M.N. Final

3. A nurse is reviewing discharge teaching with a client who has a urinary tract infection. Which of the following statements by the client indicates understanding of the teaching? (Select all that apply.) "I will perform peri care and apply a perineal pad in a back-to-front direction." "I will drink cranberry and prune juices to make my urine more acidic." "I will drink large amounts of fluids to flush the bacteria from my urinary tract." "I will go back to breastfeeding after I have finished taking the antibiotic." "I will take Tylenol for any discomfort."

"I will drink cranberry and prune juices to make my urine more acidic." "I will drink large amounts of fluids to flush the bacteria from my urinary tract." "I will take Tylenol for any discomfort."

Which of the following should the nurse include when teaching a client about the potential disadvantages of the minipill? (Select all that apply). -Amenorrhea -Irregular vaginal bleeding -Increased appetite -Lowered libido -Ovarian cysts

-Irregular vaginal bleeding -Increased appetite -Lowered libido -Ovarian cysts

5. A nurse is preparing to administer clindamycin hydrochloride (Cleocin) 600 mg IV intermittent bolus in 50 mL of 0.9% sodium chloride over 30 min. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number.)

100ml/hr

1. A nurse is preparing to administer betamethasone acetate and betamethasone sodium phosphate (Celestone Soluspan) 6 mg IM to a client who will undergo a cesarean birth due to premature rupture of membranes. Available is betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg suspension per mL. How many mL should the nurse administer? (Round the answer to the nearest whole number.)

2 mL

1. A nurse is conducting a home visit for a client who is 2 weeks postpartum and breastfeeding. The client reports breast engorgement. Which of the following recommendations should the nurse make? A. "Apply cold compresses between feedings." B. "Take a warm shower right after feedings." C. "Apply breast milk to the nipples and allow them to air dry." D. "Use the various infant positions for feedings."

A. "Apply cold compresses between feedings."

5. A nurse is reviewing postpartum nutrition needs with a group of new mothers who are breastfeeding their newborns. Which of the following statements by a member of the group requires clarification? A. "I am glad I can have my morning coffee." B. "I know that certain foods that I eat will affect my baby." C. "I will continue adding 330 calories per day to my diet." D. "I will continue my calcium supplements because I don't like milk."

A. "I am glad I can have my morning coffee."

4. A nurse in a clinic is caring for a client who is to be seen by the provider for a postoperative appointment following a salpingectomy due to an ectopic pregnancy. Which of the following statements by the client requires clarification? A. "It is good to know that I won't have a tubal pregnancy in the future." B. "The doctor said that this surgery can affect my ability to get pregnant again." C. "I understand that one of my fallopian tubes had to be removed." D. "Ovulation can still occur because my ovaries were not affected."

A. "It is good to know that I won't have a tubal pregnancy in the future."

5. A nurse educator in the labor and delivery unit is reviewing the use of chemical agents to promote cervical ripening with a group of newly hired nurses. Which of the following statements by a nurse indicates understanding of the teaching? A. "They are administered in an oral form." B. "They act by absorbing fluid from tissues." C. "They promote dilation of the os." D. "They include an amniotomy."

A. "They are administered in an oral form."

5. A nurse is caring for a client who is 1 hr following a vaginal birth and experiencing uncontrollable shaking. The nurse should understand that the shaking is due to which of the following? (Select all that apply.) A. A change in body fluids B. The metabolic effort of labor C. Diaphoresis D. A decrease in body temperature E. A decrease in prolactin levels

A. A change in body fluids B. The metabolic effort of labor

4. A nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. Which of the following is the first action the nurse should take? A. Assist the client into the left-lateral position. B. Apply a fetal scalp electrode. C. Insert an IV catheter. D. Perform a vaginal exam. 5. A nurse is performing Leopold maneuvers on a client who is in labor.

A. Assist the client into the left-lateral position.

3. A nurse is caring for a client who has a diagnosis of gonorrhea. Which of the following medications should the nurse anticipate the provider will prescribe? A. Ceftriaxone (Rocephin) B. Fluconazole (Diflucan) C. Metronidazole (Flagyl) D. Zidovudine (Retrovir)

A. Ceftriaxone (Rocephin)

3. A nurse is caring for a client who is 1 day postpartum. The nurse is assessing for maternal adaptation and mother-infant bonding. Which of the following behaviors by the client indicates a need for the nurse to intervene? (Select all that apply.) A. Demonstrates apathy when the infant cries B. Touches the infant and maintains close physical proximity C. Views the infant's behavior as uncooperative during diaper changing D. Identifies and relates infant's characteristics to those of family members E. Interprets the infant's behavior as meaningful and a way of expressing needs

