fam final

A nurse is providing instructions for parents of a child that has scoliosis in regards to instructions with use of a brace which statement by the parents indicates further teaching?

I should apply lotion under the brace to prevent skin breakdown

A nurse is teaching an adolescent how to use peak expiratory flow meter the adolescent has understood the teaching if what statement is made?

I will record the readings at the same time every day

The nurse administers RhoGAM to a postpartum client. Which of the following isthe goal of the medication?

Inhibit the mother's active immune response.

When planning care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman's risk for _________________________ has increased.

Intrauterine infection

The risk for babies born to women who have pregestational diabetes and gestational diabetes are similar which risk is seen in babies born to mothers who have pre-gestational diabetes.

hypoglycemia

a nurse is providing care for a neonate born to a mother with preexsising diabetes who has poor glycemic control. Which neonate assessment finding does the nurse express

hypoglycemia

You are the nurse educator for a small community hospital. You are teaching staff education sessions for preeclampsia and eclampsia complications. What statements are accurate about heelp syndrome

increased liver enzymes low platelets deconstruction of RBC's

Bishops score is used to assess Cervical ripening prior to administering Pitocin. Which is not apart of BISHOP score

length of gestation

A full-term baby's bilirubin level is 12 mg/dL on day 3. Which of the following neonatal behaviors would the nurse expect to see?

lethargic

The nurse is caring for a child who has a concussion. Which of the following actions should the nurse to decrease intracranial pressure

minimize oral suctioning nasal suctioning is contraindicated. avoid extreme flexion, extension, and rotation

When caring for a child with reye syndrome the priority the nursing intervention should be

monitor I&O

A child has a right femur fracture caused by a motor vehicle accident and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedal pulse is absent on the right foot. What action should the nurse take?

notify the physican

The nursing is caring for a 31-year-old female patient who is pregnant at 37 weeks and 5 days gestation. The patient is having contractions every 3 minutes and was found to have a platypelloid pelvis upon examination. The fetus has an estimated fetal weight of 7 lbs and is in the LOA position. This patient is laboring on the birth ball, and her mother-in-law is helping her labor. The nurse is concerned about the five Ps and their effect on the patient's labor. Which P is the nurse most likely concerned about based on the patient's history?

passage

A young couple is going home with their newborn who was circumcised earlier in the day. The nurse is doing discharge wants to make sure they are informed of circumcision care. She informs them to notify the provider if

red and swollen

A child is in a palvoic harness for congenital hip dysplasia. All of the following are appropriate nursing interventions in traction except

reduce Calorie intake to prevent wt gain d/t inactivity

Home care is being considered for a young child who is ventilator dependent. Which of the following factors is most important in deciding whether home care is appropriate?

Adequate family training

B12 is recommended for which diet?

vegan

A mother brings her 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the mother indicates a need for further teaching regarding this disorder?

"i need to bring my infant back to the clinic in 1 month for a new cast"

A client comes to the emergency department after being bitten by a bat. The nurse observes 2 small, nondraining puncture wounds resembling pinpricks on the fingertip. Which action should the nurse implement first?

-Administer an intramuscular injection of human rabies vaccine

Intervention for the child after a cardiac catheterization should include what interventions. Select all

-Maintain patent pIV catheter till discharge -Assess effected extremity for temp./color

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which action should the nurse include in the child's postoperative care plan? SELECT ALL THAT APPLY:

-Notify the surgeon if the child swallows frequently. -allow child to have ice chips -place in ab until fully awake?

There are three types of deaccelerations. None of these are concerning. Which type of deaccelerations alerts the nurse the mother may be close to birthing

-early

which are possible reasons of secondary amenorrhea

-fibroids -PCOS -endocrine disorders

Research has shown is the best person to administer pictocin is an experienced labor and delivery nurse. With this in mind what does the nurse need to assess when administering Pitocin

-fundal resting tone -freq -fetal heart tones

a nurse is caring for a school age patient who possibly has reye syndrome. What the possible risk factors for developing reye syndrome select all that apply

-influenza A -chicken pox -aspirin

Postpartum hemorrhage is not a predictable even in labor and delivery. However there are several that can contribute to post partum hemoorrhage. Which of the following is considered a risk factor

-prior post partum hemorrhage -neonatal macrosomia - obesity

Accelerations are a sign of a fetal heart well being what are some of the characteristics causes of accelerations in the fetal heart tracing select all that apply

15bpm above the baseline lasting 15 seconds Fetal movement

A nurse is taking care of a 10 year old that weighs 30kg and has an order for azithromycin PO 300mg times one dose, azithromycin comes in oral suspension of 100mg/5mL in a 15 mL bottle. According to the drug handbook children's 2-15yrs of age 10mg/kg/day but not to exceed 500mg/day. How many mL should be given?

