NU260 Final

If a patient's normal pre-pregnancy diet contains 45 g of protein daily, how many more grams of protein should she consume per day during pregnancy? a. 5 b. 10 c. 25 d. 30

c. 25

What is the most appropriate nursing response to the father of a newborn infant with myelomeningocele who asks about the cause of this condition?

"There may be no definitive cause identified."

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. The most essential part of the nursing assessment to detect early signs of a worsening condition is:

Level of consciousness.

The nurse is discussing various sites used for insulin injections with a child and her family. Which site usually has the fastest rate of absorption?

Abdomen

Therapeutic management of a child with tetanus includes the administration of:

Antibiotics to control bacterial proliferation at the site of injury.

What action may be beneficial in reducing the risk of Reye's syndrome?

Avoidance of aspirin and ibuprofen for children with varicella or those suspected of having influenza

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

Buck's extension

When is the nursing care when using digoxin?

Digoxin(brush teeth to prevent tooth decay from sweetened liquids)

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites?

Femur

The most common clinical manifestation of brain tumors in children is:

Headaches and vomiting.

Which term is used to describe a child's level of consciousness when the child can be aroused with stimulation?

Obtundation

Manifestations of hypoglycemia include:

Shaky feeling and dizziness.

Which type of hernia has an impaired blood supply to the herniated organ?

Strangulated hernia

A 3-year-old child is hospitalized after a near-drowning accident. The child's mother complains to the nurse, "This seems unnecessary when he is perfectly fine.

" The nurse's best reply is: complications could still occur." Although many children do not appear to have suffered adverse effects from the event, complications such as respiratory compromise and cerebral edema may occur up to 24 hours after the incident

Which description of a stool is characteristic of intussusception?

"Currant jelly" stools With intussusception, passage of bloody mucus-coated stools occurs.

What would cause a nurse to suspect that an infection has developed under a cast?

"Hot spots" felt on cast surface

The nurse is conducting teaching for an adolescent being discharged to home after a renal transplantation. The adolescent needs further teaching if which statement is made?

"I am glad I only have to take the immunosuppressant medication for two weeks."The immunosuppressant medications are taken indefinitely after a renal transplantation

A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching?

"I should expect my child to have some behavioral changes after the accident."If the child has episodes of vomiting, sleep disturbances, or diplopia, they should be immediately reported for evaluation

The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching?

"My child should not eat bananas or kiwis."

The nurse is preparing a school-age child for a computed tomography (CT) scan to assess cerebral function. When preparing the child for the scan, which statement should the nurse include?

"The scan will not hurt."

A child is brought to the emergency department after experiencing a seizure at school. There is no previous history of seizures. The father tells the nurse that he cannot believe the child has epilepsy.The nurse's best response is:

"The seizure may or may not mean that your child has epilepsy."

A 6-year-old child is having a generalized seizure in the classroom at school. Place in order the interventions the school nurse should implement

1.Ease child to the floor. 2.Turn child to the side. 3.Take vital signs. 4. Allow child to rest. 5.Integrate child back into the school environment.

A dose of oxycodone (OxyContin) 2 mg/kg has been ordered for a child weighing 33 lb. The nurse should administer ______ milligrams of OxyContin. (Record your answer as a whole number.)

30

How many infants born to narcotic addicted mother show signs of withdrawal?

55%-94%

The nurse has received report on four children. Which child should the nurse assess first?

A preschool child with a head injury and decreasing level of consciousness

The class of drugs known as opioid analgesics (butorphanol, nalbuphine) is not suitable for administration to women with known opioid dependence. The antagonistic activity could precipitate withdrawal symptoms (abstinence syndrome) in both mothers and newborns. Signs of opioid/narcotic withdrawal in the mother would include (Select all that apply): a. Yawning, runny nose. b. Increase in appetite. c. Chills and hot flashes. d. Constipation. e. Irritability, restlessness.

A, C, E

A mother tells the nurse that she will visit her 2-year-old son tomorrow about noon. During the child's bath, he asks for mommy. The nurse's BEST reply is: A. "Mommy will be here after lunch." B. "Mommy always comes back to see you." C. "Your mommy told me yesterday that she would be here today about noon." D. "Mommy had to go home for a while, but she will be here today."

A. "Mommy will be here after lunch."

In caring for the woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate? A. Administration of blood B. Preparation of the client for invasive hemodynamic monitoring C. Restriction of intravascular fluids D. Administration of steroids

A. Administration of blood

In caring for an immediate postpartum client, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder: A. Disseminated intravascular coagulation B. Amniotic fluid embolism C. Hemorrhage D. HELLP syndrome

A. Disseminated intravascular coagulation

A woman with a past history of varicose veins has just delivered and the nurse suspects she has developed a pulmonary embolism. Which of the data below would lead to this nursing judgment? A. Sudden dyspnea and confusion B. Hypertension C. Chills and fever D. Leg pain

A. Sudden dyspnea and confusion

Diastasis Recti Abdominis

Abdominal wall muscles separated. This is usually from oversdistention from a large fetus or multiple fetus.

Which type of seizure may be difficult to detect?

Absence Absence seizures may go unrecognized because little change occurs in the child's behavior during the seizure

An important nursing consideration when suctioning a young child who has tracheostomy :

Administer supplemental oxygen before and after suctioning.

The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. The nurse should recognize that this is most likely related to:

Adolescents often resenting the control and enforced dependence imposed by dialysis.

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include:

Answering questions with straightforward honesty.

A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate immediate action by the school nurse is to:

Apply ice.

When infants are seen for fractures, which nursing intervention is a priority?

Assess for child abuse. Fractures in infants are often nonaccidental.

An appropriate nursing intervention when caring for a child in traction is to:

Assess for tightness, weakness, or contractures in uninvolved joints and muscles.

The nurse is admitting a school-age child with suspected Guillain-Barré syndrome . Which nursing intervention is a priority in the care for this child?

Assessing respiratory efforts Treatment modalities include aggressive ventilatory support in the event of respiratory compromise, administration of IV immunoglobulin , and sometimes steroids; plasmapheresis and immunosuppressive drugs may also be used.

What laboratory marker is indicative of disseminated intravascular coagulation (DIC)? A. Bleeding time of 10 minutes B. Presence of fibrin split products C. Thrombocytopenia D. Hyperfibrinogenemia

B. Presence of fibrin split products

An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure.Pupils are dilated and fixed. What type of head injury should the nurse suspect

Brainstem

Which clinical manifestations would suggest hydrocephalus in a neonate?

Bulging fontanel and dilated scalp veins

A 4-year-old child will be having cardiac surgery next week. The child's parents call the hospital, asking about how to prepare her for this. The nurse's BEST response is to inform the parents that: A. Preparation at this age will only increase the child's stress. B. Preparation needs to be at least 2 to 3 weeks before hospitalization. C. Children who are prepared experience less fear and stress during hospitalization. D. Children who are prepared experience overwhelming fear by the time hospitalization occurs.