A. Demonstrates apathy when the infant cries C. Views the infant's behavior as uncooperative during diaper changing

3. A nurse is caring for a postpartum client who delivered her third infant 2 days ago. The nurse recognizes that which of the following findings are suggestive of postpartum depression? (Select all that apply.) A. Fatigue B. Insomnia C. Euphoria D. Flat affect E. Crying

A. Fatigue B. Insomnia D. Flat affect E. Crying

2. A nurse is caring for a client who has been in labor for 12 hr, and her membranes are intact. The provider has decided to perform an amniotomy in an effort to facilitate the progress of labor. The nurse performs a vaginal examination to ensure which of the following prior to the performance of the amniotomy? A. Fetal engagement B. Fetal lie C. Fetal attitude D. Fetal position

A. Fetal engagement

4. A nurse is caring for a client who is in labor. The nurse is aware that which of the following conditions have medications that can be prescribed as prophylactic treatment during labor or immediately following delivery? (Select all that apply.) A. Gonorrhea B. Chlamydia C. HIV D. Group B Streptococcus ß-hemolytic E. TORCH

A. Gonorrhea B. Chlamydia C. HIV D. Group B Streptococcus ß-hemolytic

1. A nurse is caring for a postpartum client. The nurse should understand that which of the following findings are the earliest indication of hypovolemia caused by hemorrhage? A. Increasing pulse and decreasing blood pressure B. Dizziness and increasing respiratory rate C. Cool, clammy skin, and pale mucous membranes D. Altered mental status and level of consciousness

A. Increasing pulse and decreasing blood pressure

1. A nurse is caring for a client who is pregnant and states that her last menstrual period was April 1, 2013. Which of the following is the client's estimated date of delivery? A. Jan. 8, 2014 B. Jan. 15, 2014 C. Feb. 8, 2014 D. Feb. 15, 2014

A. Jan. 8, 2014

1. A nurse is caring for a client at 14 weeks of gestation who has hyperemesis gravidarum. The nurse is aware that which of the following are risk factors for the client? (Select all that apply.) A. Obesity B. Multifetal pregnancy C. Maternal age greater than 40 D. Migraine headache E. Oligohydramnios

A. Obesity B. Multifetal pregnancy D. Migraine headache

4. A nurse is caring for a newborn who is preterm and has respiratory distress syndrome. Which of the following should the nurse monitor to evaluate the newborn's condition following administration of synthetic surfactant? A. Oxygen saturation B. Body temperature C. Serum bilirubin D. Heart rate

A. Oxygen saturation

5. A nurse is caring for a client who has disseminated intravascular coagulation (DIC). Which of the following antepartum complications should the nurse understand is a risk factor for this client? A. Preeclampsia B. Thrombophlebitis C. Placenta previa D. Hyperemesis gravidarum

A. Preeclampsia

4. A nurse in the labor and delivery unit is caring for a client who is in the second stage of labor. The client's labor has been progressing, and she is expected to deliver vaginally in 20 min. The provider is preparing to administer lidocaine (Xylocaine) for pain relief and perform an episiotomy. The nurse should know that the type of regional anesthetic block that is to be administered is which of the following? A. Pudendal block B. Epidural block C. Spinal block D. Paracervical block

A. Pudendal block

4. A nurse is caring for a client who has mastitis. Which of the following is the typical causative agent of mastitis? A. Staphylococcus aureus B. Chlamydia trachomatis C. Klebsiella pneumonia D. Clostridium perfringens

A. Staphylococcus aureus

5. A nurse is preparing to bathe a newborn and observes a bluish marking across the newborn's lower back. The nurse should understand that this mark is A. frequently seen in newborns who have dark skin. B. a finding indicating hyperbilirubinemia. C. a forceps mark from an operative delivery. D. related to prolonged birth or trauma during delivery.

A. frequently seen in newborns who have dark skin.

4. A nurse is caring for a client who has a prescription for magnesium sulfate. The nurse should recognize that which of the following are contraindications for use of this medication. (Select all that apply.) Acute fetal distress Preterm labor Vaginal bleeding Cervical dilation greater than 6 cm Severe gestational hypertension

Acute fetal distress Vaginal bleeding Cervical dilation greater than 6 cm

4. A nurse is completing an assessment. Which of the following data indicate the newborn is adapting to extrauterine life? (Select all that apply.) Expiratory grunting Inspiratory nasal flaring Apnea for 10-second periods Obligatory nose breathing Crackles and wheezing

Apnea for 10-second periods Obligatory nose breathing

4. A nurse is completing postpartum discharge teaching to a client who had no immunity to varicella and was given varicella vaccine. Which of the following statements by the client indicates understanding of the teaching? A. "I will need to use contraception for 3 months before considering pregnancy." B. "I need a second vaccination at my postpartum visit." C. "I was given the vaccine because my baby is O-positive." D. "I will be tested in 3 months to see if I have developed immunity."

