proctor OB ATI questions
A nurse is providing care to a client who is in labor. heart tracing shows early decelerations. Which of the following action should the nurse take? Continue to monitor the fetal heart tracing elevate the clients legs increase the rate of IV fluid administer oxygen via face mask
Continue to monitor the fetal heart tracing
A nurse is caring for a client who states I think I am pregnant. Which of the following findings should the nurse identify as a positive sign of pregnancy a. Positive serum pregnancy test b. Amenorrhea c. Fetal heart tones heard on an auscultated Doppler d. Chadwick sign
Fetal heart tones auscultated by Doppler
A nurse is evaluating a client who has just received instructions about breast-feeding. Which of the following statements should the nurse identify as an indication that the client understands how to prevent mastitis? a. I will wear an underwire bra to provide support when my milk comes in b. I will apply petroleum jelly if my nipples become cracked c. I will apply warm compress to my breast twice a day d. I should avoid waiting too long between feedings
I should avoid waiting too long between feedings
a nurse is preparing to help with vacuum-assisted birth. which of the following actions should the nurse plan to take? a. instruct the client to stop pushing during contractions b. inform the client that caput succedaneum resolves in a few days c. monitor the newborn for decreased levels of bilirubin after birth d. identify that the newborn is at risk for facial palsy
Informed the client that caput succedaneum resolves in a few days
A nurse is assessing a newborn for congenital hip dysplasia. Which of the following findings should the nurse expect? legs that are shorter than the arms temperature of one leg differing from that of another symmetrical gluteal fold limited abduction of the hip
Limited abduction of the hip
A nurse is caring for a client request an IUD for contraception. Which of the following findings is a contraindication for this device? Hypertension MENORRHAGia history of multiple gestation history of thromboembolic disease
MENORRHAGia
A nurse is caring for a client who is two hours postpartum. The nurse notes the clients peroneal that has a large amount of lochia rubra with several clots. Which of the following actions should the nurse perform first? Check for a full bladder massage the fundus measure vital signs administer carboprost
Massage the fundus
A nurse is assessing a 12 hour old newborn notes mild jaundice of the face and trunk. Which of the following action should the nurse take? A. administer vitamin K b. Obtain a stat prescription for a Bilirubin level c obtain a bagged urine sample d. Performance gestational age assessment
Obtain a stat prescription for a Bilirubin level
A nurse is caring for a client who recently gave birth and plans to breast-feed. Which of the following action should the nurse take? a. Place the unwrapped newborn on the mothers bare chest b. Feed the infant 5 to 15 mL of 5% glucose water to assess the suck swallow reflux c. Bathe the newborn under running warm water before feeding d. Administer vitamin K and I prophylaxis prior to feeding
Place the unwrapped newborn on the mothers bare chest
A nurse is caring for a client who is attempting a trial of labor after several C-sections. The client reports a sudden onset of constant abdominal pain and the nurse observes a pro long deceleration on the fetal heart rate tracing. Which of the following action should the nurse take a. Assist the client to the bathroom to empty her bladder b. Place the client in the knee chest position c. Plan to administer calcium gluconate d. Prepare the client for an emergency C-section
Prepare the client for an emergency C-section
A nurse is providing teaching for a client about hormonal changes during pregnancy. The nurse identifies that which of the following hormones plays a key role in preventing miscarriage? a. Oxytocin b. prolactin c. progesterone d. estrogen
Progesterone, maintains the endometrium and has a relaxing effect on the uterus of the fetus is not expelled
A nurse is providing care for a pregnant adolescent who is at 12 weeks gestation and verbalizes a fear of gaining weight during pregnancy. Which of the following action should the nurse take? a. Have the client watch a video on field growth and development during pregnancy b. Supply pamphlets that discuss the importance of nutrition during pregnancy c. Explain how poor nutrition can prevent baby from growing properly d. Provide examples of how eating will help maintain a healthy weight during pregnancy
Provide examples of how eating well will help maintain a healthy weight during pregnancy explanation: adolescence are typically preoccupied with self and lack the ability to understand outcomes that will occur in the future
