Nursing SS #1

Descriptions of young people with anorexia nervosa (AN) often include which criteria? Impulsive Extroverted Perfectionist Low achieving

Perfectionist

A nurse investigates energy theUrapSies aNndTlearns tOhat which therapies would be included? (Select all that apply.) Qi gong Osteopathy Imagery Healing touch Magnet therapy

Qi gong Healing touch Magnet therapy

What statement is true about smoking in college students? The rate of smoking cigarettes is declining. Smokeless tobacco use is rising dramatically. Regular cigar use is becoming more common. Students in the health professions do not smoke.

Regular cigar use is becoming more common.

Which behavior indicates that a woman is "seeking safe passage" for herself and her infant? She keeps all prenatal appointments. She "eats for two." She slowly drives her car. She wears only low-heeled shoes

She keeps all prenatal appointments.

A patient informs the nurse, "I can't sit in the yard for even 10 minutes without my skin turning red and tender." The nurse would assess for the use of which complementary alternative medicine (CAM)? St. John's wort Ginkgo biloba Feverfew Echinacea

St. John's wort

What best describes central nervous system (CNS) stimulants? Acute intoxication can lead to coma. They produce strong physical dependence. Withdrawal symptoms are life threatening. They can result in strong psychologic dependence.

They can result in strong psychologic dependence.

The school nurse is developing a curriculum for a junior human sexuality class. In order to provide the most up-to-date information, the nurse should be aware that which is the single most effective primary prevention strategy for preventing sexually transmitted infections (STIs)? a. A vaccine to prevent HPV infection b. HIV screening c. Abstinence d. The male condom

c. Abstinence

The client is emotionally upset about the recent diagnosis of stage IV endometrial cancer. Which action by the nurse is best? a. Let the client alone for a long period of reflection time. b. Ask friends and relatives to limit their visits. c. Tell the client that an emotional response is unacceptable. d. Create an atmosphere of acceptance and discussion.

d. Create an atmosphere of acceptance and discussion.

Pregnant adolescents are at greater risk for decreased body mass index (BMI) and "fad" dieting with which condition? Obesity Gestational diabetes Low-birth-weight babies High-birth-weight babies

Low-birth-weight babies

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. Which guidance should the nurse provide? "Since you're in your second trimester, there's no problem with having one drink with dinner." "One drink every night is too much. One drink three times a week should be fine." "Since you're in your second trimester, you can drink as much as you like." "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

"Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). Which response by the nurse is the most accurate? "The lubricant prevents vaginal irritation." "Nonoxynol-9 does not provide protection against STIs as originally thought" "The additional lubrication improves sex." "Nonoxynol-9 improves penile sensitivity."

"Nonoxynol-9 does not provide protection against STIs as originally thought"

After the nurse completes nutritional counseling for a pregnant woman, she asks the client to repeat the instructions to assess the client's understanding. Which statement indicates that the client understands the role of protein in her pregnancy? "Protein will help my baby grow." "Eating protein will prevent me from becoming anemic." "Eating protein will make my baby have strong teeth after he is born." "Eating protein will prevent me from being diabetic."

"Protein will help my baby grow."

In the acronym BRAIDED, which letter is used to identify the key components of informed consent that the nurse must document? B stands for birth control. R stands for reproduction. A stands for alternatives. I stands for ineffective.

A stands for alternatives.

Which sign of a potential complication is the most important for the nurse to share with the client? Constipation Alteration in the pattern of fetal movement Heart palpitations Edema in the ankles and feet at the end of the day

Alteration in the pattern of fetal movement

At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytic medications are administered and she is placed on bed rest, she continues to experience regular uterine contractions and her cervix is beginning to dilate and efface. What is an important test for fetal well-being at this time? Percutaneous umbilical blood sampling (PUBS) Ultrasound for fetal size Amniocentesis for fetal lung maturity Non stress test (NST)

Amniocentesis for fetal lung maturity

Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include? Sun exposure increases effectiveness. Cosmetics with lanolin and petrolatum are preferred in acne. Applying of the medication occurs at least 20 to 30 minutes after washing. Erythema and peeling are indications of toxicity and need to be reported.

Applying of the medication occurs at least 20 to 30 minutes after washing.

To prevent gastrointestinal (GI) upset, when should a pregnant client be instructed to take the recommended iron supplements? On a full stomach At bedtime After eating a meal With milk

At bedtime

The use of plants in conventional modern medicine is evidenced by the drug atropine, which is derived from which plant? Digitalis purpurea Cephaelis ipecacuanha Rauwolfia serpentina Atropa belladonna

Atropa belladonna

Which information is the highest priority for the nurse to comprehend regarding the biophysical profile (BPP)? BPP is an accurate indicator of impending fetal well-being. BPP is a compilation of health risk factors of the mother during the later stages of pregnancy. BPP consists of a Doppler blood flow analysis and an amniotic fluid index (AFI). BPP involves an invasive form of an ultrasonic examination.

BPP is an accurate indicator of impending fetal well-being.

Which contraceptive method should the nurse identify as protecting against sexually transmitted infections (STIs) and the human immunodeficiency virus (HIV)? Periodic abstinence Barrier methods Hormonal methods Same protection with all methods

Barrier methods

A 41-week pregnant multigravida arrives at the labor and delivery unit after testing indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool yields more detailed information about the condition of the fetus? Ultrasound for fetal anomalies Biophysical profile (BPP) MSAFP screening Percutaneous umbilical blood sampling (PUBS)

Biophysical profile (BPP)

With regard to medications, herbs, boosters, and other substances normally encountered by pregnant women, what is important for the nurse to be aware of? Both prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus. The greatest danger of drug-caused developmental deficits in the fetus is observed in the final trimester. Killed-virus vaccines (e.g., tetanus) should not be administered during pregnancy, but live-virus vaccines (e.g., measles) are permissible. No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.

Both prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.

A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that these are Braxton Hicks contractions. What other information is important for the nurse to share? Braxton Hicks contractions should be painless. They may increase in frequency with walking. These contractions might cause cervical dilation. Braxton Hicks contractions will impede oxygen flow to the fetus.

Braxton Hicks contractions should be painless.

A perimenopausal client has arrived for her annual gynecologic examination. Which preexisting condition would be extremely important for the nurse to identify during a discussion regarding the risks and benefits of hormone therapy? Breast cancer Vaginal and urinary tract atrophy Osteoporosis Arteriosclerosis

Breast cancer

Why is the various forms of complementary alternative medicine (CAM) gaining popularity in Western society? (Select all that apply.) Consumers want knowledgeable, trained physicians to control their care. CAM consumers want personalized health care. Quantity, rather than quality, of life is most important in Western society. Consumers have access to evidence that support CAMs. Consumers want to remain indifferent to the health care provider.

CAM consumers want personalized health care. Consumers have access to evidence that support CAMs.

Many factors, male and female, contribute to normal fertility. Which factors are possible causes for female infertility? (Select all that apply.) Congenital or developmental Hormonal or ovulatory Tubal or peritoneal Uterine Emotional or psychologic

Congenital or developmental Hormonal or ovulatory Tubal or peritoneal Uterine

Importantly, the nurse must be aware of which information related to the use of intrauterine devices (IUDs)? Return to fertility can take several weeks after the device is removed. Copper IUDs can serve as an emergency contraception under certain situations. IUDs offer the same protection against STIs as the diaphragm. Consent forms are not needed for IUD insertion.

Copper IUDs can serve as an emergency contraception under certain situations.

During the first trimester, which of the following changes regarding her sexual drive should a client be taught to expect? Increased sexual drive, because of enlarging breasts Decreased sexual drive, because of nausea and fatigue No change in her sexual drive Increased sexual drive, because of increased levels of female hormones

Decreased sexual drive, because of nausea and fatigue

Women who have undergone an oophorectomy, have ovarian failure, or a genetic defect may be eligible to receive donor oocytes (eggs). Which statements regarding oocyte donation are accurate? (Select all that apply.) Donor is inseminated with semen from the parent. Donor eggs can be fertilized with the male partner's sperm. Donors are under 35 years of age. Recipient undergoes hormonal stimulation. Ovum is placed into a surrogate.

Donor eggs can be fertilized with the male partner's sperm. Donors are under 35 years of age. Recipient undergoes hormonal stimulation.

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. Which recommendation would the nurse make for this client after a tennis match? Drink several glasses of fluid. Eat extra protein sources such as peanut butter. Enjoy salty foods to replace lost sodium. Consume easily digested sources of carbohydrate.

Drink several glasses of fluid.

Which consideration is essential for the nurse to understand regarding follow-up prenatal care visits? The interview portions become more intensive as the visits become more frequent over the course of the pregnancy. Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester. During the abdominal examination, the nurse should be alert for supine hypotension. For pregnant women, a systolic BP of 130 mm Hg and a diastolic BP of 80 mm Hg is sufficient to be considered hypertensive.

During the abdominal examination, the nurse should be alert for supine hypotension.

A woman who has undergone an induced abortion be instructed to return to the emergency department when what situation exists? (Select all that apply.) Fever higher than 38C Chills Foul-smelling vaginal discharge Bleeding greater than 2 pads in 2 hours Abdominal tenderness and or pain

Fever higher than 38C Chills Foul-smelling vaginal discharge Bleeding greater than 2 pads in 2 hours Abdominal tenderness and or pain

The nurse, responsible for providing health teaching regarding the side effects of combined USNT O oral contraceptives (COCs), should discuss what issues? (Select all that apply.) Gallbladder disease Myocardial infarction Hypotension Breast tenderness Dry skin and scalp

Gallbladder disease Myocardial infarction Breast tenderness

Which sexual transmitted infection (STI) does not respond well to antibiotic therapy? Chlamydia Gonorrhea Genital herpes Syphilis

Genital herpes

Which finding in the urinalysis of a pregnant woman is considered a variation of normal? Proteinuria Glycosuria Bacteria in the urine Ketones in the urine

Glycosuria

A pregnant woman's diet may not meet her increased need for folates. Which food is a rich source of this nutrient? Chicken Cheese Potatoes Green leafy vegetables

Green leafy vegetables

What behavior is the nurse most likely to assess in an adolescent with anorexia nervosa (AN)? Eats in secrecy Uses food as a coping mechanism Has a marked preoccupation with food Lacks awareness of how eating affects weight loss

Has a marked preoccupation with food

While assessing the vital signs of a pregnant woman in her third trimester, the client reports feeling faint, dizzy, and agitated. Which nursing intervention is appropriate? Have the patient stand up, and then retake her BP. Have the patient sit down, and then hold her arm in a dependent position. Have the patient lie supine for 5 minutes, and then recheck her BP on both arms. Have the patient turn to her left side, and then recheck her BP in 5 minutes.

Have the patient turn to her left side, and then recheck her BP in 5 minutes.

Which clinical presentation should the nurse assess for if a pregnant client is experiencing a Jarisch-Herxheimer reaction? (Select all that apply) Vomiting and diarrhea Headache Preterm labor contractions Bright red vaginal bleeding Arthralgia

Headache Preterm labor contractions Bright red vaginal bleeding Arthralgia

What is the primary role of the doula during labor? Helps the woman perform breathing techniques and provides support to the woman and her partner Checks the fetal monitor tracing for effects of the labor process on the fetal heart rate Takes the place of the father as a coach and support provider Administers pain medications as needed by the woman

Helps the woman perform breathing techniques and provides support to the woman and her partner

Which statement regarding the various forms of hepatitis is accurate? Vaccine exists for hepatitis C virus (HCV) but not for hepatitis B (HBV). Hepatitis A (HAV) is acquired by eating contaminated food or drinking polluted water. Hepatitis B (HBV) is less contagious than HIV. Incidences of hepatitis C (HCV) is decreasing.

Hepatitis A (HAV) is acquired by eating contaminated food or drinking polluted water.

hCG is an important biochemical marker for pregnancy and therefore the basis for many tests. Which statement regarding hCG is true? hCG can be detected as early as weeks after conception. hCG levels gradually and uniformly increase throughout pregnancy. Significantly lower-than-normal increases in the levels of hCG may indicate a postdate pregnancy. Higher-than-normal levels of hCG may indicate an ectopic pregnancy or Down syndrome.

Higher-than-normal levels of hCG may indicate an ectopic pregnancy or Down syndrome.

A 3-year-old girl's mother is 6 months pregnant. What concern is this child most likely to verbalize? How the baby will get out? How will the baby eat? Will you die having the baby? What color eyes will the baby have?

How will the baby eat?

The diagnosis of pregnancy is based on which positive signs of pregnancy? (Select all that apply.) Identification of fetal heartbeat Palpation of fetal outline Visualization of the fetus Verification of fetal movement Positive hCG test

Identification of fetal heartbeat Visualization of the fetus Verification of fetal movement

Assessment of a woman's nutritional status includes a diet history, medication regimen, physical examination, and relevant laboratory tests. Which finding might require consultation to a higher level of care? Oral contraceptive use may interfere with the absorption of iron. Illnesses that have created nutritional deficits, such as PKU, may require nutritional care before conception. The woman's socioeconomic status and educational level are not relevant to her examination; they are the province of the social worker. Testing for diabetes is the only nutrition-related laboratory test most pregnant women need.

Illnesses that have created nutritional deficits, such as PKU, may require nutritional care before conception.

A client with a history of bipolar disorder is called by the postpartum support nurse for follow-up. Which symptoms would reassure the nurse that the client is not experiencing a manic episode? Psychomotor agitation and rapid speech patterns Increased appetite and sleeping 8 hours a night Hyperactivity and distractibility Pressured speech and grandiosity

Increased appetite and sleeping 8 hours a night

Which renal system adaptation is an anticipated anatomic change of pregnancy? Increased urinary output makes pregnant women less susceptible to urinary infections. Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty. Renal (kidney) function is more efficient when the woman assumes a supine position. Using diuretic agents during pregnancy can help keep kidney function regular.

Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty.

Which procedure falls into the category of micromanipulation techniques of the follicle? (Select all that apply.) Intrauterine insemination Preimplantation genetic diagnosis Intracytoplasmic sperm injection (ISCI) Assisted hatching IVF-ET

Intracytoplasmic sperm injection (ISCI) Assisted hatching

The nurse understands that the risk of perinatal transmission of human immunodeficiency virus (HIV) can be significantly decreased by a number of prophylactic interventions. Which interventions should be included in the plan of care of a pregnant client with a viral load of more than 1000 copies/ml.? (Select all that apply.) Intrapartum treatment with antiviral medications Cesarean birth Postpartum treatment with antiviral medications Avoidance of breastfeeding Pneumococcal, HBV, and Haemophilus influenzae vaccine

Intrapartum treatment with antiviral medications Cesarean birth Avoidance of breastfeeding

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? Genetic changes and anomalies Extensive CNS damage Fetal addiction to the substance inhaled Intrauterine growth restriction

Intrauterine growth restriction

Which minerals and vitamins are usually recommended as a supplement in a pregnant client's diet? Fat-soluble vitamins A and D Water-soluble vitamins C and B6 Iron and folate Calcium and zinc

Iron and folate

Which statement most accurately describes complicated grief? Occurs when, in multiple births, one child dies and the other or others live Is a state during which the parents are ambivalent, as with an abortion Is an extremely intense grief reaction that persists for a long time Is felt by the family of adolescent mothers who lose their babies

Is an extremely intense grief reaction that persists for a long time

During an admission history and physical, a female patient states, "I use 5000 mg/day of calcium to prevent osteoporosis and to maintain health." The nurse should assess for what possible side effect? Excessive bleeding Kidney stones Lower blood sugar Jaundice

Kidney stones

A pregnant woman reports back pain and wants to try a complementary alternative medicine (CAM) therapy. The nurse knows that which CAM would be contraindicated? Magnet therapy Aromatherapy Imagery Therapeutic touch

Magnet therapy

Which information regarding protein in the diet of a pregnant woman is most helpful to the client? Many protein-rich foods are also good sources of calcium, iron, and B vitamins. Many women need to increase their protein intake during pregnancy. As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet. High-protein supplements can be used without risk by women on macrobiotic diets.

