Kaplan Maternity test A

The nurse instructs a client who recently had a modified radical mastectomy . The nurse explains it is very important for the client to exercise the affected arm . Which statement by the nurse is the most important reason for the client to exercise the arm ?

1. Increases muscle strength and diameter .

2. Maintains body balance .

3. Limits full range of motion .

4. Prevents lymphedema .

4. Prevents lymphedema .

A primigravida client diagnosed with type 1 diabetes mellitus reviews the insulin regimen with the nurse . The nurse explains which changes in insulin requirements will occur in pregnancy ?

1. Insulin requirements will increase during pregnancy and decrease after delivery .

2. Insulin requirements will decrease during pregnancy and increase after delivery .

3. Insulin requirements will increase during pregnancy and remain increased after delivery .

4. Insulin requirements decrease during pregnancy and remain decreased after delivery .

1. Insulin requirements will increase during pregnancy and decrease after delivery .

A pregnant client comes to the clinic . The client questions the nurse about the amount of exercise that is acceptable during the pregnancy . Which is the most important response by the nurse ?

1. " You can continue your activities but rest when you get tired .

2. " You should take a brisk walk daily . "

3. " You can exercise as much as you want but limit household activities . "

4. " What is your usual type of exercise ? "

4. " What is your usual type of exercise ? "

The nurse identifies which pregnant woman as most likely to have a problem with Rh incompatibility with the fetus ?

1. An Rh - positive client who conceived with a Rh - negative partner and has two children who are Rh - positive .

2. An Rh - negative client who conceived with a Rh - positive partner and gave birth 3 years ago to an Rh - positive infant .

3. An Rh - positive client who conceived with a Rh - positive partner , who previously aborted a fetus at 12 weeks gestation .

4. An Rh - negative client who conceived with a Rh - negative partner and never received Rho ( D ) immune globulin .

2. An Rh - negative client who conceived with a Rh - positive partner and gave birth 3 years ago to an Rh - positive infant .

A client comes to the prenatal clinic for the first visit . The nursing history reveals the client's last menstrual period was five months ago , and the client is certain of pregnancy , and reports feeling the baby move . Which response by the nurse is best ?

1. " Since you have felt fetal movement , I am sure that you are pregnant . "

2. " Lie down so that I can listen for fetal heart tones with the Doppler . "

3. " We'll collect a urine specimen for testing to confirm that you are pregnant . "

4. " Have you noticed feeling more fatigued lately ? "

2. " Lie down so that I can listen for fetal heart tones with the Doppler . "

The nurse in the prenatal clinic assesses a client at 31 weeks gestation . The client's blood pressure is 150/96 , serum albumin level is 3 g / dL ( 30 g / L ) , 3+ protein is found in the urine , and the client's face and hands are edematous . Which instruction by the nurse is most important ?

1. The client should decrease caloric intake .

2. The client should eliminate all salt from the diet .

3. The client should ensure adequate protein .

4. The client should increase the intake of iron .

3. The client should ensure adequate protein .

The nurse monitors a client at 30 weeks gestation , and the client reports periodic heartburn . It is most important for the nurse to make which recommendation ?

1. Lie down after eating a meal .

2. Eat frequent small meals .

3. Take sodium bicarbonate as needed .

4.Sip milk in between meals .

2. Eat frequent small meals .

The nurse provides care for a client after an abdominal hysterectomy . The client asks when the indwelling urinary catheter will be removed . Which statement by the nurse is most appropriate ?

1. " You will keep the catheter until you develop a temperature . "

2. " You will have the catheter until discharge so that we can measure your output accurately . "

3. " The catheter is removed as soon as you are able to ambulate . "

4. " The catheter will be removed when there is no further bleeding from the bladder . "

3. " The catheter is removed as soon as you are able to ambulate . "

The nurse provides care for a client in labor . The fetus is displaying occasional category 2 fetal heart rate patterns on the monitor . Which is the first action for the nurse to perform ?

1. Immediately call the health care provider .

2. Time the contractions from the beginning of one contraction to the beginning of the next contraction .

3. Have the client roll onto the right side and take deep breaths .

4. When the fetal heart rate is baseline perform fetal stimulation to assess for heart rate acceleration .

4. When the fetal heart rate is baseline perform fetal stimulation to assess for heart rate acceleration .

The nurse provides education on increasing dietary iron to a client diagnosed with anemia . The nurse recommends the client eat which food ? ( Select all that apply . )

1. Chicken livers .

2. Pork chop .

3. Hamburger .

4. Bananas .

5. Spinach .

6. Tofu .

1. Chicken livers .

5. Spinach .

6. Tofu .

A client in active labor suddenly shouts , " I have to push ! I have to push ! " The nurse determines the client is 8 cm dilated . Which action does the nurse take first ?

