Neneh Sheriff Flashcards
Master test 1 material
During a prenatal visit, a client expresses interest in accessing community-based care and services. Which response allows the registered nurse to best describe services that are offered by way of community-based care?
A. “Most healthcare services provided to childbearing women and their families take place in a hospital setting.”
B. “Community-based care can provide a client with certain primary care services.”
C. “Nurses are the sole providers of services related to home care.”
D. “Due to lack of support from third-party payers, community-based care has decreased.”
B.
The labor and delivery nurse and a novice nurse are admitting a client who is in labor. The client is making groaning guttural sounds during contractions and answers questions with one-word answers. The labor and delivery nurse is quickly setting up the instruments and sterile field for this delivery while asking admission questions between contractions. The labor and delivery nurse has not completed a pelvic exam. The novice nurse understands that this is an example of:
A. An expert nurse assessing advanced labor and imminent delivery in the client.
B. The correct order of steps when admitting a who is in labor.
C. Inconsistencies in an individual nurse’s approach to client care.
D. Advanced nurse practice.
A.
Currently, one-third of children under 20 years old come from families of minority populations. The new nurse is observing her preceptor assess the client’s communication pattern, religious beliefs, level of education, and support system. The new nurse understands that the best reason for her preceptor to assess these areas is to increase the:
A. Client’s cooperation with the plan of care.
B. Hospitals compliance with the Joint Commission on Accreditation of Healthcare Organizations JCAHO standards.
C. Nurse’s knowledge of cultural beliefs.
D. Client’s satisfaction with her care.
A.
The client at 30 weeks’ gestation expresses a desire for the registered nurse to independently manage her perinatal care and the birth of her baby. When the nurse explains she is not credentialed to independently manage the client’s perinatal care and delivery, the nurse is recognizing principles related to:
A. Standards of care.
B. Scope of practice.
C. Right to privacy.
D. Informed consent.
B.
The certified nurse-midwife (CNM) role includes which of the following? Select all that apply.
A. Prepared to independently the care of women that are at low risk for complications during pregnancy and birth
B. Provides primary care for high-risk patients who are in hospital settings
C. Provides primary care for healthy newborns
D. Obtains a physician consultation for any technical procedures at delivery
E. Formal educated in two disciplines of nursing
A, C, C
The new graduate is learning about advanced practice nursing. Which of the following situations best illustrates an advanced practice nursing role? Select all that apply.
A. An experienced registered nurse who is the manager of a large obstetrical unit
B. A registered nurse who is the circulating nurse at surgical (cesarean) deliveries
C. A clinical nurse specialist who is the staff nurse on a mother—baby unit
D. A nurse practitioner consults with a physician in the newborn nursery
E. A nurse-midwife who attends vaginal deliveries of uncomplicated pregnancies
D, E
The major focus of the nurse practitioner (NP) is on:
A. Leadership.
B. Physical and psychosocial clinical assessment.
C. Independent care of a patient with a high-risk pregnancy.
D. Tertiary prevention.
B
The nurse is reviewing charts for quality improvement. A client experienced a complication during labor. The nurse is uncertain if the labor nurse took the appropriate action during the situation. What is the best method for the quality improvement nurse to determine if the action by the labor and delivery nurse was justified?
A. Call the nurse manager of the labor and delivery unit and ask what the nurse should be doing.
B. Ask the departmental chair of the obstetrical physicians what the best nursing action should be.
C. Examine other charts to find cases of the same complication, and determine how it was handled in those situations.
D. Look in the policy and procedure book. Examine the practice guidelines published by a professional nursing organization.
D
According to the 1973 United States Supreme Court decision in Roe v. Wade, abortion is legal if induced:
A. At a federally funded clinic.
B. Before the period of viability.
C. To provide tissue for therapeutic research.
D. At a military hospital overseas.
B
The nurse is caring for a client who has delivered her first child. The client states, “My mother said that I have to have a bowel movement before I can go home, but my girlfriend said that isn’t true anymore. What caused this change?” Which response by the nurse is best?
A. “Doctors just want clients to go home sooner these days.”
B. “It really doesn’t matter. Don’t worry about it.”
C. “Research indicates that it is normal for bowel function to be slow for a few days.”
D. “We used to give all clients laxatives, but now they cost too much.”
C
Which of the following practices characterize the basic competencies related to evidence-based practice? Select all that apply.