Many protein-rich foods are also good sources of calcium, iron, and B vitamins.

A 30-year-old gravida 3, para 2-0-0-2 is at 18 weeks of gestation. Which screening test should the nurse recommend be ordered for this client? Biophysical profile (BPP) Chorionic villi sampling Maternal Serum Alpha-Fetoprotein Screening (MSAFP) screening Screening for diabetes mellitus

Maternal Serum Alpha-Fetoprotein Screening (MSAFP) screening

The use of methamphetamine (meth) has been described as a significant drug problem in the United States. The nurse who provides care to this client population should be cognizant of what regarding methamphetamine use? Methamphetamines are similar to opiates. Methamphetamines are stimulants with vasoconstrictive characteristics. Methamphetamines should not be discontinued during pregnancy. Methamphetamines are associated with a low rate of relapse.

Methamphetamines are stimulants with vasoconstrictive characteristics.

The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection by the nurse should include what information? Drugs actual content Mode of administration Adolescents level of interest in rehabilitation Function the drug plays in the adolescents life

Mode of administration

What type of cultural concern is the most likely deterrent to many women seeking prenatal care? Religion Modesty Ignorance Belief that physicians are evil

Modesty

Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? Multiple-marker screening Lecithin-sphingomyelin ratio (L/S ratio) Biophysical profile (BPP) Blood type and crossmatch of maternal and fetal serum

Multiple-marker screening

Which pharmacologic therapy provides optimal pain relief for primary dysmenorrhea? Acetaminophen Oral contraceptive pills (OCPs) Nonsteroidal antiinflammatory drugs (NSAIDs) Aspirin

Nonsteroidal antiinflammatory drugs (NSAIDs)

A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2019. What is the client's expected date of birth (EDB)? September 17, 2019 November 7, 2019 November 21, 2019 December 17, 2019

November 21, 2019

A woman has chosen the calendar method of conception control. Which is the most important action the nurse should perform during the assessment process in preparation to discuss the implementation of this method? Obtain a history of the woman's menstrual cycle lengths for the past 6 to 12 months. Determine the client's weight gain and loss pattern for the previous year. Examine skin pigmentation and hair texture for hormonal changes. Explore the client's previous experiences with conception control.

Obtain a history of the woman's menstrual cycle lengths for the past 6 to 12 months.

Which statement regarding gamete intrafallopian transfer (GIFT) is most accurate? Semen is collected after laparoscopy. Women must have two normal fallopian tubes. Ovulation spontaneously occurs. Ova and sperm are transferred to one tube.

Ova and sperm are transferred to one tube.

A probable cause for increasing infertility is the societal delay in pregnancy until later in life. What are the natural reasons for the decrease in female fertility? (Select all that apply.) Ovulation dysfunction Endocrine dysfunction Organ damage from toxins Endometriosis Tubal infections

Ovulation dysfunction Organ damage from toxins Endometriosis Tubal infections

Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. Which condition is rarely associated with fetal alcohol syndrome (FAS)? Respiratory conditions Intellectual impairment Neural development disorder Alcohol-related birth defects (ARBDs)

Respiratory conditions

What do nursing responsibilities regarding weight gain for an adolescent with anorexia nervosa include? Administer tube feedings until target weight is achieved. Restore body weight to within 10% of the adolescents ideal weight. Encourage continuation of strenuous exercise as long as adolescent is not losing weight. Facilitate as rapid a weight gain as possible with a high-calorie diet.

Restore body weight to within 10% of the adolescents ideal weight.

A couple comes in for an infertility workup, having attempted to achieve pregnancy for 2 years. The woman, 37 years of age, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional testing is needed? Testicular biopsy Antisperm antibodies Serum prolactin level Examination for testicular infection

Serum prolactin level

A pregnant woman who abuses cocaine admits to exchanging sex to finance her drug habit. This behavior places the client at the greatest risk for what? Depression of the CNS Hypotension and vasodilation Sexually transmitted infections (STIs) Postmature birth

Sexually transmitted infections (STIs)

During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. What does the nurse advise? Slow down eating meals. Avoid between-meal snacks. Include low-fat foods in meals. Use foods that child likes as special treats.

Slow down eating meals.

A client has requested information regarding alternatives to hormonal therapy for menopausal symptoms. Which current information should the nurse provide to the client? (Select all that apply.) Soy Vitamin C Vitamin K Vitamin E Vitamin A

Soy Vitamin E

Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth? Epulis Chloasma Telangiectasia Striae gravidarum

Striae gravidarum

During an inpatient psychiatric hospitalization, what is the most important nursing intervention? Contacting the client's significant other Supervising and guiding visits with her infant Allowing no contact with anyone who annoys her Having the infant with the mother the majority of the time

Supervising and guiding visits with her infant

Which system responses would the nurse recognize as being related to prostaglandin (PGF2) release? (Select all that apply) Systemic responses Gastrointestinal system Central nervous system Genitourinary system

Systemic responses Gastrointestinal system Central nervous system

A woman will be taking oral contraceptives using a 28-day pack. What advice should the nurse provide to protect this client from an unintended pregnancy? Limit sexual contact for one cycle after starting the pill. Use condoms and foam instead of the pill for as long as the client takes an antibiotic. Take one pill at the same time every day. Throw away the pack and use a backup method if two pills are missed during week 1 of her cycle.

Take one pill at the same time every day.

A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview, the nurse learns that the client has not had any immunizations. Which immunizations should she receive at this point in her pregnancy? (Select all that apply.) Tetanus Diphtheria Chickenpox Rubella Hepatitis B

Tetanus Diphtheria Hepatitis B

Which information is an important consideration when comparing the contraction stress test (CST) with the nonstress test (NST)? The NST has no known contraindications. The CST has fewer false-positive results when compared with the NST. The CST is more sensitive in detecting fetal compromise, as opposed to the NST. The CST is slightly more expensive than the NST.

The NST has no known contraindications.

The nurse has determined that an adolescents body mass index (BMI) is in the 90th percentile. What information should the nurse convey to the adolescent? The adolescent is overweight. The adolescent has maintained weight within the normal range. The adolescent is at risk for becoming overweight. Nutritional supplementation should occur at least three times per week

The adolescent is at risk for becoming overweight.

Why might it be more difficult to diagnose appendicitis during pregnancy? The appendix is displaced upward and laterally, high and to the right. The appendix is displaced upward and laterally, high and to the left. The appendix is deep at the McBurney's point. The appendix is displaced downward and laterally, low and to the right.

The appendix is displaced upward and laterally, high and to the right.

During the physical examination of a client beginning prenatal care, which initial action is most important for the nurse to perform? Only women who show physical signs or meet the sociologic profile should be assessed for physical abuse. The client should empty her bladder before the pelvic examination. The distribution, amount, and quality of body hair are of no particular importance. The size of the uterus is discounted in the initial examination because it will be increasing in size during the second trimester.

The client should empty her bladder before the pelvic examination.

What is important for the nurse to recognize regarding the new father and his acceptance of the pregnancy and preparation for childbirth? The father goes through three phases of acceptance of his own. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after the birth. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home. Typically, men remain ambivalent about fatherhood right up to the birth of their child.

The father goes through three phases of acceptance of his own.

Which client would be an ideal candidate for injectable progestins such as medroxyprogesterone acetate as a contraceptive choice? The ideal candidate wants menstrual regularity and predictability. The client has a history of thrombotic problems or breast cancer. The ideal candidate has difficulty remembering to take oral contraceptives daily. The client is homeless or mobile and rarely receives health care.

The ideal candidate has difficulty remembering to take oral contraceptives daily.

What is the importance of obtaining informed consent when educating a client regarding contraceptive methods? Contraception is an invasive procedure that requires hospitalization. The method may require a surgical procedure to insert a device. The contraception method chosen may be unreliable. The method chosen has potentially dangerous side effects.

The method chosen has potentially dangerous side effects.

During the initial visit with a client who is beginning prenatal care, which action should be the highest priority for the nurse? The first interview is a relaxed, get-acquainted affair during which the nurse gathers some general impressions of his or her new client. If the nurse observed handicapping conditions, he or she should be sensitive and not inquire about them because the client will do that in her own time. The nurse should be alert to the appearance of potential parenting problems, such as depression or lack of family support. Because of legal complications, the nurse should not ask about illegal drug use; that is left to the physician.

The nurse should be alert to the appearance of potential parenting problems, such as depression or lack of family support.

Which finding would indicate to the nurse that the grieving parents have progressed to the reorganization phase of grieving? The parents say that they "feel no pain." The parents are discussing sex and a future pregnancy The parents have abandoned those moments of "bittersweet grief." The parents' questions have progressed from "Why?" to "Why us?"

The parents are discussing sex and a future pregnancy

In comparing the abdominal and transvaginal methods of ultrasound examination, which information should the nurse provide to the client? Both require the woman to have a full bladder. The abdominal examination is more useful in the first trimester. Initially, the transvaginal examination can be painful. The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.

The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.

Some pregnant clients may report changes in their voice and impaired hearing. What should the nurse explain to the client concerning these findings? Voice changes are caused by decreased estrogen levels. Displacement of the diaphragm results in thoracic breathing. These changes are the results of congestion and swelling of the upper respiratory tract. Increased blood volume causes changes in the voice.

These changes are the results of congestion and swelling of the upper respiratory tract.

Which information is most important to provide to the client interested in using the lactational amenorrhea method for contraception? LAM is effective until the infant is 9 months of age. This popular method of birth control works best if the mother is exclusively breastfeeding. Its typical failure rate is 5%. Feeding intervals should be 6 hours during the day.

This popular method of birth control works best if the mother is exclusively breastfeeding.

The nurse is providing contraceptive instruction to a young couple who are eager to learn. The nurse should be cognizant of which information regarding the natural family planning method? The natural family planning method is the same as coitus interruptus or "pulling out." This contraception method uses the calendar method to align the woman's cycle with the natural phases of the moon. This practice is the only contraceptive method acceptable to the Roman Catholic Church. The natural family planning method relies on barrier methods during the fertility phases.

This practice is the only contraceptive method acceptable to the Roman Catholic Church.

The client is instructed to place her thumb and forefinger on the areola and gently press inward. What is the purpose of this exercise? To check the sensitivity of the nipples To determine whether the nipple is everted or inverted To calculate the adipose buildup in the abdomen To see whether the fetus has become inactive

To determine whether the nipple is everted or inverted

Which statement regarding multifetal pregnancy is incorrect? The expectant mother often develops anemia because the fetuses have a greater demand for iron. Twin pregnancies come to term with the same frequency as single pregnancies. The mother should be counseled to increase her nutritional intake and gain more weight. Backache and varicose veins often are more pronounced with a multifetal pregnancy.

Twin pregnancies come to term with the same frequency as single pregnancies.

A 39-year-old primigravida woman believes that she is approximately 8 weeks pregnant, although she has had irregular mensural periods all her life. She has a history of smoking approximately one pack of cigarettes a day; however, she tells the nurse that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique would be useful at this time? Ultrasound examination Maternal serum alpha-fetoprotein (MSAFP) screening Amniocentesis Nonstress test (NST)

Ultrasound examination

What factor is most likely to increase the likelihood that an adolescent will misuse alcohol? Female gender Regular school attendance Rural environment Unconventional behavior

Unconventional behavior

Which sexual behaviors are associated with high exposure to a sexually transmitted infection (STI)? (Select all that apply.) Monogamy Unprotected anal intercourse Multiple sex partners Dry kissing Self-masturbation

Unprotected anal intercourse Multiple sex partners

Which sign or symptom is considered a first-trimester warning sign and should be immediately reported by the pregnant woman to her health care provider? Nausea with occasional vomiting Fatigue Urinary frequency Vaginal bleeding

Vaginal bleeding

Which signs and symptoms should a woman immediately report to her health care provider? (Select all that apply.) Vaginal bleeding Rupture of membranes Heartburn accompanied by severe headache Decreased libido Urinary frequency

Vaginal bleeding Rupture of membranes Heartburn accompanied by severe headache

Which test is performed around the time of ovulation to diagnose the basis of infertility? Hysterosalpingogram Vaginal ultrasonography Laparoscopy Follicle-stimulating hormone (FSH) level

Vaginal ultrasonography

Which vitamins or minerals may lead to congenital malformations of the fetus if taken in excess by the mother? Zinc Vitamin D Folic acid Vitamin A

Vitamin A

A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about? Calcium Protein Vitamin B12 Folic acid

Vitamin B12

An important distinction in understanding substance abuse is that drug misuse, abuse, and addiction are considered what? Voluntary behaviors based on psychosocial needs Problems that occur in conjunction with addiction Involuntary physiologic responses to the pharmacologic characteristics of drugs Legal use of substances for purposes other than medicinal.

Voluntary behaviors based on psychosocial needs

Which pregnant woman should strictly follow weight gain recommendations during pregnancy? Pregnant with twins In early adolescence Shorter than 62 inches or 157 cm Was 20 pounds overweight before pregnancy

Was 20 pounds overweight before pregnancy

Many pregnant women have questions regarding work and travel during pregnancy. Which education is a priority for the nurse to provide? Women should sit for as long as possible and cross their legs at the knees from time to time for exercise. Women should avoid seat belts and shoulder restraints in the car because they press on the fetus. Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them several times. While working or traveling in a car or on an airplane, women should arrange to walk around at least every hour or so.

While working or traveling in a car or on an airplane, women should arrange to walk around at least every hour or so.

Of which physiologic alteration of the uterus during pregnancy is it important for the nurse to alert the patient? Lightening occurs near the end of the second trimester as the uterus rises into a different position. Woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anti-reflexion caused by softening. Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise. Uterine souffle is the movement of the fetus.

Woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anti-reflexion caused by softening.

What should the nurse be cognizant of concerning the client's reordering of personal relationships during pregnancy? Because of the special motherhood bond, a woman's relationship with her mother is even more important than with her partner. Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other. Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the partner. The woman's sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier.

Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the partner.

The patient asks the nurse to explain the function of the sinoatrial node in the heart. What is the nurse's best response? a. "The sinoatrial node stimulates the heart to beat in a normal rhythm." b. "The sinoatrial node protects the heart from atherosclerotic changes." c. "The sinoatrial node provides the heart with oxygenated blood." d. "The sinoatrial node protects the heart from infection."

a. "The sinoatrial node stimulates the heart to beat in a normal rhythm."

