335 exam 1 questions

Nurse Jill is teaching Ms. Anderson the technique for self-blood glucose monitoring. Identify the sequence of actions Ms. Anderson should take when performing a self-blood glucose test. Place them in order of performance

1.) Choose a vascular Puncture Site2.) Wipe the finger with an antiseptic swab3.) Prick the finger using a dart-like motion4.) Gently Squeeze around the puncture site5.) Hold the Strip under the puncture site6.) Apply pressure to the puncture site

Nurse Jill is reviewing the components of the biophysical profile for Ms. Anderson. Nurse Jill should recognize which of the following components of a biophysical profile?

1.) Fetal Tone2.) Fetal Breathing Movement3.) Amniotic fluid volume4.) Gross body movement

Scenario:Nurse Darla is preparing to obtain a urine specimen from the urinary catheter. Question:Nurse Darla is preparing to obtain a urine specimen from the urinary catheter after the catheter was clamped 3 inches below the collection port. Identify the sequence of steps Darla should take when preforming this procedure. (Reorder the steps by dragging them into the desired sequence.)

1.Don gloves.2.Disinfect the port.3.Access the port.4.Unclamp the drainage tube. 5.Withdraw the specimen.

Nurse Morgan is preparing to teach Ms. Klein about delivery by C-section. Which of the following should Morgan Include in the teaching? (select all that apply)

1.Monitoring of the fetal HR will continue 2. you will receive antiemetic meds 3. you will receive pain med following the procedure

Scenario:Nurse Darla is teaching Ms. Goodwin about signs of true labor. Question:Nurse Darla is teaching Ms. Goodwin about signs of true labor. Which of the following statements by Ms. Goodwin indicates an understanding of the teaching?

"I will experience pressure in my pelvis."

Scenario:Nurse Darla is planning care for Ms. Goodwin after Ms. Goodwin experienced a gush of fluid. Question:Nurse Darla is planning care for Ms. Goodwin after Ms. Goodwin experienced a gush of fluid. Which of the following is the priority action at this time?

Evaluate the fetal heart rate

This test can be done to predict if the pt will deliver in the next 2 weeks

FFN

Antiretrovirals

For HIV When do we start? à immediately

What is Calcium gluconate used for?

For mag toxicity

Mrs. Haala is in the clinic for a scheduled appointment at 36 weeks. The nurse is providing education to her about a test that the provider wants to perform today. What test is it?

GBS

This test is done around 35-36 weeks, if mom is positive, she will receive abs during labor

GBS

Patient is in clinical for preconception healthcare, she is adopted & has unknown health hx, what test can be done?

Genetic counseling

what meds anticipate for pt in preterm labor

INMT Indomethacin Nifedipine Magnesium sulfate Terbutaline ***betamethasone (also)

Good way to remember to do an NST first

If ultrasound is going to be near an hour wait

Patient wants this blood test done to see the chances of baby having spina bifida, but she is only 22 weeks along so it's too early to have this test done

MSAFP

Nurse Ellen is preparing to administer a 1-hour oral glucose tolerance test for Ms. Anderson. Which of the following actions should Ellen take?

Obtain a blood specimen 1 hour after Ms. Anderson ingests the oral glucose solution

Mrs. Haala's provider suspects her fetus to be anemic. What diagnostic test will the provider recommend be done at this time?

PUBS

Patient is 18 weeks pregnant; provider thinks there is a blood type incompatibility, provider recommends which diagnostic test to be done

PUBS

What med would you give to a patient with an eclamptic seizure

magnesium sulfate

What med would you give to a patient with an ectopic pregnancy

methotrexate

hypertensive crisis plus preeclamptic

nifedipine labetalol hydralazine betamethasone

Nurse Jill is teaching Ms. Anderson about a 3-hr oral glucose tolerance test to confirm a diagnosis of gestational diabetes. Which of the following should be included in the teaching?

the nurse will check your blood glucose level hourly during the test

Mrs. Robinson and her partner became pregnant through IVF. She is 32 y/o G1P0 at 9 weeks gestation. During the IVF, she had 4 embryos transferred to her uterus, and today they are going to determine the number of fetuses she is carrying. What antepartal test will be used for this determination?

ultrasound

Provider wants to rule out issues with placenta, what test to check for internal bleeding

ultrasound

Scenario:Nurse Darla and the charge nurse are discussing nifedipine (Procardia). Question:Nurse Darla and the charge nurse are discussing nifedipine (Procardia). Which of the following statements by Darla indicates an understanding of the medication?

· "I should assess her for facial flushing."

When should you perform Leopold's maneuver?

· 3rd trimester

Scenario:Nurse Darla completed a vaginal examination on Ms. Goodwin. Question:Nurse Darla completed a vaginal examination on Ms. Goodwin and notified the provider of her findings. Which of the following actions is the highest priority?

· Administer nifedipine (Procardia).

