Another maternity

Nurse is performing a Heel stick on a newborn. Which of the following actions should the nurse take? a. Use an automatic puncture device on the heel b. Puncture the heels of the inner aspect of the foot c. cleanse the newborns heel with an alcohol swab after the procedure d. place an ice pack on the newborn's heel 5 minutes before the procedure

Use an automatic puncture device on the heel

A nurse is caring for a newborn who is 24 hr old. Which of the following Laboratory findings should the nurse report to the provider? A. Hgb 20 g/dL B. Bilirubin 2mg/dL C. Platelets 200 .000/mm3 D. WBC count 32.000/mm3

WBC count 32.000/mm3

A nurse is performing an assessment of a newborn's but Bensky reflex. Which of the following findings should the nurse expect? a. Flexion of the forearm b. extension of the leg c. Downward curl of the toes d. dorsiflexion of the greater toes

. dorsiflexion of the greater toes

A nurse is preparing to perform a fundal massage for a postpartum client with hearing seeing uterine atony. In which order should the nurse plan to perform the following actions? (molded steps into the box on the right. Placing them in order of performance use all steps )

1. Ask the client to lie on her back in with her knees flexed 2. Position one hand around the top of the client's when fundus in one hand just above the client's symphysis pubis 3. Rotate the upper hand to massage that clients uterus while using slight downward pressure to compress the fundus 4. observe the client's perineum for the passage of clots and the amount of bleeding

A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effect should the nurse include? A. Tinnitus B. Urinary Frequency C. Breast Tenderness D. Chills

Breast Tenderness

A nurse caring for a client who is at 20 weeks of gestation and has trichomoniasis. Which of the following findings should the nurse expect? A. Thick, White Vaginal Discharge B. Urinary Frequency C. Vulva Lesions D. Malodorous Discharge

Malodorous Discharge

A nurse is assessing a newborn immediately following a vaginal birth. For which of the following findings should the nurse intervene? A. Molding B. Vernix Caseosa C. Acrocyanosis D. Sternal retractions

Sternal retractions

A nurse is monitoring a client who has preeclampsia and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings should the nurse reports to the provider? A. Blood pressure 148/94mm Hg B. Respiratory rate 14mm C. Urinary output 20 mL/hr D. 2+deep tendon reflexes

Urinary output 20 mL/hr

A nurse is caring for a client who has hyperemesis gravidarum. Which of the following laboratory tests should the nurse anticipate? A. Urine Ketones B. Rapid plasma regain C. Prothrombin time D. Urine culture

Urine Ketones

A nurse is caring for a client who is in the latent phase of the first stage of Labor and is in pain. Which of the following nursing interventions is appropriate to reduce pain? Select all that apply

a. have a client sit in a tub of warm water b. ambulate the client in the hallway c. apply counter pressure to the sacral area

a nurse is assessing a client who is at 32 weeks of gestation and is receiving magnesium sulfate via continuous IV solution. Which of the following findings should the nurse report to the provider? a. decrease in frequency of contractions b. absent deep tendon reflexes c. urinary output 35 ml/hr d. BP 150 / 100 mmhg

absent deep tendon reflexes

A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions Should the nurse include in the plan of care? a. Use a fetal scalp electrode during labor and delivery b. Bathe the newborn before initiating skin to skin contact c. instruct the client to stop taking the antiretroviral medication at 32 weeks of gestation d. administer pneumococcal immunization to the newborn within 4 hours following birth

administer pneumococcal immunization to the newborn within 4 hours following birth

A nurse is caring for a newborn following delivery. Which of the following actions should the nurse take first? a. Apply prophylactic eye ointment b. apply identification bands to the newborn c. administer IM vitamin K d. obtain the newborn's weight

apply identification bands to the newborn

A nurse is assessing a client who is in preterm labor and has a new prescription or terbutaline 0.25 mg subcutaneous. For which of the following findings should the nurse Withhold the medication and Report to the provider? a. fasting blood glucose 75 mg / DL b. blood pressure 88/58 mmhg c. urinary output 40 ml /hr d. FHR 120/min

blood pressure 88/58 mmhg

A nurse is caring for a client who was in active labor and has gonorrhea. Which of the following potential complications of Gonorrhea should the nurse monitor? a. oligo hydramnios b. vaginal laceration during birth c. excessive bleeding after birth d. chorioamnionitis