The female athlete triad includes which common menstrual disorder? a. Amenorrhea b. Dysmenorrhea c. Menorrhagia d. Metrorrhagia

a. Amenorrhea

What symptom would the nurse caring for a patient who practices Ayurveda assess for? a. An increased stool osmolality gap resulting from dehydration b. Petechiae resulting from fine-needle punctures c. Use of over-the-counter remedies intended for intended symptom d. Magnets strategically placed on affected joints

a. An increased stool osmolality gap resulting from dehydration

The nurse preparing to care for a patient after a suspected stroke would question which order? a. Antihypertensive b. Antipyretic c. Osmotic diuretic d. Sedative

a. Antihypertensive

On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish-white vaginal discharge with a "fishy" odor and reports of pruritus. Based upon these findings, which condition would the nurse suspect? a. Bacterial vaginosis b. Candidiasis c. Trichomoniasis d. Gonorrhea

a. Bacterial vaginosis

A 23-year-old female has been diagnosed with genital warts. Which action by the nurse is best? a. Encourage the client to have an annual Papanicolaou (Pap) test. b. Recommend an over-the-counter wart treatment for genital tissue. c. Report the case to the Centers for Disease Control and Prevention (CDC). d. Discuss popular options for contraception.

a. Encourage the client to have an annual Papanicolaou (Pap) test.

A 55-year-old male patient post-myocardial infarction (MI) asks the nurse whether he will be healthy enough for sexual activity after discharge from the hospital. The patient has been prescribed anti-hypertensives and beta-blockers. During health teaching, the nurse understands that the three phases of the four-stage model of the human sexual response cycle that are of concern for this patient include which phases? a. Excitement, plateau, and orgasmic b. Plateau, orgasmic, and resolution c. Excitement, orgasmic, and resolution d. Arousal, excitement, and plateau

a. Excitement, plateau, and orgasmic

When planning to evaluate a patient's satisfaction with a teaching activity, what is the most appropriate strategy? a. Include a survey instrument. b. Observe for level of skill mastery. c. Present information more than one time. d. Provide for a return demonstration.

a. Include a survey instrument.

A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline heart rate of approximately 120 beats per minute without any decelerations. What is the correct interpretation of this test? a. Negative b. Positive c. Satisfactory d. Unsatisfactory

a. Negative

A patient informs the nurse, "I burn a lavender-scented candle for an hour before bedtime to help me relax and sleep." The nurse realizes this patient is using what complementary alternative medicine (CAM)? a. The mind-body intervention of aromatherapy b. An energy technique known as qi gong c. The manipulative method using the Alexander technique d. Conventional medicine, also called allopathic

a. The mind-body intervention of aromatherapy

A 26-year-old client with multiple sexual partners is being assessed for symptoms of dysuria and vaginal discharge. Because the results from the culture of the cervical cells are not available, the client will be treated for both Chlamydia and gonorrhea. Which explanation by the nurse is best? a. This early treatment will prevent obstruction to the fallopian tubes. b. Only azithromycin (Zithromax) is prescribed for both sexually transmitted diseases. c. The treatment will prevent aortic valve disease and aneurysms. d. Oral antibiotic treatment will prevent frequent occurrences of meningitis.

a. This early treatment will prevent obstruction to the fallopian tubes.

A pregnant 15-year-old adolescent tells the nurse that she did not use any form of contraception because she was afraid her parents would find out. The nurse should recognize what? a. This is a frequent reason given by adolescents. b. This suggests a poor parentchild relationship. c. This is not a good reason to not get contraception. d. This indicates that the adolescent is unaware of her legal rights.

a. This is a frequent reason given by adolescents.

A male client is diagnosed with primary syphilis. Which question by the nurse is a priority at this time? a. Have you been using latex condoms? b. Are you allergic to penicillin? c. When was your last sexual encounter? d. Do you have a history of sexually transmitted disease?

b. Are you allergic to penicillin?

Which treatment regime would be most appropriate for a client who has been recently diagnosed with acute pelvic inflammatory disease (PID)? a. Oral antiviral therapy b. Bed rest in a semi-Fowler position c. Antibiotic regimen continued until symptoms subside d. Frequent pelvic examination to monitor the healing progress

b. Bed rest in a semi-Fowler position

Strategies to include in a teaching plan for an adult who has repeatedly not followed the written discharge instructions would include which information source? a. Individualized handout b. Instructional videos c. Internet resources d. Self-help books

b. Instructional videos

A client has recently been diagnosed with stage III endometrial cancer and asks the nurse for an explanation. What response by the nurse is correct about the staging of the cancer? a. The cancer has spread to the mucosa of the bowel and bladder. b. It has reached the vagina or lymph nodes. c. The cancer now involves the cervix. d. It is contained in the endometrium of the cervix.

b. It has reached the vagina or lymph nodes.

A patient observes the practitioner burning a dried herb on the needle during an acupuncture session and asks about this practice. The practitioner responds by referring to this practice using what term? a. Doshas b. Moxibustion c. Yoga d. Kapha

b. Moxibustion

Which statement regarding the probable signs of pregnancy is most accurate? a. Determined by ultrasound b. Observed by the health care provider c. Reported by the client d. Confirmed by diagnostic tests

b. Observed by the health care provider

The patient is brought to the emergency department after a motor vehicle accident. The patient is diagnosed with internal bleeding. What is the priority of care for this patient? a. Mental alertness b. Perfusion c. Pain d. Reaction to medications

b. Perfusion

The Centers for Disease Control and Prevention (CDC) recommends which therapy for the treatment of the HPV? a. Miconazole ointment b. Topical podofilox 0.5% solution or gel c. Two doses of penicillin administered intramuscularly (IM) d. Metronidazole by mouth

b. Topical podofilox 0.5% solution or gel

A client is scheduled to start external beam radiation therapy (EBRT) for her endometrial cancer. Which teaching by the nurse is accurate? (Select all that apply.) a. You will need to be hospitalized during this therapy. b. Your skin needs to be inspected daily for any breakdown. c. It is not wise to stay out in the sun for long periods of time. d. The perineal area may become damaged with the radiation. e. The technician applies new site markings before each treatment.

b. Your skin needs to be inspected daily for any breakdown. c. It is not wise to stay out in the sun for long periods of time. d. The perineal area may become damaged with the radiation.

While working with the pregnant client in her first trimester, what information does the nurse provide regarding when chorionic villus sampling (CVS) can be performed (in weeks of gestation)? a. 4 b. 8 c. 10 d. 14

c. 10

What is the drug of choice for the treatment of gonorrhea? a. Penicillin G b. Tetracycline c. Ceftriaxone d. Acyclovir

c. Ceftriaxone

Which condition is the most life threatening virus to the fetus and neonate? a. Hepatitis A virus (HAV) b. Herpes simplex virus (HSV) c. Hepatitis B virus (HBV) d. Cytomegalovirus (CMV)

c. Hepatitis B virus (HBV)

The nurse is caring for a patient who has undergone a thyroidectomy. Which patient complaint is highest priority requiring further evaluation? a. Pain at surgical site b. Thirst c. Hoarseness d. Nausea

c. Hoarseness

Barriers to patient education the nurse considers in implementing a teaching plan include which factor? a. Family resources b. High school education c. Hunger and pain d. Need perceived by patient

c. Hunger and pain

A woman is admitted to the hospital for antibiotic therapy for pelvic inflammatory disease. She is in pain, with a rating of 7 on a scale of 0 to 10. What comfort measure can the nurse delegate to the unlicensed assistive personnel (UAP)? a. Administer Tylenol #3 immediately. b. Apply a heating pad to the lower abdomen. c. Position the client in a semi-Fowlers position. d. Teach the client to increase intake of fluids.

c. Position the client in a semi-Fowlers position.

The emergency department nursing assessment of a pregnant female at 35 weeks gestation reveals back pain, blood pressure 150/92, and leaking of clear fluid from the vagina. Which complication of pregnancy does the nurse suspect? a. Ectopic pregnancy b. Spontaneous abortion c. Premature rupture of membranes d. Supine hypotension

c. Premature rupture of membranes

The nurse is caring for a patient who is experiencing alcohol withdrawal. What is the highest priority for this patient? a. Describe how the alcohol is causing the withdrawal effects. b. Leave the patient by him/herself so as not to cause agitation. c. Promote a safe, calm, and comfortable environment. d. Refer the patient to an alcohol-abuse counselor.

c. Promote a safe, calm, and comfortable environment.

Before marriage, a female client has a blood test drawn for syphilis. The test reveals a positive Venereal Disease Research Laboratory (VDRL) serum test. What is the advice that the nurse should give the client? a. Check with your future husband about his sexual activity.b . You must determine if you are pregnant at this time. c. Submit to a more specific treponemal test to confirm the infection. d. Agree to a benzathine penicillin G injection in multiple doses.

c. Submit to a more specific treponemal test to confirm the infection.

The nurse is caring for a 44-year-old married woman who is complaining of painful intercourse and incontinence due to prolapse of reproductive organs. Clinical evaluation reveals that the patient has a cystocele. Which treatment option is most appropriate for this patient? a. Pelvic floor training b. Vaginal pessaries c. Surgical correction d. Lifestyle changes

c. Surgical correction

Women who are given the job of caretaker for aging relatives are subject to caregiver strain due to a. feminine attributes. b. unequal gender. c. fixed gender roles. d. female inequality.

c. fixed gender roles.

In order to fully assess the patient and plan appropriate care including health teaching regarding sexuality the nurse should realize that which patient is most at risk for sexual abuse? a. A recently divorced 50-year-old woman b. A Hispanic teenage girl c. A 30-year-old African-American male d. An individual with intellectual or developmental disabilities

d. An individual with intellectual or developmental disabilities

Which manifestation differentiates primary syphilis from secondary syphilis? a. Fever, headache, and malaise b. Widespread rash c. Identified by serologic testing d. Appearance of a chancre 2 months after infection

d. Appearance of a chancre 2 months after infection

An older adult diagnosed with atrial fibrillation uses imagery to alter the dysrhythmia. The client is using which type of complementary alternative medicine (CAM)? a. Ayurveda b. Dosha c. Homeopathy d. Biofeedback

d. Biofeedback

ollowing a parathyroidectomy, which electrolyte should the nurse most closely monitor? a. Potassium b. Sodium c. Magnesium d. Calcium

d. Calcium

The nurse is caring for a postoperative client following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)? a. Reviewing the hematocrit and hemoglobin results b. Teaching the client to avoid lifting her 4-year-old grandson c. Assessing the level of pain and any drainage d. Drawing a shallow hot bath for comfort measures

d. Drawing a shallow hot bath for comfort measures

A client has just returned from a total abdominal hysterectomy and needs postoperative nursing care. What action can the nurse delegate to the unlicensed assistive personnel (UAP)? a. Assess heart, lung, and bowel sounds. b. Check the hemoglobin and hematocrit levels. c. Evaluate the dressing for drainage. d. Empty the urine from the urinary catheter bag.

d. Empty the urine from the urinary catheter bag.

During the physical examination of an adolescent with significant weight loss, what finding may indicate an eating disorder? a. Diarrhea b. Amenorrhea c. Appetite suppression d. Erosion of tooth enamel

d. Erosion of tooth enamel

A nurse caring for a family during a loss might notice that a family member is experiencing survivor guilt. Which family member is most likely to exhibit this guilt? a. Siblings b. Mother c. Father d. Grandparents

d. Grandparents

The nurse teaches a client with genital herpes about effective comfort measures. Which statement by the client indicates a need for further teaching by the nurse? a. I can apply warm towels or ice packs to the lesions. b. Sitz baths three times a day may help ease the pain. c. I understand there are anesthetic sprays and ointments. d. I really should try to limit urination due to the pain.

d. I really should try to limit urination due to the pain.

The nurse at the family planning clinic conducts a male history for infertility evaluation. Which finding has the greatest implication for this patient's care? a. Practice of nightly masturbation b. Primary anovulation c. High testosterone levels d. Impotence due to alcohol ingestion

d. Impotence due to alcohol ingestion

Which alteration in cyclic bleeding best describes bleeding that occurs at any time other than menses? a. Oligomenorrhea b. Menorrhagia c. Leiomyoma d. Metrorrhagia

d. Metrorrhagia

When describing patient education approaches, the nurse educator would explain that informal teaching is an approach that involves which quality? a. Addresses group needs b. Follows formalized plans c. Has standardized content d. Often occurs one-to-one

d. Often occurs one-to-one

The nurse would anticipate that which of the following patient conditions will be treated with the collaborative treatment of regular phlebotomies? a. Hemophilia b. Thrombocytopenia c. Eosinophilia d. Polycythemia

d. Polycythemia

The nurse educator would identify a need for further teaching when the student lists which example as a type of learning? a. Affective b. Cognitive c. Psychomotor d. Self-directed

d. Self-directed

A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best? a. Suggest increasing vitamins and supplements daily. b. Discuss the value of a balanced diet and exercise. c. Reinforce that weight gain may be inevitable. d. Teach that estrogen cream inserted vaginally may help.

d. Teach that estrogen cream inserted vaginally may help.

Interrelated concepts to the professional nursing role a nurse manager would consider when addressing concerns about the quality of patient education include which factor? a. Adherence b. Developmental level c. Motivation d. Technology

d. Technology

Which statement made by a nurse regarding the prophylactic vaccination to prevent human papillomavirus (HPV) demonstrates a need for further education? a. "Currently there is only one vaccine for the HPV available." b. "The vaccine is given in three doses over a 6-month period." c. "The vaccine is recommended for both boys and girls." d. "Ideally, the vaccine is administered before the first sexual contact."

"Currently there is only one vaccine for the HPV available."

A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she does not know what is happening; one minute she is happy that she is pregnant and the next minute she cries for no reason. Which response by the nurse is most appropriate? "Don't worry about it; you'll feel better in a month or so." "Have you talked to your husband about how you feel?" "Perhaps you really don't want to be pregnant." "Hormone changes during pregnancy commonly result in mood swings."

"Hormone changes during pregnancy commonly result in mood swings."

What represents a typical progression through the phases of a woman's establishing a relationship with the fetus? Accepts the fetus as distinct from herself—accepts the biologic fact of pregnancy—has feelings of caring and responsibility. Fantasizes about the child's gender and personality—views the child as part of herself—becomes introspective. Views the child as part of herself—has feelings of well-being—accepts the biologic fact of the pregnancy. "I am pregnant"—"I am going to have a baby"—"I am going to be a mother."

"I am pregnant"—"I am going to have a baby"—"I am going to be a mother."

Which statement is the most appropriate for the nurse to make when caring for bereaved parents? "This happened for the best." "You have an angel in heaven." "I know how you feel." "What can I do for you?"

"What can I do for you?"

A patient states, "My cancer is in remission finally after all that chemotherapy, my friend used the same chemotherapy and wasn't so lucky. I want to continue participating in spiritual care and 'mind games' to keep my memory intact. I am also enrolled in Tai chi, but I just can't stop thinking about my sick lung." This patient adheres to which principle underlying alternative healing? A negative alteration in the body produces a parallel effect on the mind and spirit. The body can heal itself with the help of complementary alternative therapies. Approaches to therapy are individualized. There is a focus on the total lifestyle.

A negative alteration in the body produces a parallel effect on the mind and spirit.

A client gives birth to a stillborn infant. At first, she appears stunned by the news, cries a little, and then asks the nurse to call her mother. What is the proper term for the phase of bereavement that this client is experiencing? Anticipatory grief Acute distress Intense grief Reorganization

Acute distress

As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth? Heroin Alcohol Phencyclidine (1-phenylcyclohexylpiperidine; PCP) Cocaine

Cocaine

A client in the third trimester has just undergone an amniocentesis to determine fetal lung maturity. Which statement regarding this testing is important for the nurse in formulating a care plan? Because of new imaging techniques, an amniocentesis should have been performed in the first trimester. Despite the use of ultrasonography, complications still occur in the mother or infant in 5% to 10% of cases. Administration of Rho(D) immunoglobulin may be necessary. The presence of meconium in the amniotic fluid is always a cause for concern.