1. Instructs the client to take a deep breath and bear down .

2. Applies pressure to the client's fundus .

3. Coaches the client in relaxation techniques .

4. Encourages the client to pant with pursed lips .

4. Encourages the client to pant with pursed lips .

The nurse assesses four newborns . Which characteristics noted by the nurse are most common in a preterm infant ?

1. Red , wrinkled skin , lanugo , and hypotonic muscles .

2. Vernix caseosa , silky hair , and facial edema .

3. Absent nose bridge , depressed fontanels , and absent lanugo .

4. Mottled skin , meconium stools , and hypertonic muscles .

1. Red , wrinkled skin , lanugo , and hypotonic muscles .

Click to highlight the information in the nurse's notes that most concerns the nurse . 0900 : Client is a G4 T1 P0 A2 L1 with history of 2 elective abortions . Client has received no prenatal care and is uncertain about her estimated date of conception ( EDC ) . Client believes that she conceived while breastfeeding her last child; estimates current gestation is 32 weeks . A moderate amount of bright red vaginal blood is noted . Client is crying loudly and asking for someone to call her partner . States , " I don't understand why I'm bleeding! Nothing hurts at all . Fetal heart tones at 148 beats / minute with fetal activity palpable externally . 0945 : Abdominal ultrasound complete . Client transported to Obstetrics unit .

received no prenatal care ✓

uncertain about her estimated date of conception ( EDC ) ✓

current gestation is 32 weeks ✓

A moderate amount of bright red vaginal blood is noted ✓

Nothing hurts at all ✓

A client is in active labor . As labor progresses , the client becomes irritable and reports feeling increasingly uncomfortable . The client is 8 cm dilated . Which action does the nurse take first ?

1. Contacts the health care provider .

2. Coaches the client in proper breathing and relaxation techniques .

3. Administers an analgesic .

4. Removes the fetal monitor to allow the client to move around

2. Coaches the client in proper breathing and relaxation techniques .

Complete the following sentence by choosing from the list of options . The nurse recognizes the client is likely exhibiting

placenta previa as evidenced by painless vaginal bleeding

An abdominal ultrasound indicates that the placenta is partially covering the cervix . The client is admitted to the obstetrics unit and the physician writes several orders . Which intervention does the nurse question ? ( Select all that apply . )

1. Vaginal assessment of cervical dilatation .

2. Type and cross 2 units of packed red blood cells .

3. Continuous external fetal monitoring .

4. Maintain client as NPO .

5. Encourage activity as tolerated .

6. Start an IV of D & W at 125 mL / hour .

7. Insert an indwelling urinary catheter

1. Vaginal assessment of cervical dilatation .

5. Encourage activity as tolerated .

The nurse from the Neonatal Intensive Care Nursing ( NICU ) meets with the client and partner to explain the challenges and possible care interventions for the baby in the event the child is delivered before 36 weeks gestation . Which information is correct for the NICU nurse to discuss with the client ? ( Select all that apply . )

1. The baby might have breathing problems and need supplemental oxygen by cannula .

2. The baby might require medications and may need insertion of an umbilical IV line .

3. The baby might have trouble staying warm and implementation of Kangaroo care will help with thermoregulation .

4.The baby may have trouble regulating its glucose , so we may give glucose water after every feeding to combat hypoglycemia .

5. The baby might become jaundiced and may need phototherapy .

1. The baby might have breathing problems and need supplemental oxygen by cannula .

2. The baby might require medications and may need insertion of an umbilical IV line .

3. The baby might have trouble staying warm and implementation of Kangaroo care will help with thermoregulation .

5. The baby might become jaundiced and may need phototherapy .

The nurse assesses the client's vital signs . The client has a sudden increase in vaginal bleeding and dropping baseline in the fetal heart tones ( FHT ) with late decelerations noted . Complete the following sentences from the lists of options .

