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Family RN Final questions and answers solved solution

Family RN Final questions and answers solved solution 1 A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine 2 Complications and risks associated with cesarean births include (select all that apply): 3 The nurse is conducting a staff in-service on childhood blood disorders. Which describes the pathology of idiopathic thrombocytopenic purpura? 4 A nurse is planning to use an interpreter during a health history interview of a non-English speaking patient and family. Which nursing care guidelines should the nurse include when using an interpreter? Select all that apply 5 When caring for the child with Reye syndrome, the priority nursing intervention should be to 6 An appropriate nursing intervention when caring for an unconscious child should be 7 Metabolic changes throughout pregnancy that affect glucose and insulin in the mother and the fetus are complicated but important to understand. Nurses should know that: 8 A school nurse is conduction pediculosis capitis assessments. A child with a “positive” head check would have which of the following noted upon examination? 9 The nurse recognizes that a woman is in true labor when she states: 10 A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which medication for immediate administration? 11 A woman’s obstetric history indicates that she is pregnant for the fourth time, and all her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system? 12 An important nursing intervention when caring for a child who is experiencing a seizure would be to : 13 Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for: 14 A laboring woman received meperidine (Demerol) IV 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate? 15 HELLP syndrome is associated with an increased risk for adverse perinatal outcomes, including (select all that apply): 16 Nurses should know some basic definitions concerning preterm birth, preterm labor, and low birth weight. For instance: 17 Probable signs of pregnancy are: 18 A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman’s IV fluid for a preprocedural bolus. Prior to initiation of the epidural the woman should be informed regarding the disadvantages of an epidural block. They include all except: 19 The exact cause of preterm labor is unknown and believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Select the type of infection that has not been linked to preterm births: 20 A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2011. Her expected date of birth (EDB) is: 21 Ryan is an 11 month old with Down’s syndrome and Atrial Septal Defect. His parents report that Ryan has been lethargic and has had diarrhea the last 24 hours. His weight is 7 kg (15.4lb). His Vital signs are: • Temperature 36.5C (97.7F) rectal • Pulse 80 beats/minute • Respirations 35 breaths/minute • Pulse ox 95% on room air His lab results are: • Potassium 2.9 mmol/L • Digoxin 2.5 mg/mL 1. The nurse questions digoxin toxicity. What results support this? (Select all that apply). 22 Magnesium sulfate is given to women with preeclampsia and eclampsia to: 23 When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective is: 24 Five essential components of any fetal heart rate (FHR) tracing must be evaluated regularly. These include (select all that apply): 25 A child is admitted with acute glomerulonephritis. The nurse should expect the urinalysis during this acute phase to show: 26 Your client is being induced because of her worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active despite several hours of oxytocin administration. She asks the nurse, “Why is it taking so long?” The most appropriate response by the nurse is: 27 During a prenatal visit a nurse is explaining dietary management to a woman with pregestational diabetes. The nurse evaluates that teaching has been effective when the woman states: 28 Four-year-old David is placed in buck’s traction for Legg-Calve’ Perthes disease. He is crying with pain as the nurse assess that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first? 29 Pancreatic enzymes are administered to the child with cystic fibrosis (CF). Nursing consideration should include to: 30 The Physician ordered an IV fluid bolus to be followed by IV rehydration maintenance. The directions in the policy for rehydration maintenance are as follows: Give 100ml/kg for the first 10 kg, then give 50ml/kg for the next 10 kg and then give 20ml/kg for each of the remaining kg. The child weighs 36 kg. What will the nurse set the IV pump at (mL/hr)? (the pump functions at the tenth space) Incorrect answer: 3.5 General Feedback 1000 + 500 + = 1820/24= 75.8333 (you do not round) 31 Which is an advantage of peritoneal dialysis? 32 A perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is: 33 The nurse has received a report about a woman in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. The nurse’s interpretation of this assessment is that: 34 The nurse is teaching parents of a child with chronic renal failure (CRF) about the use of recombinant human erythropoietin (rHuEPO) subcutaneous injections. Which statement indicates the parents have understood the teaching? 35 E nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which action should the nurse include in the child’s postoperative care plan? (select all that apply) 36 Which are characteristic of physical development of a 30-month-old child? Select all that apply. 37 The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct? 38 What position is least effective when gravity is desired to assist in fetal descent? 39 The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy? 40 Phenylketonuria (PKU) is a genetic disease that results in the body’s inability to correctly metabolize: 41 When caring for the child with Kawasaki disease, the nurse should know which information? 42 The most critical nursing action in caring for the newborn immediately after birth is: 43 An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of: 44 Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH). For instance: 45 The nurse is caring for a child with acute renal failure. Which clinical manifestation should the nurse recognize as a sign of hyperkalemia? 46 Which is characteristic of the immune-mediated type 1 diabetes mellitus? 47 Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? (Select all that apply). 48 While taking a diet history the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. This represents a nutritional problem known as: 49 The nurse is caring for a preschool child with suspected diabetes insipidus. Which clinical manifestation should the nurse expect to observe? 50 Nurses should be aware that chronic hypertension: 51 A nurse caring for a laboring woman is cognizant that early decelerations are caused by: 52 As a perinatal nurse, you realize that a fetal heart rate (FHR) that is tachycardic, bradycardic, has late decelerations, or loss of variability is nonreassuring and is associated with: 53 A school-age child has been admitted to the hospital with an exacerbation of nephrotic syndrome. Which clinical manifestations should the nurse expect to assess? (Select all that apply.) 