Exam 4 practice questions

potassium is a critical lab value to kidney injury, what is the expected range? a. 3.5-5 mmol/L b. 3-4 mmol/L c. 5.2-7 mmol/L d. It is not important in kidney disease

a. 3.5-5 mmol/L

A PATIENT DELIVERED AN INFANT I HOUR AGO. DURING THE PP CHECK, THE NURSE FINDS A LARGE AMOUNT OF FRANK RED BLOOD ON THE PAD BENEATH THE PATIENT. PLACE IN ORDER OF IMPORTANCE, THE FOLLOWING INTERVENTIONS

1) Massage the uterus 2) Obtain vital signs 3) Empty the patient's bladder 4) Notify the physician

a liver enzyme affected by severe pre-ecampsia is ALT. true or false

true

a newborn will experience dyspnea if congenital heart defect is suspected? true or false

true

gestational diabetes leads to LGA? true or false

true

increased creatine is a serum value specific to kidney injury?

true

repeated and multiple organism infections lead to kidney damage?

true

The nurse is caring for a young client reports being beaten in a street fight with resultant acute kidney injury. What nursing actions would be appropriate? Select all that apply 1. a thorough assessment to determine the extent of clients injuries 2. dietary restrictions of potassium, phosphate, and sodium 3. fluid restriction of 600 mL plus previous 24 hour fluid loss 4. hourly serum BUN and creatinine levels 5. schedule a renal ultrasound as prescribed

1. a thorough assessment to determine the extent of clients injuries 2. dietary restrictions of potassium, phosphate, and sodium 3. fluid restriction of 600 mL plus previous 24 hour fluid loss 5. schedule a renal ultrasound as prescribed

The nurse is caring for a client with renal failure. The client is on a special diet and strict and take an output. What nursing assessment for the nurse do for this client? Select all that apply. 1. daily weights 2. monitor appetite 3. monitor edema in the extremities 4. monitor bowel movements 5. monitor urine volume and characteristics

1. daily weights 3. monitor edema in the extremities 5. monitor urine volume and characteristics

The nurse is discussing the plan of care with a client receiving dialysis. The nurse understands what aspect of care is priority for the client? 1. eating fruits and vegetables 2. monitoring fluid intake 3. daily exercise 4. monitoring outlet

2. monitoring fluid intake

during labor with external fetal monitor you note LATE decels, what does this mean a. Mother is hypotensive b. Fetus is in breech position c. Potential fetal hypoxia d. Normal response to contractions

c. Potential fetal hypoxia

which phase takes up to 1 year? a. Oliguric b. Diuretic c. Recovery d. initial

c. Recovery

middle-aged woman with irregular periods and hot flashes. what other findings might she have? a. Body hair thickens b. Estrogen levels increase c. Strange vaginal odor d. Vaginal lubrication decreases

d. Vaginal lubrication decreases

how many months will an end stage renal disease (ESRD) patient need dialysis before function returns? a. 3 months b. 6 months c. 18 monts d. None of the above

d. none of the above

7) A pregnant client with preeclampsia delivers the fetus. What care will the client need within the first 48 hours after delivery? Select all that apply. A) Antihypertensives as prescribed B) Frequent assessment of serum electrolytes C) Oxygen 2 liters nasal cannula as prescribed D) Seizure precautions E) Vital sign assessment every 4 hours

A) Antihypertensives as prescribed D) Seizure precautions E) Vital sign assessment every 4 hours

6) The nurse instructs a married couple on the importance of treatment for a chlamydia infection. Which statement or statements indicate that teaching was effective? Select all that apply. A) "He could get an infection in the tube that carries the urine out." B) "She could have severe vaginal itching." C) "It could cause us to develop rashes." D) "She could develop a worse infection of the uterus and tubes." E) "She could become pregnant."

A) "He could get an infection in the tube that carries the urine out." D) "She could develop a worse infection of the uterus and tubes."

8) A client with renal failure will be discharged to home in the next few days. The nurse plans to reinforce dietary teaching for the client. The nurse teaches the client to choose proteins that are high in biological value. Which client statement indicates that teaching has been effective? A) "I will be sure to include eggs in my diet." B) "I should include vegetables at every meal." C) "Legumes should be included in my diet, as they are complete proteins." D) "I will eat nuts daily because they are high in protein."

A) "I will be sure to include eggs in my diet."

3) A client is concerned about becoming impotent because of the inability to sustain an erection and a history of a sexually transmitted infection as a young adult. What is the nurse's best response to this client's concerns? A) An occasional incident like this is normal and common, and there is no reason to be concerned. B) Sexually transmitted infections may result in sexual problems in adults. C) Erectile dysfunction is the correct term for the inability to achieve or sustain an erection. D) The medical diagnosis of erectile dysfunction is not made until the man has erection difficulties in 25% or more of his interactions.

A) An occasional incident like this is normal and common, and there is no reason to be concerned.

5) A nurse is caring for the 1-hour-old infant of a diabetic mother. What should be included in the plan of care for this newborn? Select all that apply. A) Assess blood glucose hourly and then every 4 hours. B) Evaluate blood glucose levels at birth and at 6-hour intervals. C) Assess for hyperthyroidism. D) Assess the newborn's temperature hourly. E) Use formula for all feedings, avoiding 5% dextrose.

A) Assess blood glucose hourly and then every 4 hours. E) Use formula for all feedings, avoiding 5% dextrose.

