Final OB NCLEX questions
A 25-year-old client at 18 weeks' gestation has returned to the clinic for her second prenatal visit. Her initial pulse was 60. The nurse can expect her pulse to be _______ bpm at term.
70-75
A male client is having some problems with infertility, and is waiting for a report on his semen sample. The nurse knows that the problem might not be related to the pH level of the semen based on the following pH lab value: a. 5.5 b. 7.5 c. 6.5 d. 4.5
b
A nurse is caring for a client who has undergone female genital mutilation (FGM) some time ago as an adolescent. This woman has been admitted to the hospital to have her first child. Which childbirth complications are associated with infibulation? Select all that apply. a. Nonreassuring labor. b. Postpartum sepsis. c. Obstructed labor. d. Postpartum depression.
ALL correct
3. A nurse is assessing a prenatal client's cardiovascular function. When should the nurse expect this client's cardiac output (CO) to begin rising? a. 8-10 weeks. b. 12-18 weeks. c. 31-38 weeks. d. 20-24 weeks.
a
A 14-year-old girl and her mother go to her yearly checkup at the pediatrician's office. The nurse wants to offer a new vaccine against the human papilloma virus. Why is it important for the client to receive this vaccine?a. The human papilloma virus is associated with cervical dysplasia and cancer. b. There is only one type of human papilloma virus that infects the genital tract. c. The human papilloma virus is found exclusively in genital warts. d. The human papilloma virus is spread through casual contact in schools.
a
A 29-week pregnant woman presents to the clinic with complaints of itching that worsens at night. Upon examination, the client is found to have noticeable erythematous papular lesions. Which treatment option is best for this client? a. Permethrin 5%. b. Podofilox gel. c. Kwell cream. d. Lindane 1%.
a
A G3P0 client in active labor is admitted to the birthing center. Which data set should the nurse interpret as being within the normal range? (Hint: Provision of Care in the First Stage) a. Temperature 99.4°F and blood pressure 130/80. b. Temperature 98.6°F and pulse 56. c. Temperature 98.4°F and blood pressure 142/90. d. Temperature 99.8°F and pulse 88.
a
A Hmong client has just given birth to a 5-pound baby girl. What culturally sensitive nursing action is appropriate at this time? a. Offer the mother a soft-boiled egg to eat. b. Comment on the daintiness of her baby girl. c. Assist the mother in bathing the baby. d. Encourage the client to eat cold foods and drink cold fluids.
a
A client describes breast swelling and tenderness. What piece of data would be most important for the nurse to gather initially? a. Timing of the symptoms. b. Method of breast self-examination. c. Diet history. d. Birth control method.
a
A client reports breasts that "feel lumpy" when she performs breast self-exam, and she has an expressible nipple discharge. She asks the nurse if that means she has cancer. The best response by the nurse would be: a. "These findings are consistent with fibrocystic changes, but all nipple discharge should be evaluated." b. "Did you perform breast self-exam during the middle of the menstrual cycle?" c. "It is not a problem unless the discharge is bloody." d. "You will need to avoid caffeine to prevent these symptoms."
a
A client sees her physician about having a medical abortion. The client is currently 6 weeks pregnant. The client is given mifepristone in the office. The client is instructed to return in three days to complete the procedure. The nurse is teaching the client adverse signs to look for before returning in three days. Which signs must the client report back to the physician immediately? a. Diarrhea, fever, and weakness. b. Headache, stomach pain, and syncope. c. Nausea, diarrhea, and tachypnea. d. Tachycardia, stomach pain, and headache.
a
A client, admitted to the emergency room for a broken leg, confides to the nurse that her boyfriend pushed her down the stairs. The client asks the nurse, "Why would he be so cruel to me?" The nurse's best response would be: a. "Men who abuse women are insecure and feel powerless." b. "I bet this is a family trend for you. Were you battered as a child?" c. "I guess you did something to provoke him, and he overreacted." d. "Was your boyfriend drinking? Alcohol causes domestic violence."
a
A female client and her husband are exploring operative types of sterilization. The couple is now discussing the benefits of, and risks associated with, having a vasectomy. Which misconception about vasectomies needs to be clarified with the couple before their decision is made? a. Once the vasectomy procedure is complete, sterilization is immediately achieved. b. A couple is advised to use another form of birth control for about 4 to 6 weeks after the procedure. c. A vasectomy is a surgical procedure that severs the vas deferens in both sides of the scrotum. d. The man needs to be rechecked at 6 and 12 months to ensure that fertility has not been restored by recanalization.
a
A home care nurse is caring for four elderly female clients. The nurse is trying to determine which client is most at risk for becoming a victim of elder abuse. Which client is most at risk for abandonment as a form of elder abuse? a. An African American woman with cognitive impairment. b. An Asian woman with few financial resources. c. A Hispanic woman in poor health. d. A Caucasian woman who lives with an adult son.
a
A lesbian woman and her partner have a daughter after undergoing infertility treatment and artificial insemination. The lesbian's long-term partner wishes to be recognized as a parent as well for this child. How can this be accomplished? a. The partner can apply for a second-parent adoption. b. The partner can put herself down on the birth certificate in the United States. c. Being recognized as a legal parent of this child is not possible in the United States. d. Being recognized as a legal parent is possible once the child turns 1 year old.
a
A new nurse is learning about environmental hazards in the workplace and at home in nursing orientation. Which statement, if made by the new nurse, indicates the need for further teaching? a. "Radon, a naturally occurring radioactive gas, is the first leading cause of lung cancer, which kills more women than any other type of cancer, including breast." b. "Indoor air pollution poses the more serious threat to women's health, as most Americans spend 90% of their time indoors." c. "Air pollution is an environmental hazard caused by the release of toxins into the air." d. "Asthma, an increasingly common and serious problem in children, is worsened by most forms of indoor air pollution."
