NR 327 CMS quiz review

a nurse is caring for a client who is PP. the nurse should identify which of the following findings as an early indicator of hypovolemia caused by hemorrhage

increasing pulse and decreasing blood pressure

a rn is preparing to admin prophylactic eye ointment to a NB to prevent neonatorum. which of the following meds should the rn anticipate admin

erythromycin

a NB was not dried completely after birth. this places the infant at high risk for what type of heat loss

evaporation

a rn is caring for a PP client who delivered their 3rd infant days ago. which of the following manifestations could indicate PP depression

fatigue, insomnia, flat affect

a nurse is reviewing the findings of a client's biophysical profile (BPP). the nurse should expect which of the following variables to be included in this test

fetal breathing movement, tone, and amniotic fluid volume

a nurse is caring for a client who is has a Rx for mag sulfate. the RN should recognize that which of the following are contraindications for the use of this medication

fetal distress, vag bleeding, cervical dilation > 6cm

a nurse is caring for client who has been in labor for 12 hrs w/ intact membranes. the rn performs a SVEto ensure which of the following prior to performance of the amniotomy

fetal engagement

a nurse is caring for a client having contractions q8 min that are 30-40sec in duration. the client's cervix is 2cm dilated, 50%effaced, and fetus is at -2, FHR is 140. which of the following stages and phases of labor is this client experiencing

first stage latent phase

a client in the early PP period is excited and talkative. they repeatedly tell the rn every detail of the labor and birth. bc the client will not stop talking, the rn is having difficulty completing the PP assessments. which of the following actions should the rn take

give the client time to express their feelings

a nurse is caring for a client who is in labor. the RN should identify that which of the following infxn can be treated in during labor or immediately after birth

gonorrhea, chlamydia, group B strep beta hemolytic, HIV

a nurse is reviewing the health record of a client who is pregnant. the provider indicated the client exhibits probable signs of pregnancy. which of the following findings should the nurse expect

goodell's sign, ballottement, chadwick's sign

a rn is caring for a client who is active labor and reports severe back pain. during the assessment the fetus is noted to be in occiput posterior position. which of the following maternal positions should the rn suggest to the client to facilitate normal labor progress

hands and knees

a rn is assessing the reflexes of NB. in checking for the moro reflex, the rn should perform which of the following

hold the NB in a semi sitting position and then allowing the head and trunk to fall

a nurse at an antepartum clinic is caring for a client that is 4 mon gestation. the client reports continued N/V, and scant prune colored discharge. the client is experiencing weight loss and has a fundal height larger than expected. what finding is expected

hydatidiform mole

a rn is reviewing contraindications for circumcision with a newly hired rn. which of the following conditions are contraindications

hypospadias, fam hx of hemophilia, epispadias

a nurse is reviewing new Rx for ferrous sulfate with a client at 12 wk gest. which of the following statements by the client indicates understanding of the teaching

i plan to drink more OJ with this medication

a nurse in an obstetrical clinic is teaching a client about using an IUD for contraception which of the following statements by the client indicates an understanding of the teaching?

i will check to be sure the strings of the IUD are still present after my period

a rn is providing d/c teaching to parents of a NB regarding circumcision care. which of the following statements made by a parent indicates an understanding of the teaching

i will clean the penis with each diaper change

a RN is reviewing PP nutrition needs with a group of clients who have begun BF their NB. which of the following statements by a member of the group indicates an understanding of the teaching

i will continue my Ca supp bc i dont like milk

a rn is reviewing d/c teaching with a client who has a UTI. which of the following statements by the client indicates understanding of the teaching

i will drink large amounts of fluids to flush the bacteria from the urinary tract, i will take tylenol for any discomfort

a rn is completing PP d/c 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 understanding of the teaching

i will need a 2nd vaccination at my PP visit

a nurse in a prenatal clinic is caring for 4 clients. which of the following clients' weight gain should the RN report to the provider