chorioamnionitis

A nurse is caring for a client who is 6 weeks of gestation and reports nausea and vomiting. Which of the following Recommendations should the nurse make? a. avoid Eating snacks before bedtime b. eat high-fat snack before getting out of bed c. drink additional liquids with each meal d. consume food served at cool temperatures

consume food served at cool temperatures

A nurse is caring for a client who is postpartum and experiencing hypovolemic shock. Which of the following findings should the nurse expect? a. Bounding pulses b. cool clammy skin c. respiratory rate 18 / minutes d. urinary output 30ml / hour

cool clammy skin

A nurse is caring for a newborn who has an exstrophy of the bladder. Which of the following actions should the nurse take prior to the beginning of the surgical correction? a. keep the newborn in a side-lying position b. restricted newborns fluid intake c. Exert gentle pressure on the newborn splattered with sterile gauze d. cover the newborns bladder with a sterile non-adherent dressing

cover the newborns bladder with a sterile non-adherent dressing

A nurse is observing an adolescent client who is offering her newborn a bottle while he is laying in the bassinet. When the nurse offers to pick the newborn up and place them in the client's arms, the mother States " No, the baby is too tired to be held". Which of the following actions should the nurse take? a. Insist that the mother pick up the newborn to feed him b. demonstrate how to hold a newborn and allow the client to practice c. persuade the client to breastfeed the newborn to promote bonding d. offer to take the newborn to the nursery to finish his feeding

demonstrate how to hold a newborn and allow the client to practice

A nurse is providing prenatal teaching to a client who practices of vegan diet and is trying to increase intake on vitamin 12. Which of the following foods should the nurse recommend? a. fortified soy milk b. brown rice c. fresh citrus fruits d. raw carrots

fortified soy milk

ction during pregnancy. The newborn acquired CMV trans placenta Lee. Which of the following findings should the nurse expect the newborn to exhibit? a. urinary tract infection b. hearing loss c. Macrosomia d. Cataracts

hearing loss

A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate. Which of the following clinical findings should the nurse instruct the client to report? a. Increased urinary output b. increased respiratory rate c. increased fetal movement d. increased muscle weakness

increased muscle weakness

A nurse is caring for a client who has gestational diabetes mellitus. Which of the following clinical findings should indicate to the nurse the client has hyperglycemia? a. double vision b. increased urination c. Sweating d. dizziness

increased urination

A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following information places the client at risk for infection? a. Placenta previa b. midline episiotomy c. gestational hypertension d. meconium stained fluid

midline episiotomy

The nurse is teaching a client and her partner about the technique of counter pressure during labor. Which of the following statements by the nurse is appropriate? a. your partner will apply upward pressure on your lower abdomen between contractions b. your partner will apply continuous from pressure between your thumb and index finger c. your partner will apply pressure to the top of your uterus during contractions d. your partner will apply steady pressure with a tennis ball to your lower back

your partner will apply steady pressure with a tennis ball to your lower back

A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client which of the following vaccinations? Select all the apply

Diphtheria - acellular pertussis inactivated influenza

A nurse is receiving laboratory results for a term newborn who is 24 hr old. Which of the following results require intervention by the nurse? A. WBC count 10,000/mm3 B. Platelets 180,000/mm3 C. Hemoglobin 20g/dL D. Glucose 20 mg/dL

Glucose 20 mg/dL

A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include? a. You should use an oil based vaginal lubricant when inserting your diaphragm b. you should store your diaphragm in sterile water after each use c. you should keep the diaphragm in place for at least 4 hours after intercourse d. you should have your provider refit you for a new diaphragm

you should have your provider refit you for a new diaphragm

A nurse is planning to teach a group of clients who are about breastfeeding after returning to work .Which of the following infection should the nurse include in the teaching? A. "Thawed breast milk can be refrigerated for up to 72 hours." B. "Breast milk can be stored in a deep freezer for 12 months." C. Breast milk can be stored at room temperature for up to 12 hours." D. "Thawed breast milk that is unused can be refrozen."

"Breast milk can be stored in a deep freezer for 12 months."

A nurse on a labor and delivery unit is providing teaching to a client who plans to use hypnosis to control labor pain. Which of the following information should the nurse include? A. Focusing on controlling body functions B. "Synchronized breathing will be required during hypnosis" C. "Hypnosis can be beneficial in you practiced it during the prenatal period" D. "Hypnosis does not work for controlling pain associated with labor".

