proctor OB ATI questions

A nurse is caring for a client who just delivered 24 hours ago. Which of the following findings should the nurse report to provider? Urinary output of more than 2000 mL, 3+ deep tendon reflexes, soft breast

3+ dtr

A nurse is assessing a client who is at 35 weeks of gestation and has preeclampsia without severe features. Which of the following findings should the nurse identify as a priority? 480 mL of an output in 24 hours, Blood pressure 144/92, +2 Adema of the feet, plus one protein in urine

480 mL urinary output

a nurse is providing education to a client who delivered 12 hours ago. which of the following client statements indicates an understanding of the teaching? i should have less cramping while im breast feeding i should breast feed 8-12 times in 24 hours i should wait to breastfeed until my baby awakens from her nap i should switch breasts after 5 minutes

8-12 x a day

A nurse is caring for several clients. Which of the following clients are the nurse identify as a candidate for oral contraceptives? A client who smokes 2 packs of cigarettes per week, claims breast-feeding a seven month year-old baby, a client who is taking an anti-convulsant, a client who is taking an anti-HIV medication

A client who is breast-feeding a seven month old

The nurse is assisting with fetal heart monitoring during labor for a client who is at 40 weeks gestation. The nurse should identify that which of the following findings on the fetal monitoring tracing requires intervention? A fetal heart rate of 180 per minute for 15 minutes a deceleration that returns to baseline at the end of the contraction acceleration of 20 minutes for 18 seconds during a contraction

A fetal heart rate of 180 per minute for 15 minutes

A nurse is providing postpartum discharge teaching for a client who is breast-feeding. The client states I've heard that I can't use any birth control until I stop breast-feeding. Which of the following responses should the nurse make? You will not get pregnant while you're breast-feeding so you will not need any birth control, a birth control pill that contains only estrogen is available for use while you breast-feed, condoms are the only method of contraception that is appropriate while you're breast-feeding, a progesterone only pill or injection is available for use while you're breast-feeding

A progesterone only pill or injection is available for use while you are breast-feeding

A nurse is teaching a client who is postpartum and breast-feeding which of the following statements should the nurse include? He will need to wait three months before resuming sexual intercourse, you don't need to use contraception until you are for months postpartum, as long as you're breast-feeding will experience an overproduction of vaginal lubrication, a reduction in sexual interest could indicate postpartum depression

A reduction in sexual interest could indicate postpartum depression

A nurse is preparing to obtain a newborn's temperature. Which of the following message to the nurse use? Auxiliary temporal Tympanic rectal

axillary

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 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 35 weeks gestation who has severe preeclampsia. Which of the following assessments provide the most accurate information regarding the clients fluid and electrolyte status

daily weight

A nurse is providing education to a client who is at 34 weeks of gestation about a nonstress test. Which of the following pieces of information should the nurse include? It will take about 10 minutes to complete the test you might have to drink orange juice during the test during this test you will need to be asked to massage your nipples during the test you receive a medication to relax your uterus

drink OJ

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 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 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 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 reviewing the electronic medical record of a newborn. Which of the following maternal factors may increase the risk of pathologic hyperbilirubinemia in the newborn? Placenta previa multiple gestation infection anemia

Infection

A nurse is caring for a client who has clinical manifestations of an ectopic pregnancy. Which of the following findings as a risk factor for an ectopic pregnancy? Anemia frequent urinary tract infections previous C-section pelvic inflammatory disease

PID

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 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 assisting with an amniotomy for a client in active labor. Which of the following action should the nurse take? assess fhr monitor temp every 4 hours medicate the client for 30 mins prior to procedure perform cervical assessment every 2 hours

Assess the fetal heart rate before and after the procedure

A nurse is caring for an infant begins displaying manifestations of NAS. Which of the following action should the nurse take? Swaddle the infant with arms and legs extended, administer naloxone, avoid eye contact during feedings, discourage the mother from handling the infant during withdrawal

Avoid eye contact during 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 provider tells a client at 12 weeks gestation who practices Hinduism that she needs more protein in her diet and suggest eating more meat. After the provider leave the examination room, the client tells the nurse that eating animal products will cause her to Miss Carrie. Which of the following responses should the nurse make?