1) The nurse is assessing a client who is in the third trimester of pregnancy. Which finding would require immediate intervention by the nurse? A) Blood pressure of 142/92 B) Pulse of 92 beats per minute C) Respiratory rate of 24 per minute D) Weight gain of 16 oz per week

A) Blood pressure of 142/92

6) The nurse is caring for a client who has been diagnosed with acute renal failure. The nurse is reviewing the client's most recent laboratory data. Which lab result is an indicator to the nurse that a client with acute renal failure has met the expected outcomes? Select all that apply. A) Decreasing serum creatinine B) Decreasing blood urea nitrogen (BUN) levels C) Decreasing neutrophil count D) Decreasing lymphocyte count E) Decreasing erythrocyte count

A) Decreasing serum creatinine B) Decreasing blood urea nitrogen (BUN) levels

2) A client with frequent urinary tract infections in being seen in the urology clinic. The client asks the nurse if there is a chance of acute renal failure. The nurse explains that which risk factor can lead to acute renal failure? Select all that apply. A) Dehydration B) Renal calculi C) Ineffective would healing D) Low serum albumin E) Hypertension

A) Dehydration B) Renal calculi E) Hypertension

10) The nurse is concerned that an older client is at risk for developing acute renal failure. What client information caused the nurse to have this concern? Select all that apply. A) Diagnosed with hypotension B) Scheduled for aortic valve replacement surgery C) Prescribed high doses of intravenous antibiotics D) Previous total hip replacement surgery E) Taking medication for type 2 diabetes mellitus

A) Diagnosed with hypotension B) Scheduled for aortic valve replacement surgery C) Prescribed high doses of intravenous antibiotics

8) The laboring client's fetal heart rate baseline is 120 beats per minute (bpm). Accelerations are present to 135 bpm. During contractions, the fetal heart rate gradually slows to 110 bpm and is at 120 bpm by the end of the contraction. What nursing action is best? A) Document the fetal heart rate. B) Prepare for imminent delivery. C) Apply oxygen via mask at 10 liters. D) Assist the client into the Fowler's position.

A) Document the fetal heart rate.

7) A client with syphilis is allergic to penicillin. Which medication would the client need to be prescribed to treat the infection? Select all that apply. A) Doxycycline B) Amoxicillin C) Tetracycline D) Gentamicin E) Erythromycin

A) Doxycycline C) Tetracycline

11) While visiting a family, the community nurse learns that the youngest child is home from school because of a sudden onset of nausea, vomiting, and lethargy. For which additional manifestations of acute renal failure should the nurse assess the child? Select all that apply. A) Elevated blood pressure B) Postural hypotension C) Wheezing D) Edema E) Hematuria

A) Elevated blood pressure D) Edema E) Hematuria

4) During a routine prenatal visit, a client who is 24 weeks pregnant has an increased blood pressure. The nurse identifies which nursing diagnosis as appropriate for the client at this time? A) Fluid Volume Excess B) Anxiety C) Excess Fluid Volume D) Ineffective Coping

A) Fluid Volume Excess

13) A nurse working in Labor and Delivery cares for clients with preeclampsia. The nurse understands that the exact cause of this condition is not known; however, research suggests: A) It is a disorder of placental dysfunction. B) It is a disorder of fetal liver compromise. C) It is a disorder of maternal hyporesponsiveness to vasoactive peptides. D) It is a disorder of excess trophoblast invasion within the placenta.

A) It is a disorder of placental dysfunction.

10) Nurses caring for clients in labor anticipating a vaginal birth after cesarean (VBAC) typically would want to verify that orders are in place to obtain a blood count, type, and screen on admission, to insert a heparin lock for IV access if needed, to provide continuous electronic fetal monitoring, and to allow clear fluids. What additional care actions are generally required for women expecting a VBAC whose previous birthing history places them at higher risk (e.g., had a previous caesarean birth and other than a low transverse uterine incision)? Select all that apply. A) Maintaining NPO status B) Limiting visitors in the labor room to one individual C) Verifying that the woman has no allergies to any drugs D) Placing a urinary catheter to more accurately measure urinary output E) Insertion of an intrauterine catheter to monitor intrauterine pressure during labor

A) Maintaining NPO status E) Insertion of an intrauterine catheter to monitor intrauterine pressure during labor

1) Which assessment data would be of the greatest concern in a sleeping 1-hour-old newborn of 39 weeks' gestation? Select all that apply. A) Respirations of 68 per minute B) Temperature of 97.9°F C) Blood pressure of 72/44 mmHg D) Acrocyanosis present E) Heart rate of 166 bpm

A) Respirations of 68 per minute E) Heart rate of 166 bpm

7) The nurse is caring for a client with erectile dysfunction (ED). Which medication should the nurse anticipate being prescribed for this client? Select all that apply. A) Sildenafil (Viagra) B) Methylphenidate (Ritalin) C) Vardenafil (Levitra) D) Buspirone (BuSpar) E) Tadalafil (Cialis)

A) Sildenafil (Viagra) C) Vardenafil (Levitra) E) Tadalafil (Cialis)

5) The home care nurse is planning care for a client with a history of postpartum depression with previous children. What should be included in this plan of care? Select all that apply. A) Take advantage of those who want to help and maintain outside interests. B) Contact the physician to ensure the client is prescribed medication for postpartum depression. C) Encourage as much sleep as possible. D) Focus on the care the other children need. E) Instruct to eat a healthful diet with limited alcohol intake.

A) Take advantage of those who want to help and maintain outside interests. E) Instruct to eat a healthful diet with limited alcohol intake.