A. Clinical practice supported by good evidence
B. Clinical practice supported by intuitive evidence
C. Clinical practice supported by data
D. Clinical practice that promotes quality
E. Clinical practice that provides a useful approach to problem solving
A, C, D, E
The nurse is preparing a report on the number of births by three service providers at the facility (certified nurse—midwives, family practitioners, and obstetricians). This would be an example of:
A. Inferential statistics.
B. Descriptive statistics.
C. Evidence-based practice is the use of conclusions of research to improve nursing care.
D. Secondary use of data.
B
An example of descriptive statistics is:
A. A positive correlation between breastfeeding and infant weight gain.
B. The infant mortality rate in the state of Oklahoma.
C. A causal relationship between the number of sexual partners and sexually transmitted diseases.
D. The total number of spontaneous abortions in women who abuse drugs compared to women who do not abuse drugs.
B
The 2011 estimated infant mortality rate in the United States exceeds the infant mortality rate of several other developed countries, including Sweden, Japan, France, Germany, and Canada. Which research question most effectively explores variables that may potentially influence these statistics?
A. What is the average age of healthcare providers in each country?
B. What is the level of racial diversity in each country?
C. What is the average age of children in each country?
D. What is the level of awareness related to contraception in each country?
B.
The nurse knows the birth rate by age group in the state. Which research question could be developed for further study from this data?
A. What is the average number of children per family in the United States?
B. How does educational level affect the incidence of unplanned pregnancy?
C. What is the overall nutritional status of adolescents?
D. Which high schools provide day care for student parents?
B
The major focus of the clinical nurse specialist (CNS) involves:
A. Conducting physical and psychosocial assessments, including history, physical examination, and certain diagnostic tests and procedures.
B. Independently managing the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns.
C. Generating new research relevant to topics such as health care and administrative issues.
D. Demonstrating leadership within his or her specialty and working to improve inpatient care both directly and indirectly.
D
A couple has been attempting pregnancy for the last three years and is looking for assistance from the fertility specialist. The nurse assesses the client’s emotional response to infertility. Which responses could the nurse expect? Select all that apply.
A. Love, no matter what, they have each other
B. Failure, they cannot conceive a child
C. Anger, other people have children
D. Fear, they may never experience parenthood
E. Sadness, they may never have a child
B, C, D, E
The student is reading an article that states the pregnancy-related mortality rate in the United States in the year 2011 was 17.8. Which statement(s) by the student could be an accurate explanation? Select all that apply.
A. In 2011, there were 17.8 maternal deaths per 100,000 women of childbearing age in the United States.
B. In 2011, there were 17.8 maternal deaths per 100,000 live births in the United States.
C. In 2011, there were 17.8 maternal deaths per 100,000 women in the country in the United States.
D. In 2011, there were 17.8 maternal deaths per 100,000 pregnancies in the United States.
E. In 2011, there were 17.8 deaths of women from the United States as a result of the childbearing period per 100,000 live births.
D, E
While conducting a family assessment, the nurse determines that a particular family’s structure is binuclear. Some potential challenges inherently faced by binuclear families include:
A. Challenges related to coparenting and joint custody, including negotiation and compromise between the parents about childrearing decisions.
B. Issues related to both parents being employed, including child care, household chores, and spending time together.
C. Challenges related to children interacting with peers and when revealing their parents sexual orientation.
D. Issues related to single parenting, including lack of social and emotional support, need for assistance with childrearing, and financial strain.
A
The nurse is preparing a community presentation on family development. Which of the following statements should the nurse include?
A. The youngest child’s age determines the family’s current stage.
B. A family does not experience overlapping of stages.
C. Family development ends when the youngest child leaves home.
D. The stages describe the family’s progression over time.
D
The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that the primary use of a family assessment tool is to:
A. Obtain a comprehensive medical history of family members.
B. Determine which clinic the client should be referred to.
C. Predict how a family will likely change with the addition of children.
D. Understand the physical, emotional, and spiritual needs of members.
D
A nurse is caring for a Muslim client who is pregnant. She is anticipating delivery within the next few days. The nurse asks if she and her husband have chosen a name for their baby. The patient quietly shakes her head, “no.” Based upon the patient’s response, the nurse understands that:
A. The client is not happily anticipating the arrival of her baby.
B. Cultural beliefs may require the couple to choose the baby’s name following the birth.
C. The client does not speak English.
D. Cultural beliefs may require that the baby’s name be kept secret until after the delivery.
B
A woman of Korean descent has just given birth to a son. Her partner wishes to give her sips of hot broth from a thermos that he brought from home. The client has refused your offer of ice chips or other cold drinks. The nurse should:
A. Explain to the client that she can have the broth if she will also drink cold water or juice.
B. Encourage the partner to feed the client sips of broth. Ask if the client would like you to bring her some warm water to drink as well.
