OB/PEDS
19 - The nurse has provided teaching about home care management for the parents of a child diagnosed with cystic fibrosis. Which statements by the parents indicate a need for further teaching? Select all that apply. A) Bronchodilator breathing treatment should be given right after chest physiotherapy B) Loss of appetite and weight loss could mean that our child has developed a lung infection C) Our child will need to follow a high calorie, high protein diet to stay healthy D) Pancreatic enzymes should be administered every morning and evening E) We will prohibit our child from participating in sports activities
A) Bronchodilator breathing treatment should be given right after chest physiotherapy D) Pancreatic enzymes should be administered every morning and evening E) We will prohibit our child from participating in sports activities
46 - The nurse is teaching the parents of a 2-year-old child with a congenital heart defect about signs and symptoms of congestive heart failure. Which information about the child is most important for the parents to report to the health care provider? A - Sits or squats frequently when playing outdoors B - Exhibits a sudden and unexplained weight gain C - Is not completely toilet-trained and has some accidents D - Demonstrates irritation and fatigue 1 hour before bedtime
B - Exhibits a sudden and unexplained weight gain
12 - A nursing instructor is reviewing the menstrual cycle with a nursing student who will be conducting a prenatal teaching session. The instructor asks the student to describe the FSH and LH. The student accurately responds by stating that: A - FSH and LH are secreted by the adrenal glands B - FSG and LF are released from the anterior pituitary gland C - FSH and LH are secreted by the corpus luteum of the ovary D - FSH and LH stimulate the formation of the milk during pregnancy
B - FSG and LF are released from the anterior pituitary gland
34 - Which of the following is a probable sign of pregnancy? A - Quickening B - Goodell's Sign C - Amenorrhea D - Fetal heart rate detected by electronic device
B - Goodell's Sign
9 - An infant is diagnosed with a congenital hip dislocation. On assessment, the nurse expects to note: A - symmetrical thigh and gluteal folds. B - Ortolani's sign. C - increased hip abduction. D - femoral lengthening.
B - Ortolani's sign.
10 - The nurse is reinforcing instructions to a postpartum cesarean delivery client who is preparing for discharge. Which statement by the client indicates a need for further teaching? A - "If I develop a fever, I will call my doctor." B - "I will lift nothing heavier than the baby for 2 weeks." C - "I can start doing abdominal exercises as soon as I get home." D - "When getting out of bed, I will turn on my side and push up with my arms."
C - "I can start doing abdominal exercises as soon as I get home."
20 - The nurse assessing a child admitted to the pediatric floor for dehydration observes that the child has varicella lesions. Which nursing intervention has the highest priority? A - Apply the prescribed calamine lotion topically to the lesions. B - Order a soft diet for the next meal. C - Implement airborne precautions. D - Collect additional health history data.
C - Implement airborne precautions.
25 - The nurse is caring for a hospitalized child with leukemia, experiencing bone marrow depression from chemotherapy. The nurse should contact the health care provider to question which prescribed medication? A - Amoxicillin, clavulanic acid (Augmentin) B - Epoetin intravenous (Epogen) C - Measles, Mumps, Rubella vaccine (MMR) D - Odansetron (Zofran)
C - Measles, Mumps, Rubella vaccine (MMR)
48 - Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80mmhg to 90/60 mm hg. Which action should the nurse take immediately? A - Notify the HCP or anesthesiologist. B - Continue to assess the BP every 5 minutes. C - Place the client in a lateral position. D - Turn off the continuous epidural.
C - Place the client in a lateral position.
