NUR 411 Final Exam Questions

A nurse is reviewing an article about preterm premature rupture of membranes. Which factors would the nurse expect to find placing a woman at high risk for this condition? Select all that apply.

urinary tract infection low socioeconomic status smoking

A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis?

vaginal odor smelling of fish

A woman in active labor has just had her membranes ruptured to speed up labor. The nurse is concerned the woman is experiencing a prolapse of the umbilical cord when the nurse notices which pattern on the fetal heart monitor?

variable deceleration pattern

The nurse is assessing a toddler and palpates a sausage-shaped mass in the upper mid abdomen. When taking the toddler's history, what question would the nurse ask the parent first?

"Has your toddler been having different colored stools?"

An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done?

"I always keep phenobarbital with me in case of a fever."

A nurse on the postpartum floor is conducting a class on danger signs for postpartum women after discharge. The nurse recognizes that further teaching is needed when a new mother makes which statement?

"I am breastfeeding so I can anticipate that there will be reddened, painful areas in my breasts when I am engorged."

The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education?

"I will use rubber pants over the cloth diapers in the future."

A nurse taking a health history from an adolescent female would become concerned about anorexia if the adolescent made which statement?

"I've been really tired lately, but I'm afraid that if I rest I will get fatter than I am already."

The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or during the birth for the infant. Which statement by the mother indicates that further teaching is needed by the nurse?

"If my blood sugars are elevated, my baby's lungs will mature faster, which is good."

A client is about 16 weeks' pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to this client's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. What should the nurse say in response?

"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

A nursing instructor teaching students how to check the client's uterus postpartum realizes that further instruction is needed when one of the students says:

"One to two hours after birth the fundus is typically at the level of the umbilicus."

A nurse is presenting a program to a church group about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because he has seen that phrase used in the media. Which of the following responses by the nurse would be most appropriate?

"People who grow up in violent home situations tend to be involved in domestic violence situations as an adult."

The nurse is teaching a prenatal class on potential problems during pregnancy to a group of expectant parents. The risk factors for placental abruption (abruptio placentae) are discussed. Which comment validates accurate learning by the parents?

"Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain."

A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize?

"Start taking the medication when you first get your period."

A hospitalized 4-year-old child reports having difficulty falling asleep at night due to a fear of monsters. How will the nurse respond?

"You sound scared. I will show you under the bed that there are no monsters."

The nurse is preparing to assess a client who is 1 day postpartum. The nurse predicts the client's fundus will be at which location on assessment?

1 cm below the umbilicus

The nurse is caring for four female clients, all prescribed oral contraceptive pills (OCPs). The nurse will question giving an oral contraceptive pill to which client?

37-year-old client who has migraines with aura several times a week and smokes

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply.

hemolysis elevated liver enzymes low platelet count

The nurse is caring for a child with sickle-cell anemia admitted to the pediatric unit. The child reports severe pain and fever. The nurse notes the following laboratory values: white blood cells 18,000/mm3, hemoglobin 6.6 mg/dl (66 g/L), and bilirubin 8 mg/dl (136.83 µmol/L). Which nursing action is priority?

Administer pain medication.

As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, what would the nurse do next?

Assess fetal heart rate for fetal safety.

During which time is the nurse correct to document the end of the third stage of labor?

At the time of placental delivery

A child being treated for leukemia is diagnosed with neutropenia. What nursing instructions directly prevent client infections? Select all that apply.

Avoid large crowds. Inspect the skin daily for scratches or scrapes. Remove house plants, flowers, and goldfish from the home environment. Stay away from people who have obvious colds, rashes, or other infections.

A nurse is caring for an infant. A serum blood sugar of 40 was noted at birth. What care should the nurse provide to this newborn?

Begin early feedings either by the breast or bottle.

A child has been prescribed desmopressin acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse?

Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output.

A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge?

Candidiasis

A 30-minute-old newborn starts crying in a high-pitched manner and cannot be consoled by the mother. Which action should the nurse prioritize if jitteriness is also noted and the infant is unable to breastfeed?

Check blood glucose.

The nurse is developing a presentation for a group of young adult women about premenstrual syndrome. Which treatment options should the nurse point out as most appropriate? Select all that apply.

Reduction of caffeine intake Vitamin and mineral supplements Diuretic therapy NSAIDs

Parents state they are "worn out" at their child's 6-month check-up because their child awakens each night and cries. The nurse suggests which measures?

Establish a quieting ritual before bed.

While assessing the progress of the labor, the nurse explains that the fetal heart rate variability is moderate. Which explanation is best to use with the parents?

FHR fluctuates from 6 to 25 beats per minute.

A nurse is caring for a breastfeeding client who reports engorgement. The nurse identifies that the client's condition is due to not fully emptying her breasts at each feeding. Which suggestion should the nurse make to help her prevent engorgement?