B. "I need a second vaccination at my postpartum visit."

1. A nurse in a health clinic is reviewing contraceptive use with a group of adolescent clients. Which of the following statements by an adolescent requires clarification? A. "A water-soluble lubricant should be used with condoms." B. "Spermicide is applied once when using a diaphragm." C. "Oral contraceptives can improve a case of acne." D. "A contraceptive patch is worn for a week."

B. "Spermicide is applied once when using a diaphragm." C. "Oral contraceptives can improve a case of acne." D. "A contraceptive patch is worn for a week."

4. A nurse is providing care to multiple clients on the postpartum unit. Which of the following clients is at greatest risk for developing a puerperal infection? A. Aclientwhohasanepisiotomythatiserythematousandhasextendedintoathird-degreelaceration B. A client who does not wash her hands between perineal care and breastfeeding C. A client who is not breastfeeding and is using measures to suppress lactation D. A client who has a cesarean incision that is well-approximated with no drainage

B. A client who does not wash her hands between perineal care and breastfeeding

1. A nurse in a clinic is caring for a group of female clients who are being evaluated for infertility. Which of the following clients should the nurse anticipate the provider will refer to a genetic counselor? A. A client whose sister has alopecia B. A client whose partner has von Willebrand disease C. A client who has an allergy to sulfa D. A client who had rubella 3 months ago

B. A client whose partner has von Willebrand disease

3. A nurse is caring for a newborn. Which of the following actions by the newborn indicates readiness to feed? A. Spits up clear mucus B. Attempts to place his hand in his mouth C. Turns his head toward sounds D. Lies quietly with his eyes open

B. Attempts to place his hand in his mouth

5. A nurse is caring for a newborn who has suspected neonatal abstinence syndrome. Which of the following findings supports this diagnosis? A. Decreased muscle tone B. Continuous high-pitched cry C. Sleeps for 2 hr after feeding D. Mild tremors when disturbed

B. Continuous high-pitched cry

3. A nurse is caring for a client who is receiving nifedipine (Procardia) for prevention of preterm labor. The nurse should monitor the client for which of the following clinical manifestations? A. Blood-tinged sputum B. Dizziness C. Pallor D. Somnolence

B. Dizziness

4. A nurse is caring for a client who is receiving oxytocin (Pitocin) for induction of labor and has an intrauterine pressure catheter (IUPC) placed to monitor uterine contractions. For which of the following contraction patterns should the nurse discontinue the infusion of oxytocin? A. Frequency of every 2 min B. Duration of 90 to 120 seconds C. Intensity of 60 to 90 mm Hg D. Resting tone of 15 mm Hg

B. Duration of 90 to 120 seconds

1. A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states she missed one menstrual cycle and cannot be pregnant because she has an intrauterine device. The nurse should suspect which of the following? A. Missed abortion B. Ectopic pregnancy C. Severe preeclampsia D. Hydatidiform mole

B. Ectopic pregnancy

3. A nurse is reviewing the health record of a client who is pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following would be included? (Select all that apply.) A. Montgomery's glands B. Goodell's sign C. Ballottement D. Chadwick's sign E. Quickening

B. Goodell's sign C. Ballottement D. Chadwick's sign

5. A nurse is reviewing the health record of a client who is to undergo hysterosalpingography. Which of the following data alert the nurse that the client is at risk for a complication related to this procedure? (Refer to the chart below.) CHAPTER 2 infeRtiLity A. Vital signs B. History and physical C. Laboratory findings D. Medications

B. History and physical

Which of the following techniques should the nurse use to identify the fetal lie? A. Apply palms of both hands to sides of uterus. B. Palpate the fundus of the uterus. C. Grasp lower uterine segment between thumb and fingers. D. Stand facing client's feet with fingertips outlining cephalic prominence.

B. Palpate the fundus of the uterus

3. A nurse is caring for a client who is in the transition phase of labor and reports that she needs to have a bowel movement with the peak of contractions. Which of the following is an appropriate nursing intervention? A. Assist the client to the bathroom. B. Prepare for an impending delivery. C. Prepare to remove a fecal impaction. D. Encourage the client to take deep, cleansing breaths.

