ticket ins 353 Flashcards
1
Q
formation of a viable zygote
A
conception
2
Q
the union of a spermatozoal nucleus with an egg nucleus to form a primary nucleus of an embryo
A
fertilization
3
Q
the formation and development of germ cells, oocytes and spermatocytes
A
gamestogenesis
4
Q
the period of development in the uterus from conception until birth
A
gestation
5
Q
a process that interferes with the normal process of ovulation, fertilization and implantation
A
contraception
6
Q
What is the term for the innermost layer of the uterine wall , the lining where the fertilized ovum implants?
A
Endometrium
7
Q
In order to place a catheter, the nurse must visualize the female urethra.
Which phrase best describes where the female urethral opening is located?
A
between the clitoris and the vaginal opening
8
Q
Where, in the female anatomy, does fertilization typically occur?
A
Ampulla of fallopian tube
9
Q
At approximately 3 weeks after conception, the fertilized ovum differentiates into THREE primary germ layers. All of the fetal tissues and organs develop from these three germ layers.
What is the middle germ layer called and what does this middle layer give rise to?
A
Mesoderm; bones, muscles, cardiovascular system
10
Q
In a healthy pregnancy, maternal and fetal blood never mix.
Where in the placenta - on a microscopic level - does the transfer of oxygen and nutrients occur between mother and fetus?
A
Intervillous space
11
Q
Increased vascularity in the vaginal mucosa and cervix which results in violet-bluish color
A
chadwick sign
12
Q
The first recognition of fetal movements by the mother
A
quickening
13
Q
The capacity to live outside of the uterus
A
viability
14
Q
Approximate increase in blood volume during pregnancy, above nonpregnancy levels
A
1500ml or 40-50%
15
Q
A pigmented line extending from the symphysis pubis to the top of the fundus
A
linea negra
16
Q
The normal baseline heart rate in a full-term fetus is between 110 and 160 beats per minute.
A
110
160
17
Q
During fetal monitoring, which monitor is able to detect and record the frequency, duration and intensity of contractions?
A
Intrauterine pressure catheter (IUPC)
18
Q
The nurse observes the fetal monitor and notes that the fetal heart rate baseline is 135 beats/min, with moderate variability, no decelerations and occasional accelerations.
According to the Three-Tier FHR Classification System, how would the nurse document this fetal heart rate tracing?
A
Category 1
19
Q
What is the fetal heart rate baseline in the tracing?
A
140 beats per minute
20
Q
This maternal labor position can help relieve “back labor,” often caused by a fetus in the “occiput posterior” position of the presenting part.
A
Hands and Knees position
21
Q
This type of anesthesia is a nerve block, typically administered in the second stage of labor; it does not change maternal vital signs or fetal heart rate status.
Although the patient can still feel contractions, this method relieves pain in the vagina and perineum.
A
Pudendal
22
Q
The nurse recognizes that a client is in true (versus false) labor when the client states:
A
“My contractions are now stronger and closer together.”
23
Q
When planning care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman’s risk for _________________________ has increased.
A
Infection
24
Q
The baby is born and the nurse assists with facilitating mother-baby skin-to-skin contact, while the provider watches for signs that the placenta is ready to deliver.
What stage of labor is this?
A
third
25
A nurse is completing the admission assessment of a client who is at 38 weeks gestation and has severe preeclampsia.
Which one of the following findings is consistent with the diagnosis of severe preeclampsia?
Epigastric pain
26
A nurse in a prenatal clinic is reviewing results from recent one-hour oral glucose tolerance tests.
Which one of the 4 pregnant clients needs to be scheduled for a follow-up, diagnostic three-hour glucose tolerance test?
One hour GTT result: 160 mg/dl
27
A nurse is caring for a client at 30 weeks gestation who has just been diagnosed with gestational diabetes.
The client has a lot of questions about the risks to her baby with GDM.
What is the best explanation by the nurse for why her fetus is at risk for macrosomia and hypoglycemia at delivery?
Extra sugar (glucose) can cross the placenta to your baby. This may cause your baby to gain extra weight and to have sudden low blood glucose after birth.
28
Why is magnesium sulfate is given to women with preeclampsia and eclampsia?
To prevent and treat convulsions
29
A nurse is assessing a patient with preeclampsia who delivered 12 hours ago.
Which of the following assessments would indicate that the condition has not yet resolved?
patient complaints of blurred vision and headache
30
Preterm labor is defined as uterine contractions and cervical change that happens between ____ and ____ weeks gestation.
