Practice Questions for Final

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data, if noted on the client's record, would alert the nurse that the client is at risk for a spontaneous abortion? 1. Age of 35 years 2. History of syphilis 3. History of genital herpes 4. History of diabetes mellitus

2. History of syphilis

A nurse is caring for a client with a diagnosis of placenta previa. The nurse collects data knowing that which is a characteristic of placenta previa? 1. A tender and rigid uterus 2. Painless, bright red vaginal bleeding 3. Greenish discoloration of the amniotic fluid 4. Vaginal bleeding accompanied by abdominal pain

2. Painless, bright red vaginal bleeding

The nurse reviews the laboratory results for a client with a suspected ectopic pregnancy. The nurse would expect which result of the beta subunit of human chorionic gonadotropin (β-hCG) if the client had an ectopic pregnancy? 1. Not present 2. Present in low levels 3. Present in high levels 4. Within normal limits

2. Present in low levels

A maternity unit nurse is developing a plan of care for a client with severe preeclampsia who will be admitted to the nursing unit. The nurse should include which nursing intervention in the plan? 1. Restrict food and fluids. 2. Reduce external stimuli. 3. Monitor blood glucose levels. 4. Maintain the client in a supine position.

2. Reduce external stimuli.

A nurse provides dietary instructions to a pregnant woman regarding food items that contain folic acid. Which food item should the nurse recommend as a good source of folic acid? 1. Cheese 2. Spinach 3. Potatoes 4. Bananas

2. Spinach

A nurse is collecting data on a pregnant client in the first trimester of pregnancy diagnosed with iron deficiency anemia. The nurse should monitor the client to detect which sign/symptom indicating that this problem has not yet resolved? 1. Pink mucous membranes 2. Increased vaginal secretions 3. Complaints of daily headaches and fatigue 4. Complaints of increased frequency of voiding

3. Complaints of daily headaches and fatigue

The nurse must evaluate a male patient's knowledge regarding the use of a condom. The nurse would recognize the need for further instruction if the patient states that he: A lubricates the condom with a spermicide containing nonoxynol-9 B leaves an empty space at the tip of the condom. C leaves a small amount of air in the tip. D removes his still-erect penis from the vagina while holding onto the base of the condom.

A

Which statement by an 8 year-old child with asthma indicates that she understands the use of her peak flow meter? a. if i use my peak flow meter everyday i will not have asthma attack b. i always start with the meter reading above h c. my peak flow meter can tell me if an asthma episode may be coming

c. my peak flow meter can tell me if an asthma episode may be coming

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?

diet should be high in carbs and protein

A possible cause of acquired aplastic anemia in children is:

drugs

Which type of croup is always considered a medical emergency?

epiglotitis

An important nursing consideration when suctioning a young child who has had heart surgery is to:

give supplemental oxygen before and after suctioning

A client arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. The client tells the nurse that a home pregnancy test was positive but that she began to have mild cramps and is now having moderate vaginal bleeding. On physical examination of the client, it is noted that she has a dilated cervix. The nurse determines that the client is experiencing which type of abortion? 1. Septic 2. Inevitable 3. Incomplete 4. Threatened

2. Inevitable

The nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. Which instruction should the nurse provide? 1. Avoid wearing a bra. 2. Wash the breasts with warm water and keep them dry. 3. Wear tight-fitting blouses or dresses to provide support. 4. Wash the nipples and areolar area daily with soap, and massage the breasts with lotion.

2. Wash the breasts with warm water and keep them dry.

The nurse should suspect epiglottitis if the child has: a) Cough, sore throat, and agitation b) Cough, drooling, and retractions c) Drooling, agitation, and absence of cough d) Hoarseness, retractions, and absence of cough

Drooling, agitation, and absence of cough

An acquired hemorrhagic disorder that is characterized by excessive destruction of platelets

Idiopathic thrombocytopenic purpura.

bryan, 10 year old idiopathic thromnocytopenia purpura and is complaining of a headache. medications for pain should be AVOIDED?

NSAIDS

The most common causative agent of bacterial endocarditis is:

Streptococcus viridans.

An appropriate nursing intervention when caring for a child with pneumonia is which of the following? a) Avoid placing child on affected child b) Monitor respiratory status frequently c) Place in Trendelenburg position d) Administer antitussive agents around the clock

b) Monitor respiratory status frequently

A 6 month-old is hospitalized for bronciolitis from a respiratory RSV infection. On auscultating breath sounds you would expect to hear narrowing of the lower airways which you would document as: a. rales b. stridor c. wheezing

c. wheezing

A complication that may occur after a cardiac catheterization is:

cardiac arrythmia

A common, serious complication of rheumatic fever is:

cardiac valve damage

A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure is:

peripheral edema

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. An important objective to decrease this risk is to:

prevent dehydration

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should explain that narcotic analgesics:

rarely caused addiction bc they are medically indicated

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend:

swimming

Because the absorption of fat-soluble vitamins is decreased in cystic fibrosis, supplementation of which vitamins is necessary? A. C and D B. A, E, and K C. A, D, E, and K D. C and folic acid

C. A, D, E, and K * A, D, E, and K are fat-soluble vitamins that need to be supplemented in higher doses.

A pregnant client asks the nurse about the types of exercises that are allowable during pregnancy. The nurse should tell that client that which exercise is safest? 1. Swimming 2. Scuba diving 3. Low-impact gymnastics 4. Bicycling with the legs in the air

1. Swimming

A pregnant woman's last menstrual period began on April 8, 2009, and ended on April 13. Using Nägele's rule, her estimated date of birth would be________.

January 15, 2010

When preparing a school-age child and the family for heart surgery, the nurse should consider:

Letting child hear the sounds of an electrocardiograph monitor.

The most likely reason that the respiratory tract infection rate increases drastically in the age range from 3 to 6 months is that the: a) Infant's exposure to pathogens is greatly increased during this time b) Viral agents that are mild in older children are severe infants c) Maternal antibodies have disappeared and the infant's own antibody production is immature d) Diameter of the airways is smaller in the infant than in the older child

Maternal antibodies have disappeared and the infant's own antibody production is immature

An appropriate nursing intervention when caring for a child with pneumonia is to:

encourage rest Cluster care to conserve energy. AND Administration of antibiotics.

A 22-year-old client at 7 weeks' gestation attended the first trimester class on nutrition. Which of the following statements indicates a need for further teaching? -"I should gain around 30 pounds by my due date." -"Planning meals around the food pyramid guide is best." -"Frozen foods are more nutritious than canned foods." -"My craving are probably caused by iron deficiency."

"My craving are probably caused by iron deficiency."

The nurse is describing cardiovascular system changes that occur during pregnancy to a client and understands that which finding would be normal for a client in the second trimester? 1. Increase in pulse rate 2. Increase in blood pressure 3. Frequent bowel elimination 4. Decrease in red blood cell production

1. Increase in pulse rate

A home care nurse is visiting a pregnant client with a diagnosis of mild preeclampsia. What is the priority nursing intervention during the home visit? 1. Monitor for fetal movement. 2. Monitor the maternal blood glucose. 3. Instruct the client to maintain complete bed rest. 4. Instruct the client to restrict dietary sodium and any food items that contain sodium.

1. Monitor for fetal movement.

The nurse has assisted in performing a nonstress test on a pregnant client and is reviewing the documentation related to the results of the test. The nurse notes that the health care provider has documented the test results as reactive. How should the nurse interpret this result? 1. Normal findings 2. Abnormal findings 3. The need for further evaluation 4. That the findings on the monitor were difficult to interpret

1. Normal findings

The charge nurse on a labor and delivery unit has numerous admissions of laboring clients and must transfer one of the clients to the postpartum/gynecological unit, where the nurse-to-client ratio will be 1:4. Which antepartum client would be the most appropriate one to transfer? 1. The 36-year-old, gravida I, para 0 client who is at 24 weeks' gestation and is being monitored for preterm labor 2. The 26-year-old, gravida I, para 0 client who is at 10 weeks' gestation and is experiencing vaginal bleeding 3. The 40-year-old, gravida III, para 0 client who is at 38 weeks' gestation and is complaining of decreased fetal movement 4. The 29-year-old, gravida I, para 0 client who is at 42 weeks' gestation and had a biophysical profile score of 5 earlier today

2. The 26-year-old, gravida I, para 0 client who is at 10 weeks' gestation and is experiencing vaginal bleeding

The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching? 1. "I should stay on the diabetic diet." 2. "I should perform glucose monitoring at home." 3. "I should avoid exercise because of the negative effects on insulin production." 4. "I should be aware of any infections and report signs of infection immediately to my health care provider."

3. "I should avoid exercise because of the negative effects on insulin production."

