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NCLEX-RN 515 Exam Dump Questions
QUESTION 1 To appropriately monitor therapy and client progress, the nurse should be aware that increased myocardial work and O2 demand will occur with wh... [Show More] ich of the following? A. Positive inotropic therapy B. Negative chronotropic therapy C. Increase in balance of myocardial O2 supply and demand D. Afterload reduction therapy Correct Answer: A Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Inotropic therapy will increase contractility, which will increase myocardial O2 demand. (B) Decreased heart rate to the point of bradycardia will increase coronary artery filling time. This should be used cautiously because tachycardia may be a compensatory mechanism to increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon pump therapy, would decrease myocardial work and O2 demand. QUESTION 2 The nurse would need to monitor the serum glucose levels of a client receiving which of the following medications, owing to its effects on glycogenolysis and insulin release? A. Norepinephrine (Levophed) B. Dobutamine (Dobutrex) C. Propranolol (Inderal) D. Epinephrine (Adrenalin) Correct Answer: D Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Norepinephrine’s side effects are primarily related to safe, effective care environment and include decreased peripheral perfusion and bradycardia. (B) Dobutamine’s side effects include increased heart rate and blood pressure, ventricular ectopy, nausea, and headache. (C) Propranolol’s side effects include elevated blood urea nitrogen, serum transaminase, alkaline phosphatase, and lactic dehydrogenase. (D) Epinephrine increases serum glucose levels by increasing glycogenolysis and inhibiting insulin release. Prolonged use can elevate serum lactate levels, leading to metabolic acidosis, increased urinary catecholamines, false elevation of blood urea nitrogen, and decreased coagulation time. QUESTION 3 Which of the following medications requires close observation for bronchospasm in the client with chronic obstructive pulmonary disease or asthma? A. Verapamil (Isoptin) B. Amrinone (Inocor) C. Epinephrine (Adrenalin) D. Propranolol (Inderal) Correct Answer: D Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Verapamil has the respiratory side effect of nasal or chest congestion, dyspnea, shortness of breath (SOB), and wheezing. (B) Amrinone has the effect of increased contractility and dilation of the vascular smooth muscle. It has no noted respiratory side effects. (C) Epinephrine has the effect of bronchodilation through β stimulation. (D) Propranolol, esmolol, and labetalol are all β- blocking agents, which can increase airway resistance and cause bronchospasms. QUESTION 4 The following medications were noted on review of the client’s home medication profile. Which of the medications would most likely potentiate or elevate serum digoxin levels? A. KCl B. Thyroid agents C. Quinidine D. Theophylline Correct Answer: C Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Hypokalemia can cause digoxin toxicity. Administration of KCl would prevent this. (B) Thyroid agents decrease digoxin levels. (C) Quinidine increases digoxin levels dramatically. (D) Theophylline is not noted to have an effect on digoxin levels. QUESTION 5 In the client with a diagnosis of coronary artery disease, the nurse would anticipate the complication of bradycardia with occlusion of which coronary artery? A. Right coronary artery B. Left main coronary artery C. Circumflex coronary artery D. Left anterior descending coronary artery Correct Answer: A Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Sinus bradycardia and atrioventricular (AV) heart block are usually a result of right coronary artery occlusion. The right coronary artery perfuses the sinoatrial and AV nodes in mostindividuals. (B) Occlusion of the left main coronary artery causes bundle branch blocks and premature ventricular contractions. (C) Occlusion of the circumflex artery does not cause bradycardia. (D) Sinus tachycardia occurs primarily with left anterior descending coronary artery occlusion because this form of occlusion impairs left ventricular function. QUESTION 6 When inspecting a cardiovascular client, the nurse notes that he needs to sit upright to breathe. This behavior is most indicative of: A. Pericarditis B. Anxiety C. Congestive heart failure D. Angina Correct Answer: C Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Pericarditis can cause dyspnea but primarily causes chest pain. (B) Anxiety can cause dyspnea resulting in SOB, yet it is not typically influenced by degree of head elevation. (C) The inability to oxygenate well without being upright is most indicative of congestive heart failure, due to alveolar drowning. (D) Angina causes primarily chest pain; any SOB associated with angina is not influenced by body position. QUESTION 7 When a client questions the nurse as to the purpose of exercise electrocardiography (ECG) in the diagnosis of cardiovascular disorders, the nurse’s response should be based on the fact that: A. The test provides a baseline for further tests B. The procedure simulates usual daily activity and myocardial performance C. The client can be monitored while cardiac conditioning and heart toning are done D. Ischemia can be diagnosed because exercise increasesO2 consumption and demand Correct Answer: D Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) The purpose of the study is not to provide a baseline for further tests. (B) The test causes an increase in O2 demand beyond that required to perform usual daily activities. (C) Monitoring does occur, but the test is not for the purpose of cardiac toning and conditioning. (D) Exercise ECG, or stress testing, is designed to elevate the peripheral and myocardial needs for O2 to evaluate the ability of the myocardium and coronary arteries to meet the additional