B. Prepare for an impending delivery.

2. A nurse is caring for a client who is having an induction of labor. Based on the use of external electronic fetal monitoring, the nurse notes that the FHR variability is decreased and resembles a straight line. The client has not received pain medication. Which of the following should occur first before the nurse can apply an internal scalp electrode? A. Dilation B. Rupture of the membranes C. Effacement D. Engagement

B. Rupture of the membranes

2. A nurse is caring for a client who is in active labor. The client reports lower back pain. The nurse suspects that this pain is related to a persistent occiput posterior fetal position. Which of the following nonpharmacological nursing interventions is appropriate? A. Abdominal effleurage B. Sacral counterpressure C. Showering if not contraindicated D. Back rub and massage

B. Sacral counterpressure

3. A nurse is assessing a postpartum client for fundal height, location, and consistency. The fundus is found to be displaced laterally to the right, and there is uterine atony. Which of the following is the cause of the uterine atony? A. Poor involution B. Urinary retention C. Hemorrhage D. Infection

B. Urinary retention

5. A nurse is caring for a client who has suspected hyperemesis gravidarum and is reviewing the client's laboratory reports. Which of the following findings is a clinical manifestation of this condition? A. Hgb 12.2 g/dL B. Urine ketones present C. Alanine aminotransferase (ALT) 20 IU/L D. Serum glucose 114 mg/dL

B. Urine ketones present

1. A nurse is caring for a newborn who was born at 38 weeks of gestation, weighs 3,200 g, and is in the 60th percentile for weight. Based on the weight and gestational age, the nurse should classify this neonate as A. low birth weight. B. appropriate for gestational age. C. small for gestational age. D. large for gestational age.

B. appropriate for gestational age.

2. A client in the early postpartum period is very excited and talkative. She is repeatedly telling the nurse every detail of her labor and birth. Because the client will not stop talking, the nurse is having difficulty completing the postpartum assessments. The appropriate action by the nurse is to A. come back later when the client is more cooperative. B. give the client time to express her feelings. C. tell the client she needs to be quiet so the assessment can be completed. D. redirect the client's focus so that she will become quiet.

B. give the client time to express her feelings.

1. A nurse on the postpartum unit is caring for several clients. The nurse should recognize that the greatest risk for development of a postpartum infection is the client who A. experienced a precipitous labor less than 3 hr in duration. B. had premature rupture of membranes and prolonged labor. C. delivered a large for gestational age infant. D. had a boggy uterus that was not well-contracted.

B. had premature rupture of membranes and prolonged labor.

4. A home-health nurse is conducting a visit to the home of a client who has a 2-month-old infant and a 4-year-old son. The client expresses frustration about the behavior of the 4-year-old who was previously toilet trained and is now frequently wetting himself. The nurse should provide education and explains to the client that A. her son was probably not ready for toilet training and should wear training pants. B. her son is showing an adverse sibling response. C. this indicates the child requires counseling. D. this can be resolved by sending the child to preschool.

B. her son is showing an adverse sibling response.

3. A client experiences a large gush of fluid from her vagina while walking in the hallway of the birthing unit. The nurse's first nursing action after establishing that the fluid is amniotic fluid should be to A. assess the amniotic fluid for meconium. B. monitor the FHR for distress. C. dry the client and make her comfortable.

B. monitor the FHR for distress.

1. A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation between hypertonic contractions. The nurse recognizes the adverse effect of this contraction pattern is A. prolonged labor. B. reduced fetal oxygen supply. C. delayed cervical dilation. D. increased maternal stress.

B. reduced fetal oxygen supply.

2. A nurse is teaching a client who is breastfeeding and has mastitis. Which of the following is an appropriate statement by the nurse? A. "Limit the amount of time the infant nurses on each breast." B. "Nurse the infant only on the unaffected breast until resolved." C. "Completely empty each breast at each feeding or use a pump." D. "Wear a tight-fitting bra until lactation has ceased."

C. "Completely empty each breast at each feeding or use a pump."

4. A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements by the client requires clarification? A. "I will report cramping or signs of infection to the physician." B. "I should drink lots of fluids during the 24 hours following the procedure." C. "I need to have a full bladder at the time of the procedure." D. "The test is done to detect genetic abnormalities."

C. "I need to have a full bladder at the time of the procedure."

4. A nurse is reviewing a new prescription for ferrous sulfate with a client who is at 12 weeks of gestation. Which of the following statements by the client indicates understanding of the teaching? A. "I will take this pill with my breakfast." B. "I will take this medication with a glass of milk." C. "I plan to drink more orange juice while taking this pill." D. "I plan to add more calcium-rich foods to my diet while taking this medication."