"Hypnosis can be beneficial in you practiced it during the prenatal period"

A nurse is providing discharge teaching to a new parent about car seat safety. Which of the following statements by the parent indicates an understanding of the teaching? A. "I should position my baby's car seat at a 45-degree angle in the car." B. "I should place the car seat rear facing until my baby is 12 months old." C. "I should place the harness snugly in a slot above my baby's shoulders." D. "I should position the retainer clip at the top of my baby's abdomen."

"I should position my baby's car seat at a 45-degree angle in the car."

A nurse is providing teaching to a client who has mild preeclampsia and will be caring for herself at home during the last 2 months of pregnancy. This of the following statements by the client indicates an understanding of the teaching. A. "I will count baby's lacks every other day. B. "I will alternate the arm use to check my blood pressure. C. I will consume 50 grams of protein daily

"I will alternate the arm use to check my blood pressure.

A nurse is assessing a client who is at 37 weeks of gestation. Which of the following statement by the client requires immediate intervention by the nurse? A. "It burns when I urinate B. "My feet are really swollen today". C. I didn't have lunch today, but I had breakfast this morning". D. "I have been seeing spot this morning"

"It burns when I urinate

A nurse is providing teaching about terbutaline to a client who is experiencing preterm labor. Which of the following statement by client indicates an understanding of the teaching? A. "The medication could cause me to experience heart palpitation" B. "This medication could cause me to experience blurred vision" C. "This medication could cause me to experience ringing in my ears" D. "This medication could cause me to experience frequent ..."

"The medication could cause me to experience heart palpitation"

A nurse is teaching a client who is at 41 weeks of gestation about a non stress test. Which of the following information should the nurse include in the teaching? A. "This test will confirm fetal lung maturity ". B. "This test will determine adequacy of placental perfusion". C. "This test will detect fetal infection". "D. This test will predict maternal readiness for labor".

"This test will determine adequacy of placental perfusion".

A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statement should the nurse make? A. "You can bathe and dress your baby if you'd like to." B. "If you don't hold the baby it will make letting go much harder." C. "You should name the baby so she can have an identity." D. "I'm sure you will be able to have another baby when you're ready."

"You can bathe and dress your baby if you'd like to."

A nurse is providing teaching about expected changes during pregnancy to a client who is at 24 weeks of gestation. Which of the following information should the nurse include? A. "Your stomach will empty rapidly" B. "You should expect your uterus to double in size" C. "You should anticipate nasal stuffiness." D. "Your nipples will become lighter in color".

"You should expect your uterus to double in size"

A nurse is reviewing signs of effective breathing with a client who is 5 days postpartum. Which of the following information should the nurse include in the teaching? A. "You should feel a tugging sensation when the baby is sucking. B. You should expect your baby to have two to three wet diapers in 24hour period C. "Your baby's urine should appear dark and concentrated". D. "Your breast should stay firm after the baby breastfeeds".

"You should feel a tugging sensation when the baby is sucking.

A nurse is teaching a prenatal class regarding false labor. Which of the following information should the nurse include? A. "your contraction will become more intense when walking" B. "you will have dilation and effacement of the cervix" C. You will have bloody show" D. "Your contraction will become temporally regular"

"Your contraction will become temporally regular"

A nurse is providing teaching to a client who is at 38 weeks of gestation and has a prescription to receive misoprostol intravaginally. Which of the following statement should the nurse make? A. "you will need to stay in a side-lying position for 30 minutes after each dose." B. "You will receive an IV infusion of oxytocin 1 hour after your last dose." C. " You will receive a magnesium supplement immediately following therapy." D. " You will need to have a full bladder before the therapy begins."

"you will need to stay in a side-lying position for 30 minutes after each dose."

A nurse is providing nutritional guidance to a client who is pregnant and follows a vegan diet. The client asks the nurse which foods she should eat to ensure adequate calcium intake. The nurse should instruct the client that which of the following foods has the highest amount of calcium? A. 1⁄2 cup cubed avocado B. 1 large banana C. 1 medium potato D. 1 cup cooked broccoli

1 cup cooked broccoli

A nurse is caring for a client who is receiving prenatal care and is at her 24-week appointment. Which of the following laboratory tests should the nurse plans to conduct? A. Group B strep culture B. 1-hr glucose tolerance test C. Rubella titer D. Blood type and Rh

1-hr glucose tolerance test

A nurse is caring for a client who is receiving oxytocin to induce labor. The nurse should discontinue the oxytocin if which of the following occurs? a. Contractions last 60 Seconds b. non-repetitive early decelerations c. 6 contractions in 10 minutes d. moderate variability of the fetal heart rate