15mL

An eleven year old child has a recurrence of ewing sarcoma and is verbalizing wanting to stop all treatment the nurse is aware that best ethical practice would be which of the following plan?

Plan a meeting with the parents/child/medical team to provide an opportunity to discuss the child's concerns.

The nurse is assisting a newborn's PCP with the performance of a circumcision. Which intervention is used to manage the neonate's pain?

A sucrose-dipped pacifier is offered during the nerve block

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have: A) Amenorrhea B) positive pregnancy test C) Chadwick's sign D) Hegar's sign

A) Amenorrhea

The nurse must assess 10-month-old Chad. He is sitting on his father's lap and appears to be afraid of the nurse and of what might happen next. Which of the following initial actions by the nurse would be most appropriate? A) Initiate a game of peek-a-boo B) ask father to place Chad on the examination table C) talk softly to Chad while taking him from his father D) Undress Chad while he is still sitting on his father's lap

A) Initiate a game of peek-a-boo

calculate mL question

260mL

A school nurse is present during a school assembly when a student falls to the floor with a seizure. Which intervention does the nurse intitate when providing care during the seizure

remove tight clothing

Category 3 fetal tracing are showing late deaccelerations and prolonged variables. Quick actions are required by the nurse. Which action should the nurse immediately implement

Turn the client onto her side, provide oxygen (O2) via face mask, and increase intravenous (IV) fluids.

A woman arrives at the clinic for a pregnancy test her last mentraul period was April 1st her expected delivery date is

January 8

A nurse is preparing to perform a visual assessment of the perineum of postpartum woman the nurse will use the REEDA acronym what assessments are covered by REEDA

Perineal coloration Amount of swelling Appearance of laceration Soft tissue trauma

A nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions would be included on the list? (Select all that apply)

B) keep small toys and sharp objects away from the cast C) contact the physician if the child complains of numbness or tingling in the extremity F) elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling

A woman presents to the clinic for a pregnancy test which symptoms are considered presumption signs of pregnancy that leads the RN to suspect she is pregnant?

Amenorrhea Nausea Breast tenderness

Which is prefer intermuscular injection site for infants?

Anterolateral thigh (vastus lateralis)

The nurse is assessing a 7-year-old child at a pediatric clinic. The nurse notices that severaldevelopmental milestones have been missed or are late during previous visits. The parent states, "Iknow she is a little slow, but she will catch up quickly." Which action by the nurse is warranted?

Ask the parent detailed questions about the pregnancy, birth, and early childhood health.

A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She is groaning and perspiring excessively; she states that she did not attend childbirth classes. What is the optimal intervention for the nurse to provide at this time?

Assist her with simple breathing and relaxation instructions.

A nurse is assessing a newborns reflexes during postpartum assessment, which of the following will cause the greatest concern

Asymmetrical moro reflex

The mother brings her child with cerebral palsy in to the clinic and is afraid the child is having seizures as the child has the slow worm like movements in her arms and she drools when this occurs. The nurse explains to the mother that this is not a seizure by what type of activity?

Athetoid

A patient recently came into the Emergency Department with a diagnosis of Guillain-Barre Syndrome (GBS). What is the priority system to initially monitor for this patient?

C) respiratory

Acog recommends a 3 tier interpretation system of fetal heart tones. Category 3 is categorized as presence of

Persistent late deaccelerations

A baby at 48 hours has elevated bilirubin with slightly jaundice what is the probable cause for these

Physiological destruction Neonatal red blood cells during extrauterine period

A child has been complaining of joint pain in the knees and jaw for the last six weeks, both joints are swollen and warm to the touch but not red the physician is ordering blood to rule out junior idiopathic arthritis which of the following lab tests would the nurse expect the physician to order.(select all)

CDC Rheumatoid factor C-reactor protein Anti-nuclear antibodies anti titer

Five essential components of fetal heart rate tracing must be evaluated by (select all)

Changes or trends over time Baseline rate Baseline variability Decelerations/accelerations

A nurse enters a patient's room and notices a patient has very deep and laborious rapid respirations what is the priority nursing action.