A nurse enters a postpartum clients room and notices many visitors in the room, conversing loudly and taking turns holding the baby. The newborn intermittently cries and attempts to suck on her hand. After a few minutes, the newborn quiet, stairs and turns her head away when someone talks to her. What teaching should the nurse provide for the family? The newborn would benefit from skin to skin contact in a quiet environment the newborns blanket should be removed so her movements will not be restricted The newborns hat should be removed to avoid overheating The newborn should be discouraged from sucking on her hands since this habit can interfere with feeding
The newborn would benefit from skin to skin contact in a quiet environment
A nurse is caring for a client who had pelvic measurements recorded by the provider. The client asks since my pelvis is gynecoid will I be able to deliver vaginally? Which of the following responses should the nurse make? a. The shape of your pelvis will make vaginal childbirth difficult but it is possible b. The shape of your pelvis will require a cesarean delivery c. The shape of your pelvis is ideal for vaginal childbirth d. The shape of your pelvis will change as you near delivery, and the provider will determine if the vagina delivery is possible
The shape of your pelvis is ideal for vaginal birth
A nurse is assessing a client at 35 weeks gestation who is receiving magnesium sulfate be a continuous IV infusion for severe preeclampsia. Which of the following findings should the nurse report to the provider a. deep tendon reflex is 2+ b. bp 150/96 c. urinary output 20 ml/hr d. rr 16
Urinary output 20 ml/hr
A nurse is caring for a client in the third trimester of pregnancy he reports difficulty sleeping. Which of the following instruction should the nurse provide a. eat a high fat snack before bed b. exercise in the evening before bed c. sleep in supine position d. use additional pillows to support extremities and abdomen
Use additional pillows to support extremities and abdomen
a nurse is providing teaching to the parents of a newborn about home safety. which of the following statements by the parents indicates an understanding of the teaching? a. i will place my baby on his back when putting him to sleep b. i will keep my baby's crib close to heat vents to keep him warm c. i will use an infant carrier when i drive to places close to my house d. i will tie my baby's pacifier around his neck with piece of yarn
a. i will place my baby on his back when putting him to sleep
a nurse is teaching a client about squatting exercises during pregnancy, which of the following statements should the nurse include? a. these exercises should be done for 15 minutes each day to strengthen perineal muscles b. squatting exercises can tone your abdomen helping you lose weight faster following delivery c. practicing squatting exercises during pregnancy will reduce lower back pain during labor d. doing squatting exercises 3 times per week will improve your overall fitness
a. these exercises should be done for 15 minutes each day to strengthen perineal muscles
a nurse is caring for a client at 12 weeks gestation who has a BMI of 45. which of the following pieces of information should the nurse provide for the client regarding the recommended weight gain during her pregnancy? a. you should plan to gain no more than 20 pounds during your pregnancy b. you should plan to gain between 25 and 35 lbs c. you should not plan to gain any weight d. since you have higher energy needs than an average size pregnant client so you should plan to gain 45-50 lbs
a. you should plan to gain no more than 20 pounds during your pregnancy
a nurse is assisting with an amniocentesis for a client who is RH negative. which of the following actions should the nurse take following the procedure? a. send a sample of amniotic fluid to the lab to screen the client for chlamydia b. send a sample of amniotic fluid to laboratory to test for an elevated rh negative titer c. administer immune globulin to the client to prevent fetal isoimmunization d. administer IV antibiotics to prevent an infection
administer immune globulin to the client to prevent fetal isoimmunization
a nurse is preparing to administer routine medications to a newborn following birth. which of the following actions should the nurse take? a. administer vitamin K subq b. administer erythromycin eye ointment within 12 hours c. administer erythromycin eye ointment from the outer to inner d. administer vitamin k in the newborn's thigh
administer vit k in the newborn's thigh