demands. QUESTION 8 In assessing cardiovascular clients with progression of aortic stenosis, the nurse should be aware that there is typically: A. Decreased pulmonary blood flow and cyanosis B. Increased pressure in the pulmonary veins and pulmonary edema C. Systemic venous engorgement D. Increased left ventricular systolic pressures and hypertrophy Correct Answer: D Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) These signs are seen in pulmonic stenosis or in response to pulmonary congestion and edema and mitral stenosis. (B) These signs are seen primarily in mitral stenosis or as a late sign in aortic stenosis after left ventricular failure. (C) These signs are seen primarily in right-sided heart valve dysfunction. (D) Left ventricular hypertrophy occurs to increase muscle mass and overcome the stenosis; left ventricular pressures increase as left ventricular volume increases owing to insufficient emptying. QUESTION 9 The cardiac client who exhibits the symptoms of disorientation, lethargy, and seizures may be exhibiting a toxic reaction to: A. Digoxin (Lanoxin) B. Lidocaine (Xylocaine) C. Quinidine gluconate or sulfate (Quinaglute,Quinidex) D. Nitroglycerin IV (Tridil) Correct Answer: B Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Side effects of digoxin include headache, hypotension, AV block, blurred vision, and yellow-green halos. (B) Side effects of lidocaine include heart block, headache, dizziness, confusion, tremor, lethargy, and convulsions. (C) Side effects of quinidine include heart block, hepatotoxicity, thrombocytopenia, and respiratory depression. (D) Side effects of nitroglycerin include postural hypotension, headache, dizziness, and flushing. QUESTION 10 Which of the following ECG changes would be seen as a positive myocardial stress test response? A. Hyperacute T wave B. Prolongation of the PR interval C. ST-segment depression D. Pathological Q wave Correct Answer: C Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) Hyperacute T waves occur with hyperkalemia. (B) Prolongation of the P R interval occurs with first- degree AV block. (C) Horizontal ST-segment depression of>1 mm during exercise isdefinitely a positive criterion on the exercise ECG test. (D) Patho-logical Q waves occur with MI. QUESTION 11 Assessment of the client with pericarditis may reveal which of the following? A. Ventricular gallop and substernal chest pain B. Narrowed pulse pressure and shortness of breath C. Pericardial friction rub and pain on deep inspiration D. Pericardial tamponade and widened pulse pressure Correct Answer: C Section: Questions Set A Explanation Explanation/Reference: Explanation: (A) No S3 or S4 are noted with pericarditis. (B) No change in pulse pressure occurs. (C) The symptoms of pericarditis vary with the cause, but they usually include chest pain, dyspnea, tachycardia, rise in temperature, and friction rub caused by fibrin or other deposits. The pain seen with pericarditis typically worsens with deep inspiration. (D) Tamponade is not typically seen early on, and no change in pulse pressure occurs. QUESTION 12 Clinical manifestations seen in left-sided rather than in right-sided heart failure are: A. Elevated central venous pressure and peripheral edema B. Dyspnea and jaundice C. Hypotension and hepatomegaly D. Decreased peripheral perfusion and rales Correct Answer: D Section: Questions Set A Explanation Explanation/Reference: Explanation: (A, B, C) Clinical manifestations of right-sided heart failure are weakness, peripheral edema, jugular venous distention, hepatomegaly, jaundice, and elevated central venous pressure. (D) Clinical manifestations of left-sided heart failure are left ventricular dysfunction, decreased cardiac output, hypotension, and the backward failure as a result of increased left atrium and pulmonary artery pressures, pulmonary edema, and rales. ...........................................................................................................................................................................................................................CONTINUE. [Show Less]
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NCLEX RN Cardiovascular Questions & Answers Revision Guide
A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which medication woul... [Show More] d need to be withheld for 24 hours before the procedure and for 48 hours after the procedure? 1. Glipizide 2. Metformin 3. Repaglinide 4. Regular insulin 2. A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of these findings, the nurse would anticipate that the client is at risk for which problem? 1. Hypovolemia 2. Acute kidney injury 3. Glomerulonephritis 4. Urinary tract infection 3. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats/minute. Which action should the nurse take? 1. Check vital signs. 2. Check laboratory test results. 3. Notify the health care provider. 4. Continue to monitor for any rhythm change. 4. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse sees no electrocardiographic complexes on the screen. Which is the priority nursing action? 1. Call a code. 2. Call the health care provider. 3. Check the client's status and lead placement. 4. Press the recorder button on the electrocardiogram console. 5. The nurse is evaluating a client's response to cardioversion. Which assessment would be the priority? 1. Blood pressure 2. Status of airway 3. Oxygen flow rate 4. Level of consciousness 6. The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator. The nurse should assess which item based on priority? 1. Anxiety level of the client and family 2. Presence of a Medic-Alert card for the client to carry 3. Knowledge of restrictions on post-discharge physical activity 4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver 7. A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm? 1. Sinus tachycardia 2. Sinus bradycardia 3. Sinus dysrhythmia 4. Normal sinus rhythm 8. The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. How should the nurse correctly interpret the client's neurovascular status? 