a
A newly married Catholic couple comes to the nurse in the family planning clinic. They are not yet ready to start a family but wish to abide by their religious beliefs. The nurse decides to teach the couple about natural family planning (NFP). Which statement, if made by the couple, would indicate the need for further teaching? a. "If we have intercourse during the fertile days, this is known as natural family planning." b. "Natural family planning does not involve the use of artificial substances or devices." c. "If we use natural family planning, it will also be useful in helping us to plan a pregnancy." d. "Natural family planning is free, safe, and acceptable according to our religion."
a
A nurse in the fertility clinic is teaching clients about the process of fertilization. Which statement by the client would not require further teaching by the nurse? a. "If the sperm plasma membrane is not removed (capacitation), the sperm will not be able to fertilize the ovum." b. "Testosterone in the semen helps to transport the sperm by increasing uterine smooth muscle contractions." c. "Transportation of the sperm to the fallopian tube takes an average of 12-24 hours after ejaculation." d. "Progesterone increases peristalsis in the fallopian tubes during ovulation, moving the ovum toward the uterus."
a
A nurse is reviewing a basal body temperature chart with a couple. Which change would indicate probable ovulation? a. Decrease in temperature followed by an increase for several days. b. Steadily increasing temperature over 7 days. c. Increase in temperature followed by a decrease for several days. d. Decrease in temperature that remains until menses begins.
a
A nurse is reviewing a client's record, and notices a physician's report of a malformation in one of the fallopian tubes. The nurse knows that the client is most at risk for: a. Ectopic pregnancy. b. Urinary tract infections. c. A decrease in estrogen levels. d. Early menopause.
a
A nurse is teaching psychosocial development to a group of adolescents. The nurse expects teens in which stage of adolescence to be most able to recognize STDs and pregnancy as risks of unprotected sex? a. Late adolescence. b. Preadolescence. c. Middle adolescence. d. Early adolescence.
a
A nurse is working with a pregnant teenager in the prenatal clinic. What would be the most important nursing action to help this teen meet the third-trimester developmental tasks of pregnancy? a. Assess the client for discomforts of pregnancy. b. Discuss continued education plans. c. Reassure the client that ambivalence is normal. d. Emphasize the need for good nutrition.
a
A nurse who keeps the childbearing woman informed of choices and includes family members while focusing on the specific goals of the individual childbearing woman is delivering care that is: a. Contemporary childbirth centered. b. Primary care. c. Culturally competent care. d. Collaborative practice.
a
A school nurse is teaching a group of high school boys about condom use. Which statement, if made by one of the students, indicates that further teaching is needed?a. "It is safest to withdraw my penis after it has become flaccid after ejaculation." b. "If the condom does not have a reservoir end, I still need to leave a little space at the tip." c. "I need to place the condom before initial contact with the vulva." d. "Since my girlfriend is allergic to latex, we cannot use a condom as a barrier method."
a
A woman presents to the gynecologic clinic with a case of pediculosis pubis. The clinic nurse teaches the client about the treatment for this disorder. Which statement, if made by the client, would indicate the need for further teaching? a. "Bed linens, towels, and clothing should be bagged up in a dark-colored bag for 30 days." b. "My partner and I should both be treated and tested for other sexually transmitted infections." c. "I cannot use lindane as the treatment since I am still nursing my baby." d. "Pediculosis pubis is also known as crabs."
a
In order to assess the origin of nipple discharge, the nurse must gather which of the following data? a. Color and consistency of discharge. b. Whether position dimpling is noticeable. c. Location of masses. d. Density of rash
a
The nurse assesses for complications of pregnancy in a 19-year-old client. Which of the following data might indicate a complication associated with adolescent pregnancy? a. Hypertension, proteinuria, edema. b. Large-for-gestational-age infant. c. Painless vaginal spotting. d. Bright red, painful vaginal bleeding.
a
The nurse in the prenatal clinic assesses a 26-year-old client at 13 weeks' gestation. Which presumptive (subjective) signs and symptoms of pregnancy should the nurse anticipate? a. Excessive fatigue and urinary frequency. b. Chadwick's sign and uterine souffle. c. Hegar's sign and quickening. d. Ballottement and positive pregnancy test.
a
The nurse is caring for four laboring clients at Stage 1 of labor. Which client is demonstrating responses commonly seen during the latent phase? a. A client who is happy and talkative. b. A client who has just delivered a healthy newborn. c. A client with increased fatigue, restlessness, and anxiety. d. A client with increased irritability and feeling out of control.
a
The nurse is planning a community program to decrease adolescent pregnancy. According to research, successful community teen pregnancy prevention programs use which approaches? a. Address societal issues of poverty and education. b. Programs are short-term due to limited teen attention span. c. Have a board of directors made up of community dignitaries. d. Focus on negative aspects of teen sexual behavior, pregnancy, and parenting.
a
The nurse researcher is gathering data about the types of rape. She is interviewing clients who were recently raped. A 65-year-old woman describes her rapist as extremely violent. She states that the rapist continually screamed, "This is what you get." The nurse researcher classifies this type of rape as: a. Anger rape. b. Sadistic rape. c. Acquaintance rape. d. Stranger rape.
a
The nurse's teaching plan for a rape prevention class should include which of the following regarding Flunitrazepam (Rohypnol)? a. Ingestion of the drug accelerates intoxication. b. White sediment develops in the drink laced with Rohypnol. c. After ingestion, the client may become hyperactive. d. Always smell your drinks, because adding the drug to a drink creates a citrus aroma.