54 A nurse is teaching an adolescent how to use a peak expiratory flowmeter. The adolescent has understood the teaching if which statement is made? 55 Nisha is a 14 year old girl with sickle cell anemia. She comes into the clinic with complaints for severe generalized pain following a softball game. She is admitted to the pediatric unit. Her vital signs are: • Temperature 37.7 C (99.7 F) orally • Pulse 110 beats/minute • Respirations 30 breaths/minute • Blood Pressure 96/70 • O2 sat. 89% • Pain 8/10, sharp, stabbing • Weight 110 lbs Her lab results: • Hemoglobin= 9g/L • Hematocrit= 24% • WBC= 12,000 cells/mm2 • Platelet count= 140,000 cells/mm2 The physician has written the following orders for Nisha. Which if any of these orders should the nurse questions? Incorrect answer: Vital signs q 4 hours. Notify the health care provider if temp > 38 C (100.4 f). CBC with manual differential in the morning. , Not Selected IV fluids of 3% dextrose in water with 0.43% normal saline to infuse at 175 ml/hr , Not Selected PCA Meperidine 20 mg continuous with 3mg every 8 minutes PCA dose , Not Selected Oxygen 2L per nasal cannula titrating to maintain oxygen sat. > 94% , Not Selected All are fine , Not Selected 56 An infant with pyloric stenosis experiences excessive vomiting that can result in: 57 When planning care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman’s risk for _____ has increased. 58 One of the first symptoms of puerperal infection to assess for in the postpartum woman is: 59 Enemas are ordered to empty the bowel preoperatively for a child with Hirschsprung disease. The enema solution should be: 60 A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to: 61 A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She is groaning and perspiring excessively; she states that she did not attend childbirth classes. The most important nursing action is to: 62 A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely has: 63 A nurse in a special education program is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care? 64 The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant’s postoperative care include: 65 Lacerations of the cervix, vagina, or perineum are also causes of PPH. Factors that influence the causes and incidence of obstetric lacerations of the lower genital tract include all except: 66 A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly. The purpose of this pharmacologic treatment is to: 67 Obese women are at risk for several complications during pregnancy and birth. These include all except: 68 Preeclampsia is a unique disease process related only to human pregnancy. The exact cause of this condition continues to elude researchers. The American College of Obstetricians and Gynecologists has developed a comprehensive list of risk factors associated with the development of preeclampsia. Which client exhibits the greatest number of these risk factors? 69 A child with hypoparathyroidism is receiving vitamin D therapy. The parents should be advised to watch for which sign of vitamin D toxicity? 70 A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. The nurse should base the explanation on which knowledge? 71 Misoprostol (Cytotec) has been ordered for a pregnant woman at 43 weeks of gestation. The nurse recognizes that this medication is administered to: 72 The nurse should expect to assess which clinical manifestations in an adolescent with Cushing syndrome? (Select all that apply.) 73 As part of the treatment for heart failure, the child takes the diuretic furosemide (Lasix). As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in: 74 An emergency department nurse is caring ro a child diagnosed with epiglottitis. Assessing the child, the nurse monitors for which indication that the child may be experiencing airway obstruction? 75 Which immunization should not be given to a child receiving chemotherapy for cancer? 76 A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup. The nurse should be concerned that psychosocial outcomes are not being met if the woman: 77 The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot? 78 A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She can expect the following advice: 79 Nursing care of the newborn with oral candidiasis (thrush) includes: 80 A Hispanic toddler had pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items such as Jell-O, Popsicles, and juices are left. Which statement would best explain this behavior? 81 What three measures should the nurse implement to provide intrauterine resuscitation? Select the best response that indicates the priority of actions that should be taken, starting with the most important. 82 The nurse providing care for the laboring woman understands that variable fetal heart rate (FHR) decelerations are caused by: 83 With regard to the care management of preterm labor, nurses should be aware that: 84 A nurse educator is preparing to conduct a session to the nursing staff regarding the theories of growth and development and plans to discuss Kohlberg’s theory of moral development. Which of the following should the nurse include in the sessions? Select all that apply. 85 The nurse is caring for a school-age child with hyperthyroidism (Graves disease). Which clinical manifestations should the nurse monitor that may indicate a thyroid storm? (Select all that apply.) 86 Which fetal heart rate (FHR) finding concerns the nurse during labor? 87 The nurse is caring for a child with Wilm’s tumor. What is the most important nursing intervention preoperatively? 88 A child steps on a nail and sustains a puncture wound of the foot. Which is the most appropriate method for cleansing this wound? 89 Home care is being considered for a young child who is ventilator-dependent. Which factor is most important in deciding whether home care is appropriate? 90 The nurse must assess a 10 month-old infant. The infant is sitting in the father’s lap and appears to be afraid of the nurse and of what happens next. Which initial action by the nurse would be most appropriate? 91 A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH) is most likely caused by: 92 Emergency conditions during labor that require immediate nursing intervention can arise with startling speed. Examples of such emergencies include (select all that apply): 93 The nurse is teaching the parents of a child who is receiving methimazole (Tapazole) for the treatment of hyperthyroidism (Graves disease). Which statement made by the parent indicates a correct understanding of the teaching? 94 A woman gave birth to a 7-lb, 6-oz infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When assessing the woman’s vital signs, the nurse is concerned to see: 95 Nursing interventions for the child after a cardiac catheterization should include which actions? (Select all that apply.) 96 Medications used to manage postpartum hemorrhage (PPH) include (select all that apply): 97 Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could you use to raise the client’s blood pressure? (Select all that apply). 98 Which is the preferred site for intramuscular injections in infants? 99 Signs and symptoms that a woman should report immediately to her health care provider include (select all that apply): 100 Which statement about pregnancy is accurate?

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