a nurse is discussing epidural anesthesia with a client who is receiving oxytocin to induce labor. which of the following statements should the nurse make? a. an epidural given to early during labor can cause maternal hypertension b. an epidural given too early during labor will not be effective in active labor c. an epidural given too early can cause fetal depression d. an epidural given to early can prolong labor
an epidural given to early can prolong labor
a nurse is caring for a client who is at 38 weeks of gestation and is in the active phase of the first stage of labor. the nurse notes 2 late decelerations of the fetal heart rate during the last 5 contractions. which of the following actions should the nurse take? a. slow the IV infusion rate b. assist the client to a lateral position c. assess the bladder for urinary retention d. initiate oxytocin infusion
assist the client to a lateral position
a nurse is caring for a client who reports intestinal gas pain following a c section. which of the following actions should the nurse take? a. assist the client to ambulate in the hallway b. instruct the client to splint the incision with a pillow c. have the client drink fluids through a straw d. encourage the client to drink carbonated beverages
assist the client to ambulate in the hallway
a nurse is caring for a client who is postpartum and is having difficulty voiding. which of the following actions should the nurse take first? a. place the client's hand in warm water b. administer an analgesic to the client c. pour water from a squeeze bottle over the client's perineum d. assist the client to the bathroom
assist the client to the bathroom
a nurse is teaching a parent of a newborn about circumcision care. which of the following instructions should the nurse include? a. wash the site with soap and warm water once daily b. gently remove the yellow exudate that forms around the site c. avoid using diaper wipes on the site during diaper changes d. apply the diaper tightly to apply pressure
avoid using diaper wipes on the site during diaper changes
A nurse is assisting a client who is four hours postpartum to get out of bed for the first time. The client becomes frightened by Kesha dark red blood from her vagina. Which of the following statements should the nurse make in response? a. you might have retained placental fragments in the uterus b. blood pools in the vagina when you are lying in bed c. you might have a damaged Blood vessel d. your blood flow will increase the first few days after birth
b. blood pools in the vagina when you are lying in bed
a nurse is caring for a client who experienced a fetal loss. when initiating communication with this client, which of the following statements should the nurse make? a. i understand how you feel b. im here for you to talk if you would like to talk c. It is better that the loss happened now, before you got to know your baby d. you are young and can have other children
b. im here for you to talk if you would like to talk
a nurse is teaching a client about using the lamaze method to manage pain during labor. which of the following pieces of information should the nurse include? a. learning about child birth will reduce any fear you might have, which will help you focus more on abdominal breathing during contractions b. you will learn how to prevent pain during labor by focusing your mind to control your breathing c. during labor, you will be encouraged to disassociate by using an internal focal point d. during labor you will use conscious relaxation and levels of progressive breathing
b. you will learn how to prevent pain during labor by focusing your mind to control your breathing
a nurse is assessing a newborn who has a congenital diaphragmatic hernia. which of the following findings should the nurse expect? a. distended abdomen b. increased blood pressure c. generalized petechiae d. barrel-shaped chest
barrel shaped chest
a nurse is caring for a client at 32 weeks gestation who is experiencing preterm labor. which of the following medications should the nurse plan to administer? a. betamethasonee b. misoprostol c. methylergonovine d. proctant alfa
betamethasone
A nurse is teaching a client who is pregnant and has pre-gestational diabetes about dietary changes. Which of the following statements should the nurse include in the teaching? a. Carbohydrates should make up 55% of your diet b. Pro Tien should make up 70% of your diet c. That should make up 45% of your diet d. Fiber should make up 10% of your diet
carbs 55%
a nurse is assessing a newborn. which of the following findings should the nurse report to the provider? a. anterior fontanel of 5 cm b. central cyanosis c. edematous scrotum d. capillary refill under 2 second
central cyanosis