35 - A nurse is preparing a plan of care for a pregnant client who will be given oxytocin to induce labor. Which occurrence does the nurse include in the plan of care as a reason for immediate discontinuation of the oxytocin infusion? A - Uterine atony B - Severe drowsiness C - Uterine hyperstimulation D - Early decelerations of the FHR
C - Uterine hyperstimulation
54 - When assessing a child's cultural background, the nurse in charge should keep in mind that: A - Physical characteristics mark the child as part of a particular culture. B - Cultural backgrounds usually have little bearing on a family health practices. C - Heritage dictates a group's shared values. D - Behavioral patterns are passes from one generation to the next,
D - Behavioral patterns are passes from one generation to the next,
38 - A 6 month old infant, diagnosed with hydrocephalus, is recovering from surgery to place a shunt. Which of the following should the nurse instruct the parents regarding the client's care? A - A low grade fever is expected after the surgery B - Seizures are common after this procedure C - Constipation should not be treated D - Notify the physician if the client demonstrates malaise or irritability
D - Notify the physician if the client demonstrates malaise or irritability
52 - Within minutes of giving birth to a healthy infant, the client displays symptoms of respiratory distress. An amniotic fluid embolism is suspected. In addition to respiratory distress, for what other complication should the nurse assess the client? A - Hypertension B - Uterine atony C - Thrombophlebitis D - Uncontrolled bleeding
D - Uncontrolled bleeding
17 - A 5 year old girl is recently diagnosed with Kawasaki Disease. Which of the following is she at risk for developing? A) Sepsis B) Meningitis C) Mitral valve disorder D) Aneurysm formation
D) Aneurysm formation
45 - When performing newborn resuscitation, which action would the nurse do first? A) Intubate with an appropriate-sized endotracheal tube. B) Give chest compressions at a rate of 80 times per minute. C) Administer epinephrine intravenously. D) Suction the mouth and then the nose.
D) Suction the mouth and then the nose.
39 - A 9-year-old boy with diabetes mellitus tests his glucose level in the nurse's office before lunch. According to this sliding scale of insulin, he's due for 1 unit of regular insulin. What steps should a nurse follow after confirming the medication order, washing her hands, drawing up the appropriate dose, verifying the boy's identity, and putting on gloves? Put the following steps in chronological order. 1. Pinch the skin around the injection site 2. Release the skin and give the injection. 3. Clean site with an alcohol pad; loosen needle cover. 4. Select appropriate injection site with the child. 5. Cover the site with an alcohol pad. 6. Uncover needle; insert at 45- to 90- degree angle.
4, 3, 1, 6, 2, 5
8 - A toddler develops acute otitis media and is ordered cefpodoxime proxetil (Vantin) 5 mg/kg P.O. every 12 hours. If the child weighs 22 lb (10 kg), how many milligrams will the nurse administer with each dose? A - 50 mg b - 100 mg c - 110 mg d - 220 mg c - 110 mg d - 220 mg
A - 50 mg
28 - A child, age 15 months, is admitted to the health care facility. During the initial nursing assessment, which statement by the mother most strongly suggests that the child has a Wilms' tumor? A - "My child has grown 3" in the past 6 months." B - "My child seems to be napping for longer periods." C - "My child's abdomen seems bigger, and his diapers are much tighter." D - "My child's appetite has increased so much lately."
C - "My child's abdomen seems bigger, and his diapers are much tighter."
33 - A client is admitted with a marginal placenta previa. Which item should the nurse have readily available? A - One unit of freeze-dried plasma B - Vitamin K for intramuscular injection C - Two units of typed and screened blood D - Heparin sodium for intravenous injection
C - Two units of typed and screened blood
29 - The nurse is caring for an adolescent who had an external fixator placed after suffering a fracture of the wrist during a bicycle accident. Which statement by the adolescent would be expected about separation anxiety? a. "I wish my parents could spend the night with me while I am in the hospital." b. "I think I would like for my siblings to visit me but not my friends." c. "I hope my friends don't forget about visiting me." d. "I will be embarrassed if my friends come to the hospital to visit."
c. "I hope my friends don't forget about visiting me."