1. The neurovascular status is normal because of increased blood flow through the leg. 2. The neurovascular status is moderately impaired, and the surgeon should be called. 3. The neurovascular status is slightly deteriorating and should be monitored for another hour. 4. The neurovascular status is adequate from an arterial approach, but venous complications are arising. 9. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective? 1. Muffled heart sounds 2. A rise in blood pressure 3. Jugular venous distention 4. Client expressions of dyspnea 10. A client with variant angina is scheduled to receive an oral calcium channel blocker twice daily. Which statement by the client indicates theneed for further teaching? 1. "I should notify my doctor if my feet or legs start to swell." 2. "My doctor told me to call his office if my pulse rate decreases below 60." 3. "Avoiding grapefruit juice will definitely be a challenge for me, since I usually drink it every morning with breakfast." 4. "My spouse told me that since I have developed this problem, we are going to stop walking in the mall every morning." .....................................................................................................................................................................................................................CONTINUE. [Show Less]
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NUR10005- Med Surg 2 _Musculoskeletal| Musculoskeletal System from Saunders 2022
1- The nurse is conducting health screening for osteoporosis. Which client isat greatest risk of developing this disorder? 1. A 25-year-old woman who ru... [Show More] ns 2. A 36-year-old man who has asthma 3. A 70-year-old man who consumes excess alcohol 4. A sedentary 65-year-old woman who smokes cigarettes Rationale: Risk factors for osteoporosis include female gender, being postmenopausal, advanced age, a low-calcium diet, excessive alcohol intake, being sedentary,and smoking cigarettes. Long-term use of corticosteroids, anticonvulsants, and/or furosemide also increases the risk. 2- The nurse has given instructions to a client returning home after knee arthroscopy. Which statement by the client indicates that the instructionsare understood? 1. "I can resume regular exercise tomorrow." 2. "I can't eat food for the remainder of the day." 3. "I need to stay off the leg entirely for the rest of the day." 4. "I need to report a fever or swelling to my health care provider." Rationale: After arthroscopy, the client usually can walk carefully on the leg once sensationhas returned. The client is instructed to avoid strenuous exercise for at least a few days. The client may resume the usual diet. Signs and symptoms of infection should be reported to the health care provider. 3- The nurse witnessed a vehicle hit a pedestrian. The victim is dazed andtries to get up. A leg appears fractured. Which intervention should the nurse take? 1. Try to reduce the fracture manually. 2. Assist the victim to get up and walk to the sidewalk. 3. Leave the victim for a few moments to call an ambulance. 4. Stay with the victim and encourage him or her to remain still. Rationale: With a suspected fracture, the victim is not moved unless it is dangerous to remain in that spot. The nurse should remain with the victim and have someoneelse call for emergency help. A fracture is not reduced at the scene. Before the victim is moved, the site of fracture is immobilized to prevent further injury. 4- Which cast care instructions should the nurse provide to a client who justhad a plaster cast applied to the right forearm? Select all that apply. 1. Keep the cast clean and dry. 2. Allow the cast 24 to 72 hours to dry. 3. Keep the cast and extremity elevated. 4. Expect tingling and numbness in the extremity. 5. Use a hair dryer set on a warm to hot setting to dry the cast. 6. Use a soft, padded object that will fit under the cast to scratch the skin under the cast. Rationale: A plaster cast takes 24 to 72 hours to dry (synthetic casts dry in 20 minutes). The cast and extremity should be elevated to reduce edema if prescribed. A wetcast is handled with the palms of the hand until it is dry, and the extremity is turned (unless contraindicated) so that all sides of the wet cast will dry. A cool setting on the hair dryer can be used to dry a plaster cast (heat cannot be used on a plaster cast because the cast heats up and burns the skin). The cast needs to be kept clean and dry, and the client is instructed not to stick anything under the cast because of the risk of breaking skin integrity. The client is instructed to monitor the extremity for circulatory impairment, such as pain, swelling, discoloration, tingling, numbness, coolness, or diminished pulse. The health care provider is notified immediately if circulatory impairment occurs. 5- The nurse is evaluating a client in skeletal traction. When evaluating thepin sites, the nurse would be most concerned with which finding? 1. Redness around the pin sites 2. Pain on palpation at the pin sites 3. Thick, yellow drainage from the pin sites 4. Clear, watery drainage from the pin sites Rationale: The nurse should monitor for signs of infection such as inflammation, purulent drainage, and pain at the pin site. However, some degree of inflammation, painat the pin site, and serous drainage would be expected; the nurse should correlate assessment findings with other clinical findings, such as fever, elevated white blood cell count, and changes in vital signs. Additionally, the nurse should compare any findings to baseline findings to determine if there were any changes. 6- The nurse is assessing the casted extremity of a client. Which sign is indicative of infection? 