C. Children who are prepared experience less fear and stress during hospitalization.

Despite popular belief, there is a rare type of hemophilia that affects women of childbearing age. Von Willebrand disease is the most common of the hereditary bleeding disorders and can affect males and females alike. It results from a factor VIII deficiency and platelet dysfunction. Although factor VIII levels increase naturally during pregnancy, there is an increased risk for postpartum hemorrhage from birth until 4 weeks postdelivery as levels of von Willebrand factor (vWf) and factor VIII decrease. The treatment that should be considered first for the client with von Willebrand disease who experiences a postpartum hemorrhage is: A. Cryoprecipitate B. Factor VIII and vWf C. Desmopressin D. Hemabate

C. Desmopressin

A woman who has recently given birth complains of pain and tenderness in her leg. Upon physical examination, the nurse notices warmth and redness over an enlarged, hardened area. The nurse should suspect _____ and should confirm the diagnosis by _____. A. Disseminated intravascular coagulation; asking for laboratory tests B. von Willebrand disease; noting whether bleeding times have been extended C. Thrombophlebitis; using real time and color Doppler ultrasound D. Coagulopathies; drawing blood for laboratory analysis

C. Thrombophlebitis; using real time and color Doppler ultrasound

A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. nurse should base the explanation on knowing that:

Children are better able to manage the diabetes.

A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by:

Complex carbohydrate and protein.

The nurse should recommend medical attention if a child with a slight head injury experiences:

Confusion or abnormal behavior.

The nurse is conducting discharge teaching with parents of a preschool child with myelomeningocele, repaired at birth, who is being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the child's genitourinary function?

Continue to perform the clean intermittent catheterizations (CIC) at home. Administer the oxybutynin chloride (Ditropan) as prescribed.Monitor for signs of a recurrent UTI.

The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?

Covered with a sterile, moist, nonadherent dressing

The nurse working in an outpatient surgery center for children should understand that: A. Children's anxiety is minimal in such a center. B. Waiting is not stressful for parents in such a center. C. Accurate and complete discharge teaching is the responsibility of the surgeon. D. Families need to be prepared for what to expect after discharge.

D. Families need to be prepared for what to expect after discharge.

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

Describe and record the seizure activity observed.

Which statement best describes a neuroblastoma?

Diagnosis is usually made after metastasis occurs. treatment of brain tumors in children consists of surgery, chemotherapy, and radiotherapy alone or in combination

A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child's level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is to:

Discuss with practitioner what analgesia can be safely administered.

A nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized.instructions should be included in the teaching?

Elevate casted arm when resting and when sitting up.

The priority nursing intervention when a child is unconscious after a fall is to:

Establish an adequate airway.

An infant with pyloric stenosis experiences excessive vomiting that can result in:

Metabolic alkalosis.

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement?

Growth can be affected by this type of fracture.

A laboring woman received an opioid agonist meperidine intravenously 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate?

Naloxone (Narcan)

most common problem of children born with a myelomeningocele is:

Neurogenic bladder.

The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as:

Neurosurgical emergency. Pinpoint pupils or fixed, bilateral pupils for more than 5 minutes are indicative of brainstem damage.

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

Nonsteroidal antiinflammatory drugs (NSAIDs)

The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool.The most appropriate nursing action is to:

Notify the practitioner.

What is most descriptive of the therapeutic management of osteosarcoma?

Treatment usually consists of surgery and chemotherapy.

The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. The nurse should explain that:

Extra snacks are needed before exercise.

A current recommendation to prevent neural tube defects is the supplementation of:

Folic acid for all women of childbearing age.

The nurse is caring for an 11-year-old boy who has recently been diagnosed with diabetes. What should be included in the teaching plan for daily injections?

He is old enough to give most of his own injections.

What is the therapeutic management for endocarditis

High doses antibiotic-culture dependent 2-8 weeks. Prevention with prophylactic antibiotics one hour before procedure high-risk patient

Which problem is most often associated with myelomeningocele?

Hydrocephalus

The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity. The nurse's response should be based on knowing that:

Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.

Which statement is most descriptive of a concussion?

It is a transient, reversible neuronal dysfunction. with instantaneous loss of awareness and responsiveness resulting from trauma to the head.

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests:

Leaking of cerebrospinal fluid

Which assessment findings should the nurse note in a school-age child with Duchenne's muscular dystrophy (DMD)

Lordosis Gower's sign Waddling gait Typically, affected boys have a waddling gait and lordosis, fall frequently, and develop a characteristic manner of rising from a squatting or sitting position on the floor Gower's sign Lordosis occurs as a result of weakened pelvic muscles, and the waddling gait is a result of weakness in the gluteus medius and maximus muscles.

Which drug would be used to treat a child who has increased intracranial pressure resulting from cerebral edema?

Mannitol an osmotic diuretic, administered IV, is the drug used most frequently for rapid reduction

When caring for the child with Reye's syndrome, the priority nursing intervention is to:

Monitor intake and output.

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt.

Observe closely for signs of infection. Maintain an accurate record of intake and output. Monitor for abdominal distention.

Which test is never performed on a child who is awake?

Oculovestibular response or caloric test involves the instillation of ice water into the ear of a comatose child. The caloric test is painful and is never performed on a child who is awake or one who has a ruptured tympanic membrane.

Under what conditions would you withhold digoxin from a child?

Older kids: HR < 70-85 - as ordered by HCP Infants: HR < 90-110 - as ordered by HCP Withhold and call HCP

What is the diagnostic evaluation for endocarditis

Onset usually insidious Endo cardiogram Duke criteria Janeway lesion Osler node

An advantage of peritoneal dialysis is that:

Parents and older children can perform treatments.

The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death?

Periodic or irregular breathing

The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease?

Progressive weakness and wasting of skeletal muscle

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is to place him:

Prone potion, turn head to side, and nipple feed.

Discharge planning for the child with juvenile arthritis includes the need for:

Routine ophthalmologic examinations to assess for visual problems.

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome

Severe pain not relieved by analgesics Tingling of extremity Inability to move extremity

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions.What should the nurse suggest to remove this material?

Soak in a bathtub.

Immediately after birth, the palpated cervix is _________.

Soft

A 10-year-old boy has been hit by a car while riding his bicycle in front of the school. school nurse immediately assesses airway, breathing, and circulation. The next nursing action should be to:

Stabilize neck and spine.

A child has been seizure-free for 2 years. father asks the nurse how much longer the child will need to take the antiseizure medications. nurse includes which intervention in the response?

Stepwise approach will be used to reduce the dosage gradually.A predesigned protocol is used to wean a child gradually off antiseizure medications, usually when the child is seizure-free for 2 years and has a normal electroencephalogram

An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) is to:

Teach child and family the correct administration of medications.

The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant?

Temperature instability Irritability Lethargy

Calcium carbonate is given with meals to a child with chronic renal disease.

The purpose of this is to Bind phosphorus.The diet of a child with chronic renal failure is usually characterized as: Low in phosphorus. . Protein should be limited in chronic renal failure to decrease intake of phosphorus.

how long does it take for restoration or healing times with vagina, hemorrhoids, episiotomies?