20 and 37
31
The nurse is assessing these prenatal clients in the prenatal clinic today.
Which of these pregnant clients would the nurse identify as at risk TODAY for preterm labor and birth?
Select all that apply
Becca, a 40-year-old G1 P0000 at 20 weeks gestation currently pregnant with triplets
Ava, a 30-year-old G4 P0303 at 32 weeks gestation with documented cervical length of 20mm
32
Ava calls the clinic nurse on call later that night and states, “I’ve been feeling crampy all evening, there’s more pressure ‘down there’ and it seems like I have to pee more frequently.”
What is the best response by the nurse?
“Empty your bladder now, drink 2-3 glasses of water and rest for an hour. Call me if the cramping is still happening after all that.”
33
Ava comes to the hospital later that night, stating, “I’m having contractions every 3 minutes!” The nurse places Ava on the fetal monitor and her contractions are, indeed, every 3 minutes, lasting approximately 50-60 seconds and moderate intensity per palpation.
What type of medication order from the provider does the nurse anticipate?
Tocolytic
34
Ava’s contractions have subsided but the sterile vaginal exam reveals that her cervix is dilated 2cm/80%/-1. At 32 weeks gestation, the nurse and provider know that it is too early for delivery.
What medication may be ordered to help the fetal lungs mature, just in case delivery does happen early?
Betamethasone
35
The nurse is caring for a client who sustained a third degree vaginal laceration during delivery.
Which description best defines the extent of this injury to the perineum?
It involves the anal sphincter.
36
A 25-year-old multiparous woman gave birth to an infant boy 1 day ago.
When the nurse brings the client snacks including ice water, a popsicle and crackers, the client's partner states, "We try to avoid cold food and drink after giving birth. If you could bring her some warm tea, that's better for healing."
What is the nurse's most appropriate response?
"Thanks for letting me know. I'll be right back with some warm tea and soup."
37
A client delivered a 7 lb 9 oz newborn by spontaneous vaginal delivery three hours ago.
The nurse assesses the client and notes that her fundus is soft, to the right of the midline and two fbs (fingerbreadths) above the umbilicus. How should the nurse intervene?
Encourage the client to void, then reassess her fundus.
38
A nurse is providing instructions to a mother who has been diagnosed with mastitis.
Which of the following statements, if made by the mother, indicates a correct understanding of the condition?
"I need to take these antibiotics until they are gone."
39
On a busy postpartum unit, a nurse has 4 couplets (mom-baby clients).
Which task could the nurse appropriately delegate to the unlicensed assistive personnel (UAP) on the postpartum floor?
Assist a client with ambulation
40
The nurse is preparing to discharge a mother who delivered a healthy newborn at term 2 days ago.
The patient has decided to bottlefeed her baby. What is especially important for the nurse to teach her regarding the care of her breasts?
She should wear a supportive bra and apply ice packs to both breasts to decrease engorgement.
41
A new father calls the hospital's maternal-newborn hotline and states that his wife is 5 weeks postpartum.
He is concerned because, in the last 2 or 3 days, she has reported hearing voices "telling her scary things about the baby" and he found a knife under her pillow. The nurse's most appropriate response is:
Go to the local hospital emergency department immediately
42
A nurse is assessing a client who delivered a healthy infant by c-section for signs and symptoms of superficial venous thrombosis.
Which of the following signs or symptoms would the nurse note if a superficial venous thrombosis were present?
Redness and swelling in the calf of one leg
43
The MOST important key to establishing and maintaining milk production is:
Frequent and effective milk removal
44
The composition of breast milk changes over time according to an infant's needs and growth spurts.
yes
45
A newborn’s hands and feet are blue. What term is usually used for this common and temporary condition?
Acrocyanosis
46
Which nursing intervention is appropriate when caring for an infant who has hyperbilirubinemia and is receiving phototherapy?
Place eye shields over the newborn's closed eyes
47
What is the cheeselike, wihitish substance that fuses with the epidermis and serves as a protective coating on newborns?
Vernix caseosa
48
What is the reason that vitamin K is administered to a newborn?
Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract
49
Which of the following is a safe method to remove the breast from the infant’s mouth?
Break the suction by inserting your finger into the corner of the infant's mouth
50
When teaching a young couple about the appropriate use of a latex male condom, which statement, if made by the couple, indicates the teaching was effective?
“I need to use a water-based lubricant, like KY jelly.”
51
Which statement is true regarding patient teaching about the IUD contraceptive?
There are 2 types of IUDs: hormonal and non-hormonal.