3.6 kg (8 lb) weight gain and is in the 1TM (3-4lb wt gain is expected in the 1TM)

a nurse instructs a client who is taking an oral contraceptive about manifestations to report to the provider. which of the following manifestations should the nurse include

SOB

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

blunt abdominal trauma, cocaine use, cigarette smoking

RN is teaching a client @ 6 wks gestation about common discomforts of pregnancy. which should the RN include

breast tenderness, urinary freq, epistaxis

a nurse is caring for a client that is 14 wks gest. and has hyperemesis gravidarum. the RN should identify that which of the following are risk factors for the client

DM, multifetal pregnancy, gestational trophoblastic disease

a nurse is reviewing the MR of a client who is to undergo hysterosalpingography. which of the following data alert the nurse that the client is at risk for a complication related to this procedure? vital signs: temp 36.1C, HR 60; H&P: employed as a rad tech, allergy to shrimp,tonsilectomy @18, glucose 103, hgb 13.1, total cholesterol 265, meds: rosuvastatin, Mg oxide, mafenide acetate

H & P

a RN in a clinic is teaching a client of childbearing age about recommend folic acid supplements. which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency

NTD

a nurse is assessing a PP client who is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown. which of the following conditions are assoc with these manifestations

PP blues

a nurse is administering magnesium sulfate IV for seizure prophylaxis to a client who has severe preeclampsia. which of the following indicated toxicity

RR<12, UOP <25ml/hr, decreased LOC

a rn is caring for a client who had no prenatal care, Rh-, and will undergo an external version at 38 wks gest. which of the following meds should the nurse plan to admin prior to the version

Rho (D) immune globulin ** this is given to rh- moms at 28 weeks, since no prenatal care was given prior to version to prevent isoimmunization***

a nurse is caring for a client who reports manifestations of PTL. which of the findings are RF for this condition

UTI, multifetal preg, hydramnios, DM, uterine abn

a nurse manager is reviewing ways to prevent TORCH infxn during pregnancy with a group of licensed nurses. which of the following statements by a nurse indicates understanding of the teaching

a client should avoid eating undercooked meat

a rn is providing care for 4 clients on the PP unit. which of the following clients is at greatest risk for developing a PP infxn

a client who does not wash their hands between perineal care and BF

a rn on the PP unit is caring for 4 clients. which of the following clients should the rn recognize as the greatest risk for development of a PP infxn

a client who had PROM and prolonged membranes **poses the greatest for developing PPInfxn bc the birth canal was open allowing pathogens to enter

a nurse caring for a client who is in the 1st stage of labor and is encouraging the client to void every 2 hr. which statement should the RN make

a distended bladder reduces pelvic space needed for birth

during ambulation to the bathroom, a PP client experiences a gush of dark red blood that soon stops. on assess a rn finds the uterus to be firm, midline, and at the level of the umbilicus. which of the following findings should the rn interpret htis data as being

a normal postural d/c of lochia

a nurse in a health clinic is reviewing contraceptive use w/ a group of clients. which of the following client statements demonstrates understanding

a water soluble lubricant should be used with condoms

a nurse is caring for a client at 40 wks gest and experiencing contractions Q3-5 min and becoming stronger. a vaginal exam reveals that the client's cervix is 3cm dilated 80% effaced, and-1 station. the client asks for pain medication. which of the following actions should the RN take

admin opioid analgesic medication, suggest cold application

a rn is completing an assessment. which of the following data indicate the NB is adapting to extrauterine life

apnea for 10 sec periods,obligatory nose breathing

a nurse is conducting a home visit for a client who is 1 week PP and BF. the client reports breast engorgement. which of the following recommendations should the rn make

apply cold compress between feedings

a rn is caring for a NB immediately following a circumcision using a gomco procedure. which of the following actions should the rn implement

apply petroleum gauze to the site

a nurse is caring for a client in active labor. when last examined 2 hrs ago, the client's cervix was 3cm dilated 100% effaced, membrane intact, and the fetus at -2 station. the client suddenly staes "my water broke." the monitor reveals FHR 80-85/min, the rn performs a SVE< noticing clear fluid and a pulsing loop of umbilical cord in the client's vagina. which of the following actions should the rn perform

