PEDS/OB 5
Which fine motor activity does the nurse observe in a 6-month-old infant? The infant can hold a milk bottle. The infant drops a cube in the cup. The infant is able to hold two cubes. The infant grabs a bell by the handle.
1
An 8-month-old infant is able to pick up pieces of food. The parent is impressed with this skill and tells the nurse about it. What does the nurse tell to the infant's parent about this behavior? a. It indicates that the infant is hyperactive. b. It is pincer grasp, which is expected at this age. c. It is palmar grasp, which is expected at this age. d. It is an abnormal finding that requires evaluation.
b
During the assessment of a 12-month-old infant, the nurse finds that the infant's head and chest circumference are equal, the length of the infant has increased by 50% since birth, and the weight is triple that of the birth weight. What does the nurse interpret from these findings? a. The infant has slow development. b. The infant has normal development. c. The infant has inadequate weight gain. d. The infant has insufficient dietary protein.
b
A 4-month-old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention? a. "Keep doors of appliances closed at all times." b. "Never shake baby powder directly on your infant because it can be aspirated into his lungs." c. "Do not permit your child to chew paint from window ledges because he might absorb too much lead." d. "When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall."
d
The nurse is interviewing the parents of a 4-month-old male infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. They say he was "just fine" when they put him in his crib already asleep. The nurse should suspect his death was caused by what? a. Suffocation b. Child abuse c. Infantile apnea d. Sudden infant death syndrome (SIDS)
d
While assessing an infant, the nurse notices a typical bald spot, a symmetric distortion of the skull, and torticollis. What should the nurse interpret from this assessment? a. The infant has a bacterial infection. b. The infant has a vitamin E deficiency. c. The infant has a vitamin C deficiency. d. The infant has positional plagiocephaly.
d
An obese patient reports amenorrhea for the past 2 months. A pregnancy test is negative, and an ultrasound does not reveal any abnormalities in the reproductive system. The primary health care provider prescribes oral estrogen (Altavera) and progestin (Prometrium). What kind of preventive measures for polycystic ovarian disorder does the nurse explain? "Start exercising regularly." "Eat a nonvegetarian diet." "Reduce the intake of fluids." "Sleep for at least 10 hours a day."
1
The mammography report of a 23-year-old patient confirms the presence of a tumor in the breast. On regular follow-up assessments, the nurse finds that the size of the tumor does not change with the phase of the menstrual cycle. What can the nurse infer from this finding? The patient has fibroadenoma. The patient has a thyroid disorder. The patient has mammary duct ectasia. The patient has an intraductal papilloma.
1
The mother of a 3-month-old breastfed infant asks about giving her baby water because it is summer and very warm. What should the nurse recommend? Fluids in addition to breast milk are not needed. Clear juices would be better than water to promote adequate fluid intake. Water should be given if the infant seems to breastfeed longer than usual. Water once or twice a day will make up for losses caused by environmental temperature.
1
The nurse is assessing a 36-year-old patient, who is planning for a second pregnancy. After reviewing the patient's medical record, the nurse provides information about the egg donation process to the patient. What would be the reason for providing this information to the patient? The patient has age-related infertility. The patient has congenital disorders. The patient has premature ovarian failure. The patient suffers from reduced fecundity.
1
The nurse is assessing a patient with menstrual cycle irregularity. While speaking with the patient, the nurse learns the patient is an athlete. What should the nurse suggest to the patient so as to promote a regular menstrual cycle? Increase intake of food and water Undergo aromatherapy treatments Perform aerobic exercise regularly No strenuous exercise for 5 months
1
When providing care to a young, single woman just diagnosed with acute pelvic inflammatory disease, what should the nurse do? Position the woman in a semi-Fowler position. Point out that inappropriate sexual behavior caused the infection. Tell her that antibiotics need to be taken until pelvic pain is relieved. Explain to the woman that infertility is a likely outcome of this type of infection.
