Next gen OB/Peds
A nurse in a hospital is caring for a 22-year-old G2P1 client who is at 32 weeks' gestation in active labor. The client calls out, "I think my water broke." The nurse at the bedside pulled back the sheet and found clear fluid with an umbilical cord in the client's vagina.
contact healthcare provider follow hospital protocol insert hand to hold up cord delegate task to other nurses
A nurse in a pediatrician's office is assessing a 4-year-old child. What assessment techniques will the nurse use with a preschool-age child?
involve the child in the assessment allow the child to play with safe medical equipment
An 8-year-old child is admitted to a medical-surgical unit with a diagnosis of syndrome of inappropriate antidiuretic syndrome (SIADH).
LOC Fluid balance serum sodium
A nurse is caring for a 16-year-old primigravida client who is in active labor. The client did not attend prenatal classes and nervously asks the nurse to explain to what will happen. The nurse performs a focused assessment to determine the stage of labor and then explains the different phases of the first stage of labor. The nurse determines client understanding when they correctly identifies how each phase differs.
Latent: contractions 5 to 30 minutes apart contractions irregular, mild to moderate contraction duration 30 to 45 seconds Active: Everything else
A nurse in a pediatrician's office is educating a parent of a 2-month-old infant about developmental milestones.
My infant should be able to sit on their own at 3 months "I will be able to play games like peek-a-boo with my infant when they are 4 months old." "At 6 months, my baby should be able to feed themselves."
A nurse in the hospital is performing a focused assessment on a 40-year-old client who has been trying to conceive and is now experiencing moderate, painful vaginal bleeding since this morning. The client has a past medical history of longer, heavier menstrual cycles.
Ovarian cancer: 40 years, mod-severe bleeding Uterine Fibroids: 40 years, painful bleeding, mod-severe bleeding, longer heavier menstrual cycle Spontaneous abortion: 40 years, painful bleeding, mod-severe bleeding
A 9-year-old female child was brought to the emergency department after experiencing wheezing and shortness of breath while playing soccer. The parents administered two puffs of albuterol metered dose inhaler (MDI) with little effect, and 911 was notified. Paramedics applied oxygen 2 liters by nasal cannula for oxygen saturation of 90% on room air, and administered an albuterol nebulizer treatment. Audible wheezing was heard, and a 20-gauge intravenous (IV) catheter was inserted. Vital signs upon arrival at the emergency room: temperature, 98.8°F (37.1°C); heart rate, 125 beats/min; blood pressure, 88/50 mm Hg; respiratory rate, 32 breaths/min; oxygen saturation, 92% on simple face mask. Child appears anxious.
assess airway methylprednisolone
A nurse is caring for a newborn with Down syndrome.
autoimmune disorders spinal problems endocrine disorders
A nurse in a prenatal clinic is caring for a 26-year-old client in the second trimester who has come to the clinic for a scheduled checkup. The nurse performs a focused assessment and discusses unexpected signs and symptoms during the second trimester that, if experienced, will require prompt treatment.
dysuria diarrhea hyperemesis sudden shortness of breath
The parent of a newborn diagnosed with Turner syndrome asks the nurse about the treatment that will be required for their newborn.
growth hormone estrogen therapy
A nurse in the hospital nursery cares for a preterm newborn, born at 30 weeks' gestation. The newborn had an APGAR score of 6 at 1 minute (1 point for color, 1 point for respiratory effort, 1 point for muscle tone, 1 point for reflex, 2 points for heart rate) and 8 at 5 minutes. The newborn has a lot of vernix on the whole body, acrocyanosis of the hands, a glucose level of 40 mg/dl (2.22 mmol/l), and a temperature of 96.1°F (35.6°C).
observe for respiratory distress dry newborn to prevent hypothermia
A client in their third trimester comes to the clinic reporting vaginal bleeding that started this morning. The nurse performs an assessment to determine the underlying cause of the bleeding. Assessment reveals fundal height appropriate for expected gestational age, uterine pain 10 out of 10 on scale 0 to 10, and bright red vaginal bleeding. Vital signs include a heart rate of 110 beats/min and a blood pressure reading of 90/50 mm Hg.
previa: bright red blood, fundal height, hemoglobin, heart rate, blood pressure abruptio: pain, bright red blood, hemoglobin, heart rate, blood pressure, uterine tenderness, hemoglobin
An emergency department nurse is caring for a 5-year-old child who was just brought in by ambulance with partial-thickness (second-degree) and full-thickness (third-degree) burns to their face, neck, and chest. The client is awake and alert. Vital signs: temperature, 97.2°F (36.2°C); heart rate, 148 beats/min; blood pressure, 68/39 mm Hg; respiratory rate, 32 breaths/min; oxygen saturation, 90% on 2 liters by nasal cannula.