1. A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which of the following nursing measures should the nurse do FIRST? a. Institute seizure precautions b. Assess neurologic status c. Place in respiratory isolation d. Assess vital signs
c. Place in respiratory isolation
56 - Before surgery to remove an ectopic pregnancy and the fallopian tube, which signs or symptoms would alert the nurse to the possibility of tubal rupture? A - Amount of vaginal bleeding and discharge B - Profuse sweating C - Slow, bounding pulse rate of 80 bpm D - Marked abdominal edema
B - Profuse sweating
24 - The nurse is caring for an infant with bronchiolitis in the hospital pediatric unit. During breastfeeding, the nurse observes the infant's oxygen saturation decreasing from 95% to 92%. Which intervention should the nurse implement first? A - Stop the feeding and replace the infant in the crib. B - Slightly increase oxygen flow through the nasal cannula and observe the infant's response. C - Initiate NPO measures and notify the infant's healthcare provider. D - Request that the provider prescribe nasogastric gavage feedings for the infant.
B - Slightly increase oxygen flow through the nasal cannula and observe the infant's response.
36 - A pregnant client is receiving magnesium sulfate for the management of preeclampsia. Which assessment finding indicates to the nurse that the client is experiencing magnesium toxicity? A - Proteinuria of +3 B - Sudden drop in FHR C - Presence of DTR D - Serum magnesium level of 2.5 mEq/L
B - Sudden drop in FHR
16 -A patient has gestational diabetes and is currently 34 weeks pregnant. Which assessment findings below should you immediately report to the physician? Select all that apply: A. Blood glucose 129 mg/dL B. Blood pressure 190/102 C. Proteinuria D. Linea nigra E. Negative glycosuria
B. Blood pressure 190/102 C. Proteinuria
18 - A home care nurse is visiting a pregnant client with a diagnosis of mild preeclampsia. What is the priority nursing intervention during the home visit? A - Monitor for fetal movement. B - Monitor the maternal blood glucose. C - Instruct the client to maintain complete bed rest. D - Instruct the client to restrict dietary sodium and any food items that contain sodium
A - Monitor for fetal movement.
15 - A client at 34 weeks gestation is receiving terbutaline (Brethine) subcutaneously. Her contractions increase to every 5 minutes, and her cervix dilates to 4 cm, the tocolytic is discontinued. What is the priority nursing care during this time? A - Promoting maternal-fetal well-being during labor B - Reducing the anxiety associated with preterm labor C - Supporting communication between the client and her partner D - Assisting the client and her partner with the breathing techniques needed as labor progresses
A - Promoting maternal-fetal well-being during labor
4 - A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 wks and tells the nurse that she does not have a history of any type of abortion or fetal demise. The nurse would document the GTPAL for this client as: A. G3, T2, P0, A0, L1 B. G2, T1, P0, A0, L1 C. G1, T1, P1, A0, L1 D. G2, T0, P0, A0, L1 D. G2, T0, P0, A0, L1
B. G2, T1, P0, A0, L1
30 - A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for. A. Enlargement of the breast B. Complaints of feeling hot when the room is cool C. Periods of fetal movement followed by quiet periods D. Evidence of bleeding, such as in the gums, petechiae, and purpura
D. Evidence of bleeding, such as in the gums, petechiae, and purpura
31 - A 40 week gestation primigravada client is being induced with an oxytocin (pitocin) secondary infusion and complains pain in her lower back. Which intervention should the nurse implement? A. discontinue the oxytocin (Pitocin) infusion B. place the client in a semi-Fowler's position C. inform the healthcare provider D. apply firm pressure on the sacral area.
D. apply firm pressure on the sacral area.
5 - A nurse is teaching an adolescent with inflammatory bowel disease about treatment with corticosteroids. Which adverse effects are concerns for this client? Select all that apply. A - Acne b - Hirsutism c - Mood swings d - Osteoporosis e - Growth spurts f - Adrenal suppression
A - Acne b - Hirsutism c - Mood swings d - Osteoporosis f - Adrenal suppression
60 - A nurse is caring for a client following delivery of a stillborn infant. Which actions should the nurse take? Select All That Apply A - Ask the parents if they would like to help bathe the infant b - Discourage the parents from naming the infant c - Discuss the importance of organ donation with the parents d - Encourage the parents and family members to hold the infant e - Offer to obtain handprints, footprints, and photographs of the infant.
