health promotion an dmaintenance nclex review

A client is a long-distance runner and is 8 weeks pregnant with her first baby. The client tells the nurse that she would like to continue running throughout the pregnancy and asks the nurse if there are any safety risks. Which response by the nurse correctly identifies musculoskeletal changes in pregnancy that may be a safety risk to the client? a. "The joints of the pelvis relax." b. "All muscles are weakened." c. "The long bones increase in density." d. "The spinal column flattens."

a. "The joints of the pelvis relax."

A nulligravid client with gestational diabetes tells the nurse that she had a reactive nonstress test 3 days ago and asks, "What does that mean?" The nurse explains that a reactive nonstress test indicates which of the following about the fetus? a. Fetal well-being at this point in the pregnancy. b. No accelerations demonstrated within a 20-minute period. c. Evidence of late decelerations occurring during the test. d. Evidence of some compromise that will require birth soon.

a. Fetal well-being at this point in the pregnancy.

The nurse is working in the labor and birth unit when a client with active herpes simplex virus-Type 2 (HSV-2) appears in active labor. Which adjustment in the plan of care is anticipated? a. Place an antibacterial ointment on the mother's lesions. b. Prepare the client for a cesarean section. c. Administer an intravenous antibiotic to the client while in labor. d. Complete a full assessment of the newborn on birth.

b. Prepare the client for a cesarean section.

Which findings are considered positive signs of pregnancy? a. quickening and breast enlargement b. fetal heartbeat and fetal movement on palpation c. abdominal enlargement and Braxton Hicks contractions d. fatigue and skin changes

b. fetal heartbeat and fetal movement on palpation

The nurse is caring for a pregnant client. The nurse notes hypotension and a non-reassuring fetal heart tracing. Which action would the nurse include in the client's plan of care? a. Encourage the client to hold her breath. b. Position the client on her left side. c. Have the client empty her bladder. d. Call the health care provider

b. position the client on her left side

A pregnant client's last menstrual period began on October 12. Using Naegele's rule, the nurse calculates the estimated date of delivery (EDD) as: a. June 5. b. June 19. c. July 19. d. July 5.

c. July 19.

A 24-year-old client admitted to the hospital is suspected of having an ectopic pregnancy. On admission, which factor would be most important to assess? a. type of oral contraceptives b. use of a diaphragm c. date of last menstrual period d. sexual practices

c. date of last menstrual period

A 16-year-old primigravid client at 37 weeks' gestation with severe preeclampsia is in early active labor. The client's blood pressure is 164/110 mm Hg. Which finding would alert the nurse that the client may be about to experience a seizure? a. decreased temperature b. hyporeflexia c. epigastric pain d. decreased contraction intensity

c. epigastric pain

A 29-year-old multigravida at 37 weeks' gestation is being treated for severe preeclampsia and has magnesium sulfate infusing at 3 g/h. What is the priority intervention to maintain safety for this client? a. Encourage family members to remain at bedside. b. Monitor maternal liver studies every 4 hours. c. Maintain continuous fetal monitoring. d. Assess reflexes, clonus, visual disturbances, and headache.

d. assess reflexes, clonus, visual disturbances, and headache

A client is in the last trimester of pregnancy. The nurse should instruct the client to notify the primary health care provider immediately if she notices: a. blurred vision. b. hemorrhoids. c. increased vaginal mucus. d. dyspnea on exertion.

a. blurred vision

The nurse is administering intravenous magnesium sulfate as prescribed for a client at 34 weeks' gestation with severe preeclampsia. What are desired outcomes of this therapy? Select all that apply. a. magnesium level = 5.6 mg/dL (2.8 mmol/L) b. urinary output less than 30 mL/h c. temperature, 98° F (36.7° C); pulse, 72 beats/min; respiratory rate, 14 breaths/min d. fetal heart rate with late decelerations e. deep tendon reflexes 2+ f. blood pressure less than 140/90 mm Hg

a. magnesium level = 5.6 mg/dL (2.8 mmol/L) c. temperature, 98° F (36.7° C); pulse, 72 beats/min; respiratory rate, 14 breaths/min e. deep tendon reflexes 2+

The nurse caring for a multigravida in active labor observes a variable fetal heart rate deceleration pattern. What should the nurse do first? a. Contact the client's primary care provider. b. Change the client's position. c. Document the tracing in the client's record. d. Administer oxygen by mask at 4 L.

b. Change the client's position.

