NP2

Nurse Jeara is evaluating a pregnant patient diagnosed with abruptio placentae. Which symptoms should she anticipate observing? Select all that apply.

While caring for a client in the active stage of labor, she observes a late deceleration on the fetal monitor strip. What immediate action should she plan?

Document the findings.
Prepare for immediate birth.
Increase the rate of oxytocin infusion.
Administer oxygen to the client via face mask.

She is preparing to assess a client in her second trimester of pregnancy. When measuring fundal height, what should she expect regarding its relationship to gestational age?

It is less than gestational age.
It corresponds with gestational age.
It is greater than gestational age.
It has no correlation with gestational age.

A pregnant client informs her that she noticed wetness on her peripad and discovered some clear fluid. Upon inspecting the perineum, Jeara observes the umbilical cord. What should the nurse do immediately?

Monitor the fetal heart rate.
Notify the primary health care provider.
Transfer the client to the delivery room.
Place the client in the Trendelenburg position.

She is giving advice to a patient in the third trimester of pregnancy regarding heartburn management techniques. Which instructions should she give to the patient?

Sip some hot tea or milk.
Make use of sodium-containing antacids.
Consume fatty meals only once a day in the morning.
Rather than eating short, regular meals, eat three big meals a day.

Nurses Jessa is assigned in high risk maternity ward. Here are some cases which she handles for the morning shift.

She is caring for a client in labor. She determines that the client is beginning in the 2nd stage of labor when which of the following assessments is noted?

The client begins to expel clear vaginal fluid
The contractions are regular
The membranes have ruptured
The cervix is dilated completely

Nurse Jessa is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which of the following actions is most appropriate?

Document the findings and tell the mother that the monitor indicates fetal well-being
Take the mothers vital signs and tell the mother that bed rest is required to conserve oxygen.
Notify the physician or nurse mid-wife of the findings.
Reposition the mother and check the monitor for changes in the fetal tracing

She is caring for a client with abruptio placenta and is monitoring the client for disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with disseminated intravascular coagulation?

Swelling of the calf in one leg
Prolonged clotting times
Decreased platelet count
Petechiae, oozing from injection sites, and hematuria

A client is admitted to the birthing suite in early active labor. The priority nursing intervention on admission of this client would be:

Auscultating the fetal heart
Taking an obstetric history
Asking the client when she last ate
Ascertaining whether the membranes were ruptured

A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours. For which of the following would nurse Jessa be alert?

Endometritis
Endometriosis
Salpingitis
Pelvic thrombophlebitis

A prenatal client is suspected of having iron deficiency anemia. During the assessment, which finding should the nurse he expect to observe as a result of this condition?

Dehydration
Overhydration
A high hematocrit level
A low hemoglobin level

A prenatal client has been diagnosed with a vaginal infection caused by Candida albicans. What should he expect to observe during the assessment?

Costovertebral angle pain
No observable signs
Pain, itching, and vaginal discharge
Proteinuria, hematuria, and hypertension

For a client starting oral medication, he gives instructions regarding the use of oral contraceptives. Which of the client’s statements suggests that more instruction is necessary?

“Every day at the same time, I will take one pill.”
“I have to take the missed pill as soon as I remember it if I miss it.”
“After I begin using these, I won’t need to use any other birth control methods.”
“I will take both pills as soon as I remember if I had missed two pills, ,and then two tablets the following day.”

A client with a family history of heart disease presents to the primary health care provider’s office with a request to start oral contraceptive therapy for birth control. What important topic should Nurse Tommy ask the client about next?

Smoking
Regular exercise
Low cholesterol diet
Alternative methods of contraception

Nurse Tommy teaches a pregnant client to perform Kegel exercises. Which statement by the client indicates an understanding of the purpose of these types of exercises?

“The exercises will help reduce backache.”
“The exercises will help prevent ankle edema.”
“The exercises will help strengthen the pelvic floor.”
“The exercises will help prevent urinary tract infections.”

Nurse Dan is caring for a postpartum client. He should suspect endometritis if which of the following is observed?