Let's discuss other foods that are also high in protein that you could substitute for meat

A nurse is caring for a client who is in labor and ask her partner to perform FFLEURAGE. The client has on a monitor belt for electronics you are monitoring. Which of the following instruction should the nurse provide to the clients partner? Lightly stroke the upper thighs, steadily apply pressure to the sacrum, gently massage mid abdominal area, firmly squeeze both hips

Lightly stroke the upper thighs

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 providing teaching about formula feeding to a guardian of a newborn. Which of the following pieces of information should the nurse include? Boil bottles and nipples for 20 minutes after each use, mix one scoop of powdered formula with 2 ounces of water, store prepared bottles in the refrigerator for up to four days, warm formula by heating bottles in the microwave on the lowest setting

Mix one scoop of powdered formula 2 ounces of water

A nurse is teaching a prenatal class about nonpharmacological comfort measures during labor. Which of the following statements should the nurse identify as an indication that the instructions have been understood? I can have my partner apply counter pressure to my upper abdomen, my baby will be monitored with a Doppler device during hydrotherapy, I can have the nerve supply acupressure to my lower abdomen, my TENS unit will not help with my lower back pain during early labor

My baby will be monitored with a Doppler device during hydrotherapy

A nurse is assessing a newborn. Which of the following findings suggest anyone's is post mature,? You guys are talking about the pill transition skin, nails extending over fingers, we got reflux, thin covering a fine hair and shoulders and back

Nails extending over fingers

A nurse is assessing a newborn which of the following findings should the nurse immediately report to the provider? MILIE, Epstein pearls, nasal flaring, meconium store

Nasal flaring

A nurse is assessing a postpartum client and observes a steady trickle of bright red blood from the clients vagina. That uterus populated as firm, midline and located 1 cm below the umbilicus. Which of the following action should the nurse take? Massage the fundus, instruct the client to empty her bladder, notify the provider, teach the client to perform a sits bath

Notify the provider

A nurse is providing discharge instructions to a client who is breast-feeding her newborn. Which of the following statements should the nurse include? Notify your provider if you notice cracking on your nipples, notify the provider if you've not had a bowel movemnt in five days, notify your provider of your breasts leak when you shower, notify your provider if your vaginal discharge is a brownish red color

Notify your providers her nipples are cracking

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 reviewing the medical record of a client at 33 weeks gestation who had placenta previa and bleeding. Which of the following prescriptions to the nurse clarify with the provider? Performing vaginal examination performed continuous external fetal monitoring a large BOREIV catheter obtain a blood sample for laboratory testing

Performing vaginal examination

A nurse is discussing the expected changes related to pregnancy with a client who was at eight weeks gestation period which of the following findings should the client report to the provider first trimester? Breast tenderness, urinary frequency, persistent vomiting, no fetal movement

Persistent vomiting

A nurse is caring for a newborn who is premature in the neonatal intensive care unit. Which of the following action should the nurse take to promote development? rapidly advance oral feedings position the naked newborn on the parent's bare chest provide frequent periods of visual and auditory stimulation discourage use of pacifiers

Position in the naked newborn on the parent 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 planning care for a client in active labor his fetus is in an occipital brow presentation. Which of the following complications to the nurse anticipate as a result of this photo presentation? Precipitous labor prolonged labor hypertonic uterine dysfunction umbilical cord prolapse

Prolonged labor

A nurse is assessing a client who is in the first stage of labor and has preeclampsia. Which of the following findings should the nurse expect? Severe hypotension, proteinuria, elevated platelet count, seizures

