OB Final

An 18-year-old female is to have a pelvic exam. Which of the following responses by the nurse would be best when the client says that she is nervous about the upcoming pelvic examination? 1. "Can you tell me more about how you're feeling?" 2. "You're not alone. Most women feel uncomfortable about this examination." 3. "Do not worry about Dr. Smith. He's a specialist in female problems." 4. "We'll do everything we can to avoid embarrassing you."

1

The primary reason that a herpes simplex virus (HSV) infection is a serious concern to a client with human immunodeficiency virus (HIV) infection is that it: 1. Is an acquired immunodeficiency virus (AIDS)-defining illness. 2. Is curable only after 1 year of antiviral therapy. 3. Leads to cervical cancer. 4. Causes severe electrolyte imbalances.

1

What is most important for the nurse to teach a client newly diagnosed with genital herpes? 1. Use condoms at all times during sexual intercourse. 2. A urologist should be seen only when lesions occur. 3. Oral sex is permissible without a barrier. 4. Determine if your partner has received a vaccine against herpes.

1

Which of the following groups has experienced the greatest rise in the incidence of sexually transmitted diseases (STDs) over the past two decades? 1. Teenagers. 2. Divorced people. 3. Young married couples. 4. Older adults.

1

A sexually active male client has burning on urination and a milky discharge from the urethral meatus. Documentation on the client's chart should include which of the following information? Select all that apply. 1. History of unprotected sex (sex without a condom). 2. Length of time since symptoms presented. 3. History of fever or chills. 4. Presence of any enlarged lymph nodes on examination. 5. Names and phone numbers of all sexual contacts. 6. Allergies to any medications.

1, 2, 3, 4, 6

The nurse is giving prenatal instructions to a 32-year-old primigravida. Which nutritional instructions would the nurse review? Select all that apply. 1. Caloric intake would be increased by 300 cal/day 2. Protein intake would be increased to more than 30 g/day 3. Vitamin intake would not increase from prepregnancy requirements 4. Folic acid intake would be increased to 800 mg/day 5. Intake of all minerals, especially iron, would be increased 6. Water intake would be doubled

1. Caloric intake would be increased by 300 cal/day 2. Protein intake would be increased to more than 30 g/day 4. Folic acid intake would be increased to 800 mg/day 5. Intake of all minerals, especially iron, would be increased

A neonate has been placed on a cardiac and apnea monitoring in the neonatal nursery. The nurse notes that apnea alarm repeatedly triggers. Place the following actions in the order in which they should be completed by the nurse. Use all the options.

1. Perform a focused assessment on the neonate 2. count the respiratory rate for 60 secs 3. silence the alarm to decrease environmental stimuli 4. check all connects on apnea monitor; 5. document the assessment findings, interventions, and neonate's response

During her first prenatal visit, a client asks a nurse what physiological changes she can expect during pregnancy. The nurse begins the discussion with the presumptive changes of pregnancy. Put the following presumptives changes in ascending chronological order according to when they occur. Use all of the options.

1. breast changes 2. frequent urination 3. uterine enlargement in which the uterus can be palpated over the symphysis pubis' quickening 4. appearance of linea nigra, melasma, and striae gravidarum

A client at 32 weeks of gestation has mild preeclampsia. She is discharged home with instructions to remain in bed rest. She would also be instructed to call her HCP if she experiences which symptoms? Select all that apply. 1. headache 2. increased urine output 3. blurred vision 4. difficulty sleeping 5. epigastric pain 6. severe N/V

1. headache 3. blurred vision 5. epigastric pain 6. severe N/V

Benzathine penicillin G, 2.4 million units IM, is prescribed as treatment for an adult client with primary syphilis. The nurse should administer the injection in the: 1. Deltoid. 2. Upper outer quadrant of the buttock. 3. Quadriceps lateralis of the thigh. 4. Midlateral aspect of the thigh

2

The nurse assesses the mouth and oral cavity of a client with human immunodeficiency virus (HIV) infection because the most common opportunistic infection initially presents as: 1. Herpes simplex virus (HSV) lesions on the lips. 2. Oral candidiasis. 3. Cytomegalovirus (CMV) infection. 4. Aphthae on the gingiva

2

The nurse is interviewing a client with newly diagnosed syphilis. In order to prevent the spread of the disease, the nurse should focus the interview by: 1. Motivating the client to undergo treatment. 2. Obtaining a list of the client's sexual contacts. 3. Increasing the client's knowledge of the disease. 4. Reassuring the client that records are confidential.