a nurse is caring for a client who is in labor. the client speaks a different language than the nurse and is grimacing. which of the following actions should the nurse take while waiting for an interpreter. a. administer pain meds b. change positions c. insert a catheter d. prepare for an epidural
change positions
a nurse is developing a plan of care for a newborn who has hyperbilirubinemia and a prescription for phototherapy. Which of the following interventions should the nurse include in the plan ? a. discontinue therapy if a fine rash appears b. place moisturizing lotion on the newborn's skin c. supplement feedings with 1 oz of glucose water every 4 hours d. change the newborn's position every 2-3 hours
change the newborn's position every 2-3 hours
A nurse is caring for a client who is at 39 weeks gestation and shows manifestations of labor. Which of the following findings will alert the nurse that the client isn't true labor? a. contractions felt in the upper abdomen b. a small amount of bloody discharge c. contractions occuring every 2-10 minutes d.changes in cervical dilation of effacement
changes in cervical dilation or effacement
A nurse is preparing to provide umbilical cord care for a newborn 12 hours after delivery. Upon inspection the nurse notes moderate bleeding from the blood vessel. Which of the following action should the nurse take a. check the newborn's heart rate b. place a pressure dressing on the cord stump c. adminster vitamin k d. check the integrity of the cord clamp
check the integrity of the cord clamp
a nurse is teaching a parent of a newborn how to care for the newborn's umbilical cord stump. which of the following instructions should the nurse include? a. cover the cord with the edge of the diaper b. clean the cord stump with tap water c. apply a damp cloth over the cord stump once each day d. you should gently tug on the cord stump in 5 days if It has not yet fallen off
clean the cord stump with tap water
a nurse is caring for a client during her first prenatal visit and notes that she is lactose intolerant. which of the following foods should the nurse include on a list of calcium sources for this client? a. collard greens b. cottage cheese c. orange juice d. broccoli
collard greens
a nurse is caring for a client who is receiving oxytocin to induce labor. which of the following actions should the nurse take? a. perform continuous FHR monitoring b. measure maternal temp every hour c. evaluate the maternal contraction pattern every hour d. check bp every 5 minutes
conitnous FHR
a nurse receives a report for a client who is in labor and is experiencing contractions that are 4 minutes apart. which of the following patterns should the nurse expect on the fetal monitoring tracing? a. contractions that last for 60 seconds each with a 4 minutes rest between contractions b. contractions that last for 60 seconds each with a 3 minute rest between contractions c. a contraction that lasts for 4 minute followed by a period of relaxation d. contractions that last for 45 seconds with a 3 minute rest between contractions
contractions that last 60 seconds each with a 3 minute rest between contractions
a nurse is discussing contraceptive choices with a client who has a history of thrombophelbitis. which of the following methods of contraception should the nurse recommend? a. copper IUD b. Combo pill c. vaginal ring d. medroxyprogesterone injection
copper IUD
While assessing a client who is in the fourth stage of labor, the nurse suspects bladder distention. Which of the following findings should the nurse anticipate with bladder distention? a. The fundus is at midline b. The fundus is below the umbilicus c. the bladder is resonant with percussion d. The bladder fluctuates with palpation
d. The bladder fluctuates with palpation In bladder distention, the bladder suprapubic, round, bulging and daughter percussion and fluctuates like a balloon filled with water
a nurse is assessing a postpartum client who reports strong contractions whenever she breastfeeds her newborn. the nurse should respond with which of the following statements? a. prolactin is increasing the blood supply to your uterus and you are feeling blood vessel engorgement b. you probably have a small blood clot in your uterus, which is causing uterus to contract in order to expel It c. your breasts are secreting a hormone that enters the blood stream and causes your abdominal muscles to contract d. the same hormone that is released in respone to the baby's sucking and causes milk to flow also makes the uterus contract
d. the same hormone that is released in respone to the baby's sucking and causes milk to flow also makes the uterus contract