A primigravida at 35wks gestation is scheduled for a BPP. After instructing the client about the test, Which of the following, if stated by the client as one of the parameters of the test, indicates effective teaching? A. Amniotic fluid volume B. Size of the placenta C. Amniotic fluid color D. Fetal Gestational age

A. Amniotic fluid volume

A client at 30 wks gestation is admitted with vaginal bleeding. What should be the nurse's initial nursing action? A. Assess blood pressure and pulse B. Count and weigh peripads C. Observe for pallor, clammy skin and perspiration D. Start an IV drip

A. Assess blood pressure and pulse

839 weeks pregnant client has been admitted to labor and delivery with a potential placenta previa. As a nurse prepares for the examination which nursing action in the client's exam is omitted? A. conducting the vaginal exam b. using Leopold's maneuvers c. placing the client on her side D. placing the client in high flowers position

A. conducting the vaginal exam

THE NURSE IS CARING FOR A PREGNANT PATIENT WITH A HISTORY OF TYPE I DM.THE NURSE KNOWS THIS CLIENT IS AT RISK FOR WHICH OF THE FOLLOWING: (SELECT ALL THAT APPLY) A. Hydramnios B. Hyperglycemia C. Hypoglycemia D. Low postprandial glucose level E. Fetal macrosomia

A. Hydramnios B. Hyperglycemia E. Fetal macrosomia

THE NURSE KNOWS THAT THE PATIENT'S BABY IS ALSO AT RISK FOR WHICH OF THE FOLLOWING PROBLEMS R/T MATERNAL DM (SELECT ALL THAT APPLY) A. Hypoglycemia B. Small for Gestational Age (SGA) C. Hyperbilirubinemia D. True Cretinism

A. Hypoglycemia C.Hyperbilirubinemia

A primigravida Type 1 diabetic is in the pushing phase of labor. The nurse observes the fetal head making a turtling sign as the woman pushes with each contraction. Which intervention(s) will the nurse prepare to initiate? A. McRoberts Maneuver B. Administer oxytocin C. Prepare for cesarean section D. Prepare for the HCP to perform an episiotomy E. Prepare to apply suprapubic pressure

A. McRoberts Maneuver D. Prepare for the HCP to perform an episiotomy E. Prepare to apply suprapubic pressure

Magnesium sulfate is being administered IV to a severely preeclamptic patient for seizure prophylaxis. Select all assessment findings that indicate magnesium sulfate toxicity. A. Respirations less than 12/min B. Urinary output less than 50 mL/hr C. Hyperreflexia of deep tendons D. Decreased level of consciousness E. Flushing and sweating

A. Respirations less than 12/min D. Decreased level of consciousness

A nurse is preparing to administer oxvtocin to a client to stimulate uterine contractions. Which of the following action(s) should the nurse plan to take? A. Use an infusion pump for medication administration B. Monitor maternal blood pressure and pulse frequently C. Stop the infusion if the uterine contractions occur every 4 minutes and last 45 seconds D. Increase the medication infusion rate rapidly E. Monitor the fetal heart rate continuously

A. Use an infusion pump for medication administration B. Monitor maternal blood pressure and pulse frequently E. Monitor the fetal heart rate continuously

A nurse is caring for a client in the first stage of labor. Which nursing interventions are appropriate for a client who is experiencing postpartum hemorrhage? Select all that apply. A. way the client's pads b. administer a uterotonic drug c. massage the client's fundus d. discontinue the client and dwelling urinary catheter E. express any clots in the uterus

A. way the client's pads b. administer a uterotonic drug c. massage the client's fundus E. express any clots in the uterus

WHICH OF THE FOLLOWING ARE INDICATED FOR A BPP? (SELECT ALL THAT APPLY) A.Gestational diabetes B. Reactive NST C. Preeclampsia D. Anemia E.Post term gestational age

A.Gestational diabetes C. Preeclampsia E.Post term gestational age

Which of the following patients is at most risk for PPD? A. the G4P2 mother with a history of depression B. The 16 yo GIPO mother who lives at home with her parents C. The 40 yo G2P2 who is in the middle of a divorce D. The 25 yo G5PO mother who is married with a stepchild at home

All of them are at risk

1) During a health history, the nurse learns that a client has a recent onset of impotence. Which question will help identify a potential cause of this manifestation? A) "Does this occur often?" B) "For what diseases and disorders have you been treated?" C) "Are you on any medications?" D) "How does your partner feel about this problem?"

B) "For what diseases and disorders have you been treated?"

9) A client in her 5th month of pregnancy who is attending an antepartum clinic remarks to the nurse that her long-standing chronic disease has markedly improved since she's been pregnant. What teaching would the nurse provide about conditions that often go into remission during the antepartum period? Select all that apply. A) "Systemic lupus erythematosus (SLE) is often difficult to diagnose; perhaps because you are improving during pregnancy this diagnosis was made in error and should be revisited." B) "Rheumatoid arthritis (RA) tends to go into remission during pregnancy; unfortunately, relapses typically occur in the postpartum period." C) "For whatever reason, having HIV during pregnancy leads to a remission of signs and symptoms and, thankfully, helps to stall the progression of the disease, including following delivery." D) "Medical researchers aren't sure why signs and symptoms of multiple sclerosis often get better during pregnancy, but be aware that there also tends to be a slight increase in relapse rates after delivery." E) "Women with epilepsy who have frequent seizures often find that their level of seizure activity significantly improves during pregnancy, but then seizure episodes tend to return to pre-pregnancy levels."

B) "Rheumatoid arthritis (RA) tends to go into remission during pregnancy; unfortunately, relapses typically occur in the postpartum period." D) "Medical researchers aren't sure why signs and symptoms of multiple sclerosis often get better during pregnancy, but be aware that there also tends to be a slight increase in relapse rates after delivery."