During a woman's 38-week prenatal visit, the nurse assesses the fetal heart rate. Which finding would the nurse note as normal? 1. 80 beats/minute 2. 100 beats/minute 3. 150 beats/minute 4. 180 beats/minute

3. 150 beats/minute

A client with severe preeclampsia is admitted to the maternity department. Which room assignment would be most appropriate for this client? 1. A private room across from the elevator 2. A semiprivate room across from the nurses' station 3. A private room two doors away from the nurses' station 4. A semiprivate room with another client who enjoys watching television

3. A private room two doors away from the nurses' station

The nurse in the prenatal clinic is providing nutritional counseling to a pregnant client. The nurse instructs the client to increase the intake of folic acid and tells the client that which food item is highest in folic acid? 1. Pork 2. Cheese 3. Chicken 4. Green leafy vegetables

4. Green leafy vegetables

The nurse is reviewing a nutritional plan of care with a pregnant client and is identifying the food items highest in folic acid. The nurse determines that the client understands the foods that supply the highest amounts of folic acid if the client states that she will include which item in the daily diet? 1. Milk 2. Yogurt 3. Bananas 4. Leafy green vegetables

4. Leafy green vegetables

An infant with a congenital heart defect is receiving palivizumab (Synagis). The purpose of this is to: A. prevent RSV infection. B. make isolation of infant with RSV unnecessary. C. prevent secondary bacterial infection. D. decrease toxicity of antiviral agents.

A. prevent RSV infection. * Synagis is a monoclonal antibody specific for RSV. Monthly administration is expected to prevent infection with RSV.

Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with: A spina bifida. B intrauterine growth restriction. C diabetes mellitus. D Down syndrome.

B Spina bifida is not associated with inadequate maternal weight gain. An adequate amount of folic acid has been shown to reduce the incidence of this condition. Both normal-weight and underweight women with inadequate weight gain have an increased risk of giving birth to an infant with intrauterine growth restriction. Diabetes mellitus is not related to inadequate weight gain. A gestational diabetic mother is more likely to give birth to a large-for-gestational age infant. Down syndrome is the result of a trisomy 21, not inadequate maternal weight gain.

A child who has been receiving morphine intravenously will now start receiving it orally. The nurse should anticipate that to achieve equianalgesia (equal analgesic effect), the oral dose will be: A. the same as the IV dose. B. greater than the IV dose. C. one-half of the IV dose. D. one-quarter of the IV dose.

B. greater than the IV dose. * Oral morphine is not as effective at the same dosage as IV morphine.

An important consideration when using the FACES Pain Rating scale with children is: A. children color the face with the color they choose to best describe their pain. B. the scale can be used with most children as young as 3 years. C. the scale is not appropriate for use with adolescents. D. the FACES scale is useful in pain assessment but not as accurate as physiologic responses.

B. the scale can be used with most children as young as 3 years.

An effective relief measure for primary dysmenorrhea would be to: A reduce physical activity level until menstruation ceases. B begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow. C decrease intake of salt and refined sugar about 1 week before menstruation is about to occur. D use barrier methods rather than the oral contraceptive pill (OCP) for birth control.

C Staying active is helpful since it facilitates menstrual flow and increases vasodilation to reduce ischemia. Prostaglandin inhibitors should be started a few days before the onset of menstruation. Decreasing intake of salt and refined sugar can reduce fluid retention. OCPs are beneficial in relieving primary dysmenorrhea as a result of inhibition of ovulation and prostaglandin synthesis.

A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should: A tell the couple they need to have an abortion within 2 to 3 weeks. B explain that the fetus has a 50% chance of having the disorder. C discuss options with the couple, including amniocentesis to determine whether the fetus is affected. D refer the couple to a psychologist for emotional support.

C The couple should be given information about the likelihood of having another baby with this disorder so that they can make an informed decision. A genetic counselor is the best source for determining genetic probability ratios. Genetic testing, including amniocentesis, would need to be performed to determine whether the fetus is affected. The couple eventually may need emotional support, but the status of the pregnancy must be determined first.

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her: A "You don't need to modify your exercising any time during your pregnancy." B "Stop exercising, because it will harm the fetus." C "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." D "Jogging is too hard on your joints; switch to walking now."

C The nurse should inform the woman that she may need to reduce her exercise level as the pregnancy progresses. Physical activity promotes a feeling of well-being in pregnant women. It improves circulation, promotes relaxation and rest, and counteracts boredom. Typically, running should be replaced with walking around the seventh month of pregnancy. Simple measures should be initiated to prevent injuries, such as warm-up and stretching exercises to prepare the joints for more strenuous exercise.

The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other trauma resulting from a motor vehicle injury. The child is experiencing severe pain. What is an important consideration in managing the child's pain? A. Give only an opioid analgesic at this time. B. Increase dosage of analgesic until the child is adequately sedated. C. Plan a preventive schedule of pain medication around the clock. D. Give the child a clock and explain when (s)he can have pain medications.

C. Plan a preventive schedule of pain medication around the clock. * An around-the-clock administration strategy should be used for a child recovering from trauma and surgery. This schedule will help prevent low plasma levels of the drug leading to breakthrough pain.

A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent:

CNS disease

Most children with croup syndromes: a) Require hospitalization b) Will need to be intubated c) Can be cared for at home d) Are over 6 years old

Can be cared for at home

One of the goals for children with asthma is to prevent respiratory tract infection. This is because respiratory tract infection does which of the following? a) Increases sensitivity to allergens b) Causes exercise-induced asthma c) Lessens effectiveness of medications d) Can trigger an episode or aggravate asthmatic state

Can trigger an episode or aggravate asthmatic state

What laboratory results would be a cause for concern if exhibited by a woman at her first prenatal visit during the second month of her pregnancy? A Hematocrit 38%, hemoglobin 13 g/dL B White blood cell count 6000/mm3 C Platelets 300,000/mm3 D Rubella titer 1:6

D This is a normal laboratory value in the pregnant woman. This is a normal laboratory value in the pregnant woman. This is a normal laboratory value in the pregnant woman. A rubella titer of less than 1:10 indicates a lack of immunity to rubella, a viral infection that has the potential to cause teratogenic effects on fetal development. Arrangements should be made to administer the rubella vaccine after birth during the postpartum period since administration of rubella, a live vaccine, would be contraindicated during pregnancy. Women receiving the vaccine during the postpartum period should be cautioned to avoid pregnancy for 3 months.

A pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to: A assess the woman's blood pressure and pulse. B have the woman breathe into a paper bag. C raise the woman's legs. D turn the woman on her side.

D Vital signs can be assessed next. Breathing into a paper bag is the solution for dizziness related to respiratory alkalosis associated with hyperventilation. Raising her legs will not solve the problem since pressure will still remain on the major abdominal blood vessels, thereby continuing to impede cardiac output. During a fundal height measurement the woman is placed in a supine position. This woman is experiencing supine hypotension as a result of uterine compression of the vena cava and abdominal aorta. Turning her on her side will remove the compression and restore cardiac output and blood pressure.

A child with asthma is having pulmonary function tests. Which explains the purpose of the peak expiratory flow rate (PEFR)? A. Confirm diagnosis of asthma B. Determine cause of asthma C. Identify "triggers" of asthma D. Assess severity of asthma

D. Assess severity of asthma

What is the most consistent indicator of pain in infants? A. Increased respirations B. Increased heart rate C. Squirming and jerking D. Facial expression of discomfort

D. Facial expression of discomfort

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent: A. otitis media. B. diabetes insipidus. C. nephrotic syndrome. D. acute rheumatic fever.

D. acute rheumatic fever.

A child who is terminally ill with bone cancer is in severe pain. Nursing interventions should be based on knowledge that: A. children tend to be overmedicated for pain. B. giving large doses of opioids causes euthanasia. C. narcotic addiction is common in terminally ill children. D. large doses of opioids are justified when there are no other treatment options.

D. large doses of opioids are justified when there are no other treatment options. * Large doses may be needed because the child has become physiologically tolerant to the drug, requiring higher doses to achieve the same degree of pain control.

What's the neurotransmitter known for its involvement in pain modulation?

Prostaglandin

The primary therapeutic regimen for croup usually includes: a) Vigilant assessment, racemic epinephrine, and corticosteroids b) Vigilant assessment, racemic epinephrine, and antibiotics c) Intubation, racemic epinephrine, and corticosteroids d) Intubation, racemic epinephrine, and antibiotics

Vigilant assessment, racemic epinephrine, and corticosteroids

Which drug is an angiotensin-converting enzyme (ACE) inhibitor?

captopril (captoten)

A 9 month-old is receiving O2 in a mist tent, it is most important for the nurse to:

change the child's clothes frequently so the child remains dry

Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on knowing that:

child needs opportunities to play with peers

which nursing intervention is most appropriate when caring for an infant with heart failure?

cluster nursing activities

When caring for a 10-month old infant with RSV, an important nursing consideration would be: a. encouraging infant to drink 8oz of formula every 4 hours. b. administering antibiotics c. administer cough syrup d. Place in a mist tent.

d. Place in a mist tent.