6 contractions in 10 minutes

A nurse is caring for four clients. For which of the following clients should the nurse auscultate the fetal heart rate during the prenatal visit? A. A client who has an ultrasound that confirms a molar pregnancy B. A client who has a crown-rump length of 7 weeks gestation C. A client who has a positive urine pregnancy test 1 week after missed menses D. A client who has felt quickening for the first time

A client who has felt quickening for the first time

A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for an induction of labor with misoprostol? A. A client who has active genital herpes B. A client who has gestational diabetes mellitus C. A client who has a previous uterine incision D. A client who has placenta previa

A client who has gestational diabetes mellitus

A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following clients should the nurse assess first? A. A client who has diabetes mellitus and an HbA1c of 5.8% B. A client who has preeclampsia and a creatinine level of 1.1 mg/ dL C. A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L D. A client who has placenta previa and a hematocrit of 36%

A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L

A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider? A client who has a urinary output of 300 ml in 8 hr A. A client who reports abdominal cramping during breastfeeding B. A client who is receiving C. magnesium sulfate and has absent deep tendon reflexes D. A client who reports lochia rubra requiring changing perineal pads every 3 hr

A client who is receiving magnesium sulfate and has absent deep tendon reflexes

A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care? A. Instruct the client to stop taking the antiretroviral medication at 32 weeks of gestation. B. Use a fetal scalp electrode during labor and delivery. C. Administer a pneumococcal immunization to the newborn within 4 hr following birth. D. Bathe the newborn before initiating skin-to-skin contact

Administer a pneumococcal immunization to the newborn within 4 hr following birth.

A nurse is planning care immediately following birth for a newborn who has Myelomeningocele that is cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care? a. Administer broad-spectrum antibiotics b. cleanse the site with Povidone iodinec. monitor the rectal temperature every 4 hours d. prepare for surgical closure after 72 hours

Administer broad-spectrum antibiotics

A nurse in a prenatal Clinic is reviewing the laboratory results for a client who is at 12 weeks of gestation. Which of the following actions should the nurse take? (Click on the exhibit button for additional information about the client. There are three tabs that contain separate categories of data.) EXHIBIT 1.

Administer ceftriaxone IM

A nurse is caring for a client who is receiving oxytocin for induction of labor and notes late decelerations of the fetal heart rate on the monitor Tracing. Which of the following action should the nurse take? A. Decrease maintenance IV solution infusion rate. B. Place the client in lateral position. C. Administer misoprostol 25 mcg vaginally D. Administer oxygen via face mask at 2 L/min

Administer oxygen via face mask at 2 L/min

A nurse is assessing a client following an amniocentesis. Which of the following findings should the nurse recognize as complications? (select all that apply).

Amnionitis Leakage of amniotic fluid Preterm labo

A nurse is providing discharge instructions to a client is 24 hours post partum and has decided not to breastfeed. Which of the following instruction should the nurse include in the teaching? a. Wear loose-fitting non-binding bra for 72 hours b. shower daily allow warm water to run directly over your dress c. Apply ice packs to your breast using a 15 minutes on, 45 minutes off schedule d. Pump your breast twice-daily to relieve discomfort from engorgement

Apply ice packs to your breast using a 15 minutes on, 45 minutes off schedule

A nurse is caring for a client who is in the transition phase of labor and reports a pain level of 7 on a scale of 0 to 10. Which of the following actions should the nurse take? A. Instruct the client to use effleurage B. Apply counter pressure to the client sacral. C. Assist the client with patterned-paced breathing. D. Teach the client the technique of biofeedback.

Assist the client with patterned-paced breathing.

A nurse is caring for a client who is in labor and requests nonpharmacological pain management. Which of the following nursing actions promotes client comfort? A. Assisting the client into squatting position B. Having the client lie in a supine position C. Applying fundal pressure during contractions D. Encouraging the client to void every 6 hr

Assisting the client into squatting position

13. A nurse is providing teaching to a client about exercise safety during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply).

B. "I should consume three 8-ounce glasses of water after I exercise." C. "I will check my heart rate every 15 minutes during exercise sessions." E. "I should rest by lying on my side for 10 minutes following exercise."