1
The nurse is teaching a group of adolescents about preventing sexually transmitted infections (STIs). What can the nurse include in the teaching? Encouraging abstinence Using vaginal spermicides Getting vaccinated against certain reproductive viruses Checking the expiration dates on condoms or other physical barriers Performing anal-genital intercourse instead of genital-genital intercourse
1, 3, 4
The nurse should provide further teaching about sudden infant death syndrome (SIDS) prevention when hearing the mother of an 8-week-old make which statement? "I only smoke in the kitchen." "I put my baby to sleep on her back." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."
1, 3, 4, 5
What interventions should the nurse perform while caring for a 16-year-old patient diagnosed with gonococcal infection? Obtain an order for a serologic test for syphilis. Refer the patient for cryotherapy to remove lesions. Administer 100 mg doxycycline (Vibramycin) twice daily. Tell the patient to take bed rest in a semi-Fowler position. Report the infection to the patient's local health authorities.
1, 3, 5
The nurse is caring for a patient who is taking ganirelix acetate (Antagon) to treat infertility. Which adverse effects associated with the use of ganirelix acetate are found in this patient? Headaches Depression Nosebleeds Abdominal pain Vaginal bleeding
1, 4, 5
The nurse is preparing to speak to a group of women who are at risk for developing dysmenorrhea. Which patients should be included in the teaching session? Patients who smoke. Patients who have a low body mass index. Patients who have more than two children. Patients who are involved in strenuous exercise. Patients who have high stress as a result of work.
1, 5
The nurse is assessing a patient who is planning to conceive. While reviewing the patient's laboratory reports, the nurse notices a decrease in hypothalamic hormone levels. What should the nurse interpret from this? The patient demonstrates impairment in fallopian factors. The patient will not be able to successfully produce any ova. The patient has a family history of fetal hemorrhagic disorders. The patient has an increased risk of fetal congenital anomalies.
2
Which activities are indicative of the teething process in an infant? Increased need for sleep Infant rubbing on the gums Infant biting on hard objects Eating a lot more solid foods Increased sucking on fingers
2, 3, 5
Which normal findings (age and developmentally appropriate) does the nurse find during the assessment of a 5-month-old child? . Startle reflex Tooth eruption Babinski reflex Tonic neck reflex Doubling of birth weight
2, 3, 5
A 16-year-old patient with amenorrhea does not want to undergo estrogen therapy. What other possible approaches to treatment might the nurse recommend to the patient? Vitamin D Biofeedback Acupressure Acupuncture Massage therapy Herbal medications
2, 5
A patient reports fever and painful urination for the past 2 to 3 weeks. The physical examination shows multiple lesions in the vaginal area. The symptoms were relieved after treatment with acyclovir (Zovirax). What advice should the nurse give the patient to prevent secondary infection? "Avoid sexual intercourse for 2 weeks." "Undergo a Pap test at least once a year." "Clean vaginal lesions twice a day with saline." "Wear cotton underwear and loose-fitting clothes."
3
On interacting with a patient, the nurse finds that the patient uses lubricants that contain nonoxynol-9 (N-9) at least twice a day. The nurse instructs the patient to not use N-9. What is the reason for giving such advice to the patient? Because frequent use of this medication reduces bone mineral density and causes osteoporosis Because frequent use of this medication can cause a significant decrease in the patient's libido Because frequent use of this medication raises the patient's risk of sexually transmitted infections Because frequent use of this medication increases the patient's progesterone and estrogen levels
3
Which contraceptive method is contraindicated in a woman with a history of toxic shock syndrome? Condom Spermicide Cervical cap Oral contraceptives
3
Which symptom should the nurse expect in a female patient who presents with elevated androgen levels? Loss of body hair Skin rashes and acne Pigmentation changes Decreased body weight
3
Which risk factors for breast cancer should the nurse teach to a woman? Multiparity Younger aged women High breast tissue density Excessive alcohol consumption Early menarche (before 12 years)
3, 4, 5
The nurse is assessing a patient with amenorrhea. The patient eats very little, is obsessed with having a lean figure, and fears gaining weight. Which test does the nurse expect the health care provider to order to determine whether the patient has female athlete triad syndrome? Anthropometric test Thyroid function test Exercise tolerance test Bone mineral density test
4
The nurse is teaching the nursing student about semen analysis. Which statement by the student indicates the need for further teaching? "The patient should be instructed to masturbate to obtain the semen sample." "The test must be performed within 2 hours of collecting the semen sample." "A spermicide-free plastic sheath must be used to collect the semen sample." "A cold environment or low temperature is suitable for storing the semen sample."
