315 - Exam 2 (Prep U & Nearpod)
What is a consequence of hypothermia in a newborn? A. respirations of 46 B. heart rate of 126 C. holds breath 25 seconds D. skin pink and warm
C
What anatomic area should be examined when assessing Montgomery glands (Montgomery tubercles)? A. thorax B. abdomen C. breasts D. perineum
C
For a 7 year old child, which specific gravity reading is most suggestive of post surgical blood volume loss... A. 1.001 B. 1.010 C. 1.020 D. 1.045
D
A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the neonate is being born. Which intervention should the nurse implement as a result of this finding? A. Provide supplemental oxygen and monitor respiratory status B. Administer oxygen via a bag and mask C. Gently shake the neonate D. Flick the sole of the neonate's foot
A
Besides "carrier" of the cystic fibrosis allele, which word describes the genetic state of the two parents described in this case? A. homozygous B. heterozygous C. normozygous D. unizygous
B
A primigravida at her 12-week prenatal visit expresses concern that she hasn't felt her baby move yet. What is the best response from the nurse? A. "Fetal movements can be felt at 13 weeks." B. "You should start to feel fetal movements within the next few weeks." C. "You usually cannot feel them until approximately 16 to 20 weeks." D. "You won't be able to feel movements until you lie down and concentrate on them."
C
An adolescent at 8 weeks' gestation is at her first prenatal visit. During the health history interview, the nurse asks the client, "Are you afraid of anyone?" What is the nurse assessing with this question? A. mood B. mental status C. intimate partner violence D. social history
C
A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn? A. meconium aspiration in utero or at birth B. seizures, respiratory distress, cyanosis, and shrill cry C. yellow appearance of the newborn's skin D. tremors, irritability, and high-pitched cry
A
A cesarean birth results in an infant weighing 4,990 g (11 lb). The nurse assesses the infant for which complication? A. transient lung fluid B. diaphragmatic paralysis C. broken clavicle D. serum glucose 45 mg/dl (2.50 mmol/L)
A
A newborn's mother has a history of prenatal oxycontin abuse. Which of the following nursing intervention would be most appropriate for this infant? A. Offer infant a pacifier B. Place musical mobile in crib C. Encourage family to stroke and talk to the infant D. Give sucrose water in a bottle in between feedings
A
A nurse is providing care to a large for gestational age newborn. The newborn's blood glucose level was 32 mg/dL one hour ago. Breast-feeding was initiated. The nurse checks the newborn's blood glucose level and finds it to be 23 mg/dL. Which action would the nurse do next? A. Administer intravenous glucose. B. Feed the newborn 2 ounces of formula. C. Initiate blow-by oxygen therapy. D. Place the newborn under a radiant warmer.
A
An LGA newborn has a blood glucose level of 30 mg/dL and is exhibiting symptoms of hypoglycemia. Which action would the nurse do next? A. Encourage frequent feedings B. Feed the newborn 2 ounces of dextrose water. C. Initiate blow-by oxygen therapy. D. Place the newborn under a radiant warmer.
A
An infant is born with respiratory depression. The provider begins actions to maintain effective ventilation. When would the nurse initiate chest compressions? A. when the heart rate is less than 60 beats per minute B. when there is no cardiac activity detectable C. when no spontaneous respiratory effort is visible D. when the pulse oximetry reading is less than 80%
A
An infant who is diagnosed with meconium aspiration displays which symptom? A. intercostal and substernal retractions B. pink skin C. respirations of 45 D. no heart murmur
A
An obese woman with diabetes has just given birth to a term, large-for-gestational-age (LGA) newborn. Which condition should the nurse most expect to find in this infant? A. hypoglycemia B. hyperglycemia C. hypotension D. hypertension
A
Baby is ordered to have two antibiotics, ampicillin and gentamycin. Since she is on gentamycin, what is an important consideration? A. She will need to have a hearing screening test B. You will need to check daily electrolytes C. She will need liver function tests D. You will need o monitor for bradycardia
A
During the health assessment of a pregnant client who is 30 years old, the nurse discusses preventive breast care. Which recommendation would the nurse include? A. "A breast examination by a health care provider can help detect if there are any structural problems that may affect breastfeeding." B. "You should perform monthly breast self-examination." C. "Beginning now, at age 30, you should have annual mammograms." D. "You should consider being vaccinated against HPV, a virus associated with the development of breast cancer."