a
Which of the following is important to include in a teaching plan presented to young girls to assist them in preventing toxic shock syndrome? a. Change tampons every 3-6 hours, and wash hands before insertion. b. Change pads every 1-2 hours, and wash hands after application. c. Change tampons every 6-8 hours, and wash hands before insertion. d. Change pads every 3-4 hours, and wash hands before application.
a
Which of the following lists the correct order of the four phases of the menstrual cycle? a. Menstrual, proliferative, secretory, ischemic. b. Menstrual, follicular, secretory, ischemic. c. Luteal, secretory, ischemic, follicular. d. Luteal, follicular, secretory, menstrual.
a
Which of the following statements made by a preteen girl indicates successful adaptation to menarche? a. "My cycle should occur every 28 days and last about 5 days." b. "My cycle should occur every 20 days and last about 3 days." c. "Super-absorbent tampons are the best for teenagers." d. "I won't need to wear protection on the last few days of my period."
a
A nurse is working with four clients desiring in vitro fertilization (IVF). Which clients would be good candidates for IVF? Select all that apply. a. The client with tubal blockage. b. The client whose husband has a very low sperm count. c. The client with immunological infertility. d. The client with absence of a uterus.
a, b
A nurse is evaluating the background of four teenagers. Which statements by the teens should the nurse recognize as psychosocial factors contributing to the risk of pregnancy for these teens? Select all that apply. a. "I just want someone to love me." b. "I'd leave my boyfriend, but I'm afraid of what he might do." c. "I have a hard time feeling good about myself." d. "I want a prescription for oral contraceptives."
a,b,c
A nurse is teaching a contraception class to a group of women and their partners. Which statements best describe the reasons women and couples choose to use contraception? Select all that apply. a. Couples use contraception to space future pregnancies. b. Couples use contraception to gain control over the number of children conceived. c. Couples use contraception to avoid a pregnancy. d. Couples use contraception to lose control over the number of children conceived.
a,b,c
An 18-year-old client states that she has not had her period for 9 months. Her menstrual cycle began when she was 13. The nurse asks about which of the following to help identify potential causes of secondary amenorrhea? Select all that apply. a. Diet and food habits. b. Medications. c. Exercise and activity patterns. d. Turner's syndrome.
a,b,c
The nurse is discussing treatment options for a woman with endometriosis. Which of the following will be important for the woman to consider in planning treatment with her physician? Select all that apply. a. Desire for future pregnancy. b. Toleration of drug side effects. c. Severity of symptoms. d. Number of previous pregnancies.
a,b,c
A newly pregnant mother wants to tell her employer that she is expecting a child, but is afraid to do so. The client is afraid that her boss may treat her differently when it becomes known that she is pregnant. The nurse, as part of her teaching to this client, knows that the client is entitled to certain rights as a result of the Pregnancy Discrimination Act of 1978. Which areas are covered under this act? Select all that apply. a. The same procedure for using sick-leave pay or disability benefits must be used for the pregnant woman as for other employees. b. The mother can use all her maternity benefits without penalty. c. A pregnant woman cannot be denied a job if she is able to perform major job functions. d. Employee medical coverage must include pregnancy benefits. e. Employee medical coverage does not need to include pregnancy benefits.
a,b,c,d
A school nurse is teaching a group of high school students about the importance of effective prevention and control of sexually transmitted infections. Which concepts support this initiative by the school nurse? Select all that apply. a. Expedited partner therapy (EPT), whereby partners are treated, recommended by the CDC. b. Identification of infected, asymptomatic individuals and of people with symptoms of STI who are not likely to seek diagnostic and treatment services. c. Effective diagnosis and treatment of people with an STI. d. Education and counseling for people at risk on ways to practice safer sexual behavior. e. Post-exposure vaccination of individuals at risk for vaccine-preventable STIs.
a,b,c,d
A nurse is educating a group of clients about the risk factors for developing toxic shock syndrome (TSS). Which of the following statements by a client would indicate that she understood the teaching on the risk factors of TSS? Select all that apply. a. "We should use a condom in place of my diaphragm during my period." b. "I should change my tampon every 3-6 hours during my period." c. "I should use superabsorbent tampons only at night during my period." d. "I should alternate using tampons and pads during my period."
a,b,d
A nurse is teaching a group of first-trimester prenatal clients about the discomforts of pregnancy. A client asks the nurse, "What causes my nausea and vomiting?" The nurse responds indicating which of the following as contributing factors to first-trimester emesis? Select all that apply. a. Alterations in carbohydrate metabolism. b. Elevated human chorionic gonadotropin. c. Prostaglandins .d. Alterations in taste and smell. e. Estrogen.
a,b,d
The nurse is writing a grant for an adolescent pregnancy prevention program. She needs to include factors that contribute to adolescent pregnancy. Select all that apply. a. Hispanic or African-American heritage. b. Poverty. c. Attending community college. d. Lack of adult supervision.
a,b,d
A 12-year-old girl presents to the emergency room and reports being raped by her stepfather. The emergency room nurse knows that the chain of evidence must be preserved. What are the uses of the evidence that the nurse collects? Select all that apply. a. Evidence is used to show that force or coercion was used. b. Evidence is used to identify the assailant. c. Evidence is used to determine the assailant's reason to rape. d. Evidence is used to confirm recent sexual contact. e. Evidence is used to corroborate the survivor's story.
a,b,d,e
A married woman presents to the clinic with complaints of grayish vaginal discharge with a "fishy" odor. Which of the following statements demonstrate that teaching regarding bacterial vaginosis (BV) has been understood? Select all that apply. a. "It is not necessary to treat my partner." b. "I should avoid Metronidazole gel during pregnancy." c. "BV is a sexually transmitted disease." d. "I should avoid alcohol consumption during treatment with Flagyl."