a nurse is teaching a client who is at 12 weeks gestation and has HIV. which of the following should the nurse include in the teaching? a. breastfeed your newborn to provide passive immunity b. abstain from sexual intercourse throughout the pregnancy c. you will be in isolation after delivery d. you should continue to take zidovudine throughout the pregnancy
d. you should continue to take zidovudine throughout the pregnancy
a nurse is assessing a client who is at 12 weeks gestation and has hydatidiform mole. which of the following findings should the nurse expect? a. hypothermia b. dark brown vaginal discharge c. decreased urinary output d. fetal heart tones
dark brown discharge
a nurse is assessing a client at 34 weeks gestation who has a mild placental abruption, which of the following findings should the nurse expect? a. increased platelet count b. fetal distress c. decreased urinary output d. dark red vaginal bleeding
dark red vaginal bleeding
a nurse is providing teaching for new parents about formula feeding. which of the following instructions should the nurse include? a. the bedtime bottle can be placed in the crib after the infant is 6 months age b. discard opened cans of formula after 48 hours refrigeration c. powdered can concentrated formula can be reconstituted with tap water straight from the faucet d. bottle and nipples can be hand washed in hot, soapy water
discard opened cans of formula after 48 hours of refrigeration
a nurse is reviewing the lab report for a client with suspected HELLP syndroe, which of the following findings should the nurse report to the provider as an indication of this disorder? a. elevated hemo b. elevated creatine c. elevated liver enzymes d. elevated platelet
elevated liver enzymes
a nurse is assessing a client who is 14 hours postpartum and has a third degree perineal laceration. the client's temp is 37.8 and her fundus is firm and slightly deviated to the right. the client reports a gush of blood when she ambulates and no bowel movement since delivery. which fo the following actions should the nurse take? a. notify the provider about the client's elevated temperature b. assist the client to empty the bladder c. administer a bisacodyl suppository d. massage the client's fundus
empty bladder
A nurse is assessing the respiratory status of a newborn who was born two hours ago. Which of the following findings should the nurse identify as a manifestation of respiratory distress a. Acrocyanosis b. Expiratory grunting c. Respiratory rate 56 minute d. Irregular respirations
expiratory grunting
a nurse is assessing a newborn at birth who was delivered at 32 weeks gestation. which of the following findings should the nurse anticipate? a. heel creases over the entire sole of the foot b. pendulous testes c. extended extremities d. leathery cracked skin
extended extremities
a nurse is providing teaching to a client who is 1 hour postpartum about using the perineal squeeze bottle. which of the following instructions should the nurse include? a. fill the perineal bottle with warm water prior to use b. squeeze the perineal bottle while standing up in the bathroom to cleanse the perineum c. only use half of the perineal bottle for cleansing d. wipe the perineum with toilet from back to front after using the perineal bottle
fill the perineal bottle with warm water prior to use
a nurse is reviewing the risk factors for PP depression with a newly licensed nurse. which of the following risk factors should the nurse include? a. gestational diabetes b. planned pregnancy c. being married d. post term birth
gestational diabetes
A nurse is caring for a client who is eclampsia and just had a tonic clonic seizure. After turning the clients head to the side which of the following action should the nurse take next? Administer magnesium sulfate 4 g IV bolus insert an indwelling urinary catheter give oxygen at 10 L per minute keep the environment quiet and lights dimmed
give oxygen
A nurse is reviewing the laboratory findings of a 24 hour old newborn. Which of the following findings should the nurse report to the provider a. hemoglobin 12 b. platelet 200,000 c. total bilirubin 4 d. glucose 50
hemoglobin 12
A nurse is administering a rubella immunization to a client who is two days postpartum. Which of the following statements indicates a need to further instruct the patient? a. I can't continue to breast-feed b. I still need to have my provider perform a rubella tighter check during my next pregnancy c. I cannot receive the rubella immunization during pregnancy d. I can conceive anytime I want after 10 days
i can conceive anytime i want after 10 days
a nurse is teaching a parent how to care for his newborn's circumscion site. which of the following statements indicates an understanding of the teaching? a. i should clean the circumcision site with half strength hydrogen peroxide twice daily b. i should apply the diaper loosely until circumcision site is healed c. i should notify the doctor if yellow discharge forms on the head of the penis d. newborns typically do not experience any pain from this procedure