A 7 year-old child is brought to the ER for acute asthma attack. He's wheezing, tachypnic, diaphoretic, and looks frightened. The nurse should prepare to administer: a. IV methoprednisone b. epinephrine c. oral prednisone d. epinephrine

d. epinephrine

Myelosuppression associated with chemotherapeutic agents or some malignancies such as leukemia can cause bleeding tendencies because of a/an:

dec in blood platelets

3 year-old child has cystic fibrosis, the child is admitted to the pediatric unit. The nurse needs to administer pancreatic enzyme, the best way to administer this drug would be by:

dissolving the medication by mixing in a teaspoon of apple sauce

The nurse is preparing a child for possible alopecia from chemotherapy. What should be included?

explain that when hair regrows it might have a slightly different color or texture

A 15 year-old with a history of cystic fibrosis is admitted to pediatrics with the following assessment findings - crackles, increased cough, and green sputum. A 2 week hospitalization is anticipated. Which of the following nursing interventions hold the priority?

gaining IV access

What describes the pathologic changes of sickle cell anemia?

inc red blood cell destruction

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be to:

place child in knee to chest position

What is often administered to prevent or control hemorrhage in a child with cancer?

platelets

As part of the tx for CHF, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child bananas, oranges, and leafy vegetables. These foods are recommended because they are high in:

potassium

14 year old girl is admitted for sickle cell crisis

provide adequate oxygenation, hydration, and pain management

Seventy-two hours after cardiac surgery, a young child has a temperature of 37.7 C (101 F). The nurse should:

report findings to physician

The nurse is caring for a child after heart surgery. What should he or she do if evidence is found of cardiac tamponade?

report this to physician

A condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin is:

sickle cell anemia

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop:

slowed growth

4 month-old is brought to the ER with a hacking cough and difficulty breathing. On assessment the nurse determines the infant is in respiratory distress when the following signs are present:

substernal retractions

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

sweat chloride test

3 year old has a high RBC count and polycythemia. in planning care, the nurse should anticipate which goal to help prevent clot formation?

the child will not exhibit s/s of dehydration

What is most descriptive of the pathophysiology of leukemia?

unrestricted proliferation of immature white blood cells

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant:

Shows signs of an earache.

A common sign of digoxin toxicity is:

vomitting

s/s should a nurse expect to be present in a 12 yr old admitted to the ped unit with a diagnosis of possible brain tumor?

behavioral changes

A boy with leukemia screams whenever he needs to be turned or moved. The most probable cause of this pain is:

bone involvement

A nurse working in an infertility clinic reviews the medical history of a 35-year-old woman who is currently taking fertility medications and is planning a pregnancy. Which medication, if present in the client's history, would indicate a need for teaching related to the woman's potential risk for carrying a fetus with a congenital cleft lip or cleft palate? 1. Methyldopa 2. Folic acid (Folvite) 3. Phenytoin (Dilantin) 4. Bupropion (Wellbutrin SR)

3. Phenytoin (Dilantin)

The nurses caring for a child are concerned about the child's frequent requests for pain medication. During a team conference a nurse suggests that they consider administering a placebo instead of the usual pain medication. What should this decision be based on? A. This practice is unjustified and unethical. B. This practice is effective to determine if a child's pain is real. C. The absence of a response to a placebo means the child's pain has an organic basis. D. A positive response to a placebo will not occur if the child's pain has an organic basis.

A. This practice is unjustified and unethical. * Placebos should never be given by any route in the assessment or management of pain.

2 year old child with hemophilia who sustains a joint injury is best treated promptly in which location?

at home

Which defect results in increased pulmonary blood flow?

atrial septal defect

What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?

CHF

When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to:

Give small amounts of favorite fluids frequently to prevent dehydration.

What is the most frequent form of internal bleeding in the child with hemophilia?

Hemarthrosis

The parents of a young child with congestive heart failure tell the nurse that they are ""nervous"" about giving digoxin. The nurse's response should be based on knowing that:

Parents must learn specific, important guidelines for administration of digoxin.

What best describes why children have fewer respiratory tract infections as they grow older?

Repeated exposure to organisms causes increased immunity.

A 9 year-old child is brought to the ER with a severe asthma episode. ABG's reveal the following: pH is 7.25, PCO2 is 55, HCO2 is 24. The child is in what?

Respiratory acidosis

The severity of asthma in a child with daily asthmatic symptoms would be classified as: a) Mild intermittent b) Mild persistent c) Moderate persistent d) Severe persistent

Severe persistent

What is descriptive of most cases of hemophilia?

X-linked recessive inherited disorder in which a blood-clotting factor is deficient

Which description is most descriptive of bronchiole asthma? a. heightened airway reactivity b. decreased resistance in the airway c. the single cause of asthma is an allergic hypersensitivity d. inherited

a. heightened airway reactivity.

Jose is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:

adapted to level of development so he can understand

During a prenatal visit, a nurse is explaining dietary management to a client with pre-existing diabetes mellitus. The nurse determines that teaching has been effective if the client makes which statement? 1. "Diet and insulin needs change during pregnancy." 2. "I will plan my diet based on the results of urine glucose testing." 3. "I will need to eat 600 more calories every day because I am pregnant." 4. "I can continue with the same diet as before pregnancy, as long as it is well balanced."

1. "Diet and insulin needs change during pregnancy."

A nurse is assisting in conducting a prenatal session with a group of expectant parents. One of the expectant parents asks, "How does the milk get secreted from the breast?" What is the nurse's best response? 1. "Prolactin stimulates the secretion of milk, which is called lactogenesis." 2. "Oxytocin stimulates the secretion of milk, which is called lactogenesis." 3. "Progesterone stimulates the secretion of milk, which is called lactogenesis." 4. "Testosterone stimulates the secretion of milk, which is called lactogenesis."

1. "Prolactin stimulates the secretion of milk, which is called lactogenesis."

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The health care provider (HCP) prescribes a contraction stress test. The test is performed, and the nurse notes that the HCP has documented the results as negative. How should the nurse interpret this finding? 1. A normal test result 2. An abnormal test result 3. A high risk for fetal demise 4. The need for a cesarean delivery

1. A normal test result

The nurse is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. The nurse determines that the client understands dietary and insulin needs if the client states that the second half of pregnancy may require which treatment? 1. Increased insulin 2. Increased caloric intake 3. Decreased protein intake 4. Decreased insulin

1. Increased insulin

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data if noted on the client's record would alert the nurse that the client is at risk for developing gestational diabetes during this pregnancy? 1. The client's last baby weighed 10 pounds at birth. 2. The client's previous deliveries were by cesarean birth. 3. The client has a family history of cardiovascular disease. 4. The client is 5 feet 3 inches in height and weighs 165 pounds.

1. The client's last baby weighed 10 pounds at birth.

The nurse is assessing a client with a diagnosis of gestational trophoblastic disease (hydatidiform mole). The nurse understands that which findings are associated with this condition? Select all that apply. 1. Vaginal bleeding 2. Excessive fetal activity 3. Excessive nausea and vomiting 4. Larger-than-normal uterus for gestational age 5. Elevated levels of human chorionic gonadotropin (hCG)

1. Vaginal bleeding 3. Excessive nausea and vomiting 4. Larger-than-normal uterus for gestational age 5. Elevated levels of human chorionic gonadotropin (hCG)

A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement made by the client indicates a need for further instruction? 1. "I will watch for the evidence of the passage of tissue." 2. "I will maintain strict bed rest throughout the remainder of the pregnancy." 3. "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." 4. "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding."

2. "I will maintain strict bed rest throughout the remainder of the pregnancy."

A pregnant client in the first trimester calls the nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement to the client? 1. "Come to the clinic immediately." 2. "The vaginal discharge may be bothersome, but is a normal occurrence." 3. "Report to the emergency department at the maternity center immediately." 4. "Use tampons if the discharge is bothersome, but to be sure to change the tampons every 2 hours."

2. "The vaginal discharge may be bothersome, but is a normal occurrence."

A nurse is assessing a woman in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding would the nurse expect to note if abruptio placentae is present? 1. Soft uterus 2. Abdominal pain 3. Nontender uterus 4. Painless vaginal bleeding

2. Abdominal pain

The clinic nurse is reviewing the medical record of a woman scheduled for her weekly prenatal appointment. The nurse notes that the woman has been diagnosed with mild preeclampsia. Of the following interventions, which should the nurse list as having the lowest priority in planning nursing care for this client? 1. Assess blood pressure. 2. Discuss the need for hospitalization. 3. Assess deep tendon reflexes and edema. 4. Teach the importance of keeping track of a daily weight.