Proteinuria

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 client who is pregnant tells the nurse that she is financially unable to buy the food and vitamins recommended during pregnancy. Which of the following action should the nurse take? Explain to the client in proper nutrition could be two birthday facts and her baby, instruct the client to return to the clinic for a weekly Wayans for the reminder of the pregnancy, provide the client with sample menus to promote nutritious meal preparation, or for the client to community resources that could assist with providing nutrition

Refer the client to community resource that could assist with providing nutrition

A nurse is reviewing the medical record of a client who is at 20 weeks of gestation period which of the following findings should the nurse identify as a present bit of indication of pregnancy? Report a fetal movement by the client auscultation of the fetal heart rate with Doppler ultrasound presence of Chadwick sign on pelvic examination report of Braxton Hicks contractions by the client

Report a fetal movement by client

Is providing teaching to the parents of a newborn about how to care for his circumcision at home. Which of the following instruction should the nurse include in the teaching? Apply the diaper tightly over the circumcision area, remove yellow x-ray, use pre-package commercial flights, encourage nutritive sucking for painted

Sucking for pain relief

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 speaking with an expectant father who says that he feels resentful of the added attention others are getting to his wife since the pregnancy was announced several weeks ago. Which of the following responses should the nurse make? Has your wife sent her anger toward her and the baby?, These feelings are common for expectant fathers in early pregnancy, I'm sure that excepting the situation is challenging when it's your baby to, you should speak to a therapist about these feelings

These feelings are comment for expectant fathers in early pregnancy

Anders is caring for a newborn who is receiving treatment for jaundice with traditional phototherapy light. Which of the following intervention should the nurse perform? Turn the newborn every two hours, supplement with 5% glucose water between scheduled feedings, dress the infant lightly in a T-shirt and diaper, apply lotion to the skin every four hours

Turn baby every two hours

A nurse is caring for a client in active labor whose members have ruptured. If you don't monitor tracing reveals late decelerations. Which of the following actions should the nurse take? Turn the client onto her left side? Palpate the clients uterus, administer oxygen to the client, increase the clients IV fluids

Turn the client onto her left side

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

Nurses assessing a client at 37 weeks gestation who has a suspected pelvic fracture due to black abdominal trauma. Which of the following findings should the nurse expect? Bradycardia, uterine contractions, seizures, Bradypnea

Uterine contractions

A nurse is caring for a client at 39 weeks gestation who is in the active phase of labor. The nurse observes late decelerations in the fetal heart rate. Which of the following findings should the nurse identify as the cause of late decelerations? Uteroplacental insufficiency, if you don't have a compression, fetal ventricular septal defect, umbilical cord compression

Uteroplacental insufficiency

A nurse is monitoring a newborn is receiving phototherapy. There should identify which of the following findings as a requiring intervention? Bilirubin level five, weight loss 12% of birth weight, the screen stores, axillary temperature of 36.6

Weight loss a 12% birthweight

A nurse is providing counseling for a couple experiencing infertility issues. Which of the following statements by the nurse is appropriate? Even though you can't have children biologically you can always adopt, you need to take a break from these attempts to conceive, you might want to join our support group for a couple to experiencing similar problems, why didn't you get your immunizations when you were younger

You might want to join our support group for a couple so experiencing similar problems

A nurse in the clinic is providing education to a client at 32 weeks gestation is PURURITUS gravidarum. Which of the following pieces of information should the nurse provide? You should slightly increase your exposure to sunlight, you all need extensive dermatological treatment for this condition after your delivery, your provider will schedule weekly lab testing to monitor your liver function, your provider will prescribe isotretinoin

You should slightly increase your exposure to sunlight

A nurse is caring for a client who is at 26 weeks gestation and reports constipation. Which of the following responses by the nurse is appropriate? You should drink 1 ounce of mineral oil every morning you should walk for at least 30 minutes a day you should eat at least 3 ounces of red meat per day you should stop taking your prenatal vitamin