52
Which one of the following statements about Emergency Contraception (EC) is TRUE?
EC can be given up to 5 days after a single incidence of unprotected intercourse.
53
Menopause is medically defined as which of the following?
Cessation of menstrual cycles for 12 months or longer
54
Regarding combined (estrogen, progesterone) oral contraceptives, the nurse should be aware that which potential adverse condition dictates contraindications and client teaching about warning signs?
blood clots
55
A nurse is caring for a client who is terminally ill and exhibiting signs of impending death. The client’s medical record states that the client is a practicing Roman Catholic. Which of the following nursing actions is appropriate?
Offer to make arrangements for the Sacrament of the Sick
56
A nurse is developing a plan of care for a client who practices Islam. Which of the following actions should the nurse include in the plan?
Request a meal tray without pork
57
A nurse is about to explain a therapeutic procedure to a client who doesn’t speak the same language as the nurse. Which of the following actions should the nurse take?
Have a medical interpreter present during the teaching
58
A nurse is providing dietary teaching for a client who is Asian-American and is gazing at the floor during the instructions. Which of the following actions should the nurse take to demonstrate culturally sensitive nursing care?
Continue with the discussion
59
A nurse notices an assistive personnel (AP) preparing to deliver a food tray to a client who practices the Orthodox Jewish faith. On the tray is a roast beef dinner with nonfat milk. Which of the following actions should the nurse take?
Call the dietary department and ask for a kosher tray
60
The nurse manager of a pediatric clinic could confirm that the new nurse recognized the purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is used to assess for needs related to:
anticipatory guidance
61
The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, the expected stage of development for a preschooler is:
preoperational
62
The school nurse talking with a high school class about the difference between growth and development would best describe growth as:
quantitative changes in size or weight
63
The most appropriate response of the nurse when a mother asks what the Denver II does is that it:
is a developmental screening tool
64
To plan early intervention and care for a child with a developmental delay, the nurse would consider knowledge of the concepts most significantly impacted by development, including:
functional status
65
A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks to her toys and makes up stories. The mother wants her child to have a psychological evaluation. The nurse’s best initial response is to:
explain that playing make believe is normal at this age
66
Sits without assistance
9 months
67
Laughs freely
4 months
68
Uses 2 fingers to pick up peas
12 months
69
Feeds self with spoon
18 months
70
Recognizes parents and nanny
6 months
71
What is the term for the toddler's need to maintain sameness and reliability which provides a sense of comfort?
HINT: You may wish to know all of these terms in your studying for your exam.
Ritualism
72
What are the major characteristics of a child with Down syndrome? (Select all that apply)
Hyperflexibility and muscle weakness
High arched, narrow palate
Oblique palpebral fissures
Small nose
73
What is the earliest age that an infant might begin having fear of strangers (stranger anxiety)?
6 months
74
Many toddlers have problems with bedtime resistance. What is the best action to reduce this issue?
Establishing a regular bedtime routine
75
In terms of development, what should the 3-year-old child be expected to do?
Copy a circle
76
Which of the following is a description of how a preschooler understands time?
Associates time with events
77
What is the age that children begin puberty?
10-year-old girls, 12-year-old boys
78
Which statement best describes the cognitive ability of school-age children?
ability to reason abstractly
able to classify, group, and sort thoughts and ideas
79
Which of the following represents a characteristic of a child with autism spectrum disorder (ASD)? (Select all that apply)
Inability to maintain eye contact with another person
Repetitive motor mannerisms
80
Which aspect of cognition develops during adolescence?
Capability to use a future time perspective
81
Which predisoses the adolescent to feel an increased need for sleep?
Rapid physical growth
82
Which therapeutic management of attention deficit hyperactivity disorder (ADHD) has been found to be the most effective?
Multimodal treatment
83
When assessing the young adult for risk factors that contribute to mortality and morbidity, which of the following is most likely a leading contributing factor?
Repeated exposure to violence
84
For young adults there are several hallmark indicators for emotional health, which assessment indicates a need for further assessment?
Focuses on disappointments in life or in the past
85
A 55-year-old female presents to the outpatient clinic describing irregular menstrual periods and hot flashes. Which information should the nurse share with the patient?
The patient’s assessment points toward normal menopause.
86
A 50-year-old male patient is seen in the clinic. He tells a nurse that he has recently lost his job and his wife of 26 years has asked for a divorce. He has a flat affect. Family history reveals that his father committed suicide at the age of 53. The nurse assesses for the following
Depression
87
A nurse determines that a middle-aged patient is a typical example of the “sandwich generation.” What did the nurse discover the patient is caught between?