a,d
6. A nurse is teaching a class on the environmental factors affecting male fertility. Which factors should the nurse indicate that could reduce the sperm count? Select all that apply. a. Exposure to pesticides. b. Wearing briefs. c. The use of hot tubs. d. Cigarette smoking. e. Heavy use of marijuana, alcohol, or cocaine.
a,e
A nurse is teaching a client with a diagnosis of infertility secondary to endometriosis. Which medications should the nurse anticipate the physician ordering for the treatment of endometriosis? Select all that apply. a. Danazol (Danocrine). b. Progesterone. c. Menotropins. d. Oral hypoglycemia agents (metformin). e. Gonadotropin-releasing hormone (GnRH) agonists.
a,e
A client in the prenatal clinic tells the nurse that her sister has twins. The client is concerned that she also might have twins. The nurse's response is based upon her knowledge of which of the following facts? a. The survival rate of monozygotic twins is about 10% higher than that of dizygotic twins. b. Genetic factors in the mother can lead to elevated serum gonadotropin levels, causing double ovulation. c. Twinning occurs more often in Asian women. d. The chance of dizygotic twins decreases with maternal age up to about 35 years.
b
A home care nurse is assessing a client's home environment as part of the initial visit. The client is an 85-year-old Caucasian woman who is widowed. The client never had any children. The client worked sporadically throughout her life, but relies on her husband's social security benefits. Based upon the client's profile, which risk factor puts the client most at risk for being noncompliant with the treatment plan? a. Age. b. Financial status. c. Race. d. Marital status.
b
A laboring client complains of numbness of nose, fingers, and toes, and spots before her eyes. What should be the initial action by the nurse? a. Implement seizure precautions. b. Encourage slow, shallow breaths. c. Administer oxygen at 5 L per minute. d. Notify the physician or midwife.
b
A laboring client in the birthing center has a hematocrit of 49. The nurse should anticipate that this finding is related to: a. Anemia. b. Dehydration. c. Infection. d. Hemorrhage.
b
A nurse is caring for elderly clients in an assisted living facility. The vast majority of clients are widowed, poor, elderly women. The nurse knows this phenomenon as the feminization of later life. Which statement correctly depicts a factor that contributes to the economic vulnerability of older women? a. Older women tend to have more educational preparation than older men. b. Women typically earn less than men and often work in jobs without pension benefits or only limited benefits. c. Intermittent employment is less common in women and increases their social security and retirement benefits. d. Women generally have fewer family caregiving responsibilities than men.
b
A nurse is counseling a group of sexually active college-age women about the use of birth control pills. The pill would be contraindicated for a woman with: a. Oligomenorrhea. b. Gallbladder disease. c. Migraine headaches without visual disturbances. d. Epilepsy but with no recent seizures.
b
A nurse is instructing her students where to listen for a uterine souffle. Each student has placed the fetoscope on the pregnant woman's abdomen. Based on the following placements of the fetoscopes, the student most likely to hear a uterine souffle is the one who placed her fetoscope on which of the following area? a. Under the area of the umbilical cord of the fetus. b. Just above the symphysis pubis. c. Just below the symphysis pubis. d. Over the area of the umbilical cord of the fetus.
b
A nurse is planning a prenatal program for a group of adolescents. Which teaching techniques will be most appropriate for this age group? Select all that apply. a. Include infant growth and development content. b. Use a variety of teaching methods. c. Assign teaching content to the students. d. Hold separate academic classes for pregnant teens.
b
A nurse is researching the topic of edema during pregnancy. Which physiologic mechanism contributes to fluid retention? a. Decreased nitrogen retention. b. Increased level of steroid sex hormones. c. Decreased intracapillary pressure and permeability. d. Increased serum protein.
b
A pregnant client is concerned about a blow to the abdomen if she continues to play basketball during her pregnancy. The nurse's response is based upon her knowledge of which of the following facts concerning amniotic fluid? a. The fetus does not contribute to the production of amniotic fluid. b. Amniotic fluid functions as a cushion to protect against mechanical injury. c. Amniotic fluid is slightly acidic. d. The total amount of amniotic fluid during pregnancy is 300 mL.
b
At 17 weeks pregnant, a mother asks the nurse questions about the development of her baby. The mother states that it might be too early to visualize any body structures via ultrasound. The nurse's best response in relation to fetal development at 17 weeks is: a. "The earlobes are soft with little cartilage." b. "Differentiation of hard and soft palate can be seen." c. "Myelination of the spinal cord has occurred." d. "Hard tissue (enamel) for teeth has developed."
b
The nurse in the prenatal clinic is taking a history from a prenatal client at 7 weeks' gestation. The client states, "I don't know if I want this baby. How will I know if I'll be a good mother?" What is the most appropriate response by the nurse? a. "This is a sign of depression, and I'd like you to see a mental health specialist." b. "Ambivalence can be a normal reaction to parenthood in the first trimester." c. "This is an abnormal reaction, and I'd like you to speak with Family Services." d. "This would be the best time to consider an abortion or adoption."
b
The nurse is assessing the pH level of the vaginal environment of a 26-year-old client. Which of the following would be an expected finding for this client?a. pH level of 5.7 b. pH level of 4.6 c. pH level of 3.4 d. pH level of 6.9
b
The nurse is caring for a client in the transitional stage of labor. What objective physiologic data would indicate that the client is having pain? a. Muscle relaxation and decreased blood pressure. b. Dilated pupils and increased blood pressure. c. Constricted pupils and decreased blood pressure. d. Decreased respiration and decreased blood pressure.
b
The nurse is caring for a severely disabled pregnant woman. The client has not had any type of regular healthcare prior to this admission for preterm labor at 30 weeks. Which reason most likely contributed to the unplanned pregnancy in this client? a. The client has difficulty getting transportation to a doctor's office. b. The client was not given contraceptive counseling. c. The client was not given empathy by her physician. d. This client has difficulty getting up on an examination table.