A - Ask the parents if they would like to help bathe the infant d - Encourage the parents and family members to hold the infant e - Offer to obtain handprints, footprints, and photographs of the infant.
58 - You're assessing a 4 year old with epiglottitis who just arrived to the pediatric clinic. The child is drooling and has a respiratory rate of 45 breaths per minute. In addition, the child is becoming increasingly apprehensive. Which findings below exhibited by the patient represents an acute upper airway obstruction that requires IMMEDIATE treatment? Select all that apply: A. Stridor B. Cyanosis C. Chest retractions. D. Nasal flaring
A. Stridor B. Cyanosis C. Chest retractions. D. Nasal flaring
3 - A client arrives at the clinic for the first prenatal assessment. The client tells a nurse that the first day of her LMP was October 19, 2012. Using Naegele's rule, the nurse determines the EDD is: A. July 12, 2012 B. July 26, 2013 C. August 12, 2013 D. August 26, 2013
B. July 26, 2013
44 - The nurse is managing care of a primigravida at full term who is in active labor. What should be included in developing the plan of care for this client? A - Oxygen saturation monitoring every half hour B -Supine positioning on back, if comfortable C -Anesthesia/pain level assessment every 30 minutes D - Vaginal bleeding, rupture of membranes assessment every shift
C -Anesthesia/pain level assessment every 30 minutes
51 - A client's membranes rupture, and the nurse immediately detects the presence of a prolapsed umbilical cord. The nurse alerts another nurse, who calls the primary healthcare provider. Place the following interventions in the order in which they should be performed. A - Placing the client in the Trendelenburg position. B - Check the fetal heart rate C - Moving the presenting part of the cord D - Administering oxygen by facemask
C, A, D, B
6 - A nurse is conducting an examination of a 6-month-old baby. During the examination, the nurse should be able to elicit which reflex? A - Babinski's b - Startle c - Moro's d - Dance
A - Babinski's
61 - The nurse reviews the chart of a client who gave birth 4 hours ago. Which contributing factor indicates that the client has an increased risk of postpartum hemorrhage? A - Infant birth weight of 9lb 2oz b - Labor and birth without pain medication c - Labor that lasted 8 hours d - Third stage of labor lasting 20 minutes
A - Infant birth weight of 9lb 2oz
41 - A client receiving epidural anesthesia begins to experience nausea and becomes pale and clammy. What intervention should the nurse implement first? a. Raise the foot of the bed b. Assess for vaginal bleeding c. Evaluate the fetal heart rate d. Take the client's blood pressure
a. Raise the foot of the bed
55 - While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel is open. The nurse should: A - Look for other signs of abuse. B - Notify the doctor. C - Recognize this as a normal finding. D - Ask about a family history of Tay-Sachs disease.
B - Notify the doctor.
11 - The nurse is providing discharge instructions to a postpartum client who delivered a healthy newborn infant. The occurrence of which event should be reported to the health care provider? A - Uterine cramping while breast-feeding B - Pain, redness, or swelling in the breasts C - Diaphoresis that occurs during the night D - Existence of a serosanguineous vaginal drainage
B - Pain, redness, or swelling in the breasts
21 - The nurse is assessing a 7 -day- old infant at home. The infant is breastfeeding, and the mother is concerned about whether the baby is receiving breastmilk during the feedings. Which question is most important for the nurse to ask the mother, when assessing the infant's breastmilk intake? A - "Is the baby sleeping through the night?" B - "Do you hear swallowing noises while the baby is nursing?" C - "How many minutes is the baby suckling on your nipple?" D - "Are you eating a balanced, high protein diet each day?"
B - "Do you hear swallowing noises while the baby is nursing?"