1. Dependent edema 2. Diminished distal pulse 3. Presence of a "hot spot" on the cast 4. Coolness and pallor of the extremity Rationale: Signs of infection under a casted area include odor or purulent drainage from the cast or the presence of "hot spots," which are areas of the cast that are warmer than others. The health care provider should be notified if any of these occur. Signs of impaired circulation in the distal limb include coolness andpallor of the skin, diminished distal pulse, and edema. 7- A client has sustained a closed fracture and has just had a cast applied tothe affected arm. The client is complaining of intense pain. The nurse elevates the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem may be causing this pain? 1. Infection under the cast 2. The anxiety of the client 3. Impaired tissue perfusion 4. The recent occurrence of the fracture Rationale: Most pain associated with fractures can be minimized with rest, elevation, application of cold, and administration of analgesics. Pain that is not relieved bythese measures should be reported to the health care provider because pain unrelieved by medications and other measures may indicate neurovascular compromise. Because this is a new closed fracture and cast, infection would nothave had time to set in. Intense pain after casting is normally not associated with anxiety or the recent occurrence of the injury. Treatment following the fracture should assist in relieving the pain associated with the injury. 8- The nurse is admitting a client with multiple trauma injuries to the nursing unit. The client has a leg fracture and had a plaster cast applied.Which position would be best for the casted leg? 1. Elevated for 3 hours, then flat for 1 hour 2. Flat for 3 hours, then elevated for 1 hour 3. Flat for 12 hours, then elevated for 12 hours 4. Elevated on pillows continuously for 24 to 48 hours Rationale: A casted extremity is elevated continuously for the first 24 to 48 hours tominimize swelling and promote venous drainage. Options 1, 2, and 3 are incorrect. 9- A client is being discharged to home after application of a plaster leg cast. Which statement indicates that the client understands proper careof the cast? 1. "I need to avoid getting the cast wet." 2. "I need to cover the casted leg with warm blankets." 3. "I need to use my fingertips to lift and move my leg." 4. "I need to use something like a padded coat hanger end to scratch under the cast if it itches." Rationale: A plaster cast must remain dry to keep its strength. The cast should be handledwith the palms of the hands, not the fingertips, until fully dry; using the fingertips results in indentations in the cast and skin pressure under the cast. Air should circulate freely around the cast to help it dry; the cast also gives off heat as it dries. The client should never scratch under the cast because of the risk of altered skin integrity; the client may use a hair dryer on the cool settingto relieve an itch. 10-A A client being measured for crutches asks the nurse why the crutches cannot rest up underneath the arm for extra support. The nurse respondsknowing that which would most likely result from this improper crutchmeasurement? 1. A fall and further injury 2. Injury to the brachial plexus nerves 3. Skin breakdown in the area of the axilla 4. Impaired range of motion while the client ambulates Rationale: Crutches are measured so that the tops are 2 to 3 fingerwidths from the axillae.This ensures that the client's axillae are not resting on the crutch or bearing theweight of the crutch, which could result in injury to the nerves of the brachial plexus. Although the conditions in options 1, 3, and 4 can occur, they are not the most likely result from resting the axilla directly on the crutches. ....................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI RN MEDSURG 2022 PROCTORED EXAM STUDY GUIDE
1. The nurse is preparing the discontinue long term TPN therapy for a client. The nurse should plan to discontinue the TPN gradually to reduce the risk of ... [Show More] which of the following adverse effects? a. Hyperglycemia b. Diarrhea c. Constipation d. Hypoglycemia- You taper it off to avoid this!!! Rationale PDF p.298: Never abruptly stop TPN. Speeding up/slowing down the rate is contraindicated. An abrupt rate change can alter blood glucose levels significantly. Rationale PDF nutrition p.58: don’t discontinue abruptly, must taper to prevent rebound hypoglycemia 2. A nurse is preparing a client for an ECG. The client is anxious and says that he is afraid the equipment will give him an electric shock. Which of the following is an appropriate response by the nurse? a. The machine only senses and records electrical currents coming from your heart – pg.170 ➢ Electrocardiography uses an electrocardiograph to record the electrical activity of the heart over time. b. The lead wires and cables are insulated for your safety c. The electrode pads will prevent the conduction of electricity to your skin d. The machine voltage delivery is low enough that you won’t feel any discomfort 3. A nurse is caring for client who has hypertension and has a new prescription for lisinopril. The nurse should consult with the provider about which of the following medications in the client’s medication administration record? a. Potassium chloride b. Levothyroxine c. Acetaminophen d. Metformin 4. A nurse is administering furosemide 80 mg PO twice daily to a client who has pulmonary edema. Which of the following assessment findings indicates to the nurse that the medication is effective? a. Elevation in blood pressure b. Adventitious breath sounds c. Weight loss of 1.8 kg (4 lb) in the past 24 hr d. Respiratory rate of 24/min 5. Couldn't paste the picture on here. But it asked where u can hear pericardial friction rub the best at… Erb’s Point (3rd Intercostal, Central) 6. A nurse is completing discharge teaching with a client who has a new diagnosis of AIDS. Which