9) A nurse is caring for a client who is prescribed a selective phosphodiesterase type 5 inhibitor for the treatment of erectile dysfunction. The nurse should include which statement when educating the client regarding this medication? A) "You should take this medication about 30 minutes before sexual activity." B) "The action of this medication will last up to 36 hours." C) "This medication will enhance erections with or without sexual stimulation." D) "This medication should not be taken more than twice daily."

B) "The action of this medication will last up to 36 hours."

1) The nurse is caring for a client admitted with a diagnosis of acute renal failure. The client asks the nurse, "Are my kidneys failing? Will I need a kidney transplant?" What is the appropriate nurse response? A) "No, don't think that. You're going to be fine." B) "Your condition can be reversed with prompt treatment and usually will not destroy the kidney." C) "Kidney transplantation is highly likely, and it would be a good idea to start talking to family members." D) "When the doctor comes to see you, we can talk about whether you will need a transplant."

B) "Your condition can be reversed with prompt treatment and usually will not destroy the kidney."

1) During an assessment, the nurse suspects a client is experiencing genital herpes. What did the nurse assess in this client? Select all that apply. A) Low blood pressure B) Headache C) Fever D) Back pain E) Vaginal discharge

B) Headache C) Fever D) Back pain E) Vaginal discharge

12) Which clinical consideration should the nurse implement for the client in labor who has been diagnosed with preeclampsia? A) Place the client in the room closest to the nurse's station, even if it is a shared room. B) Place the client in left lateral position when the client feels the urge to push. C) Monitor client's fetus intermittently while client is in first stage of labor. D) Encourage the client to be alone in the room without family in order to maintain a quiet environment.

B) Place the client in left lateral position when the client feels the urge to push.

8) A client with preeclampsia begins to seize. What should the nurse should do to protect the client and fetus from injury? A) Elevate the client's legs. B) Place the client on the left side and protect the airway. C) Place the client in the supine position. D) Elevate the head of the bed.

B) Place the client on the left side and protect the airway.

5) The nurse is planning care for a client with a history of sexually transmitted infections. What should be included in this plan of care? A) Instruction to limit sexual contact until recovered from illness B) Plan for the client to contact sexual partners regarding the diagnosis C) Need to increase fluids and rest D) Importance of adequate nutrition

B) Plan for the client to contact sexual partners regarding the diagnosis

1) The postpartum client states that she cannot understand why she does not enjoy being with her baby. What should cause the nurse concern? A) Postpartum infection B) Postpartum depression C) Postpartum psychosis D) Postpartum blues

B) Postpartum depression

4) A male client tells the nurse that he has no idea why his wife wants to stay married to him because he has not been able to "perform" sexually since his prostate surgery. Which diagnosis would be appropriate for this client? A) Ineffective Coping B) Situational Low Self-Esteem C) Hormonal Imbalance D) Sexual Dysfunction

B) Situational Low Self-Esteem

A mother is at a one week F/U in the clinic and reports to the nurse that she has "crazy mood swings" and "will break down and cry for no reason" the nurse knows that this is likely: A) postpartum psychosis B) postpartum blues C) major depressive disorder with peripartum onset D) postpartum depression

B) postpartum blues

CLINICAL MANIFESTATIONS OF PROGRESSING PREECLAMPSIA INCLUDE WHICH OFTHE FOLLOWING? (SELECT ALL THAT APPLY) A. Left side abdominal pain B. Decreased urine output C. Proteinuria D. Vision changes E.Nausea & Vomiting

B. Decreased urine output C. Proteinuria D. Vision changes E.Nausea & Vomiting

A nurse is caring for a client who delivered a baby 8 hours ago. When assessing the fundus, the nurse notes it feels boggy & soft. Which interventions are most appropriate? A. Elevate the client's legs B. Firmly massage the fundus C. Encourage the client to void D. Apply compression stockings E. Administer methergine per orders

B. Firmly massage the fundus C. Encourage the client to void E. Administer methergine per orders

A nurse is caring for a g2p1 client at 26 weeks gestation. Which of the following findings will the nurse prioritize to report to the HCP? A. Vaginal secretion pH of 5 B. Hemoglobin of 9.2 g/dL C. WBC count of 14,000 D. 1 hour OGTT result of 128 mg/dL

B. Hemoglobin of 9.2 g/dL

WHICH OF THE FOLLOWING ANTEPARTUM PHARMACOLOGIC AL THERAPIES ARE INDICATED FOR THE PATIENT WITH HYPERTENSIVE DISORDERS OF PREGNANCY? A.Furosemide B. Labetalol C. Enalapril D. Nifedipine

B. Lebetalol

The nurse is caring for a client at term gestation, anticipating a NSVD. Which of the following is an example of a warning sign of potential complications? Select all that apply. A. Maternal temperature led than 98.6 F B. Meconium stained amniotic fluid C. Fetal heart rate baseline of 120bpm D. Foul-smelling discharge from vagina E.Moderate fetal heart variability

B. Meconium stained amniotic fluid D. Foul-smelling discharge from vagina

WHICH OF THE FOLLOWING ARE CERVICAL RIPENING AGENTS? (SELECT ALL THAT APPLY) A. Oxytocin B. Misoprostol C.Dinoprostone D. Foley catheter E. Methylergonovine

B. Misoprostol C.Dinoprostone D. Foley catheter

CHARACTERISTICS OF GESTATIONAL HYPERTENSION INCLUDE WHICH OF THE FOLLOWING? (SELECT ALL THAT APPLY) A. Discovered prior to 20 weeks gestation B. Occurs in the 2nd half of pregnancy C. Includes signs of end organ damage D. Seizures E.Persists for more than |2 weeks postpartum