Check blood sugar stat

The nurse is counseling the parents of a 12-year-old child with Duchenne Muscular Dystrophy about problems that may develop during adolescence. What body system does the nurse expect may be affected?

D) Cardiopulmonary

What is most important for a nurse to teach the parents of a child with Duchenne Muscular Dystrophy to do for their child?

D) perform ROM exercises

An important nursing intervention when caring for a child who is experiencing a swizure would be to?

Describe and record the seizure activity

Ryan is 11 months with down syndrome and atrial septal defect his parents report that Ryan has been lethargic and has diarrhea for the last 24 hours his weight is 7kg vitals: t 99.7 P; R:35 O2 95 on room air...suspects dig toxicity what supports this

Dig level is 2.5

When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective would be:

Dilation of the cervix.

A nurse is planning on using an interpreter during the health history interview of a non English speaking patient and family. Which nursing care guidelines should the nurse include when using an interpreter. Select all that apply

Elicit one answer at a time Arrange for the family to speak with the same interpreter, if possible Introduce the interpreter to the family

a nurse in a special education program is planning care for a child with autism. Which of the following interventions should the nurse include in the plan of care

Establish a reward system for positive behavior

during a vaginal delivery of a gravida 1 shoulder dislocation has occurred. Which action does the nurse immediately perform

Flex knees towards shoulder and lower head

A woman's obstetric history indicates that she is pregnant for the fifth time with one child born at 39 weeks gestation, another was born at 38 weeks gestation, twins born at 30 weeks gestation, all children are alive and one miscarriage. GTPAL system?

G: 5 T: 2 P: 1 A: 1 L: 4

Which of the following is the leading cause of death in females in the United States?

Heart disease

A 16 year old boy is diagnosed with a slipped capital femoral epiphysis which symptom would support this diagnosis? ( it included limping w/walking/running, pain in hip, groin, thigh, knee, external rotation of affected leg)

Hip of knee swelling Limp and thigh pain External rotation of affected leg

As a perinatal nurse you realize that a fetal heart rate (FHR) that is tachycardic, bradycardic, has late decelerations, or loss of variablitity is nonreassuring and is nonreassuring and is associated with?

Hypoxemia

A neonate is born after 37 weeks gestation, and the nurse is concerned about avoiding cold stress after discharge. Which suggestions does the nurse give the mother to keep the baby safe? *Select all that apply:

Keep the baby wrapped in a warm blanket. Position the baby away from vents and drafts. D. Place a stocking cap on the neonate's head. E. Change wet clothing immediately.

Assessment of the breasts is an important component of the postpartum assessment and should be done each shift as nurses we know this is optimal if?

LATCH score

The biophysical profile consists of a NST with the intention of 30 minutes of ultrasound observation the ultrasound is looking for five indicators of fetal well being which is not a component of a BPP

Location of the placenta

Several medications in OB have more then one use in labor which medication is not used for postpartum hemorrhage

Nifidiapine

A nurse is providing teaching to a parent of a child who has a fracture of epiphyseal plate which of the following statements should the nurse make

Normal bone growth can be affected by the fracture

Niesha is a 14 year old girl with sickle cell anemia she comes to the clinic with c/o of severe pain following a softball game she is admitted to the pediatric unit. Vital signs are 99.7, P:110, R: 30 BP 96/70, stating at 89, pain is 8/10, she weights 110. Hemoglobin is 9, hemocoratic is 24%, WBC 12,000, platelet is 140. Physician has written the following orders for Niesha. Which orders should the nurse question?

Only medications on eMAR is ibuprofen

Pancreatic enzymes are administered to the child with cystic fibrosis nursing considerations should include

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

Home care is being considered for a young child who is ventilator dependent. Which factor is most important in deciding whether home care is appropriate?

Preparation and training of family

Came to the emergency department with a diagnosis of Gillian Barr syndrome what is the priority to initially monitor for this patient?