Breast engorgement
Elevated white blood cell count
Lochia rubra on the second day postpartum
Fever over 38° C (100.4° F) starting 2 days postpartum

He gives instructions to a new mother who is preparing to breastfeed her newborn. While observing the first breastfeeding session, he determines that further teaching is needed if the new mother performs which technique?

Turns the newborn onto his side, facing the mother
Tilts up the nipple or squeezes the areola, pushing it into the newborn’s mouth
Draws the newborn further onto the breast when the newborn opens his mouth
Inserts a clean finger into the side of the newborn’s mouth to break the suction before removing the newborn from the breast

A breastfeeding client, ten days postpartum, calls the postpartum unit, reporting a painful, reddened breast and a fever. Considering the client’s symptoms, what guidance should he provide?

“Continue breastfeeding from the unaffected breast only.”
“Cease breastfeeding as it’s likely you have an infection.”
“Contact your healthcare provider as medication may be necessary.”
“Continue with breastfeeding as this reaction is typical in breastfeeding mothers.”

When a breastfeeding mother mentions experiencing nipple soreness, nurse Dan offers guidance on alleviating the discomfort. Which statement from the mother demonstrates comprehension of the instructions?

“I should refrain from changing breastfeeding positions to toughen the nipple.”
“I should temporarily halt nursing to give the nipples time to heal.”
“I should breastfeed less often and replace some feedings with bottle feeding until the nipples feel better.”
“I should position my baby so her ear, shoulder, and hip are aligned and her stomach is against me.”

A new breastfeeding mother, suffering from breast engorgement, receives guidance on managing the condition. Which statement from the mother indicates to nurse Dan that she comprehends the strategies for alleviating discomfort from breast engorgement?

“I will breastfeed using just one breast.”
“I will use cold compresses on my breasts.”
“I will refrain from wearing a bra while my breasts are engorged.”
“I will massage my breasts before feeding to stimulate milk letdown.”

During an assessment of a mother who recently gave birth to a healthy newborn, where should the nurse anticipate finding the fundus positioned?

On the right side of the abdomen
Level with the umbilicus
Above the umbilicus
One finger’s breadth above the symphysis pubis

A new mother received an intramuscular injection of methylergonovine maleate following delivery. The nurse comprehends that this medication was administered for what purpose?

To decrease uterine contractions.
To prevent postpartum hemorrhage.
To sustain normal blood pressure.
To diminish the amount of lochia drainage.

Methylergonovine maleate is prescribed for a woman who has just delivered a healthy newborn. Which is the priority assessment to complete before administering the medication?

Lochia
Uterine tone
Blood pressure
Deep tendon reflexes

A registered nurse is a preceptor for a new nurse and is observing the new nurse organize the client assignments and prioritize daily tasks. The registered nurse should intervene if the new nurse implements which action?

Provides times for staff meals
Gathers the supplies needed for a task
Combines all tasks for clients in one list
Documents task completions at the end of the day

When the nurse manager encourages staff to provide input in the decision making-process, which leadership style is being demonstrated?

Autocratic
Situational
Democratic
Laissez-faire

She is educating a pregnant client about the physiological impacts and hormonal shifts during pregnancy. What information should she convey regarding the function of estrogen?

Estrogen maintains the uterine lining to facilitate implantation.
Estrogen boosts glucose metabolism and converts glucose into fat.
Estrogen inhibits the regression of the corpus luteum, maintaining progesterone production until the placenta forms.
Estrogen stimulates uterine growth to create a conducive environment for the fetus and primes the breasts for lactation.

She is preparing to conduct a class on testicular self-examination (TSE) at a local high school, should incorporate which guidance for the attendees?

Conduct the self-examination every two months.
Perform the self-examination following a cold shower.
Anticipate slight discomfort during the self-examination.
Gently roll the testicle between the thumb and forefinger.

She is teaching a group of females how to prevent pelvic inflammatory disease (PID). What instruction should the nurse include?