Feed the baby at least every two or three hours.

A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority?

Have the client void, and then massage the fundus until it is firm.

Which assessment on the third postpartum day would indicate to the nurse that a woman is experiencing uterine subinvolution?

Her uterus is at the level of the umbilicus.

A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. Which intervention should the nurse take initially?

Institute droplet precautions in addition to standard precautions.

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?

Regular insulin

Which of the following would the nurse expect a woman with dysmenorrhea to report?

Intermittent sharp suprapubic pain

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case?

Intussusception

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?

Irritability, fever, and vomiting

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis?

Maculopapular on hands and feet and flu-like symptoms

There are no diagnostic tests to reliably determine the existence of premenstrual disorder.

TRUE

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client?

oral contraceptive pills (OCPs)

The nurse is caring for a child with thickened pulmonary secretions. Which action(s) would the nurse use to assist the child breathe with less effort? Select all that apply

Perform chest physiotherapy Encourage oral fluids

Within three days of birth, a newborn has developed a yellowish tinge that extends from face to mid-chest, is lethargic, and has to be awoken to feed. Which condition does the nurse suspect this infant is manifesting?

Physiologic jaundice.

A nurse is giving discharge instructions to the parents of a newborn with a congenital heart disorder. What should the nurse instruct the parents to do in the event that the child becomes cyanotic?

Place him in a knee-chest position

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between placental abruption (abruptio placentae) and placenta previa. Which statement will the nurse include in the teaching?

Placenta previa is an abnormally implanted placenta that is too close to the cervix.

A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take?

Provide instruction on how to care for a diaper rash.

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which of the following as most helpful in determining the extent of the child's hypoxia?

Pulse oximetry

A young child has just been admitted to the emergency department with a burn that encompasses the epidermis and the underlying dermis. From which type of burn does this child suffer?

Second-degree or partial-thickness burn

A nurse is caring for a postpartum client who has been treated for deep vein thrombosis (DVT). Which prescription would the nurse question?

Take an oral contraceptive pill daily.

During a routine prenatal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse take next?

Tell the woman that this is entirely normal.

The nurse is assessing an 8-year-old boy who is performing academically at a second-grade level. The mother reports that the boy states feeling weak and tired and has had a weight increase of 6 pounds (13.2 kg) in 3 months. Which additional data would fit with a possible diagnosis of hypothyroidism?

The child states that the exam room is cold.

In caring for a child with sickle cell disease, the highest priority goal is:

The child's fluid intake will improve.

A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor?

The client reports back pain, and the cervix is effacing and dilating.

To feed lunch to a child with autism spectrum disorder (ASD), which action would be most important for the nurse to take?

Use a repetitive series of movements.

The nurse notes the fetal heart rate has slowed in a woman in labor at 8 cm dilation (dilatation). Assessment reveals a prolapsed umbilical cord. Which action should the nurse prioritize?

Use fingers to press upward on the presenting part.

A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant?

Use the crib for sleeping only, not for play activities.

The nurse discovers that the FHM is now recording late decelerations in a client who is in labor. The nurse predicts this is most likely related to which event?

Uteroplacental insufficiency

The nurse is caring for a child with a history of cystic fibrosis (CF). Which finding will the nurse report to the primary health care provider?

Wheezing

The nurse is caring for a child with a suspected head injury. The nurse observes for what response to the child's eye reflex examination that would indicate potential increased intracranial pressure (ICP)?

While assessing the child's pupils, there is no change in diameter in response to a light.

A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth?

oxytocin

The nurse is teaching a prenatal class and illustrating some of the basic events that will happen right after the birth. The nurse should point out which action will best help the infant maintain an adequate body temperature?

Wrap the infant in a warm, dry blanket.

An adolescent has been diagnosed with oppositional defiant disorder. Which symptom does the nurse anticipate?

angry outbursts directed at authority figures

Which intervention would be helpful to a bottle-feeding client who's experiencing hard or engorged breasts?

applying ice

In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder?

asthma

The nurse is teaching a young couple who desire to start their family the various methods for determining fertility. After discovering the woman regularly travels internationally for work, deals with a lot of job anxiety, and frequently uses an electric blanket at home, the nurse will discourage the use of which method?

basal body temperature method

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?

burning on urination

Various medications are available to help control hemorrhage in the postpartum client. When reviewing the client's history, the nurse notes the client's history of asthma. Which medication if prescribed would the nurse question?

carboprost

A specialty nurse working in the OB-GYN clinic cares for pregnant women who have been diagnosed with cancer during the pregnancy. The most common cancer in the pregnant population in regards to reproductive malignancies is which of the following?

cervical cancer

A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely?

chancres at the vaginal site

A newborn's axillary temperature is 97.6° F (36.4° C). He has a cap on his head. His T-shirt is damp with spit-up milk. His blanket is laid over him, and several children are in the room running around his bassinet. The room is comfortably warm, and the bassinet is beside the mother's bed away from the window and doors. What are the most likely mechanisms of heat loss for this newborn?