The vagina gradually returns to prepregnancy size by 6 to 10 weeks after childbirth. Hemorrhoids can take 6 weeks to decrease in size. Most episiotomies take 2 to 3 weeks to heal.

Which clinical manifestation would be seen in a child with chronic renal failure?

Unpleasant "uremic" breath odor

The parent of a child with diabetes mellitus asks the nurse when urine testing will be necessary. The nurse should explain that urine testing is necessary for which?

Urine testing is still performed to detect evidence of ketonuria.

The mother of a 1-month-old infant tells the nurse that she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response on knowing that:

Vaccination to prevent Haemophilus influenzae type b meningitis has decreased the frequency of this disease in children.

When taking the history of a child hospitalized with Reye's syndrome, the nurse should not be surprised that a week ago the child had recovered from:

Varicella or influenza.

The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?

Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

Visible peristalsis and weight loss The upper abdomen is distended

A thrombosis results from the formation of a blood clot or clots inside a blood vessel and is caused by inflammation or partial obstruction of the vessel. Three thromboembolic conditions are of concern during the postpartum period and include all except: a) Amniotic fluid embolism (AFE) b) Superficial venous thrombosis c) Deep vein thrombosis d) Pulmonary embolism

a) Amniotic fluid embolism (AFE)

The nurse providing care for the laboring woman understands that accelerations with fetal movement: a) Are reassuring b) Are caused by umbilical cord compression c) Warrant close observation d) Are caused by uteroplacental insufficiency

a) Are reassuring

As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is 1 day postpartum. An expected finding is: a) Little if any change b) Leakage of milk at let-down c) Swollen, warm and tender on palpation d) A few blisters and a bruise on each areola

a) Little if any change

A woman in active labor receives an opioid agonist analgesic. Which medication relieves severe, persistent, or recurrent pain, creates a sense of well-being, overcomes inhibitory factors, and may even relax the cervix but should be used cautiously in women with cardiac disease? a) Meperidine (Demerol) b) Promethazine (phenergan) c) Butorphanol tartrate (Stadol) d) Nalbuphine (Nubain)

a) Meperidine (Demerol)

Fetal well-being during labor is assessed by: a) The response of the fetal heart rate (FHR) to uterine contractions (UCs) b) Maternal pain control c) Accelerations in the FHR d) An FHR greater than 110 beats/min

a) The response of the fetal heart rate (FHR) to uterine contractions (UCs)

After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so you can assess her understanding of the instructions given. Which statement indicates that she understands the role of protein in her pregnancy? a. "Protein will help my baby grow." b. "Eating protein will prevent me from becoming anemic." c. "Eating protein will make my baby have strong teeth after he is born." d. "Eating protein will prevent me from being diabetic."

a. "Protein will help my baby grow."

During a prenatal examination, the woman reports having two cats at home. The nurse informs her that she should not be cleaning the litter box while she is pregnant. When the woman asks why, the nurse's best response would be: a. "Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that can infect you and have severe effects on your unborn child." b. "You and your baby can be exposed to the human immunodeficiency virus (HIV) in your cats' feces." c. "It's just gross. You should make your husband clean the litter boxes." d. "Cat feces are known to carry Escherichia coli, which can cause a severe infection in both you and your baby."

a. "Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that can infect you and have severe effects on your unborn child."

A young child from Mexico is hospitalized for a serious illness. The father tells the nurse that "the child is being punished by God for being bad." The nurse should recognize this as: a. A health belief common in this culture. b. An early indication of potential child abuse. c. A misunderstanding of the family's common beliefs. d. A belief common when fortune tellers have been used.

a. A health belief common in this culture.

Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation. The nurse who instructs them about pumping, storing, and transporting the milk needs to assess their knowledge of lactation. Which statement is valid? a. A premature infant more easily digests breast milk than formula. b. A glass of wine just before pumping will help reduce stress and anxiety. c. The mother should pump only as much as the infant can drink. d. The mother should pump every 2 to 3 hours, including during the night.

a. A premature infant more easily digests breast milk than formula.

Before giving a dose of digoxin (Lanoxin), the nurse checked an infant's apical heart rate and it was 114 bpm. What should the nurse do next? a. Administer the dose as ordered. b. Hold the medication until the next dose. c. Wait and recheck the apical heart rate in 30 minutes. d. Notify the physician about the infant's heart rate.

a. Administer the dose as ordered.

A pregnant woman presents in labor at term, having had no prenatal care. After birth her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. On the basis of her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy? a. Alcohol b. Cocaine c. Heroin d. Marijuana

a. Alcohol

The abuse of which of the following substances during pregnancy is the leading cause of cognitive impairment in the United States? a. Alcohol b. Tobacco c. Marijuana d. Heroin

a. Alcohol

The nurse caring for the laboring woman should understand that early decelerations are caused by: a. Altered fetal cerebral blood flow. b. Umbilical cord compression. c. Uteroplacental insufficiency. d. Spontaneous rupture of membranes.

a. Altered fetal cerebral blood flow.

Many common drugs of abuse cause significant physiologic and behavioral problems in infants who are breastfed by mothers currently using (Select all that apply): a. Amphetamine. b. Heroin. c. Nicotine. d. PCP. e. Morphine.

a. Amphetamine. b. Heroin. c. Nicotine. d. PCP.

In which cultural group is good health considered to be a balance between yin and yang? a. Asians b. Australian aborigines c. Native Americans d. African-Americans

a. Asians

The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to: a. Assess fetal heart rate (FHR) and maternal vital signs b. Perform a venipuncture for hemoglobin and hematocrit levels c. Place clean disposable pads to collect any drainage d. Monitor uterine contractions

a. Assess fetal heart rate (FHR) and maternal vital signs

Knowing that the condition of the new mother's breasts will be affected by whether she is breastfeeding, nurses should be able to tell their clients all the following statements except: a. Breast tenderness is likely to persist for about a week after the start of lactation. b. As lactation is established, a mass may form that can be distinguished from cancer by its position shift from day to day. c. In nonlactating mothers colostrum is present for the first few days after childbirth. d. If suckling is never begun (or is discontinued), lactation ceases within a few days to a week.

a. Breast tenderness is likely to persist for about a week after the start of lactation.

The nurse providing couplet care should understand that nipple confusion results when: a. Breastfeeding babies receive supplementary bottle feedings. b. The baby is weaned too abruptly. c. Pacifiers are used before breastfeeding is established. d. Twins are breastfed together.

a. Breastfeeding babies receive supplementary bottle feedings.

The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by: a. Change in position. b. Oxytocin administration. c. Regional anesthesia. d. Intravenous analgesic.

a. Change in position.

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. The nurse's first priority is to: a. Change the woman's position. b. Notify the care provider. c. Assist with amnioinfusion. d. Insert a scalp electrode.

a. Change the woman's position.