The nurse immediately applies oxygen by mask at 5 L / minute . It is a priority for the nurse to turn the client onto the left side The nurse will increase the IV rate to wide open ( 1pt ) . The nurse ensures the amount of bleeding is measured ✓

The nurse instructs a client how to prevent conception using the basal body temperature ( BBT ) method . The nurse explains that during ovulation , the basal body temperature will change in which direction ?

1. Lowers significantly .

2. Rises significantly .

3. Is unchanged .

4. Rises slightly .

4. Rises slightly .

When the nurse accidentally bumps into a newborn's bassinet , the newborn jumps and pulls the extremities into the trunk . The nurse identifies the newborn is demonstrating which reflex ?

1. Tonic neck .

2. Moro .

3. Babinski .

4. Rooting .

2. Moro .

The nurse prepares a client for a gynecological examination . The nurse explains that a pelvic examination will be performed and a Pap smear obtained . The nurse gives the client which information about the Pap smear ?

1. It is taken from exudates of the vagina and cervix .

2. It is a sample of tissue used to locate a lesion .

3. It is an x - ray film taken from various angles .

4. It is a scraping of the cervix used to identify abnormal cells .

4. It is a scraping of the cervix used to identify abnormal cells .

An infant shows a tendency to bleed two days after birth . The nurse understands this is most likely caused by which reason ?

1. Hemophilia .

2. Absence of intestinal bacteria and lack of vitamin K.

3. An immature liver that is unable to synthesize clotting factors .

4. Delayed production of red blood cells .

2. Absence of intestinal bacteria and lack of vitamin K.

A client is prescribed a colposcopy . The nurse tells the client which information about the purpose of this procedure ?

1. Magnifies the tissue for examination .

2. Directly examines ovaries , fallopian tubes , uterus , and small intestine .

3 . Views structures in the pelvic cavity .

4. Visualizes the bladder .

1. Magnifies the tissue for examination .

The nurse assesses an apical pulse on a 8 lb 4 oz ( 3742.14 g ) newborn infant . The nurse takes which action ?

1. Places the diaphragm of the stethoscope between the left nipple and the sternal notch .

2. Places the diaphragm of the stethoscope between the second and third intercostal spaces at the left midaxillary line .

3. Places the bell of the stethoscope at the fourth intercostal space at the left midclavicular line .

4. Places the bell of the stethoscope between the second and third intercostal spaces at the left sternal border .

3. Places the bell of the stethoscope at the fourth intercostal space at the left midclavicular line .

A client reports experiencing weight gain and muscle cramps during the menstrual period . The nurse suggests which measures to the client to alleviate these symptoms ?

1. Use a mild analgesic , restrict caffeine , exercise moderately .

2. Avoid analgesics , rest frequently , drink herbal tea .

3. Restrict fluid intake , exercise moderately , increase caffeine .

4. Restrict sodium intake , avoid exercise , use sedatives .

1. Use a mild analgesic , restrict caffeine , exercise moderately .

A client had a cesarean delivery . The nurse places the priority on monitoring the client for which potential complication ?

1. Infection and pain .

2. Hemorrhage and shock .

3. Hemorrhage and pain management .

4. Dehydration and infection .

2. Hemorrhage and shock .

The nurse understands which medication is most likely to be prescribed for a client with a diagnosis of gonorrhea ?

1. Penicillin vaginal suppositories

2. Penicillin G benzathine intramuscularly in divided doses once a week .

3. Ceftriaxone IM plus doxycycline for seven days by

4. Ampicillin by mouth .

3. Ceftriaxone IM plus doxycycline for seven days by mouth .

The nurse assesses an infant born by vaginal delivery . At birth , the infant is crying and moving all extremities , and respirations and pulse rate are good . One minute after birth , the baby is noted to have slightly cyanotic extremities . At five minutes after birth , the extremities are pink . Which is the Apgar score for the baby at one minute and five minutes ?

1.)8 and 9 , respectively .

2.)7 and 10 , respectively .

3.) 9 and 10 , respectively .

4.)7 and 9 , respectively .

3. ) 9 and 10 , respectively .

The nurse ambulates a postpartum client to the bathroom for the first time after the client gave birth three hours ago . The client reports feeling a sudden gush of bleeding from the vagina while ambulating . Which is the most likely cause of the bleeding ?

1. Lochia has pooled in the client's vagina .

2. A cervical tear needs to be repaired .

3. The fundus is relaxed and requires massaging .

4. The client may have bladder distention and needs to void .

1. Lochia has pooled in the client's vagina .