To douche monthly
To avoid unprotected intercourse
To use only ultra-low dose oral contraceptive pills
To consult with a gynecologist regarding the placement of an intrauterine device (IUD)

She is providing discharge teaching to a client after a vasectomy. Which statement by the client indicates the need for further teaching?

“I can use a scrotal support if I need to.”
“I don’t need to practice birth control any longer.”
“I can resume sexual intercourse whenever I want.”
“I can use an ice bag and take an analgesic for pain or swelling.”

She asks a student to identify risk factors for and methods of preventing prostate cancer. Which statement by the student indicates the need for further teaching?

“Smoking increases the risk for this type of cancer.”
“A high-fat diet will assist in preventing this type of cancer.”
“A history of a sexually transmitted infection is a risk for this disease.”
“Men more than 50 years old should be monitored with a yearly digital rectal exam.”

On assessment of a newborn being admitted to the nursery, Nurse Angel palpates the anterior fontanel and notes that it feels soft. She determines that this finding indicates which condition?

Dehydration
A normal finding
Increased intracranial pressure
Decreased intracranial pressure

Nurse Angel is assessing a postterm infant. Which physical characteristic should the nurse expect to observe?

Peeling skin
Smooth soles without creases
Lanugo covering the entire body
Thick layer of vernix covering the body

A postterm infant delivered vaginally is showing signs of tachypnea, grunting, retractions, and nasal flaring. Angel interprets these findings as indicative of which condition?

Hypoglycemia
Respiratory distress syndrome
Meconium aspiration syndrome
Transient tachypnea of the newborn

The nurse is evaluating a 3-day-old preterm neonate diagnosed with respiratory distress syndrome (RDS). Which assessment finding suggests improvement in the neonate’s respiratory condition?

Edema of the hands and feet
Urine output of 3 mL/kg/hour
Presence of a systolic murmur
Respiratory rate ranging from 60 to 70 breaths per minute

A newborn baby whose mother is Rh negative is told to be admitted to the nursery by the nurse. Which move should the Angel make in preparation for the infant’s arrival?

Determine the blood type of the newborn and direct Coombs results.
Acquire from the blood bank the supplies required for an exchange transfusion.
Request the installation of a phototherapy unit by calling the maintenance department to be taken to the nursery.
To avoid isoimmunization, get a vial of vitamin K from the pharmacy and be ready to give an injection.

A newborn baby has been diagnosed with imperforate anus. How should Nurse Adolf explain this condition to the parents?

The occurrence of fecal incontinence
Inadequate development of the anus
Difficulty passing infrequent, dry stools
Folding of a portion of the intestine into the lower bowel

Which nursing assessment findings indicate normal vital signs in a newborn infant?

Pulse, 112; respiratory rate, 24
Pulse, 124; respiratory rate, 28
Pulse, 144; respiratory rate, 48
Pulse, 164; respiratory rate, 55

Nurse Adolf teaches nursing students about mumps. Which clinical manifestation will the specialist identify as the most common complication of this disease?

Pain
Nuchal rigidity
Impaired hearing
A red swollen testicle

Nurse Adolf is assigned to care for an infant on the first postoperative day after a surgical repair of a cleft lip. Which nursing intervention is appropriate when caring for this child’s surgical incision?

Rinsing the incision with sterile water after feeding
Cleaning the incision only when serous exudate forms
Rubbing the incision gently with a sterile cotton-tipped swab
Replacing the Logan bar carefully after cleaning the incision

He is caring for a child diagnosed with Reye’s syndrome. He monitors for manifestations of which condition associated with this syndrome?

Protein in the urine
Symptoms of hyperglycemia
Increased intracranial pressure
A history of a staphylococcus infection

A 10-year-old child is newly diagnosed with type 1 diabetes mellitus. The nurse is planning for home care with the child and the family and determines that which is an age-appropriate activity for health maintenance?