You should walk for at least 30 minutes today

A nurse is teaching a client who has active General herpes, tied to which of the following statements should the nurse include in the teaching? You will have a C-section prior to the onset of labor your baby receive eryhthromyosin eye ointment after birth to treat the infection you should take oral Metondiazole for seven days prior to 37 weeks gestation you should schedule a C-section birth after your water breaks

You will have a C-section prior to the onset of labor your baby

A nurse is providing discharge teaching to a parent of a newborn. Which of the following statements should the nurse include in the teaching? Your baby should be rear facing in a car seat until two years of age cover your baby with a light blanket during naps set your hot water heater to no more than 140°F insure your babies crib has side rails that can be lowered

Your baby should be rear facing in a car seat until two years of age

A nurse is providing teaching for a postpartum client who is breast-feeding. Which of the following pieces of information should the nurse include in the teaching? You should supplement your baby with formula until you notice that your breasts become firm in full, you should adhere to a schedule in feeding your baby to ensure she's getting enough to eat, your milk supply will notice of the increase in volume or the third or fourth day after delivery, is typical for your nipples to hurt for the first few weeks while you're breast-feeding

Your milk supply will notice we increase the volume around the fourth or third day after delivery

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

The parents of a child of P can you ask the nurse if their second unborn child could I have the same condition. The nurse should base the response on which of the following inheritance patterns responsible for pku? X-linked recessive X-linked dominant autosomal recessive autosomal dominant

autosomal recessive

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 who is experiencing preterm labor. Which of the following medication should the nurse anticipate administering to enhance fetal lung maturation

betamethasone

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 at a prenatal clinic is assessing an adult client who had genital cutting performed as a child as part of her cultural practices. the nurse notes the client's clitoris and labia minora were removed, and she has scarring in the vaginal area. which of the following actions should the nurse take? report the findings to the local authorities ask the cleint who performed the cutting inform the client that giving birth vaginally might not be possible prepare the client for the increased risk of spontaneous abortion

cannot give birth vaginally

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 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 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 is teaching a client who is at 10 weeks gestation about self-care management for common discomforts during pregnancy. Which of the following instruction should the nurse include? Douche every other day to minimize leukorrhea consume frequent snacks to decrease episodes of nausea refrain from scheduling dental procedures until the third trimester decrease fluid intake to reduce urinary frequency

consume frequent snacks to decrease episodes of nausea

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 providing education to a female client of child bearing age. the nurse should state that which of the following structure expels the mature ovum? a. blastocyst b. fallopian tube c. corpus luteum d. graffian follicle

d. graffian follicle

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 performing a physical assessment of a male newborn. Which of the following findings should the nurse report to the provider? Superficial cracking and peeling are evident on the skin of the Hands and Feet The bulge of the testes is palpable in the inguinal canal There is decreased abdominal movement with breathing

decreased abdominal movement with breathing

a nurse adminsters betamethasone to a client who is at 33 weeks gestation to stimulate fetal lung maturity. when planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this medications? a. hyperthermia b. decreased blood glucose c. rapid pulse rate d. irritability

decreased bg

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 assessing a newborn who was born at 39 weeks gestation period which of the following findings should the nurse expect? Symmetric rib cage, dry wrinkled skin, vernix over the entire body, abundantly go on the back

dry wrinkled skin

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 caring for a client who is in labor. Which of the following methods will determine the frequency of the clients contractions? Palpating in the firmness of the uterus during a contraction calculating the time from the end of each contraction to the beginning of the next measuring the time from the beginning of a contraction to the end of the same contraction evaluating the time from the beginning of a contraction to the beginning of the next contraction

evaluating the time from the beginning of a contraction to the beginning of the next contraction