Administration of Rho(D) immunoglobulin may be necessary.

Ideally, when should prenatal care begin? Before the first missed menstrual period After the first missed menstrual period After the second missed menstrual period After the third missed menstrual period

After the first missed menstrual period

Which medications can be taken by postmenopausal women to treat and/or prevent osteoporosis? (Select all that apply.) Calcium NSAIDs Alendronate Risedronate sodium Calcitonin

Calcium Alendronate Risedronate sodium Calcitonin

Which sexually transmitted infection (STI) can be successfully treated? Herpes simplex virus Acquired immunodeficiency syndrome (AIDS) Venereal warts Chlamydia

Chlamydia

Significant advances have been made with most reproductive technologies. Which improvement has resulted in increased success related to preimplantation genetic diagnosis? Embryos are transferred at the cleavage stage. Embryos are transferred at the blastocyst stage. More than two embryos can be transferred at a time. Two cells are removed from each embryo.

Embryos are transferred at the blastocyst stage.

Pregnancy is a hypercoagulable state in which women are at a fivefold to sixfold increased risk for thromboembolic disease. The tendency for blood to clot is greater, attributable to an increase in various clotting factors. Which of these come into play during pregnancy? (Select all that apply.) Factor VII Factor VIII Factor IX Factor XIII Fibrinogen

Factor VII Factor VIII Factor IX Fibrinogen

The nurse has formulated a diagnosis of Inadequate Nutrition for the client. Which goal is most appropriate for this client to obtain? Gain a total of 30 pounds. Consistently take daily supplements. Decrease her intake of snack foods. Increase her intake of complex carbohydrates.

Gain a total of 30 pounds.

What is the usual presenting symptom for testicular cancer? Solid, painful mass Hard, painless mass Scrotal swelling and pain Epididymis easily palpated

Hard, painless mass

When a woman is diagnosed with postpartum depression (PPD) with psychotic features, what is the nurse's primary concern in planning the client's care? Displaying outbursts of anger Neglecting her hygiene Harming her infant Losing interest in her husband

Harming her infant

What is the correct term used to describe the mucous plug that forms in the endocervical canal? Operculum Leukorrhea Funic souffle Ballottement

Operculum

The nurse is planning the care for a laboring client with diabetes mellitus greater risk for which clinical finding? Oligohydramnios Polyhydramnios Postterm pregnancy Chromosomal abnormalities

Polyhydramnios

An Maternal Serum Alpha-Fetoprotein Screening (MSAFP) screening indicates an elevated level of alpha-fetoprotein. The test is repeated, and again the level is reported as higher than normal. What is the next step in the assessment sequence to determine the well-being of the fetus? Percutaneous umbilical blood sampling (PUBS) Ultrasound Biophysical profile (BPP) Amniocentesis

Ultrasound

A patient who is pregnant has used the herb feverfew for a history of migraine headaches. The nurse should provide teaching related to a risk for what side effect? Uterine contractions resulting in possible miscarriage Reduced fetal growth Insomnia Tiredness the following day

Uterine contractions resulting in possible miscarriage

Which statement by a patient indicates additional teaching is required about the medication warfarin? a. "I will continue my diabetic diet and restrict sugar." b. "I will increase the intake of green, leafy vegetables for a more healthful diet." c. "I will restrict the intake of foods high in vitamin C." d. "I will increase the amount of protein in my diet to protect my kidneys."

b. "I will increase the intake of green, leafy vegetables for a more healthful diet."

To prevent Wernicke's encephalopathy from heavy alcohol use, the nurse anticipates an order for which medications? a. Benzodiazepine b. Thiamine and B complex c. Vitamins C and D3 d. Klonopin

b. Thiamine and B complex

When a nurse is counseling a woman experiencing primary dysmenorrhea, which nonpharmacologic intervention might be recommended? a. Increasing the intake of red meat to replace blood loss b. Reducing the intake of diuretic foods such as peaches and asparagus c. Temporarily substituting physical activity for a sedentary lifestyle d. Using a heating pad on the abdomen to relieve cramping

d. Using a heating pad on the abdomen to relieve cramping

Once the Human immunodeficiency virus (HIV) has entered the body, what is the time frame for seroconversion to HIV positivity? 6 to 10 days 2 to 4 weeks 6 to 12 weeks 6 months

6 to 12 weeks

Which hormone is essential for maintaining pregnancy? a. Estrogen b. hCG c. Oxytocin d. Progesterone

d. Progesterone

A couple is attempting to cope with an infertility problem. They want to know what they can do to preserve their emotional equilibrium. What is the nurse's most appropriate response? "Tell your friends and family so that they can help you." "Talk only to other friends who are infertile, because only they can help." "Get involved with a some names." "Start adoption proceedings immediately, because adopting an infant can be very difficult."

"Get involved with a some names."

After giving birth to a stillborn infant, the woman turns to the nurse and says, "I just finished painting the baby's room. Do you think that caused my baby to die?" What is the nurse's most appropriate response? "That's an old wives' tale; lots of women are around paint during pregnancy, and this doesn't happen to them." "That's not likely. Paint is associated with elevated pediatric lead levels." Silence. "I can understand your need to find an answer to what caused this. What else are you thinking about?"

"I can understand your need to find an answer to what caused this. What else are you thinking about?"

Which symptom described by a client is characteristic of premenstrual syndrome (PMS)? "I feel irritable and moody a week before my period is supposed to start." "I have lower abdominal pain beginning on the third day of my menstrual period." "I have nausea and headaches after my period starts, and they last 2 to 3 days." "I have abdominal bloating and breast pain after a couple days of my period."

"I feel irritable and moody a week before my period is supposed to start."

Which statement made by a lactating woman leads the nurse to believe that the client might have lactose intolerance? "I always have heartburn after I drink milk." "If I drink more than a cup of milk, I usually have abdominal cramps and bloating." "Drinking milk usually makes me break out in hives." "Sometimes I notice that I have bad breath after I drink a cup of milk."

"If I drink more than a cup of milk, I usually have abdominal cramps and bloating."

The nurse is reviewing the educational packet provided to a client about tubal ligation. Which information regarding this procedure is important for the nurse to share? (Select all that apply.) "It is highly unlikely that you will become pregnant after the procedure." "Tubal ligation is an effective form of 100% permanent sterilization. You won't be able to get pregnant." "Sterilization offers some form of protection against sexually transmitted infections (STIs)." "Sterilization offers no protection against sexually transmitted infections (STIs)." "Your menstrual cycle will greatly increase after your sterilization."

"It is highly unlikely that you will become pregnant after the procedure." "Sterilization offers no protection against sexually transmitted infections (STIs)."

A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant. Which guidance should she expect to receive? "Discontinue all contraception now." "Lose weight so that you can gain more during pregnancy." "You may take any medications you have been regularly taking." "Make sure you include adequate folic acid in your diet."

"Make sure you include adequate folic acid in your diet."

A young adult experiencing pain states, "I want to see a chiropractor, but I don't have any money. However, I do have health insurance." What is the most appropriate response the nurse can provide regarding payment for this form of health care service? "Most insurance companies will pay for chiropractic treatment." "Because chiropractors are not required to be licensed, services must be paid for by the patient." "Chiropractic medicine is a new complementary alternative medicine (CAM) therapy that has not yet been recognized by insurance companies." "Chiropractic medicine is more than 100 years old, but because it is preventive in nature, it is not covered by most insurance."

"Most insurance companies will pay for chiropractic treatment."

While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the client's recent menstrual cycles. Which statement by the client should prompt the nurse to collect further information? "My menstrual flow lasts 5 to 6 days." "My flow is very heavy." "I have had a small amount of spotting midway between my periods for the past 2 months." "The length of my menstrual cycles varies from 26 to 29 days."

"My flow is very heavy."

A patient in her first trimester complains of nausea and vomiting. She asks, "Why does this happen?" What is the nurse's best response? "Nausea and vomiting are due to an increase in gastric motility." "Nausea and vomiting may be due to changes in hormones." "Nausea and vomiting are related to an increase in glucose levels." "Nausea and vomiting are caused by a decrease in gastric secretions."

"Nausea and vomiting may be due to changes in hormones."

A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parent's class. Which aspect of their birth plan should be considered potentially unrealistic and require further discussion with the nurse? "My partner and I have agreed that my sister will be my coach because he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is okay." "We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labor." "We want the labor and birth to take place in a birthing room. My partner will come in the minute the baby is born." "Regardless of the circumstances, we do not want the fetal monitor used during labor because it will interfere with movement and doing effleurage."

"Regardless of the circumstances, we do not want the fetal monitor used during labor because it will interfere with movement and doing effleurage."

Many clients are concerned about the increased levels of mercury in fish and may be reluctant to include this source of nutrients in their diet. What is the best advice for the nurse to provide? "Canned white tuna is a preferred choice for inclusion in your diet." "Shark, swordfish, and mackerel are types of fish that have high mercury levels" "Fish caught in local waterways is the safest to consume." "Avoid salmon and shrimp since they contain high levels of mercury."

"Shark, swordfish, and mackerel are types of fish that have high mercury levels"

A man smokes two packs of cigarettes a day. He wants to know if smoking is contributing to the difficulty he and his wife are having getting pregnant. Which guidance should the nurse provide? "Your sperm count seems to be okay in the first semen analysis." "Only marijuana cigarettes affect sperm count." "Although smoking has no effect on sperm count, it can give you lung cancer." "Smoking can reduce the quality of your sperm."

"Smoking can reduce the quality of your sperm."

A client currently uses a diaphragm and spermicide for contraception. She asks the nurse to explain the major differences between the cervical cap and the diaphragm. What is the most appropriate response by the nurse? "No spermicide is used with the cervical cap, so it's less messy." "The diaphragm can be left in place longer after intercourse." "Repeated intercourse with the diaphragm is more convenient." "The cervical cap can be safely used for repeated acts of intercourse without adding more spermicide later."

"The cervical cap can be safely used for repeated acts of intercourse without adding more spermicide later."

A couple have arrived for their preprocedural In vitro fertilization-embryo transfer (IVF-ET) interview. Which explanation regarding the procedure is most accurate? "The procedure begins with collecting eggs from the woman's ovaries." "A donor embryo will be transferred into the woman's uterus." "Donor sperm will be used to inseminate the woman." "Don't worry about the technical stuff; that's what we are here for."

"The procedure begins with collecting eggs from the woman's ovaries."

A pregnant woman's biophysical profile (BPP) score is 8. She asks the nurse to explain the results. How should the nurse respond initially? "The test results are within normal limits." "Immediate delivery by cesarean birth is being considered." "Further testing will be performed to determine the meaning of this score." "An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery."

"The test results are within normal limits."

A newborn in the neonatal intensive care unit (NICU) is dying of a massive infection. The parents speak to the neonatologist, who informs them of their son's prognosis. When the father sees his son, he says, "He looks just fine to me. I can't understand what all this is about." What is the most appropriate response or reaction by the nurse at this time? "Didn't the physician tell you about your son's problems?" "This must be a difficult time for you. Tell me how you're doing." Quietly stand beside the infant's father. "You'll have to face up to the fact that he is going to die sooner or later."

"This must be a difficult time for you. Tell me how you're doing."

Which options for saying "good-bye" would the nurse want to discuss with a woman who is diagnosed with having a stillborn girl? The nurse should not discuss any options at this time; plenty of time will be available after the baby is born. "Would you like a picture taken of your baby after birth?" "When your baby is born, would you like to see and hold her?" "What funeral home do you want notified after the baby is born?"

"When your baby is born, would you like to see and hold her?"

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of the exercise on the fetus. Which guidance should the nurse provide? "You don't need to modify your exercising any time during your pregnancy." "Stop exercising because it will harm the fetus." "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." "Jogging is too hard on your joints; switch to walking now."

"You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."

A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." What is the nurse's most appropriate response? "This probably means that you're pregnant." "Don't worry; it's probably nothing." "Have you been sick this month?" "You probably didn't ovulate during this cycle."

"You probably didn't ovulate during this cycle."

A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. What is the nurse's best response? "Oral contraceptives are a highly effective method, but they have some side effects." "Your current medications will reduce the effectiveness of the pill." "Oral contraceptives will reduce the effectiveness of your seizure medication." "The pill is a good choice for a woman of your age and with your personal history."

"Your current medications will reduce the effectiveness of the pill."

A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is this client's total recommended weight gain during pregnancy? 20 kg (44 lb) 16 kg (35 lb) 12.5 kg (27.5 lb) 10 kg (22 lb)

12.5 kg (27.5 lb)

Which nutritional recommendation regarding fluids is accurate? A woman's daily intake should be eight to ten glasses of water, milk, and/or juice. Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worry. Of the artificial sweeteners, only aspartame has not been associated with any maternity health concerns. Water with fluoride is especially encouraged because it reduces the child's risk of tooth decay.

A woman's daily intake should be eight to ten glasses of water, milk, and/or juice.

A client who had a hysterectomy has a 200-mg dose of ciprofloxacin (Cipro) ordered to infuse in 30 minutes. At what rate should the nurse infuse the medication if the pharmacy provides 200 mg in a 100-mL bag of normal saline? (Record your answer using a whole number.) ___ mL/hr

ANS: 200 mL/hr 100 mL 2 = 200 mL/hr.

A woman arrives at the clinic for a pregnancy test. The first day of her LMP was September 10, 2014. Her expected date of birth (EDB) is __________.

ANS: June 17, 2015 Using the Nägele's rule, June 17, 2015, is the correct EDB. The EDB is calculated by subtracting 3 months from the first day of the LMP and adding 7 days + 1 year to the day of the LMP. Therefore, with an LMP of September 10, 2014: September 10, 2014 - 3 months = June 10, 2014 + 7 days = June 17, 2014 + 1 year = June 17, 2015.

A 23-year-old female was admitted to the hospital for intravenous antibiotic treatment of pelvic inflammatory disease. The provider has ordered cefazolin (Ancef) to be administered every 8 hours. At what rate should the nurse infuse the medication if the pharmacy provides 1 g of the medication in 50 mL of 0.9% NaCl to infuse in 30 minutes? (Record your answer using a whole number.) _____ mL/hr

ANS:100 mL/hr To calculate using the dimensional analysis method: (50 mL/30 min) (60 min/1 hr) = 100 mL/hr.

The BMI for a woman who is 51 kg before pregnancy and 1.57 m tall is _________.

ANS:20.7 A commonly used method of evaluating the appropriateness of weight for height is the BMI, which is calculated by the following formula.BMI = Weight in kg divided by the height in meters squaredBMI = 51 kg (1.57 m)2 51 2.47 = 20.69

The practice of the calendar rhythm method is based on the number of days in each menstrual cycle. The fertile period is determined after monitoring each cycle for 6 months. The beginning of the fertile period is estimated by subtracting 18 days from the longest cycle and 11 days from the shortest. If the woman's cycles vary in length from 24 to 30 days, then her fertile period would be day _____ through day ______.

ANS:6:19 To avoid pregnancy, the couple must abstain from intercourse on days 6 through 19. Ovulation occurs on day 12 (plus or minus 2 days either way).

Which statement regarding abnormal uterine bleeding (AUB) is most accurate? AUB is most commonly caused by anovulation. AUB most often occurs in middle age. The diagnosis of AUB should be the first consideration for abnormal menstrual bleeding. Steroids are the most effective medical treatment for AUB.

AUB is most commonly caused by anovulation.

Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy. Why is this the case? Maternal nutritional status is extremely difficult to adjust because of an individual's ingrained eating habits. Adequate nutrition is important preventative measure for a variety of problems. Women love obsessing about their weight and diets. A woman's preconception weight becomes irrelevant.

Adequate nutrition is important preventative measure for a variety of problems.

The massage therapist uses kinesthesia to correct habits that cause poor posture and limited movement. What is this type of massage called? Alexander technique Feldenkrais method healing touch Reiki

Alexander technique

Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)? All women, regardless of risk factors Women who have had more than one sexual partner Women who have had a sexually transmitted infection (STI) Woman who are monogamous with one partner

All women, regardless of risk factors

Which presumptive sign or symptom of pregnancy would a client experience who is approximately 10 weeks of gestation? Amenorrhea Positive pregnancy test Chadwick sign Hegar sign

Amenorrhea

Which suggestions are appropriate for a client who reports experiencing hot flashes? (Select all that apply.) Avoiding caffeine. Drinking a glass of wine to relax. Wearing layered clothing. Drinking ice water. Consuming spicy foods

Avoiding caffeine. Wearing layered clothing. Drinking ice water.

A client states that she plans to breastfeed her newborn infant. What guidance would be useful for this new mother? The mother's intake of vitamin C, zinc, and protein can now be lower than during pregnancy. Caffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful. Critical iron and folic acid levels must be maintained. Lactating women can go back to their prepregnant caloric intake.

Caffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful.

A client states that she does not drink milk. Which foods should the nurse encourage this woman to consume in greater amounts to increase her calcium intake? Fresh apricots Canned clams Spaghetti with meat sauce Canned sardines

Canned sardines

To reassure and educate their pregnant clients regarding changes in their blood pressure, nurses should be cognizant of what? A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high. Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. Systolic blood pressure slightly increases as the pregnancy advances; diastolic pressure remains constant. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of a term pregnancy.

Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of a term pregnancy.

Which action is the highest priority for the nurse when educating a pregnant adolescent? Emphasize the need to eliminate common teenage snack foods because they are high in fat and sodium. Determine the weight gain needed to meet adolescent growth and add 35 pounds. Suggest that she not eat at fast-food restaurants to avoid foods of poor nutritional value. Realize that most adolescents are unwilling to make dietary changes during pregnancy.

Determine the weight gain needed to meet adolescent growth and add 35 pounds.

Which action should the nurse first take when meeting with a new client to discuss contraception? Obtain data about the frequency of coitus. Determine the woman's level of knowledge concerning contraception. Assess the woman's willingness to touch her genitals and cervical mucus. Evaluate the woman's contraceptive life plan.

Determine the woman's level of knowledge concerning contraception.

Which is the most common technique used for the termination of a pregnancy in the second trimester? Dilation and evacuation (D&E) Methotrexate administration Prostaglandin administration Vacuum aspiration

Dilation and evacuation (D&E)

Which is the most accurate description of postpartum depression (PPD) without psychotic features? Postpartum baby blues requiring the woman to visit with a counselor or psychologist Condition that is more common among older Caucasian women because they have higher expectations Distinguishable by pervasive sadness along with mood swings Condition that disappears without outside help

Distinguishable by pervasive sadness along with mood swings

The nurse sees a woman for the first time when she is 30 weeks pregnant. The client has smoked throughout the pregnancy, and fundal height measurements now are suggestive of intrauterine growth restriction (IUGR) in the fetus. In addition to ultrasound to measure fetal size, what is another tool useful in confirming the diagnosis? Doppler blood flow analysis Contraction stress test (CST) Amniocentesis Daily fetal movement counts

Doppler blood flow analysis

Male fertility declines slowly after age 40 years; however, no cessation of sperm production analogous to menopause in women occurs in men. What condition is not associated with advanced paternal age? Autosomal dominant disorder Schizophrenia Autism spectrum disorder Down syndrome

Down syndrome

. A patient who is interested in herbal medicine attends a seminar to learn more about complementary alternative medicine (CAM). The nurse discusses what common belief related to all CAMs? (Select all that apply.) The body is not able to repair itself; thus, natural remedies are used to inhibit the immune system. Many different CAMs that focus on specific body parts and the mind are needed. The focus of CAM is on an intervention for the diseased body part. Each CAM treatment is unique to the person who is being treated. Health promotion is incorporated into CAM.

Each CAM treatment is unique to the person who is being treated. Health promotion is incorporated into CAM.

A woman in the 34th week of pregnancy reports that she is very uncomfortable because of heartburn. Which recommendation would be appropriate for this client? Substitute other calcium sources for milk in her diet. Lie down after each meal. Reduce the amount of fiber she consumes. Eat five small meals daily.

Eat five small meals daily.

Nutrition is an alterable and important preventive measure for a variety of potential problems such as low birth weight and prematurity. While completing the physical assessment of the pregnant client, the nurse can evaluate the client's nutritional status by observing a number of physical signs. Which physical sign indicates to the nurse that the client has unmet nutritional needs? Normal heart rate, rhythm, and blood pressure Bright, clear, and shiny eyes Alert and responsive with good endurance Edema, tender calves, and tingling

Edema, tender calves, and tingling

Nurses should be cognizant of what information regarding the non-contraceptive medical effects of combination oral contraceptives (COCs)? COCs can cause TSS if the prescription is wrong. Hormonal withdrawal bleeding is usually a little more profuse than in normal menstruation and lasts a week for those who use COCs. COCs increase the risk of endometrial and ovarian cancers. Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

Which statement regarding emergency contraception is correct? Emergency contraception requires that the first dose be taken within 120 hours of unprotected intercourse. Emergency contraception may be taken right after ovulation. Emergency contraception has an effectiveness rate in preventing pregnancy of approximately 50%. Emergency contraception is commonly associated with the side effect of menorrhagia.

Emergency contraception requires that the first dose be taken within 120 hours of unprotected intercourse.

A client reports experiencing severe abdominal and pelvic pain around the time of menstruation. This pain has become progressively worse over the last 5 years. She also experiences pain during intercourse and has tried unsuccessfully to become pregnant for the past 18 months. To which condition are these symptoms most likely related? Endometriosis Premenstrual Syndrome (PMS) Primary dysmenorrhea Secondary dysmenorrhea

Endometriosis

Which statement related to the condition of endometriosis accurately describes it's pathophysiology? Endometriosis is characterized by the presence and growth of endometrial tissue inside the uterus. It is found more often in African-American women than in Caucasian or Asian women. Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause. It is unlikely to affect sexual intercourse or fertility.

Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause.

To assist a client in managing the symptoms of Premenstrual Syndrome (PMS), what intervention should the nurse recommend based on current evidence? Adhering to a diet with more body-building and energy foods, such as carbohydrates Engaging in herbal therapies, yoga, and massage therapy Seeking antidepressant therapy for symptom control Avoiding the use of natural diuretics

Engaging in herbal therapies, yoga, and massage therapy

A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine "several times" during the past year and occasionally drinks alcohol. Her blood pressure is 108/70 mm Hg. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics places this client in a high-risk category? Blood pressure, age, BMI Drug and alcohol use, age, family history Family history, blood pressure (BP), BMI Family history, BMI, drug and alcohol abuse

Family history, BMI, drug and alcohol abuse

Which term best describes the conscious decision concerning deciding when to conceive or avoid pregnancy as opposed to the intentional prevention of pregnancy during intercourse? Family planning Birth control Contraception Assisted reproductive therapy

Family planning

The middle school nurse is planning a behavior modification program for overweight children. What is the most important goal for participants of the program? Learn how to cook low-fat meals. Improve relationships with peers. Identify and eliminate inappropriate eating habits. Achieve normal weight during the program.

Identify and eliminate inappropriate eating habits.

Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the client who elects to use this alternative modality, understanding the action of these herbal preparations is important. Match the herbal medicine with the appropriate action. Uterine antispasmodic Uterotonic Antiinflammatory Estrogen-like luteinizing hormone suppressant Decreases prolactin levels

Fennel, dong quai=Uterotonic Chaste tree fruit=Decreases prolactin levels Black cohosh root=Estrogen-like luteinizing hormone suppressant Valerian, wild yam=Uterine antispasmodic Ginger= Antiinflammatory

Cell-free deoxyribonucleic acid (cfDNA) screening is a new method of noninvasive prenatal testing (NIPT) that has recently become available in the clinical setting. This technology can provide a definitive diagnosis of which findings? (Select all that apply.) Fetal Rh status Fetal gender Maternally transmitted gene disorder Paternally transmitted gene disorder Trisomy 21

Fetal Rh status Fetal gender Paternally transmitted gene disorder Trisomy 21

All pregnant women should be instructed to recognize and report potential complications for each trimester of pregnancy. Match the sign or symptom with a possible cause. Severe vomiting in early pregnancy Epigastric pain in late pregnancy Severe backache and flank pain Decreased fetal movement Glycosuria

Fetal jeopardy or intrauterine fetal death= Decreased fetal movement Kidney infection or stones= Severe backache and flank pain Gestational diabetes= Glycosuria Hyperemesis gravidarum= Severe vomiting in early pregnancy Hypertension, preeclampsia=Epigastric pain in late pregnancy

Which assessments are included in the fetal biophysical profile (BPP)? (Select all that apply.) Fetal movement Fetal tone Fetal heart rate Amniotic fluid index (AFI) Placental grade

Fetal movement Fetal tone Fetal heart rate Amniotic fluid index (AFI)

What is a major physical risk for young adolescents during pregnancy? Osteoporosis frequently develops. Fetopelvic disproportion is a common problem. Delivery is usually precipitous in this age group. Pregnancy will adversely affect the adolescents development.

Fetopelvic disproportion is a common problem.

In providing counseling to pregnant women, the nurse can include information on the components of weight gain during pregnancy and the amount of weight that will be lost after the birth. Match the tissues contributing to maternal weight gain at 40 weeks of gestation with the approximate amount of weight gain in kilograms. 0.5 to 1.8 1.8 to 2.3 3.2 to 3.9 0.9 0.9 to 1.1

Fetus= 3.2 to 3.9 Placenta= 0.9 to 1.1 Breast tissue= 0.5 to 1.8 Amniotic fluid= 0.9 Blood volume= 1.8 to 2.3

Which statements regarding the Human papillomavirus (HPV) are accurate? (Select all that apply.) HPV infections: HPV is thought to be less common in pregnant women than in women who are not pregnant. HPV is thought to be more common in pregnant than in non-pregnant women. HVP was previously referred to as genital warts. HVP was previously referred to as herpes. HVP is thought to sometimes cause cervical cancer.

HPV is thought to be more common in pregnant than in non-pregnant women. HVP was previously referred to as genital warts. HVP is thought to sometimes cause cervical cancer.

Which action is the priority for the nurse who is assessing the influence of culture on a client's diet? Evaluate the client's weight gain during pregnancy. Assess the socioeconomic status of the client. Discuss the four food groups with the client. Identify food preferences and methods of food preparation

Identify food preferences and methods of food preparation

Dental care during pregnancy is an important component of good prenatal care. Which instruction regarding dental health should the nurse provide? Regular brushing and flossing may not be necessary during early pregnancy because it may stimulate the woman who is already nauseated to vomit. A cleaning is all that is necessary. Dental surgery is contraindicated during pregnancy and should be delayed until after delivery. If dental treatment is necessary, then the woman will be most comfortable with it in the second trimester. If a woman has dental anxiety, then dental care may interfere with the expectant mother's need to practice conscious relaxation and to prepare for labor.

If dental treatment is necessary, then the woman will be most comfortable with it in the second trimester.

Parents are often asked if they would like to have an autopsy performed on their infant. Nurses who are assisting parents with this decision should be aware of which information? Autopsies are usually covered by insurance. Autopsies must be performed within a few hours after the infant's death. In the current litigious society, more autopsies are performed than in the past. Some religions prohibit autopsy.

In the current litigious society, more autopsies are performed than in the past.

Pregnancy hormones prepare the vagina for stretching during labor and birth. Which change related to the pelvic viscera should the nurse share with the client? Because of several changes in the cervix, abnormal Papanicolaou (Pap) tests are easier to evaluate. Quickening is a technique of palpating the fetus to engage it in passive movement. The deepening color of the vaginal mucosa and cervix (Chadwick sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor. Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.

Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.

Nafarelin is used to treat mild-to-severe endometriosis. What instruction or information should the nurse provide to a client regarding nafarelin administration? Nafarelin stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity. It should be administered by intramuscular (IM) injection. Nafarelin should be administered by a subcutaneous implant. It can cause the client to experience some hot flashes and vaginal dryness.

It can cause the client to experience some hot flashes and vaginal dryness.

A patient regularly experiences migraine headaches that are not relieved by traditional Western medical practices. Why does the family physician suggest acupuncture? (Select all that apply.) It is based on the belief that meridians are vital for life, and when they are out of balance, pain occurs. It uses strategically placed, slender needles for pain relief. It uses breathing exercises and meditation to relieve pain. It corrects metabolic imbalance through purification regimens. It determines distinct metabolic body types.

It is based on the belief that meridians are vital for life, and when they are out of balance, pain occurs. It uses strategically placed, slender needles for pain relief.

Which statement regarding the term contraceptive failure rate is the most accurate? The contraceptive failure rate refers to the percentage of users expected to have an accidental pregnancy over a 5-year span. It refers to the minimum rate that must be achieved to receive a government license. The contraceptive failure rate increases over time as couples become more careless. It varies from couple to couple, depending on the method and the users.

It varies from couple to couple, depending on the method and the users.

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy. Which statement regarding monitoring techniques is the most accurate? Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. Maternal serum AFP (MSAFP) screening is recommended only for women at risk for neural tube defects (NTDs). Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome. Maternal serum AFP (MSAFP) is a screening tool only; it identifies candidates for more definitive diagnostic procedures.

Maternal serum AFP (MSAFP) is a screening tool only; it identifies candidates for more definitive diagnostic procedures.

A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding? Melasma Linea nigra Striae gravidarum Palmar erythema

Melasma

Counseling and education are critical components of the nursing care of women with herpes infections. Clients should be taught to identify triggers that might result in a herpes attack. Which factors are possible triggers for a recurrence? (Select all that apply.) Menstruation Trauma Febrile illness Soap Ultraviolet light

Menstruation Trauma Febrile illness Ultraviolet light

With one exception, the safest pregnancy is one during which the woman is drug and alcohol free. What is the optimal treatment for women addicted to opioids? Methadone Detoxification Smoking cessation 4 Ps Plus

Methadone

An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurses response should be based on what? Hormone therapy is necessary for the treatment of dysmenorrhea. Acetaminophen is the drug of choice for the treatment of dysmenorrhea. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.

NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.

Which gastrointestinal alteration of pregnancy is a normal finding? Insufficient salivation (ptyalism) is caused by increases in estrogen. Acid indigestion (pyrosis) begins early but declines throughout pregnancy. Hyperthyroidism often develops (temporarily) because hormone production increases. Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.

Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.

During a follow-up home visit, the nurse plans to evaluate whether parents have progressed to the second stage of grieving (phase of intense grief). Which behavior would the nurse not anticipate finding? Guilt, particularly in the mother Numbness or lack of response Bitterness or irritability Fear and anxiety, especially about getting pregnant again

Numbness or lack of response

Which condition is the least likely cause of amenorrhea in a 17-year-old client? Anatomic abnormalities Type 1 diabetes mellitus Obesity Pregnancy

Obesity

A woman who is 16 weeks pregnant has come in for a follow-up visit with her partner. To reassure the client regarding fetal well-being, which is the highest priority action for the nurse to perform? Assess the fetal heart tones with a Doppler stethoscope. Measure and document the girth of the woman's abdomen. Complete an ultrasound examination (sonogram) in a timely manner. Offer the woman and her partner the opportunity to listen to the fetal heart tones.