Administering insulin drawn up by an adult
Self-administering insulin with adult supervision
Making independent decisions with regard to sliding-scale coverage of insulin
Having an adult assist in the self-administration of insulin and glucose monitoring

A home care nurse is providing instructions to the mother of a toddler regarding safety measures in the home to prevent an accidental burn injury. Which statement by the mother indicates a need for further instruction?

“I need to use the back burners for cooking.”
“I need to remain in the kitchen when I prepare meals.”
“I need to be sure to place my cup of coffee on the counter.”
“I need to turn pot handles inward and to the middle of the stove.”

The nurse is reviewing the results of the rubella screening (titer) with a pregnant client. The test results are positive, and the client asks if it is safe for her toddler to receive the vaccine. Which response by the nurse is most appropriate?

“Most children do not receive the vaccine until they are 5 years of age.”
“You are still susceptible to rubella, so your toddler should receive the vaccine.”
“It is not advised for children of pregnant women to be vaccinated during their mother’s pregnancy.”
“Your titer supports your immunity to rubella, and it is safe for your toddler to receive the vaccine.”

The nurse is assigned to care for a hospitalized toddler. Which measure should the nurse plan to implement as the highest priority of care?

Providing a consistent caregiver
Protecting the toddler from injury
Adapting the toddler to the hospital routine
Allowing the toddler to participate in play and diversional activities

A mother of a 3-year-old child asks the nurse what personal and social developmental milestones she can expect to see in her child. The nurse should tell the mother to expect which findings? Select all that apply.

Begins problem-solving
Exhibits sexual curiosity
May begin to masturbate
Notices gender differences
Develops a sense of initiative
Develops positive self-esteem through skill acquisition

What action should you take before performing a venipuncture to start continuous intravenous (IV) therapy?

Apply a cool compress to the area.
Inspect the IV solution and check the expiration date.
Secure a padded armboard above the IV site.
Apply a tourniquet below the venipuncture site.

The doctor prescribes acetaminophen liquid 450 mg orally every 4 hours PRN for pain. The medication label reads 160 mg/5 mL. You prepare how many milliliters (mL) to administer one dose?

12 mL
15 mL
13 mL
14 mL

You are sending an arterial blood gas (ABG) specimen to the laboratory for analysis. What information should be included on the laboratory requisition? Select all that apply.

Ventilator settings
List of client allergies
Client’s temperature
Date and time the specimen was drawn
Any supplemental oxygen the client is receiving
Extremity from which the specimen was obtained

Which arterial blood gas (ABG) values should you anticipate in the client with a nasogastric tube attached to continuous suction?

pH 7.25, Paco2 55, HCO3 24
pH 7.30, Paco2 38, HCO3 20
pH 7.48, Paco2 30, HCO3 23
pH 7.49, Paco2 38, HCO3 30

For ensuring client safety, which assessment should you prioritize before transitioning a client from liquid to solid food?

Bowel sounds
Chewing ability
Current appetite
Food preferences

The burn initially affected the upper half of the client’s anterior torso, and there were circumferential burns to the lower half of both of the arms. The client’s clothes caught on fire, and the client ran causing subsequent burn injuries to the entire face (anterior half of the head), and the upper half of the posterior torso. Using the rule of nines, the extent of the burn injury would be what percent?

27%
48.5%
54%
31.5%

You are anticipating rapid fluid replacement therapy for the patient. With the previously identified percentage of burn injury, how much fluid should be administered over the first 24 hours if the patient weighs 72 kg?

9,072 mL
7,776 mL
13,968 mL
15,552 mL

A client who is brought to the emergency department has experienced a burn covering greater than 25% of his total body surface area (TBSA). When reviewing the laboratory results drawn on the client, which value should you most likely expect to note?

Hematocrit 65% (0.65)
Albumin 4.0 g/dL (40 g/L)
Sodium 140 mEq/L (140 mmol/L)
White blood cell (WBC) count 6000 mm³ (6 × 10⁹/L)

The client is scheduled for hydrotherapy for a burn dressing change. Which action should you take to ensure that the client is comfortable during the procedure?