b
The nurse is preparing an educational workshop on fetal development. Which statement by the student would require the nurse to explain further? a. "The high blood volume and Wharton's jelly content of the umbilical cord prevent compression of the cord." b. "The umbilical cord normally contains two veins and one artery." c. "The average cord length at term is 22 inches." d. "True knots are usually associated with a cord that is too long."
b
The nurse is preparing an educational workshop on the time frames for fetal exposure to potential teratogens. Which defect is most likely to occur at 7 weeks' gestation? a. A cleft lip. b. A cleft palate. c. Septal or aortic abnormalities. d. The shortening of fingers and toes.
b
The nurse is taking a neurologic health history from a female client who is concerned about symptoms of premenstrual syndrome. Which symptom should the nurse inquire? a. Edema. b. Vertigo. c. Acne. d. Urinary retention.
b
The nurse is teaching a couple about fertility during the female reproductive cycle. The couple asks the nurse, "When is the most fertile time for intercourse?" What is the best response by the nurse? a. During the luteal phase. b. 3-4 days before and after ovulation. c. During the follicular phase. d. 12-24 hours before and after ovulation.
b
The nurse is teaching a parenting class to prospective fathers. The nurse correctly teaches that couvade refers to the: a. Development of attachment and bonding behaviors in the father of the baby. b. Development of the physical symptoms of pregnancy in the father of the baby. c. Expectant father's transition from nonparent to parent. d. Expectant father's fear of hurting the unborn baby during intercourse.
b
Which nursing question would take priority for assessment of the coping and adjustment of a client with a newly diagnosed breast disorder? a. "What is your marital status?" b. "How do you usually cope with stress?" c. "Do you exercise regularly?" d. "What is your weekly intake of caffeine?"
b
Nurses should evaluate family response to teen pregnancy. Which of the following psychosocial factors should be included in the nursing assessment of the family because of their potential influence on family response to teen pregnancy? Select all that apply. a. Birth setting. b. Cultural and religious beliefs. c. Nutritional status. d. Educational and career level.
b,d
A G1P0 client at 39 weeks' gestation arrives at the birthing center with irregular contractions ranging from 10 to 30 minutes apart. Assessment reveals 1-2 cm cervical dilation, membranes intact, and a thick cervix. There are no complications. What treatment decision would the nurse expect at this time? a. The client will be admitted to the birthing center. b. The client will be started on hydration with IV fluids. c. The client will be sent home to ambulate. d. The client will be monitored with pelvic checks every hour.
c
A client at the family planning clinic is diagnosed with primary dysmenorrhea. Which of the following should be included in the nurse's teaching plan for nonpharmacological comfort measures? a. Application of cold to the abdomen. b. Initiation of oral contraception. c. Balanced meals and adequate rest. d. Regular emotional counseling.
c
A client comes to the free clinic with multiple bruises on her arms and chest. Her lip is swollen and one of her front teeth is missing. She denies domestic violence and claims to have fallen into the fireplace. Which response by the nurse is most appropriate? a. "I'm sure you did fall into the fireplace. Your injuries are not very life threatening." b. "You'll have no one to blame but yourself if you don't tell us the truth. This will happen again if you return home." c. "These signs are common among women who have been abused. We are trained to assist these women in finding a safe place to escape the abuse." d. "I know you've been abused. No one is fooled. Why not admit it?"
c
A client states that she had a spontaneous abortion 12 months ago. The client asks if her hormones might have contributed to the loss of the pregnancy. The nurse's response is based upon her knowledge of which of the following facts? a. The spontaneous abortion occurred at 16 weeks. b. The client's estrogen levels are too high. c. The client's hCG levels were not high enough to support the corpus luteum. d. Progesterone is produced only by the corpus luteum during pregnancy.
c
A married woman presents to the infertility clinic. She reports an inability to get pregnant again. She has no children, and a history of two ectopic pregnancies. The nurse can anticipate which test or workup to be ordered for this client? a. Endometrial biopsy. b. Huhner test. c. Hysterosalpingography. d. Basal body temperature recording.
c
A nurse is assessing a client with hepatitis. The nurse thinks the client may have hepatitis A but needs to collect objective assessment data before conferring with the physician. Which characteristics below support a diagnosis of hepatitis A? a. Malaise, rash, and fever. b. Nausea, vomiting, and rash. c. Jaundice, anorexia, and malaise. d. Jaundice, anorexia, and arthritis.
c
A nurse is explaining to a female client about the advantages and disadvantages of using an intrauterine device. Which of the following is a disadvantage of intrauterine devices? a. Non-coitus-related activity. b. Continuous contraceptive protection. c. Increased bleeding during menses. d. Expensiveness of the device.
c
A nurse is teaching a class about the female reproductive system. The nurse asks participants in the class to state the purpose of the labia minora. Which statement, by a participant, indicates that teaching has been effective? a. "The labia minora lubricate the vaginal vestibule and stimulate the release of hormones." b. "The labia minora secrete mucus with an alkaline pH that enhances the viability and motility of sperm." c. "The labia minora lubricate the vulvar skin and provide bactericidal secretions." d. "The labia minora secrete substances that enhance sexual stimulation."
c
A nurse is teaching a class on the anatomy of the reproductive system. A student states that she has pain during menstruation. The nurse knows that painful menstruations can be due to which of the following ligaments? a. Round ligament b. Broad ligament c. Uterosacral ligament d. Ovarian ligament
c
A nurse is teaching a client with infertility about the medication Clomid (clomiphene citrate). The nurse should instruct the client to report which side effect of Clomid to her health care provider? A. Hot flashes. b. Abdominal distention. c. Visual disturbances. d. Headaches.