of the following statements by the nurse indicates an understanding of the teaching? a. I will increase the amount of fresh veggies b. I will wipe up areas soiled with body fluids with alcohol and immediately dispose of the trash c. I will need to take my clothes to the dry cleaners to sterilize them d. I will be sure to wear gloves and wash my hands when I change my cat’s litter box 7. A nurse is performing a venipuncture on an older adult client whose veins are difficult. Which of the following actions should the nurse take? a. Apply cool compresses b. Elevate the client’s extremity using a pillow c. Tap the skin around the insertion site d. Raise the angle of the catheter to 30 degrees above the insertion site 8. A nurse is caring for a client in the ER following a myocardial infarction. which of the following actions should the nurse anticipate if the client develops asystole? a. Administer atropine b. Defibrillate with 200 joules c. Starts a continuous lidocaine infusion d. Begin CPR – first line of medical management is CPR and ACLS. 9. A nurse is caring for a client with severe burn injury. The nurse should recognize which of the following client findings as an indication of hypovolemic shock? a. Potassium 5.2 mEq/L b. Capillary refill 1.5 seconds c. Urine output 45 mL/hr d. PaCO3 37 mmHg 10. A critical care nurse is assessing a client who has a severe head injury. In response to painful stimuli the client does not open her eyes, displays decerebrate posturing, and makes incomprehensible sounds. Which of the following Glasgow coma scale scores should the nurse assign the client? a. 2 b. 5 c. 10 d. 13 .........................................................................................................................................................................................................................CONTINUE. [Show Less]
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NUR 2633 Maternal Child Health Final Question and Answers Study Guide
1. The student nurse is preparing education for the parents of a 6yo that will begin Fe supps following a dx of Fe deficient anemia. What should be include... [Show More] d in the ed. Select all that apply. o Fe should be given with a glass of OJ o Given with Food o Black tarry stools o Cause constipation o Cause increase in appetite 2. Pedi nurse assesses 7mo infant brought to the clinic with S/S of irritability N? V and taut anterior fontanel. Based on the standard growth chart, the nurse notes that the child has an increased head circumference which may indicate which of the following med conditions? o Brain tumor o Gastrointestinal infection o Acute lymphocytic leukemia o Chronic lyphocytic leukemia 3. To offset chemo related effects of nausea and vomiting. The pediatric nurse administers which medications? o Ondasetron o Bethamethasone o Doxorubicin o Mesna 4. The pediatric nurse is familiar with Kubler ross stages of grief. Parents who are feeling confused and refuse to discuss the disease with any nurse or doctor are in which stage of grief? o Denial o Grief o Bargaining o Acceptance 5. During a pedi nursing orientation session to a new unit. The child like specialist is introduced as an important member of the healthcare team. What is an important role of the child like specialist. o To provide opportunities for therapeutic play and information o To accompany children on their way to surgery o To assist with family counseling regarding discipline and limits o To describe normal growth and development to parents and families 6. The pedi nurse is caring for a child who has been in a motor vehicle collision. The dr explains to the family that there serious physical disabilities. The father is upset and states I don’t know how I will be able to cope. I have two other children. What can I do? What is the nurses response? o You obviously were not listening to the dr. he can explain it to you again o Don’t worry. You will be able to manage o Don’t worry. You will get through the crisis o Many parents find the initial news to be overwhelming. What questions can I answer for you? 7. Asking the pregnant woman about her use of recreational drug is essential component of the prenatal hx. The use of rec drugs cause harm to the fetus resulting in which OB outcomes? Select all. o Miscarriage/ spontaneous abortions o Low birth weight o Macrosomia o Postterm labor birth o Cord prolapse 8. Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a client with this condition should be away that the optimal pharm therapy for pain is? o NSAID o Oral contraceptives o ASA o Acetaminophen 9. Screening at 23wks reveals that a pregnant woman has gest DM. in planning her care the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. What is the fetus at greatest risk for? o Preterm birth o Low birth weight o Congenital anomalies of the CNS o Macrosomia 10. The nurse caring for a pregnant client knows that her health teach regarding fetal circulation has been effective when the client reports that she has been sleeping in what position? o On her back with a pillow under her knees o In a sidelying position o On her abs o With HOB elevated .....................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI MATERNITY PROCTORED EXAM