apply pressure to the presenting part with fingers

a rn is caring for a NB who was born at 38 wks gest, weighs 3,200 g, and is in the 60th percentile for weight. based on the weight and gestational age, the rn should classify the neonate as the following

appropriate for gestational age **normal at 10-90 percentile

a rn is caring for a client who has PP psychosis. which of the following actions is the rn's priority

ask the client if they have thoughts of harming themself or their baby

a nurse is caring for a client who is labor and observes late decelerations on electronic fetal monitor. which of the following is the first action the nurse should take

assist client to the left lateral position

a rn is caring for a NB. which of the following actions by the NB indicates readiness to feed

attempts to place their hand in their mouth

a rn is reviewing car seat safety with the parents of a NB. which of the following instructions should the rn include in the teaching regarding car seat positions

back seat, rear facing

a nurse is caring for a client who is at 32 wks of gestation and 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

betamethasone

a nurse is providing care for a client that is in PTL at 32 wks. which of the following medications should the RN anticipate the provider will prescribe to hasten fetal lung maturity

betamethasone

a nurse is caring for a client who is receiving mag sulfate. which of the following medications should the RN anticipate administering if toxicityis suspected

calcium gluconate

a rn on the PP unit is assessing a client who is being admitted with a suspected DVT. which of the following clinincal findings should the rn expect

calf tenderness w/ palpation, elevated temp, are of warmth

a RN is caring for client who has gonorrhea. which of the following medications should the rn expect the provider will prescribe

ceftriaxone

a nurse is caring for client who is 40 wks gest and reports having a large gush of fluid from the vagina while walking from the bathroom . which of the following actions should the RN take first

check FHR

a nurse in a prenatal clinic is caring for a client who is in the 1TM of pregnancy. the client's health record includes this data: G3T1P0A1L1. how should the nurse interpret the data

client has delivered one NB at term, client has had 2 prior pregnancies, client has 1 living child

a rn is teaching a client who BF and has mastitis. which of the following responses should the rn make

completely empty each breast at each feeding or use a pump

a rn assessing a clinet who has PP depression. the rn should expect which of the following manifestations

concern about lack of income to pay bills, anx about assuming a new role as a parent, rapid decline in estrogen and progesterone, feeling of inadequacy with the new role as a parent

a rn is caring for a NB immediately following birth. which of the following interventions is the highest priority

covering the NB head with a cap

a rn is reviewing BF positions with the parent of a NB. which of the following positions should the rn discuss

cradle

a rn in a prenatal clinic is providing education to a pt at 8 wks gestation. the client states " i dont like milk" whick of the following foods should the RN recommend as a good source of calcium

dark green leafy vegetables

a nurse is caring for a client who is pregnant to undergo a contraction stress test (CST). which of the following findings are indications for this procedure

decreased fetal movement, IUGR, post maturity

a nurse is planning care for a newly admitted client who reports,"i am in labor and i have been having vaginal bleeding for 2 weeks" which of the following should the nurse include in the plan of care

defer vag exams

a rn is caring for a client who is 1 day PP. the rn is assessing the maternal adaptation and parent infant bonding. which of the following behaviors by the client indicates a need for the rn to intervene

demonstrates apathy when the NB cries, views the NB behavior as uncooperative during diaper changing

a nurse is caring for a client who is receiving nifedipine for prevention of PTL. the RN should monitor client for which of the following manifestations

dizziness assoc with orthostatic hypoTN which occurs when taking this med

a nurse is caring for a client who is receiving oxytocin for induction of labor and has an intrauterine pressure catheter placed to monitor uterine contractions. which of the following patterns should the RN d/c the infusion of oxytocin

duration of 90-120 sec

client @ 7 wks gestation is experiencing N/V in the morning. what info should the RN include

eat crackers or plain toast before getting out bed

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 on menstrual cycle and cannot be pregnant because i have an IUD" the nurse should suspect which of the following