Offer the woman and her partner the opportunity to listen to the fetal heart tones.

An adolescent girl is brought to the hospital emergency department by her parents after being raped. The girl is calm and controlled throughout the interview and examination. The nurse should recognize this behavior is what? A sign that a rape has not actually occurred One of a variety of behaviors normally seen in rape victims Indicative of a higher than usual level of maturity in the adolescent Suggestive that the adolescent had severe emotional problems before the rape occurred

One of a variety of behaviors normally seen in rape victims

Parents have asked the nurse about organ donation after that infant's death. Which information regarding organ donation is important for the nurse to understand? Federal law requires the medical staff to ask the parents about organ donation and then to contact their state's organ procurement organization (OPO) to handle the procedure if the parents agree. Organ donation can aid grieving by giving the family an opportunity to see something positive about the experience. Most common donation is the infant's kidneys. Corneas can be donated if the infant was either stillborn or alive as long as the pregnancy went full term.

Organ donation can aid grieving by giving the family an opportunity to see something positive about the experience.

While educating the client regarding the risks and benefits of a vasectomy, which information should the nurse include? (Select all that apply.) Sterilization should be performed under general anesthesia. Pain, bleeding, and infection are possible complications. For several months, pregnancy may still be possible. Vasectomy may affect potency. Secondary sex characteristics are unaffected.

Pain, bleeding, and infection are possible complications. For several months, pregnancy may still be possible. Secondary sex characteristics are unaffected.

The nurse is teaching a class on obesity prevention to parents in the community. What is a contributing factor to childhood obesity? Birth weight Parental overweight Age at the onset of puberty Asian ethnic background

Parental overweight

What strategy is considered one of the best for preventing smoking in teenagers? Large-scale printed information campaigns Emphasis on the long-term effects of smoking on health Threatening the social norms of groups most likely to smoke Peer-led programs emphasizing the social consequences of smoking

Peer-led programs emphasizing the social consequences of smoking

A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild-to-moderate intensity. Which intervention should the nurse recommend? Kegel exercises Pelvic rock exercises Softer mattress Bed rest for 24 hours

Pelvic rock exercises

The number of routine laboratory tests during follow-up visits is limited; however, those that are performed are essential. Which statements regarding group B Streptococcus (GBS) testing are correct? (Select all that apply.) Performed between 32 and 34 weeks of gestation. Performed between 35 and 37 weeks of gestation. All women should be tested. Only women planning a vaginal birth should be tested. Women with a history of GBS should be retested.

Performed between 35 and 37 weeks of gestation. All women should be tested. Women with a history of GBS should be retested.

Intrauterine growth restriction (IUGR) is associated with which pregnancy-related risk factors? (Select all that apply.) Poor nutrition Multifetal pregnancy Gestational hypertension Premature rupture of membranes Smoking

Poor nutrition Multifetal pregnancy Gestational hypertension Smoking

An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before and does not want to be pregnant. What should the nurse explain? It is too late to prevent an unwanted pregnancy. An abortion may be the best option if she is pregnant. The risk of pregnancy is minimal, so no action is necessary. Postcoital contraception is available to prevent implantation and therefore pregnancy.

Postcoital contraception is available to prevent implantation and therefore pregnancy.

While providing care to the maternity client, the nurse should be aware that one of these anxiety disorders is likely to be triggered by the process of labor and birth. Which disorder fits this criterion? Phobias Panic disorder Posttraumatic stress disorder (PTSD) Obsessive-compulsive disorder (OCD)

Posttraumatic stress disorder (PTSD)

Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. However, the nurse or midwife may need to refer a client to a registered dietitian for in-depth nutritional counseling. Which conditions would require such a consultation? (Select all that apply.) Preexisting or gestational illness such as diabetes Ethnic or cultural food patterns Obesity Vegetarian diets Multifetal pregnancy

Preexisting or gestational illness such as diabetes Ethnic or cultural food patterns Obesity Vegetarian diets

Part of the normal vaginal flora in 20% to 30% of healthy pregnant women. GBS has been associated with poor pregnancy outcomes and is an important factor in neonatal morbidity and mortality. Which finding is not a risk factor for neonatal Group B Streptococcus (GBS) infection? Positive prenatal Group B Streptococcus culture Preterm birth at 37 weeks or less of gestation Intrapartum maternal temperature of 38 C (100.4°F) or higher Premature rupture of membranes (PROM) lasting 12 hours

Premature rupture of membranes (PROM) lasting 12 hours

Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both. The nurse who provides prenatal care should have an understanding of these risk factors. Match the specific pregnancy problem with the related risk factor. Polyhydramnios IUGR (maternal cause) Oligohydramnios Chromosomal abnormalities IUGR (fetoplacental cause)

Premature rupture of membranes= Oligohydramnios Advanced maternal age= Chromosomal abnormalities Fetal congenital anomalies= Polyhydramnios Abnormal placenta development= IUGR (fetoplacental cause) Smoking, alcohol, and illicit drug use= IUGR (maternal cause)

According to research, which risk factor for postpartum depression (PPD) is likely to have the greatest effect on the client postpartum? Prenatal depression Single-mother status Low socioeconomic status Unplanned or unwanted pregnancy

Prenatal depression

Which clinical finding is a major use of ultrasonography in the first trimester? Amniotic fluid volume Presence of maternal abnormalities Placental location and maturity Cervical length

Presence of maternal abnormalities

What is a priority goal in the postpartum care of an adolescent mother? Prevention of subsequent pregnancies Ensuring that the father of the baby cares for the child Returning the mother to a prepregnancy lifestyle Facilitating formula feeding to minimize interruptions

Prevention of subsequent pregnancies

A 21-year-old client reports experiencing severe pain immediately after the commencement of her menses. Which gynecologic condition is the most likely cause of this client's presenting symptoms? Primary dysmenorrhea Secondary dysmenorrhea Dyspareunia Endometriosis

Primary dysmenorrhea

Which nutrient's recommended dietary allowance (RDA) is higher during lactation than during pregnancy? Protein Iron Vitamin A Folic acid

Protein

Many adolescents use alcohol for self-medication. How does an adolescent view the benefit of alcohol? Believes it has a stimulant effect Believes it increases alertness Provides a sense of euphoria Provides a defense against depression

Provides a defense against depression

The nurses role in facilitating successful childrearing in unmarried teenage mothers includes what? Facilitating marriage between the mother and father of the baby Teaching the adolescent the long-term needs of the growing child Providing information and feedback about positive parenting skills Encouraging the infants grandmother to take responsibility for care

Providing information and feedback about positive parenting skills

During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criterion? (Select all that apply.) Leukorrhea Development of the operculum Quickening Ballottement Lightening

Quickening Ballottement Lightening

A patient is prescribed reserpine to decrease mild anxiety and treat hypertension. The patient researches the medication on the Internet and finds that this medication comes from which plant? Atropa belladonna Digitalis purpurea Rauwolfia serpentina Cephaelis ipecacuanha

Rauwolfia serpentina

As part of the discharge teaching, the nurse can prepare the mother for her upcoming adjustment to her new role by instructing her regarding self-care activities to help prevent postpartum depression (PPD). Which statement regarding this condition is most helpful for the client? Stay home and avoid outside activities to ensure adequate rest. Be certain that you are the only caregiver for your baby to facilitate infant attachment. Keep your feelings of sadness and adjustment to your new role to yourself. Realize that PPD is a common occurrence that affects many women.

Realize that PPD is a common occurrence that affects many women.

A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action? Refer him for immediate medical evaluation. Administer analgesics and recommend scrotal support. Apply an ice bag and observe for increasing pain. Reassure the adolescent that occasional pain is common with the changes of puberty.

Refer him for immediate medical evaluation.

A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action? Explain that this is not unusual. Refer the adolescent for an evaluation. Make an assumption that the adolescent is pregnant. Suggest that the adolescent stop exercising until menarche occurs.

Refer the adolescent for an evaluation.

A family is visiting two surviving triplets. The third triplet died 2 days ago. What action indicates that the family has begun to grieve for the dead infant? Refers to the two live infants as twins Asks about the dead triplet's current status Brings in play clothes for all three infants Refers to the dead infant in the past tense

Refers to the dead infant in the past tense

A nurse practices a relaxing massage technique to stimulate and apply pressure to the feet or hands, increasing blood supply circulation to various parts of the body and relieving pain. The massage technique used by the practitioner is referred to by term? Reflexology Feldenkrais method Reiki Rolfing

Reflexology

Nurses are in an ideal position to educate clients who experience Premenstrual dysphoric disorder (PMDD). What self-help activities have been documented as helpful in alleviating the symptoms of PMDD? Regular exercise Improved nutrition Daily glass of wine Smoking cessation Oil of evening primrose

Regular exercise Improved nutrition Smoking cessation Oil of evening primrose

A patient who is just beginning to use homeopathy to treat depression is concerned because symptoms are becoming worse with increasing sadness, anxiety, and fatigue. The practitioner of homeopathy bases teaching on the Law of Cure and provides what instructions to the patient? Discontinue the therapy and seek another alternative therapy. Concentrate the preparation to increase its potency in hopes to improve depressive symptoms. Increase the dosage of the substance to increase its effectiveness. Remain on the current regimen since worsening is a positive sign that healing is occurring.

Remain on the current regimen since worsening is a positive sign that healing is occurring.

A client is seen at the clinic at 14 weeks of gestation for a follow-up appointment. At which level does the nurse expect to palpate the fundus? Nonpalpable above the symphysis at 14 weeks of gestation Slightly above the symphysis pubis At the level of the umbilicus Slightly above the umbilicus

Slightly above the symphysis pubis

During the initial acute distress phase of grieving, parents still must make unexpected and unwanted decisions about funeral arrangements and even naming the baby. What is the nurse's role at this time? To take over as much as possible to relieve the pressure To encourage the grandparents to take over To ensure that the parents, themselves, approve the final decisions To leave them alone to work things out

To ensure that the parents, themselves, approve the final decisions

During a well-child visit, the nurse plots the childs BMI on the health record. What is the purpose of the BMI? To determine medication dosages To predict adult height and weight To identify coping strategies used by the child To provide a consistent measure of obesity

To provide a consistent measure of obesity

Cardiac output increases up to 50% by the 32nd week of pregnancy. What is the rationale for this change? To compensate for the decreased renal plasma flow To provide adequate perfusion of the placenta To eliminate metabolic wastes of the mother To prevent maternal and fetal dehydration

To provide adequate perfusion of the placenta

Which infections, collaboratively referred to as TORCH infections, are capable of crossing the placenta and causing serious prenatal effects on the fetus? (Select all that apply.) Toxoplasmosis Cytomegalovirus (CMVN) Rubella Clostridium Herpes simplex 1 (HSV-1)

Toxoplasmosis Cytomegalovirus (CMVN) Rubella Herpes simplex 1 (HSV-1)

A patient has fallen at home and complains that joints are very painful when trying to climb stairs. The patient desires to use an alternative complementary medicine rather than pain medication. The practitioner begins treatment with touch consisting of rocking, rhythmical motions to loosen tense, sore muscles and joints. The patient is receiving which type of treatment? Swedish massage Rolfing Trager approach Reflexology

Trager approach

A 21-year-old client exhibits a greenish, copious, and malodorous discharge with vulvar irritation. A speculum examination and wet smear are performed to help confirm the diagnosis. Which condition is this client most likely experiencing? Bacterial vaginosis Candidiasis Yeast infection Trichomoniasis

Trichomoniasis

Which guidance might the nurse provide for a client with severe morning sickness? Trying lemonade and potato chips Drinking plenty of fluids early in the day Immediately brushing her teeth after eating Never snacking before bedtime

Trying lemonade and potato chips

A client at 34 weeks of gestation seeks guidance from the nurse regarding personal hygiene. Which information should the nurse provide? Tub bathing is permitted even in late pregnancy unless membranes have ruptured. The perineum should be wiped from back to front. Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath. Expectant mothers should use specially treated soap to cleanse the nipples.

Tub bathing is permitted even in late pregnancy unless membranes have ruptured.

Which infection control practice should the nurse use when providing eye prophylaxis to a term newborn possibly infected with human immunodeficiency virus (HIV)? Wearing gloves. Wearing mouth, nose, and eye protection. Wearing a mask. Washing the hands after medication administration.

Wearing gloves.

With regard to weight gain during pregnancy, the nurse should be aware of which important information? In pregnancy, the woman's height is not a factor in determining her target weight. Obese women may have their health concerns, but their risk of giving birth to a child with major congenital defects is the same as with women of normal weight. Women with inadequate weight gain have an increased risk of delivering a preterm infant with intrauterine growth restriction (IUGR). Greater than expected weight gain during pregnancy is almost always attributable to old-fashioned overeating.

Women with inadequate weight gain have an increased risk of delivering a preterm infant with intrauterine growth restriction (IUGR).

A postmenopausal client is experiencing low back and pelvic pain, fatigue, and bloody vaginal discharge. What laboratory tests would the nurse expect to see ordered for this client if endometrial cancer is suspected? (Select all that apply.) a. Cancer antigen-125 (CA-125) b. White blood cell (WBC) count c. Hemoglobin and hematocrit (H&H) d. International normalized ratio (INR) e. Prothrombin time (PT)

a. Cancer antigen-125 (CA-125) c. Hemoglobin and hematocrit (H&H)

Which assessment finding would be the earliest and most sensitive indicator that there is an alteration in intracranial regulation? a. Change in level of consciousness b. Inability to focus visually c. Loss of primitive reflexes d. Unequal pupil size

a. Change in level of consciousness

When assessing high-risk behaviors, which question specifically identifies a blood-related risk for a sexually transmitted infection? a. "Have you ever received donor semen, eggs, or transplanted tissue?" b. "Have you ever exchanged sex for drugs, money, or shelter?" c. "How do you protect yourself from HIV and sexually transmitted infections?" d. "Have you ever injected drugs using shared equipment?"

a. "Have you ever received donor semen, eggs, or transplanted tissue?"