c
A nurse is teaching a couple about the process of fertilization. Which statement by the couple would indicate understanding of fertilization? a. "Fertilization takes place in the fimbria, or outer third, of the fallopian tube." b. "Fertilization takes place in the uterine cavity." c. "Fertilization takes place in the ampulla, or outer third, of the fallopian tube." d. "Fertilization takes place in the isthmus, or inner third, of the fallopian tube."
c
A nurse practitioner is taking an initial history of a prenatal client. Which of the following, if detected by the nurse practitioner, would indicate a positive, or diagnostic, sign of pregnancy? a. Uterine enlargement and amenorrhea. b. Goodell's sign. c. Fetal heartbeat with a Doppler at 11 weeks' gestation. d. Positive pregnancy test.
c
A post-abortion 16-year-old female asks the nurse questions concerning birth control options prior to discharge. Which of the following legal or ethical issues are involved when this nurse answers questions concerning birth control for this client? a. Moral dilemma. b. Advance directives. c. Emancipated minor. d. Mature minor.
c
A school nurse is teaching a health class to a group of sophomore level girls. The nurse is teaching about the various types of barrier methods. In which instance would the use of a barrier method be indicated? a. A man who is using a condom. b. A woman who is at 38 weeks' gestation. c. A woman who is lactating. d. A man who underwent a vasectomy one year ago.
c
A woman who is two weeks postpartum presents to the emergency room (ER) with complaints of chills, a temperature of 104°F, right flank pain, nausea, vomiting, and general malaise. The ER nurse knows, based on these symptoms, that which of the following orders must be carried out first? a. Initiate bed rest. b. Administer ampicillin as ordered. c. Draw blood cultures. d. Administer Pyridium as ordered.
c
The client describes her male partner's behavior as intimidating and states that she is afraid of him. Which form of intimidation would most likely induce this fear in the client? a. Forbidding her to see her friends. b. The use of religious standards. c. A display of weapons. d. Making negative comments about her.
c
The individual ultimately responsible for obtaining an informed consent from the client prior to a cesarean section is the: a. Admitting nurse. b. Unit manager. c. Obstetrician. d. Staff nurse.
c
The nurse is teaching a class on infertility. The nurse describes infertility as: a. Difficulty conceiving because both partners have decreased fecundity. b. Women over 35 who are having difficulty conceiving. c. The lack of conception despite unprotected sexual intercourse for at least 12 months. d. An absolute factor preventing reproduction.
c
The nurse is working with a pregnant adolescent. The client is experiencing morning sickness, and has not been able to eat regular meals. What would be the priority nursing diagnosis? a. Self-esteem Disturbance. b. Ineffective Individual Coping. c. Altered Nutrition: Less Than Body Requirements. d. Alteration in Comfort.
c
The nurse must choose an appropriate location for, and a method of taking a sexual health history. Which of the following would be the best choice? a. Mailing a preprinted history form to the patient's residence. b. Giving the patient a preprinted history form and asking her partner to assist. c. An interview in the examination room with the door closed. d. An interview in the waiting room of the clinic.
c
There are four clients in the birthing center. Which client should the nurse encourage to ambulate? a. G2P1 with ruptured membranes and 0 engagement .b. G4P3 with ruptured membranes and 9 cm dilation. c. G3P2 with intact membranes and 4 cm dilation. d. G5P4 with intact membranes and 8 cm dilation.
c
Upon reviewing the client's chart, the nurse would communicate which of the following data to the physician in order to investigate endometriosis? a. Vaginal discharge and dysmenorrhea. b. Ovarian pain and dysuria. c. Pelvic cramping and dyspareunia. d. Back discomfort and dysphagia.
c
When the nurse asks a child's parents what they feel caused their newborn's illness, the nurse is recognizing the importance of the family's: a. Communication patterns. b. Religion. c. Cultural values and beliefs. d. Education.
c
Which disorder has lower-than-expected levels of alpha-fetoprotein (AFP). a. Multiple gestation. b. Anencephaly. c. Down syndrome. d. Open neural tube defects.
c
Which of the following nursing statements made to a 17-year-old pregnant client at the initial prenatal visit would be most effective in developing a trusting nurse-client relationship? a. "Tell me what caused you to get pregnant while still in high school." b. "We don't have room in the exam room for your mother. I'm sure you'll do fine." c. "Since this is your first pelvic exam, I'd like to explain what will be happening." d. "We'll have to weigh you each time so we'll know if you've been eating correctly."
c
A nurse is teaching a class for adolescents about the female reproductive system. When the nurse asks the class what the function of the vagina is, she knows that the class has understood when they answer which of the following? Select all that apply. a. "It's a passageway for menstrual flow." b. "It protects the labia minora." c. "It's a passageway for the sperm and the fetus." d. "It is highly sensitive and contributes to orgasm." e. "It protects against infections from pathogenic organisms."
c, a, e
A married couple is planning a pregnancy. She suffers from premenstrual syndrome, and asks the nurse which relief measure would be appropriate. What is the nurse's best response? Select all that apply. a. "Increase foods containing methylxanthine." b. 'Take low-dose oral contraceptives." c. "Increase intake of complex carbohydrates." d. "Zoloft." e. "Exercise."
c,e
8. During a discussion about the pelvic bony structure, a client relates that she has been told by her physician that she has a narrow pubic arch, and she wants to know how this might affect childbirth. The nurse's best response is: a. "The sacrococcygeal joint is flexible, and will allow passage of the fetal head through the outlet." b. "Giving birth in a squatting or sitting position will increase the diameter of the outlet enough to allow passage of the fetal head." c. "The hormones of pregnancy will relax the joint enough to allow passage of the fetal head through the pubic arch." d. "If the arch is too narrow for the head, it could result in the need for forceps or cesarean birth."