2

Women who have human papillomavirus (HPV) are at risk for development of: 1. Sterility. 2. Cervical cancer. 3. Uterine fibroid tumors. 4. Irregular menses.

2

A nurse is caring for a client who is in the third stage of labor. Which characteristic behaviors does the nurse anticipate at this stage. Select all that apply 1. The client is excited about the process 2. the client is focused on the neonate's condition 3. the client is exhausted from the labor process 4. the client states she has discomfort from uterine contractions 5. the client is apprehensive about the process 6 .the client is feeling embarrassed as she has an urge to defecate.

2. the client is focused on the neonate's condition 4. the client states she has discomfort from uterine contractions

A client with human immunodeficiency virus (HIV) infection is taking zidovudine (AZT). The expected outcome of AZT is to: 1. Destroy the virus. 2. Enhance the body's antibody production. 3. Slow replication of the virus. 4. Neutralize toxins produced by the virus.

3

The nurse is caring for a client from Southeast Asia who has HIV-AIDS. The client does not speak or comprehend the English language. The nurse should? 1. Contact the hospital's chaplain. 2. Do an Internet search for the Joint United Nations Programme on HIV/AIDS. 3. Utilize language-appropriate interpreters. 4. Ask a family member to obtain informed consent.

3

The typical chancre of syphilis appears as: 1. A grouping of small, tender pimples. 2. An elevated wart. 3. A painless, moist ulcer. 4. An itching, crusted area.

3

The nurse is administering Didanosine (Videx) to a client with HIV. Before administering this medication, the nurse should check which lab test results? Select all that apply. 1. Elevated serum creatinine. 2. Elevated blood urea nitrogen (BUN). 3. Elevated aspartate aminotransferase (AST). 4. Elevated alanine aminotransferase (ALT). 5. Elevated serum amylase

3, 4, 5

A female client with gonorrhea informs the nurse that she has had sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men the symptoms of gonorrhea include: 1. Impotence. 2. Scrotal swelling. 3. Urine retention. 4. Dysuria.

4

A male client with human immunodeficiency virus (HIV) infection becomes depressed and tells the nurse: "I have nothing worth living for now." Which of the following statements would be the best response by the nurse? 1. "You are a young person and have a great deal to live for." 2. "You should not be too depressed; we are close to finding a cure for AIDS." 3. "You are right; it is very depressing to have HIV." 4. "Tell me more about how you are feeling about being HIV positive."

4

A nurse is planning care for a 25-year-old female client who has just been diagnosed with human immunodeficiency virus (HIV) infection. The client asks the nurse, "How could this have happened?" The nurse responds to the question based on the most frequent mode of HIV transmission, which is: 1. Hugging an HIV-positive sexual partner without using barrier precautions. 2. Inhaling cocaine. 3. Sharing food utensils with an HIV-positive person without proper cleaning of the utensils. 4. Having sexual intercourse with an HIV-positive person without using a condom.

4

In educating a client about human immunodeficiency virus (HIV), the nurse should take into account the fact that the most effective method known to control the spread of HIV infection is: 1. Premarital serologic screening. 2. Prophylactic treatment of exposed people. 3. Laboratory screening of pregnant women. 4. Ongoing sex education about preventive behaviors.

4

When educating a female client with gonorrhea, the nurse should emphasize that for women gonorrhea: 1. Is often marked by symptoms of dysuria or vaginal bleeding. 2. Does not lead to serious complications. 3. Can be treated but not cured. 4. May not cause symptoms until serious complications occur.

4

At 5 minutes of age, a neonate is pink with acrocyanosis; has flexed knees, clenched fists, a whimpering cry, and a heart rate of 128 bpm; and withdraws the foot when slapped on the sole. What 5-minute Apgar score would the nurse record for this neonate?

8

A 2-week-old neonate is admitted to the hospital with a diagnosis of possible sepsis. The neonate weighs 3.2 kg. The physician writes the following orders for the neonate and signs the order sheet. Which order should the nurse question?