Ensure that the client is appropriately dressed.
Administer an opioid analgesic 30 to 60 minutes before therapy.
Schedule the therapy at a time when the client generally takes a nap.
Assign an unlicensed assistive personnel (UAP) to stay with the client during the procedure.

He receives a prescription for a regular diet. Which is the best meal for you to provide to the client to promote wound healing?

Peanut butter and jelly sandwich, apple, tea
Chicken breast, broccoli, strawberries, milk
Veal chop, boiled potatoes, Jell-O, orange juice
Pasta with tomato sauce, garlic bread, ginger ale

She was asked by a first-time mom how she can provide and meet the needs of her 3- year old infant. She tries to fill the crib with toys, but her infant is not responding to it very well. What should she do?

Place large, colorful teddy bears around the infant’s crib
Provide safe and washable toys such as pacifier
Give brightly-colored building blocks to the infant
Give her infant a rattle for her to shake

Toddlers exhibit signs of readiness for toilet training. Which among the following are not included as its criteria?

Child is able to stay dry for 2 hours
Child is waking up dry from a nap
Child is able to sit, squat, and walk
Child is able to wear clothing by themselves

This type of attachment or complex is present among pre-school children wherein the strong emotional attachment of a preschool boy is present towards the mother, and they usually tend to hate the father.

Electra complex
Oedipus complex
Persephone complex
Adolphus complex

The nurse observes an 8-year old child for any signs of psychosexual development. What should they expect from this stage?

a time in which children’s libido appears to be diverted into concrete thinking
at the age where they want to fulfill their intimate desires
at the age where they are ready to learn how to defecate by themselves
at the time where they will explore their own genitals

The nurse understands that Freud’s phallic stage of psychosexual development, which compares with Erikson’s psychosocial phase of initiative versus guilt, is seen best at:

Adolescence
6 to 12 years
3 to 5 1/2 years
Birth to 1 year

The nurse understands that problems with dependence versus independence develop during the sage of growth and development known as:

Infancy
School age
Toddlerhood
Preschool age

When planning to teach about the stages of growth and development, what stage does the nurse indicate as basically concerned with role identifications?

Oral stage
Genital stage
Oedipal stage
Latency stage

The nurse incorporates play in interactions with preschool-aged children, recognizing that play is essential for their emotional development in the areas of:

Projection
Introjection
Competition
Independence

The nurse understands that the resolution of the Oedipus complex occurs when the child:

Rejects the parent of the same sex
Adopts behaviors of both parents
Identifies with the parent of the same sex
Identifies with the parent of the opposite sex

Surgery can be a very traumatic even for a child. The nurse, when performing preoperative preparation, knows that according to Piaget’s stages of cognitive development, children will experience the greatest fear during the:

Sensorimotor stage
Preoperational stage
Formal operational stage
Concrete operational stage

Nurse Nina further assesses May. When BP was taken at 11:00 am, the reading was at 140/80 mmHg. She knows that the physician may confirm that May is developing PIH when which criterion is satisfied?

BP is at 130/90 mmHg at 12:00 NN
A BP reading is read to be 140/90 at 1:30 PM
30/15 mmHg is added to the baseline BP at 7:00 PM
BP is at 90/60 mmHg at 11:00 PM

May asks Nurse Nina to explain the reason why PIH occurs. Nurse Nina’s most appropriate answer would be:

“An increase in blood volume to support the growing child caused an increased pressure in the arteries causing damage to the walls. This led to the blood vessels in the body to suddenly tighten up or get narrower, thus causing the blood pressure to shoot up.”
“Blood volume is increased by 40-50% in pregnancy, which usually peaks at the 2nd trimester due to an increase in plasma volume. That caused an increase in pressure in the endothelial lining of the arteries eventually leading to vasospasm. Hypertension occurs due to the narrowing of the blood vessels due to the spasms.”
“The precise etiology revolves around aberrations in vascular homeostasis, with dysregulation of endothelial function and vascular tone modulation being paramount. This intricate cascade encompasses the intricate dance between vasoconstriction-promoting factors and vasodilation-mediating substances, leading to an imbalance favoring heightened vascular resistance and augmented systemic arterial pressure.”
“I am not sure if I am allowed to give details about that diagnosis. I will ask your physician to explain it to you instead.”