4) A nurse is teaching a group of parents about newborn safety. Which of the following statements by a parent indicates an understanding of the teaching? ... [Show More] "I will put a bib on my baby at night to keep her clothing dry." The parents should avoid placing a bib around their newborns' necks at night to prevent choking and suffocation. "I will cover the crib mattress with plastic to prevent staining." The parents should avoid placing plastic over the crib mattress to prevent suffocation. "I will warm my baby's formula using the lowest setting in the microwave." The parents should avoid heating the formula in a microwave to prevent uneven warming of the formula. "I will dress my baby in flame-retardant clothing." The parents should dress their newborns in flame-retardant clothing to prevent injury. 5) A nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura (ITP). Which of the following findings should the nurse expect? Decreased platelet count A client who has ITP has an autoimmune response that results in a decreased platelet count. Increased erythrocyte sedimentation rate (ESR) An increased ESR is an indication of chronic renal failure. Decreased megakaryocytes A client who has ITP will have megakaryocytes within the expected reference range. Increased WBC An increased WBC is an indication of infection 6) A nurse is caring for a newborn who was transferred to the nursery 30 min after delivery. Which of the following actions should the nurse take first? Confirm the newborn's Apgar score. The Apgar score is a physiologic assessment that occurs 1 min following birth and again at 5 min. The nurse should confirm the score when the newborn arrives in the nursery. However, there is another action the nurse should take first. Verify the newborn's identification. When using the safety/risk reduction approach to client care, the first action the nurse should take is to verify the newborn's identity upon arrival to the nursery. Administer vitamin K to the newborn. The nurse should administer IM vitamin K to the newborn soon after birth to increase clotting factors and prevent bleeding. However, the injection can be delayed until after initial bonding time and the first breastfeeding if necessary. Therefore, there is another action the nurse should take first. Determine obstetrical risk factors. The nurse should identify obstetrical risk factors to determine if interventions are required for the newborn. However, there is another action the nurse should take first. 7) A nurse is assessing a client who is in active labor and notes early decelerations in the FHR on the monitor tracing. The client is at 39 weeks of gestation and is receiving a continuous IV infusion of oxytocin. Which of the following actions should the nurse take? Discontinue the oxytocin infusion. Early decelerations in the FHR are considered benign. Early decelerations occur due to compression of the fetal head during contractions, vaginal examinations, and pushing during the second stage of labor. No interventions are necessary for early decelerations. Continue monitoring the client. Early decelerations in the FHR are considered benign. Early decelerations occur due to compression of the fetal head during contractions, vaginal examinations, and pushing during the second stage of labor. No interventions are necessary for early decelerations. Therefore, the nurse should continue to monitor the client. Request that the provider assess the client. Early decelerations in the FHR are considered benign. Early decelerations occur due to compression of the fetal head during contractions, vaginal examinations, and pushing during the second stage of labor. No interventions are necessary for early decelerations. Increase the infusion rate of the maintenance IV fluid. Early decelerations in the FHR are considered benign. Early decelerations occur due to compression of the fetal head during contractions, vaginal examinations, and pushing during the second stage of labor. No interventions are necessary for early decelerations. 11) A nurse in a provider's office is reviewing the medical record of a client who is in her first trimester of pregnancy. Which of the following findings should the nurse identify as a risk factor for the development of preeclampsia? Singleton pregnancy Multifetal gestation, rather than a single fetus pregnancy, increases a client's risk for the development of preeclampsia. BMI of 20 Having a BMI greater than 30 increases a client's risk for the development of preeclampsia. Maternal age 32 years A maternal age of younger than 19 or older than 40 increases the client's risk for the development of preeclampsia. Pregestational diabetes mellitus Pregestational diabetes mellitus increases a client's risk for the development of preeclampsia. Other risk factors include preexisting hypertension, renal disease, systemic lupus erythematosus, and rheumatoid arthritis. 12) A nurse is assessing a client who received carboprost for postpartum hemorrhage. Which of the following findings is an adverse effect of this medication? Muscle weakness is not an adverse effect of carboprost. 13) A nurse is caring for a newborn who is undergoing phototherapy to treat hyperbilirubinemia. Which of the following actions should the nurse take? Cover the newborn's eyes while under the phototherapy light. Applying an opaque eye mask prevents damage to the newborn's retinas and corneas from the phototherapy light. Keep the newborn in a shirt while under the phototherapy light. It is acceptable for the nurse to keep a diaper or other covering over the newborn's genitals and buttocks, but the nurse should remove all other clothing and blankets to expose as much body surface area as possible to the phototherapy light. Apply a light moisturizing lotion to the newborn's skin. The nurse should not apply any cream or moisture to the newborn's skin because it can absorb heat and cause burns. Turn and reposition the newborn every 4 hr while undergoing phototherapy. The nurse should turn and reposition the newborn every 2 to 3 hr to allow for maximum exposure of body surfaces to the phototherapy light. 