C. Explain to the couple that food cant be brought from home but that the nurse will make hot broth for the client.
D. Encourage the client to have the broth after the nurse takes it to the kitchen and boils it first.
B
The nurse works in a facility that cares for clients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation for nurses new to the facility on the client population of the facility?
A. “Our clients come from a broad range of backgrounds, but we have a good interpreter service.”
B. “Many of our clients come from backgrounds different from your own, but it doesn’t cause problems for the nurses.”
C. “Because most of the doctors are bilingual, we don’t have to deal with the differences in cultural backgrounds of our clients.”
D. “Understanding the common values and health practices of our diverse clients will facilitate better care and health outcomes.”
D
The nurse manager in a hospital with a large immigrant population is planning an in-service. The nurse manager is aware of how ethnocentrism affects nursing care. Which statement should the nurse manager include? “The belief that ones own values and beliefs are the only or the best values:
A. “Strangers to the United States should adopt U.S. norms and values.”
B. “Can create barriers to communication through misunderstanding.”
C. “Leads to an expectation that patients will exhibit pain the same way.”
D. “Improves the quality of care provided to culturally diverse patient bases.”
B
When preparing to teach a culturally diverse group of childbearing families about hospital birthing options, in order to be culturally competent, the nurse should:
A. Understand that the families have the same values as the nurse.
B. Teach the families how childbearing takes place in the United States.
C. Insist that the clients answer questions instead of their husbands.
D. Learn about the cultural groups that are likely to attend the class.
D
A nurse is admitting a Mexican woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which question would be most important for the nurse to ask?
A. “What other treatments have you used for your abdominal pain?”
B. “What is your country of origin; where were you were born?”
C. “When you talk to family members, how close do you stand?”
D. “How would you describe your role within your family?”
A
The labor and delivery nurse is caring for a laboring client who has asked for a priest to visit her during labor. The client’s mother died during childbirth, and although there are no complications during the client’s pregnancy, she is fearful of her own death during labor. What is the best response of the nurse?
A. “Nothing is going to happen to you. Well take very good care of you during your birth.”
B. “Would you like to have an epidural so that you wont feel the pain of the contractions?”
C. “The priest wont be able to prevent complications and might get in the way of your providers.”
D. “Would you like me to contact your parish or our hospital chaplain to come see you?”
D
A pregnant client reports experiencing occasional gastroesophageal reflux. She explains that she relieves her symptoms through acupressure treatments, as well as by taking an over-the-counter medication recommended by her obstetrician. The nurse recognizes acupressure to be a form of:
A. Homeopathy.
B. Alternative therapy.
C. Biofeedback.
D. Complementary therapy.
D
A client reports using “homeopathic remedies” to ease her back pain. In order to more fully explore the client’s use of complementary and alternative medicine (CAM), the nurse should ask:
A. “Will you tell me more about the homeopathic remedies you’re using?”
B. “Are you aware that some complementary and alternative therapies can be dangerous?”
C. “Does your physician approve of your use of homeopathic remedies?”
D. “Have you prioritized your need for comfort above your concern for your baby’s health?”
A
The client pregnant with her first child reports that her husband wants her to visit a homeopath for help with her nausea and vomiting. The client asks what the nurse’s opinion of homeopathy is. The best response by the nurse is:
A. “Homeopathy is unproven and potentially dangerous. Avoid using homeopathic remedies.”
B. “The FDA has approved homeopathic remedies, and practitioners undergo education and certification.”
C. “I cant give you advice about what alternatives to try. Go online and do some research to get information.”
D. “Homeopathy is the same as herbal remedies. Some are safe during pregnancy and some are not.”
B
Complementary and alternative therapies have many benefits for the childbearing family and others. However, many of these remedies have associated risks. Which of the following situations would be considered risks? Select all that apply.
A. Getting a massage from a licensed massage therapist for back pain, prescribed by the primary caregiver
B. Sampling a homeopathic medicine from a friend to reduce swelling in the legs
C. Getting a chiropractic treatment for low back pain due to discomforts of pregnancy without telling the primary health care provider
D. Taking an herbal preparation suggested by a health food store worker for treatment of leg pain
E. Joining a group that practices tai chi weekly to help with physical fitness and movement
B, C, D
The labor and delivery unit nurse manager is incorporating complementary and alternative therapies into the units policies and procedures. Which statement should the nurse manager include during an in-service educational presentation for the nursing staff?