The nurse further assesses May for any other signs while she interviews her in the clinic as she documents the findings in May’s chart. Which statement from May would she record as possible evidence that May is developing pre-eclampsia instead?

“I’m struggling to slip on my bedroom slippers because my feet are so puffy at night.”
“My mom taught me a lot of things about being pregnant, but she never warned me that I would always feel so tired.”
“I’ve been having the desire to really take care of how I look like these past few weeks.”
“The puffy feet are tolerable, but the swollen hands and wrists are not.”

Eventually, May’s physician ordered magnesium sulfate to be infused on piggyback with a loading dose of 5 g to be infused slowly over 30 minutes and a maintaining dose of 2 g/hr. Which of the following symptoms, when observed by Nurse Nina, would warrant her to discontinue the drug and notify the physician?

An RR of 16 breaths per minute
Urine output of 12 cc/hr
BP 110/80
DTR of 2+

In case toxicity occurs, what emergency item must Nurse Nina prepare at bedside?

Protamine sulfate
Atropine sulfate
Kalcinate
Vitamin K

Nurse Kate teaches a preoperative patient about the nasogastric (NG) tube that will be inserted before surgery. She concludes that the patient understands when the tube will be removed postoperatively based on which statement by the patient?

“When my doctor says so.”
“When I can tolerate food without vomiting.”
“When my gastrointestinal (GI) system is healed.”
“When my bowels start working again and I begin to pass gas.”

A patient is receiving intravenous lipid (fat emulsion) therapy at home, managed by the patient’s spouse. During a visit, the Nurse Kate discusses the potential side effects and adverse reactions of the therapy with both the patient and the spouse. After the discussion, she expects the spouse to understand that the priority action in case of a suspected adverse reaction is to:

Stop the infusion.
Contact the nurse.
Take the patient’s blood pressure.
Contact the local emergency response team.

Nurse Kate suspects that a client’s spouse may be experiencing caregiver strain. Which action should the nurse take to assess this condition?

Refer the family to a social services agency.
Gather information from both the caregiver and the client.
Wait for the caregiver to mention the stress.
Obtain feedback from the client about the caregiver.

Nurse Kate is educating a client newly diagnosed with diabetes mellitus about blood glucose monitoring. The nurse should instruct the client to report glucose levels that consistently exceed which value?

150 mg/dL (8.57 mmol/L)
200 mg/dL (11.42 mmol/L)
250 mg/dL (14.28 mmol/L)
350 mg/dL (20.0 mmol/L)

A client diagnosed with gastritis asks the Nurse Kate about analgesics that won’t cause epigastric distress. She should recommend which medication?

Aspirin
Naproxen
Ibuprofen
Acetaminophen

When should Nurse Violet she plan to begin discharge planning to a mother with a preterm infant?

When the mother is in labor
When the discharge date is set
After the infant is stabilized during the early stages of hospitalization
When the parents feel comfortable with and can demonstrate adequate care for the infant

Nurse Violet is performing an assessment on a primigravida client who has been a marathon runner for several years. The client verbalizes concern because she is no longer able to run in marathons and is concerned about the brown discoloration on her face and her increasing size. Which statements by the Nurse Violet are therapeutic? Select all that apply.

“I can see you’re disappointed at not being able to run.
“Tell me how you are feeling about the changes in your body.”
“Don’t worry. Your body will go back to normal after delivery.”
“You need to ask your obstetrician about whether or not you can run.”
“Wait and see. You will be back to marathon running after delivery before you know it.”
“Some of the changes in pregnancy are permanent and that is the price that you have to pay for that bundle of joy.”

Which goal is most appropriate for postpartum client who is at risk for uterine infection?

The client will verbalize a reduction of pain.
The client will report how to treat an infection.
The client will be able to identify measures to prevent infection.
The client will identify the presence of Braxton Hicks contractions.