The management of a child who has just been stung by a bee or wasp should include the application of which of the following? a. Cool compresses b. Warm compresses c. Antibiotic cream d. Corticosteroid cream

a. Cool compresses

Which deceleration of the fetal heart rate would not require the nurse to change the maternal position? a. Early decelerations b. Late decelerations c. Variable decelerations d. It is always a good idea to change the woman's position.

a. Early decelerations

Leopold maneuvers would be an inappropriate method of assessment to determine: a. Gender of the fetus. b. Number of fetuses. c. Fetal lie and attitude. d. Degree of the presenting part's descent into the pelvis.

a. Gender of the fetus.

A pictorial tool that can assist the nurse in assessing aspects of family life related to health care is the: a. Genogram. b. Family values construct. c. Life cycle model d. Human development wheel.

a. Genogram.

Compared with contraction stress test (CST), nonstress test (NST) for antepartum fetal assessment: a. Has no known contraindications. b. Has fewer false-positive results. c. Is more sensitive in detecting fetal compromise. d. Is slightly more expensive.

a. Has no known contraindications.

The most critical nursing action in caring for the newborn immediately after birth is: a. Keeping the newborn's airway clear. b. Fostering parent-newborn attachment. c. Drying the newborn and wrapping the infant in a blanket. d. Administering eye drops and vitamin K.

a. Keeping the newborn's airway clear.

With regard to protein in the diet of pregnant women, nurses should be aware that: a. Many protein-rich foods are also good sources of calcium, iron, and B vitamins. b. Many women need to increase their protein intake during pregnancy. c. As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet. d. High-protein supplements can be used without risk by women on macrobiotic diets.

a. Many protein-rich foods are also good sources of calcium, iron, and B vitamins.

As the United States and Canada continue to become more culturally diverse, it is increasingly important for the nursing staff to recognize a wide range of varying cultural beliefs and practices. Nurses need to develop respect for these culturally diverse practices and learn to incorporate these into a mutually agreed on plan of care. Although it is common practice in the United States for the father of the baby to be present at the birth, in many societies this is not the case. When implementing care, the nurse would anticipate that a woman from which country would have the father of the baby in attendance? a. Mexico b. Iran c. China d. India

a. Mexico

Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? a. Multiple-marker screening b. Lecithin/sphingomyelin (L/S) ratio c. Biophysical profile d. Type and crossmatch of maternal and fetal serum

a. Multiple-marker screening

A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min without any decelerations. The interpretation of this test is said to be: a. Negative. b. Positive. c. Satisfactory. d. Unsatisfactory.

a. Negative.

The father of a hospitalized child tells the nurse, "He can't have meat. We are Buddhist and vegetarians." The nurse's best intervention is to: a. Order the child a meatless tray. b. Ask a Buddhist priest to visit. c. Explain that hospital patients are exempt from dietary rules. d. Help the parent understand that meat provides protein needed for healing.

a. Order the child a meatless tray.

Which describe avoidance behaviors a parent may exhibit when learning that his or her child has a chronic condition (select all that apply)? a. Refuses to agree to treatment b. Shares burden of disorder with others c. Verbalizes possible loss of child d. Withdraws from outside world e. Punishes self because of guilt and shame

a. Refuses to agree to treatment d. Withdraws from outside world e. Punishes self because of guilt and shame

The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is: a. Respiratory depression. b. Bradycardia. c. Acrocyanosis. d. Tachypnea.

a. Respiratory depression.

A means of controlling the birth of the fetal head with a vertex presentation is: a. The Ritgen maneuver. c. The lithotomy position. b. Fundal pressure. d. The De Lee apparatus.

a. The Ritgen maneuver.

Nursing care for the child in congestive heart failure includes a. Counting the number of saturated diapers b. Putting the infant in the Trendelenburg position c. Removing oxygen while the infant is crying d. Organizing care to provide rest periods

d. Organizing care to provide rest periods

Which assessment indicates to a nurse that a 2-year-old child is in need of pain medication? a. The child is lying rigidly in bed and not moving. b. The child's current vital signs are consistent with vital signs over the past 4 hours. c. The child becomes quiet when held and cuddled. d. The child has just returned from the recovery room.

a. The child is lying rigidly in bed and not moving.

The nurse is talking with the parents of a child who died 6 months ago. They sometimes still "hear" the child's voice and have trouble sleeping. They describe feeling "empty" and depressed. The nurse should recognize that: a. These are normal grief responses. b. The pain of the loss is usually less by this time. c. These grief responses are more typical of the early stages of grief. d. This grieving is essential until the pain is gone and the child is gradually forgotten.

a. These are normal grief responses.

Examples of appropriate techniques to wake a sleepy infant for breastfeeding include (Select all that apply): a. Unwrapping the infant. b. Changing the diaper. c. Talking to the infant. d. Slapping the infant's hands and feet. e. Applying a cold towel to the infant's abdomen.

a. Unwrapping the infant. b. Changing the diaper. c. Talking to the infant.

The nurse providing care for the laboring woman should understand that amnioinfusion is used to treat: a. Variable decelerations. b. Late decelerations. c. Fetal bradycardia. d. Fetal tachycardia.

a. Variable decelerations.

The nurse caring for the newborn should be aware that the sensory system least mature at the time of birth is: a. Vision. b. Hearing. c. Smell. d. Taste.

a. Vision.

What intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure? a. Weigh the infant every day on the same scale at the same time. b. Notify the physician when weight gain exceeds more than 20 g/day. c. Put the infant in a car seat to minimize movement. d. Administer digoxin (Lanoxin) as ordered by the physician.

a. Weigh the infant every day on the same scale at the same time.

Isotretinoin (Accutane) is indicated for the treatment of acne during adolescence when: a. acne has not responded to other treatments. b. the adolescent is or may become pregnant. c. the adolescent is unable to give up foods causing acne. d. frequent washing with antibacterial soap has been unsuccessful.

a. acne has not responded to other treatments.

The nurse comes into the room of a child who was just diagnosed with a chronic disability. The child's parents begin to yell at the nurse about a variety of concerns. The nurse's best response is: a. "What is really wrong?" b. "Being angry is only natural." c. "Yelling at me will not change things." d. "I will come back when you settle down."

b. "Being angry is only natural."

The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know what type of visual stimuli they should provide for their newborn. The nurse responds to the parents by telling them: a. "Infants can see very little until about 3 months of age." b. "Infants can track their parent's eyes and distinguish patterns; they prefer complex patterns." c. "The infant's eyes must be protected. Infants enjoy looking at brightly colored stripes." d. "It's important to shield the newborn's eyes. Overhead lights help them see better."

b. "Infants can track their parent's eyes and distinguish patterns; they prefer complex patterns."

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is: a. "Don't worry about it. You'll do fine." b. "It's normal to be anxious about labor. Let's discuss what makes you afraid." c. "Labor is scary to think about, but the actual experience isn't." d. "You can have an epidural. You won't feel anything."

b. "It's normal to be anxious about labor. Let's discuss what makes you afraid."

Which statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth? a. "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter." b. "My first menstrual cycle will be heavier than normal and will return to my pre-pregnant volume within three or four cycles." c. "I will not have a menstrual cycle for 6 months after childbirth." d. "My first menstrual cycle will be heavier than normal and then will be light for several months after."

b. "My first menstrual cycle will be heavier than normal and will return to my pre-pregnant volume within three or four cycles."