A. “Policies have been developed for using massage and aromatherapy.”
B. “When clients ask questions you don’t know, tell them to look online.”
C. “Because herbs are dangerous during pregnancy, we will not use them.”
D. “Be sure to ask clients what alternative therapies they have used.”
A
A nurse is discussing the 8 stages of the family cycle with the parents of a 12-year-old child. Which stages should the nurse discuss first? Select all that apply.
A. Readjustment of the marital relationship, parent/child establishment of separate identities outside of family
B. Facilitating peer relationships while maintaining family dynamics
C. Marriage between partners, identification as part of family, establishment of goals for future, interaction and building relationship
D. Increase in child’s independence, parents concentrate on shift to aging parent careers and marital relationship
E. Established family network, socialization of child, reinforce independence in child when apart from parents
B, D
The nurse is discussing culture with the Japanese family and practices to which they subscribe. Which examples clearly define acculturation?
Select all that apply.
A. A first generation Italian lives in an Italian community in the United States and follows Italian traditions and values, continues to speak Italian.
B. A 65-year-old was born and raised in Pennsylvania, moved to Georgia at the age of 40, has a change in pronunciation and customs.
C. A Native American from the reservation goes to Phoenix to live and go to school. The Native American goes home on the weekends to help the family with chores, when sick goes home for traditional healing.
D. The granddaughter of a Chinese immigrant has lived in the United States all of her life including college. She spends most of her time with American friends, dresses as they do and appreciates their values and interests.
E. A young couple were raised and grew up in Mexico, decided to move to the United States. They attend school, acquire professional jobs and eventually start a family. They learn English and speak English when speaking to their children, and follow the holidays of the United States.
B, D, E
A nurse is teaching a classroom of teenage girls about the female reproductive system. After teaching, the nurse asks the students to describe the release of an ovum during ovulation. Which of the following is a correct student response?
A. “During ovulation, an egg is released from the ovary and enters the fallopian tube.”
B. “Around the middle of the menstrual cycle, one of the fallopian tubes releases an egg.”
C. “Ovulation is when the uterus releases an unfertilized egg or ovum.”
D. “The endometrium is where the eggs are formed and released into the fallopian tube.”
A
The clinic nurse is caring for a young woman seeking contraception. Recently, she married and became sexually active. The woman states, “The opening of my husbands penis isn’t at the tip; its around the corner below the tip. He tells me that he was born that way. Will that cause problems if we want to have children?” What is the best response for the nurse to give?
A. “The variation is called epispadias. It is not likely to impact his fertility.”
B. “The variation is called epispadias. It will likely cause him to be infertile.”
C. “The variation is called hypospadias. It is not likely to impact his fertility.”
D. “The variation is called hypospadias. It will likely cause him to be infertile.”
C
A prenatal patient states, “The doctor said he might have to cut my cervix so the baby can get out during delivery.” Based upon this statement, the nurse should provide teaching related to episiotomy, which includes defining:
A. The perineal body.
B. The labia majora.
C. The mons pubis.
D. The vaginal vestibule.
A
A pregnant patient asks, “What’s the difference between the true pelvis and the false pelvis?” The nurse’s best response is:
A. “The true pelvis doesn’t affect fetal passage during labor and childbirth.”
B. “The false pelvis consists of the inlet, the pelvic cavity, and the outlet.”
C. “The true pelvis helps direct the presenting fetal part into the false pelvis.”
D. “The false pelvis helps support the weight of the pregnant uterus.”
A
A pregnant adolescent asks the nurse, “Why does the physician call measuring my uterus a fundal height?” The nurse’s answer is based on the fact that the fundus of the uterus is located:
A. In the elongated portion where the fallopian tubes enter.
B. In the lower third area.
C. At the uppermost (dome-shaped top) portion.
D. Between the internal cervical os and the endometrial cavity.
C
A nurse teaches newly pregnant patients that if an ovum is fertilized and implants in the endometrium, the hormone the fertilized egg begins to secrete is:
A. Estrogen.
B. Human chorionic gonadotropin (hCG).
C. Progesterone.
D. Luteinizing hormone.
B
A school nurse is teaching a health class to middle school children. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are secreted by the:
A. Hypothalamus.
B. Ovaries and testes.
C. Posterior pituitary.
D. Anterior pituitary.
A
The nurse is presenting a community education session on female hormones. Which statement from a participant indicates the need for further information?