i should apply the diaper loosely until circumcision site is healed
A nurse is teaching a client who is in labor about the use of nitrous oxide analgesia for pain control. Which of the following statements by the client indicates an understanding of the teaching a. Nitrous oxide could make my baby sleepy when he is born b. I should inhale the nitrous oxide between contractions c. I will feel the effects of the nitrous oxide on this immediately d. Nitrous oxide can make me feel disoriented
i will feel the effect of nitrous oxide almost immediately
a nurse is teaching a client who is pp about keeping a newborn safe. which of the following statements should the nurse identify as an indication that the client understands the instructions? a. i will put bumper pads in the cribs b. i will warm my baby's formula in the microwave on a low setting c. i will place my baby on his stomach to sleep d. i will purchase a firm mattress for the crib
i will purchase a firm mattress for the crib
a nurse is providing education for a pregnant client about symptoms that should be reported immediately to the provider. which of the following client responses indicates an understanding of the teaching? a. i should call my provider if i develop melasma b. if i notice that my eyes are puffy, i should call my provider c. i should call my provider if i notice that my feet and ankles are swollen d. if i notice periodic numbness and tingling in my fingers, i should call my provider
if i notice my eyes are puffy, i should call my provider
a charge nurse is providing teaching for a newly hired nurse about the potential side effects of an epidural anesthetic for a laboring client. which of the following effects should the charge nurse include in the teaching? a. newborn Respiratory depression at birth b. impaired ability of the neonate to maintain body temp c. impaired placental perfusion d. decreased FHR variability
impaired placental perfusion
a nurse is assessing a client who has hyperemesis gravidarum. which of the following should the nurse expect? a. elevated serum potassium level b. rapid weight gain c. peripheral edema d. ketones in urine
ketones in the urine
a nurse is assessing a pregnant client who is at 38 weeks gestation. the client reports that her breathing has become easier but notes an increased frequency of urination. the nurse should document this occurrence as which of the following? a. effacement b. dilation c. lightening d. quickening
lightening
A nurse is providing education to a client who is four weeks postpartum and breast-feeding. The client asks about expected weight loss. Which of the following responses should the nurse make a. losing 2.2 pounds each month would be acceptable b. losing 4.4 pounds each month would be acceptable c. losing 5.5 pounds each month would be acceptable d. losing 6.6 lbs each month would be acceptable
losing 2.2 lbs
a nurse is planning care for a client who is scheduled to have prostaglandins e2 gel inserted for cervical ripening. which of the following actions should the nurse take? a. assess fetal heart rate and contraction pattern every 15 minutes after insertion b. thaw the frozen gel in a warm water bath prior to insertion c. maintain the client in a side-lying position for 30 minutes after insertion d. initiate an oxytocin infusion for induction 1 hour after gel insertion
maintain the client in a side-lying position for 30 minutes after insertion
A nurse is assessing a seven month old infant during a well child visit notes at the presence of a full moro reflex. For which of the following conditions to the nurse screen the infant? a. congenital heart disease b hearing loss c. neurological disorder d. ambylyopia
neurological disorder
a nurse is caring for a client at 36 weeks gestation who has preeclampsia. which of the following findings should the nurse identify as the priority? a. 1+ proteinuria b. bp 140/98 c. Nonreactive NST d. fundal height 33 cm
nonreactive NST
A nurse is reviewing laboratory results for a client who is at 37 weeks gestation. The nurse notes that the client is rubella nonimmune is positive for group a beta hemolytic streptococcus and has a blood type of a negative. Which of the following action should the nurse take a. administer a dose of Rho D immune globulin b. prescription for an antibiotic until delivery c. obtain rubella after delivery d. inform the client that she will need to deliver via c section
obtain rubella after delivery
a nurse is calculating a pregnant client's estimated due date. the clients LMP was on january 20. when is the due date?