43 - A client who's gravida 2 at 32 weeks gestation with elevated blood pressure has been taught about the danger signs to report. Which of the following statements would demonstrate that she understands when she should call the health care provider's office? Select all that apply. A - "If I get up in the morning and feel dizzy, even if it goes away." B - "If I see any bleeding, even if I have no pain." C - "If I have a pounding headache that doesn't go away." D - "If I notice the veins in my legs getting bigger." E - "If the leg cramps at night are waking me up." F - "If the baby seems to be more active than usual."
B - "If I see any bleeding, even if I have no pain." C - "If I have a pounding headache that doesn't go away." F - "If the baby seems to be more active than usual."
7 - A nurse is teaching a parent of a school-age child about signs and symptoms of fever that require immediate notification of the physician. Which description should the nurse include? A - Burning or pain with urination b - Complaints of a stiff neck c - Fever disappearing for longer than 24 hours, then returning d - History of febrile seizures
b - Complaints of a stiff neck
14 - An adolescent is admitted for treatment of bulimia nervosa. When developing the care plan, the nurse anticipates including interventions that address which metabolic disorder? A - Hypoglycemia b - Metabolic alkalosis c - Metabolic acidosis d - Hyperkalemia
b - Metabolic alkalosis
47 - Which of the following instructions should be included in the nurse's teaching regarding oral contraceptives? a. Weight gain should be reported to the physician. b. An alternate method of birth control is needed when taking antibiotics. c. If the client misses one or more pills, two pills should be taken per day for 1 week. d. Changes in the menstrual flow should be reported to the physician.
b. An alternate method of birth control is needed when taking antibiotics.
42 - An eight-month-old infant recently had a seizure and is lethargic and bradycardic upon arriving at the emergency room. The clinical exam revealed a retinal hemorrhage. The nurse suspects that the child is showing signs and symptoms of: a) Mastoid bone fracture b) Munchausen syndrome by proxy c) Sexual Abuse d) Shaken baby syndrome
d) Shaken baby syndrome
49 - A client who is 3 days postpartum and breastfeeding asks the nurse how to reduce breast engorgement. Which instruction should the nurse provide? A - Avoid using the breast pump B - Breastfeed the infant every 2 hours C - Reduce fluid intake for 24 hours D - Skip feedings to let the sore breasts rest
B - Breastfeed the infant every 2 hours
50 - The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid. The student responds correctly by explaining which as characteristics of amniotic fluid. Select all that apply. A - Allows for fetal movement B - Surrounds, cushions, and protects the fetus C - Maintains the body temperature of the fetus D - Can be used to measure fetal kidney function E - Prevents large particles such as bacteria from passing to the fetus F -Provides an exchange of nutrients and waste products between the mother and fetus
A - Allows for fetal movement B - Surrounds, cushions, and protects the fetus C - Maintains the body temperature of the fetus D - Can be used to measure fetal kidney function
37 - A client is to be discharged with her newborn, who was just circumcised. The nurse is planning discharge instructions about postcircumcision care. What should be included? A - Apply diapers loosely. B - Withhold feedings for 6 hours. C - Cleanse the site with alcohol daily. D - Expect some bleeding for 48 hours.
A - Apply diapers loosely.
2 - The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented? A - Jelly-like stools with mucus. B - Profuse projectile vomiting. C - Watery diarrhea D - Ribbon-like stools
A - Jelly-like stools with mucus.
27 - A nurse is reviewing a care plan for an adolescent girl who's receiving chemotherapy for leukemia who was admitted for pneumonia. The adolescent's platelet count is 50,000 μl. Which item in the care plan should the nurse revise? Select all that apply. A - Keep a sign over the bed that reads "NO NEEDLE STICKS AND NOTHING PER RECTUM." B - Use two peripheral I.V. intermittent infusion devices, one for blood draws and one for infusions. C - Administer oxygen at a rate of 4 L/minute using a nonhumidified nasal cannula. D - Use a tympanic membrane sensor to measure her temperature at the bedside.