A. “Estrogen is what causes females to look female.”
B. “The presence of some hormones causes other to be secreted.”
C. “Progesterone is present at the end of the menstrual cycle.”
D. “Prostaglandin is responsible for achieving conception.”
A
A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. This is most likely due to a lack of which hormone?
A. Estrogen
B. Progesterone
C. Follicle-stimulating hormone (FSH)
D. Luteinizing hormone (LH)
B
The nurse is explaining the menstrual cycle to a group of women. The teaching on phases of the menstrual cycle should include the fact that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and the blood supply to the endometrium is reduced in which phase?
A. Menstrual phase
B. Proliferative phase
C. Secretory phase
D. Ischemic phase
A
Which statement best indicates that the patient understands the differences in the follicular and luteal phases of the ovarian cycle?
A. “My period will be every 28 days.”
B. “The first part of my period might vary in length, but not the second.”
C. “The follicular phase is the second half of my cycle.”
D. “The follicular phase is when the egg is fertilized.”
B
The nurse is preparing a handout on the ovarian cycle to a group of middle school girls. Which information should the nurse include?
A. There are two phases of the ovarian cycle: luteal and follicular.
B. Irregular menstrual cycles have varying lengths of the follicular phase.
C. The ovum travels from the ovary to the tube during the luteal phase.
D. The human chorionic gonadotropin (hCG) hormone stimulates ovulation.
A
The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation?
A. “The menstrual cycle has five distinct phases that occur during the month.”
B. “One hormone controls the phases of the menstrual cycle.”
C. “The secretory phase occurs when a woman is most fertile.”
D. “Menstrual cycle phases vary in order from one woman to another.”
C
In preparation for teaching a women's community center class about physiologic changes during menopause, the nurse is preparing a handout for students. Which information should the nurse include in her teaching? A. The ovaries remain small after puberty, but they increase in size following menopause. B. Ovarian secretion of estrogen decreases between age 45 to 55, after which point ovulatory activity ceases. C. Due to changes in estrogen levels, the labia minora increase in size after menopause. D. After menopause, the endometrium continues to undergo monthly degeneration and renewal.
B
A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0°F) for the past 36 hours. This most likely indicates that:
A. Menstruation is about to begin.
B. Ovulation will occur soon.
C. Ovulation has occurred.
D. She is pregnant and will not menstruate.
C
The nurse is preparing to teach a client about the functions of the pelvis during childbearing. Which information should the nurse include in her teaching? Select all that apply.
A. Transport for the ovum B. Provides a site for fertilization C. Supports and protects contents D. Forms the axis of the birth canal E. Inhibits uterine contraction and relaxes smooth muscle
D, E
The student is learning about the menstrual cycle and the influence of hormones on the cycle. Which response suggests the student understands the function of progesterone on the menstrual cycle? Select all that apply. A. Temperature rise of 0.5 to 1.0°F B. Cervix secretes thick mucus C. Growth of body hair D. Maturation of ovarian follicles E. Vaginal epithelium proliferates
A, B, E
The nurse is explaining the difference between meiosis and mitosis. Which statement does the nurse include? Select all that apply.
A. Meiosis is the division of a cell into two exact copies of the original cell.
B. Mitosis is the splitting of one cell into two, each with half the chromosomes of the original cell.
C. Meiosis is the process by which gametes, or the sperm and ova, are formed.
D. Mitosis occurs in most of the cells of the body.
E. Meiotic division leads to cells that halve the original genetic material.
C, E
The nurse has completed a presentation on reproduction. Which participants statement indicates that the teaching has been successful?
A. “A male is born with all the sperm he will ever produce.”
B. “Females create new ova throughout their reproductive life.”
C. “Ova separate into two unequally sized cells.”
D. “Each primary spermatocyte divides into four haploid cells.”
C
After teaching a class about the female reproductive system, the nurse asks the attendees to describe the process of meiosis. Which student response suggests successful comprehension of the material?
A. “Completion of the second meiotic division results in formation of three polar bodies and one ovum.”
B. “At the time of ovulation, the first meiotic division begins.”
C. “Completion of the first meiotic division produces three polar bodies and one primary oocyte.”
D. “At the time of puberty, the second meiotic division begins.”
A
You are counseling a young woman regarding contraception. When asked if she currently uses any form of contraception, she replies, “I can’t get pregnant because I don’t have intercourse on the day I ovulate.” Based upon her response, what information should you include in your teaching?