2. Discuss the need for hospitalization.

The clinic nurse is discussing nutrition with a pregnant client who has lactose intolerance. The nurse should instruct the client to supplement the dietary source of calcium by eating which food? 1. Hard cheese 2. Dried fruits 3. Creamed spinach 4. Fresh-squeezed orange juice

2. Dried fruits

The nurse is developing a plan of care for a pregnant client who is complaining of intermittent episodes of constipation. To help alleviate this problem, the nurse should instruct the client to take which measure? 1. Consume a low-fiber diet. 2. Drink 8 glasses of water per day. 3. Use a Fleet enema when the episodes occur. 4. Take a mild stool softener daily in the evening.

2. Drink 8 glasses of water per day.

The nurse is performing an initial assessment on a client who has just been told that a pregnancy test is positive. Which assessment finding indicates that the client is at risk for preterm labor? 1. The client is a 35-year-old primigravida 2. The client has a history of cardiac disease 3. The client's hemoglobin level is 13.5 g/dL 4. The client is a 20-year-old primigravida of average weight and height

2. The client has a history of cardiac disease

The nurse is caring for a client with a diagnosis of endometriosis. The client asks the nurse to describe this condition. What is the best response by the nurse? 1. "It causes the cessation of menstruation." 2. "It is pain that occurs during ovulation." 3. "It is the presence of tissue outside the uterus that resembles the endometrium." 4. "It is also known as primary dysmenorrhea and causes lower abdominal discomfort."

3. "It is the presence of tissue outside the uterus that resembles the endometrium."

The nurse provides instructions to a malnourished pregnant client regarding iron supplementation. Which client statement indicates an understanding of the instructions? 1. "Iron supplements will give me diarrhea." 2. "Meat does not provide iron and should be avoided." 3. "The iron is best absorbed if taken on an empty stomach." 4. "On the days that I eat green leafy vegetables or calf liver I can omit taking the iron supplement."

3. "The iron is best absorbed if taken on an empty stomach."

A pregnant client tells the nurse that she has been craving "unusual foods." The nurse gathers additional assessment data and discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Laboratory studies are performed and the nurse determines that which finding indicates a physiological consequence of the client's practice? 1. Hematocrit 38% 2. Glucose 86 mg/dL 3. Hemoglobin 9.1 g/dL 4. White blood cell count 12,400 cells/mm3

3. Hemoglobin 9.1 g/dL

The nurse is preparing to care for a client who is being admitted to the hospital with a possible diagnosis of ectopic pregnancy. The nurse develops a plan of care for the client and determines that which nursing action is the priority? 1. Checking for edema 2. Monitoring daily weight 3. Monitoring the apical pulse 4. Monitoring the temperature

3. Monitoring the apical pulse

The clinic nurse is instructing a pregnant client in her first trimester about nutrition. The nurse should determine that the client needs further teaching if the client believes which is true about nutrition during pregnancy? 1. Iron supplements should be taken throughout pregnancy. 2. Calcium intake should be increased for the duration of the pregnancy. 3. Pregnancy greatly increases the risk of malnourishment for the mother. 4. The maternal diet significantly influences fetal growth and development.

3. Pregnancy greatly increases the risk of malnourishment for the mother.

The home care nurse is visiting a prenatal client who has a history of heart disease. The nurse provides instructions to the client regarding home care measures to promote a healthy pregnancy. Home care for this client should include which measure? 1. Increase daily calories to ensure weight gain. 2. Maintain a supine position during rest periods. 3. Restrict visitors who may have an active infection. 4. Avoid becoming concerned about placing stress on the heart.

3. Restrict visitors who may have an active infection.

A nurse is preparing a pregnant woman for a transvaginal ultrasound examination. The nurse should tell the woman that which will occur? 1. She will feel some pain during the procedure. 2. She will be placed in a supine left side-lying position. 3. She will feel some pressure when the vaginal probe is moved. 4. She will need to drink 2 quarts of water to attain a full bladder.

3. She will feel some pressure when the vaginal probe is moved.

A contraction stress test is scheduled for a pregnant woman, and she asks the nurse to describe the test. What should the nurse tell the woman? 1. Uterine contractions are stimulated by Leopold's maneuvers. 2. An external fetal monitor is attached, and the woman ambulates on a treadmill until contractions begin. 3. The uterus is stimulated to contract by the administration of small amounts of oxytocin (Pitocin) or by nipple stimulation. 4. Small amounts of oxytocin (Pitocin) are administered during internal fetal monitoring to stimulate uterine contractions.

3. The uterus is stimulated to contract by the administration of small amounts of oxytocin (Pitocin) or by nipple stimulation.

A woman in the third trimester of pregnancy with a diagnosis of mild preeclampsia is being monitored at home. The home care nurse teaches the woman about the signs that need to be reported to the health care provider. The nurse should tell the woman to call the health care provider if which occurs? 1. Urine tests negative for protein. 2. Fetal movements are more than four per hour. 3. Weight increases by more than 1 pound in a week. 4. The blood pressure reading is ranging between 122/80 and 132/88 mm Hg.

3. Weight increases by more than 1 pound in a week.

A nonstress test is prescribed for a pregnant client, and she asks the nurse about the procedure. How should the nurse respond? 1. "The test is a procedure that will require an informed consent to be signed." 2. "The test will take about 2 hours and will require close monitoring for 2 hours after the procedure is completed." 3. "The test is done to see if the baby can handle the stress of labor, and that medicine is given to make the uterus contract." 4. "A round, hard plastic disk called an ultrasound transducer picks up and marks the fetal heart activity on the recording paper and is secured over the abdomen."

4. "A round, hard plastic disk called an ultrasound transducer picks up and marks the fetal heart activity on the recording paper and is secured over the abdomen."

A 39-week-gestation pregnant client calls the maternity unit stating, "My baby has not moved very much in the past few days. Should I be concerned?" Which would be the best response made by the nurse? 1. "Six to eight fetal movements in a 24-hour period are adequate to determine that the fetus is healthy." 2. "Fetal movement is a sign of fetal health. Even if the amount has decreased, the fetus is still healthy." 3. "Continue to count fetal movements for the next 24 hours and call your health care provider if the number of movements continues to decrease." 4. "Fetal movements do not decrease as a woman nears term; therefore you should be seen by your health care provider for further evaluation.

4. "Fetal movements do not decrease as a woman nears term; therefore you should be seen by your health care provider for further evaluation."

The nurse in the prenatal clinic is taking a nutritional history from a 16-year-old pregnant adolescent. Which statement, if made by the adolescent, would alert the nurse to a potential psychosocial problem? 1. "I don't like dairy products." 2. "I will continue drinking my afternoon milkshake." 3. "I'm not used to eating so much food, but I will try." 4. "I only want to gain 10 pounds because I want to have a small, petite baby."

4. "I only want to gain 10 pounds because I want to have a small, petite baby."

The clinic nurse is providing instructions to a pregnant client regarding measures that assist in alleviating heartburn. Which statement by the client indicates an understanding of the instructions? 1. "I should avoid between-meal snacks." 2. "I should lie down for an hour after eating." 3. "I should use spices for cooking rather than using salt." 4. "I should avoid eating foods that produce gas and fatty foods."

4. "I should avoid eating foods that produce gas and fatty foods."

The nurse is providing instructions to a maternity client with a history of cardiac disease regarding appropriate dietary measures. Which statement, if made by the client, indicates an understanding of the information provided by the nurse? 1. "I should increase my sodium intake during pregnancy." 2. "I should lower my blood volume by limiting my fluids." 3. "I should maintain a low-calorie diet to prevent any weight gain." 4. "I should drink adequate fluids and increase my intake of high-fiber foods."

4. "I should drink adequate fluids and increase my intake of high-fiber foods."

A clinic nurse is instructing a pregnant client regarding dietary measures to promote a healthy pregnancy. The nurse tells the client about the importance of an adequate daily fluid intake. Which client statement best indicates an understanding of the daily fluid requirement? 1. "I should drink 12 glasses of fruit juices and milk every day." 2. "I should drink 8 to 10 glasses of fluid a day, and I can drink as many diet soft drinks as I want." 3. "I should drink 12 glasses of fluid a day, and I can include the coffee or tea that I drink in the count." 4. "I should drink at least 8 to 10 glasses of fluid each day, of which at least 6 glasses should be water."

4. "I should drink at least 8 to 10 glasses of fluid each day, of which at least 6 glasses should be water."