oct 27
a nurse is caring for a client who believes she may be pregnant. which of the following findings should the nurse identify as a positive sign of pregnancy? a. palpable fetal movement b. chadwick's sign c. positive pregnancy test d. amenorrhea
palpable fetal movement
A nurse is performing a routine prenatal examination of a client who is in the second trimester. The client reports back aches with no other symptoms and refuses medication. Which of the following responses should the nurse make? a. try pelvic tilt exercises b. limit physical activity c. soak in a warm bubble bath d. lie flat on back for one hour
pelvic tilt
a nurse is caring for a newly admitted newborn who is large for gestational age. after 30 minutes, the newborn becomes jittery and lethargic with hypotonic muscles and. cry that is different from the time of admission. which of the following actions should the nurse take? a. perform a heel stick to check the newborn's glucose level b. obtain a prescription for serum substance screening c. provide feeding of sterile water d. screen for PKU
perform a heel stick to check the newborn's glucose level
A nurse is caring for a newborn immediately following delivery. Which of the following action should the nurse perform first a. physical assessment b. place newborn on moms chest c. give vit k shot d. adminster eryhtromycin
place newborn on mom's chest
A nurse is caring for a client in active labor who is experiencing hypertension following epidural placement. Which of the following action should the nurse take a. decrease IV fluids b. give oxygen 2 l min via nasal cannula c. place the client in a lateral position d. administer inodmethacin
place the client in a lateral position
a nurse is assessing a 4 hour old newborn prior to breastfeeding and notes hands and feet that are cool and slightly blue. which of the following actions should the nurse take? a. apply an oxygen hood over the newborn's head and neck b. check the newborn's temperature thermometer c. place the naked newborn on the mother's chest and cover both with a blanket d. give the newborn glucose water between feedings
place the naked newborn on the mother's chest and cover both with a blanket
a nurse is providing care for a client who is in the second stage of labor, the fetal heart tracing indicates multiple variable decels. which of the following actions should the nurse take? a. prepare for an amnioinfusion b. place client in supine c. administer oxygen d. give glucocorticoid
prepare an amnioinfusion
a nurse is caring for a client who is in the first trimester of pregnancy and asks how to manage heart burn. which of the following responses should the nurse make? a. reduce the amount of food you eat during meals b. sip carbonated beverages between meals c. lie down and rest immediately after meals d. drink iced tea with meals
reduce the amount of food you eat during meals
a nurse is caring or a newborn whose mother received magneisum sulfate to treat preterm labor. which of the following clinical manifestations in the newborn indicates toxicity due to the magnesium sulfate therapy? a. respiratory depression b. hypothermia c. hypoglycemia d. jaundice
respiratory depression
a nurse is caring for a client who had a c section birth 36 hours ago and is experiencing pain due to gas. which of the following strategies should the nurse recommend? a. sip a carbonated beverage throughout the day b. rock in a rocking chair c. lie flat in bed with legs extended d. use a straw when drinking fluids
rock in a rocking chair
a nurse is planning care for a client who is postpartum. which of the following strategies should the nurse include in the plant to prevent bladder distention? a. withhold analgesics to prevent urinary retention b. run water in the sink while the patient sits on toilet c. perform Crede's maneuver every 4 hours d. restrict oral hydration
run water in the sink while the client sits on the toilet
a nurse is caring for a client who is in labor and is reporting intense pain during contractions. the client has no previous knowledge of nonpharmacological comfort measures. which of the following nursing interventions should the nurse implement? a. self hypnosis b. biofeedback c. accupuncture d. slow paced breathing
slow paced breathing
a nurse is caring for a client who is in labor and is receiving IV oxytocin. the nurse notes contractions lasting 3 minutes each. what actions should the nurse take? a. stop the oxytocin infusion b. apply oxygen at 2 l nasal cannula c. administer methylergonovine d. prepare for C section
stop oxy
a nurse is teaching a client who is in the third trimester of pregnancy and has herpes genitalis. which of the following instructions should the nurse include? a. clean the lesions twice a day with hydrogen peroxide b. apply a hot compress to the affected areas c. talk with your doctor about a prescription for acyclovir to treat your symptoms d. expect the receive penicillin prior to delivery
take acyclovir
a nurse is caring for a client who is scheduled to receive intravenous oxytocin for the induction of labor. The client has a bishop score of 10. which of the following should the nurse expect. a. the client will require dinoprostone for ripening of the cervix b. the client will experience low back pain during labor c. the client will experience successful induction of labor d. the client will require vacuum or forceps assisted delivery
the client will experience a successful induction of labor
a nurse is assessing the moro response of a newborn. which of the following findings should the nurse expect? a. abduction and extension of the arms are asymmetric b. the oppostie leg flexes while a leg is extended and the sole of the foot is stimulated c. toes hyperextended with dorsiflexion on the great toe d. the legs move in a similar pattern of response to the arms
the legs move in a similar pattern of response to the arms
a nurse is caring for a primigravid client who is at 8 weeks gestation with twins. the client states that even though she and her husband planned this pregnancy, she is experiencing ambivalent feelings about It. which of the following responses should the nurse make? a. have you told your husband of these feelings b. these feelings are quite normal at the beginning of pregnancy c. perhaps you should see a counselor to discuss these feelings d. i am quite concerned about these feelings. could you explain more?
