Exam Review

A nurse is assisting a client who is in labor to the bathroom when the client reports a sudden gush of fluid. The nurse observes an umbilical cord protruding from the client's vagina. Which of the following actions should the nurse take first?
A)
Assist the client into a knee-chest position.
B)
Administer oxygen 10 L/min via face mask.
C)
Apply an external fetal monitor on the client.
D)
Loosely wrap the cord with a saline-saturated towel.
A nurse is collecting data from a client at a 6-week postpartum checkup. The client tells the nurse, "I am breastfeeding and would like to use a birth control pill.”. Which of the following statements should the nurse make?
A)
"Progestin-only birth control pills are preferred for contraception during lactation.”.
B)
"You do not need birth control pills as long as you are lactating.”.
C)
"Birth control pills are contraindicated for breastfeeding clients.”.
D)
"Taking birth control pills while breastfeeding can increase your risk for breast cancer.”.
A nurse is administering a miconazole vaginal suppository to a client who has vaginal candidiasis. Which of the following actions should the nurse take?
A)
Insert the suppository 5 cm (2 in).
B)
Apply petroleum jelly to the suppository.
C)
Insert the suppository along the posterior vaginal wall.
D)
Assist the client into a prone position.
A nurse is caring for a client who is 1 hour postpartum following a vaginal delivery and reports discomfort at the episiotomy site. Which of the following actions should the nurse take?
A)
Apply witch hazel compresses.
B)
Administer aspirin.
C)
Have the client use a warm pack.
D)
Instruct the client to sit on a soft pillow.

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Exam Review

A nurse is reinforcing teaching about laboratory testing with a client who is at 6 weeks of gestation. Which of the following statements should the nurse include?
A)
"You will have a group B strep culture at 36 weeks of gestation.”.
B)
"You will have a maternal serum alpha-fetoprotein screening at 6 weeks of gestation.”.
C)
"You will have a screening for gestational diabetes at 12 weeks of gestation.”.
D)
"You will have to produce a clean-catch urine specimen every 2 months.”.
A nurse is assisting with the care of a client who is in labor and has received nalbuphine hydrochloride. Which of the following manifestations should the nurse identify as an adverse effect of this medication?
A)
Sedation.
B)
Fever.
C)
Diarrhea.
D)
Diuresis.
A nurse is caring for a client in an antepartum clinic following a maternal serum alpha-fetoprotein screening. The nurse should recognize that an elevated alpha-fetoprotein level is suggestive of which of the following?
A)
Neural tube defects.
B)
Phenylketonuria.
C)
Trisomy 21.
D)
Hemophilia.
A nurse is reinforcing teaching about safety precautions to take when driving a car with a client who is in the first trimester of pregnancy. Which of the following instructions should the nurse include in the teaching?
A)
Wear the lap belt high across the abdomen.
B)
Disable the vehicle's driver-side airbags.
C)
Move the seat as far away as possible from the steering wheel.
D)
Place the shoulder harness across the gravid uterus.

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Exam Review

A nurse is collecting data from an adolescent who is postoperative following a cesarean birth and is receiving morphine for pain. Which of the following findings is the nurse's priority?
A)
BP 105/62 mm Hg.
B)
Urinary retention.
C)
Respiratory rate 11/min.
D)
Blurred vision.
A nurse is reinforcing teaching with a newly licensed nurse concerning a client on a postpartum unit following a cesarean birth. Which of the following measures should the nurse include in the instructions to prevent thrombophlebitis?
(SATA)
A)
Administer NSAIDs every 4 to 6 hr.
B)
Have the client ambulate as often as possible.
C)
Apply warm, moist packs to the client's lower legs.
D)
Apply elastic stockings before the client gets out of bed.
A nurse is caring for a client in an antepartum clinic following a maternal serum alpha-fetoprotein screening. The nurse should recognize that an elevated alpha-fetoprotein level is suggestive of which of the following?
A)
Neural tube defects.
B)
Phenylketonuria.
C)
Trisomy 21.
D)
Hemophilia.
A nurse is reinforcing teaching with a client who is at 18 weeks of gestation and requires an increased intake of iron. Which of the following foods should the nurse recommend as the best source of iron?
A)
Carrots.
B)
Chicken breast.
C)
Apples.
D)
Feta cheese.