The nurse is teaching a woman in her first trimester measures to alleviate nausea and vomiting. Which statement by the woman would indicate that further teaching is required? 1. "I will avoid fried foods." 2. "I will eat five or six small meals a day." 3. "I will contact the clinic if the vomiting does not subside." 4. "I will eat dry crackers after arising out of bed in the morning."

4. "I will eat dry crackers after arising out of bed in the morning."

During a routine prenatal visit, a client complains of gums that bleed easily with brushing. The nurse performs an assessment and teaches the client about proper nutrition to minimize this problem. Which client statement indicates an understanding of the proper nutrition to minimize this problem? 1. "I will drink 8 oz of water with each meal." 2. "I will eat three servings of cracked wheat bread each day." 3. "I will eat two saltine crackers before I get up each morning." 4. "I will eat fresh fruits and vegetables for snacks and for dessert each day."

4. "I will eat fresh fruits and vegetables for snacks and for dessert each day."

A pregnant client who is anemic tells the nurse that she is concerned about her infant's condition after delivery. Which nursing response would best support the client? 1. "You should not worry about your baby's condition after the delivery because complications are rare." 2. "Your baby will probably need to spend a few days in the neonatal intensive care unit after delivery." 3. "You will not have any problems if you follow all the advice the health care provider has given you." 4. "The effects of anemia on your baby are difficult to predict, but let's review your plan of care to ensure you are providing the best nutrition and growth potential."

4. "The effects of anemia on your baby are difficult to predict, but let's review your plan of care to ensure you are providing the best nutrition and growth potential."

A client who has just been told that she is pregnant wants to know when the baby's heart will be completely developed and beating. The nurse reads in the client's chart that the health care provider has determined the client to be at 6 weeks' gestation. What is the nurse's best response? 1. "Your baby's heart right now consists of two parallel tubes, so we can't hear it today." 2. "Your baby's heart right now is beginning to partition into four chambers and has begun to beat, so we should be able to hear it with a Doppler." 3. "Your baby's heart right now is beginning to partition into four chambers and has begun to beat, so we should be able to hear it with a fetoscope." 4. "Your baby's heart right now has double heart chambers and has begun to beat, so we should be able to see it beat using an ultrasound machine."

4. "Your baby's heart right now has double heart chambers and has begun to beat, so we should be able to see it beat using an ultrasound machine."

The nurse is caring for a client with preeclampsia. The client is receiving an intravenous (IV) infusion of magnesium sulfate. When gathering items to be available for the client, which highest priority item should the nurse obtain? 1. Tongue blade 2. Percussion hammer 3. Potassium chloride injection 4. Calcium gluconate injection

4. Calcium gluconate injection

A client who is 8 weeks pregnant calls the prenatal clinic and tells the nurse that she is experiencing nausea and vomiting every morning. The nurse should suggest which measure that will best promote relief of the symptoms? 1. Eating a high-fat diet 2. Increasing fluids with meals 3. Eating a high-carbohydrate diet 4. Eating dry crackers before arising

4. Eating dry crackers before arising

The nurse in the prenatal clinic is conducting a session about nutrition to a group of adolescents who are pregnant. Which measure is most appropriate to teach these adolescents? 1. Eat only when hungry. 2. Eliminate snacks during the day. 3. Avoid meals in fast-food restaurants. 4. Monitor for appropriate weight gain patterns.

4. Monitor for appropriate weight gain patterns.

The nurse has provided instructions to a pregnant client who is preparing to take iron supplements. The nurse determines that the client understands the instructions if she states that she will take the supplements with which item? 1. Milk 2. Tea 3. Coffee 4. Orange juice

4. Orange juice

The clinic nurse is teaching a pregnant woman about the warning signs in pregnancy. Which, if identified as a warning sign by the woman, would indicate a need for further education? 1. Rapid weight gain 2. Visual disturbances 3. Generalized or facial edema 4. Presence of irregular painless contractions

4. Presence of irregular painless contractions

The nurse is instructing a pregnant client regarding measures to increase iron in the diet. The nurse should tell the client to consume which food that contains the highest source of dietary iron? 1. Milk 2. Potatoes 3. Cantaloupe 4. Whole-grain cereal

4. Whole-grain cereal

A maternity nurse should be aware of which fact about the amniotic fluid? A It serves as a source of oral fluid and as a repository for waste from the fetus. B The volume remains about the same throughout the term of a healthy pregnancy. C A volume of less than 300 mL is associated with gastrointestinal malformations. D A volume of more than 2 L is associated with fetal renal abnormalities.

A Amniotic fluid also cushions the fetus and helps maintain a constant body temperature. The volume of amniotic fluid changes constantly. Too little amniotic fluid (oligohydramnios) is associated with renal abnormalities. Too much amniotic fluid (hydramnios) is associated with gastrointestinal and other abnormalities.

With regard to dysfunctional uterine bleeding (DUB), the nurse should be aware that: A it is most commonly caused by anovulation. B it most often occurs in middle age. C the diagnosis of DUB should be the first considered for abnormal menstrual bleeding. D the most effective medical treatment involves steroids.

A Anovulation may occur because of hypothalamic dysfunction or polycystic ovary syndrome. DUB most often occurs when the menstrual cycle is being established or when it draws to a close at menopause. A diagnosis of DUB is made only after all other causes of abnormal menstrual bleeding have been ruled out. The most effective medical treatment is oral or intravenous estrogen.

During a client's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as the: A Hegar sign. B McDonald sign. C Chadwick sign. D Goodell sign.

A At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occur; this is called the Hegar sign. The McDonald sign indicates a fast-food restaurant. The Chadwick sign is a blue-violet cervix caused by increased vascularity; this occurs around the fourth week of gestation. Softening of the cervical tip is called the Goodell sign, which may be observed around the sixth week of pregnancy.

The CDC-recommended medication for the treatment of chlamydia would be: A doxycycline. B podofilox. C acyclovir. D penicillin.

A Doxycycline is effective for treating chlamydia, but it should be avoided if the woman is pregnant. Podofilox is a recommended treatment for nonpregnant women diagnosed with human papilloma virus infection. Acyclovir is recommended for genital herpes simplex virus infection. Penicillin is not a CDC-recommended medication for chlamydia; it is the preferred medication for syphilis.

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 Good protein sources such as meat, milk, eggs, and cheese have a lot of calcium and iron. Most women already eat a high-protein diet and do not need to increase their intake. Protein is sufficiently important that specific servings of meat and dairy are recommended. High-protein supplements are not recommended because they have been associated with an increased incidence of preterm births.

Bobby is a child with a respiratory disorder who needs bed rest but who is not cooperating. The nurse's best choice is to: a) Be sure Bobby's mother takes the advice seriously b) Allow Bobby to play quietly on the floor c) Insist that Bobby play quietly in bed d) Allow Bobby to cry until he stays in bed

Allow Bobby to play quietly on the floor

A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates an understanding of the nurse's instructions if she states that a positive sign of pregnancy is: A a positive pregnancy test. B fetal movement palpated by the nurse-midwife. C Braxton Hicks contractions. D quickening.

B Positive signs of pregnancy are those that are attributed to the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement. Braxton Hicks contractions are a probable sign of pregnancy. Quickening is a presumptive sign of pregnancy.

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how she should be gaining weight during pregnancy. The nurse's BEST response would be to tell the woman that her pattern of weight gain should be approximately: A a pound a week throughout pregnancy. B 2 to 5 lbs during the first trimester, then a pound each week until the end of pregnancy. C a pound a week during the first two trimesters, then 2 lbs per week during the third trimester. D a total of 25 to 35 lbs.

B A pound a week is not the correct guideline during pregnancy. A BMI of 22 represents a normal weight. Therefore, a total weight gain for pregnancy would be about 25 to 35 lbs or about 2 to 5 lbs in the first trimester and about 1 lb/wk during the second and third trimesters. These are not accurate guidelines for weight gain during pregnancy. The total is correct, but the pattern needs to be explained.

A pregnant woman experiencing nausea and vomiting should: A drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning. B eat small, frequent meals (every 2 to 3 hours). C increase her intake of high-fat foods to keep the stomach full and coated. D limit fluid intake throughout the day.

B A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the day or when nauseated. This is a correct suggestion for a woman experiencing nausea and vomiting. A pregnant woman experiencing nausea and vomiting should reduce her intake of fried foods and other fatty foods. A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the morning or when nauseated but should compensate by drinking fluids at other times.

When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should: A point out that inappropriate sexual behavior caused the infection. B position the woman in a semi-Fowler position. C explain to the woman that infertility is a likely outcome of this type of infection. D tell her that antibiotics need to be taken until pelvic pain is relieved.