these feelings are quite normal at the beginning of pregnancy
A nurse is teaching the guardian of a newborn about caring for the newborns umbilical cord. For which of the following reasons for the nurse instruct the guardian to avoid using anti-microbial agents on the cord? a. they can cause increased pain from the cord b. can cause delayed cord separation c. they can cause swelling of the surrounding tissue d. they can cause skin discoloration
they can cause delayed cord separation
a postpartum nurse is caring for a client who reports excessive sweating during the first night after delivery. which of the following statements should the nurse make? a. this is an attempt by your body to retain the fluid gained during pregnancy b. this is caused by an increase in your estrogen hormonal levels c. this is caused by the increased pressure on your veins in your lower legs d. this is a source of your fluid loss after delivery
this is a source of your fluid loss after delivery
a nurse is preparing to administer meperdine hydrochloride to a client who is in labor. which of the following statements should the nurse make to the client? a. this medication can cause your blood pressure to rise b. this medication can cause dry mouth c. this medication can cause you to urinate excessively d. this medication can make you sleepy
this medication can make you sleepy
a nurse is performing an NST on a client who is at 41 weeks of gestation. the client asks what the purpose of the test is. which of the following responses should the nurse provide? a. this test will determine if you are likely to deliver within the next week b. this test will help determine if your baby is healthy c. this test can see how your bast responds when you have contractions d. this test will determine if your baby's lungs are mature
this test will help determine if your baby is healthy
a nurse is preparing a client who is in labor for the insertion of an intrauterine pressure catheter. the client asks why this type of monitoring is needed. which of the following responses should the nurse make? a. this type of monitoring is necessary for timing the frequency of your contractions b. this type of monitoring is noninvasive so It is the best way to monitor your labor contractions c. this type of monitor allows us to evaluate your baby's heart rate while you are in labor d. this type of monitoring will allow us to measure the intensity of your contractions
this type of monitoring will allow us to measure the intensity of your contractions
a nurse is caring for a client who is labor. the client asks the nurse, why are you pressing on my abdomen? which of the following responses should the nurse make? a. i can determine the baby's heart rate b. i can confirm that you have suffcient fluid around the baby c. i can confirm that your baby moves with stimulation d. i can determine the position of the baby
to determine the position of the baby
A nurse is caring for a client at 34 weeks gestation who presents with vaginal bleeding. Which of the following assessments will indicate whether the bleeding is caused by placenta previa or abruption placenta? uterine tone fetal heart rate blood pressure amount of bleeding
uterine tone
A nurse is preparing to perform a heel stick on a newborn. Which of the following actions should the nurse take? Don sterile gloves prior to puncturing the newborns heel puncture the center aspect of the newborn heel elevate the newborn heel prior to the procedure warm the heel with a warm washcloth prior to the procedure
warm the heel with a warm washcloth prior to the procedure
A nurse is admitting a client who is imposter in labor. Which of the following statements should the nurse identify as a priority a. I had blood Streaked discharge a few hours ago b. When my water broke it was not clear c. I have not felt my baby move as much today d. I feel like I cannot breathe when I walk up the stairs
when my water broke It was not clear
A nurse is assessing a client before administering the hepatitis B vaccine. Which of the following allergy shot the nurse identify as a contra indication to receiving this vaccine? a. shellfish b. gelatin c. yeast d. eggs
yeast
a nurse is educating a client who is at 10 weeks gestation and reports frequent nausea and vomiting. which of the following statements should the nurse include in the teaching? a. you should eat foods foods served at warm temperatures b. you should brush your teeth right after you eat c. you should try to eat sweet foods when you feel nauseated d. you should eat dry foods that are high in carbs when you wake up
you should eat dry foods that are high in carbs when you wake up
a nurse in an outpatient setting is providing education for a client who is pregnant. which of the following statements should the nurse include in the teaching? a. during the last trimester, you should mainly sleep on your back b. during the second trimester, you will notice increased urinary frequency and urgency c. you will probably first notice your baby moving when you are around 20 weeks gestation d. you should plan to gain 40-45 pounds during your pregnancy
you will probably notice your baby moving when you are around 20 weeks gestation