ectopic preg

a rn is discussing RF for UTI with a newly licensed rn which of the following conditions should the rn include in the teaching

epidural anesthesia, urinary bladder cath, freq pelvic exams, history of UTIs

a rn is completing a NB assessment and observes small pearly white nodules on the roof of the NBs mouth. the finding is a characteristic of which of the following conditions

epstein's pearls

A nurse is completing an admission assessment for a client who is 39wks and reports fluid leaking from the vagina for 2 days which of the following is the client at risk for developing

infection **rupture of membranes for longer than 24hr**

a nurse is teaching a client about potential adverse effects of implantable effects of implantable progestins. which of the following adverse effects should the nurse include

irreg vag bleeding, weight gain, nausea

a rn is preparing to admin a vit k injection to a NB. which of the following responses should the rn make to the NBs parents regarding why this med is given

it assists with clotting

a nurse is caring for a client who is pregnant an undergoing a nonstress test. the client asks why the nurse is using and acoustic vibration device. which of the following responses should the RN make

it awakens the sleeping fetus

a nurse is teaching a client about benefits of internal fetal heart monitoring. which of the following statements should the nurse include?

it can detect abn FHT early, it allows for accurate readings with maternal movement, it can measure uterine contraction activity

a nurse in a clinic is caring for a client who is postoperative following a salpingectomy due to an ectopic pregnancy. which of the following statements by the client requires clarification

it is good to know that i wont have a tubal pregnancy in the future

a nurse is caring for a client following the admin of an epidural block and is preparing to admin an IV fluid bolus. the client's partner asks about the purpose of OV fluids. which of the following statements should the nurse make

it is needed to counteract hypoTN

a client who is at 8 weeks gestation tells the nurse " i am not sure i am happy about being pregnant' which of the following responses should the nurse make

it is normal to have these feelings during the first few months of pregnancy

a nurse is caring for a client who is pregnant and states that their last menstrual period was april 1st. what is her estimated date of delivery

jan 8th

a RN is reviewing D/C teaching with a client who has PROM at 26 wks gest. which of the following instructions should the RN include in the teaching

keep a record of daily kick counts

a rn is reviewing care of the umbilical cord with the parent of a NB. which of the following instructions should the rn include in the teaching

keep the diaper folded below the cord

a rn is teaching a group of new parents about proper techniques for bottle feeding. which of the following instructions should the rn provide

keep the nipple full of formula t/o the feeding

a rn is providing d/c instructions to a PP client following a C/S birth. the client reports leaking urine every time the sneeze or cough. which of the following interventions should the rn suggest

kegel exercises

a rn is called to the birthing room to assist the assessment of a NB who was born at 32 wks. weight is 1,100g. which of the following are expected findings in this NB

lanugo, weak grasp reflex, translucent skin

a nurse is caring for a client in preterm labor and is scheduled to undergo an amniocentesis. the nurse should evaluate which of the following tests to assess fetal lung maturity

lecithin/sphingomyelin (L/S) ratio

a nurse is caring for a client in the third stage of labor. which of the following findings indicate placenta separations

lengthening of the cord, appearance of dark blood from the vagina, fundus firm upon palpation

a RN in an antepartum clinic is assessing a client with a TORCH infxn. which of the following findings should the RN expect

malaise, rash, tender lymph nodes, joint pain

a rn is taking a nB to a parent following a circumcission. which of the following actions should the rn take for security purposes

match ID bracelets

a rn is planning care for a clinet who is PP and has thrombophelibitis. which of the following rn interventions should the rn include in the plan of care

measure leg circumfrence

a nurse is caring for a clinet who is at 42 gest in active labor. which of the following findings is the fetus at risk for developing

meconium aspiration

a rn is performing a fundal assessment for a client who is 2 days PP and observes the perineal pad for the lochia. the pad is saturated approx 12 cm with lochia that is bright red and contains small clots. which of the following findings should the rn document

moderate lochia rubria

a nurse is caring for a client in active labor. cervix is 5cm and the membranes are intact . based on the use of external electronic fetal monitoring, the nurse notes FHR of 115 to 125/min with occ increases up to 150 to 155/min that last for 25 seconds and have moderate variability. there is no slowing of the FHR from baseline. this client is exhibiting manifestations of which of the following?