B. Occurs in the 2nd half of pregnancy

A client is admitted to I&D at 36 weeks gest. She complains of severe abdominal pain that started less than 1 hour ago, vaginal bleeding & vomiting, The client's abdomen is rigid on palpation. What is the probable cause of her signs & symptoms? A. Preeclampsia B. Placental abruption c. Uterine rupture D. Dysfunctional labor

B. Placental abruption

INDICATIONS FOR LABOR INDUCTION INCLUDE WHICH OF THE FOLLOWING? (SELECT ALL THAT APPLY) A. Maternal exhaustion B. Polyhydramnios C. Diabetes Mellitus D. IUGR E. Reactive NST

B. Polyhydramnios C. Diabetes Mellitus D. IUGR

WHICH OF THE FOLLOWING SCREENINGS ARE ROUTINELY RECOMMENDED FOR THE GESTATIONAL DIABETIC? (SELECT ALL THAT APPLY) A. CBC B. Quadruple screen C. Nonstress test D. CMP E. Biophysical Profile

B. Quadruple screen C. Nonstress test E. Biophysical Profile

Which client is at greatest risk for post partum infection? A. client who experienced a precipitous delivery less than 3 hours ago B. client with premature ROM & prolonged labor C. A client who delivered a LGA infant D. A client with a boggy uterus that is not well contracted

B. client with premature ROM & prolonged labor

6) The nurse is instructing a client about the medication sildenafil (Viagra). Which client statement indicates teaching has been effective? A) "Viagra should be taken with food." B) "I can take Viagra anywhere from 1 to 6 hours before sex." C) "I can take only one pill in a 24-hour period." D) "Grapefruit juice will decrease the effects of Viagra."

C) "I can take only one pill in a 24-hour period."

5) A client with renal failure is being treated with peritoneal dialysis. The nurse is explaining the process to the client. Which statement would the nurse include in a discussion with the client and family? A) "The peritoneum is more permeable because of the presence of excess metabolites." B) "The metabolites will diffuse from the interstitial space to the bloodstream mainly through diffusion and ultrafiltration." C) "The peritoneum acts as a semi-permeable membrane through which wastes move by diffusion and osmosis." D) "The solutes in the dialysate will enter the bloodstream through the peritoneum."

C) "The peritoneum acts as a semi-permeable membrane through which wastes move by diffusion and osmosis."

9) A public health nurse is educating a group of adults regarding sexually transmitted infections. Which is an appropriate statement by the nurse? A) "Males have higher rates of gonorrhea and Chlamydia, whereas women have higher rates of syphilis." B) "Men are disproportionately affected by STIs compared to women and infants." C) "Women often experience few early manifestations of the infection, delaying diagnosis and treatment." D) "The incidence of STIs is highest among young Caucasian females."

C) "Women often experience few early manifestations of the infection, delaying diagnosis and treatment."

7) A client in labor with the fetus in the vertex position has a spontaneous rupture of membranes. The nurse sees that the amniotic fluid is meconium-stained and immediately takes what action? A) Notifies the physician that birth is imminent B) Changes the client's position in bed C) Begins continuous fetal heart rate monitoring D) Administers oxygen at 2 liters per minute

C) Begins continuous fetal heart rate monitoring

3) A client is experiencing dysuria, urinary frequency, and vaginal discharge. For which sexually transmitted infection(s) should the nurse prepare the client for testing? Select all that apply. A) Syphilis B) Vaginitis C) Chlamydia D) Trichomoniasis E) Gonorrhea

C) Chlamydia E) Gonorrhea

7) The nurse is administering peritoneal dialysis on a client with acute renal failure. The nurse notes the presence of a cloudy dialysate return. Which action does the nurse initiate after notifying the physician? A) Measure abdominal girth. B) Document the cloudy dialysate. C) Culture the dialysate return. D) Increase dialysate instillation.

C) Culture the dialysate return.

11) A pregnant client is diagnosed with HELLP syndrome. The client's nurse understands that which clinical finding is not a manifestation of this condition? A) Elevated liver enzymes B) Hemolysis C) Elevated lipid panel D) Decreased platelet count

C) Elevated lipid panel

9) In palpating the fundus of a woman on her first day postpartum, the nurse finds that the woman's uterus is higher than expected and is deviated to the right. She is not having excessive uterine bleeding. What action should the nurse take first? A) Contact the client's nurse midwife to notify the midwife of this condition. B) Have a nursing colleague reexamine the client to verify the nurse's finding. C) Have the client void to empty the bladder and then remeasure fundal height. D) Catheterize the woman to empty the bladder and then remeasure fundal height.

C) Have the client void to empty the bladder and then remeasure fundal height.

7) A client who is breastfeeding has been diagnosed with postpartum depression after delivering a first child. Which medications might be prescribed for this client? Select all that apply. A) Diazepam B) Phenytoin C) Paroxetine D) Fluoxetine E) Sertraline

C) Paroxetine E) Sertraline

6) A premenopausal client tells the nurse that she is not looking forward to menopause because it means her life is over. Which nursing diagnosis would be appropriate for the client at this time? A) Ineffective Sexuality Pattern B) Deficient Knowledge C) Situational Low Self-Esteem D) Disturbed Body Image

C) Situational Low Self-Esteem

3) The nurse identifies assessment findings for an African-American client with preeclampsia. Blood pressure is 158/100; urinary output 50 mL/hour; lungs clear to auscultation; urine protein 1+; 1+ edema hands, feet, ankles. On the next hourly assessment, which new assessment finding would indicate worsening of the condition? A) Blood pressure 158/100 B) Platelet count 150,000 C) Urinary output 20 mL/hour D) Reflexes 2+