Draw blood cultures x 3 AM

a nurse is demonstrating cord care to a mother of a neonate. Which actions would the nurse teach the mother to perform? a. the diaper must be placed below the cord b. gently tug on the cord as it begins to dry c. apply antibiotic ointment to the cord twice daily d. sponge bathes only the infant until the cord falls off e. clean the length of the cord with alcohol several times daily f. wash the with mild soap and water

a, d, e

A nurse is evaluating a client who is 34 weeks pregnant for preterm rupture of the membranes (PROM). Which findings indicate that PROM has occurred? Select all that apply. a. Fern like pattern when vaginal fluid is placed on a glass slide and allowed to dry b. Acidic pH of fluid when tested with nitrazine paper c. Presence of amniotic fluid in the vagina d. Cervical dilation of 6 cm e. Alkaline pH of fluid when tested with nitrazine paper f. Contractions occurring every 5 minutes

a. Fern like pattern when vaginal fluid is placed on a glass slide and allowed to dry c. Presence of amniotic fluid in the vagina e. Alkaline pH of fluid when tested with nitrazine paper

You are a nursery nurse discharging a mother of a newborn infant. What information should you include when teaching post circumcision care to parents of a neonate before discharge from the hospital? Select all that apply. a. before home discharge, the infant must void b. petroleum jelly or antibiotic ointment must be applied to the penis with each diaper change c. the infant can have tub baths while the circumcision heals d. any amount of blood noted on the front of the diaper should be reported e. the circumcisions will require care for 2 to 4 days after discharge

a. The infant must void before being discharged home; b. petroleum jelly of antibiotic ointment should be applied to the glans of the penis with each diaper change; e. the circumcision will require care for 2 to 4 days after discharge

A nurse is caring for a primagravida client. At 20 weeks of gestation, identify the location where the nurse anticipates the uterine fundus.

at umbilics

A client who is positive for HIV delivers a newborn infant. The nurse provides instructions to help the client regarding care of her infant. Which client statement indicates the need for further instruction? a. "I will be sure to wash my hands before and after bathroom use." b. "I need to breastfeed, especially for the first 6 weeks postpartum." c. "Support groups are available to assist me with understanding my diagnosis of HIV." d. "My newborn infant should be on antiviral medications for the first 6 weeks after delivery"

b

A newborn infant of a mother who has HIV infection is tested for the presence of HIV antibodies. An enzyme-linked immunosorbent assay (ELISA) is performed, and the results are positive. Which is the correct interpretation of these results? a. Positive for HIV b. Indicates the presence of maternal infections c. Indicates that the newborn will develop AIDS later in life d. Indicates the the newborn will develop AIDS later in life e. Positive for AIDS

b

During physical assessment of a client who gave birth 3 hours ago, a nurse finds that the client has completely saturated a perineal pad within 15 minutes. Which nursing actions would be appropriate? Select all that apply. a. begin an I.V. infusion of lactated Ringer's solution b. assess the client's vital sign c. palpate the client's fundus d. place the client in high fowler's position e. administer a pain medication f. relate the information to the charge nurse

b. assess the client's vital sign c. palpate the client's fundus f. relate the information to the charge nurse

a nurse is evaluating the external fetal monitoring strip (shows early decelerations) of a client who is labor. Which nursing intervention should the nurse implement? a. increase the I.V. fluid rate to boost intravascular volume b. reassure the client and continue to monitor the fetal heart tone c. elevate the client's leg d. administer supplemental oxygen e. require the client to lie on her side

b. reassure the client and continue to monitor the fetal heart tone

A 30-year-old client comes to the office for a routine prenatal visit. After reading the chart entry below, the nurse should prepare the client for which of the following studies? 6/8/19 Pt is 2 weeks pregnant; urine sample shows 1320 glycosuria. Pt has a family history of diabetes a. Triple screen b. Indirect Coombs' test c. 1-hour glucose tolerance test d. Amniocentesis

c. 1-hour glucose tolerance test

A nurse is caring for a postpartum client suspected of developing postpartum psychosis. Which of the following statements accurately characterizes this disorder? Select all the apply. a. Symptoms start 2 days after delivery - 4 weeks b. The disorder is common in postpartum women - rare, less than 1% c. Symptoms include delusions and hallucinations d. Suicide and infanticide are uncommon in this disorder - common e. The disorder rarely occurs without a psychiatric history.

c. Symptoms include delusions and hallucinations\ e. The disorder rarely occurs without a psychiatric history.

During a prenatal visit, a physician decides to admit a client to the hospital. Based on the nurse's admission note below, which complication of pregnancy would the physician suspect?

hyperemesis gravidarum

A nurse is caring for a post-term client at 41 weeks of gestation who is about to undergo a biophysical profile (BPP) to evaluate her fetus's well-being. The client asks, "What will be able to be determined from this profile?" The nurse is correct to identify which? Select all that apply.

fetal tone, fetal breathing, amniotic fluid volume

A nurse is caring for a client who is at 32 weeks of gestation and performs Leopold's maneuvers to determine that the fetus is in the cephalic position. To identify fetal heart tones, place an X where the nurse should place the doppler transducer.

in between umbilics and uterus