B Although sexual behavior may have contributed to the infection, the nurse must discuss these practices in a nonjudgmental manner and provide information about prevention measures. The position of comfort is the semi-Fowler position. In addition, the foot of the bed could be elevated to keep the uterus in a dependent position and reduce discomfort. Until treatment is complete and healing has occurred, the outcome is unknown and should not be suggested. The nurse should emphasize that medication must be continued until follow-up assessment indicates that the infection has been treated successfully.

With regard to the diagnosis and management of amenorrhea, nurses should be aware that: A it probably is the result of a hormone deficiency that can be treated with medication. B it may be caused by stress or excessive exercise or both. C it likely will require the client to eat less and exercise more. D it often goes away on its own.

B Amenorrhea may be the result of a decrease in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This is usually caused by stress, body fat to lean ratio, and in rare occurrences a pituitary tumor. It cannot be treated by medication. Amenorrhea usually is the result of stress and/or an inappropriate ratio of body fat to lean tissue, possibly as a result of excessive exercise. Management includes counseling and education about the causes and possible lifestyle changes. In most cases a client will need to decrease her amount of exercise and increase her body weight in order to resume menstruation. Management of stress and eating disorders is usually necessary to manage this condition.

With regard to nutritional needs during lactation, a maternity nurse should be aware that: A the mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy. B caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful. C critical iron and folic acid levels must be maintained. D lactating women can go back to their prepregnant calorie intake.

B Vitamin C, zinc, and protein levels need to be moderately higher during lactation than during pregnancy. A lactating woman needs to avoid consuming too much caffeine. The recommendations for iron and folic acid are somewhat lower during lactation. Lactating women should consume about 500 kcal more than their prepregnancy intake, at least 1800 kcal daily overall.

Transdermal fentanyl (Duragesic) is being used for an adolescent with cancer who is in hospice care. The adolescent has been comfortable for several hours but now complains of severe pain. The most appropriate nursing action is to: A. administer meperidine IM. B. administer an immediate-release opioid IV. C. try a nonpharmacologic strategy. D. place another Duragesic patch on the adolescent.

B. administer an immediate-release opioid IV.

Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet? A Fat-soluble vitamins A and D B Water-soluble vitamins C and B6 C Iron and folate D Calcium and zinc

C Fat-soluble vitamins should be supplemented as a medical prescription, as vitamin D might be for lactose-intolerant women. Water-soluble vitamin C sometimes is consumed in excess naturally; vitamin B6 is prescribed only if the woman has a very poor diet. Iron generally should be supplemented, and folic acid supplements often are needed because folate is so important. Zinc sometimes is supplemented. Most women get enough calcium.

During the first trimester the pregnant woman would be most motivated to learn about: A fetal development. B impact of a new baby on family members. C measures to reduce nausea and fatigue so she can feel better. D location of childbirth preparation and breastfeeding classes.

C Fetal development concerns are more apparent in the second trimester when the woman is feeling fetal movement. Impact of a new baby on the family would be appropriate topics for the second trimester when the fetus becomes "real" as its movements are felt and its heartbeat heard. During this trimester a woman works on the task of, "I am going to have a baby." During the first trimester a woman is egocentric and concerned about how she feels. She is working on the task of accepting her pregnancy. Motivation to learn about childbirth techniques and breastfeeding is greatest for most women during the third trimester as the reality of impending birth and becoming a parent is accepted. A goal is to achieve a safe passage for herself and her baby.

An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's BEST response would be: A "This is normal behavior and should begin to subside by the second trimester." B "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know." C "This is called emotional liability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant." D "You seem impatient with her. Perhaps this is precipitating her behavior."

C Mood swings are a normal finding in the first trimester; the woman does not need counseling. This is the most appropriate response since it gives an explanation and a time frame for when the mood swings may stop. This statement is judgmental and not appropriate.

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily that:

The mother's presence will reduce anxiety and ease child's respiratory efforts.

The largest percentage of respiratory tract infections in children are caused by: a) Pneumococci b) Viruses c) Streptococci d) Haemophilus influenzae

Viruses

Asthma in infants is usually triggered by:

a viral infection

A school-age child is admitted in vasoocclusive sickle cell crisis. The child's care should include:

adequate hydration and pain management

An important nursing consideration when chest tubes will be removed from a child is to:

administer analgesics before procedure

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. The most appropriate nursing action to prevent or minimize these reactions with subsequent treatments is to:

administer antienemic before chemo

It is generally recommended that a child with acute streptococcal pharyngitis can return to school:

after taking antibiotics for 24 hours

Pain is best described as: a. a creation of a person's imagination b. an unpleasant subjective experience c. a maladaptive response to a stimulus d. a neurologic event resulting from activation of neuroreceptor

an unpleasant subjective experience

In which condition are all the formed elements of the blood simultaneously depressed?

aplastic anemia

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is ""too wet."" The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to:

apply direct pressure above cath site

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests:

asthma

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include:

avoid use >3 days

The primary nursing intervention to prevent bacterial endocarditis is to:

Counsel parents of high-risk children about prophylactic antibiotics.

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman would indicate a correct understanding of the test? A "I will need to have a full bladder for the test to be done accurately." B "I should have my husband drive me home after the test because I may be nauseous." C "This test will help to determine if the baby has Down syndrome or a neural tube defect." D "This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."

D An ultrasound is the test that requires a full bladder. An amniocentesis would be the test that a pregnant woman should be driven home afterward. A maternal alpha-fetoprotein test is used in conjunction with unconjugated estriol levels, and human chorionic gonadotropin helps to determine Down syndrome. The nonstress test is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring fetal heart rate in conjunction with fetal activity and movements.

A maternal serum alpha-fetoprotein (MSAFP) test is performed at 16 to 18 weeks of gestation. An elevated level has been associated with: A Down syndrome. B sickle cell anemia. C cardiac defects. D open neural tube defects such as spina bifida.

D Low levels of MSAFP are associated with Down syndrome. Sickle cell anemia is not detected by the MSAFP. Cardiac defects would not be detected with the MSAFP. A triple marker test determines the levels of MSAFP along with serum levels of estriol and human chorionic gonadotropin; an elevated level is associated with open neural tube defects.

The nurse suspects a child is having an adverse reaction to a blood transfusion. The first action by the nurse should be to: A. notify physician. B. take vital signs and blood pressure and compare them with baseline values. C. dilute infusing blood with equal amounts of normal saline. D. stop transfusion and maintain a patent intravenous line with normal saline and new tubing.

D. stop transfusion and maintain a patent intravenous line with normal saline and new tubing. * This is the priority nursing action. If an adverse reaction is occurring, it is essential to minimize the amount of blood that is infused.

Discharge instructions after tubal ligation should include: (Select all that apply.) A being prepared for significant mood swings due to hormonal influences. Incorrect B expecting heavier menstrual periods. C using two forms of birth control to prevent pregnancy. D not expecting change in sexual functioning; may enjoy more. Correct E using condoms to prevent sexually transmitted infections.

DE

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? Choose all that apply.

Encourage infant to drink 8 ounces of formula every 4 hours. AND Cluster care to encourage adequate rest.AND Place on noninvasive oxygen monitoring.

Which structural defects constitute tetralogy of Fallot?

Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of:

bronchitis

β-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action?

bronchodilators

A 2 year-old toddler is admitted with LTB. Which of the following observations would make you most concerned for this child: a. temp of 100.2 b. productive cough with yellow sputum c. frequent barking cough d. continually increasing respiratory rate

d. continually increasing respiratory rate

A nurse should teach the parents of a 1 year-old child with nasopharyngitis to call the physician if the child develops: a. yellow drainage, irritability and sneezing b. constipation, dry skin, and fever c. runny nose d. fever, irritability, and pulling on the ears

d. fever, irritability, and pulling on the ears

Which of the following drugs is usually given first in the emergency treatment of status asthmaticus in a young child: a. epi b. theophyllin c. another drug d. short acting b2 antagonist

d. short acting b2 antagonist

A beneficial effect of administering digoxin (Lanoxin) is that it:

dec edema

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)?

if it is present in child, both parents are carriers of the defective gene

which condition by the nurse would be an early warning sign for cancer?

masses felt like tumors

The earliest recognizable clinical manifestation(s) of cystic fibrosis (CF) is:

meconium ileus

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:

monitor pulse ox

Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vasoocclusive crisis?

painful swelling of hands and feet, painful joints

A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because it: A. liquefies secretions. B. improves oxygenation. C. promotes ventilation. D. soothes inflamed mucous membrane.