convection and evaporation

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication?

deep vein thrombosis

A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia?

diabetes

A 5-year-old child is brought to the clinic by his father because the child developed a high fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs and symptoms? Select all that apply.

difficulty speaking drooling sitting with neck extended frightened appearance

When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation?

effacement

A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP?

elevated lipoproteins

A nurse is developing a plan of care for a postpartum woman with superficial venous thrombosis of the left leg. Which intervention would the nurse most likely include?

encouraging elevation of the left leg

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?

endometriosis

When caring for a 7-year-old client diagnosed with sickle cell anemia, which clinical manifestation will the nurse report to the health care provider first?

facial droop

A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment?

fluconazole

A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client?

fluid replacement

The nurse is caring for a 14-year-old girl who fears she might have a sexually transmitted infection (STI). What would the nurse expect to assess if the adolescent has trichomoniasis?

green vaginal discharge

A nurse is analyzing a journal article that explains the changes at birth from fetal to newborn circulation. The nurse can point out the closure of the ductus arteriosus is related to which event after completing the article?

higher oxygen content of the circulating blood

What is a consequence of hypothermia in a newborn?

holds breath 25 seconds

An obese woman with diabetes has just given birth to a term, large-for-gestational-age (LGA) newborn. Which condition should the nurse most expect to find in this infant?

hypoglycemia

The nurse is teaching a prenatal class on the difference between true and false labor contractions. The nurse determines the session is successful when the class correctly chooses which factor as an indication of true labor contraction?

increase even if relaxing and taking a shower

A nurse is teaching a group of parents about possible signs and symptoms of respiratory disorders. The nurse emphasizes that early detection is important in preventing more serious problems. The nurse determines that the teaching was successful when the group identifies which sign as often the first sign of a respiratory illness?

increased respirations

A nurse sees a pregnant client at the clinic. The client is close to her due date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?

increased risk of infection

The nurse is providing care at a local clinic that treats children with hemophilia. The nurse understands that if bleeding is not treated effectively, the children are at high risk for development of chronic disabling disease involving the:

joints.

The nurse is monitoring a client who is in labor and notes the client is happy, cheerful, and "ready to see the baby." The nurse interprets this to mean the client is in which stage or phase of labor?

latent

A new mother who is breastfeeding reports that her right breast is very hard, tender, and painful. Upon examination the nurse notices several nodules and the breast feels very warm to the touch. What do these findings indicate to the nurse?

mastitis

A nurse is working in a local community health care facility where many clients are victims of intimate partner violence. For which signs should the nurse assess to determine if a client is a victim? Select all that apply.

mental health problems such as depression, anxiety, or substance use disorder injuries on the face, head, and neck reported history of the injury inconsistent with the presenting problem

A pregnant woman at 37 weeks' gestation calls the clinic to say she thinks that she is in labor. The nurse instructs the woman to go to the health care facility based on the client's report of contractions that are:

occurring about every 5 minutes.

A woman who gave birth to a healthy baby 5 days ago is experiencing fatigue and weepiness, lasting for short periods each day. Which condition does the nurse believe is causing this experience?

postpartum baby blues

At the 6-week visit following delivery of her infant, a postpartum client reports extreme fatigue, feelings of sadness and anxiety, and insomnia. Based on these assessment findings, the nurse documents that the client is exhibiting characteristics of:

postpartum depression.

A client's menstrual period is two weeks late. She has been feeling tired and has had episodes of nausea in the morning. What classification of pregnancy symptoms is this client experiencing?

presumptive

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are:

prolactin and oxytocin

A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation (dilatation) and enlargement of the birth canal. What is this hormone?

relaxin

The nurse is monitoring a pregnant client and notes: contractions causing urge to push, strong intensity, cervix 10 cm, 100% effaced, fetal head crowns when client pushes. The nurse determines the client is currently in which stage or phase of labor?

second

When assessing the growth and development of a 4-year-old, which would the nurse note as being appropriate?

tells a fantasy story about a bear and a car

The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately?

temperature of 101°F (38.3°C) or greater

The American Academy of Pediatrics and the American Dietetic Association recommend breastfeeding exclusively for how long?

the first 6 months

A client who has been treated for recurring gonorrhea visits the sexual health clinic reporting dysuria, urinary frequency, and whitish-yellow vaginal discharge. A pelvic examination reveals cervicitis. How would the nurse interpret these findings?

the possibility of a chlamydia infection

Which respiratory disorder in a neonate is usually mild and runs a self-limited course?

transient tachypnea of the newborn

A client who has just given a blood sample for pregnancy testing in the health care provider's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy?

visualization of the fetus by ultrasound

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus?

when it is thin, watery, and copious