A nurse is providing dietary teaching to a client who is 32 weeks of gestation and has cholelithiasis. Which of the following foods should the nurse recommend for the client to include in her diet? a. Baked chicken b. whole milk c. french fries d. bacon cheeseburger

Baked chicken

A nurse is preparing to administer methylergonovine 0.2 mg orally to a client who is 2 hr postpartum and has a boggy uterus. For which of the following assessment findings should the nurse withhold the medication? A. Blood pressure 142/92 mm Hg B. Urine output 100 mL in hr C. Pulse 58/min D. Respiratory rate 14/min

Blood pressure 142/92 mm Hg

A nurse is assessing a newborn upon admission to the nursery. Which of the following should the nurse expect? A. Bulging Fontanels B. Nasal Flaring C. Length from head to heel of 40 cm (15.7 in) D. Chest circumference 2 cm (0.8 in) smaller than the head circumference

Chest circumference 2 cm (0.8 in) smaller than the head circumference

A nurse in a woman's health clinic is obtaining a health history from a client. Which of the following findings should the nurse identify as increasing the client's risk for developing pelvic inflammatory disease (PID)? A. Recurrent Cystitis B. Frequent Alcohol Use C. Use of Oral Contraceptives D. Chlamydia Infection

Chlamydia Infection

A nurse is caring for newborn immediately following birth and notes a large amount of mucus in the newborn's mouth and nose. Identify the sequence the nurse should follow when performing suction with a bulb syringe. (Move the streps into the box on the placing them in the selected order of performance. Use all the streps.)

Compress the bulb syringe Place the bulb syringe in the newborn's mouth. Use the bulb syringe to suction the newborn's nose. Assess the newborn for reflex bradycardia

A nurse is caring for a client who is 36 weeks gestation and has MRSA. Which of the following isolation precautions should the nurse initiate? a. Droplet b. Contact c. Airborned. Protective environment

Contact

A charge nurse is teaching a group of staff nurses about fetal monitoring during labor. Which of the following findings should the charge nurse instruct the staff members to report to the provider? A. Contraction durations of 95 to 100 seconds B. Contraction frequency of 2 to 3 min apart C. Absent early deceleration of fetal heart rate D. Fetal heart rate is 140/min

Contraction durations of 95 to 100 seconds

A nurse is planning care for a client following a chorionic villus sampling. The nurse should recognize that the client is at risk for developing which of the following complications? a. Late decelerations b. Infection c. Anemia d. placental insufficiency

Infection

A nurse is caring for a client who is experiencing sore nipples from breastfeeding. Which of the following actions should the nurse take? A. Place a snug dressing on the client's nipple when not breastfeeding. B. Ensure the newborn's mouth is wide open before latching to the breast. C. Encourage the client to limit the newborn's feeding to 10 min on each breast. D. Instruct the client to begin the feeding with the nipple that is most tender.

Ensure the newborn's mouth is wide open before latching to the breast.

A nurse is assessing a newborn following a forceps assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method? A. Hypoglycemia B. Polycythemia C. Facial Palsy D. Bronchopulmonary dysplasia

Facial Palsy

A nurse is assessing a newborn following a forceps assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method? A. Hypoglycemia B. Polycythemia C. Facial Palsy D. Bronchopulmonary dysplasia

Facial palsy

A nurse is caring for a client following an amniocentesis. The nurse should observe the client for which of the following complications? A. Hyperemesis B. Proteinuria C. Hypoxia D. Hemorrhage

Hemorrhage

A nurse is teaching a client who is 28 weeks of gestation and not up-to date on current immunization. Which of the following immunizations should the nurse inform the client to anticipate receiving following birth. A. Pneumococcal B. Hepatitis C. Human papillomavirus D. Rubella

Hepatitis

A nurse is teaching a prenatal class about immunizations that newborns receive following birth. Which of the following immunizations should the nurse include in the teaching? A. Hepatitis B B. Rotavirus C. Pneumococcal D. Varicella

Hepatitis B

A nurse is assessing a newborn was exposed to cocaine in utero. Which of the following findings should the nurse expect? a. High-pitched cry b. Hypotonicity c. increased head circumference d. decreased startle response

High-pitched cry

A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication? A. Hypnosis B. Polyuria C. Bilateral crackles D. Hyperglycemia

Hypnosis

A nurse is providing teaching to a postpartum client who has a prescription for a rubella immunization. Which of the following client statements indicates an understanding of the teaching? a. I will receive a series of three immunizations and each one will be a month apart b. I should avoid becoming pregnant for at least one month following the immunization c. I should avoid breastfeeding for two weeks following the immunization d. I will report joint pain that develops after the immunization to my provider immediately