C) Urinary output 20 mL/hour

RISK FACTORS FOR PREECLAMPSIA INCLUDE WHICH OF THE FOLLOWING? (SELECT ALL THAT APPLY) A. Second half of pregnancy occurs in the spring months B. History of congenital heart disease C. First time pregnancy D. Maternal age - 35 E. New paternity

C. First time pregnancy E. New paternity

A client just delivered her 5th infant 4 hours ago, after an oxytocin induction. The infant weighed gibs 100z. The client informs the nurse that she "feels funny" and "just had a big gush". Upon assessment, the nurse notes excessive rubra flow with a saturated pad, & cool, clammy skin. VS show a normal BP Pulse of 117. What is the client most likely experiencing? A. Puerperal infection resulting in excessive lochia B. Normal PP physiologic change C. Hypovolemic shock from post partum hemorrhage D. Hematoma from LGA infant

C. Hypovolemic shock from post partum hemorrhage

THE NURSE KNOWS THAT GESTATIONAL DIABETES WOULD BE DIAGNOSED WITH WHICH OF THE FOLLOWING TEST RESULTS (SELECT ALL THAT APPLY): A. AIC equal to or greater than 6.0% B. Fasting blood glucose level of 130 mg/dl C. I hour oral glucose test (OGTT) result of 140 D. 3 hour oral glucose test (OGTT) result of 150 mg/dI E. The 2nd hour of a 3 hour OGTT test result of 140 mg/dl

C. I hour oral glucose test (OGTT) result of 140 D. 3 hour oral glucose test (OGTT) result of 150 mg/dI E. The 2nd hour of a 3 hour OGTT test result of 140 mg/dl

WHICH OF THE FOLLOWING ARE REASONS THE PRETERM INFANT IS AT RISK FOR CARDIAC AND RESPIRATORY COMPLICATIONS? (SELECT ALL THAT APPLY) A. Too much surfactant B. The early closure of the ductus arteriosus C. Incompletely developed pulmonary blood vessel D. Decreased body fat

C. Incompletely developed pulmonary blood vessel

Which of the following complications can be potentially life- threatening & can occur in a client receiving tocolytic agents? A. Diabetic ketoacidosis B. Hyperemesis gravidarum C. Pulmonary edema D. Sickle cell anemia

C. Pulmonary edema

A client presents with gestational HTN. What is the primary adverse effect of this disorder that results in risk to the fetus? A. Enlargement of the liver B.Increased urinary output C. Uteroplacental insufficiency D. Pulmonary edema

C. Uteroplacental insufficiency

WHAT IS THE CURE FOR PREECLAMPSIA? A. Bedrest B.Hypertensive medication C. Delivery of baby D. Diuretic medication

C. delivery of baby

THE NURSE IS CARING FOR A 16 YO CLIENT, GI PO, ADMITTED FOR LABOR. HER BP. 168/112 MMHG. SHE HAS 3+ PROTEIN IN HER URINE & HER FACE & HANDS ARE SWOLLEN. WHAT INITIAL MEDICATION SHOULD THE NURSE EXPECT TO GIVE? A. Furosemide B.Oxytocin C. Magnesium sulfate D. Prostaglandin

C. magnesium sulfate

8) A client asks for a prescription for tadalafil (Cialis). What would be important for the nurse know prior to planning interventions for this client? A) "Do you have diabetes mellitus?" B) "Do you take blood pressure medication?" C) "Do you have any sexually transmitted infections?" D) "Do you use nitroglycerine?"

D) "Do you use nitroglycerine?"

2) A client reports an open area on the penis. Which question will help the nurse with data collection? A) "Do you think you have a disease?" B) "Have you had sexual intercourse recently?" C) "Are you promiscuous?" D) "When did you initially notice this open area?"

D) "When did you initially notice this open area?"

3) A 5-year-old child is in the hospital with acute renal failure following a streptococcus infection. The parents are Spanish-speaking and speak little English. The parents, through an interpreter, ask the nurse what mistake they made that caused the child to be so sick. What is the most appropriate response by the nurse? A) "Your child does not have enough dietary protein." B) "Your child has a congenital defect that led to renal failure." C) "Your child's renal failure has been caused by a low calcium level." D) "Your child's recent infection precipitated the renal failure."

D) "Your child's recent infection precipitated the renal failure."

10) A nurse is treating a client with diabetes mellitus who complains of erectile dysfunction (ED). Which hormonal cause contributes to ED? A) Increased prolactin levels B) Decreased aldosterone levels C) Decreased circulating catecholamines D) Decreased thyroid-stimulating hormone

D) Decreased thyroid-stimulating hormone

10) A nurse working in Labor and Delivery is caring for a client with preeclampsia. Which clinical manifestation is the nurse most likely to find in this client? A) Increased nitric oxide production B) Decreased serum sodium C) Decreased blood urea nitrogen (BUN) D) Increased serum creatinine

D) Increased serum creatinine

2) The nurse is assessing a client who is 20 weeks pregnant. Which health issue should the nurse recognize as increasing this client's risk for the development of eclampsia? A) Treatment for vitamin D deficiency B) Surgery for ruptured appendix 1 year prior C) Fibrocystic breast disease D) Obesity

D) Obesity

13) A client agrees to receive long-term hemodialysis to treat acute renal failure. For which surgical procedure should the nurse instruct this client? A) Insertion of a double-lumen catheter into the subclavian artery B) Placement of a peritoneal catheter C) Insertion of a subarachnoid-peritoneal shunt D) Placement of an arteriovenous fistula

D) Placement of an arteriovenous fistula

9) The nurse is planning care for a client admitted with heart failure. For which type of kidney failure should the nurse select interventions to prevent the development in this client? A) Prerenal hypovolemia B) Intrarenal glomerular injury C) Intrarenal acute tubular necrosis D) Prerenal low cardiac output

D) Prerenal low cardiac output

6) Which statement indicates that instruction provided to a pregnant client and spouse about amniocentesis was effective? A) The client tells the spouse that the test has to be done before the 14th week of pregnancy. B) The client tells the spouse that childbirth classes are not necessary if the baby has Down syndrome. C) The client and spouse state that it is not unusual for amniocentesis to misdiagnose a problem with the baby. D) The client and spouse state that the results of the amniocentesis will take up to 2 weeks.