The nurse and a new nurse are caring for a child who will require palliative care. Which statement made by the new nurse would indicate a correct understanding of palliative care? a. "Palliative care serves to hasten death and make the process easier for the family." b. "Palliative care provides pain and symptom management for the child." c. "The goal of palliative care is to place the child in a hospice setting at the end of life." d. "The goal of palliative care is to act as the liaison between the family, child, and other health care professionals."

b. "Palliative care provides pain and symptom management for the child."

A first-time mother is concerned about the type of medications she will receive during labor. She is in a fair amount of pain and is nauseous. In addition, she appears to be very anxious. You explain that opioid analgesics often are used with sedatives because: a. "The two together work the best for you and your baby." b. "Sedatives help the opioid work better, and they also will assist you to relax and relieve your nausea." c. "They work better together so you can sleep until you have the baby." d. "This is what the doctor has ordered for you."

b. "Sedatives help the opioid work better, and they also will assist you to relax and relieve your nausea."

For women who have a history of sexual abuse, a number of traumatic memories may be triggered during labor. The woman may fight the labor process and react with pain or anger. Alternately, she may become a passive player and emotionally absent herself from the process. The nurse is in a unique position of being able to assist the client to associate the sensations of labor with the process of childbirth and not the past abuse. The nurse can implement a number of care measures to help the client view the childbirth experience in a positive manner. Which intervention would be key for the nurse to use while providing care? a. Telling the client to relax and that it won't hurt much b. Limiting the number of procedures that invade her body c. Reassuring the client that as the nurse you know what is best d. Allowing unlimited care providers to be with the client

b. Limiting the number of procedures that invade her body

The perinatal nurse is giving discharge instructions to a woman after suction curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. The best response from the nurse would be: a. "If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore, if you desire a future pregnancy, it would be better for you to use the most reliable method of contraception available." b. "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult." c. "If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, it is better not to get pregnant at this time." d. "Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pregnancy."

b. "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult."

Which statement about family systems theory is inaccurate? a. A family system is part of a larger suprasystem. b. A family as a whole is equal to the sum of the individual members. c. A change in one family member affects all family members. d. The family is able to create a balance between change and stability.

b. A family as a whole is equal to the sum of the individual members.

During labor a fetus with an average heart rate of 135 beats/min over a 10-minute period would be considered to have: a. Bradycardia. b. A normal baseline heart rate. c. Tachycardia. d. Hypoxia.

b. A normal baseline heart rate.

Which best describes how preschoolers react to the death of a loved one? a. The preschooler is too young to have a concept of death. b. A preschooler is likely to feel guilty and responsible for the death. c. Grief is acute but does not last long at this age. d. Grief is usually expressed in the same way in which the adults in the preschooler's life are expressing grief.

b. A preschooler is likely to feel guilty and responsible for the death.

Approach behaviors are coping mechanisms that result in a family's movement toward adjustment and resolution of the crisis of having a child with a chronic illness or disability. What is considered an approach behavior in parents? a. Are unable to adjust to a progression of the disease or condition b. Anticipate future problems and seek guidance and answers c. Look for new cures without a perspective toward possible benefit d. Fail to recognize seriousness of child's condition despite physical evidence

b. Anticipate future problems and seek guidance and answers

Which myth may interfere with the treatment of pain in infants and children? a. Infants may have sleep difficulties after a painful event. b. Children and infants are more susceptible to respiratory depression from narcotics. c. Pain in children is multidimensional and subjective. d. A child's cognitive level does not influence the pain experience.

b. Children and infants are more susceptible to respiratory depression from narcotics.

Which represents a common best practice in the provision of services to children with chronic or complex conditions? a. Care is focused on the child's chronologic age. b. Children with complex conditions are integrated into regular classrooms. c. Disabled children are less likely to be cared for by their families. d. Children with complex conditions are placed in residential treatment facilities.

b. Children with complex conditions are integrated into regular classrooms.

The primary nursing intervention to prevent bacterial endocarditis is a. Institute measures to prevent dental procedures. b. Counsel parents of high-risk children about prophylactic antibiotics. c. Observe children for complications, such as embolism and heart failure. d. Encourage restricted mobility in susceptible children.

b. Counsel parents of high-risk children about prophylactic antibiotics.

With regard to systemic analgesics administered during labor, nurses should be aware that: a. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. b. Effects on the fetus and newborn can include decreased alertness and delayed sucking. c. Intramuscular administration (IM) is preferred over intravenous (IV) administration. d. IV patient-controlled analgesia (PCA) results in increased use of an analgesic.

b. Effects on the fetus and newborn can include decreased alertness and delayed sucking.

Which intervention will encourage a sense of autonomy in a toddler with disabilities? a. Avoid separation from family during hospitalizations. b. Encourage independence in as many areas as possible. c. Expose child to pleasurable experiences as much as possible. d. Help parents learn special care needs of their child.

b. Encourage independence in as many areas as possible.

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by: a. Denial. b. Guilt and anger. c. Social reintegration. d. Acceptance of child's limitations.

b. Guilt and anger.

If an opioid antagonist is administered to a laboring woman, she should be told that: a. Her pain will decrease. b. Her pain will return. c. She will feel less anxious. d. She will no longer feel the urge to push.

b. Her pain will return.

What correctly matches the type of deceleration with its likely cause? a. Early deceleration—umbilical cord compression b. Late deceleration—uteroplacental inefficiency c. Variable deceleration—head compression d. Prolonged deceleration—cause unknown

b. Late deceleration—uteroplacental inefficiency

Which strategy is appropriate when feeding the infant with congestive heart failure? a. Continue the feeding until a sufficient amount of formula is taken. b. Limit feeding time to no more than 30 minutes. c. Always bottle feed every 4 hours. d. Feed larger volumes of concentrated formula less frequently.

b. Limit feeding time to no more than 30 minutes.

When pain is assessed in an infant, it is inappropriate for the nurse to assess for: a. Facial expressions of pain. b. Localization of pain. c. Crying. d. Thrashing of extremities.

b. Localization of pain.

Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period? a. Codeine b. Morphine c. Methadone d. Meperidine

b. Morphine

To provide optimal care of infants born to mothers who are substance abusers, nurses should be aware that: a. Infants born to addicted mothers are also addicted. b. Mothers who abuse one substance likely will use or abuse another, thus compounding the infant's difficulties. c. The NICU Network Neurobehavioral Scale (NNNS) is designed to assess the damage the mother has done to herself. d. No laboratory procedures are available that can identify the intrauterine drug exposure of the infant.

b. Mothers who abuse one substance likely will use or abuse another, thus compounding the infant's difficulties.