A. Refrain from intercourse on the day of ovulation will effectively prevent pregnancy.
B. Sperm are believed to be healthy and highly fertile for at least five days.
C. After ovulation, ova are considered fertile for about 72 to 96 hours.
D. Sperm survive 48 to 72 hours in the female reproductive tract.
D
When evaluating information taught about conception and fetal development, the patient verbalizes understanding about transportation time of the zygote through the fallopian tube and into the cavity of the uterus with which statement?
A. “It will take at least three days for the egg to reach the uterus.”
B. “It will take eight days for the egg to reach the uterus.”
C. “It will only take 12 hours for the egg to go through the fallopian tube.”
D. “It will take 18 hours for the fertilized egg to implant in the uterus.”
A
If only a small volume of sperm is discharged into the vagina, an insufficient quantity of enzymes might be released when sperm encounters the ovum. In that case, pregnancy would probably not result because:
A. Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus.
B. The block to polyspermy (cortical reaction) would not occur.
C. The fertilized ovum would be unable to implant in the uterus.
D. Sperm would be unable to penetrate the zona pellucida of the ovum.
D
The nurse is caring for a client who is pregnant with twins. Which statement indicates the client needs additional information?
A. “Because both of my twins are boys, I know that they are identical.”
B. “If my twins came from one fertilized egg that split, they are identical.”
C. “If I have one boy and one girl, I will know they came from two eggs.”
D. “It is rare for twins to both be within the same amniotic sac.”
A
A pregnant client asks you to describe the differences between monozygotic and dizygotic twins. Which statement should you include in your teaching?
A. “Dizygotic twinning occurs less frequently than does monozygotic twinning.”
B. “Monozygotic twins originate from division of the fertilized ovum at different stages.”
C. “Dizygotic twins share one placenta and one chorion.”
D. “Monozygotic twins are also referred to as ‘fraternal twins.”
B
Which statement by a pregnant client would indicate that additional teaching was necessary?
A. “Because of their birth relationship, fraternal twins are more similar to each other than if they had been born singly.”
B. “Identical twins can be the same or different sex.”
C. “Congenital abnormalities are more prevalent in identical twins.”
D. “Identical twins occur more frequently than fraternal twins.”
C
The nurse is creating a poster for pregnant mothers. Which description of fetal development does the nurse include?
A. Four layers of cells form after the embryo is at the ball stage.
B. After fertilization, the cells only become larger for several weeks.
C. Most organs are formed by 8 weeks after fertilization.
D. The embryonic stage is from fertilization until 5 months.
C
The nurse is presenting an early pregnancy class to a group of pregnant women. Which statement indicates a need for further education?
A. “The placenta develops and grows larger until about 20 weeks’ gestation.”
B. “The placenta creates hormones and enzymes that are necessary during pregnancy.”
C. “The placenta ages and becomes less permeable during the last month of pregnancy.”
D. “The placenta floats in the amniotic sac and filters waste products from the fetus.”
D
The nurse is working with a client who has experienced a fetal death in utero at 20 weeks. The client asks what her baby will look like when it is delivered. Which statement by the nurse is the best response?
A. “Your baby will be covered in fine hair called lanugo.”
B. “Your child will have arm and leg buds, but not fully formed limbs.”
C. “A white, cheesy substance called vernix caseosa will be on the skin.”
D. “The genitals of the baby will be ambiguous.”
A
At her first prenatal visit, the client states, “I’m five weeks’ pregnant now and I would like to hear my baby’s heartbeat today.” How should the nurse respond?
A. Prepare to assist with auscultation of the fetal heartbeat using a fetoscope.
B. Explain to the client that the fetal heart does not begin to beat until approximately 7 weeks’ gestation.
C. Anticipate that the client will be scheduled for Doppler ultrasound.
D. Explain to the client that the fetal heartbeat is not yet detectable at 5 weeks’ gestation.
D
The client, at 18 weeks’ gestation, thinks she might have been exposed to a toxin at work that could affect fetal development. The client asks the nurse what organs might be affected at this point in pregnancy. The best response of the nurse is:
A. “The brain is developing now and could be affected.”
B. “Because you are in the second trimester, there is no danger.”
C. “The internal organs like the heart and lungs could be impacted.”
D. “Its best to not worry about possible problems with your baby.”
A
The nurse is preparing a preconception information class. Information about causes of fetal organ malformation in the first trimester will be presented. What prenatal influences on the intrauterine environment should be included in the instruction? Select all that apply.