A
Jennie Agg, the woman who experienced 4 miscarriages prior to a successful pregnancy, described expecting her husband to say "I have good news" you're still pregnant and the tests were a big mistake." Which stage of grief is she describing? A. Denial B. Anger C. Bargaining D. Depression E. Acceptance
A
The blood tests for a primigravida client indicate that the client is Rh-negative and her partner is Rh-positive. What is an appropriate nursing intervention for this client? A. Arrange for Rho(D) immune globulin at 28 weeks' gestation. B. Make necessary arrangements for blood transfusion. C. Inform the client about the possibility of a cesarean section. D. Prepare the client for the possibility of a spontaneous abortion (miscarriage).
A
The infant is born with copious secretions in the mouth and nose. When using a bulb syringe to remove secretions, the nurse might observe what response from the infant? A. heart rate of 88 beats per minute B. heart rate of 180 beats per minute C. respiratory rate of 72 breaths per minute D. respiratory rate of 40 breaths per minute
A
The nurse begins frequent oral feedings for a small-for-gestational-age newborn to prevent which occurrence? A. hypoglycemia B. polycythemia C. meconium aspiration D. asphyxia
A
The nurse examines a 26-week-old premature neonate. The skin temperature is lowered. What could be a consequence of the infant being cold? A. apnea B. tachycardia C. sleepiness D. crying
A
The nurse places a newborn experiencing respiratory difficulty under a radiant warmer to prevent which complication? A. acidosis B. alkalosis C. hypoxia D. hypercapnia
A
Which assessments on a preterm infant are of most concern to the nurse? A. Grunting respirations B. Respiratory rate 65/minute C. Auscultated crackles D. Nasal flaring absent
A
Which condition may cause intrauterine asphyxia? Select all that apply. A. cord compression B. placental abruption (abruptio placentae) C. intrauterine growth restriction (IUGR) D. gestational diabetes E. group B streptococcus (GBS) infection
A B C
What is a classic sign of neonatal respiratory distress syndrome? Select all that apply. A. expiratory grunting B. nasal flaring C. retractions D. tachypnea E. bradypnea
A B C D
A nurse is conducting a program about the importance of prenatal care for a group of women in a community health clinic. Which information would the nurse include when describing the purpose of prenatal care? Select all that apply. A. Establish a baseline of present health. B. Determine the gestational age of the fetus. C. Monitor for fetal development and maternal well-being. D. Maximize the risk of possible complications. E. Identify women at risk for complications. F. Increase the business of the clinic.
A B C E
A client at 10 weeks' gestation is reporting nausea and vomiting throughout the day. What interventions would the nurse recommend to this client? Select all that apply. A. Eat small frequent meals. B. Avoid fried foods. C. Take an over the counter antiemetic. D. Eat saltine crackers before getting out of bed. E. Eat a large, protein-rich meal in the evening.
A B D
A baby's mother is HIV positive. Which of the following interventions is most important when planning care for this newborn? A. Encourage mother to breast feed B. Administer zidovudine (ZDV) after delivery C. Swaddle the baby, hold and rock D. Place baby's crib in a quiet corner of the. nursery
B
A nurse is taking a history during a client's first prenatal visit. Which assessment finding would alert the nurse to the need for further assessment? A. history of exercising twice a week B. history of diabetes for 4 years C. history of occasional use of OTC pain relievers D. maternal age of 28 years
B
An 18-year-old client has given birth at 28 weeks' gestation and her newborn is showing signs of respiratory distress syndrome (RDS). Which statement is true for a newborn with RDS? A. Glucocorticoid (GC) is given to the newborn following birth. B. RDS is caused by a lack of alveolar surfactant. C. Respiratory symptoms of RDS typically improve within a short period of time. D. RDS is characterized by heart rates below 50 beats per minute.
