NCLEX Book Questions Flashcards
When teaching a 22-year-old woman about breast self-awareness, the nurse should tell the woman to perform the assessment:
About 1 week following the onset of menses.
About halfway between menses. Incorrect
On the same day every month.
About 1 week before the onset of menses.
About 1 week following the onset of menses.
Women should perform a breast self-examination breast self-awareness (BSE) about 1 week following the onset of menses, when hormonal influences on the breasts are at a low level.
Clinical breast examinations should be performed every __ years for women 20 to 39 years of age and ___ for woman 40 years or older.
3
annually
The American Cancer Society and American College of Obstetricians and Gynecologists recommends that mammograms start at the age of ___ unless the woman is at high risk for breast cancer.
40
Vulvar self-examinations should begin in women ___ and in women younger than that if they are sexually active.
18 years old
When scheduling times for women to have a pelvic examination and Papanicolaou (Pap) test, what question is important to ask the woman?
When was her last examination?
On what date will her next menstrual period start?
Does she have insurance coverage of the examination?
Does she use any type of birth control?
On what date will her next menstrual period start?
Pelvic examinations should be scheduled ____ menstrual periods.
between
Which of the following is correct concerning the performance of a Pap test?
- The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test.
- It should be performed once a year, beginning with the onset of puberty.
- A lubricant such as petroleum jelly should be used to ease speculum insertion. Incorrect
- The specimen for the Pap test should be obtained after a specimen is collected to test for cervical infection.
The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test.
When using tampons, they should be changed at least every __ hours to prevent excessive bacterial growth
4
A woman is being admitted to the outpatient surgical unit for a tubal ligation. She states to the nurse, “I know I have to go through with the surgery since I have already signed all the papers, but I was thinking this morning how wonderful it would be to have another baby.” The nurse’s next action should be to:
- Inform the woman that the surgery unit has already been prepared and that it would be expensive to cancel the surgery at this time.
- Inform the woman that the surgery can be reversed at a later date if she should change her mind.
- Inform the surgeon of the woman’s feelings.
- Document the conversation and continue to prepare the woman for surgery.
- Inform the surgeon of the woman’s feelings.
Essure procedure
- a tiny coil is inserted into each fallopian tube.
- The tubes become permanently blocked during the next 3 months as tissue grows into the inserts.
- During this time, another contraceptive method is used.
- The procedure can be performed in the physician’s office.
- It is a nonsurgical method of sterilization.
A woman is to have an Essure procedure performed to produce sterilization. The nurse should include in the client teaching that:
- This procedure requires minor surgery and will be done in the outpatient surgical unit.
- The woman should use another form of birth control for 3 months after the procedure.
- The woman should rest for 24 hours after the procedure and should not lift heavy objects for a week.
- Narcotic analgesics will be prescribed for pain control after the procedure.
The woman should use another form of birth control for 3 months after the procedure.
Following a vasectomy, complete sterilization does not occur until sperm are no longer present in the semen. This may be ___ months or longer.
3
Depo-Provera is an injectable progestin that prevents ovulation for 12 weeks. This requires the woman to return to the clinic every___ months for the injection.
3
The Depo-Provera injection is best given ___ of the menstrual period. If given later in the cycle, an additional form of contraception should be used for the first week.
within 5 days
A lactating woman asks the nurse about contraception. She states that she has always used a combination pill and would like to continue with that method. The nurse should advise the woman that:
- Oral contraceptives are contraindicated during the lactation period.
- Progestin-only contraceptives may be started 6 weeks after birth.
- Combination contraceptive pills may be started 3 to 4 weeks after birth.
- Only barrier methods are recommended during the lactation period.
- Progestin-only contraceptives may be started 6 weeks after birth.
A woman asks the nurse about the “new vaginal ring everyone is talking about for birth control.” When counseling the woman about this method of contraception, the nurse should assess for the woman’s:
- Ability to remember to insert the device every morning.
- Feelings about having to insert the device before sexual intercourse. Incorrect
- Comfort level about self-insertion of the ring every 3 weeks.
- Ability to return to the clinic once a month for reinsertion.
Comfort level about self-insertion of the ring every 3 weeks
A woman is being counseled concerning the calendar method type of natural family planning. The woman states that her cycles run from 27 to 29 days. The nurse teaches the woman that ovulation will probably occur on about days:
10 to 12.
13 to 15.
16 to 18.
18 to 20.
13 to 15.
Ovulation occurs approximately __ days before the onset of menses.
14
To obtain an accurate blood pressure of a woman in labor, the nurse should assess the blood pressure:
- Between contractions, with the woman lying on her side.
- Between contractions, with the woman lying on her back.
- With a contraction while the woman is lying on her side.
- With a contraction while the woman is lying on her back.
Between contractions, with the woman lying on her side.
During contractions the fetus has mechanisms in place to protect it from the decrease in blood flow. Those mechanisms include:
- Fetal hemoglobin levels that are more resistant to oxygen.
- Lower hemoglobin and hematocrit levels. Incorrect
- A high cardiac output level.
- A higher respiratory level.
A high cardiac output level.
When doing a vaginal exam, the nurse notes a triangular-shaped depression toward the mother's left side and pointing up toward her abdomen. The nurse can record the fetal position as: LOP. ROP. LOA. ROP.
LOA
Which of the following are considered theories about the onset of labor? (Select all that apply).