Caring for children and aging parents
88
A nurse is preparing a health promotion course for a group of middle adults. Which of the following strategies should the nurse recommend? (select all that apply.)
Screening for depressive disorders
Dexascan screening for osteoporosis
Eye examination every 1-3 years
89
Upon assessment of a middle-aged adult, the nurse observes uneven weight bearing and decreased range of joint motion. Which area is priority?
Fall Precautions
90
what is the major component of life transitions in the older adult?
loss
91
The suicide rate of which group is the highest in the United States?
White males over the age of 85
92
An older adult who is subject to threats, insults, harassment and isolation is receiving what kind of mistreatment?
psychosocial/emotional abuse
93
An example of therapeutic touch for the older age group includes all of the following except:
Patting someone on the head
94
Forgetfulness is an expected consequence of aging.
false
95
What primary prevention measures are appropriate to implement to maintain optimum mobility?
fall prevention measures
optimal nutrition
regular physical activity
96
The nurse will instruct the patient with a fractured left radius that the cast will need to remain in place:
For at least 3 weeks
97
A patient with a fracture of the left femoral neck has Buck’s traction in place while waiting for surgery. To assess for pressure areas on the patient’s back and sacral area and to provide skin care, the nurse should:
Have the patient lift the buttocks slightly by using a trapeze over the bed
98
A patient with a right lower leg fracture will be discharged home with an external fixation device in place. Which information will the nurse teach?
“Check and clean the pin insertion sites daily.”
99
After a motorcycle accident, a patient arrives in the emergency department with severe swelling of the left lower leg. Which action will the nurse take first?
Assess leg pulses and sensation
100
Which of the following is an advantage to using a plaster cast instead of a fiberglass (synthetic) cast?
molds closely to body parts
101
Which of the following statements is correct regarding the difference between children and adults in relation to fractures?
Children heal faster than in adults
102
Which of the following would be included in a teaching plan for a Pavlik harness? (Select all that apply)
Check skin every 8 hours under the straps for red areas
Gently message skin under straps daily to stimulate circulation
103
Which of the following would be included in a plan to teach parents about hip spica cast?
Hip spica cast will need to be changed every 6 weeks.
104
Which of the following is a manifestation of osteomyleitis?
Tachycardia
105
The nurse is caring for a patient in hospice. The nurse notes that the patient is getting adequate care, but the spouse is not sleeping well. The nurse also assesses the need for better family nutrition and meals assistance. The nurse discusses these needs with the patient and family and develops a plan of care with them using community resources. Which approach is the nurse using?
Family as system
106
A nurse is working with a patient. When the nurse asks about family members, the patient states that it includes my spouse, children, and aunt and uncle. How will the nurse describe this type of family?
Extended
107
A nurse is caring for a patient who needs constant care in the home setting and for whom most of the care is provided by the patient’s family. Which action should the nurse take to help relieve stress?
Provide education.
108
The Calgary Family Assessment Model (CFAM) is used to:
Assess a family's structure, development, and function
109
"Interelationships between and among individual family members", is the definition of:
Family dynamics
110
A family caregiver tells the home health nurse, “I feel like I can never get away to do anything for myself.”
Which action is best for the nurse to take?
Assist the caregiver in finding respite services.
111
When the nurse assesses the patient, they should include an assessment of the caregiver. An appropriate assessment question is:
What is your experience with being a caregiver?
112
For parent caregivers of children with lifelong disabilities, stressors include:
Fear of what will happen to their child if the child outlives their parents
113
Attributes of caregivers include:
Ability to care
Managing and coordinating health
care services
Serving as an advocate
Being a good listener
114
Signs of Caregiver stress include:
Social withdrawal and exhaustion
115
A 94 year old patient with congestive heart failure is receiving palliative care. Goals of palliative care include: (Select all that apply)
Help patients with chronic conditions live more comfortably
Prevent or treat the symptoms of the disease
Prevent or treat the psychological, social, and spiritual problems related to
the disease or treatment
116
One reason palliative care has become more prevalent in the United states is the fact that:
Leading causes of death in the United States are chronic diseases such as cardiovascular problems, COPD, cancer, and dementia
117
The home health nurse is providing palliative care to a 25 year old with metastatic bone cancer. Upon arrival the patient states his pain is at a level 8 (0-10 pain scale). Prioritizing care for the patient, the nurse decides to do what nursing intervention first?
Administer PRN pain medication