moderate variability, FHR accelerations, normal baseline FHR

a nurse in an infertility clinic is providing care to clients who have been unable to conceive for 18 months. which of the following data should the nurse assess

occupation, menstrual hx, childhood infectious diseases

a nurse is caring for a client who is 42wks gest and is having an US. for which of the following conditions should the nurse plan for an amnioinfusion

oligohydramnios, fetal cord compression

a nurse is reviewing a new Rx for iron supplements with a client who is at 8 wks of gestation and has iron deficiency anemia. which of the following beverages should the nurse instruct the client to take the iron supplements

orange juice

a rn is caring for a NB who is preterm and has resp distress syndrome. which of the following should the rn monitor to evaluate the NBs condition following admin of synthetic surfactant

oxygen saturation

a nurse is performing leopold maneuvers on a client who is in labor. which of the following techniques should the nurse identify the fetal lie?

palpate the fundus of the uterus

a nurse in a clinic is caring for a group of female clients who are being evaluated for infertility. which of the following clients should the nurse anticipate the provider will refer to the genetic counselor

partner has willebrand disease

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 RN include

perform the pelvic rock exercise every day, use proper upper body mechanics

a nurse is caring for a client who is using patterned breathing during labor. the client report numbness and tingling of the fingers. which of the following actions should the nurse take

place an O2 mask of the client's nose and mouth ** pt is hyperventilating, same can be accomplished by having them breathe into a paper bag-reduce the intake of O2 allowing the PCO2 to rise **

a rn is reviewing formula preparation with parents who plans to bottle feed their NB. which of the following info should the RN include in the teaching

place used bottles in dishwasher, check nipple for appropriate flow of formula, use tap water to dilute concentrated formula

a rn in the delivery room is planning to promote parent infant bonding for a client who just delivered. which of the following is the priority action by the rn

position the neonate skin to skin on the client's chest

a rn edu on the PP unit is reviewing RF for PPH with a group of rn. which of the following fx should the rn include in the teaching

precipitous delivery, inversion of the uterus, retained placental fragments

a rn is caring for a client who has disseminated intravascular coagulation (DIC) which of the following antepartum complications should the rn understand is a RF fo r this condition

preeclampsia

a nurse is caring for a client who is in the transition phase of labor and reports they need to have a BM with the peak of contractions. what action should the nurse take

prepare for an impending delivery

a rn is caring for a client who is in labor. with use of the leopold maneuver, it is noted that the fetus is in a breech presentation. for which of the following possible complications should the rn observe

prolapsed cord

a nurse concludes that the parent of a NB is not showing positive indications of parent -infant bonding. the parent appears very anxious and nervous when asked to bring the NB to the other parent. which of the following actions should the rn use to promote parent infant bonding

provide edu about infant caare when the parent is present

a nurse is caring for a client in the 2nd stage of labor. the client's labor has been progressing and a vaginal delivery is expected in 20min. the provider is preparing to administer lidocaine for pain relief and perform an episiotomy. the nurse should know that which of the following types of regional anesthetic block is to be administered

pudenal **transvaginal injection of local anesthetic the anesthetizes the perineal area for episiotomy and repair, and expulsion of the fetus. **

a rn is providing d/c teaching for nonlactating client. which of the following instructions should the rn include in the teaching

pump breast Q4 to releive discomfort

a rn is caring for a client who is labor and experiencing incomplete uterine relaxation between hypertonic contractions. the rn should identify that this contraction pattern increases the risk for which of the following complications

reduced fetal oxygen supply

a nurse is reviewing the electronic monitor tracing of a client who is in active labor. a fetus receives more oxygen when which of the following appears on a tracing