Nurse Violet transfers to the NICU. She teaches handwashing techniques to the parents of an infant who is receiving antibiotic treatment for a neonatal infection. She determines that the parents understand the primary purpose of handwashing if they make which statement?

“It is primarily done to reduce their fears.”
“It is primarily done to minimize the spread of infection to other siblings.”
“It is primarily done to allow them an opportunity to communicate with each other and staff.”
“It is primarily done to reduce the possibility of transmitting an environmental infection to the infant.”

She is preparing to educate a teenage client about sexuality. How will she start the teaching?

Inform the teenager about the risks associated with pregnancy.
Build a relationship and assess the teenager’s existing knowledge.
Counsel the teenager to abstain from sexual activity until marriage.
Offer written materials concerning sexually transmitted infections.

Charlotte is reviewing home care instructions with a client who has type 1 diabetes mellitus and a history of diabetic ketoacidosis (DKA). The client’s spouse is present during the instruction. Which statement by the spouse indicates that further teaching is needed?

“If he is vomiting, I shouldn’t give him any insulin.”
“I should bring him to the doctor if he develops a fever.”
“If our grandchildren are sick, they probably shouldn’t come to visit.”
“I should call the doctor if he has nausea or abdominal pain lasting for more than 1 or 2 days.”

Nurse Charlotte has conducted a class for pregnant clients with diabetes mellitus about the signs and symptoms of potential complications. She determines that the teaching was effective if a client makes which statement?

“I should not have ultrasounds done because I am diabetic.”
“I’m glad I don’t have to worry about developing hypoglycemia while I am pregnant.”
“I need to watch my weight for any sudden gains because I could develop gestational hypertension.”
“My insulin needs should decrease during the last 2 months because I will be using some of the baby’s insulin supply.”

Nurse Charlotte met with a postpartum patient who is recovering from disseminated intravascular coagulation. They will need to take low dosages of anticoagulant medication. She advises them to avoid:

Brushing her teeth
Taking acetylsalicylic acid (aspirin)
Walking long distances and climbing stairs
All activities due to the risk of bruising injuries

Nurse Charlotte is educating a mother diagnosed with diabetes mellitus who gave birth to a large-for-gestational-age (LGA) infant about infant care. She explains that LGA infants may appear more mature due to their size but often require stimulation for feeding and attachment. Which statement by the mother suggests the need for further teaching about infant care?

“I will talk to my baby when he is in a quiet, alert state.”
“I will allow my baby to sleep through the night because he needs his rest.”
“I will breast-feed my baby every 2½ to 3 hours and will use arousal techniques.”
“I will watch my baby closely because I know that he may not be as mature in his motor development.”

She is observing a client with type 1 diabetes mellitus. Today’s blood work reveals a glycosylated hemoglobin level of 10%. Based on this result, she formulates a teaching plan, understanding that it signifies which outcome?

A normal reading, indicating effective management of blood glucose control.
A reading devoid of information concerning the client’s disease management.
A low reading, indicating inadequate management of blood glucose control.
A high reading, indicating inadequate management of blood glucose control.

You are discussing contraceptive options with a 32-year-old patient and she expresses “I want to have children but not for a few years.” You respond with the correct statement:

“If you do not become pregnant within the next few years, you never will.”
“Women often have more difficulty becoming pregnant after about age 35.”
“Stop taking oral contraceptives several years before you want to have a child.”
“You have many more years of fertility left, so there is no rush to have children.”

A 28-year-old patient reports experiencing anxiety, headaches with dizziness, and abdominal bloating before her menstrual periods. What is the best course of action for you to take at this time?

Instruct the patient to track her symptoms in a diary for 3 months.
Recommend that the patient attempt aerobic exercise to alleviate her symptoms.
Educate the patient about lifestyle adjustments to mitigate premenstrual syndrome (PMS) symptoms.
Counsel the patient to utilize nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to manage symptoms.

A 19-year-old patient has received a diagnosis of primary dysmenorrhea. How will you advise the patient to address discomfort?