Scenario:Nurse Darla is preparing to administer betamethasone (Celestone) to Ms. Goodwin. Question:Nurse Darla is preparing to administer betamethasone (Celestone) to Ms. Goodwin. Which of the following is an appropriate action for Darla to take?

· Administer the medication into the ventrogluteal muscle (IM)

Scenario:Nurse Darla is planning to administer magnesium sulfate to Ms. Goodwin. Question:Nurse Darla is planning to administer magnesium sulfate to Ms. Goodwin. Which of the following indicate magnesium sulfate toxicity? (Select all that apply.)

· Altered level of consciousness Urinary output less than 30 mL/hr Respiratory rate less than 12/min

Mrs. Dorsey is a 38 y/o G1P0 at 16 weeks gestation. Her husband has a history of cystic fibrosis, and they would like thorough genetic testing performed. Which test would be the most appropriate for this pt at this time?

· Amniocentesis

Ms. Volz is primigravida at 35 weeks gestation. She was recently diagnosed with preeclampsia. The provider would like to induce Ms. Volz at this time but would like to determine if the lungs are developed enough in the fetus. Which diagnostic test would the provider order?

· Amniocentesis- L/S

Nurse Morgan reviews the lab test results for Ms. Klein. Which of the following findings confirms a diagnosis of severe preeclampsia?

· Aspartate aminotransferase (AST) 75 units/ L

Scenario:Nurse Darla is preparing to administer ampicillin (Ampicin) to Ms. Goodwin. Question:Nurse Darla is preparing to administer ampicillin (Ampicin) to Ms. Goodwin. Which of the following is an appropriate action for Darla to take?

· Assess Ms. Goodwin for sensitivity to cephalosporin.

Ms. Shifflett is a 17 y/o G1P0 at 34 weeks who is in OB triage complaining of decreased fetal movement. Over the last hour, the nonstress test was nonreactive, and you have not seen any movement. What test would the provider most likely perform at this time?

· BPP

Where does the EFM get placed?

· Baby back

What screening test might the provider order if her fundal height is truly more than 2 weeks different than her gestation?

· Bladder is full

which of the following labs are normally collected at the initial prenatal appointment around 8 weeks gestation?

· CBC- H&H · HIV · VDRL/ RPR- syphilis · Blood type · Hep b · Rubella

What are signs of magnesium sulfate toxicity?

· CNS effect · Urinary retention · Dec DTR · Dec RR

Scenario:Nurse Darla confirms uterine contractions are occurring on the fetal monitor. Question:Nurse Darla confirms uterine contractions are occurring on the fetal monitor. Which of the following is the priority nursing intervention?

· Check for effacement and cervical dilation

Nurse Jill is discussing the treatment of hypoglycemia with Ms. Anderson. Which of the following should Jill include in the teaching?

· Drink 4 oz. of regular non-caffeinated soft drink

Scenario:Nurse Darla is interviewing Ms. Goodwin about her report of a burning sensation when voiding. Question:Nurse Darla is interviewing Ms. Goodwin about her report of a burning sensation when voiding. Which of the following clinical findings should Darla anticipate? (Select all that apply.)

· Fever Dysuria Urinary frequency

What are some common complaints patients have when they are on magnesium sulfate?

· Flushing · Diaphoresis · Drowsiness · Headache · Dec BP

Mrs. Haala is receiving education related to how she can monitor fetal well being at home. The nurse educates Mrs. Haala on how to do this screening test by herself every day.

· Kick counts

Mrs. Sutton is a 28 y/o G3P1... at 15 weeks who is here for routine blood work and screening. She asks if youre going to do the test that checks for "that spinal problem" that she had with her other pregnancies. What test is Mrs. Sutton referring to?

· MSAFP

Mrs. Cook is a 33 y/o G2P0 at 36 weeks arriving at the OB clinic for follow- up after a car accident this morning. The provider would order this test to assess for fetal- well-being after a traumatic event.

· NST- non stress test

nurse ellen is explaining the risk factors for developing gestational diabetes to Ms. Anderson. Which of the following should Ellen include?

· Obesity, Maternal age over 30, Family History of diabetes Mellitus

What can Leopold's maneuver predict?

· Position of baby

Why might a patient receive magnesium sulfate?

· Preterm labor · Seizures- preeclampsia/ eclampsia · Neural protection

Nurse Jill is preparing to educate Ms. Anderson regarding self-administering regular insulin (Humulin R). Which of the following should Jill include in the teaching?

· Rotate the administration of insulin within one site for a week

Nurse Morgan is reviewing prescription for Dr. Hunt, For which of the following manifestations should she plan to monitor following administration of hydralazine (Apresoline

· Tachycardia and BP

Scenario:Nurse Darla is teaching Ms. Goodwin about bed rest. Question:Nurse Darla is teaching Ms. Goodwin about bed rest. Which of the following potential adverse effects should Darla include in the teaching?