4
What is an effective relief measure for primary dysmenorrhea? To reduce physical activity level until menstruation ceases To use barrier methods rather than the oral contraceptive pill (OCP) for birth control To begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow To decrease intake of salt and refined sugar about 1 week before menstruation is about to occur
4
While the nurse is assessing a patient with dysmenorrhea, the patient tells the nurse, "My grandmother makes me drink ginger tea when I have cramps during menses. Do you think that ginger tea is helpful?" What should be the nurse's response to the patient? "Ginger helps reduce pain by controlling hormones." "Ginger helps reduce pain by controlling prolactin levels." "Ginger helps reduce pain by controlling muscle spasms." "Ginger helps reduce pain by controlling the inflammatory reaction."
4
The mammography report of a 23-year-old patient confirms the presence of a tumor in the breast. On regular follow-up assessments, the nurse finds that the size of the tumor does not change with the phase of the menstrual cycle. What can the nurse infer from this finding? a. The patient has fibroadenoma. b. The patient has a thyroid disorder. c. The patient has mammary duct ectasia. d. The patient has an intraductal papilloma.
a
The nurse administers mifepristone (Mifeprex) to a patient in the first trimester for an abortion. The nurse then instructs the patient to return for a follow-up visit in 2 days to receive a 400 mcg dosage of misoprostol (Cytotec). How long after the last menstrual period is it safe to use these medications? a. 7 weeks b. 9 weeks c. 12 weeks d. 16 weeks
a
The nurse is educating a patient to palpate the cervix to assess changes that indicate ovulation. Which statement by the woman indicates the need for further teaching? a. "The cervical mucus is watery and clear during ovulation." b. "The cervical os becomes slightly dilated during ovulation." c. "The cervical mucus is copious and thick during ovulation." d. "The cervix softens and rises in the vagina during ovulation."
a
Which fine motor activity does the nurse observe in a 6-month-old infant? a. The infant can hold a milk bottle. b. The infant drops a cube in the cup. c. The infant is able to hold two cubes. d. The infant grabs a bell by the handle.
a
Which symptom described by a woman is characteristic of premenstrual syndrome (PMS)? a. "I feel irritable and moody a week before my period is supposed to start." b. "I have lower abdominal pain beginning the third day of my menstrual period." c. "I have abdominal bloating and breast pain after a couple days of my period." d. "I have nausea and headaches after my period starts, and they last 2 to 3 days."
a
Which developmental changes are observed in a 5-month-old infant? a. Birth weight has doubled. b. The rooting reflex is present. c. There are signs of tooth eruption. d. Head and chest circumference are equal. e. Length has increased by 50% from length at birth.
a, c
The nurse is teaching a patient about a dietary plan for managing premenstrual dysphoric disorder (PMDD). Which instructions given by the nurse would be beneficial for the patient? a. "Eat nuts daily." b. "Include red meat in your daily diet." c. "Avoid consuming caffeinated beverages." d. "Use good-quality vegetable oils for cooking." e. "Avoid drinking watermelon and cranberry juices."
a, c, d
The nurse is preparing to speak to a group of women who are at risk for developing dysmenorrhea. Which patients should be included in the teaching session? a. Patients who smoke. b. Patients who have a low body mass index. c. Patients who have more than two children. d. Patients who are involved in strenuous exercise. e. Patients who have high stress as a result of work.
