needs to be seen by a physician today? A) "Your baby is growing too much and getting too big." B) "Your uterus might have an abnormal shape." C) "The position of your baby can't be felt." D) "Your baby might not be growing enough."

To assess the healing of the uterus at the placental site, what does the nurse assess? A) Lab values B) Blood pressure C) Uterine size D) Type, amount, and consistency of lochia

Toward the end of the first stage of labor, a pudendal block is administered transvaginally. What will the nurse anticipate the client's care will include? A) Monitoring for hypotension every 15 minutes B) Monitoring F H R every 15 minutes C) Monitoring for bladder distention D) No additional assessments

When preparing nutritional instruction, which pregnant client would the nurse consider the highest priority? A) 40-year-old gravida 2 B) 22-year-old primigravida C) 35-year-old gravida 4 D) 15-year-old nulligravida

Which of the following is a sign of dehydration in the newborn? A) Slow, weak pulse B) Soft, loose stools C) Light colored, concentrated urine D) Depressed fontanelles

Which of the following is common in many non-Western cultures and is on the increase in the United States? A) Ceremonial rituals and rites B) Cultural assessment C) Cultural values D) Co-sleeping

Which of the following would be a newborn care procedure that will decrease the probability of high bilirubin levels? A) Monitor urine for amount and characteristics. B) Encourage late feedings to promote intestinal elimination. C) All infants should be routinely monitored for iron intake. D) Maintain the newborn's skin temperature at 36.5°C (97.8°F) or above.

Which third-trimester client would the nurse suspect might be having difficulty with psychological adjustments to her pregnancy? A) A woman who says, "Either a boy or a girl will be fine with me" B) A woman who puts her feet up and listens to some music for 15 minutes when she is feeling too stressed C) A woman who was a smoker but who has quit at least for the duration of her pregnancy D) A woman who has not investigated the kind of clothing or feeding methods the baby will need

Why is it important for the nurse to assess the bladder regularly and encourage the laboring client to void frequently? A) A full bladder impedes oxygen flow to the fetus. B) Frequent voiding prevents bruising of the bladder. C) Frequent voiding encourages sphincter control. D) A full bladder can impede fetal descent.

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