· Thrombus formation

What are some causes for a patient to have a fundal height that is greater and lesser than how many weeks gestation she is?

· Too much or too little fluid · Growth of baby

Where does the TOCO get placed?

· Top fundus

Mrs. Hunter is a 30 y/o G5P3 at 42 weeks. The provider is concerned that Mrs. Hunter's placenta is beginning to degrade and is not functioning well and needs to determine if Mrs. Hunter is developing oligohydramnios. Which screening tool would the provider use to determine this?

· Ultrasound- AFI

Is it normal for a pt at 40 week gestation to measure only 37 weeks? Why?

· Yes, lightening

Nurse Jill is teaching Ms. Anderson about dietary modifications for gestational diabetes. Which of the following should Jill include in the teaching?

· You should consume 2,000 calories daily

Nurse Jill is explaining the unexpected results of the 3-hr oral glucose tolerance test to Ms. Anderson. Which of the following is an appropriate statement by Jill?

· You will have a diagnosis of gestational diabetes if two blood glucose levels are elevated

What could you suspect if the EFM picks up fetal heart tones in the RUQ?

· breached

Nurse Morgan recognizes Ms. Klein is experiencing variable decelerations of the fetal heart rate. Which of the following nursing interventions should Morgan take at this time?

· change Ms. Klein position

List some of the warning signs that patients should be educated to report as you watch the video

· fever · severe vomiting · burning with urination · vaginal bleeding · uterine contractions · severe back pain · epigastric pain · severe headache · visual disturbances · changes in fetal movement · swelling of the finger or face

Nurse Morgan is reviewing Ms. Klein's lab test result. Which of the following findings should Morgan discuss with Ms. Klein regarding her worsening condition?

· increased proteinuria

Nurse Jill is preparing Ms. Anderson for a nonstress test. Which of the following actions should Jill take?

· instruct Ms. Anderson to press the handheld marker when she feels fetal movement

Nurse Morgan is administering IV magnesium sulfate to Ms. Klein. Which of the following manifestations indicates Ms. Klein is experiencing magnesium toxicity?

· respiration's 11/min

Scenario:Nurse Darla is teaching Ms. Goodwin about receiving tocolytic therapy. Question:Nurse Darla is teaching Ms. Goodwin about receiving tocolytic therapy. Which of the following statements by Ms. Goodwin indicates she understands the effects of the therapy?

"I may experience hot flashes throughout the day."

This test should be repeated in 12-24 hours if the score is 6-8, normally done if an NST is nonreactive

BPP

Scenario:Nurse Darla recognizes late decelerations on the fetal monitor. Question:While evaluating the heart rate of the fetus, Nurse Darla recognizes late deceleration on the fetal monitor. Identify the sequence of steps Darla should take next. (Reorder the steps by dragging them into the desired sequence.)

1.Place Ms. Goodwin in the lateral position. 2.Increase the rate of lactated Ringer's. 3.Assess the frequency of uterine contractions. 4.Apply oxygen at 8 L/min via face mask.

At which gestation should you start measuring fundal height?

20 weeks

If a pt is 24 weeks gestation, what should her fundal height measure?

24

Scenario:Nurse Lance is conducting Apgar scoring on Ms. Goodwin's newborn.Question:Nurse Lance is conducting Apgar scoring on Ms. Goodwin's newborn. Which of the following is an appropriate score to assign to the newborn?

5

An ultrasound is used during THIS test to look for/ diagnosis polyhydramnios

AFI

Scenario:Nurse Darla is evaluating Ms. Goodwin for uterine contractions. Question:Nurse Darla assists Ms. Goodwin to bed. Which of the following is an appropriate action for Darla to take?

Apply a fetal monitor and tocotransducer.

Scenario:Nurse Darla is planning care for Ms. Goodwin, who has a prolapsed cord.Question:Nurse Darla is planning care for Ms. Goodwin, who has a prolapsed cord. Which of the following is the priority action for Darla to take?

Apply pressure through the vaginal canal on the presenting parts

What med would you anticipate giving for a patient who is GBS negative

Do nothing! NO MEDS GIVEN

What meds are considered teratogens

Warfarin Lisinopril (ACE-I) Carbamazepine (epileptic drug)

An abnormal MSAFP should be followed up with THIS if the patient is 17 weeks

amniocentesis

What is the antidote?

calcium gluconate

What med would anticipate the doctor to order for infertility d/t inability to ovulate

clomid

Nurse Jill is teaching Ms. Anderson about clinical manifestations of hypoglycemia. Jills tells Ms. Anderson to watch for diaphoresis, headache, and shakiness. Which of the following additional manifestations should Jill include in the teaching?

dizziness

Nurse Jill is discussing potential complications of gestational diabetes with Ms. Anderson. Gestational diabetes places the newborn at risk for which of the following?

hypoglycemia