Refrain from engaging in aerobic exercise during menstruation.
Apply cold packs to the abdomen and back for pain relief.
Discuss with her healthcare provider the option of starting antidepressant therapy.
Take nonsteroidal anti-inflammatory drugs (NSAIDs) at the onset of her period.

While attending to a 58-year-old patient experiencing persistent menorrhagia, you will intend to oversee the:

Levels of estrogen.
Complete blood count (CBC).
Gonadotropin-releasing hormone (GNRH).
Consecutive human chorionic gonadotropin (hCG) outcomes.

A 47-year-old patient inquires to you whether she is entering menopause after not having a menstrual period for 3 months. What would be a suitable response?

“Have you considered hormone replacement therapy?”
“Many women experience some sadness when entering menopause.”
“What was your menstrual cycle like before your periods ceased?”
“Given your age in the mid-40s, it’s probable that you’re experiencing menopause.”

A client has just delivered a 6-lb 2-oz boy. She is concerned about the way he looks. Nurse Colin, a delivery nurse reassures the mother that a pink body with purple feet and hands is a normal condition called:

Acrocyanosis
Mongolian condition
Sternal retractions
Patent ductus arteriosus

A baby’s chin is quivering and he is trembling a little postdelivery. Colin replies to the mother that this is probably due to a:

High sugar level
Very cold temperature
Startle reflex
Immature nervous system

A mother is unsure about breast-feeding her newborn. His best response would be:

“I’ll tell the nursery nurse that you want a bottle.”
“You have to decide immediately.”
“Let’s feed him by breast-feeding initially; I’ll help you.”
“Breast-feeding is best; don’t even consider bottle feeding.”

A mother took tetracycline during pregnancy for an acne condition. She asks if there could be a problem with the baby. He responds that the baby could:

Be deaf
Have discolored teeth
Be a slow learner
Have webbed fingers and toes

A couple comes to the clinic very excited because the woman missed her period 5 weeks ago. She is experiencing early morning nausea, urinary frequency, and fatigue. In anticipating questions about pregnancy, he would need to be aware that these are:

Positive signs of pregnancy
Probable signs of pregnancy
Presumptive signs of pregnancy
Signs that also could indicate bladder infection

At her first prenatal visit, a Daphne is being interviewed by the nurse for her health history. She is pregnant for the fourth time, has had one baby at 38 weeks’ gestation, premature twins at 35 weeks, and a spontaneous abortion. How would the nurse communicate this information to the healthcare team?

G4, P3, A1
G4, P2, T1, P2, A1, L3
G4, P3, T1, P2, A1, L3
G4, P2, T1, P1, A1, L3

As part of a health history for pregnancy, she tells the nurse that she is unsure of her blood type and Rh factor. She had a spontaneous abortion at 10 weeks and did not seek medical attention. After lab work, she is found to have type O, Rh-negative blood. What highrisk factor should the nurse identify for the health team?

The client may be at high risk for spontaneous abortion.
The client may have become Rh sensitized during her first pregnancy.
The client’s fetus may have CNS malformations due to Rh incompatibility.
The client is at risk for noncompliance with prenatal appointments.

Daphne further expresses that her LMP was June 10th. In order to determine her estimated delivery date, what tool would the nurse use?

Nägele’s rule
McDonald’s rule
Hegar’s sign
Quickening

She is about 3 weeks larger in uterine size than her dates indicate. The physician orders an ultrasound to diagnose multiple fetuses. What information should the nurse give the client in preparation for the test?

“Do not eat or drink after midnight.”
“Drink several glasses of water 1 hour before, and do not urinate.”
“Empty your bladder immediately before the test.”
“Give yourself an enema prior to the test.”

While assessing Daphne, another client is wheeled in at the ER. She is at 35 weeks’ gestation in labor with a diagnosis of abruptio placenta. What pattern on the fetal monitor should the nurse anticipate?

Late decelerations
Early decelerations
Variable decelerations
Accelerations with fetal movement

NNN

Explorer

NP2

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