D) The client and spouse state that the results of the amniocentesis will take up to 2 weeks.

which of the following classification of drugs is the best choice for the lactating PPD patient A) lithium B) Bupropoin C) Amitripyline D) Escitalopram

D) escitalopram

A nurse is providing care for a client who is in preterm labor at 30 weeks. Which of the following meds should the nurse expect to administer to accelerate lung maturity? A. Calcium gluconate B. Indomethacin C.Oxytocin D. Betamethasone

D. Betamethasone

A nurse is caring for a neonate with cold stress hypothermia) who is being monitored for hypoglycemia. Which of the following best explains the cause of neonatal hypoglycemia in relation to cold stress? A. Room temperature B. Acquired infection from visitors C. Immaturity of the thermoregulatory center D. Increased metabolic rate

D. Increased metabolic rate

While performing a vaginal exam the nurse feels pulsating tissue against her fingertips. What would the most appropriate nursing intervention be? A. Run and call the physician B. Put the client in Trendelenburg C. Ask the patient to push with the next contraction D. Leave their fingers in place, press the nurse call light

D. Leave their fingers in place, press the nurse call light

A PREECLAMPTIC PATIENT HAS DELIVERED A HEALTH INFANT AFTER INDUCTION WITH PITOCIN. SHE IS ALSO ON IV MAGNESIUM. WHAT OTHER INTERVENTIONS WOULD THE NURSE EXPECT TO IMPLEMENT FOR THIS PATIENT? A. Discontinue the Magnesium infusion B. Monitor VS every 4 hours C. Assist the patient out of bed to see the infant in the nursery D. Monitor for signs of Mag toxicity

D. Monitor for signs of mag toxicity

A nurse is caring for a neonate who has developed meconium aspiration syndrome. Findings include an Apgar score below 6, apnea, cyanosis, barrel- shaped chest and siow heartbeat. Which of the following is true about the condition? A. Alveoli are under distended B. Hypoinflation of the lungs occurs C. Air is not allowed in the lungs D. Pneumothorax may occur

D. Pneumothorax may occur

A client with gestational HIN reports to the nurse a worsening stomach pain. The nurse assesses the TR and notes them to be 4+ with 2 beats of clonus. Based on this assessment, which of the following should the nurse do? A. Obtain a urine specimen to assess for proteinuria B. Explain that this is normal due to fetal growth C. Anticipate the administration of calcium gluconate D. Raise padded side rails and darken the room

D. Raise padded side rails and darken the room

A nurse has just administer 2 mg of Butorphonol intravenously to a laboring client. Which assessment changes should the nurse recognize as the most significant? A. neonatal respiratory rate of 40 breaths per minute after birth b. maternal nausea and vomiting c. maternal drowsiness D. a decrease in the fetal heart rate fluctuation from baseline

D. a decrease in the fetal heart rate fluctuation from baseline

CRRT and hemodialysis are the same thing?

false

newborn assessment expected findings a. Chest and abdominal movements are synchronous b. Respiratory rate of 76 breaths/minute c. Acrocyanosis is noted in the newborn d. Nasal flaring is observed in the newborn

a. Chest and abdominal movements are synchronous c. Acrocyanosis is noted in the newborn

monitoring fetal heart rate, baseline is 130. contractions it slows to 115-125. what is your action a. Document FHR b. Apply non-rebreather mask c. Alert the OR of pending c-section d. Assist client to semi-fowlers position

a. Document FHR

how does dopamine increase urine output in AKI patient? a. Given with diuretics to promote renal blood flow b. Improves patient mood c. Promotes production of serotonin d. When used with metoclopramide has vasodilation properties

a. Given with diuretics to promote renal blood flow

How long does it take for acute kidney injury to develop a. Hours to days b. days to weeks c. minutes to hours d. About 24 hours

a. Hours to days

what are the most common causes of a declining glomerular filtration rate (GRF)? SATA a. Hypertension b. Heart Failure c. Diabetes Mellitus d. Childhood vaccines

a. Hypertension b. Heart Failure c. Diabetes Mellitus

during the recovery phase, what electrolyte imbalances should the nurse be concerned about. SATA a. Hyponatremia b. Hypercalcemia c. Hyperkalemia d. Hypokalemia

a. Hyponatremia c. Hyperkalemia

a hypertensive pt is at risk for? a. Intrarenal glomerular injury b. Acute tubular necrosis c. Prerenal low cardiac output d. Prerenal hypovolemia

a. Intrarenal glomerular injury

which of the three categories of acute kidney injury occurs most frequently? a. Prerenal b. Intrarenal c. Postrenal d. All occur equally

a. Prerenal

breastfeeding client with postpartum depression which antidepressant drug classification is safe? a. SSRI b. TCA c. MAO d. SNRI's

a. SSRI

what are the signs of mag sulfate toxicity a. Shortness of breath b. Adventitious lung sounds c. Flushing and sweating d. Hyporeflexia

a. Shortness of breath b. Adventitious lung sounds d. Hyporeflexia

the best support for postpartum depression is. select all a. Skilled professional nurses in the home b. Peer based postpartum support groups c. The OB/GYN in-office visits d. Lay person in-home visits

