OB and mental 3

Question 1

Instructing a pt how to perform kick counts. Which statement needs extra teaching?
a) I will record the number of movements or kicks
b) I need to lie flat on my back
c) If I count fewer than 10 kicks in a 2hurs, it could be because my baby is sleeping
d) I need to place my hands on the largest part of my abdomen and concentrate on the total movements to count

Answer 1

b
lying flat on the back is not necessary. This could make them discomfort and presnt risk odf vena cava syndrome

Question 2

Disseminated intravascular coagulation (DIC)
a) what is it?
b)OB risk factors

Answer 2

a) clotting proteins become overactive, causing organ damage and uncontrollable bleeding
b) Placental abruption
Amniotic fluid embolism
HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets)
Retained stillbirth
Preeclampsia/eclampsia

Question 3

A client with severe psoriasis has a problem of chronic low self-esteem. The nurse would incorporate which nursing action when working with this client?
a) Listening attentively
b) Keeping communications brief
c) Approaching the pt in a formal manner
d) Avoiding looking at the affected skin areas

Answer 3

a

Question 4

Therapeutic response
Do not say “ I understand how you feel” because there is no way of knowing or understanding their feelings unless they states their feelings
Reconizeing feelings

Question 5

What is some common discoumfort with pregnent?

Answer 5

Increased estrogen level can increase risk of capillary bleeding
more frequent nosebleeds
gingivitis that leads to bleeding gums
nasal congestion

Question 6

a) Itching, frothy grey vaginal discharge?
b) chlamydia
c) Which STD is reportable?

Answer 6

a) Trichomoniasis
b) usually asymptomatic until the infection has progressed to cause pelvic inflammatory disease
c) chlamydia, gonorrhea, syphilis, and chancroid

Question 7

A pt with an obsessive-compulsive ritual. The nurse recognizes the pt is attempting to achieve which outcome?
a) Control other people
b) Increase self-esteem
c) Avoid severe levels of anxiety
d) Express and manage aniety

Answer 7

c

Question 8

A pt with bipolar manic with combative behavior. Which is the priority nursing action?
a) provide adequate hygiene and nutrition
b) decrease environmental stimuli
c) Slowly involved the pt in unit activities
d) Administer and monitor sedative and mood-stabilizing medications

Answer 8

d
Because this pt in in an aggressive phase. It is most important to gain control.

Combative behavior = aggressive and eager to fight or argue.

Question 9

a) Sildenafil, which med is a contraindication?
b) sustained?
c) obtunded
d) Branden scale score

Answer 9

a) Isosorbide dinitrate(nitrate) cause hypotension
b) 持続した
c) lethargy
very high 12 or lower
high 13-14
low grater than 18

Question 10

a) stage 1 pressure injury?
b) stage 2 pressure injury?
c) what is non-blanchable skin?

Answer 10

a) non-blanchable redness
b) a blister or break in the skin
c) when we press the skin, the redness would not go away

Question 11

Which intervention is appropriate for the nurse to perform during a vaginal birth when the HCP notes shoulder dystocia?SATA
a) Apply fundal pressure during contractions to assist the mother in her efforts to push during uterine contractions.
b) Apply pressure downward, superior to the symphysis pubis.
c) Place the client’s legs in a flexed position against the abdomen
d) Coordinate with the healthcare team to assist with a forceps-assisted birth.
e) Immediately perform the Leopold maneuver on the client.
f)Record the exact time that the shoulder is delivered during childbirth

Answer 11

b,c,f
McRoberts’ maneuver
Leg flexed
presser applied to the fetal anterior shoulder

Question 12

A client who is newly diagnosed with an autoimmune disease about prescribed cyclosporine. The client also has a history of type 1 diabetes mellitus (DM).

➤Which client statement indicates the need for additional instruction?
a) I know that this medication can affect my blood glucose levels
b) I should not visit my dentist on a regular basis while on this medication.
c)I should not get any vaccines without speaking with the health care provider.”
d) It is important that I do not abruptly stop taking this medication.”

Answer 12

b
s/s swollen and inflamed gums; regular dental visits and good oral hygiene are essential

Question 13

The cycle of violence
What is the 3 phase?

Answer 13

1st Tension-building phase
Judgmental, threatening, feels like walking on the egg shells
2nd Explosion phase(an acute battering) Harm!
3rd Honeymoon

Question 14

To differentiate between caput succedaneum and cephalohematoma in a newborn
a) Cephalohematoma manifests as a localized area of swelling as compared with caput succedaneum, which appears as a general swelling of the head.
b) A cephalohematoma can develop several hours or days after the birth event, whereas caput succedaneum is noted shortly before or immediately after the birth event.
c) Edema that crosses suture lines is observed with caput succedaneum.
d) With a cephalohematoma, bleeding occurs between the bone and skull.

Answer 14

b,c,d

Question 15

Which are early signs of hypoglycemia in the newborn for which the nurse should assess? SATA
a. Jitteriness
b. Poor feeding
c. Respiratory difficulty
d. An increase in temperature
e. A capillary refill of 2 seconds

Answer 15

a,b,c
a-anxiety
d-decrease

Question 16

Which action does the nurse take to utilize milieu therapy when providing care to the client?
a) Provide a consistent set of activities and responsibilities for each pt.
b) Ask the family to bring in items from home to recreate the home environment
c) Use therapeutic communication with other staff members to foster community
d) Set consistent limits on pt behaviors

Answer 16

a
pts are encouraged to take responsibility for various tasks and to participate in activities that allow them to develop healthy social behaviors
pt’s environment is controlled or manipulated in an attempt to prevent destructive behavior
b
the goal is to develop new patterns of behavior

Question 17

A postpartum pt is diagnosed with cystitis. Which is priority care?
a) Providing sits baths
b) Encouraging fluid intake
c) Placing ice on the perineum

Answer 17

b
a and c for perineal discomfort

Question 18

A pt with a small vulvar hematoma. The nurse would include which specific action during the first 12 hrs to deliver

a) Encourage ambulation hourly
b) Assess viral q4hrs
c) Measure fundal height every 4hrs
d) Prepare an ice pack for application to the area

Answer 18

d
Localized collection of blood(can occur internally)
sever pain, presser

Question 19

A pt who delivered 1 hr ago and received epidural anesthesia. for the presence of vulvar hematoma. What assessment findings would best indicate the presence of a hematoma?
a) change in vital
b) sign of heavy bruising
c) intense pain
d) tearing sensation

Answer 19

a
because the pt cannot feel pain, or pressure d/t anesthesia
change in vital indicates hypovolemia