d
A 20-year-old female client has arrived at the clinic reporting painful urination and a fever. The nurse anticipates that a urine culture will be ordered. The rationale for this test is to: a. Detect red and white cells in urine. b. Confirm reports of dysuria. c. Rule out pregnancy as a cause of symptoms. d. Confirm cystitis so that treatment can prevent ascending infection.
d
A 20-year-old woman reports to the nurse about her menstrual flow. Which of the following statements made by the client would be cause for further investigation? a. "A panty liner is sufficient to contain my flow." b. "I always wear tampons, because they are easier to use." c. "I've saturated one tampon today." d. "I had to change my maxi pad at least 14 times today."
d
A G1P0 client calls the hospital and says to the nurse, "I think I am having labor pains. When should I come to the hospital?" The nurse correctly replies that the client should come in when her contractions are: a. 5-10 minutes apart for 30 minutes. b. 10-15 minutes apart for 1 hour. c. 6-8 minutes apart for 1 hour. d. 5 minutes apart for 1 hour.
d
A client presents to her obstetrician's office for her monthly checkup. This 24 weeks' gestation client is telling the nurse that she has been having a purulent, greenish-yellow discharge, urinary frequency, and painful urination. Which statement, if made by the nurse, is best in this situation? a. "You don't have to worry. It's only a minor infection and cannot harm your baby." b. "A vaginal birth is still recommended, and no prophylaxis is recommended for the baby at delivery." c. "Even if your baby becomes exposed to this infection, there are no health risks for the baby." d. "Your baby is protected by the presence of the mucous plug in your cervix until your membranes rupture."
d
A client tells the gynecologic nurse that she has been having a thick, white vaginal discharge, severe itching, and painful urination. Which of the following test results would correctly identify this type of infection as vulvovaginal candidiasis? a. Characteristic clue cells seen on a wet-mount preparation and leukocytes conspicuously absent. b. A vaginal pH of greater than 4.5. c. A strong, fishy odor when a 10% potassium hydroxide (KOH) solution is added to the vaginal secretions. d. A vaginal pH of less than 4.5 and observation of mycelia or pseudohyphae upon direct microscopy.
d
A low-risk client's vaginal exam reveals that her cervix is dilated to 8 cm with 75% effacement. How frequently should the nurse assess this client's blood pressure, pulse, and respirations? a. Every 5 minutes. b. Every 10 minutes. c. Every 15 minutes. d. Every 30 minutes.
d
A nurse gathers data on the number of families with small children that reside in housing units in a community with lead-based paint, which can cause serious health problems for exposed children. The nurse is using statistics in order to: a. Help establish databases for specific client populations. b. Evaluate the success of specific nursing interventions. c. Assess the relationship between specific factors. d. Determine populations at risk.
d
A nurse is teaching a prenatal client about cardiovascular changes during pregnancy. The client asks the nurse why she becomes dizzy when getting out of a chair or out of bed. What rationale should the nurse provide as to the cause of this dizziness during pregnancy? a. Decreased absorption of hemoglobin in the blood. b. Increased production of fibrinogen and plasma. c. Decreased production of estrogen and progesterone. d. Increased blood volume in the lower extremities.
d
A nurse is teaching an educational seminar about genetic disorders. The nurse correctly responds to a question about mosaicism by stating that individuals who have this chromosomal abnormality also can have which of the following? a. A congenital heart defect. b. Underdeveloped sex characteristics. c. Severe mental retardation. d. Normal intelligence.
d
A nurse who uses current research, statistical data, and quality measurements as a guide for nursing care is providing care that is: a. Based on personal opinion. b. Directed by habit. c. Derived from memory. d. Evidence-based.
d
A pregnant woman has been diagnosed with syphilis. Her symptoms include acute arthritis, skin eruptions on her vulva, and a chronic sore throat with hoarseness. Upon examination, the nurse finds the client to have an enlarged liver and spleen, condylomata lata, and non-tender,enlarged lymph nodes. Based on these signs and symptoms, which risk does this pose for her fetus?a. Postterm birth. b. Increased amniotic fluid level. c. Intrauterine growth promotion. d. Stillbirth.
d
A woman and her husband are speaking with the nurse about female sterilization. The client is scheduled to have a laparoscopic tubal ligation. Which of the following signs should the nurse alert this client to watch for after the procedure is completed? a. Syncope, hemorrhage, and orthostatic hypotension. b. Urinary retention, infection, and hemorrhage. c. Pain, dizziness, and fatigue .d. Pain, bowel perforation, and hemorrhage.
d
A woman presents to an obstetrician's office complaining that she and her husband have been trying to conceive for the past 6 months. The client's medical history is significant for diabetes, hypertension, migraine headaches, and pelvic inflammatory disease (PID). Which reason is most likely causing the client's infertility? a. Tubal damage from hyperglycemia. b. Tubal damage from migraine headaches. c. Tubal damage from hypertension. d. Tubal damage from PID.
d
A woman suspected of having been raped presents to the emergency room. Which statement, if made by the client, requires the need for further clarification and teaching by the nurse? a. "I didn't have anything to drink and my clothes were modest, so no one could accuse me of leading him on." b. "I thought he was a polite guy who was interested in me. Guess you can't be too careful because a rapist doesn't have any identifying characteristics." c. "I'm going to learn self-defense and fight back next time." d. "Because he just made me have oral sex I wasn't raped."
d
A young woman states that her menstrual cycle occurs every 20 days. What additional data should the nurse gather? a. Number of sexual partners. b. Type of protection used. c. Mother's age at menopause. d. The amount of flow per cycle.