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 reviewing the medical record of a client who is 39 weeks gestation who is polyhydramnios. Which of the following findings should the nurse expect? fundal height 34 cm total pregnancy weight gain of 3.6 kg gestational hypertension fetal gastrointestinal anomaly

fetal gi anomaly

A nurse is performing an admission assessment of a client who just arrived at the labor and delivery unit. Which of the following findings should the nurse identify as a priority? The client reports pain level eight on a scale from 0 to 10 during contractions the clients blood pressure is 148/92 temperature of 101 the fetal heart rate is 90

fetal heart rate is 90

A nurse is reviewing the providers admission orders for a client who is at 37 weeks of gestation and is HIV positive. Which of the following orders for the nurse clarify with the provider? Intermittent auscultation biophysical profile nonstress test fetal scalp electrode

fetal scalp electrode

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 assessing a client who is at 34 weeks gestation and has a cardiac disorder. the nurse should notify the provider about which of the following assessment findings? a. the client reports a frequent cough b. the client reports that none of her shoes fit her anymore .c. the client reports a weight gain of 2lb in two weeks d. reports leg cramps in the evening

frequent cough

A nurse is caring for a client who has a BMI of 22.6. And expresses concern about weight gain during pregnancy. which of the following responses should the nurse make youre eating for 2 so you should double your caloric intake youll loss weight easily after the birth of your baby plan to gain a total of 15-20 lbs gaining weight will promote a healthy pregnancy

gaining weight will promote a healthy pregnancy

A nurse is planning care for a client who is at 35 weeks of gestation period which of the following lab tests should the nurse obtain? a. rubella titer b. blood type c. gbs d. 1 hour blood glucose

gbs

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 about an NST. which of the following statements by the client indicates an understanding of the teaching? i know not to eat anything after midnight i will have medication given to me to cause contractions i should press the button on the handheld marker when my baby moves i will have to stimulate my breast contractions

i should press the button on the handheld marker when my baby moves

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 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 planning care for a client who is PP and has cardiac disease. for which of the following prescriptions should the nurse seek clarification? monitor the clients i and o initiate a high fiber diet for the client monitor the clients weight weekly initate bedrest with head of bed elevated

monitor weight weekly

a nurse is providing teaching to a client who is planning to breastfeed her newborn. which of the following by the client indicates an understandings of the teaching? a. i must drink milk every day in order to assure good quality breast milk b. drinking lots of fluids will increase breast milk production c. after the first few weeks, my nipples will toughen and breastfeeding won't hurt anymore d. my baby may sometimes feed every hour for several hours in a row

my baby may sometimes feed every hour for several hours in a row

a nurse is caring for a client who is at 34 weeks gestation and has a prescription for terbutaline for preterm labor. which of the following statements by the client is a priority? a. my ankles are swollen at the end of the day b. i can feel the baby kicking my ribs, and It is very uncomfortable c. i am growing more and more worried every day d. my heart feels like its racing

my heart feels like its racing

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 assessing a client who has placenta previa. which of the following findings should the nurse expect? painless, bright red bleeding board like uterus persistent uterine contractions abdominal pain

painless bright red bleeding

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 providing postpartum discharge teaching to a client who is nonlactating about breast discomfort relief measures. Which of the following pieces of information should the nurse include? Wear a loose fitted bra to elevate breast discomfort place some fresh cabbage leaves on your breasts apply warm moist compress to your breast express small amounts of milk from the breast frequently

place some fresh cabbage leaves on your breasts

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 assessing a client who has postpartum following a vacuum assisted birth. For which of the following findings should the nurse monitor to identify a cervical laceration? Continuous Lochia flow and a flaccid uterus report of increasing pain and pressure in the peroneal area slow trickle bright vaginal bleeding and a firm fundus gush of rubra when the uterus is massage

slow trickle bright vaginal bleeding and a firm fundus

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

The nurse is teaching a client who is at eight weeks gestation and has a uterine fibroid about potential effects of the fibroid during pregnancy. Which of the following pieces of information should the nurse include? The fibroid will shrink during the pregnancy the fibroid can increase the risk of postpartum hemorrhage you will receive an injection of Medroxyprogesterone acetate to shrink the fibroid you will undergo a C-section