C. "I plan to drink more orange juice while taking this pill."

3. A nurse is caring for a client following the administration of an epidural block and is preparing to administer a prescribed IV fluid bolus. The client's partner asks about the purpose of the IV fluids. Which of the following is an appropriate response by the nurse? A. "It is needed to promote increased urine output." B. "It is needed to counteract respiratory depression." C. "It is needed to counteract hypotension." D. "It is needed to prevent oligohydramnios."

C. "It is needed to counteract hypotension."

1. A nurse is caring for a client and her partner during the second stage of labor. The client's partner asks the nurse to explain how he will know when crowning occurs. Which of the following is an appropriate response by the nurse? A. "The placenta will protrude from the vagina." B. "Your partner will report a decrease in the intensity of contractions." C. "The vaginal area will bulge as the baby's head appears." D. "Your partner will report less rectal pressure."

C. "The vaginal area will bulge as the baby's head appears."

4. A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following is an appropriate response by the nurse? A. "This is due to an increase in blood volume." B. "This is due to pressure from the uterus on the diaphragm." C. "This is due to the weight of the uterus on the vena cava." D. "This is due to increased cardiac output."

C. "This is due to the weight of the uterus on the vena cava."

4. A nurse is caring for a newborn immediately following a circumcision using a Gomco procedure. Which of the following is an appropriate nursing intervention? A. Apply Gelfoam powder to the site. B. Place the newborn in the prone position. C. Apply petroleum gauze to the site. D. Avoid changing the diaper until the first voiding.

C. Apply petroleum gauze to the site.

5. A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time she sneezes or coughs. Which of the following should the nurse suggest? A. Performing sit-ups B. Performing pelvic tilt exercises C. Doing Kegel exercises D. Doing abdominal crunches

C. Doing Kegel exercises

1. A nurse is preparing to administer prophylactic eye ointment to a newborn to treat ophthalmia neonatorum. Which of the following medications should the nurse anticipate administering? A. Ofloxacin (Floxin) B. Nystatin (Mycostatin) C. Erythromycin (Romycin) D. Ceftriaxone (Rocephin)

C. Erythromycin (Romycin)

2. A newborn was not dried completely after delivery. The nurse should understand that which of the following mechanisms causes the newborn to lose heat? A. Conduction B. Convection C. Evaporation D. Radiation

C. Evaporation

2. A nurse is teaching a group of new parents about proper techniques for bottle feeding. Which of the following instructions should the nurse provide? A. Burp the newborn at the end of the feeding. B. Hold the newborn close in a supine position. C. Keep the nipple full of formula throughout the feeding. D. Refrigerate any unused formula.

C. Keep the nipple full of formula throughout the feeding.

5. A nurse is taking a newborn to a mother for breastfeeding. Which of the following is an appropriate action for the nurse to take for security purposes? A. Ask the mother to state her full name. B. Look at the name on the newborn's bassinet. C. Match the mother's identification band with the newborn's band. D. Compare name on the bassinet and room number.

C. Match the mother's identification band with the newborn's band.

4. A nurse is reviewing formula preparation with parents who plan to bottle feed their newborn. Which of the following should be included in the teaching? (Select all that apply.) A. Use a disinfectant wipe to clean the lid of the formula can. B. Store prepared formula in the refrigerator for up to 72 hr. C. Place used bottles in the dishwasher. D. Check the nipple for appropriate flow of formula. E. Use tap water to dilute concentrated formula.

C. Place used bottles in the dishwasher. D. Check the nipple for appropriate flow of formula. E. Use tap water to dilute concentrated formula.

3. A nurse is caring for client who had no prenatal care, is Rh-negative and will undergo an external version at 37 weeks of gestation. The nurse anticipates a prescription for which of the following medications to be administered prior to the version? A. Prostaglandin gel (Cervidil) B. Magnesium sulfate C. RhO(D) immune globulin (RhoGAM) D. Oxytocin (Pitocin)

C. RhO(D) immune globulin (RhoGAM)

2. A nurse is providing discharge instructions for a client. At 4 weeks postpartum, the client should contact her provider for which of the following client findings? A. Scant, nonodorous white vaginal discharge B. Uterine cramping during breastfeeding C. Sore nipple with cracks and fissures D. Decreased response with sexual activity

C. Sore nipple with cracks and fissures

3. A nurse is caring for an infant who has a high bilirubin level and is receiving phototherapy. Which of the following is the priority finding in this newborn? A. Conjunctivitis B. Bronze skin discoloration C. Sunken fontanels D. Maculopapular skin rash

C. Sunken fontanels

2. During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, a nurse finds the client's uterus to be firm and midline and at the level of the umbilicus. The nurse interprets this finding as A. evidence of a possible vaginal hematoma. B. an indication of a cervical or perineal laceration. C. a normal postural discharge of lochia. D. abnormally excessive lochia rubra flow.