D. soothes inflamed mucous membrane.

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the MOST important? A Several glasses of fluid B Extra protein sources, such as peanut butter C Salty foods to replace lost sodium D Easily digested sources of carbohydrate

A If no medical or obstetric problems contraindicate physical activity, pregnant women should get 30 minutes of moderate physical exercise daily. Liberal amounts of fluid should be consumed before, during, and after exercise, because dehydration can trigger premature labor. Also the woman's calorie intake should be sufficient to meet the increased needs of pregnancy and the demands of exercise. All pregnant women should consume the necessary amount of protein in their diet, regardless of level of activity. Many pregnant women of this gestation tend to retain fluid. This may contribute to hypertension and swelling. An adequate fluid intake prior to and after exercise should be sufficient. The woman's calorie and carbohydrate intake should be sufficient to meet the increased needs of pregnancy and the demands of exercise.

What symptom described by a woman is characteristic of premenstrual syndrome (PMS)? A "I feel irritable and moody a week before my period is supposed to start." B "I have lower abdominal pain beginning the third day of my menstrual period." C "I have nausea and headaches after my period starts, and they last 2 to 3 days." D "I have abdominal bloating and breast pain after a couple days of my period."

A PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses. PMS begins in the luteal phase and resolves as menses occurs. It does not start after menses has begun. This complaint is associated with PMS. However, the timing reflected in this statement is inaccurate. PMS begins in the luteal phase and resolves as menses occurs. It does not start after menses has begun. Abdominal bloating and breast pain are likely to occur a few days prior to menses, not after it has begun.

When planning a diet with a pregnant woman, the nurse's FIRST action would be to: A review the woman's current dietary intake. B teach the woman about the food pyramid. C caution the woman to avoid large doses of vitamins, especially those that are fat-soluble. D instruct the woman to limit the intake of fatty foods.

A Reviewing the woman's dietary intake as the first step will help to establish if she has a balanced diet or if changes in the diet are required. These are correct actions on the part of the nurse, but the first action should be to assess the patient's current dietary pattern and practices since instruction should be geared to what she already knows and does.

Of the following children, the one who is most likely to be hospitalized for treatment of croup is: a) A 2 year old child whose croupy cough worsens at night b) A 5 year old child whose croupy cough worsens at night c) A 2 year old child using accessory muscles to breath d) A child with inspiratory stridor during the physical examination

A 2 year old child whose croupy cough worsens at night

RSV is: a) An uncommon virus that usually causes severe bronchiolitis b) An uncommon virus that usually does not require hospitalization c) A common virus that usually causes severe bronchiolitis d) A common virus that usually does not require hospitalization

A common virus that usually does not require hospitalization

When giving tips for how to increase humidity in the home of a child with a respiratory tract infection, the nurse should emphasize that the primary concern is to ensure that the child has: a) A steam vaporizer b) A warm humidification source c) A safe humidification source d) A cool humidification source

A safe humidification source

The parent of a child with cystic fibrosis calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic, because these symptoms are suggestive of: A. pneumothorax. B. bronchodilation. C. carbon dioxide retention. D. increased viscosity of sputum.

A. pneumothorax. * The child is exhibiting signs of increasing respiratory distress suggestive of a pneumothorax. The child needs to be seen as soon as possible.

Semen analysis is a common diagnostic procedure related to infertility. In instructing a male patient regarding this test, the nurse would tell him to: A ejaculate into a sterile container. B obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days C transport specimen with container packed in ice. D ensure that the specimen arrives at the laboratory within 30 minutes of ejaculation.

B

Asthma is now classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include all of the following except: a) Lung function b) Associated allergies c) Frequency of symptoms d) Frequency and severity of exacerbations

Associated allergies

What best describes the pattern of genetic transmission known as autosomal recessive inheritance? A Disorders in which the abnormal gene for the trait is expressed even when the other member of the pair is normal B Disorders in which both genes of a pair must be abnormal for the disorder to be expressed C Disorders in which a single gene controls the particular trait D Disorders in which the abnormal gene is carried on the X chromosome

B Autosomal dominant inheritance occurs when the abnormal gene for the trait is expressed, even when the other member of the pair is normal, such as Huntington disease or Marfan syndrome. An autosomal recessive inheritance disorder occurs when both genes of the pair are abnormal, such as phenylketonuria or sickle cell anemia. Disorders in which a single gene controls the particular trait describe the unifactorial inheritance. X-linked recessive inheritance occurs when the abnormal gene is carried on the X chromosome, such as hemophilia or Duchenne muscular dystrophy.

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be: A constipation. B alteration in the pattern of fetal movement. C heart palpitations. D edema in the ankles and feet at the end of the day.

B Constipation is a normal discomfort of pregnancy that occurs in the second and third trimesters. An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy. Heart palpitations are a normal change related to pregnancy. This is most likely to occur during the second and third trimesters. As the pregnancy progresses, edema in the ankles and feet at the end of the day is not uncommon.

What is an indicator for performing a contraction stress test? A Increased fetal movement and small for gestational age B Maternal diabetes mellitus and postmaturity C Adolescent pregnancy and poor prenatal care D History of preterm labor and intrauterine growth restriction

B Decreased fetal movement is an indicator for performing a contraction stress test; the size (small for gestational age) is not an indicator. Maternal diabetes mellitus and postmaturity are two indications for performing a contraction stress test. Although adolescent pregnancy and poor prenatal care are risk factors of poor fetal outcomes, they are not indicators for performing a contraction stress test. Intrauterine growth restriction is an indicator; but history of a previous stillbirth, not preterm labor, is the other indicator.

A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate? A "Many women imagine what their baby is like." B "A baby in utero does respond to the mother's voice." C "You'll need to ask the doctor if the baby can hear yet." D "Thinking that your baby hears will help you bond with the baby."

B Fetuses respond to sound by 24 weeks. The fetus can be soothed by the sound of the mother's voice. This statement is not appropriate. The mother should be instructed that her fetus can hear at 24 weeks and can respond to the sound of her voice. The statement is not appropriate. It gives the impression that her baby cannot hear her. It also belittles the mother's interpretation of her fetus's behaviors.

A pregnant woman at 7 weeks of gestation complains to her nurse midwife about frequent episodes of nausea during the day with occasional vomiting. She asks what she can do to feel better. The nurse midwife could suggest that the woman: A drink warm fluids with each of her meals. B eat a high-protein snack before going to bed. C keep crackers and peanut butter at her bedside to eat in the morning before getting out of bed. D schedule three meals and one midafternoon snack a day.

B Fluids should be taken between (not with) meals to provide for maximum nutrient uptake in the small intestine. A bedtime snack of slowly digested protein is especially important to prevent the occurrence of hypoglycemia during the night that would contribute to nausea. Dry carbohydrates such as plain toast or crackers are recommended before getting out of bed. Eating small, frequent meals (about five or six each day) with snacks helps to avoid a distended or empty stomach, both of which contribute to the development of nausea and vomiting.

If exhibited by an expectant father, what would be a warning sign of ineffective adaptation to his partner's first pregnancy? A Views pregnancy with pride as a confirmation of his virility B Consistently changes the subject when the topic of the fetus/newborn is raised C Expresses concern that he might faint at the birth of his baby D Experiences nausea and fatigue, along with his partner, during the first trimester

B Persistent refusal to talk about the fetus-newborn may be a sign of a problem and should be assessed further. This is an expected feeling for an expectant father. This is an expected finding with expectant fathers.

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? A Less audible heart sounds (S1 , S2 ) B Increased pulse rate C Increased blood pressure D Decreased red blood cell (RBC) production

B Splitting of S1 and S2 is more audible. Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term. In the first trimester blood pressure usually remains the same as the prepregnancy level, but it gradually decreases up to about 20 weeks of gestation. During the second trimester both the systolic and diastolic pressures decrease by about 5 to 10 mm Hg. Production of RBCs accelerates during pregnancy.

When assessing the fetal heart rate (FHR) of a woman at 30 weeks of gestation, the nurse counts a rate of 82 beats/min. Initially the nurse should: A recognize that the rate is within normal limits and record it. B assess the woman's radial pulse. C notify the physician. D allow the woman to hear the heartbeat.

B The expected FHR is 120 to 160 beats/min. The nurse may have inadvertently counted the uterine souffle, the beatlike sound of blood flowing through the uterine blood vessels, which corresponds to the mother's heartbeat. The physician should be notified if the FHR is confirmed to be 82 beats/min. Allow the woman to hear the heart beat as soon as a full assessment is made.

A married woman has made the decision to use a diaphragm as her primary method of birth control. The clinic nurse should provide which instructions regarding care of, insertion, and removal of the diaphragm? (Select all that apply.) A Remove the diaphragm by catching the rim from below the dome. B Avoid using mineral oil body products. C On insertion, direct the diaphragm down toward the space below cervix. D Wash diaphragm monthly with mild soap and water. E A dusting of cornstarch is appropriate after drying the diaphragm

BCDE

A 26-year-old woman is considering Depo-Provera as the form of contraception that is best for her since she does not like to worry about taking a pill every day. To assist this woman with decision making concerning this method of contraception, the nurse would tell her that Depo-Provera: A is a combination of progesterone and estrogen B is a small adhesive hormonal birth control patch that is applied weekly. C thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation D has an effectiveness rate in preventing pregnancy of 99% when used correctly.