the fibroid can increase the risk of postpartum hemorrhage

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 testing the reflections of anyone to assess neurological maturity. Which of the following reflects the nurse assessed by quickly and gently turning the newborn head to one side

tonic neck

A nurse is assessing a client who is in the fourth stage of labor. Which of the following findings should the nurse expect? A. breast engorgement B. hypothermia C. urinary retention D. rupture of membranes

urinary retention

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 reinforcing teaching about nutritional requirements during lactation for a client who is planning to breast-feed. Which of the following to transfer the client increase during lactation? Calcium iron vitamin D vitamin C

vitamin c

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 caring for a client who is in labor. The client questions the application of an internal fetal scalp monitor. Which of the following responses should the nurse provide?

we need to observe your baby more closely

A postpartum nurse is caring for a client who has developed hemorhhagic shock. which of the following manifestations should the nurse expect? urinary output of 40 deep abdominal breathing weak and irregular pulse warm dry hands with good cap refill

weak and irregular pulse

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

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 is in the first stage of labor. Which of the following findings should the nurse identify as a cause of concern? Pink, mucoid vaginal discharge, brownish vaginal discharge, contractions lasting 100 sec, contractions occurring every 4-5 minutes

Contractions lasting 100 seconds

A nurse is caring for a client who is in active labor and his birth plan request only nonpharmacological pain relief strategies. Which of the following strategies for the nurse offer as a form of cutaneous stimulation? Breathing techniques, counter pressure, biofeedback, use of focal point

Counterpressure

A nurse is monitoring a newborn for indications of septic shock. Which of the following findings should the nurse expect if the newborn develops this complication? Slow respirations, decrease blood pressure, bradycardia, flushed skin

Decrease blood pressure

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 caring for a client who is scheduled to receive a continuous IV infusion of oxytocin following a vaginal birth. Which of the following assessment findings should the nurse monitor to evaluate the effectiveness of the medication? Urinary output, blood pressure, fundal consistency, pulse rate

Fundal consistency

A nurse is assessing a newborn. Which of the following findings should the nurse report to the provider? Pink tinged urine, scant amount of nipple discharge, grunting with expiration, bluish discoloration of feet and hands

Grunting with expiration

A nurse is caring for a client who is using patterned paced breathing during the first stage of labor. The client reports a lightheaded feeling and tingling in the fingers, which of the following actions should the nurse take? The client reports her breath and beer down, and sure the clients breathing rate is more than twice for normal rate, apply counter pressure to the clients lower back, have a client breathe into a paper bag

Have a client breathe into a paper bag

A nurse is caring for a client who is 24 years old and 13 weeks of gestation. The clients history includes a BMI of 31 prior to pregnancy, a prior post term delivery and a newborn birth weight of 4167.38. Which of the following laboratory valuation the nurse expect to collect?

HbA1c

A nurse is caring for a client who is in labor and has an epidural for pain relief. Which of the following is a complication of the epidural block? Nausea and vomiting, tachycardia, hypotension, respiratory depression

Hypotension

A nurse is teaching a prenatal class about pain management during labor. Which of the following statements should the nurse identify as an indication that the client understands instructions? I can play heating pad to my back to relieve back pain, I can have a low spinal block to help with labor pain, I can have beauty 0RPHANOL every two hours during labor, my time limit for staying in a hydrotherapy tub is 30 minutes

I can apply a heating pad to my back

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 providing teaching about the rubella immunization to the client who is 24 hours postpartum. Which of the following client statements indicates an understanding of the teaching? I should not breast-feed for at least three days after receiving this immunization, I will need a second rubella booster when I see my midwife at six weeks postpartum, I should be careful to avoid becoming pregnant within the next month, the vaccine will be given into my arm muscle

I should be careful to avoid becoming pregnant within the next month

A nurse is providing teaching for a postpartum client who is breast-feeding. Which of the following statements indicates an understanding of the teaching? I should feed my baby 8 to 12 times a day based on feeding cues baby should have six or seven wet diapers a day during the first week I should switch my baby to the other breast after 15 minutes of feeding nipple pain should go away after a few weeks of breast-feeding