I should avoid becoming pregnant for at least one month following the immunization

A nurse is providing teaching to a client who is receiving medroxyprogesterone IM for contraception. Which of the following statements by the client indicates an understanding of the teaching? a. I should discontinue this medication if I experience spotting b. I will need to return to the clinic in the next eight weeks for my next injection c. I should increase my calcium intake while taking this medication d. I will get two shots each time I receive this medication

I should increase my calcium intake while taking this medication

A nurse is providing teaching to a client who is primigravid and is scheduled to have an abdominal ultrasound. Which of the following statements by the client indicates an understanding of the teaching? a. I need to take a stool softener the night before the test b. I can't have anything to eat after midnight c. I won't apply perfumed lotion to my abdomen before the test d. I will drink water before the test until my bladder feels full

I will drink water before the test until my bladder feels full

. A nurse is planning care for a client who is receiving oxytocin by continuous IV infusion for labor induction. Which of the following interventions should the nurse include in the plan? A. Increase the infusion rate every 30 to 60 min. B. Maintain the client in a supine position. C. Titrate the infusion rate by 4 milliunits/min. D. Limit IV intake to 4 L per 24 hr.

Increase the infusion rate every 30 to 60 min

A nurse is caring for a client who received epidural analgesia during labor and is 4 hours for postpartum. Which of the following client reports should the nurse address first? - page 84 a. Itching b. inability to void c. abdominal cramps d. tingling in the legs

Itching

A nurse is caring for a 2-day-old newborn who was born at 35 weeks of gestation. Which of the following actions should the nurse the nurse takes? (Click on the "Exhibit" Button for additional information about the newborn. There are three tabs that contain separate categories of date.) A. Administer nitric oxide inhalation therapy to the newborn B. Insert an orogastric decompression tube with low wall suction. C. Provide the newborn with an iron-rich formula containing vitamin B12 every 2 hr. D. Measure the abdominal circumference at the level of the newborn's umbilicus every 2 hr.

Measure the abdominal circumference at the level of the newborn's umbilicus every 2 hr.

A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors paces the client at risk for infection. A. Meconium - start fluid B. placenta previa C. Midline episiotomy D. Gestational hypertension

Meconium - start fluid

A nurse is caring for a client who has bacterial vaginosis. Which of the following medication should the nurse expect to administer? A. Metronidale B. Fluconazole C. Acyclovir

Metronidale

A nurse is caring for a client who is 14 weeks of gestation. At which the following locations should the nurse place the Doppler device when assessing the fetal heart rate? A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis B. Left Upper Abdomen C. Two fingerbreadths above the umbilicus D. Lateral at the Xiphoid Process

Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis

A nurse is assessing a preterm newborn who is at 32 weeks of gestation. Which of the following finding should the nurse expect? A. Minimal arm recoil B. Popliteal angle of less than 90 C. Creases over the entire sole D. Sparse lanugo

Minimal arm recoil

A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take? A. Provide a stimulating environment B. Monitor blood glucose level every hr. C. Initiate seizure precautions. D. Place the infants on his back with legs extended.

Monitor blood glucose level every hr.

A nurse is assessing a newborn who was born Postterm. Which of the following findings should the nurse expect? A. Nails extending over tips of fingers B. Large deposits of subcutaneous fat C. Pale, translucent skin D. Thin covering of fine hair on shoulders and back

Nails extending over tips of fingers

A community health nurse is providing education on gestational diabetes mellitus (GDM) to a group of clients who are pregnant when discussing risk factors, which of the following ethnicities should the nurse identify as having the lowest incidence of GDM? A. Asian B. Non-Hispanic White American C. Hispanic D. African American

Non-Hispanic White American

A nurse is caring for newborn who is 1 hr old and has a respiratory rate of 50/min, a heart rate of 130/min, and an auxiliary temperature of 36.1*C (97F). Which of the following actions should the nurse take? A. Give the newborn a warm bath. B. Apply a cap to the newborn head. C. Reposition the newborn. D. Obtain an oxygen saturation level

Obtain an oxygen saturation level

A nurse is caring for a client who reports spontaneous rupture. The nurse observed fetal bradycardia in the FHR tracing and notices the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following should the nurse take next? a. Initiate an infusion of IV fluids for the client b. Perform vaginal examination by applying upward pressure on the presenting part C. Administer oxygen via non rebreather mask at 8L/ min. D. Cover the umbilical cord with sterile saline saturated towel.