a. Skilled professional nurses in the home b. Peer based postpartum support groups

indications for biophysical profile a. Suspected IUGR b. Maternal diabetes mellitus c. Maternal Age between 30-35 y/o d. Fetal post maturity (>42 weeks)

a. Suspected IUGR b. Maternal diabetes mellitus d. Fetal post maturity (>42 weeks)

what does CRRT stand for? a. Constant Replacement of Renal Tendencies b. Continuous Renal Replacement Therapy c. Co-dialysis Renal Regulation Therapy d. None of the above

b. Continuous Renal Replacement Therapy

for erectile dysfunction the use of sildenafil has no drug interactions. true or false

false

causes of prerenal failure include: a. pyelonephrities, Lupus, chemotherapy b. Dehydration, diarrhea, diuretics, MI, low BP, c. Hypertension, diabetes, BPH d. BPH, kidney stones, blood clots in urete

b. Dehydration, diarrhea, diuretics, MI, low BP,

identify risk factor for postpartum depression a. Multiparity b. History of previous depressive disorder c. Overwhelming family support d. Rapid increase of estrogen and progesterone

b. History of previous depressive disorder

why is CCRT used instead of hemodialysis in some patients? a. It is less complex so the floor nurses can do it b. It is intended for the acute, critically-ill patient c. The Nephrologist is able to stay with patient d. When patients have no vascular access available for hemo

b. It is intended for the acute, critically-ill patient

pediatric symptoms of AKI. select all that apply a. Hypotension b. Nausea/vomiting c. Hypertension d. Hematuria

b. Nausea/vomiting c. Hypertension d. Hematuria

patient receiving hemodialysis becomes anxious, hypotensive, and demonstrated tachypnea. what should the nurse do? a. Return the patient's blood through the machine b. Place client on left side- trendelenburg, stop dialysis, Call medical code c. Give sedative d. Offer the patient a cocktail

b. Place client on left side- trendelenburg, stop dialysis, Call medical code

which lab value MOST indicates glomerular damage? a. Elevated albumin b. Proteinuria 1+ or greater c. Elevated hemoglobin d. Positive amphetamines

b. Proteinuria 1+ or greater

which type of diagnostic tests are used to diagnose postrenal a. Renal arteriogram b. X-ray of the kidneys, ureters and bladder c. Urinalysis d. Ultrasound of the kidney

b. X-ray of the kidneys, ureters and bladder

Which nursing interventions are appropriate for a client with syphilis? Select all that apply. Select all that apply. A. educate the client that this infection cannot be cured b. educate client the there is a cure for syphilis at any stage C. assessment for a maculupapuar rash on the palms, trunk, or soles D. assess client for adenopathy E. educate the client that this infection is caused by fungus

b. educate client the there is a cure for syphilis at any stage C. assessment for a maculupapuar rash on the palms, trunk, or soles D. assess client for adenopathy

in labor, dilated to 4 cm sudden cyanosis, mother dyspnea & hypotension, suspect amniotic fluid... a. Advise mother to push b. Prepare for vaginal delivery c. Administer positive pressure O2 d. Prepare the forceps

c. Administer positive pressure O2

1st trimester with elevated blood pressure. urine is negative for protein, what might this mean a. Preeclampsia b. Gestational hypertension c. Chronic hypertension d. Superimposed preeclampsia

c. Chronic hypertension

what is the best source of protein for a pt with decreased kidney function? a. Nuts, plant-based b. Beans, fiber-rich c. Eggs, complete protein d. Vegetables, fermented rich

c. Eggs, complete protein

what would you expect with neonatal drug withdrawal. select all a. Prolonged periods of sleep b. No expected withdrawal symptoms c. High-pitched cry d. Irritability and tremors

c. High-pitched cry d. Irritability and tremors

what are the phases of aki a. Get ready, set, go b. resuscitation, acute, rehab c. Initiation, maintenance, recovery d. Azotemia, oliguria, diuresis

c. Initiation, maintenance, recovery

with cervical exam, you discover loop of cord in pt vagina. what is best action by the nurse a. Have mother lie flat b. Attempt to return return cord above fetus c. With gloved hand elevate the presenting part to relieve pressure d. Move the client onto her left side

c. With gloved hand elevate the presenting part to relieve pressure

biophysical profile includes all except a. nonstress test b. fetal ultrasound c. maternal blood pressure d. amniotic fluid

c. maternal blood pressure

one difference between acute and chronic renal failure is a. Chronic has a greater urine output but less concentrated b. Acute can be caused by medications and chronic cannot c. Chronic is always treated dialysis and acute is never treated with dialysis d. Acute may be typically reversible and chronic is irreversible

d. Acute may be typically reversible and chronic is irreversible

term to describe the increase serum levels of nitrogen? a. Oliguria b. Acute tubular necrosis (ATN) c. Hypernitrogenous d. Azotemia

d. Azotemia

which phase lasts 7 days to 3 weeks? a. Initial phase b. Oliguric phase c. Recovery phase d. Maintenance phase

d. Maintenance phase

a 42 week gestation baby, thick green amniotic fluid is present. what is your most critical action? a. Assess rectal temp for hyperthermia b. Assess conjunctiva for exudate and irritation c. Deliver positive end-expiratory pressure d. Monitor cardiorespiratory and oxygen saturation

d. Monitor cardiorespiratory and oxygen saturation

reduced blood flow is responsible for which category of acute renal failure a. Onset b. Intrarenal c. Postrenal d. Prerenal

d. Prerenal

what is the goal of treatment in acute kidney injury? a. Prevent fluid overload b. Remove the cause of the injury c. Preserve what function they have left d. Prevent permanent damage

d. Prevent permanent damage