14) A nurse is caring for a client who is in labor and reports increasing rectal pressure. She is experiencing contractions 2 to 3 min apart, each lasting 80 to 90 seconds, and a vaginal examination reveals that her cervix is dilated to 9 cm. The nurse should identify that the client is in which of the following phases of labor? Active The active phase of labor is characterized by a cervical dilatation of 4 to 7 cm and contractions every 3 to 5 min, each lasting 40 to 70 seconds. Transition The nurse should identify that the client is in the transition phase of labor. This phase is characterized by a cervical dilatation of 8 to 10 cm and contractions every 2 to 3 min, each lasting 45 to 90 seconds. Latent The latent phase of labor is characterized by cervical dilation of 0 to 3 cm and contractions every 5 to 30 min, each lasting 30 to 45 seconds. Descent The descent phase of labor is characterized by active pushing with contractions every 1 to 2 min, each lasting for 90 seconds. 15) A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client's history should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply.) Cholecystitis Hypertension Human papillomavirus Migraine headaches Anxiety disorder Cholecystitis is correct. A history of gallbladder disease is a contraindication for the use of oralcontraceptive .Hypertension is correct. Hypertension is a contraindication for the use of oral contraceptives. Human papillomavirus is incorrect. The presence of human papillomavirus is not a contraindication for the use of oral contraceptives. Migraine headaches is correct. A history of migraine headaches is a contraindication for the use or oral contraceptives. Anxiety disorder is incorrect. The presence of an anxiety disorder is not a contraindication for the use of oral contraceptives. 16) A nurse is assessing a client who is 12 hr postpartum. The client's fundus is two fingerbreadths above the umbilicus, deviated to the right of the midline, and less firm than previously noted. Which of the following actions should the nurse take? Place the client in a side-lying position. Placing the client in a side-lying position is an action that the nurse should take for a client who is experiencing hypovolemic shock. Assist the client to the bathroom to void. A distended bladder inhibits the uterus from contracting normally and can cause uterine atony. Therefore, the nurse should assist the client to void. Obtain a prescription for IV oxytocin. Obtaining a prescription for IV oxytocin is an action that the nurse should take for a client who requires labor induction and augmentation. Administer methylergonovine. Administering methylergonovine is an action that the nurse should take for a client who is experiencing postpartum hemorrhage. 17) A nurse is performing a physical assessment of a newborn upon admission to the nursery. Which of the following clinical manifestations should the nurse expect? (Select all that apply.) Yellow sclera Creases over two-thirds of the soles of the feet Posterior fontanel larger than the anterior fontanel Molding of the head Lanugo on the shoulders Yellow sclera is incorrect. Yellow sclera is an indication of hyperbilirubinemia and is not an expected clinical manifestation. Creases over two-thirds of the soles of the feet is correct. Fewer creases over the soles of the feet is an indication of prematurity. Creases over the entire soles of the feet is an indication of postmaturity. Posterior fontanel larger than the anterior fontanel is incorrect. The posterior fontanel is located on the back of the newborn's head and is a small triangular shape. The anterior fontanel is diamond shaped and approximately 5 cm. It is located on the top of the newborn's head and is larger than the posterior fontanel. Molding of the head is correct. Molding occurs during the birth process as the newborn travels through the birth canal, resulting in compression of the soft bones of the skull. Lanugo on the shoulders is correct. Absence of lanugo is an indication of postmaturity. Abundant lanugo is an indication of prematurity. 18) A nurse is developing an educational program for adolescents about nutrition during the third trimester of pregnancy. Which of the following statements should the nurse include in the program? "Consume three to four servings of dairy each day." Calcium intake is especially important during an adolescent's pregnancy because bone absorption of calcium is still occurring. Therefore, the nurse should instruct the adolescents to consume three to four servings of dairy per day to meet their calcium needs. "Increase your daily caloric intake by 600 to 700 calories." Consuming an additional 600 to 700 cal per day could lead to excessive weight gain, which increases the adolescent's risk for complications related to pregnancy, labor, and delivery. The nurse should instruct the adolescents that, if they have a BMI within the expected reference range prior to pregnancy, they should increase their daily caloric intake by 340 cal in the first trimester and 452 cal in the second and third trimesters. "Limit your daily sodium intake to less than 1 gram." Sodium supports the increase in blood volume that occurs during pregnancy. An adequate sodium intake is approximately 1.5 g per day. The nurse should instruct the adolescents that an adequate intake of sodium is required during pregnancy. "Increase your protein intake to 40 to 50 grams each day." Adequate protein intake is necessary to support the rapid growth of the fetus, maternal tissues, increasing blood volume, and the formation of amniotic fluid. Therefore, the nurse should instruct the adolescents to increase their daily intake of protein to approximately 71 g during the second and third trimesters of pregnancy. 