When performing Leopold's maneuvers on a primigravid client at 22 weeks' gestation, the nurse performs the first maneuver to accomplish which action? a. determine whether the fetal head is at the pelvic inlet b. identify the degree of fetal descent and flexion c. determine what is in the fundus d. locate the fetal back and spine

c. determine what is in the fundus

A client is at an ideal weight when she conceives. During a prenatal visit 2 months later, the client asks the nurse how much weight she should gain during pregnancy. What is the nurse's best response? a. "You should gain 16 to 24 lb (7.3 to 10.9 kg)." b. "You should gain less than 10 lb (4.5 kg)." c. "You should gain 10 to 15 lb (4.5 to 6.8 kg)." d. "You should gain 25 to 35 lb (11.3 to 15.9 kg)."

d. "You should gain 25 to 35 lb (11.3 to 15.9 kg)."

During a nonstress test (NST), a nurse notes three fetal heart rate (FHR) increases of 15 beats/minute, each lasting 15 seconds. These increases occur only with fetal movement. How should the nurse interpret this finding? a. The test is inconclusive and must be repeated. b. The fetus is nonreactive and hypoxic. c. The client should undergo an oxytocin challenge test. d. The fetus is not in distress at this time.

d. The fetus is not in distress at this time.

A 25-year-old woman who is in the first stage of labor receives a continuous lumbar epidural block when the cervix is 6 cm dilated. After administration of this anesthesia, which assessment would be most important? a. maternal pulse b. level of anesthesia c. level of consciousness d. fetal heart rate

d. fetal heart rate

Which medication is considered safe during pregnancy? a. oral antidiabetic agents b. aspirin c. magnesium hydroxide d. insulin

d. insulin

A primigravid client is seen for her first visit in the antenatal clinic and tells the nurse that her brother was born with cystic fibrosis (CF). When teaching the client about this disorder, the nurse should include which information? Select all that apply. a. Chorionic villi sampling (CVS) can identify prenatally if their child carries the trait or has the disease. b. If both parents carry the trait, each offspring has a 25% chance of inheriting the disease. c. To inherit CF, each parent must carry a recessive trait for the disease. d. Persons of Asian descent have the highest inheritance rates. e. Fetal testing can occur by checking the shape of the red blood cells.

a. Chorionic villi sampling (CVS) can identify prenatally if their child carries the trait or has the disease. b. If both parents carry the trait, each offspring has a 25% chance of inheriting the disease. c. To inherit CF, each parent must carry a recessive trait for the disease.

The nurse is caring for a client who is in active labor. The client states, "I think my water just broke!" The fetal heart rate shows a prolonged variable deceleration to 80 beats per minute. The nurse performs a sterile vaginal exam and feels a pulsating cord in the vaginal canal. What are the nurse's priority interventions at this time? Select all that apply. a. Keep fingers in the vagina to keep pressure off of the cord. b. Move the client's bed into Trendelenburg position. c. Insert an indwelling catheter to empty the patient's bladder. d. Clip any hair from the surgical site. e. Have the anesthetist insert an epidural for pain control. f. Have the patient's family call for help.

a. Keep fingers in the vagina to keep pressure off of the cord. b. Move the client's bed into Trendelenburg position. f. Have the patient's family call for help.

The nurse on the antenatal unit is planning care for four clients. The nurse should assess which client first: a. a 19-year-old 18 weeks' intrauterine pregnancy (IUP) who is now 12 hours post motor vehicle accident with bright red vaginal bleeding b. a client at 38 weeks' gestation hospitalized frequently during this pregnancy for placenta previa and who two days ago was admitted with severe bright red vaginal bleeding that has tapered off now c. a 9-week IUP hospitalized for hyperemesis gravidarum who has not vomited for the last 12 hours d. a 29-year-old client carrying twins, being treated for preterm labor at 29 weeks' gestation and receiving magnesium sulfate at 2 g/h, with stable fetal heart rates and no contractions for the past 2 hours

a. a 19-year-old 18 weeks' intrauterine pregnancy (IUP) who is now 12 hours post motor vehicle accident with bright red vaginal bleeding

A client is admitted to the facility with a suspected ectopic pregnancy. When reviewing the client's health history for risk factors for this abnormal condition, what would the nurse most expect to find? a. a history of pelvic inflammatory disease b. use of an intrauterine device for 1 year c. grand multiparity (five or more births) d. use of a hormonal contraceptive for 5 years

a. a history of pelvic inflammatory disease

A client, 38 weeks pregnant, arrives in the emergency department complaining of contractions. To help confirm that she's in true labor, the nurse should assess for: a. changes in cervical effacement and dilation after 1 to 2 hours. b. irregular contractions. c. increased fetal movement. d. contractions that feel like pressure in the abdomen and groin.

a. changes in cervical effacement and dilation after 1 to 2 hours.