A - Keep a sign over the bed that reads "NO NEEDLE STICKS AND NOTHING PER RECTUM." C - Administer oxygen at a rate of 4 L/minute using a nonhumidified nasal cannula
23 - The nurse caring for a child who is awake and alert in the post anesthesia care unit (PACU) immediately after a tonsillectomy should implement which interventions? Select all that apply A - Observe for continuous swallowing B - Administer prescribed oral pain medications C - Offer ice pops D - Encourage throat clearing and coughing
A - Observe for continuous swallowing B - Administer prescribed oral pain medications C - Offer ice pops
57 - A 3 year old arrives to the ER. The child has a temperature of 102.4 'F, respiratory rate of 45, and is agitated. The child is diagnosed with epiglottitis. You note the child is sitting up, positioned forward with chin in the air and the tongue is protruding with the mouth open. Which nursing intervention below is NOT appropriate for this patient? A. Assist the patient in a supine position. B. Keep the child on the parent's lap during treatments. C. Keep the child nothing by mouth. D. Avoid taking a temperature on the patient orally.
A. Assist the patient in a supine position.
22 - The nurse received report on the following children on the inpatient pediatric unit. Which child should the nurse assess first? A - 8 year old who just returned from the post-anesthesia recovery unit, spitting up small amounts of brown-flecked saliva B - 3 year old with newly diagnosed asthma, with diminished right lower lobe breath sounds C - 6 month old with isotonic dehydration, full fontanel, and no skin tenting D - 14 year old with periorbital cellulitis, no discomfort and oral temperature of 99.9°F
B - 3 year old with newly diagnosed asthma, with diminished right lower lobe breath sounds
26 - A nurse is reviewing her shift assignment. Which child should she assess first? A - A 5-month-old infant with I.V. fluids infusing B - An 11-month-old infant receiving chemotherapy through a central venous catheter C - An 8-year-old child in traction with a femur fracture D - A 14-year-old child who is postoperative and has a nasogastric tube and an indwelling urinary catheter
B - An 11-month-old infant receiving chemotherapy through a central venous catheter
40 -An infant's parents ask the nurse about preventing otitis media. Which of the following should be recommended? A - Use nasal decongestant B - Avoid tobacco smoke C - Avoid children with otitis media (OM) D - Bottle feed or breastfeed in supine position
B - Avoid tobacco smoke
59 - The mother of a child with type 1 diabetes mellitus asks why her child cannot avoid all those "shots" and take pills as an uncle does. The most appropriate response by the nurse is A. "The pills work with an adult pancreas only." B. "The drugs affect fat and protein metabolism, not sugar." C. "Your child needs to have insulin replaced, and the oral hypoglycemics only add to an existing supply of insulin." D. "Perhaps when your child is older, the pancreas will produce its own insulin, and then your child can take oral hypoglycemic"
C. "Your child needs to have insulin replaced, and the oral hypoglycemics only add to an existing supply of insulin."
62 - While feeding a 3 month old infant, who has Tetralogy of Fallot, you notice the infant's skin begins to have a bluish tint and the breathing rate has increased. Your immediate nursing action is to: A. Continue feeding the infant and place the infant on oxygen. B. Stop feeding the infant and provide suction. C. Stop feeding the infant and place the infant in the knee-to-chest position and administer oxygen. D. Assess the infant's heart rate and rhythm.
C. Stop feeding the infant and place the infant in the knee-to-chest position and administer oxygen
32 - When administering morphine to a school-age child, which sign or symptom should cause the nurse to be concerned? A - Constipation B - Nausea and vomiting C - Pruritus D - Anemia
D - Anemia
53 - A nurse is caring for a client in labor. When her cervix is 3-4 cm and 60% effaced and the vertex is -1 station, there is a sudden spurt of dark blood from the vagina. The uterus is irritable upon palpation and does not relax fully between contractions. What is the initial nursing action? A - Transporting the client for a cesarean birth. B - Checking the perineum for rupture of membranes. C - Changing the underpad and positioning the client on her left side. D - Assessing the fetal heart rate, uterine activity and blood pressure.
D - Assessing the fetal heart rate, uterine activity and blood pressure.