A. The use of saunas or hot tubs B. The use of drugs C. The quality of the sperm or ovum D. Maternal nutrition E. Age of the mother at conception
A, B, D
A woman at 20 weeks’ gestation finds that her blood type is O. She tells the nurse that her boyfriends blood type is AB, and asks what blood type her child will have. Which blood types should the nurse tell the woman her child may have? Select all that apply.
A. O B. A C. B D. OA E. AB
B, C
A woman had a genetic evaluation and it is discovered that she carries on autosomal dominant gene for Huntington’s disease, while her husbands history is ordinary. Which family members should be referred for genetic counseling? Select all that apply.
A. The woman's brothers B. The woman's sisters C. The woman's parents D. The woman's husband E. The woman's children
A, B, C, E
The clinic nurse is returning phone calls. Which call should the nurse return first?
A. A 22-year-old client reporting that she has menstrual cramps and vomiting every month
B. A 17-year-old client asking if there is a problem with using one tampon for a whole day
C. A 46-year-old mother of a teen wondering if her daughter should be on birth control
D. A 34-year-old client requesting information on douching after intercourse
B
When taking a sexual history from a client, the nurse should:
A. Ask questions that the client can answer with a “yes” or “no.”
B. Ask mostly open-ended questions.
C. Have the client fill out a comprehensive questionnaire and review it after the client leaves.
D. Try not to make much direct eye contact.
B
Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea?
A. A 17-year-old female who has never had a menstrual cycle.
B. A 16-year-old female who had regular menses for 4 years, but has had no menses in four months.
C. A 19-year-old female who had regular menses for 5 years that have suddenly become painful.
D. A 14-year-old female who had irregular menses for one year, experiences cramping every cycle.
D
A client asks her nurse, “Is it okay for me to use a vaginal douche each day when I’m on my period?” The nurse’s correct response is:
A. “Douching should be avoided when you’re on your period.”
B. “Using a douche each day will help prevent vaginal infections from occurring.”
C. “During your period, douching will help promote the flow of menstrual secretions.”
D. “Regular douching is necessary in order to promote good hygiene.”
A
What should the gynecology clinic nurse recommend for the client experiencing premenstrual syndrome?
A. “Eat more chocolate and drink more caffeine beginning a week prior to when your menstrual cycle bleeding should begin.”
B. “Engage in aerobic activity often throughout the month, and continue exercising when your symptoms begin.”
C. “Decrease your dietary intake of dairy and soy slightly during the month, and especially during your days of bleeding.”
D. “Increase your consumption of red meat when you feel symptoms, and eat three large meals per day.”
B
A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for two years. The most likely cause for the client’s complaint is:
A. Primary dysmenorrhea.
B. Secondary dysmenorrhea.
C. Menorrhagia.
D. Hypermenorrhea.
B
Which issues should the nurse consider when counseling a client on contraceptive methods? Select all that apply.
A. Cultural perspectives on menstruation and pregnancy B. Efficacy of the method C. Future childbearing plans D. Whether the patient is a vegetarian E. Age at menarche
A, B, C
A client has decided to use a vaginal contraceptive ring as her method of contraception. Which statement suggests the client needs further instruction?
A. “I do not need to be examined in order to determine the contraceptive ring size that is correct for me.”
B. “Every three months, I will need to remove the contraceptive ring and replace it with a new one.”
C. “When I store my replacement rings, I should keep them in my refrigerator.”
D. “The contraceptive ring provides a sustained release of low-dose contraceptive.”
B
Which client is not a good candidate for Depo-Provera (DMPA)?
A. One who wishes to get pregnant within three months
B. One who wishes to breastfeed
C. One with a vaginal prolapse
D. One who weighs 200 pounds
A
The public health nurse receives a phone call from a 16-year-old female who asks, “Do I need to have a Pap smear just because I’m sexually active?” What is the nurse’s correct response?
A. “Yes, all sexually active females should be screened for both cervical cancer and HPV.”
B. “No, you do not need to be screened for cervical cancer until you are 21 years old.”
C. “Yes, all women under the age of 29 should be screened for both cervical cancer and HPV.”
D. “No, but you will need to begin your screenings for both cervical cancer and HPV when you are 18 years old.”
B
A nurse is providing a client with instructions regarding breast self-examination (BSE). Which of the following statements by the client would indicate the likelihood that she understands how to detect changes such as lumps in her breast? Select all that apply.