relaxation between uterine contractions

a nurse is caring for a client who is experiencing a ruptured ectopic preg. which of the following findings is expected with this condition

report of severe shoulder pain

a nurse is caring for a client in active labor. the client reports lower back pain. the RN suspects that this pain is related to persistent occiput posterior fetal position. which of the following nonpharmacological nursing interventions should the RN recommend to the client

sacral counterpressure

a rn is providing d/c instructions for a client. at 4 weeks PP the client hsould contact the provider for which of the following client findings

sore nipple w/ cracks and fissures

a rnis caring for a client who has mastitis. which of the following is the typical causative agent of mastitis

staph aureus

a rn is caring for an infant who has a high bilirubin level and is receiving phototherapy. which of the following is the priority finding in the NB

sunken fontanels

a rn is teaching a newly licensed rn about neonatal abstinence syndrome. which of the following statements by the newly licensed rn indicates understanding of the teaching

the NB will have a continuous high pitched cry

a nurse is caring for a couple who is being evaluated for infertility. which of the following statements by the nurse indicates understanding of the infertility assessment process

the male is easiest to assess, and the provider will usually begin there

a nurse is caring for a client and partner during the second stage of labor. the client's partner asks the nurse to explain how to know when the crowning occurs. what response should the rn make

the vaginal area will bulge as the baby's head appears

a nurse educator in the labor and delivery unit is reviewing the use of chemical agents to promote cervical ripening with a group of newly licensed nurses. which statement by a rn indicates understanding

they are tablets administered vaginally

a rn is teaching a newly licensed rn how to bathe a NB and observes a blush brown marking across the NB lower back. the rn should include which of the following info in the teaching

this is common for NB who have dark skin

a nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypoTN. the client asks the nurse what causes these episodes. which of the following responses should the nurse make

this is due to the weight of the uterus on the vena cava

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 is the client experiencing

transition phase

A client calls a provider's 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?

true contractions

a rn is assessing a PP client for fundal height, location, and consistency. the fundus is noted to be displaced laterally to the right and there is uterine atony. the rn should identify which of the following conditions as the cause of uterine atony

urinary retention

a RN is caring for a client who has suspected hyper emesis gravidarum and is reviewing the client's labs. which of the findings is a manifestation of this condition

urine ketones present

a rn is providing education to a client who is 2hr PP ans has perineal laceration. which of the following info should the rn include

use a perineal squeeze bottle to cleanse the perineum, apply a topical anesthetic cream or spray, apply cold/ice packs to area

a nurse admitting a client who is in labor and has HIV. which of the following interventions should the RN identify as contraindicated for the client

vacuum extractor, the use of forceps during the delivery should be avoided due to the risk of fetal bleeding, internal fetal monitoring

a RN is caring for a client that is pregnant and reviewing the manifestations of complications the client should promptly report to the provider. which should the RN include

vaginal bleeding

a nurse in a clinic is teaching a client about a new prescription for medroxyprogesterone. which of the following information should the nurse include in the teaching

weight fluctuations may occur, you should increase your calcium, irregular vaginal spotting may occur

a rn is giving instructions to a parent about how to BF their NB. which of the following actions by the parent indicates understanding of the teaching

when latched on, the infant's nose, cheek, and chin are touching the breast

a nurse in a clinic receives a phone call from a client who would like to be tested in the clinic to confirm a pregnancy. which of the following information should the nurse provide to the client

you should collect urine from the first morning void

a nurse is teaching a client who is pregnant about the amniocentesis procedure. which of the following statements should the nurse include in the teaching

you should empty your bladder prior to the procedure

a rn is caring for a client who is 42 weeks gest and in labor. the client asks the rn what to expect bc the baby is postmature. which of the following statements should the rn make

your baby's skin will have a leathery appearance

a nurse is caring for a client who is 2 days PP. the client states "my 4yo son was toilet trained and no he is freq wetting himself" which of the following statements should the rn provide to the client

your son is showing an adverse sibling response