The nurse recognizes a potential health threat to an alcoholic patient who is using the drug disulfiram when the nurse reads in the health record that the patient is also taking which of the following? (Select all that apply.) a. Blood thinners b. Diphenhydramine c. Alcohol d. Penicillin e. Mouthwash

a. Blood thinners c. Alcohol e. Mouthwash

A nurse is caring for four postoperative clients who each had a total abdominal hysterectomy. Which client should the nurse assess first upon initial rounding? a. Client who has had two saturated perineal pads in the last 2 hours b. Client with a temperature of 99 F and blood pressure of 115/73 mm Hg c. Client who has pain of 4 on a scale of 0 to 10 d. Client with a urinary catheter output of 150 mL in the last 3 hours

a. Client who has had two saturated perineal pads in the last 2 hours

A primary care clinic sees some clients with sexually transmitted diseases. Which clients would the nurse be required to report to the local authority in every state, according to the Centers for Disease Control and Prevention? (Select all that apply.) a. Client with Chlamydia b. Woman with gonorrhea c. Man with syphilis d. Client with human immune deficiency virus e. Female with pelvic inflammatory disease

a. Client with Chlamydia b. Woman with gonorrhea c. Man with syphilis d. Client with human immune deficiency virus

The nurse is conducting a patient assessment. The patient tells the nurse that he has smoked two packs of cigarettes per day for 27 years. The nurse may find which data upon assessment? a. Elevated blood pressure b. Bounding pedal pulses c. Night blindness d. Reflux disease

a. Elevated blood pressure

A nurse wants to reduce the risk potential for transmission of chlamydia and gonorrhea with a female client diagnosed with both diseases. Which items should be included in the clients teaching plan? (Select all that apply.) a. Expedited partner therapy b. Abstinence until therapy is completed c. Use of internal uterine devices d. Proper use of condoms e. Re-screening for infection f. Use of oral contraception

a. Expedited partner therapy b. Abstinence until therapy is completed d. Proper use of condoms e. Re-screening for infection

Which risk factors would the nurse teach a 23-year-old client about to prevent pelvic inflammatory disease (PID)? (Select all that apply.) a. Having multiple sexual partners b. Using an intrauterine device (IUD) c. Smoking d. Drinking two alcoholic beverages per day e. Having a history of sexually transmitted diseases (STDs)

a. Having multiple sexual partners b. Using an intrauterine device (IUD) c. Smoking e. Having a history of sexually transmitted diseases (STDs)

Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes? a. Herpes simplex virus 2 (HSV-2) b. Human papillomavirus (HPV) c. Human immunodeficiency virus (HIV) d. Cytomegalovirus (CMV)

a. Herpes simplex virus 2 (HSV-2)

The nurse would expect to administer an anticoagulant to a patient following which surgery? a. Hip replacement b. Hysterectomy c. Abdominal aorta aneurism (AAA) repair d. Appendectomy

a. Hip replacement

When caring for a patient after a head injury, the nurse would be most concerned with assessment findings which included respiratory changes along with what other findings? a. Hypertension and bradycardia b. Hypertension and tachycardia c. Hypotension and bradycardia d. Hypotension and tachycardia

a. Hypertension and bradycardia

The nurse is educating a client on the prevention of toxic shock syndrome (TSS). Which statement by the client indicates a lack of understanding? a. I need to change my tampon every 8 hours during the day. b. At night, I should use a feminine pad rather than a tampon. c. If I dont use tampons, I should not get TSS. d. It is best if I wash my hands before inserting the tampon.

a. I need to change my tampon every 8 hours during the day.

he nurse is teaching a client who is taking an oral antibiotic for treatment of a sexually transmitted disease (STD). Which statements by the client indicate a correct understanding of the treatment? (Select all that apply.) a. I need to drink at least 8 glasses of fluid each day with my antibiotic. b. I should read the instructions to see if I can take the medication with food. c. Antacids should not interfere with the effectiveness of the antibiotic. d. I need to wait 7 days after the last dose of the antibiotic to engage in intercourse. e. It should not matter if I skip a couple of doses of the antibiotic.

a. I need to drink at least 8 glasses of fluid each day with my antibiotic. b. I should read the instructions to see if I can take the medication with food. d. I need to wait 7 days after the last dose of the antibiotic to engage in intercourse.

The nurse is giving discharge instructions to a client who had a total abdominal hysterectomy. Which statements by the client indicate a need for further teaching? (Select all that apply.) a. I should not have any problems driving to see my mother, who lives 3 hours away. b. Now that I have time off from work, I can return to my exercise routine next week. c. My granddaughter weighs 23 pounds, so I need to refrain from picking her up. d. I will have to limit the times that I climb our stairs at home to morning and night. e. For 1 month, I will need to refrain from sexual intercourse.

a. I should not have any problems driving to see my mother, who lives 3 hours away. b. Now that I have time off from work, I can return to my exercise routine next week.

The nurse is making a home visit to a patient who was discharged from the hospital on Lovenox and warfarin following replacement of the patient's pacemaker. Which observation indicates excessive bleeding? (Select all that apply.) a. New ecchymosis on the abdomen b. A nosebleed that does not stop with pressure c. Pain of the lower extremity with flexion d. Extreme fatigue e. Pallor f. Sudden onset of severe headache

a. New ecchymosis on the abdomen b. A nosebleed that does not stop with pressure d. Extreme fatigue e. Pallor f. Sudden onset of severe headache

Screening questions for alcohol and drug abuse should be included in the overall assessment during the first prenatal visit for all women. The 4 Ps Plus is a screening tool specifically designed to identify the need for a more in-depth assessment. Which are the correct components of the 4 Ps Plus? (Select all that apply.) a. Parents b. Partner c. Present d. Past e. Pregnancy

a. Parents b. Partner d. Past e. Pregnancy

A client being treated for syphilis visits the office with a possible allergic reaction to benzathine penicillin G. Which abnormal findings would the nurse expect to document? (Select all that apply.) a. Red rash b. Shortness of breath c. Heart irregularity d. Chest tightness e. Anxiety

a. Red rash b. Shortness of breath d. Chest tightness e. Anxiety

A 28-year-old client is diagnosed with endometriosis and is experiencing severe symptoms. Which actions by the nurse are the most appropriate at this time? (Select all that apply.) a. Reduce the pain by low-level heat. b. Discuss the high risk of infertility with this diagnosis. c. Relieve anxiety by relaxation techniques and education. d. Discuss in detail the side effects of laparoscopic surgery. e. Suggest resources such as the Endometriosis Association.

a. Reduce the pain by low-level heat. c. Relieve anxiety by relaxation techniques and education. e. Suggest resources such as the Endometriosis Association.

A 60-year-old Italian immigrant presents for an annual physical. He is counseled about diagnostic testing including laboratory testing, colonoscopy, influenza vaccination, and pneumococcal vaccination. His reply is "If it ain't broke, don't try to fix it." When developing a plan of care, the nurse should consider which cultural orientation for this patient? a. Short term b. Long term c. Leisurely term d. Noncommittal

a. Short term

The nurse is taking the history of a 24-year-old client diagnosed with cervical cancer. What possible risk factors would the nurse assess? (Select all that apply.) a. Smoking b. Multiple sexual partners c. Poor diet d. Nulliparity e. Younger than 18 at first intercourse

a. Smoking b. Multiple sexual partners c. Poor diet e. Younger than 18 at first intercourse

A patient presents to the emergency room complaining of vomiting with severe back and leg pain. The patient's home medications include daily oral corticosteroids. Vital signs reveal a low blood pressure and there are peaked T waves on the electrocardiogram. What is the nurse's priority intervention? a. Start an intravenous line b. Collect urine specimen c. Administer antiemetic d. Administer narcotic analgesia

a. Start an intravenous line

During history-taking, a patient tells the nurse that he is addicted to alprazolam and that he takes six 1 mg tablets a day. He quit cold turkey yesterday and now presents with extreme agitation, increased heart rate, and panic. The nurse suspects which disorder? a. Stress reaction b. Delerium tremens c. Overdose d. Relapse

a. Stress reaction

The nurse is admitting a prenatal patient for diagnostic testing. While eliciting the psychosocial history, the nurse learns the patient smokes a pack of cigarettes daily, drinks a cup of cappuccino with breakfast, has smoked marijuana in the remote past, and is a social drinker. Which action should the nurse first take? a. Strongly advise immediate tobacco cessation b. Elimination of all caffeinated beverages c. Serum and urine testing for drug use and alcohol use d. Referral to a 12-step program

a. Strongly advise immediate tobacco cessation

A patient diagnosed with kyphosis is visiting a practitioner of chiropractic medicine for the first time and asks, "How does this therapy work?" The practitioner replies, "I will use my hands along with heat to correct the misalignment of your spine by placing pressure on the nerves that have produced pain." What term will the practitioner use to refer to the misalignment of the spine? a. Subluxation b. A sprain c. A fracture d. Epicondylitis

a. Subluxation

A woman is in her seventh month of pregnancy. She reports episodes of nasal congestion and occasional epistaxis. Which statement best describes why this may be happening to this client? a. This respiratory change is normal in pregnancy and caused by an elevated level of estrogen. b. This cardiovascular change is abnormal, and the nosebleeds are an ominous sign. c. The woman is a victim of domestic violence and is being hit in the face by her partner. d. The woman has been likely intranasally using cocaine for several months.

a. This respiratory change is normal in pregnancy and caused by an elevated level of estrogen.

A client has scheduled brachytherapy sessions and states that she feels as though she is not safe around her family. What is the best response by the nurse? a. You are only reactive when the radioactive implant is in place. b. To be totally safe, it is a good idea to sleep in a separate room. c. It is best to stay a safe distance from friends or family between treatments. d. You should use a separate bathroom from the rest of the family.

a. You are only reactive when the radioactive implant is in place.

Understanding cultural differences in health care is important because it will help the nurse to understand the manner in which people decide on obtaining treatments and medical care. In independent cultures an individual will a. put himself first. b. consult family members for advice. c. ask for a second opinion. d. travel great distances to receive the best care.

a. put himself first.

Which statement made by a student nurse indicates the need for further teaching about pituitary insufficiency? a. "Synthetic human growth hormone may be prescribed for children who are small for gestational age." b. "Testosterone supplements may be prescribed for women with gonadotropin deficiency." c. "Estrogen is known to regulate the action of growth hormone in men and women." d. "Chronic kidney disease treatment may include synthetic growth hormone replacement."

b. "Testosterone supplements may be prescribed for women with gonadotropin deficiency."

A 19-year-old college student seeks information from the schools nurse about how to avoid sexually transmitted diseases (STDs) without abstinence as a choice. Which statement by the nurse is best? a. Urinating after intercourse will eliminate the risk of infection. b. A vaccine can prevent genital warts caused by some strains of the human papilloma virus (HPV). c. Oral contraception can prevent pregnancy and STDs. d. Good handwashing helps prevent infection associated with STDs.

b. A vaccine can prevent genital warts caused by some strains of the human papilloma virus (HPV).

Which nursing observation would indicate that the nurse hold the medication warfarin (Coumadin)? a. An INR (international normalize ratio) of 1.8 b. An INR of 4.8 c. A partial thromboplastin time (APTT) level of 25 seconds d. An APTT level of 35 seconds

b. An INR of 4.8

Radioactive iodine is indicated for the treatment of hyperthyroidism. The nurse should include which teaching in this patient's plan of care? a. Isolation is required for 6-8 weeks b. An additional dose may be needed c. Thyroid replacement therapy is prescribed d. An overnight hospital stay is required

b. An additional dose may be needed

A 31-year-old woman believes that she may be pregnant. She took an over-the-counter (OTC) pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview, the nurse asks about the woman's last menstrual period and whether she is taking any medications. The client states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which confirms that she is not pregnant. What is the most likely cause of the false-positive pregnancy test result? a. The pregnancy test was taken too early. b. Anticonvulsant medications may cause the false-positive test result. c. The woman has a fibroid tumor. d. She has been under considerable stress and has a hormone imbalance.

b. Anticonvulsant medications may cause the false-positive test result.

An African-American female with blisters on the vagina is being treated with acyclovir (Zovirax) for genital herpes. She is angry at her partner for transmitting the infection. Which action by the nurse is best? a. Encourage the client to engage in sexual activity since she is on medication. b. Be sensitive to the clients feelings and refer her to a support group. c. Reinforce that the disease can no longer be spread to other partners. d. Reassure the client that sexual activity will not be painful while on acyclovir.

b. Be sensitive to the clients feelings and refer her to a support group.

The nurse is providing health education to a pregnant client regarding the cardiovascular system. Which information is correct and important to share? a. A pregnant woman experiencing disturbed cardiac rhythm requires close medical and obstetric observation no matter how healthy she may appear otherwise. b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term. c. Palpitations are twice as likely to occur in twin gestations. d. All of the above changes will likely occur.

b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term.

The nurse is caring for a patient with increased intracranial pressure. Which action is considered unsafe? a. Aligning the neck with the body b. Clustering many nursing activities c. Elevating the head of the bed 30 degrees d. Providing stool softeners or laxatives as ordered

b. Clustering many nursing activities

A patient who was admitted 24 hours ago has become increasingly irritable and now says there are bugs on his bed. Which condition should the nurse suspect? a. Alcohol-induced psychosis b. Delirium tremens (DTs) c. Neurologic injury related to a fall d. Posttraumatic stress reaction

b. Delirium tremens (DTs)

Which statement best describes the rationale for the physiologic anemia that occurs during pregnancy? a. Physiologic anemia involves an inadequate intake of iron b. Dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia. c. Fetus establishes the iron stores. d. Decreased production of erythrocytes occur.

b. Dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia.

A 20-year-old client is interested in protection from the human papilloma virus (HPV) since she may become sexually active. Which response from the nurse is the most accurate? a. You are too old to receive an HPV vaccine. b. Either Gardasil or Cervarix can provide protection. c. You will need to have three injections over a span of 1 year. d. The most common side effect of the vaccine is itching at the injection site.

b. Either Gardasil or Cervarix can provide protection.

Strategies that a nurse could use in a motivational interview to increase the chances of change include which of the following? (Select all that apply.) a.Educating the patient on the physical damage the substance is causing b. Encouraging the patient to think of ways to change environmental triggers to abuse substances c. Asking the patient how they think substance abuse affects their family life d. Explaining to the patient that substance abuse affects everyone in the family and give examples e. Asking the patient what methods they think would work and encouraging participating in self-help groups

b. Encouraging the patient to think of ways to change environmental triggers to abuse substances c. Asking the patient how they think substance abuse affects their family life e. Asking the patient what methods they think would work and encouraging participating in self-help groups

A female infertility patient is found to be hypoestrogenic at the preconceptual clinic visit. She asks the nurse why she has never been able to get pregnant. Which response is best? a. Circulating estrogen contributes to secondary sex characteristics. b. Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility. c. Hyperestrogen may be preventing the zona pellucida from forming an ovum protective layer. d. The corona radiata is preventing fertilization of the ovum.

b. Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.

Which complementary alternative medicine (CAM) may interfere with early detection of the dementia? a. Large doses of calcium can cause cerebral plaques to form, thereby disguising atrophy of the brain. b. Excess doses of folic acid can mask a vitamin B12 deficiency that led to dementia. c. Hypnotherapy focused on current pleasant thoughts can eliminate clues to the past. d. The electrical current from magnetic fields can interfere with normal brain waves, resulting in confusion and inability to concentrate.

b. Excess doses of folic acid can mask a vitamin B12 deficiency that led to dementia.

After shunt procedure, the nurse would monitor the patient's neurologic status by using which test? a. Electroencephalogram b. Glasgow Coma Scale c. National Institutes of Health Stroke Scale d. Monro-Kellie doctrine

b. Glasgow Coma Scale

A 37-year-old heterosexual African-American man has come for his annual health screening. Which test must the nurse ensure is ordered for this patient? a. Human papilloma virus (HPV) b. Prostate-specific antigen (PSA) c. HIV d. Venereal disease research laboratory (VDRL)

b. Prostate-specific antigen (PSA)

A client is admitted to the emergency department with toxic shock syndrome. Which action by the nurse is the most important? a. Administer IV fluids to maintain fluid and electrolyte balance. b. Remove the tampon as the source of infection. c. Collect a blood specimen for culture and sensitivity. d. Transfuse the client to manage low blood count.

b. Remove the tampon as the source of infection.

A person who is recovering from a stroke is becoming more forgetful and is unable to recall people's names. A friend suggests the use of a natural ingredient, ginkgo biloba. The nurse is concerned about which serious risk associated with this herb? a. Thromboembolism b. Seizures c. Hypertension d. Photosensitivity

b. Seizures

The musculoskeletal system adapts to the changes that occur throughout the pregnancy. Which musculoskeletal alteration should the client expect? a. Her center of gravity will shift backward. b. She will have increased lordosis. c. She will have increased abdominal muscle tone. d. She will notice decreased mobility of her pelvic joints.

b. She will have increased lordosis.