19) A nurse is performing a vaginal exam on a client who is in labor and reports severe pressure and pain in the lower back. The nurse notes that the fetal head is in a posterior position. The nurse should identify that which of the following is the best nonpharmacological intervention to perform to relieve the client's discomfort? Back rub A back rub is an effective nonpharmacological intervention to assist the client with pain. However, there is a better nonpharmacological intervention the nurse should use. Counter-pressure According to evidence-based practice, counter-pressure is the best nonpharmacological technique to use when relieving the client's discomfort from the fetus being in a posterior position because this intervention lifts the fetal head off of the spinal nerve. Playing music Playing music is an effective nonpharmacological intervention to assist the client with pain. However, there is a better nonpharmacological intervention the nurse should use. Foot massage A foot massage is an effective nonpharmacological intervention to assist the client with pain. However, there is a better nonpharmacological intervention the nurse should use. • 20) A nurse is developing a plan of care for a client who has preeclampsia and is receiving magnesium sulfate via a continuous IV infusion. Which of the following interventions should the nurse include in the plan? Monitor the client's blood pressure every hour. MY ANSWER The nurse should monitor the client's vital signs, including blood pressure, every 15 to 30 min. Magnesium sulfate, which is used to prevent seizures in clients who have preeclampsia, is a high-alert medication that requires close monitoring. Restrict the total hourly intake to 200 mL. The nurse should restrict the client's total hourly intake to no more than 125 mL. Clients who have preeclampsia can have an alteration in kidney function, leading to increases in edema. Monitor the FHR continuously. Magnesium sulfate, which is used to prevent seizures in clients who have preeclampsia, is a high-alert medication that requires close monitoring. The FHR and uterine contractions should be monitored continuously while the client is receiving magnesium sulfate. Administer protamine sulfate for manifestations of toxicity. The nurse should administer calcium gluconate if the client shows manifestations of magnesium sulfate toxicity. Findings of toxicity include loss of deep-tendon reflexes, respiratory depression, slurred speech, and cardiac arrest. 21)A nurse is planning care for a client who is 2 hr postpartum. Which of the following interventions should the nurse plan to implement during the taking-hold phase of postpartum behavioral adjustment? Discuss contraceptive options with the client and her partner. The discussing of contraceptive options occurs during the letting-go phase. This phase focuses on moving forward as a family with interchanging members. Repeat information to ensure client understanding. The repeating of information to ensure client understanding occurs during the taking-in phase. During this phase, which is experienced on the first postpartum day, the client displays dependent and passive behaviors. Due to excitement and fatigue, the client is unable to retain information. Therefore, the nurse should repeat instructions to ensure that the client understands what is being said. Listen to the client and her partner as they reflect upon the birth experience. Listening to the client and her partner reflect upon the birth experience occurs during the taking-in phase. During this phase, the new mother is focused on herself and meeting her basic needs. There is also much excitement about the newborn and the birth experience. Therefore, the nurse should allow the client to reflect, ensuring a healthy transition and a successful adaptation into the new family unit. Demonstrate to the client how to perform a newborn bath. Demonstrating to the client how to perform a newborn bath occurs during the taking-hold phase. The new mother moves from being passively dependent to taking a stronger interest in her new role as a mother. She is now focusing on the care her newborn and acquiring parenting skills. The nurse should provide positive reinforcement during this phase to give the new mother confidence and promote maternal adjustment. 22) A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn? Apply a cool pack for 10 min to the heel prior to the puncture. A cool pack will constrict the blood vessels, making it more difficult to obtain an adequate specimen. The nurse should apply a warm pack prior to the puncture. Request a prescription for IM analgesic. The pain experienced from a heel stick is too brief to warrant risking the adverse effects of parenteral analgesia. Use a manual lance blade to pierce the skin. A spring-loaded, automatic puncture device is recommended to minimize pain by ensuring that the depth of the puncture is not too deep, avoiding injury to the newborn. Place the newborn skin to skin on the mother's chest. Placing the newborn skin to skin on the mother's chest is an effective technique to significantly decrease the newborn's pain level and anxiety. The nurse should implement this technique before, during, and after the procedure. 23) A nurse is caring for a client who is to receive oxytocin to augment her labor. Which of the following findings contraindicates the initiation of the oxytocin infusion and should be reported to the provider? Late decelerations Late decelerations are indicative of uteroplacental insufficiency. Therefore, this is a contraindication for the administration of oxytocin and should be reported to the provider. Moderate variability of the FHR Moderate variability of the FHR is an expected assessment finding associated with normal fetal acid base balance. It is not a contraindication to the administration of oxytocin. Cessation of uterine dilation Cessation of uterine dilation is an indication for the initiation of an oxytocin infusion to augment the client's labor progression. Prolonged active phase of labor A prolonged active phase of labor is an indication for the initiation of an oxytocin infusion to augment the client's labor progression. .................................................................................................................................................................................................................CONTINUE. [Show Less]
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