C

The nurse should include questions regarding sexuality when gathering data for a reproductive health history of a female patient. Which principle should guide the nurse when interviewing the patient? A An in-depth exploration of specific sexual practices should be included for every patient. B Sexual histories are optional if the patient is not currently sexually active. C Misconceptions and inaccurate information expressed by the patient should be corrected promptly. D Questions regarding the patient's sexual relationship are unnecessary if she is monogamous.

C More in-depth assessments are required if the patient is sexually active or if problems or concerns are raised during general questions. Sexuality should be included on every reproductive health history whether or not the patient is sexually active. To obtain the most accurate reproductive health history, the nurse needs to correct misconceptions and inaccurate information. The relationship and sexual partner should be discussed even if the patient is monogamous.

Several noted health risks are associated with menopause. These risks include all except: A osteoporosis. B coronary heart disease. C breast cancer. D obesity.

C Osteoporosis is a major health problem in the United States. It is associated with an increase in hip and vertebral fractures in postmenopausal women. A woman's risk of developing and dying of cardiovascular disease increases significantly after menopause. Breast cancer may be associated with the use of hormone replacement therapy for women who have a family history of breast cancer. Women tend to become more sedentary in midlife. The metabolic rate decreases after menopause, which may require an adjustment in lifestyle and eating patterns.

A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she: A Wiggles and points her toes during the cramp. B Applies cold compresses to the affected leg. C Extends her leg and dorsiflexes her foot during the cramp. D Avoids weight bearing on the affected leg during the cramp.

C Pointing toes can aggravate rather than relieve the cramp. Application of heat is recommended. Extending the leg and dorsiflexing the foot is the appropriate relief for a leg cramp. Bearing weight on the affected leg can help to relieve the leg cramp, so it should not be avoided.

A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? A "We don't really know when such defects occur." B "It depends on what caused the defect." C "They occur between the third and fifth weeks of development." D "They usually occur in the first 2 weeks of development."

C Regardless of the cause, the heart is vulnerable during its period of development, the third to fifth weeks. The cardiovascular system is the first organ system to function in the developing human. Blood vessel and blood formation begins in the third week, and the heart is developmentally complete in the fifth week.

The student nurse is giving a presentation about milestones in embryonic development. Which information should he or she include? A At 8 weeks of gestation, primary lung and urethral buds appear. B At 12 weeks of gestation, the vagina is open or the testes are in position for descent into the scrotum. C At 20 weeks of age, the vernix caseosa and lanugo appear. D At 24 weeks of age, the skin is smooth, and subcutaneous fat is beginning to collect.

C The primary lung and urethral buds appear at 6 weeks of gestation. The vagina is open or the testes are in position for descent into the scrotum at 16 weeks. Two milestones that occur at 20 weeks are the appearance of the vernix caseosa and lanugo. The appearance of smooth skin occurs at 28 weeks, and subcutaneous fat begins to collect at 30 to 31 weeks.

Which hematocrit (Hct) and hemoglobin (Hgb) results represent(s) the lowest acceptable values for a woman in the third trimester of pregnancy? A 38% Hct; 14 g/dL Hgb B 35% Hct; 13 g/dL Hgb C 33% Hct; 11 g/dL Hgb D 32% Hct; 10.5 g/dL Hgb

C This is within normal limits in the nonpregnant woman. This is within normal limits for a nonpregnant woman. Represents the lowest acceptable value during the first and the third trimesters. This represents the lowest acceptable value for the second trimester when the hemodilution effect of blood volume expansion is at its peak.

The nurse is starting an intravenous line on a school-age child with cancer. The child says "I have had a million IVs. They hurt." The nurse's response should be based on knowledge that children: A. tolerate pain better than adults. B. become accustomed to painful procedures. C. often lie about experiencing pain. D. often demonstrate increased behavioral signs of discomfort with repeated painful procedures.

D. often demonstrate increased behavioral signs of discomfort with repeated painful procedures.

If exhibited by a pregnant woman, what represents a positive sign of pregnancy? A Morning sickness B Quickening C Positive pregnancy test D Fetal heartbeat auscultated with Doppler/fetoscope

D Morning sickness and quickening, along with amenorrhea and breast tenderness, are presumptive signs of pregnancy; subjective findings are suggestive but not diagnostic of pregnancy. Other probable signs include changes in integument, enlargement of the uterus, and Chadwick sign. A positive pregnancy test is still considered to be a probable sign of pregnancy (objective findings are more suggestive but not yet diagnostic of pregnancy) since error can occur in performing the test or in rare cases human chorionic gonadotropin (hCG) may be detected in the urine of nonpregnant women. Chances of error are less likely to occur today since pregnancy tests used are easy to perform and are very sensitive to the presence of the hCG associated with pregnancy. Detection of a fetal heartbeat, palpation of fetal movements and parts by an examiner, and detection of an embryo/fetus with sonographic examination would be positive signs diagnostic of pregnancy.

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse tells her: A "Because you're in your second trimester, there's no problem with having one drink with dinner." B "One drink every night is too much. One drink three times a week should be fine." C "Because you're in your second trimester, you can drink as much as you like." D "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

D Regardless of which trimester the woman has reached, no amount of alcohol during pregnancy has been deemed safe for the fetus. Neither one drink per night nor three drinks per week is a safe recommendation. Although the first trimester is a crucial period of fetal development, pregnant women of all gestations are counseled to eliminate all alcohol from their diet. A safe level of alcohol consumption during pregnancy has not yet been established. Although the consumption of occasional alcoholic beverages may not be harmful to the mother or her developing fetus, complete abstinence is strongly advised.

An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. The nurse should tell the couple that: A intercourse should be avoided if any spotting from the vagina occurs afterward. B intercourse is safe until the third trimester. C safer-sex practices should be used once the membranes rupture. D intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.

D Some spotting can normally occur as a result of the increased fragility and vascularity of the cervix and vagina during pregnancy. Intercourse can continue as long as the pregnancy is progressing normally. Safer-sex practices are always recommended; rupture of the membranes may require abstaining from intercourse. Uterine contractions that accompany orgasm can stimulate labor and would be problematic if the woman were at risk for or had a history of preterm labor.

When obtaining a reproductive health history from a female patient, the nurse should: A limit the time spent on exploration of intimate topics. B avoid asking questions that may embarrass the patient. C use only accepted medical terminology when referring to body parts and functions. D explain the purpose for the questions asked and how the information will be used.

D Sufficient time must be spent on gathering relevant data. All questions should be asked, even if it may be embarrassing for the patient or the nurse, or if it involves intimate topics. Always use terms the patient can understand. Explanation of the purpose for the questions asked while obtaining a reproductive health history will help to gather honest and relevant data.

Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)? A Radioimmunoassay B Radioreceptor assay C Latex agglutination test D Enzyme-linked immunosorbent assay (ELISA)

D The radioimmunoassay tests for the summit of hCG in serum or urine samples. This test must be performed in the laboratory. The radioreceptor assay is a serum test that measures the ability of a blood sample to inhibit the binding of hCG to receptors. The latex agglutination test in no way determines pregnancy. Rather, it is done to detect specific antigens and antibodies. OTC pregnancy tests use ELISA for its one-step, accurate results.

In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that: A a blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high. B shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. C the systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant. D compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the latter stage of term pregnancy.

D The tightness of a cuff that is too small produces a reading that is too high; similarly, the looseness of a cuff that is too large results in a reading that is too low. Because maternal positioning affects readings, blood pressure measurements should be obtained in the same arm and with the woman in the same position. The systolic blood pressure generally remains constant but may decline slightly as pregnancy advances. The diastolic blood pressure first drops and then gradually increases. This compression also leads to varicose veins in the legs and vulva.

When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that: A milk, coffee, and tea aid iron absorption if consumed at the same time as iron. B iron absorption is inhibited by a diet rich in vitamin C. C iron supplements are permissible for children in small doses. D constipation is common with iron supplements.

D These beverages inhibit iron absorption when consumed at the same time as iron. Vitamin C promotes iron absorption. Children who ingest iron can get very sick and even die. Constipation can be a problem.

A 4-year-old girl is brought to the emergency department. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. What should the nurse do? A. Examine her oral pharynx and report to the physician. B. Make her lie down and rest quietly. C. Auscultate her lungs and make preparations for placement in a mist tent. D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation. * Sitting upright, drooling, agitation, and a froglike cough are indicative of epiglottitis. This is a medical emergency and tracheostomy or intubation may be necessary.

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.