A nurse is planning palliative care for a child with severe pain. Which should the nurse expect to be prescribed for pain relief? a. Opioids as needed b. Opioids on a regular schedule c. Distraction and relaxation techniques d. Nonsteroidal antiinflammatory drugs

b. Opioids on a regular schedule

In which developmental stage is the child first able to localize pain and describe both the amount and the intensity of the pain felt? a. Toddler stage b. Preschool stage c. School-age stage d. Adolescent stage

b. Preschool stage

A common parental reaction to a child with special needs is parental overprotection. Parental behavior suggestive of this includes: a. Giving inconsistent discipline. b. Providing consistent, strict discipline. c. Forcing child to help self, even when not capable. d. Encouraging social and educational activities not appropriate to child's level of capability.

b. Providing consistent, strict discipline.

With regard to the postpartum changes and developments in a woman's cardiovascular system, nurses should be aware that: a. Cardiac output, the pulse rate, and stroke volume all return to prepregnancy normal values within a few hours of childbirth. b. Respiratory function returns to nonpregnant levels by 6 to 8 weeks after birth. c. The lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections. d. A hypercoagulable state protects the new mother from thromboembolism, especially after a cesarean birth.

b. Respiratory function returns to non-pregnant levels by 6 to 8 weeks after birth.

A nurse is working in a clinic that serves a culturally diverse population of children. The nurse should plan care, understanding that the following complementary and alternative practices may be used by this patient population (Select all that apply): a. Seeking another doctor's opinion b. Seeking advice from a curandero or curandera c. Using acupuncture or acupressure as a therapy d. Consulting an herbalist e. Consulting a kahuna

b. Seeking advice from a curandero or curandera c. Using acupuncture or acupressure as a therapy d. Consulting an herbalist e. Consulting a kahuna

A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items such as Jell-O, Popsicles, and juices are left. What would best explain this? a. The parent is trying to feed child only what child likes most. b. The parent is trying to restore normal balance through appropriate "hot" remedies. c. Hispanics believe that the "evil eye" enters when a person gets cold. d. Hispanics believe that an innate energy called chi is strengthened by eating soup.

b. The parent is trying to restore normal balance through appropriate "hot" remedies.

Lindsey, age 5 years, will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize that her disability was so severe. The best interpretation of this situation is that: a. This is a sign that parents are in denial. b. This is a normal anticipated time of parental stress. c. The parents need to learn more about cerebral palsy. d. The parents are used to having expectations that are too high.

b. This is a normal anticipated time of parental stress.

Which maternal condition always necessitates delivery by cesarean section? a. Partial abruptio placentae b. Total placenta previa c. Ectopic pregnancy d. Eclampsia

b. Total placenta previa

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1 is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure? a. Amniocentesis for fetal lung maturity b. Ultrasound for placental location c. Contraction stress test (CST) d. Internal fetal monitoring

b. Ultrasound for placental location

The nurse providing care for the laboring woman realizes that variable fetal heart rate (FHR) decelerations are caused by: a. Altered fetal cerebral blood flow. b. Umbilical cord compression. c. Uteroplacental insufficiency. d. Fetal hypoxemia.

b. Umbilical cord compression.

Which description of postpartum restoration or healing times is accurate? a. The cervix shortens, becomes firm, and returns to form within a month postpartum. b. Vaginal rugae reappear by 3 weeks postpartum. c. Most episiotomies heal within a week. d. Hemorrhoids usually decrease in size within 2 weeks of childbirth.

b. Vaginal rugae reappear by 3 weeks postpartum.

The nurse should be aware that the criteria used to make decisions and solve problems within families are based primarily on family: a. Rituals and customs. b. Values and beliefs. c. Boundaries and channels. d. Socialization processes.

b. Values and beliefs.

With regard to the condition and reconditioning of the urinary system after childbirth, nurses should be aware that: a) Kidney function returns to normal a few days after birth b) Diastasis recti abdominis is a common condition that alters the voiding reflex c) Fluid loss through perspiration and increased urinary output accoun for a weight loss of more than 2kg during the puerperium d) With adequate emptying of the bladder, bladder tone usually is restored 2 to 3 weeks after childbirth

c) Fluid loss through perspiration and increased urinary output accoun for a weight loss of more than 2kg during the puerperium

A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks, "What is that medicine for?" The nurse responds: a. "It is an eye ointment to help your baby see you better." b. "It is to protect your baby from contracting herpes from your vaginal tract." c. "Erythromycin is given prophylactically to prevent a gonorrheal infection." d. "This medicine will protect your baby's eyes from drying out over the next few days."

c. "Erythromycin is given prophylactically to prevent a gonorrheal infection."

Changes in blood volume after childbirth depend on several factors such as blood loss during childbirth and the amount of extravascular water (physiologic edema) mobilized and excreted. A postpartum nurse anticipates blood loss of (Select all that apply): a. 100 mL b. 250 mL or less c. 300 to 500 mL d. 500 to 1000 mL e. 1500 mL or greater

c. 300 to 500 mL d. 500 to 1000 mL

At what age do most children have an adult concept of death as being inevitable, universal, and irreversible? a. 4 to 5 years b. 6 to 8 years c. 9 to 11 years d. 12 to 16 years

c. 9 to 11 years

The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says that she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize that this is: a. Child abuse. b. A cultural practice to rid the body of disease. c. A cultural practice to treat enuresis or temper tantrums. d. A child discipline measure common in the Vietnamese culture.

c. A cultural practice to treat enuresis or temper tantrums.

At a 2-month well-baby examination, it was discovered that a breastfed infant had only gained 10 ounces in the past 4 weeks. The mother and the nurse agree that, to gain weight faster, the infant needs to: a. Begin solid foods. b. Have a bottle of formula after every feeding. c. Add at least one extra breastfeeding session every 24 hours. d. Start iron supplements.

c. Add at least one extra breastfeeding session every 24 hours.

In caring for the mother who has abused (or is abusing) alcohol and for her infant, nurses should be aware that: a. The pattern of growth restriction of the fetus begun in prenatal life is halted after birth, and normal growth takes over. b. Two thirds of newborns with fetal alcohol syndrome (FAS) are boys. c. Alcohol-related neurodevelopmental disorders not sufficient to meet FAS criteria (learning disabilities, speech and language problems) are often not detected until the child goes to school. d. Both the distinctive facial features of the FAS infant and the diminished mental capacities tend toward normal over time.

c. Alcohol-related neurodevelopmental disorders not sufficient to meet FAS criteria (learning disabilities, speech and language problems) are often not detected until the child goes to school.

What should the nurse identify as major fears in the preschool child who is hospitalized with a chronic illness (select all that apply)? a. Altered body image b. Separation from peer group c. Bodily injury d. Mutilation e. Being left alone

c. Bodily injury d. Mutilation e. Being left alone

Near the end of the first week of life, an infant who has not been treated for any infection develops a copper-colored, maculopapular rash on the palms and around the mouth and anus. The newborn is showing signs of: a. Gonorrhea. b. Herpes simplex virus infection. c. Congenital syphilis. d. Human immunodeficiency virus.

c. Congenital syphilis.

The uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter (IUPC). The nurse notes that the intrauterine pressure at the peak of the contraction ranges from 65 to 70 mm Hg and the resting tone range is 6 to 10 mm Hg. The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. On the basis of this information, the nurse should: a. Notify the woman's primary health care provider immediately. b. Prepare to administer an oxytocic to stimulate uterine activity. c. Document the findings because they reflect the expected contraction pattern for the active phase of labor. d. Prepare the woman for the onset of the second stage of labor.

c. Document the findings because they reflect the expected contraction pattern for the active phase of labor.