I should feed my baby 8 to 12 times a day based on feeding cues

A nurse is teaching a client at 30 weeks fascination about the treatment of incompetent cervix with cervical CERCLAGE. Which of the following statements by the client indicates an understanding of the teaching? I am sad that I won't be able to get pregnant again, I can resume having sex as soon as I feel up to it, I should go to the hospital if I think I may be in labor, I should expect bright red bleeding while the CERCLAG is in place

I should go to the hospital if I think I may be in labor

A nurse is providing nutritional teaching for a pregnant client who had a pre-pregnancy body mass of 38. Which of the following statements by the client demonstrates an understanding of the teaching about recommended weight during pregnancy? I should plan to gain 12.7 to 18.1 kg during my pregnancy I should plan to get an 11.3 215.9 kg during my pregnancy I should plan to gain 6.8 to 11.3 kg I should plan to gain 5 to 9.1 kg

I should plan to gain 5 to 9.1 kg

A nurse is discussing diaphragm use with a client. Which of the following statements by the client indicates an understanding of the teaching? I should clean my diaphragm with alcohol each time I use it I should leave the diaphragm in place for four hours after intercourse I should replace my diaphragm every two years I should use a vaginal lubricant insert my diaphragm

I should replace my diaphragm every two years

A nurse is explaining lactation suppression to the client his newborn will be bottle-fed. Which of the following client statements indicates an understanding of the teaching? I should lightly massage my breast when I feel discomfort, I should expressed a song out of milk if my breast feels tight, I should take a warm shower twice a day, I should wear support bra for a few days

I should wear a support bra for a few days

A nurse is providing postpartum discharge teaching about proper storage of breastmilk for a client who is breast-feeding. Which of the following client statements indicates an understanding of the teaching? I can store my pumped milk in the door of the refrigerator I can use the microwave to thaw my frozen breastmilk I will discard any unused breast milk that is left in the bottle I can refreeze any breastmilk after it has been thawed

I will discard any unused breast milk that is left in the bottle

A nurse is teaching a client who is pregnant about non-stress testing. Which of the following pieces of information should the nurse include? The test is an invasive procedure that presents a minimal risk to the fetus, if the test is reactive this means your babies heart rate is healthy, when your baby moves the test should record the babies heart rate decreasing by about 15 minutes per minute, the results of the test will be recorded as positive if no feel movement occurs during the 20 minute test

If the test is reactive that means your babies heart rate is healthy

A nurse is caring for a client in the early stage of labor who has preeclampsia with severe features. Which of the following intervention should the nurse perform? Assess the fetal heart rate and contractions hourly, encourage oral intake of clear low sodium fluids, instruct the client ambulate during the early phase of labor, implement seizure precautions

Implement seizure precautions

A nurse is caring for a client and third term master pregnancy who is scheduled to undergo a nonstress test. Which of the following actions should the nurse take prior to the test? Ask the client to drink a glass of orange juice prepare the client for a vaginal exam request a serum hemoglobin level obtain a clean catch urine specimen

Ask the client to drink orange juice

A nurse is providing teaching to a client who is at eight weeks rotation about manifestations to report to the provider during pregnancy. Which of the following piece of information should the nurse include in the teaching? Nausea upon awakening leg cramps while sleeping increase white vaginal discharge blurred or double vision

Blurred or double vision

A nurse is assessing a client who is two days postpartum period in which of the following location should the nurse expect to locate the clients fundus? 3 cm above the umbilicus, 1 cm above, 3 cm below, 1 cm below

3 cm below

A nurse in a prenatal clinic is performing telephone triage for several clients. Which of the following client reports to the nurse identify as an expected physiological adaptation to pregnancy? Spotting with urination breast tenderness thick white vaginal discharge facial swelling

BREAST TENDERNESS