C. a normal postural discharge of lochia.

5. A nurse is caring for a client who is in active labor and becomes nauseous and vomits. The client is very irritable and feels the urge to have a bowel movement. She states, "I've had enough. I can't do this anymore. I want to go home right now." The nurse knows that these signs indicate the client is in the A. second stage of labor. B. fourth stage of labor. C. transition phase of labor. D. latent phase of labor.

C. transition phase of labor.

3. A nurse on the postpartum unit is performing a physical assessment of a client who is being admitted with a suspected deep-vein thrombosis (DVT). Which of the following clinical findings should the nurse anticipate the client will exhibit? (Select all that apply.) Calf tenderness to palpation Swelling of the extremity Elevated temperature Area of warmth Report of nausea

Calf tenderness to palpation Swelling of the extremity Elevated temperature Area of warmth

2. A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy. The client's health record includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply.) Client has delivered one newborn at term. Client has experienced no preterm labor. Client has been through active labor. Client has had two prior pregnancies. Client has one living child.

Client has delivered one newborn at term. Client has had two prior pregnancies. Client has one living child.

2. A nurse is caring for a client who has postpartum depression. Which of the following are expected findings? (Select all that apply.) Disappointment in the characteristics of the infant Concerns about lack of income to pay bills Anxiety about assuming a new role as a mother Rapid decline in estrogen and progesterone Postpartum physical discomfort and/or pain

Concerns about lack of income to pay bills Anxiety about assuming a new role as a mother Rapid decline in estrogen and progesterone Postpartum physical discomfort and/or pain

3. A nurse is conducting a home visit with a client who is 3 months postpartum and breastfeeding. Menses has not yet resumed. The client is discussing contraception with the nurse, stating that she does not want to have another child for a couple of years. The nurse understands that this client needs further instruction if the client makes which of the following statements? A. "I have already started using the mini pill for protection." B. "Because of our beliefs, we are going to use the rhythm method." C. "I am being refitted for a diaphragm by my doctor next week." D. "I will begin using birth control when I stop breastfeeding."

D. "I will begin using birth control when I stop breastfeeding."

2. A nurse is providing discharge teaching to the parents of a newborn regarding circumcision care. Which of the following statements made by a parent indicates a need for further clarification? A. "His circumcision will heal within a couple of weeks." B. "I do not need to remove the yellow mucus that will form." C. "I will clean his penis with each diaper change." D. "I will give him a tub bath within a couple of days."

D. "I will give him a tub bath within a couple of days."

5. A nurse in a clinic receives a phone call from a client who believes she is pregnant and would like to be tested in the clinic to confirm her pregnancy. Which of the following information should the nurse provide to the client? A. "You should wait until 4 weeks after conception to be tested." B. "You should be off any medications for 24 hours prior to the test." C. "You should be NPO for at least 8 hours prior to the test." D. "You should collect urine from the first morning void."

D. "You should collect urine from the first morning void."

3. A nursing is caring for a client who is receiving IV magnesium sulfate. Which of the following medications should the nurse anticipate administering if magnesium sulfate toxicity is suspected? A. Nifedipine (Adalat) B. Pyridoxine (vitamin B6) C. Ferrous sulfate D. Calcium gluconate

D. Calcium gluconate

5. A nurse is reviewing breastfeeding positions with the mother of a newborn. Which of the following is an appropriate position for the nurse to discuss? A. Over-the-shoulder position B. Supine position C. Chin-supported position D. Cradle position

D. Cradle position

4. A nurse in labor and delivery is planning care for a newly admitted client who reports she is in labor and has been having vaginal bleeding for 2 weeks. Which of the following should the nurse include in the plan of care? A. Inspect the introitus for a prolapsed cord. B. Perform a test to identify the ferning pattern. C. Monitor station of the presenting part. D. Defer vaginal examinations.