Respiratory

A 12 year old girl is noted to walk with an uneven gate and her shoulders appear uneven the left should sits lower then the right and the waist appears to be tilted from side to side

Scoliosis

The midwife has an order for a non stress test to be done on a 41 week mother during the 30 minute test the nurse observed 3 heart accelerations that were 15 beats above the baseline and lasted 15 seconds, no contractions were observed the nurse next action would be too?

Send the client home and report positive results to the midwife

The most effective and least expensive treatment of post partum infection is prevention what is the most important strategy

Strict aseptic and handwashing care by all staff

A prenatal nurse caring for a postpartum woman understands that late postpartum hemorrhage is most likely caused by?

Subinvolution of the placental site

A nurse is conducting a staff in service on child blood disorders which statement by the student nurse would indicate a need for further instruction

Teach about side effects about steroid therapy including possible fluid and weight loss

At 37 weeks a 19 year old patient has confirmed that she has GBS positive which comments would be appropriate for you use to explain this to your patient

The bacteria is living in your vagina and it will not hurt you but you will need medicine in your labor to protect your baby from getting sick.

An emergency department nurse is caring for a child that diagnosed with epiglottitis assessment of the child indicates that the child may be experiencing airway obstruction.

The child is leaning forward, with the chin thrust out.

the nurse is providing care to a 7 year old child who has been diagnosed with avascular necrosis. The patients guardians ask the nurse what to expect due to this diagnosis. Which of the following would be appropriate information to provide to the parents?

The child will be hospitalized and placed in traction

With regard to the care management of preterm labor, nurses should be aware that:

The diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

A nurse is caring for a child whose family that has identified as being part of a specific culture which of the following supports the nurse demonstrating cultural competency

The nurse is aware that all generations may not interpret all practices the same

There are several risk factors for prolapse of the umbilical cord these include? Select all

Unengaged presenting part Artificial rupture of the membrane Polyhydramnios Malpresentation of the fetus

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits which patient does the nurse identify in having the highest risk pregnancy?

The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension

The nurse is providing care for a prenatal patient who is told she will require a cesarean delivery b/c of cephalopelvic disproportion. Which explanation of the condition will the nurse provide to the patient?

The size and/or shape of either the fetal head or patient pelvis is an issue

Which specific nursing interventions are implemented in the care of the child with leukemia that is at risk for infection? Select all that apply

Use strict aseptic technique for all procedures Ensure that anyone entering the room wears a mask Maintain the child in a private room Reduce exposure to environmental organisms Avoid rectal temperatures

A school nurse is examining a third grade student complaining of a small lump on her head after parting her hair it is evident that a tick has embedded into the scalp

Use tweezers or forceps to remove the tick pulling up with steady pressure

The nurse is teaching the patient about risks of epidural anesthesia which of the following should the nurse relay about epidural anesthesia? Select all that apply

When using an epidural women are more likely to develop a fever There is a higher rate of sepsis Higher rate of instrumental vaginal delivery labor may be longer.

The school nurse is conducting an assessment for pediculosis capitis (head lice) on a group of school-age children. Which describes a child with a positive head check?

White sacs attached to the hair shafts in the occipital area

Which time based description of pregnancy is correct

abortion loss prior than 20 weeks

The nurse has received report about a woman in labor. The Woman in labor last vaginal exam was recorded as 6cm effaced -1 the nurses interpretation of this assessment is

above ischial spine

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of which of the following complications? a. Air embolism b. Allergic reaction c. Hemolytic reaction d. Circulatory overload

d. Circulatory overload

An important nursing intervention when caring for a child who is experiencing a seizure would be to

describe and record the seizure activity observed.

A nurse is seeing a patient in the clinic 3 weeks after a woman had a vaginal delivery the nurse suspects that the woman may have postpartum depression when the mother confides that she is having feelings that she is a?

failure as a mother

Amniotic fluid has several functions including what (select all)

fetal movt temp cushions

Discharge instructions with family the nurse is reviewing safe sleep. The parents understand safe sleep when they state?

firm matress

a nurse is educating parents on age appropriate activities. Which should be included for an 18 month old

hand puppet

a 19 year old was Diagnosed with adolescent idiopathic scoliosis. the curve in her back was treated with spinal infusion with rod insertion .which is the priority nursing intervention in the postoperative period

keep back straight

PKU cannot metabolize

phenyaline

A 17 year old child steps on a nail and sustains a puncture wound of a foot which finding is most concerning to the nurse?

slight drainage from the wound