Perform vaginal examination by applying upward pressure on the presenting part

A nurse on a labor and delivery unit is receiving infection control standards with a newly licensed nurse. The nurse should instruct the newly licensed nurse to don gloves for which of the following procedures? A. Assisting a mother with breastfeeding B. Performing a newborn's initial bath C. Administering the measles, mumps, rubella vaccine D. Performing umbilical cord care

Performing umbilical cord care

.A nurse is assessing a client who is at 27 weeks of gestation and has preeclampsia. Which of the following findings should the nurse report to the provider? A. Urine protein concentration 200 mg/ 24 hr B. Creatnine 0.8 mg/ dL C. Hemoglobin 14.8 g/ dL D. Platelet Count 60.000/ mm3

Platelet Count 60.000/ mm3

A nurse is assessing a client who is 27 weeks of gestation and has pre eclampsia. Which of the following findings should the nurse report to the provider? a. Hemoglobin 14.8 g/dL b. Platelet count 60,000/ mm c. Creatine 0.8 mg/ dL d. Urine protein concentration 200 mg/24hr

Platelet count 60,000/ mm

A nurse is reviewing laboratory results for client who is pregnant. The Nurse should expect which of the following laboratory values to increase? A. RBC count B. Bilirubin C. Fasting blood glucose D. Bun

RBC count

A nurse is caring for a newborn who is 6 hr old and has a bedside glucometer reading of 65 mg/ dL. The newborn's mother has type 2 diabetes mellitus. Which of the following actions should the nurse take? A. Obtain a blood sample for a serum glucose level B. Feed the newborn immediately C. Administer 50 mL of dextrose solution IV D. Reassess the blood glucose level prior to the next feeding

Reassess the blood glucose level prior to the next feeding

A nurse is caring for a client who has preterm labor and receiving magnesium sulfate by continuous IV infusion. Which of the following laboratory values should the nurse review during tocolytic therapy? a. indirect Coombs test b. liver enzymes c. uric acid level d. Serum medication level

Serum medication level

A nurse is caring for a client who is in the second stage of labor. Which of the following manifestations should the nurse expect? A. The client expels the placenta B. The client experiences gradual dilation of the cervix C. The client begins have regular contractions. D. The client delivers the newborn

The client delivers the newborn

A nurse is caring for a newborn. Which of the following assessment findings should indicate to the nurse that suctioning of the nasopharynx is needed? a. The newborn's pulse oximeter is 91% b. the newborns respiratory rate is 32 / minutes c. the newborn is beginning to cough d. the newborns respiratory rate is the regular

The newborn's pulse oximeter is 91%

A nurse is caring for client who is in active labor. Following epidural placement the nurse a maternal blood pressure of 98/58 mmHg and minimal FHR variability on the fetal monitor. Which of the following images indicates the action the nurse should take?

These are the signs of complication of epidural anesthesia as Hypotension, patient need to be connected with Oxygen immediately, rush IV fluids, check for bleeding status and the progress of labor

A nurse is conducting a class for a group A client's about birth control. Which of the following information should the nurse include in the teaching? a. Your fertility will return six months after your provider removes your IUD b. you should use spermicide 3 hours prior to sexual intercourse c. you will not need to use birth control for one month after receiving emergency contraception d. you should have an annual examination to assess your diaphragm

Your fertility will return six months after your provider removes your IUD

A nurse is caring for four enter-partum clients. Which of the following clients should the nurse assess first? a. A client who is at 7 weeks of gestation and reports urinary frequency b. a client who is at 32 weeks of gestation and reports seeing floating spots c. a client who is 38 weeks of gestation and reports leg cramps d. a client who is at 20 weeks of gestation and reports periodic numbness in her fingers

a client who is at 32 weeks of gestation and reports seeing floating spots

A nurse in a newborn Nursery is receiving change-of-shift report for for newborns. Which of the following newborn should the nurse assess first? a. Newborn who is 24 hours old and has not had meconium stool b. a newborn who is 10 hours old and has a new onset tachypnea c. newborn who has a short frenulum and is having difficulty breastfeeding d. a newborn was 30 hours old and has blood-tinged discharge in her diaper

a newborn who is 10 hours old and has a new onset tachypnea

A nurse is assessing the results of a non-stress test for an antepartal client at 35 weeks of gestation. Which of the following findings should indicate to the nurse the need for further diagnostic testing? a. 3 fetal movements perceived by the client in a 20-minute testing period b. No late deceleration in the fetal heart rate loaded with 3 uterine contractions of 60 seconds in duration within a 10-minute testing period c. Irregular contractions of 10 to 20 seconds in duration that are not felt by the client d. an increase in fetal heart rate to 150 / minute above Baseline of 140 minute lasting 10 seconds in response to fetal movement with a 40 minute testing period

an increase in fetal heart rate to 150 / minute above Baseline of 140 minute lasting 10 seconds in response to fetal movement with a 40 minute testing period