A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply: a. 4% Liposomal Lidocaine (LMX) 15 minutes before the procedure. b. A transdermal fentanyl (Duragesic) patch immediately before the procedure. c. Eutectic mixture of local anesthetics (EMLA) 1 hour before the procedure. d. EMLA 30 minutes before the procedure.

c. Eutectic mixture of local anesthetics (EMLA) 1 hour before the procedure.

Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug include which of the following? a. Avoid use of sunscreen agents. b. Cosmetics with lanolin and petrolatum are preferred in acne. c. Explain that medication should not be applied until at least 20 to 30 minutes after washing. d. Explain that erythema and peeling are indications of toxicity.

c. Explain that medication should not be applied until at least 20 to 30 minutes after washing.

The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home. Whom should the nurse invite to the conference? a. Family and nursing staff b. Social worker, nursing staff, and primary care physician c. Family and key health professionals involved in child's care d. Primary care physician and key health professionals involved in child's care

c. Family and key health professionals involved in child's care

As relates to the condition and reconditioning of the urinary system after childbirth, nurses should be aware that: a. Kidney function returns to normal a few days after birth. b. Diastasis recti abdominis is a common condition that alters the voiding reflex. c. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium. d. With adequate emptying of the bladder, bladder tone usually is restored 2 to 3 weeks after childbirth.

c. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium.

What finding on a prenatal visit at 10 weeks could suggest a hydatidiform mole? a. Complaint of frequent mild nausea b. Blood pressure of 120/80 mm Hg c. Fundal height measurement of 18 cm d. History of bright red spotting for 1 day, weeks ago

c. Fundal height measurement of 18 cm

Which medications are the most effective choices for treating pain associated with inflammation in children (Select all that apply)? a. Morphine b. Acetaminophen (Tylenol) c. Ibuprofen (Advil) d. Ketorolac (Toradol) e. Aspirin

c. Ibuprofen (Advil) d. Ketorolac (Toradol)

The nurse providing care for the antepartum woman should understand that contraction stress test (CST): a. Sometimes uses vibroacoustic stimulation. b. Is an invasive test; however, contractions are stimulated. c. Is considered negative if no late decelerations are observed with the contractions. d. Is more effective than nonstress test (NST) if the membranes have already been ruptured.

c. Is considered negative if no late decelerations are observed with the contractions.

A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend which of the following? a. Administer antihistamine. b. Cleanse with soap and water. c. Keep child quiet and come to emergency department. d. Remove stinger and apply cool compresses.

c. Keep child quiet and come to emergency department.

Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early postpartum period is: a. Elevated temperature caused by postpartum infection. b. Increased basal metabolic rate after giving birth. c. Loss of increased blood volume associated with pregnancy. d. Increased venous pressure in the lower extremities.

c. Loss of increased blood volume associated with pregnancy.

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. The first step in the provision of this care is: a. Pharmacologic treatment. b. Reduction of environmental stimuli. c. Neonatal abstinence syndrome scoring. d. Adequate nutrition and maintenance of fluid and electrolyte balance.

c. Neonatal abstinence syndrome scoring.

An appropriate tool to assess pain in a 3-year-old child is the (Select all that apply): a. Visual Analog Scale (VAS) b. Adolescent and pediatric pain tool c. Oucher tool d. Poker Chip Tool e. FACES pain rating scale

c. Oucher tool d. Poker Chip Tool e. FACES pain rating scale

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman? a. Estrogen b. Progesterone c. Prolactin d. Human placental lactogen

c. Prolactin

Fetal bradycardia is most common during: a. Intraamniotic infection. b. Fetal anemia. c. Prolonged umbilical cord compression. d. Tocolytic treatment using terbutaline.

c. Prolonged umbilical cord compression.

Which of the following is the primary clinical manifestation of scabies? a. Edema b. Redness c. Pruritus d. Maceration

c. Pruritus

A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, "I have been getting a migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain? a. Acute b. Chronic c. Recurrent d. Subacute

c. Recurrent

A plan of care for an infant experiencing symptoms of drug withdrawal should include: a. Administering chloral hydrate for sedation. b. Feeding every 4 to 6 hours to allow extra rest. c. Swaddling the infant snugly and holding the baby tightly. d. Playing soft music during feeding.

c. Swaddling the infant snugly and holding the baby tightly.

The labor and delivery nurse is preparing a bariatric patient for an elective cesarean birth. Which piece of "specialized" equipment is unnecessary when providing care for this pregnant woman. a. Extra long surgical instruments b. Wide surgical table c. Temporal thermometer d. Increased diameter blood pressure cuff

c. Temporal thermometer

When assessing pain in any child, the nurse should consider that: a. Any pain assessment tool can be used to assess pain in children. b. Children as young as 1 year old use words to express pain. c. The child's behavioral, physiologic, and verbal responses are valuable when assessing pain. d. Pain assessment tools are minimally effective for communicating about pain.

c. The child's behavioral, physiologic, and verbal responses are valuable when assessing pain.

Using the family stress theory as an intervention approach for working with families experiencing parenting, the nurse can help the family change internal context factors. These include: a. Biologic and genetic makeup. b. Maturation of family members. c. The family's perception of the event. d. The prevailing cultural beliefs of society.

c. The family's perception of the event.

The nurse caring for a woman in labor understands that prolonged decelerations: a. Are a continuing pattern of benign decelerations that do not require intervention. b. Constitute a baseline change when they last longer than 5 minutes. c. Usually are isolated events that end spontaneously. d. Require the usual fetal monitoring by the nurse.

c. Usually are isolated events that end spontaneously.

The nurse providing care for the laboring woman should understand that late fetal heart rate (FHR) decelerations are the result of: a. Altered cerebral blood flow. b. Umbilical cord compression. c. Uteroplacental insufficiency. d. Meconium fluid.

c. Uteroplacental insufficiency.

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise the father to: a. apply warm compresses. b. carefully scrape off stinger. c. take child to emergency department. d. apply a thin layer of corticosteroid cream.

c. take child to emergency department.

The most common cause of decreased variability in the FHR that lasts 30 minutes or less is: a) Altered cerebral blood flow b) Fetal hypoxemia c) Umbilical cord compression d) Fetal sleep cycles

d) Fetal sleep cycles

You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase IV fluid, and perform a vaginal exam. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should you take? a) Call for help b) Insert a foley catheter c) Start oxytocin (Pitocin) d) Notify the primary health care provider immediately

d) Notify the primary health care provider immediately

Physiologic measurements in children's pain assessment are: a. The best indicator of pain in children of all ages. b. Essential to determine whether a child is telling the truth about pain. c. Of most value when children also report having pain. d. Of limited value as sole indicator of pain.

d. Of limited value as sole indicator of pain.