Apply oxygen to maintain oxygen saturations 95% or greater. Administer 100 mcg/kg morphine via intravenous push (IVP) for pain prn q4 hour. Initiate fluid resuscitation per Lund and Browder chart using Parkland formula with 0.9% saline.
A nurse in the hospital is caring for a client at 37 weeks' gestation who experienced premature rupture of the membranes (PROM) more than 24 hours prior to coming to the hospital. The client presents with a fever of 100.4°F (38°C).
Group B streptococcus administer IV antibiotics
A nurse is performing an assessment on a 25-year-old white female client who is obese and is trying to conceive. The client presents to the clinic concerned about a newly found lump in their breast. The nurse explains to the client the difference between benign nodules and breast cancer.
benign: soft and movable breast cancer: hard and fixed
A nurse is providing education to a client experiencing postpartum blues. The nurse determines client understanding when the client makes which of statements regarding factors that contribute to postpartum blues, signs and symptoms associated with postpartum blues, and collaborative care to treat symptoms?
contributing factors: "Postpartum blues are due to changes in hormones." "Postpartum blues are due to fatigue." S/S: "A symptom of postpartum blues is being emotionally labile up to 10 days postpartum." Collaborative Care: "Sleep hygiene can help with postpartum blues." "Adequate nutrition can help with postpartum blues." "Regular physical exercise can help with postpartum blues." "Ensuring adequate support for newborn care can help with postpartum blues."
The nurse is performing a focused assessment on a client who is 2 days postpartum. The client reports pelvic pain, chills, profuse dark, foul-smelling lochia with blood clots. The client states, "my bleeding before was light and now it is heavy." Vital signs: temperature, 99.5°F (37.5°C); heart rate, 102 beats/min; blood pressure, 100/66 mm Hg.
retained fragments of placenta pelvic pain profuse dark lochia with blood clots
A nurse is caring for a 4-year-old male child brought to the emergency department (ED) for symptoms of influenza. The parents state the child has "had high fevers for the past 3 days even though we have been giving our child acetaminophen and they do not really want to eat or drink anything and has been very sleepy." Client opens eyes to voice, follows simple commands, and skin is very warm, ruddy, and dry. Vital signs: 101.5°F (38.6°C); heart rate, 138 beats/min; oxygen saturation, 95% on room air. Laboratory values: white blood cell (WBC) count, 43 × 103 cells/mm3 (43 × 109/l); hemoglobin, 10 mg/dl (100 g/l); hematocrit, 32% (0.32); platelets, 20,000/ml (20 × 109/l); neutrophil bands, 48/mcl (0.05 × 109/l); lymphoblasts, 33 (NA).
risk for bleeding implementing bleeding precautions
A nurse in a pediatrician's office is performing a comprehensive assessment on an 8-year-old male client at a scheduled wellness visit.
round, protruding The parent expresses a concern, stating that my child seems to be having difficulty in school even though they sit in the front of the class. My child also seem to trip and fall frequently
A 35-year-old client visits the clinic reporting the inability to conceive after trying for the past year. The nurse discusses reasons for infertility with the client. The nurse evaluates client understanding of the causes of infertility.
"A history of sexually transmitted infections may cause infertility." "Abnormalities of the uterus may contribute to infertility." "Women older than 35 may have difficulty conceiving."
A nurse is caring for a 28-year-old female client in the emergency department (ED) who is accompanied by their partner. The client reports accidentally falling down stairs. Assessment reveals bruising at multiple stages of healing on upper extremities, back, and abdomen. X-ray reveals a right wrist fracture. The client does not make eye contact with the nurse and allows their partner to answer most of the questions.
IPV stages of bruising
A nurse on a pediatric unit finds a 3-year-old child unconscious. The child does not respond to stimuli. The nurse calls a code and starts to perform cardiopulmonary resuscitation (CPR).
airway breathing perfusion
A nurse is caring for a 33-year-old primigravida client who is obese and near the end of their second trimester. The client has a history of prepregnancy obesity, hypertension, and smoking.
gestational diabetes change lifestyle
A nurse is caring for a client who is a 22-year-old gravida 1 para 0 in labor. The client has been in labor for 10 hours. The nurse assesses the fetal monitor, and the client has contractions every 3 to 5 minutes, lasting 40 to 45 seconds, and are palpated moderately. The vaginal examination is completed, and the client is only 3 cm, at 60% effacement, and at -3 station. The client states that the pain level is 7 out of 10.
dystocia cervical dilation at 3 cm
A community health nurse completes the home visit. The client is 2 weeks postpartum and is breastfeeding. The nurse asks the client if they have any breastfeeding questions.
