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Which is the priority nursing action for a premature neonate who is experiencing
apnea?
a) Administering oxygen
b) Performing back blows and chest thrusts
c) Calling a code blue
d) Providing stimulation by stroking the back
Give this one a try later!
, D: Providing stimulation by stroking the back
The nurse is caring for an infant with abdominal contents protruding at the location of
the umbilicus. What statement differentiates between omphalocele and gastroschisis?
a) With omphalocele, the abdominal contents are not covered with a sac; with
gastroschisis, the abdominal contents are covered by a sac
b) With omphalocele, the abdominal contents are covered with a sac; with
gastroschisis, the abdominal contents are not covered by a sac
c) With omphalocele, the abdominal contents protrude into the base of the umbilical
cord; with gastroschisis, the abdominal contents protrude to the right of an intact
umbilical cord
d) With omphalocele, the abdominal contents protrude to the right of an intact
umbilical cord; with gastroschisis, the abdominal contents protrude into the base of
an umbilical cord
Give this one a try later!
C: With omphalocele, the abdominal contents protrude into the base of
the umbilical cord; with gastroschisis, the abdominal contents protrude to
the right of an intact umbilical cord
Which should the nurse include in a teaching session for the mother of a 3-year-old
client who is concerned about her child choking?
a) Show the mother how to do cardiac compressions and rescue breathing
b) Recommend the mother perform back blows and chest thrusts
c) Teach the mother how to perform abdominal thrusts
d) Tell the mother to do nothing until the child loses consciousness
Give this one a try later!
, C: Teach the mother how to perform abdominal thrusts
A pregnant woman is having a nipple-stimulated contraction stress test. Which result
indicates hyperstimulation?
a) There are more than five fetal movements in a 10-minute period.
b) There are more than three uterine contractions in a 6-minute period.
c) The fetal heart rate accelerates when contractions last up to 60 seconds.
d) The fetal heart rate decelerates when three contractions occur within a 10-minute
period.
Give this one a try later!
B: There are more than three uterine contractions in a 6-minute period.
A young child admitted to the pediatric unit has fever, irritability, and vomiting with
suspected bacterial meningitis. Which cerebrospinal fluid result should the nurse
anticipate based on these data?
a) Decreased protein count
b) Clear, straw-colored fluid
c) Positive for red blood cells
d) Decreased glucose level
Give this one a try later!
D: Decreased glucose level
Which maternal-child client should the nurse see first?
a) Blood type B, Rh-positive
b) Blood type O, Rh-negative
, c) Direct Coombs test positive
d) Indirect Coombs test negative
Give this one a try later!
C: Direct Coombs test positive
Which nursing diagnosis should the nurse include in the plan of care for an infant
diagnosed with acute bronchiolitis due to respiratory syncytial virus (RSV)?
a) Activity intolerance
b) Ineffective peripheral tissue perfusion
c) Acute pain
d) Decreased cardiac output
Give this one a try later!
A: Activity intolerance
Which is the priority nursing action when providing care to a pediatric client who is
diagnosed with hypovolemic shock?
a) Assessing the cause of bleeding
b) Establishing an open airway and administering oxygen
c) Administering analgesics for pain control
d) Providing replacement of volume
Give this one a try later!
B: Establishing an open airway and administering oxygen
Which is the priority nursing action for a premature neonate who is experiencing
apnea?
a) Administering oxygen
b) Performing back blows and chest thrusts
c) Calling a code blue
d) Providing stimulation by stroking the back
Give this one a try later!
, D: Providing stimulation by stroking the back
The nurse is caring for an infant with abdominal contents protruding at the location of
the umbilicus. What statement differentiates between omphalocele and gastroschisis?
a) With omphalocele, the abdominal contents are not covered with a sac; with
gastroschisis, the abdominal contents are covered by a sac
b) With omphalocele, the abdominal contents are covered with a sac; with
gastroschisis, the abdominal contents are not covered by a sac
c) With omphalocele, the abdominal contents protrude into the base of the umbilical
cord; with gastroschisis, the abdominal contents protrude to the right of an intact
umbilical cord
d) With omphalocele, the abdominal contents protrude to the right of an intact
umbilical cord; with gastroschisis, the abdominal contents protrude into the base of
an umbilical cord
Give this one a try later!
C: With omphalocele, the abdominal contents protrude into the base of
the umbilical cord; with gastroschisis, the abdominal contents protrude to
the right of an intact umbilical cord
Which should the nurse include in a teaching session for the mother of a 3-year-old
client who is concerned about her child choking?
a) Show the mother how to do cardiac compressions and rescue breathing
b) Recommend the mother perform back blows and chest thrusts
c) Teach the mother how to perform abdominal thrusts
d) Tell the mother to do nothing until the child loses consciousness
Give this one a try later!
, C: Teach the mother how to perform abdominal thrusts
A pregnant woman is having a nipple-stimulated contraction stress test. Which result
indicates hyperstimulation?
a) There are more than five fetal movements in a 10-minute period.
b) There are more than three uterine contractions in a 6-minute period.
c) The fetal heart rate accelerates when contractions last up to 60 seconds.
d) The fetal heart rate decelerates when three contractions occur within a 10-minute
period.
Give this one a try later!
B: There are more than three uterine contractions in a 6-minute period.
A young child admitted to the pediatric unit has fever, irritability, and vomiting with
suspected bacterial meningitis. Which cerebrospinal fluid result should the nurse
anticipate based on these data?
a) Decreased protein count
b) Clear, straw-colored fluid
c) Positive for red blood cells
d) Decreased glucose level
Give this one a try later!
D: Decreased glucose level
Which maternal-child client should the nurse see first?
a) Blood type B, Rh-positive
b) Blood type O, Rh-negative
, c) Direct Coombs test positive
d) Indirect Coombs test negative
Give this one a try later!
C: Direct Coombs test positive
Which nursing diagnosis should the nurse include in the plan of care for an infant
diagnosed with acute bronchiolitis due to respiratory syncytial virus (RSV)?
a) Activity intolerance
b) Ineffective peripheral tissue perfusion
c) Acute pain
d) Decreased cardiac output
Give this one a try later!
A: Activity intolerance
Which is the priority nursing action when providing care to a pediatric client who is
diagnosed with hypovolemic shock?
a) Assessing the cause of bleeding
b) Establishing an open airway and administering oxygen
c) Administering analgesics for pain control
d) Providing replacement of volume
Give this one a try later!
B: Establishing an open airway and administering oxygen