What is the most appropriate response to a school-age child who asks if she can talk to her dying sister? a. "You need to speak loudly so she can hear you." b. "Holding her hand would be better because at this point she can't hear you." c. "Although she can't hear you, she can feel your presence so sit close to her." d. "Even though she will probably not answer you, she can still hear what you say to her."

d. "Even though she will probably not answer you, she can still hear what you say to her."

Which statement made by a parent indicates understanding of restrictions for a child after cardiac surgery? a. "My child needs to get extra rest for a few weeks." b. "My son is really looking forward to riding his bike next week." c. "I'm so glad we can attend religious services as a family this coming Sunday." d. "I am going to keep my child out of daycare for 6 weeks."

d. "I am going to keep my child out of daycare for 6 weeks."

Which statement suggests that a parent understands how to correctly administer digoxin? a. "I measure the amount I am supposed to give with a teaspoon." b. "I put the medicine in the baby's bottle." c. "When she spits up right after I give the medicine, I give her another dose." d. "I give the medicine at 8 in the morning and evening every day."

d. "I give the medicine at 8 in the morning and evening every day."

Childbirth may result in injuries to the vagina and uterus. Pelvic floor exercises also known as Kegel exercises will help to strengthen the perineal muscles and encourage healing. The nurse knows that the client understands the correct process for completing these conditioning exercises when she reports: a. "I contract my thighs, buttocks, and abdomen." b. "I do 10 of these exercises every day." c. "I stand while practicing this new exercise routine." d. "I pretend that I am trying to stop the flow of urine midstream."

d. "I pretend that I am trying to stop the flow of urine midstream."

Which statement by a postpartum woman indicates that further teaching is not needed regarding thrombus formation? a. "I'll stay in bed for the first 3 days after my baby is born." b. "I'll keep my legs elevated with pillows." c. "I'll sit in my rocking chair most of the time." d. "I'll put my support stockings on every morning before rising."

d. "I'll put my support stockings on every morning before rising."

Which collection of risk factors most likely would result in damaging lacerations (including episiotomies)? a. A dark-skinned woman who has had more than one pregnancy, who is going through prolonged second-stage labor, and who is attended by a midwife b. A reddish-haired mother of two who is going through a breech birth c. A dark-skinned, first-time mother who is going through a long labor d. A first-time mother with reddish hair whose rapid labor was overseen by an obstetrician

d. A first-time mother with reddish hair whose rapid labor was overseen by an obstetrician

At what developmental period do children have the most difficulty coping with death, particularly if it is their own? a. Toddlerhood b. Preschool c. School-age d. Adolescence

d. Adolescence

A common, serious complication of rheumatic fever is a. Seizures b. Cardiac dysrhythmias c. Pulmonary hypertension d. Cardiac valve damage

d. Cardiac valve damage; mitral valve

The nurse caring for the postpartum woman understands that breast engorgement is caused by: a. Overproduction of colostrum. b. Accumulation of milk in the lactiferous ducts. c. Hyperplasia of mammary tissue. d. Congestion of veins and lymphatics.

d. Congestion of veins and lymphatics.

While evaluating an external monitor tracing of a woman in active labor whose labor is being induced, the nurse notes that the fetal heart rate (FHR) begins to decelerate at the onset of several contractions and returns to baseline before each contraction ends. The nurse should: a. Change the woman's position. b. Discontinue the oxytocin infusion. c. Insert an internal monitor. d. Document the finding in the client's record.

d. Document the finding in the client's record.

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain? a. FACES pain rating tool b. Numeric scale c. Oucher scale d. FLACC tool

d. FLACC tool

What bacterial infection is definitely decreasing because of effective drug treatment? a. Escherichia coli infection b. Tuberculosis c. Candidiasis d. Group B streptococcal infection

d. Group B streptococcal infection

A postpartum woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who: a. Sleeps for 6 hours at a time between feedings. b. Has at least one breast milk stool every 24 hours. c. Gains 1 to 2 ounces per week. d. Has at least six to eight wet diapers per day.

d. Has at least six to eight wet diapers per day.

As a perinatal nurse you realize that a fetal heart rate that is tachycardic, is bradycardic, or has late decelerations or loss of variability is nonreassuring and is associated with: a. Hypotension. c. Maternal drug use. b. Cord compression. d. Hypoxemia.

d. Hypoxemia.

While working in the prenatal clinic, you care for a very diverse group of patients. When planning interventions for these families, you realize that acceptance of the interventions will be most influenced by: a. Educational achievement. b. Income level. c. Subcultural group. d. Individual beliefs.

d. Individual beliefs.

Which fetal heart rate (FHR) finding would concern the nurse during labor? a. Accelerations with fetal movement b. Early decelerations c. An average FHR of 126 beats/min d. Late decelerations

d. Late decelerations

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that: a. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. b. Maternal serum alpha-fetoprotein (MSAFP) screening is recommended only for women at risk for neural tube defects. c. Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome. d. MSAFP is a screening tool only; it identifies candidates for more definitive procedures

d. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

A placenta previa in which the placental edge just reaches the internal os is more commonly known as: a. Total b. Partial c. Complete d. Marginal

d. Marginal

Most parents of children with special needs tend to experience chronic sorrow. This is characterized by: a. Lack of acceptance of the child's limitation. b. Lack of available support to prevent sorrow. c. Periods of intensified sorrow when experiencing anger and guilt. d. Periods of intensified sorrow and loss that occur in waves over time.

d. Periods of intensified sorrow and loss that occur in waves over time.

The nurse recognizes that a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period is: a. Nonreactive b. Positive c. Negative d. Reactive

d. Reactive

The nurse caring for a child diagnosed with acute rheumatic fever should assess the child for a. Sore throat b. Elevated blood pressure c. Desquamation of the fingers and toes d. Tender, warm, inflamed joints

d. Tender, warm, inflamed joints

Human immunodeficiency virus (HIV) may be perinatally transmitted: a. Only in the third trimester from the maternal circulation. b. By a needlestick injury at birth from unsterile instruments. c. Only through the ingestion of amniotic fluid. d. Through the ingestion of breast milk from an infected mother.

d. Through the ingestion of breast milk from an infected mother.

A primiparous woman is delighted with her newborn son and wants to begin breastfeeding as soon as possible. The nurse can facilitate the infant's correct latch-on by helping the woman hold the infant: a. With his arms folded together over his chest. b. Curled up in a fetal position. c. With his head cupped in her hand. d. With his head and body in alignment.

d. With his head and body in alignment.

The Glasgow Coma Scale consists of an assessment of:

eye opening and verbal and motor responses.

A toddler fell out of a second-story window. She had brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented. Her mother asks why a CT scan is required when she "seems fine." nurse should explain that the toddler

history of the fall, brief loss of consciousness, and vomiting four times necessitate evaluation of a potential brain injury.

Pinpoint pupils or fixed, bilateral pupils for more than 5 minutes are .

indicative of brainstem damage

Which term is used to describe a type of fracture that does not produce a break in the skin?

simple or closed fracture

Which term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation?

stupor

Chronic renal failure leads to water and sodium retention,

which contributes to edema and vascular congestion