B
Baby girl Humphrey was born in a small rural hospital unexpectedly at 32 weeks gestation with a weight of 1000 grams (2 lb 3 oz). Her initial blood glucose was 60 mg/dl after birth. A pediatrician ordered oxygen and nasal continuous positive airway pressure (CPAP) due to poor respiratory effort. She is unable to feed by mouth due to respiratory distress. A transport team is on the way to take the infant to a metropolitan hospital with a NICU 2 hours drive away. While waiting for the team to arrive you check a glucoscan and the level was 42 mg/dl. What is your best action? A. Notify the transport team about the glucose level when they arrive B. Confer with the doctor about starting an IV with D10%W C. Report this normal glucoscan value to the doctor D. Insert an oral gastric tube in anticipation of tube feeding a small amount of formula
B
The father carries the gene for malignant hyperthermia. What's the chance a child born to these parents will be affected with malignant hypothermia? A. 25% B. 50% C. 75% D. 100%
B
The nurse is assessing a primipara's fundal height at 36 weeks' gestation and notes the fundus is now located at the xiphoid process of the sternum. The client asks if this is normal. Which response to the client would be best? A. "By this time, the fundus should drop down lower because the baby is moving towards the pelvic inlet." B. "At 36 weeks' gestation, the fundus is in the normal expected location." C. "To be honest, the fundus should be lower since you have gained minimal weight." D. "Just get prepared, the fundus might actually get a little higher until a few days before you go into labor."
B
The nurse is conducting an assessment of a pregnant client at a routine second trimester prenatal visit. Which lower extremity assessment should the nurse prioritize? A. Lateral movement of the kneecap B. Presence of varicosities C. Diameter of the calf muscle D. Blanching and refilling of toenails
B
The nurse is providing care for a pregnant client who has been given the necessary requisitions for laboratory work by the primary care provider. The client notices that the lab tests include testing for HIV and other sexually transmitted infections, and expresses alarm, stating, "I don't understand why the doctor would suspect that I've got these diseases." What is the nurse's most therapeutic statement? A. "Unfortunately, these infections have the potential to harm the fetus. It's important that the doctor identifies them early in your pregnancy." B. "Every pregnant client is tested for these diseases; it doesn't necessarily suggest that the doctor suspects that you have them." C. "Pregnancy is a major change, so every member of the care team makes sure that your health is assessed carefully." D. "Sexually transmitted infections are much more common than most people believe."
B
The nurse receives a call from a concerned client, who is 39 weeks' gestation, indicating the woman has "blood-tinged mucus seeping from the vagina." What does the nurse understand about this? A. The woman should rest on her left side and drink water. B. This is known as "bloody show" and is a normal finding at this time. C. The woman has likely been overly active, and should be evaluated for complications. D. This is known as Braxton Hicks contractions and is not a concern at this time.
B
The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation? A. at the level of the symphysis pubis B. at the level of the umbilicus C. at the level near the bottom of the sternum D. three finger-breadths above the umbilicus
B
While triaging messages from the answering machine from clients with the following symptoms, which client would obtain the first visit of the day? A. The client at 37 weeks' gestation experiencing shortness of breath B. The client at 11 weeks' gestation experiencing abdominal cramping C. The client at 24 weeks' gestation experiencing frequent heartburn D. The client at 6 weeks' gestation experiencing nausea and vomiting
B
Why is the first prenatal visit usually the longest prenatal visit? A. Laboratory tests are performed. B. Baseline data is collected. C. A pelvic exam with Papanicolaou test is performed. D. Extensive client teaching is done.
B
A gravid client is talking with the nurse about the excessive nausea and vomiting she has been experiencing throughout the day. She asks why this is happening to her and what she can do to reduce the nausea. What information should be included in the nurse's response? Select all that apply. A. The levels of estrogen normally seen in pregnancy are associated with nausea and vomiting. B. Limiting fluid intake during the morning and evening hours has been shown to reduce nausea in pregnancy. C. The changes in progesterone in pregnancy are associated with high levels of nausea in pregnancy. D. Ingesting small frequent meals in pregnancy is helpful to manage nausea. E. Eating a high carbohydrate snack before getting out of bed may be helpful.