A. “I should perform BSE one week prior to the start of my period.”
B. “When I reach menopause, I will perform BSE every two months.”
C. “Knowing the texture and feel of my breasts is important.”
D. “I should inspect my breasts in a circular manner.”
E. “I should inspect my breasts while in a supine position, with my arms at my sides.”
C, D
What is the best indicator that the client is experiencing menopause?
A. No menses for 8 consecutive months
B. Hot flashes and night sweats
C. High serum FSH with low serum estrogen
D. Diagnosed with osteoporosis 4 months ago
C
A 63-year-old female client requests information about complementary and alternative therapies that promote wellness during menopause. Which therapies should the nurse recommend?
A. Non-weight-bearing exercise, such as swimming.
B. Increased consumption of phytoestrogens (i.e., plant products with estrogen properties) for women with a history of endometriosis or fibroids.
C. Calcium intake of 600 mg per day to help prevent osteoporosis.
D. Soy for reducing insomnia symptoms.
D
The nurse is presenting a session on intimate partner violence. Which statement indicates a need for further education?
A. “My daughter is not to blame for the violence in her marriage.”
B. “Everyone experiences anger and hitting in a relationship.”
C. “Abusers can be either husbands or boyfriends or girlfriends.”
D. “The honeymoon period follows an episode of violence.”
B
When a woman who has been raped is admitted to the emergency department, which nursing intervention has priority?
A. Explain exactly what will need to be done to preserve legal evidence.
B. Assure the woman that everything will be all right.
C. Create a safe, secure atmosphere for the woman.
D. Contact family members.
C
The nurse in the obstetrical clinic is setting appointments for clients seeking pre-conceptual care. Which client should be seen first?
A. A 36-year-old female who has never been pregnant. She takes medication for a seizure disorder.
B. A 15-year-old female who smokes one pack per day. She had a miscarriage four months ago.
C. A 22-year-old female who runs long distances. She has been on the pill for six years.
D. A 29-year-old female who has had two abortions. She takes a multiple-vitamin supplement.
A
While teaching a preconception class, the nurse should include which of the following recommendations concerning intake of vitamins during pregnancy?
A. Take a daily supplement of folic acid daily to reduce the risk of trisomy 21 (Down syndrome).
B. The pregnant woman should consult the recommended dietary allowance (RDA) guidelines regarding vitamins.
C. Take Vitamin C daily to reduce the risk of neural tube defects.
D. The pregnant woman should consume the greatest quantity of vitamins possible.
B
A 38-year-old woman with no prior pregnancies calls the clinic to inquire about preconception counseling. Which element of early prenatal education should the nurse expect to facilitate?
A. Availability of prenatal and genetic testing
B. Birth choices
C. Infertility counseling
D. Nutrition classes
A
A client comes to the clinic for birth control, while reviewing the history the client tells the nurse that she has had Toxic shock syndrome (TSS). Which forms of birth control should the nurse teach the client to avoid? Select all that apply.
A. Depo-Provera B. Sponge C. Vaginal condom D. Ring E. Intrauterine device (IUD)
B, C
A woman who was raped three months ago comes to the family practitioner for a ruddy rash on the palms of her hands and soles of her feet, and flulike symptoms. When taking a history, the nurse discovers history of rape and last month the woman had a small painless lesion that went away. The nurse is to administer 2.4 million units of Penicillin G intramuscularly. The medication is available as 1,200,000 units per milliliter (mL). How many milliliters (mLs) should the nurse administer?
A. 0.50 mLs
B. 0.2 mLs
C. 0.20 mLs
D. 2 mLs
D
The nurse is auscultating fetal heart tones in a client who is 37 weeks’ gestation. While in a supine position, the client states, “I’m getting lightheaded and dizzy, and I feel clammy.” Which of the following nursing actions is most appropriate?
A. Place a wedge beneath the client’s right hip.
B. Prepare for administration of packed red blood cells (PRBCs).
C. Help the client turn onto her right side.
D. Administer supplemental oxygen.
A
The client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy, but her underweight friend was told to gain more weight. The nurse should tell the client that recommended weight gain during pregnancy should be:
A. 25 to 35 pounds, regardless of a client’s pre-pregnancy weight.
B. More than 25 to 35 pounds for an overweight patient.
C. More than 25 to 35 pounds for an underweight woman.
D. The same for a normal-weight woman as for an overweight woman.
C
The nurse is reviewing the assessment findings of a client who is 35 weeks’ gestation. Which of the following data suggests the need for further investigation?
A. Melasma gravidarum
B. Pseudoanemia
C. Funic souffle
D. Glycosuria
D