D. Defer vaginal examinations.

2. A nurse is completing a newborn assessment and observes small white nodules on the roof of the newborn's mouth. This finding is a characteristic of which of the following conditions? A. Mongolian spots B. Milia spots C. Erythema toxicum D. Epstein's pearls

D. Epstein's pearls

5. A nurse is reviewing discharge teaching with a client who has premature rupture of membranes at 26 weeks of gestation. Which of the following should be included in the teaching? A. Use a condom with sexual intercourse. B. Avoid bubble bath solution when taking a tub bath. C. Wipe from the back to front when performing perineal hygiene. D. Keep a daily record of fetal kick counts.

D. Keep a daily record of fetal kick counts.

1. A nurse is reviewing care of the umbilical cord with the parent of a newborn. Which of the following should be included in the teaching? A. Cover the cord with a small gauze square. B. Trickle clean water over the cord with each diaper change. C. Apply hydrogen peroxide to the cord twice a day. D. Keep the diaper folded below the cord.

D. Keep the diaper folded below the cord.

4. A nurse on the postpartum unit is planning care for a client who has thrombophlebitis. Which of the following nursing interventions should the nurse include in the plan of care? A. Apply cold compresses to the affected extremity. B. Massage the affected extremity. C. Allow the client to ambulate. D. Measure leg circumferences.

D. Measure leg circumferences.

5. A nurse in the labor and delivery unit is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which of the following actions should the nurse take? A. Administer oxygen via nasal cannula at 2 L/min. B. Apply a warm blanket. C. Assist the client to a side-lying position. D. Place an oxygen mask over the client's nose and mouth.

D. Place an oxygen mask over the client's nose and mouth.

5. A nurse in the delivery room is planning to promote maternal-infant bonding for a client who just delivered. Which of the following is the priority action by the nurse? A. Encourage the parents to touch and explore the neonate's features. B. Limit noise and interruption in the delivery room. C. Place the neonate at the client's breast. D. Place the neonate skin-to-skin on the client's chest.

D. Place the neonate skin-to-skin on the client's chest.

1. A nurse concludes that the father of an infant is not showing positive signs of parent-infant bonding and appears to be very anxious and nervous when the infant's mother asks him to bring her the infant. Which of the following is an appropriate nursing intervention to promote father-infant bonding? A. Hand the father the infant, and suggest that he change the diaper. B. Ask the father why he is so anxious and nervous. C. Tell the father that he will grow accustomed to the infant. D. Provide education about infant care when the father is present.

D. Provide education about infant care when the father is present.

3. A nurse is reviewing the electronic monitor tracing of a client who is in active labor. The nurse knows that a fetus receives more oxygen when which of the following appears on the tracing? A. Peak of the uterine contraction B. Moderate variability C. FHR acceleration D. Relaxation between uterine contractions

D. Relaxation between uterine contractions

1. A nurse is giving instructions to a mother about how to breastfeed her newborn. Which of the following actions by the mother indicates understanding of the teaching? A. The mother places a few drops of water on her nipple before feeding. B. The mother gently removes her nipple from the infant's mouth to break the suction. C. When she is ready to breastfeed, the mother gently strokes the newborn's cheek with her finger. D. When latched on, the infant's nose, cheek, and chin are touching the breast.

D. When latched on, the infant's nose, cheek, and chin are touching the breast.

5. A nurse is caring for a client who is in the first stage of labor and encourages the client to void every 2 hr. The nurse explains that a A. full bladder increases the risk for fetal trauma. B. full bladder increases the risk for bladder infections. C. distended bladder will be traumatized by frequent pelvic exams. D. distended bladder reduces pelvic space needed for birth.

D. distended bladder reduces pelvic space needed for birth.

1. A nurse is assessing a postpartum client who is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown. The nurse knows these findings are characteristics of A. postpartum fatigue. B. postpartum psychosis. C. the letting-go phase. D. postpartum depression.

D. postpartum depression.

1. A nurse in the labor and delivery unit receives a phone call from a client who reports that her contractions started about 2 hr ago, did not go away when she had two glasses of water and rested, and became stronger since she started walking. Her contractions occur every 10 min and last about 30 seconds. She hasn't had any fluid leak from her vagina. However, she saw some blood when she wiped after voiding. Based on this report, the nurse should recognize that the client is experiencing A. Braxton Hicks contractions. B. rupture of membranes. C. fetal descent. D. true contractions.

D. true contractions

5. A nurse is caring for a client who is pregnant and is to undergo a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply.) Decreased fetal movement Intrauterine growth restriction (IUGR) Postmaturity Advanced maternal age Amniotic fluid emboli

Decreased fetal movement Intrauterine growth restriction (IUGR) Postmaturity Advanced maternal age

Which contraceptive method has the potential to decrease a client's bone mineral density? Depo Provera

Depo Provera has the potential for causing decreased bone density in clients. It is important to educate the client regarding dietary measures, such as adding calcium and vitamin D to her diet to decrease the likelihood of this occurring.