B D
Baby boy Ellis is born to a mother with gestational diabetes. His birth weight was 4200 grams (9 pounds 4 oz). His initial glucoscan was 42 mg/dl and he breastfed immediately after a vaginal birth. His glucoscans monitored according to protocol and the next two values were 50 mg/dl and 47 mg/dl. During the night at 12 hours of life, Baby Ellis had a value of 38 mg/dl. He has been feeding well and has no respiratory distress, stable vital signs, and good muscle tone. Which action is best? A. Call the provider and ask for an order to start an IV with D10% B. Offer the infant a bottle of formula and let the mother sleep C. Assist the mother to breastfeed and check the glucose an hour late D. Call the NICU nurse and give a report. This infant will be transferred to NICU
C
In the first 24 hours after a 15 year old child has had abdominal surgery and a colostomy. You'd be concerned about... A. Body Image B. Infection C. Hemorrhage D. Pain
C
Mrs. Humphrey wants to know why her preterm infant needs a ventilator. What's the best answer for the nurse to provide? A. Ask the doctor. She'll be around soon. SB. She's too small to breathe normally C. Her lungs are immature and need help to expand D. She'll be fine after we give her the Survanta
C
The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of which factor? A. inability to clear fluids B. immature respiratory control center C. deficiency of surfactant D. smaller respiratory passages
C
To best support a 3-month-old infant's development in the hospital, which item would be most important/ A. A colorful music mobile placed in the crib B. A tablet to show videos and play music C. A pull-out bed for a parent to stay overnight D. A bouncy chair or swing
C
When giving medications to a toddler it's best to.... A. Mix the med in a sippy-cup of juice or milk B. Tell the child its candy C. Mix the med in a small amount of pudding or apple sauce D. ask the child when she wants to take the medicine
C
Which of the following is a feature of Down Syndrome that may be seen in a newborn infant? A. increased head size B. tachycardia C. small, low set ears D. micrognathia
C
A nurse is educating a pregnant client about physical changes that can occur in pregnancy. Which conditions are associated with physical changes in pregnancy? Select all that apply. A. persistent cough B. Kussmaul respirations C. nasal stuffiness and sinus problems D. thoracic breathing instead of abdominal breathing E. swollen and tender gums
C D E
A 12 year old boy state's he's afraid of getting stuck for an IV. The nurse's best choice of response... A. Wow, that's old to be afraid B. Don't worry, it won't hurt C. Why are you afraid? D. I'll help you get through it.
D
A 35-year-old woman, Sarah, G1P0 comes into your women's health clinic for a checkup. Which action of the nurse below shows attention to avoid minimizing a woman's feelings after a miscarriage? A. "Most women have successful pregnancy after a miscarriage." B. "Are you having any pain?" C. Avoid saying anything unless Sarah brings it up. D. "I'm so sorry for your loss. How are you doing?"
D
A high school student died of bacterial meningitis a week before graduation. The school nurse is assisting with grief counseling sessions with other high school students. Which of the following suggestion would be consistent with developmental needs of the adolescent? A. Suggest that graduation parties be canceled this year in honor of the deceased students. B. Make attendance optional for the week so students can stay at home with their families. C. Advise teachers to avoid mentioning the student who died. D. Encourage students to attend the memorial service together with friends
D
A nurse is assessing a pregnant client. Which of the following would the nurse document as an abnormal finding in a pregnancy? A. Lordosis B. Pedal edema C. Linea nigra D. Visual changes
D
A widower brings in his 4 year old son in to the pediatric clinic for a well child visit and immunizations. He asks the nurse for advice, "My wife died in an auto accident 6 months ago, but my son still asks when she's coming back. I don't know how to deal with his repeated questions. What should I do?" A. Avoid mentioning your wife and remove pictures of her around the house B. Consider finding a girlfriend to take over as your son's mom C. Don't respond to him each time he asks. He's being manipulative. D. Gently remind him each time. It's normal for a child this age to repeat questions.
D
At General Hospital, a nursing student cared for Mrs. Humphrey, a 70-year-old woman who died from the Covid-19 virus during the student's time at clinical. The adult daughter told the student that she dreads telling her eight-year-old daughter Joleen about her grandma's death. What should the nursing student suggest as the best approach? A. Nothing. She should go get the co-assigned nurse. B. Telling Joleen that her grandma is now an angel. C. Telling Joleen not to worry - the people only die when sick or old. D. Giving a simple honest explanation and listening to Joleen's concerns.