The nurse is doing preoperative teaching for a client who is scheduled for removal of cervical polyps in the office. Which statement by the client indicates a correct understanding of the procedure? a. I hope that I do not have cancer of the cervix. b. There should be little or no discomfort during the procedure. c. There may be a lot of bleeding after the polyp is removed. d. This may prevent me from having any more children.

b. There should be little or no discomfort during the procedure.

A patient on a medical surgical unit has a platelet count of 90,000 per mm3. The nurse knows to include which of the following precautions in discharge instructions? a. Use a standard safety razor for shaving. b. Use a soft bristle toothbrush. c. Have aggressive dental care immediately to prevent dental caries. d. Do not eat fresh fruit.

b. Use a soft bristle toothbrush.

Which important teaching point should the nurse include in the plan of care for a patient diagnosed with Cushing's disease? a. Daily weight using same scale b. Wash hands frequently c. Use exfoliating soaps when bathing d. Avoid yearly influenza vaccine

b. Wash hands frequently

A client with pelvic inflammatory disease is seen by the nurse 72 hours after starting oral antibiotics. Which finding leads the nurse to take immediate action? a. Feelings of anger that her partner infected her b. Loose stools over the last 2 days c. Anorexia and nausea d. Chills and a temperature of 101 F

d. Chills and a temperature of 101 F

When teaching an Asian patient with newly diagnosed diabetes, the nurse notes the patient nodding yes to everything that is being said. With a better understanding of cultural interdependence in self-concept, a nurse should immediately a. write everything down for the patient to refer to later. b. prompt further to elicit additional questions or concerns. c. call the recognized elder for this patient. d. call the oldest male relative for help with decision making.

b. prompt further to elicit additional questions or concerns.

The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows the student understands this problem when the student makes which statement? a. "Central perfusion is monitored only by the physician." b."Central perfusion involves the entire body." c."Central perfusion is decreased with hypertension." d."Central perfusion is toxic to the cardiac system."

b."Central perfusion involves the entire body."

A nurse is assessing a client who presents with a scaly rash over the palms and soles of the feet and the feeling of muscle aches and malaise. The nurse suspects syphilis. Which action by the nurse is appropriate? a. Reassure the client that this stage is not infectious unless she is pregnant. b. Assess the client for hearing loss and generalized weakness. c. Don gloves and further assess the clients lesions. d. Take a history regarding any cardiovascular symptoms.

c. Don gloves and further assess the clients lesions.

An obstetric multipara with triplets is placed on bed rest at 24 weeks' gestation. Her perinatologist is managing intrauterine growth restriction with serial ultrasounds. This prescribed treatment is an example of which type of care? a. Antenatal diagnostics b. Primary prevention c. Secondary prevention d. Collaborative intervention

d. Collaborative intervention

A patient diagnosed with hypertension asks the nurse how this disease could have happened to them. What is the nurse's best response? a. "Hypertension happens to everyone sooner or later. Don't be concerned about it." b. "Hypertension can happen from eating a poor diet, so change what you are eating." c. "Hypertension can happen from arterial changes that block the blood flow." d. "Hypertension happens when people do not exercise, so you should walk every day."

c. "Hypertension can happen from arterial changes that block the blood flow."

The nurse is assessing a patient using the CAGE Questionnaire. The patient answers yes to all of the questions. The nurse suspects alcoholism and feels the patient is in denial when the patient makes which statement? a. "I go to meetings once a day and still drink." b. "My family and friends have been avoiding me lately." c. "I don't have a problem with alcohol. I can quit anytime I want to." d. "I know it will be hard to quit, but I am willing to try."

c. "I don't have a problem with alcohol. I can quit anytime I want to."

A nurse is explaining to a student nurse about perfusion. The nurse knows the student understands the concept of perfusion when the student makes which statement? a. "Perfusion is a normal function of the body, and I don't have to be concerned about it." b. "Perfusion is monitored by the physician." c. "Perfusion is monitored by vital signs and capillary refill." d. "Perfusion varies as a person ages, so I would expect changes in the body."

c. "Perfusion is monitored by vital signs and capillary refill."

The indirect Coombs' test is a screening tool for Rh incompatibility. An amniocentesis may be a necessary next step it the titer is greater than what? a. 1:2 b. 1:4 c. 1:8 d. 1:12

c. 1:8

The nurse is teaching a client who is undergoing brachytherapy about what to immediately report to her health care provider. Which signs and symptoms would be included in this teaching? (Select all that apply.) a. Constipation for 3 days b. Temperature of 99 F c. Abdominal pain d. Visible blood in the urine e. Heavy vaginal bleeding

c. Abdominal pain d. Visible blood in the urine e. Heavy vaginal bleeding

A female patient comes to the clinic after missing one menstrual period. She lives in a house beneath electrical power lines which is located near an oil field. She drinks two caffeinated beverages a day, is a daily beer drinker, and has not stopped eating sweets. She takes a multivitamin and exercises daily. She denies drug use. Which finding in the history has the greatest implication for this patient's plan of care? a. Electrical power lines are a potential hazard to the woman and her fetus. b. Living near an oil field may mean the water supply is polluted. c. Alcohol exposure should be avoided during pregnancy due to teratogenicity. d. Eating sweets may cause gestational diabetes or miscarriage.

c. Alcohol exposure should be avoided during pregnancy due to teratogenicity.

The nurse is caring for an older Chinese adult male who is grimacing and appears restless after abdominal surgery. What is the nurse's best action? a. Ask the patient if he is anxious about his hospital stay. b. Ask a translator to conduct a FACES pain scale assessment. c. Ask the patient about pain and assess vital signs. d. Ask the patient about any history of depression or anxiety.

c. Ask the patient about pain and assess vital signs.

Which sexually transmitted infection (STI) is the most commonly reported in American women? a. Gonorrhea b. Syphilis c. Chlamydia d. Candidiasis

c. Chlamydia

What goal is most important when caring for a child with anorexia nervosa (AN)? a. Limit fluid intake. b. Prevent depression. c. Correct malnutrition. d. Encourage weight gain.

c. Correct malnutrition.

A 55-year-old post-menopausal woman is assessed by the nurse with a history of dyspareunia, backache, pelvis pressure, urinary tract infections, and a frequent urinary urgency. Which condition does the nurse suspect? a. Ovarian cyst b. Rectocele c. Cystocele d. Fibroid

c. Cystocele

In the past, factors to determine whether a woman was likely to develop a high-risk pregnancy were primarily evaluated from a medical point of view. A broader, more comprehensive approach to high-risk pregnancy has been adopted today. Four categories have now been established, based on the threats to the health of the woman and the outcome of pregnancy. Which category should not be included in this group? a. Biophysical b. Psychosocial c. Geographic d. Environmental

c. Geographic

A female client returned to the clinic with a yellow vaginal discharge after being treated for Chlamydia infection 3 weeks ago. Which statement by the client alerts the nurse that there may be a recurrence of the infection? a. I did practice abstinence while taking the medication. b. I took doxycycline two times a day for a week. c. I never told my boyfriend about the infection. d. I did drink wine when taking the medication for Chlamydia.

c. I never told my boyfriend about the infection.

The nurse is providing education to a client regarding the normal changes of the breasts during pregnancy. Which statement regarding these changes is correct? a. The visibility of blood vessels that form an intertwining blue network indicates a possible infection of the tubercles. b. The mammary glands do not develop until 2 weeks before labor. c. Lactation is inhibited until the progesterone level declines after birth. d. Colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.

c. Lactation is inhibited until the progesterone level declines after birth.

What is the most appropriate resource to include when planning to provide patient education related to a goal in the psychomotor domain? a. Diagnosis-related support groups b. Internet resources c. Manikin practice sessions d. Self-directed learning modules

c. Manikin practice sessions

The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What is the nurse's best action? a. Encourage increased fluid and water intake b. Teach about risk for malignancies c. Monitor for changes in level of consciousness d. Assess labwork for potassium level changes

c. Monitor for changes in level of consciousness

A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurses discussion of this should be based on what? a. The presence of too much body fat b. Symptom that a hormonal imbalance is present c. Most likely part of normal pubertal development d. Indication that he is developing precocious puberty

c. Most likely part of normal pubertal development

The nurse assesses the outcomes of a motivational interview on a patient with a dual diagnosis of alcoholism with delirium tremens (DTs) and determines that the communication was nontherapeutic. What is the nurse's next priority? a. Encourage the patient to think of ways to change environmental triggers to abuse substances. b. Ask the patient what methods they think would work and encourage participating in self-help groups. c. Notify provider to obtain order for oxazepam and vitamin B infusion. d. Notify provider to obtain order for CT scan and psychologic consult.

c. Notify provider to obtain order for oxazepam and vitamin B infusion.

A client has a recurrent Bartholin cyst. What is the nurses priority action? a. Apply an ice pack to the area. b. Administer a prophylactic antibiotic. c. Obtain a fluid sample for laboratory analysis. d. Suggest moist heat such as a sitz bath.

c. Obtain a fluid sample for laboratory analysis.

Which clinical finding in a primiparous client at 32 weeks of gestation might be an indication of anemia? a. Ptyalism b. Pyrosis c. Pica d. Decreased peristalsis

c. Pica

While obtaining a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. Which nutritional problem does this behavior indicate? a. Preeclampsia b. Pyrosis c. Pica d. Purging

c. Pica

Reports have linked third trimester use of selective serotonin uptake inhibitors (SSRIs) with a constellation of neonatal signs. The nurse is about to perform an assessment on the infant of a mother with a history of a mood disorder. Which signs and symptoms in the neonate may be the result of maternal SSRI use? (Select all that apply.) a. Hypotonia b. Hyperglycemia c. Shivering d. Fever e. Irritability

c. Shivering d. Fever e. Irritability

Despite the presence of safety aids such as handrails in the bathrooms at an assisted living facility, the number of fractures due to unsteady ambulation upon arising from the bed and when attempting to perform activities of daily living has increased. Which complementary alternative medicine (CAM) would be an effective intervention for this population? a. Yoga b. Acupuncture c. Tai chi d. Magnet therapy

c. Tai chi

Which statements related to sexual dysfunction are correct? (Select all that apply.) a. Biological factors play a more significant role than psychologic factors. b. Sexual dysfunction is more prevalent among men than women. c. The best predictor of sexual health is emotional well-being. d. The patient with sexual dysfunction is at risk for anxiety and depression. e. Sexual dysfunction remains uncommon.

c. The best predictor of sexual health is emotional well-being. d. The patient with sexual dysfunction is at risk for anxiety and depression.

Which substance used during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications? a. Alcohol b. Caffeine c. Tobacco d. Chocolate

c. Tobacco

The emphasis on understanding cultural influence on health care is important because of a. disability entitlements. b. HIPAA requirements. c. increasing global diversity. d. litigious society.

c. increasing global diversity.

A 45-year-old man is brought to the emergency department presenting with a respiratory rate of 6 breaths/min, and cardiac dysrhythmias. What is the most appropriate question the nurse should ask the patient's friend? a. "Does he take amphetamines or uppers?" b. "Has he ever used LSD?" c. "Have you two been out of the country in the last 2 days?" d. "Is he using any opioids such as heroin?"

d. "Is he using any opioids such as heroin?"

The nurse who presents a class on different methods of complementary alternative medicine (CAM) differentiates between imagery and hypnosis in which of the following ways? a. Imagery involves the dependent mental construction of a picture, whereas hypnosis requires the patient to recall and verbally describe difficult times in his or her life. b. Hypnosis requires a trained psychologist, but imagery can be performed by any health care practitioner. c. Imagery produces a temporary sense of well-being compared with hypnosis, which evokes a permanent positive effect. d. Although both therapies focus on specific problems and guide the patient into relaxation, imagery requires the patient to formulate the impression, whereas the hypnotist constructs the image for the patient.

d. Although both therapies focus on specific problems and guide the patient into relaxation, imagery requires the patient to formulate the impression, whereas the hypnotist constructs the image for the patient.

A patient's serum electrolytes are being monitored. The nurse notices that the potassium level is low. What should the nurse monitor for in this patient? a. Tissue ischemia b. Brain malformations c. Intestinal blockage d. Cardiac dysrhythmia

d. Cardiac dysrhythmia

What interrelated constructs facilitate a nurse to become culturally competent? a. Cultural diversity, self-awareness, cultural skill, and cultural knowledge b. Cultural desire, self-awareness, cultural knowledge, and cultural identity c. Cultural desire, self-awareness, cultural knowledge, and cultural diversity d. Cultural desire, self-awareness, cultural knowledge, and cultural skill

d. Cultural desire, self-awareness, cultural knowledge, and cultural skill

A patient states that his legs have pain with walking that decreases with rest. The nurse observes absence of hair on the patient's lower leg and the patient has a thready, posterior tibial pulse. How would the nurse position the patient's legs? a. Elevated b. Crossed at the knee c. Slightly bent with a pillow under the knees d. Dependent position

d. Dependent position

A female college student is planning to become sexually active. She is considering birth control options and desires a method in which ovulation will be prevented. To prevent ovulation while reaching 99% effectiveness in preventing pregnancy, which option should be given the strongest consideration? a. Intrauterine device b. Coitus interruptus c. Natural family planning d. Oral contraceptive pills

d. Oral contraceptive pills

How does the nurse document a non-stress test (NST) during which two or more fetal heart rate (FHR) accelerations of 15 beats per minute or more occur with fetal movement in a 20-minute period? a. Nonreactive b. Positive c. Negative d. Reactive

d. Reactive

A nurse instructor is teaching a student nurse about the factors that have increased the number of people with sexually transmitted diseases (STDs) seen in practice. Which statement by the student indicates a lack of understanding? a. There are improved techniques to diagnose an STD used in practice. b. There is increased incidence of sexual abuse and sexual trafficking. c. Females feel safe using oral agents rather than a condom as contraception. d. The organisms causing STDs are all becoming more virulent.

d. The organisms causing STDs are all becoming more virulent.

A 19-year-old female is asking the nurse about the vaccine for human papilloma virus (HPV). Which statement by the nurse is accurate? a. Gardasil protects against all HPV strains. b. You are too young to receive the vaccine. c. Only females can receive the vaccine. d. This will lower your risk for cervical cancer.

d. This will lower your risk for cervical cancer.

Components of the Glasgow Coma Scale (GCS) the nurse would use to assess a patient after a head injury include which assessment? a. Blood pressure b. Cranial nerve function c. Head circumference d. Verbal responsiveness

d. Verbal responsiveness

The nurse should teach a patient that which is a primary prevention strategy to reduce the occurrence of head injuries? a. Blood pressure control b. Smoking cessation c. Maintaining a healthy weight d. Violence prevention

d. Violence prevention

Which action would the nurse teach to help the client prevent vulvovaginitis? a. Wipe back to front after urination. b. Cleanse the inner labial mucosa with soap and water. c. Use feminine hygiene sprays to avoid odor. d. Wear loose cotton underwear.

d. Wear loose cotton underwear.

While evaluating a male client for treatment of gonorrhea, which question is the most important for the nurse to ask? a. Do you have a history of sexually transmitted disease? b. When was your last sexual encounter? c. When did your symptoms begin? d. What are the names of your recent sexual partners?

d. What are the names of your recent sexual partners?