A nurse is teaching a client about hormonal contraceptive therapy. If a client misses three or more pills in a row, the nurse should instruct the client to a. discard the pack, use an alternative contraceptive method until her period begins, and start a new pack on the regular schedule. b. take two pills for the next 2 days and use an alternative contraceptive method until the next cycle. c. take all the missed doses as soon as she discovers the oversight. d. take three pills for the next 3 days and use an alternative contraceptive method until the next cycle.

a. discard the pack, use an alternative contraceptive method until her period begins, and start a new pack on the regular schedule.

When the nurse is assessing a 34-year-old multigravid client at 34 weeks' gestation experiencing moderate vaginal bleeding, which symptom would most likely alert the nurse that placenta previa is present? a. painless vaginal bleeding b. dull lower back pain c. intermittent pain with spotting d. uterine tetany

a. painless vaginal bleeding

The nurse is caring for a client who is 32 weeks pregnant. The client is started on nifedipine for preterm labor. Which of the following statements made by the client demonstrate an understanding of the plan of care? Select all that apply. a."I will check my blood pressure prior to taking my scheduled nifedipine." b. "I will avoid sexual intercourse until my physician says otherwise." c. "I will drink 2 to 3 quarts (1.9 to 2.8 liters) of water per day." d. "I will move about frequently to keep my contractions regular." e. "I will not take my scheduled nifedipine if I have a headache."

a."I will check my blood pressure prior to taking my scheduled nifedipine." b. "I will avoid sexual intercourse until my physician says otherwise." c. "I will drink 2 to 3 quarts (1.9 to 2.8 liters) of water per day."

A client who has been treated for infertility is now pregnant. During a routine ultrasound at 8 weeks' gestation, she learns that five fetuses are visualized. The client's husband is concerned that five infants will not survive and that his wife may not be able to handle the stress of the pregnancy, so he asks the nurse about selective reduction. What is the nurse's best response? a. "That choice is your wife's because she is carrying the babies." b. "It has been used to decrease the possibility of complications." c. "You should be glad that your wife has conceived." d. "Why would you consider such a procedure?"

b. "It has been used to decrease the possibility of complications."

On the first postpartum day, the nurse instructs a primipara who has given birth to a term neonate about the neonate's senses. Which statement by the mother indicates successful teaching? a. "My baby will not be able to hear very well for a few weeks." b. "My baby has very good peripheral vision and can see shapes." c. "My baby's eye color will be established by 1 month of age." d. "My baby can distinguish the color red from the color blue."

b. "My baby has very good peripheral vision and can see shapes."

After giving birth to a viable neonate 12 hours ago, the client's fundus is firm at midline, and her breasts are soft. She has scant lochia and she is voiding sufficiently. The client reports pain in her lower back. What should the nurse do next? a. Contact the primary care provider for a prescription to obtain a urinalysis. b. Administer a prescribed mild analgesic. c. Instruct the client to perform abdominal exercises. d. Ask the client how long she was in labor.

b. Administer a prescribed mild analgesic.

The health care provider prescribes clomiphene citrate for a woman who has been having difficulty getting pregnant. When teaching the client about this drug, the nurse should discuss what potential adverse effects? a. increase in spontaneous abortions b. chance of multiple gestation. c. increase in congenital anomalies d. increase in fibrocystic breast disease

b. chance of multiple gestation.

A client is attempting to give birth vaginally despite the fact that her previous child was born by cesarean birth. Her contractions are 2 to 3 minutes apart, lasting from 5 to 100 seconds. Suddenly, the client complains of intense abdominal pain and the fetal monitor stops picking up contractions. The nurse recognizes which complication has occurred? a. abruptio placentae b. complete uterine rupture c. prolapsed cord d. partial placenta previa

b. complete uterine rupture

While caring for a primigravid client with class II heart disease at 28 weeks' gestation, the nurse would instruct the client to contact her primary health care provider (HCP) immediately if the client experiences which symptom? a. mild ankle edema b. dyspnea at rest c. weight gain of 1 lb (0.45 kg) in 1 week d. emotional stress on the job

b. dyspnea at rest

A 26-week gestation pregnant woman has completed a 1-hour glucose screening test. What action should the nurse take first if the glucose level is 150 mg/dL (8.3 mmol/L)? a. Instruct the client on proper diet. b. Teach the client how to administer insulin. c. Refer the client for a 3-hour glucose test. d. Document the results as normal.

c. Refer the client for a 3-hour glucose test.