D
Baby Humphrey has been on a ventilator and improving for 2 days. Mrs. Humphrey wants to hold her so Mr. Humphrey can take a picture and put on Facebook What do you think the nurse should do? A. ask the doctor if Baby Humphrey can be extubated since she's improving B. Gently tell Mrs. Humphrey that it's unsafe for her to hold the baby at this time but you'll take a picture f all three of them up close to her. C. Assist Mrs. Humphrey to hold the baby, but advise against putting the baby's picture on Facebook. D. Assist Mrs. Humphrey to hold the baby while seated in a rocking chair, being careful not to extubate.
D
Jason, a two year old, is expected to have mastered use of which statement below? A. "Red tomatoses" B. "Please, please" C. "Baby shark" D. "Daddy come"
D
The nurse is educating the client at 12 weeks' gestation regarding the best types of exercise throughout pregnancy. Which activities should the nurse encourage? A. All activities that the client does in a prepregnant state B. Relaxing activities such as hot baths and jacuzzis C. High-impact movements enabling less time in the activity D. Stretching and breathing exercises such as yoga
D
When assessing a woman at follow-up prenatal visits, the nurse would anticipate which procedure to be performed? A. hemoglobin and hematocrit B. urine for culture C. fetal ultrasound D. fundal height measurement
D
When preparing a 5 year old for an outpatient surgical procedure the nurse advises the parent to... A. Tell the child not to worry, she'll be put to sleep for the procedure B. Remind the child of the procedure every day for several weeks prior c. Bring only a change of clothes; toys or blankets cannot be taken into the OR D. Read a children's book to the child about a child in the hospital showing usual people and activiites
D
When reviewing the medical record of a newborn who is large-for-gestational-age (LGA), which factor would the nurse identify as having increased the newborn's risk of being LGA? A. fetal exposure to low estrogen levels B. low weight gain during pregnancy C. low maternal birth weight D. maternal pregravid obesity
D
Which finding is indicative of hypothermia of the preterm neonate? A. regular respirations B. oxygen saturation of 95% C. pink skin D. nasal flaring
D
Which finding would the nurse expect to assess in a neonate experiencing opiate withdrawal? A. decreased deep tendon reflexes B. bradycardia C. difficult to arouse D. poor feeding
D
Which medication is contraindicated for the management of NAS... A. methadone B. phenobarbital C. morphine D. naloxone
D
Which of the following findings is most worrisome in Melissa, a woman in her 26th week of pregnancy? A. Generalized hair loss B. A hyperpigmented rash over the maxillary region bilaterally C. Nosebleeds D. Facial edema
D
Which of the following might get surgery canceled so you should call the doctor to inform... A. Two year old is crying loudly B. Parent does not speak English C. Child received DPT shot 2 weeks prior D. Child has temperature of 100.6F
D
Which of the following mothers needs Rhogam? A. Mother has A positive blood type and baby is O negative B. Mother has B positive blood type and baby has AB negative C. Mother has O negative blood type and baby is B negative D. Mother has B negative blood type and baby is B positive
D
Which of the following newborn infants is most at risk for hyperbilirubinemia? A. Mother has A positive blood type and baby is O negative B. Mother has AB negative blood type and baby is O negative C. Mother has B positive blood type and baby has AB negative D. Mother has O negative blood type and baby has B negative
D
Which of the following signs indicates pain in an infant? A. Grimace B. Withdrawal of limp from painful stimulus C. Decreased pulse oximeter reading D. All of the above
D
Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy? A. Split S1S2 B. Premature ventricular contractions C. S4 (atrial gallop) D. Soft systolic murmur
D
You are the nurse working in the women's health clinic in the UK where Jennie is a patient. You understand as a nurse that spiritual care is important. After reading the article and getting a sense of Jennie, which approach to spiritual care do you think would be most appropriate? A. Suggest she confides in a female priest affiliated with the Anglican church B. Put your arm around her and reassure her that her 4 previous babies who died are now angels in heaven. C. Say, "There's a reason for everything; we just don't know what those reasons are." D. Say, "Would you like to talk about how you're feeling about your pregnancy losses?"
D