A. Changes in the relative effects of estrogen and progesterone
B. An increase in prostaglandins
C. Increased secretion of prolactin
D. Decreased secretion of oxytocin
E. Stretching and irritation of the uterus and cervix
A,B,E
A 39-week primigravida calls the birthing center and tells the nurse she has contractions that are 10 to 15 minutes apart and had a small gush of fluid about 1 hour ago. The nurse should tell her to:
- Wait until the contractions are about 5 minutes apart and come to the center. Incorrect
- Come to the birthing center now.
- Come to the birthing center in about an hour if she lives farther than 1 hour away.
- Come to the birthing center if the baby stops moving.
Come to the birthing center now.
Upon completion of a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, -1. Which of the following is a correct interpretation of the data?
Fetal presenting part is 1 cm above the ischial spines.
Effacement is 4 cm from completion . Incorrect
Dilation is 50% completed .
Fetus has passed through the ischial spines.
Fetal presenting part is 1 cm above the ischial spines.
A client is being discharged, having been diagnosed with false labor. The nursing diagnosis for her is Deficient Knowledge: characteristics of true labor. An appropriate expected outcome for this diagnosis is that the:
- Client will return to the hospital when she is in true labor.
- Client will define true labor.
- Client will describe reasons for returning to the hospital for evaluation.
- Client will be able to determine false from true labor.
- Client will describe reasons for returning to the hospital for evaluation.
Which of the following findings during the fourth stage would require immediate interventions by the nurse?
Fundus firm and at midline
Fundus firm, deviated to the right, with slight distention over the symphysis pubis
Blood pressure and pulse slightly lower than reading during second stage of labor
Lochia is bright red, with a few small clots Incorrect
Fundus firm, deviated to the right, with slight distention over the symphysis pubis
The technique of delaying pushing until the reflex urge to push occurs may be called
delayed pushing, laboring down, rest and descend, or passive pushing
On review of a fetal monitor tracing, the nurse notes that for several contractions the FHR decelerates as a contraction begins and returns to baseline just before it ends. The nurse should:
Describe the finding in the notes.
Reposition the woman onto her side. Incorrect
Call the physician for instructions.
Administer oxygen at 8 to10 L/min with a tight face mask
Describe the finding in the notes.
The normal fetal pH is _____
7.25 to 7.35.
A normal fetal pulse oximetry reading is____
30% to 70%
For low-risk women, the nurse should evaluate the fetal monitoring strip or assessment fetal well-being at least every __ minutes during the active phase of labor and every ___ minutes during the second stage
30 during active
15 during second
The nurse is preparing to auscultate the fetal heart rate using a Doppler transducer. When performing the Leopold maneuver, the nurse felt the buttocks near the fundus and the back along the left side of the mother. The best position for the Doppler would be in the mother’s:
Left upper quadrant.
Left lower quadrant.
Right upper quadrant.
Right lower quadrant.
Left lower quadrant.
Which of these might cause late decelerations in the fetus? (Select all that apply).
A. Maternal hypotension B. Excessive uterine activity C. Maternal hypertension D. Fever Incorrect E. Maternal overhydration F. Prolapsed cord Incorrect
A, B, C
Immediately after birth the uterus is about the size of a large grapefruit and the fundus can be palpated ____.
midway between the symphysis pubis and umbilicus
Within 12 hours of birth the fundus rises to ___.
the level of the umbilicus
By the second day, the fundus starts to descend by approximately ____
1 cm/day
Marked leukocytosis occurs during the postpartum period. The WBC count increases to as high as ____. The WBC count should fall to normal values by day __.
30,000/mm3.
7
One nursing measure that can help prevent postpartum hemorrhage and urinary tract infections is:
Forcing fluids.
Perineal care. Incorrect
Encouraging voiding every 2 to 3 hours.
Encouraging the use of stool softeners.
Encouraging voiding every 2 to 3 hours.
A woman was admitted to the ED with her newborn baby. The baby was born 4 days ago at home. The woman had no prenatal care. The nurse is assessing the lab work and sees that the mother has an O-negative blood type, the baby is O-positive, and the Coombs test shows that the mother is not sensitized to the positive blood. The nurse’s next action should be:
- Order Rho(D) immune globulin to be given to the mother.
- Order Rho(D) immune globulin to be given to the baby. Incorrect
- Record the findings of the lab work and not plan on any further action at this time.
Record the findings of the lab work and not plan on any further action at this time.
When assessing a woman who gave birth 2 hours ago, the nurse notices a constant trickle of lochia. The uterus is well contracted. The next nursing action should be to:
Massage the fundus.
Continue to monitor.
Notify the physician.
Assess the blood pressure and pulse for changes.
Notify the physician.
Methylergonovine is contraindicated if the woman has an ____.
elevated blood pressure
Constipation is a common problem during the postpartum period. Select all the reasons for constipation during this period.
A. Diminished bowel tone B. Overhydration during labor C. Episiotomy that causes the fear of pain with elimination D. Iron supplementation E. Some pain medications
A, C, D, E
The placental site heals by a process of
exfoliation
The new parents express concern that their 4-year-old son is jealous of the new baby. They are planning on going home tomorrow and are not sure how the preschooler will react when they bring the baby home. Which of the following suggestions by the nurse will be most helpful?
Be aware that the child may regress to an earlier stage.
Have the mother go into the house alone and spend time with the child before the father brings the baby in.
Have the child stay with a grandparent until the parents adjust to the new baby.
Tell the child that he is a “big boy” now and doesn’t need his crib so the new baby will be using it for a while.
Have the mother go into the house alone and spend time with the child before the father brings the baby in.
The maternal adaptation phase in which the mother relinquishes her previous role as being childless and her old lifestyle is called the _______________ phase.
letting go
When the father develops a bond with the new infant and has an intense interest in how the infant looks and responds, this is called ________________.
engrossment