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Exam Review

A nurse is preparing to administer acyclovir 400 mg tablet PO three times per day. Available are 800 mg tablets. How many tablets should the nurse administer with each dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
A nurse is reinforcing discharge instructions with a postpartum client about breastfeeding. Which of the following statements by the client indicates an understanding of the teaching?
A)
I will increase my potassium intake while breastfeeding.
B)
I will maintain adequate fluid intake to quench my thirst.
C)
I will maintain the same caloric intake as during pregnancy.
D)
I will increase my intake of vitamin
A nurse in a prenatal clinic is reinforcing teaching with a group of women about the use of acupressure to relieve discomfort during labor. Which of the following instructions should the nurse include in the teaching?
A)
Recognize specific signals, respond, and relax.
B)
Place tennis balls on the sacral area and lean against them.
C)
Use light strokes on the abdomen with a rhythmic breathing pattern.
D)
Immerse yourself in a tub of warm water.
A nurse is caring for a client who is 12 hours postpartum and has an episiotomy. Which of the following actions should the nurse take?
A)
Instruct the client to apply warm packs to the perineum every 8 hours.
B)
Encourage the client to take a sitz bath twice per day.
C)
Tell the client to apply antibiotic ointment to the perineal area four times per day.
D)
Explain to the client how to dry her perineum by wiping with toilet tissue after each void.

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Exam Review

A nurse is reinforcing teaching about travel with a client who is pregnant. Which of the following instructions should the nurse include?
A)
Instruct the client to move their car seat forward, close to the steering wheel.
B)
Advise the client to wear the shoulder harness snug across their stomach.
C)
Direct the client to position the lap belt across their navel.
D)
Encourage the client to take a break and walk at least once every hour during long trips.
A nurse is collecting data from a newborn who was delivered at 40 weeks of gestation. Which of the following is an expected finding when eliciting reflexes from the newborn?
A)
The newborn's legs flex at the knees and hips when pressure is applied to the soles of the newborn's feet.
B)
The newborn closes their eyes and keeps them closed when tapped on the forehead.
C)
The newborn's fingers curl around the nurse's finger when placed in the newborn's palm.
D)
The newborn turns their head away from the stimulus when their cheek is touched.
A nurse is reinforcing teaching at a prenatal visit about the importance of adequate folic acid intake with a client who is at 12 weeks of gestation. Which of the following client statements indicates an understanding of the teaching?
A)
"It will prevent my baby from bleeding.”.
B)
"It will strengthen my baby's immune system.”.
C)
"It will make my baby's bones strong.”.
D)
"It will reduce my baby's risk of having a spinal cord defect.”.
A nurse is assisting with the care of a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take first?
A)
Auscultate the newborn’s bowel sounds.
B)
Swaddle the newborn in blankets.
C)
Weigh the newborn’s wet diaper.
D)
Determine the newborn’s respiratory rate.

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Exam Review

A nurse is reinforcing teaching with the mother of a newborn about the proper use of a bulb syringe for suctioning. Which of the following instructions should the nurse include in the teaching?
A)
Lubricate the bulb with sterile water prior to use.
B)
Depress the bulb prior to insertion.
C)
Place the bulb in the center of the newborn's mouth.
D)
Suction the newborn's nose first, then the mouth.
A nurse is transporting a newborn to their parents from the nursery. Which of the following actions should the nurse perform to confirm the newborn's identity?
A)
Ask a parent to state the newborn's date of birth.
B)
Request a parent to verify the newborn's name.
C)
Check the newborn's footprint sheet with the medical record.
D)
Compare the numbers on the newborn's band to the parent's band.
A nurse is collecting data from a client who is 48 hours postpartum. Which of the following findings reported by the client should the nurse identify as a postpartum psychosocial concern?
A)
The client discusses desire to have more children.
B)
The client reports fatigue and desire to sleep.
C)
The newborn reminds the client of themself as a newborn.
D)
The client does not want to feed the newborn.
A nurse is collecting data from a newborn who has an infection of Candida albicans. Which of the following findings should the nurse expect?
A)
Vesicles on the skin, lips, and around the eyes.
B)
Temperature 37.5° C (99.5° F).
C)
Edematous red conjunctivae.
D)
White patches on the tongue that cannot be removed.

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