A nurse is providing discharge teaching to a postpartum client about caring for her five-year 5- day old male newborn at home. Which of the following statements should the nurse make to the client? a. Retract the foreskin to clean your baby's penis during each bath b. use triple antibiotic ointment on your baby's umbilical cord twice per day c. Swaddle your baby tightly with legs extended before laying him down to sleep d. notify your baby's pediatrician if he urinates less than 6 times per day

notify your baby's pediatrician if he urinates less than 6 times per day

A nurse is caring for a client who has placenta previa. Which of the following findings should the nurse expect? a. Firm rigid abdomen b. painless, vaginal bleeding c. uterine hypertonicity d. persistent headache

painless, vaginal bleeding

A nurse is reviewing the laboratory results of a newborn. Which of the following findings should the nurse report to the provider? a. Blood glucose 58 mg / DL b. hematocrit 48% c. platelets 100,000/ mm 3 d. hemoglobin 16 G / DL

platelets 100,000/ mm 3

A nurse is admitting a client with a birthing unit reports for contractions started 1 hour ago. the nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions? a. Ectopic pregnancy b. postpartum hemorrhage c. hyperemesis gravidarum d. incompetent cervix

postpartum hemorrhage

nurse is caring for a newborn Boys 6 hours old and has a bedside glucose meter reading of 65 mg / DL. The New Orleans mother has Type 2 diabetes mellitus. Which of the following actions should the nurse take? a. Administer 50 mL of dextrose solution IV b. obtain a blood sample of serum glucose level c. reassess the blood glucose level prior to the next feeding d. Feed the newborn immediately

reassess the blood glucose level prior to the next feeding

A nurse is assessing a full-term newborn arm admission to the nursery. Which of the following clinical findings should the nurse report to the provider? a. Transient circumoral cyanosis - i think this is referring to acrocyanosis which is normal b. single Palmar creases - down syndrome - p.27 c. subconjunctival hemorrhage - expected d. rust stain urine - expected

single Palmar creases

A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository? a. vaginal candidiasis b. third-degree perineal laceration c. abdominal distension d. Afterpains

third-degree perineal laceration

A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching? a. transmission can occur via the saliva and urine of the newborn b. this infection requires but airborne precautions be initiated for the newborn c. lesions are visible on the mother's genitalia d. mothers will receive prophylactic treatment with acyclovir year prior to delivery

transmission can occur via the saliva and urine of the newborn

A nurse is caring for a client who is at 30 weeks of gestation and receiving magnesium sulfate for preeclampsia. The nurse should recognize which of the following manifestations as an adverse reaction to the medication? a. Respiratory rate a 16 / minutes b. Hypertension c. urine output 20 ml / hour d. Hyperglycemia

urine output 20 ml / hour

A nurse is assessing a client who is 6 hours postpartum and has endometritis. Which of the following findings should the nurse expect? a. Scant lotia b. urine tenderness c. temperature 37.4 C ( 99.3 F) d. WBC 9,000/mm

urine tenderness

A nurse is assisting the provider to administer a dinoprostone to induce labor for a client. Which of the following actions should the nurse take? a. Allow the medication to reach room temperature prior to Administration b. verify that informed consent is obtained prior to Administration c. instruct the client to avoid urinary elimination until after Administration d. please to clean and I send my followers position for 1 hour after Administration

verify that informed consent is obtained prior to Administration

A nurse is providing teaching to the parents of a newborn about the plastibell circumcision technique. Which of the following? - p170-171 - postprocedure bottom of 170 and goes into top of 171. a. the plastibell will be removed 4 hours after the procedure b. notify the provider is the end of your penis appears dark red c. make sure the newborn's diaper is snug d. yellow exudate will form at the surgical site in 24 hours

yellow exudate will form at the surgical site in 24 hour