a, e
The nurse instructs a nursing student to administer clomiphene (Clomid) to a patient in order to conduct a clomiphene citrate challenge test (CCCT). What instruction should the nurse give to the nursing student before giving this medication to the patient? a. To administer a 500-mg initial dose of clomiphene (Clomid) to the patient. b. To administer a 100-mg dose of clomiphene (Clomid) to the patient immediately. c. To administer clomiphene (Clomid) to the patient on the 12th day of the menstrual cycle. d. To administer clomiphene (Clomid) to the patient on the 15th day of the menstrual cycle.
b
The nurse is assessing a 12-month-old child during a well-child visit. The nurse notices that the child's birth weight has tripled, birth length is increased by 50%, head and chest circumference are equal, and the child has six deciduous teeth. What does the nurse conclude that the child has from these findings? a. A calcium deficiency b. Normal development c. Delayed development d. Excessive weight gain
b
The nurse is assessing a patient who has undergone hysterectomy with bilateral salpingo-oophorectomy (BSO). The patient tells the nurse that she used to have episodes of excessive irritability before menses. The patient reports having similar symptoms at times even after the surgery. What should be the nurse's response to the patient? a. "Such symptoms are absolutely normal." b. "You should get psychological counseling." c. "You should undergo a thyroid function test." d. "You need to have an abdominal ultrasound scheduled immediately."
b
The nurse is assessing a patient who is planning to conceive. While reviewing the patient's laboratory reports, the nurse notices a decrease in hypothalamic hormone levels. What should the nurse interpret from this? a. The patient demonstrates impairment in fallopian factors. b. The patient will not be able to successfully produce any ova. c. The patient has a family history of fetal hemorrhagic disorders. d. The patient has an increased risk of fetal congenital anomalies.
b
With regard to the diagnosis and management of amenorrhea, nurses should be aware of what? a. It often goes away on its own. b. It may be caused by stress or excessive exercise or both. c. It likely will require the woman to eat less and exercise more. d. It probably is the result of a hormone deficiency that can be treated with medication.
b
A 16-year-old patient with amenorrhea does not want to undergo estrogen therapy. What other possible approaches to treatment might the nurse recommend to the patient? a. Vitamin D b. Biofeedback c. Acupressure d. Acupuncture e. Massage therapy f. Herbal medications
b, e
A pregnant woman reports severe pain in the abdomen. The Thayer-Martin culture is positive. Which medication might the nurse expect to be prescribed for the patient? a. Azithromycin (Zithromax) and amoxicillin (Amoxil) b. Doxycycline (Vibramycin) and tetracycline (Sumycin) c. Ceftriaxone (Rocephin) and azithromycin (Zithromax) d. Azithromycin (Zithromax) and doxycycline (Vibramycin)
c
After reviewing the laboratory results of a patient, the nurse finds that the levels of follicle-stimulating hormone (FSH) are less than 10. What should the nurse interpret from the laboratory report? a. The patient has spinnbarkeit present in the cervix. b. The progesterone levels are markedly decreased. c. The patient has adequate ovarian follicles in reserve. d. Pregnancy is impossible with the patient's own eggs.
c
The most appropriate recommendation for relief of teething pain is to instruct the parents to do what? a. Rub gums with aspirin to relieve inflammation b. Apply hydrogen peroxide to gums to relieve irritation c. Give child a cold teething ring to relieve inflammation d. Have child chew on a warm teething ring to encourage tooth eruption
c
The primary health care provider (PHP) prescribed HepB (Recombivax HB) vaccine for a child. Which question should the nurse ask the child's parents to ensure it is safe to administer the vaccine? a. "Does your child have a history of respiratory tract infection?" b. "Does your child have a history of any urinary tract infections?" c. "Does your child have a history of being hypersensitive to yeast?" d. "Does your child have a history of skin infections such as impetigo?"
c
Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake? a. Avoiding solids until after the bottle is well accepted b. Varying schedule of routine activities on a daily basis c. Being persistent through 10 to 15 minutes of food refusal d. Using developmental stimulation by a specialist during feedings
c
Which risk factors for breast cancer should the nurse teach to a woman? a. Multiparity b. Younger aged women c. High breast tissue density d. Excessive alcohol consumption e. Early menarche (before 12 years)
c, d, e