d
An adolescent boy asks, "Does the scrotum have a function?" The nurse's best response is: a. "The scrotum is the source of ejaculation." b. "The scrotum is an insensitive structure that houses the testicles." c. "The scrotum maintains a higher temperature than the core body temperature." d. "The scrotum helps to protect the testes, and provides an ideal environment to create sperm."
d
An emergency room nurse is learning about postcoital emergency contraception (EC). Which client in the emergency room is eligible to receive this treatment? a. The client who was sexually abused by her stepfather two weeks ago. b. The client who had unprotected intercourse with her boyfriend 21 days ago. c. The client who is worried that her birth control method failed four weeks ago. d. The client who presents to the emergency room 2 days following a date rape.
d
During a pelvic exam, the nurse practitioner teaches the client about the function of the cervix. The nurse practitioner knows that teaching has been successful when the client states: a. "My cervix would be pale pink in color." b. "The cervix acts as a natural barrier against pregnancy." c. "My uterus protects the cervix from being punctured during sex." d. "Cervical mucus helps lubricate the vagina."
d
If an ethical dilemma regarding treatment arises in the care of a pregnant woman at 16 weeks' gestation, what factors will be considered in the decision-making process? a. The courts resolve all issues of maternal-fetal conflict. b. The rights of the fetus take precedence. c. The fetus is legally viewed as a nonperson. d. The rights of the mother are paramount.
d
The community health nurse discusses with a client how her husband makes her feel like a servant. The client states that her husband demands all childcare and housework be done completely by her with no help whatsoever from him. The nurse understands her next assessment questions should explore which type of abuse? a. Sexual abuse. b. Sociological abuse. c. Physical abuse. d. Psychologic abuse.
d
The nurse is caring for a client whose baby was just born with cerebral palsy. The nurse knows that this client is mourning for her baby's disability. Which type of disability best classifies the disability suffered by this client's infant? a. A sensory disability. b. A learning disability. c. A neurological disability. d. A developmental disability.
d
The nurse is researching the topic of uteroplacental blood flow. Which of the following accurately describes funic souffle? a. Increased blood pulsating through the placenta. b. Increased blood pulsating through the uterine arteries. c. A soft blowing sound of blood that is at the same rate as the maternal pulse. d. A soft blowing sound of blood that is at the same rate as the fetal heart rate.
d
The nurse obtains a health history from the following clients. To which one should she give priority in teaching about endometriosis? a. Age 14, prepubertal. b. Age 18, primary amenorrhea .c. Age 60, African-American, postmenopausal. d. Age 30, family history of infertility.
d
The nurse working on the sexual assault response team (SART) responds to a rape victim report in the emergency room. What will this nurse collect first when gathering medical and forensic data? a. Scrape under the victim's fingernails. b. Photograph any physical injuries. c. Mark clothing and seal in an airtight bag. d. Obtain a detailed history of the event.
d
The social worker has informed the community health nurse that a couple with a history of domestic violence is currently in the tension-building phase of the cycle of violence. Which situation is most likely to be assessed by the nurse during the home care visit? a. The woman states that leaving is not the solution. She has a sprained wrist. b. The male partner sent flowers and candy. He is loving and sorrowful of his actions. c. The home is disorderly. There is a large bruise under the woman's right eye, and her lip is swollen. d. The woman is hopeful that her acceptance of blame will diminish the violence.
d
When a nurse explains a procedure, the rationale for the procedure, and any associated risks to her patient, the nurse is protecting the patient's ethical right to: a. Privacy. b. Culturally competent care. c. Access to health care. d. Autonomy.
d
When a nurse follows a comprehensive interdisciplinary care plan for a specific condition that describes the sequence and timing of interventions that should result in expected patient outcomes, the nurse is using guidelines provided by: a. The scope of practice set forth in state statutes. b. Requirements set by HIPAA. c. Minimum standards of practice set by her specialty professional nursing organization. d. A clinical practice guideline adopted by her healthcare agency.
d
When asked if douching is appropriate, how should the nurse respond? a. "Douching is appropriate during the menstrual cycle only." b. "Douching adds to the cervical mucus plug and aids in bacteria prevention." c. "Scented douches are associated with relief of vaginal irritation." d. "Douching is associated with susceptibility to infection."
d
Which of the following factors influence the decrease in maternal mortality in the United States? Select all that apply. a. Use of a specialized antepartum maternity clinic. b. Home delivery. c. Delivery by a CNM. d. Availability of high-risk maternal-infant care centers.
d, a
A nurse is teaching a group of student nurses about amniotic fluid. Which of the following statements by a student nurse reflect an understanding of the fetus's contribution to the quality of amniotic fluid? Select all that apply. a. "Approximately 400 mL of amniotic fluid flows out of the fetal lungs each day." b. "A fetus can move freely and develop normally, even if there is no amniotic fluid." c. "The fetus swallows about 600 mL of the fluid in 24 hours." d. "Abnormalities in fetal urine production can affect amniotic fluid volumes." e. "The fetus contributes to the volume of amniotic fluid by excreting urine."
e, a, c, d
The nurse is working in a clinic in an economically depressed region. A lot of pregnant women utilize the services at this clinic. The nurse knows that prenatal care is especially important in this poor population. Why is it so important for these women to receive regular prenatal care? Select all that apply. a. Women who do not receive prenatal care are three times more likely to have high-birth-weight babies. b. Women who do not receive prenatal care are three times more likely to have low-birth-weight babies. c. Women who do not receive prenatal care are five times more likely to have low-birth-weight babies. d. A lack of prenatal care is a risk factor for infant morbidity and mortality. e. Women who receive adequate prenatal care are less likely to develop preterm labor.
e,b, d