1. A nurse is caring for a client at 40 weeks of gestation who is experiencing contractions every 3 to 5 min and becoming stronger. A vaginal exam reveals that the client's cervix is 3 cm dilated, 80% effaced, and -1 station. The client asks for pain medication. Which of the following actions should the nurse take at this time? (Select all that apply.) Encourage the use of patterned breathing techniques. Insert an indwelling urinary catheter. Administer opioid analgesic medication as prescribed. Suggest application of cold. Provide ice chips.

Encourage the use of patterned breathing techniques. Administer opioid analgesic medication as prescribed. Suggest application of cold.

1. A nurse on the obstetrical unit is admitting a client who is in labor. The client has a positive HIV status. The nurse is aware that which of the following is contraindicated for this client? (Select all that apply.) Episiotomy Vacuum extraction Forceps Cesarean birth Internal fetal monitoring

Episiotomy Vacuum extraction Internal fetal monitoring

3. A nurse is assessing the reflexes of a newborn. In checking for the Moro reflex, the nurse should perform which of the following? Make a loud noise such as clapping hands together over the newborn's crib. Stimulate the pads of the newborn's hands with stroking or massage. Stimulate the soles of the newborn's feet on the outer lateral surface of each foot.

Hold the newborn in a semisitting position, then allow the newborn's head and trunk to fall backward.

2. A nurse in an antepartum clinic is providing care for a client. Which of the following clinical findings are suggestive of a TORCH infection? (Select all that apply.) Joint pain Malaise Rash Urinary frequency Tender lymph nodes

Joint pain Malaise Rash Tender lymph nodes

1. A nurse is called to the birthing room to assist with the assessment of a newborn who was born at 32 weeks of gestation. The newborn's birth weight is 1,100 g. Which of the following are expected findings in this newborn? (Select all that apply.) Lanugo Long nails Weak grasp reflex Translucent skin Plump face

Lanugo Weak grasp reflex Translucent skin

2. A nurse is caring for a client in the third stage of labor. Which of the following findings indicate that placental separation has occurred? (Select all that apply.) Lengthening of the umbilical cord. Swift gush of clear amniotic fluid. Softening of the lower uterine segment. Appearance of dark blood from the vagina. Fundus is firm upon palpation.

Lengthening of the umbilical cord. Appearance of dark blood from the vagina. Fundus is firm upon palpation.

1. A nurse is providing care for a client who is in active labor. Her cervix is dilated to 5 cm, and her membranes are intact. Based on the use of external electronic fetal monitoring, the nurse notes a FHR of 115 to 125/min with occasional increases up to 150 to 155/min that last for 25 seconds, and have beat-to-beat variability of 20/min. There is no slowing of FHR from the baseline. The nurse should recognize that this client is exhibiting signs of which of the following? (Select all that apply.) Moderate variability FHR accelerations FHR decelerations Normal baseline FHR Fetal tachycardia

Moderate variability FHR accelerations Normal baseline FHR

3. A nurse in an infertility clinic is providing care to a couple who has been unable to conceive for 18 months. Which of the following data should be included in the assessment? (Select all that apply.) Occupation Menstrual history Childhood infectious diseases History of falls Recent blood transfusions

Occupation Menstrual history Childhood infectious diseases

1. A nurse is caring for a client who is at 42 weeks of gestation and is admitted to the labor and delivery unit. During an ultrasound, it is noted that the fetus is large for gestational age. The nurse reviews the prescription from the provider to begin an amnioinfusion. The nurse should know that an amnioinfusion is indicated for which of the following reasons? (Select all that apply.) Oligohydramnios Hydramnios Fetal cord compression Hydration Fetal immaturity

Oligohydramnios Fetal cord compression

2. A nurse educator on the postpartum unit is reviewing risk factors for postpartum hemorrhage with a group of nurses. Which of the following should be included in the discussion? (Select all that apply.) Precipitous delivery Lacerations Inversion of the uterus Oligohydramnios Retained placental fragments

Precipitous delivery Lacerations Inversion of the uterus Retained placental fragments

A nurse is instructing a client who has been prescribed oral contraceptives about danger signs. The nurse evaluates that the client understands the teaching regarding side effects when she states the need to report A. reduced menstrual flow or amenorrhea. B. weight gain or breast tenderness. C. chest pain or shortness of breath. D. mild hypertension or headaches.

chest pain or shortness of breath