"Breastfeeding and formula feedings offer the same benefits." "I may use a pacifier while breastfeeding when the infant becomes fussy." "I may supplement my breastmilk with formula.."
A nurse is assessing a 6-year-old male child brought to the pediatrician's office for sore throat and fever. Assessment reveals lethargy; dry, warm skin; capillary refill time <3 seconds; lungs clear to auscultation. Vital signs: temperature, 100.1°F (37.8°C); heart rate, 128 beats/min; respiratory rate, 28 breaths/min. The nurse performs a throat culture, which is positive for group A streptococcus (GAS). Urine sample results: dark concentrated urine; urine specific gravity 1.04.
Carditis Group A
A nurse on the neurology unit is monitoring an 8-year-old child admitted with seizures. The child experiences a prolonged tonic-clonic seizure.
ensure proper oxygenation administer intravenous (IV) or intramuscular (IM) benzodiazepine
A nurse is caring for a 25-year-old G1P0 at 37 weeks' gestation. The client's history indicates that the client has had alcohol abuse disorder throughout their pregnancy. What signs and symptoms does the nurse expect the newborn to exhibit?
high-pitched shrill cry thin upper lip jitteriness flat midface
A nurse in the pediatrician's office is providing teaching to a parent of a 24-month-old child who has been diagnosed with muscular dystrophy (MD).
Respiratory infection cardiomyopathy
Click to highlight the findings that will require follow-up.
-APGAR score of 5 at 1 minute -green-stained umbilical cord -95.9 -serum glucose 22 mg/dl (1.22 mmol/)
The nurse in the emergency department is caring for a 10-year-old female child with sickle cell crisis. Child rates pain 10 on a scale of 0 to 10. Vital signs: 99.8°F (37.6°C); heart rate, 122 beats/min; blood pressure, 92/50 mm Hg; respiratory rate, 26 breaths/min; oxygen saturation, 92% on room air.
Administer oxygen to maintain oxygen saturation greater than 95%. Start normal saline continuous intravenous (IV) infusion at 200 ml/hr. Administer 100 mcg/kg morphine IV for pain prn q4 hours.
The nurse in the labor and delivery unit is performing a focused assessment on a client who is 2 hours postpartum. Assessment reveals a headache 3 out of 10 on a scale of 0 to 10. Vital signs: temperature, 99.1°F (37.3°C); heart rate, 101 beats/min; blood pressure, 87/58 mm Hg; capillary refill time, less than 3 seconds. Client reports a small gush of blood the first time out of bed to ambulate to the bathroom. Three perineal pads have been saturated since birth.
Postpartum hemorrhage saturated peroneal pads blood pressure 87/58
The emergency department nurse is assessing a 13-year-old male child. The child's parents report the child "has been very tired lately" and that the child has been "very thirsty and urinating frequently" and has not had "any fever or appetite." Nursing assessment reveals very dry, warm skin with dry, cracked mucous membranes. Vital signs: temperature, 99.9°F (37.7°C); heart rate, 123 beats/min; blood pressure, 80/42 mm Hg; respiratory rate, 24 breaths/min; oxygen saturation, 97% on room air. Laboratory values: sodium, 148 mEq/l (148 mmol/l); blood urea nitrogen (BUN), 22 mg/dl (7.85 mmol/l); hemoglobin, 13 g/dl (130 g/l); hematocrit, 48% (0.48); urine specific gravity, 1.001.
DM and DI: everything except decreased appetite SIADH: decreased LOC
A nurse performs an assessment on a 35-year-old client who developed leg pain. The client smokes one pack of cigarettes per day and drinks alcohol socially. Assessment reveals a red, swollen right lower extremity that is warm to the touch, and pain increases with ambulation or dorsiflexion of the right foot. Client reports recent nausea, vomiting, breast tenderness, and weight gain after starting oral contraceptives.
DVT calf pain and swelling
Parents bring their 5-year-old child to the pediatrician's office for reports of difficulty defecating, distended abdomen, abdominal and rectal pain, decreased appetite, liquid stool-soiled underwear, and increased frequency of urinary tract infections (UTIs).
Encopresis: everything Intussusception: Everything except UTI Hirschsprung: everything except UTI and rectal pain
A school nurse is called to the school cafeteria after a 13-year-old child is reported to have sudden difficulty breathing. The child has a history of asthma and allergies to peanuts. The focused nursing assessment reveals difficulty breathing, inspiratory and expiratory wheezing, swelling of lips, and a rash on the face. The child reports feeling nauseated, having chest tightness, and feeling faint.
wheezing swelling of lips
