TEST-BANK Introduction to Maternity and Pediatric Nursing ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES VERIFIED ANSWERS ALREADY GRADED A+

TEST-BANK Introduction to Maternity and Pediatric Nursing ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES VERIFIED ANSWERS ALREADY GRADED A+ A woman can become pregnant even if the male "pulls out" before ejaculation because: a) Ejaculation occurs before insertion of the penis b) Some semen is released before ejaculation c) Sperm are added to semen after ejaculation d) Semen enters the urethra as soon as the penis is inserted - CORRECT ANSWER-b) Some semen is released before ejaculation The uterine layer that responds to hormonal changes and receives the fertilized ovum is the: a) Parametrium b) Myometrium c) Endometrium d) Cervix - CORRECT ANSWER-c) Endometrium The function of a male's scrotum is to: a) Regulate the temperature of the testes b) Carry sperm for the testes to the penis c) Secrete the hormone testosterone d) Increase the strength of ejaculation of sperm - CORRECT ANSWER-a) Regulate the temperature of the testes The endometrium of the uterus is thinnest at what time? a) Just before ovulation b) Between ovulation and menstruation c) At the beginning of menstruation d) Just after menstruation - CORRECT ANSWER-d) Just after menstruation To ensure that a woman has adequate iron intake during pregnancy, it is often recommended that she: a) Drink at least 1 quart of milk per day b) Take 30 milligrams of an iron supplement daily c) Eat combinations of meat and grains d) Eat 18 milligrams of iron daily in a variety of foods - CORRECT ANSWER-b) Take 30 milligrams of an iron supplement daily The primary goal of prenatal care is to assure the woman of: a) Labor with a minimum of pain b) The healthiest outcome possible c) Improved long-term nutrition d) Minimal pregnancy discomforts - CORRECT ANSWER-b) The healthiest outcome possible Which foods are the highest in iron? a) Citrus fruits and melons b) Milk, cheese, and other dairy products c) Dried beans, potatoes, and legumes d) Meat and dark green vegetables - CORRECT ANSWER-d) Meat and dark green vegetables Adequate stores of folic acid are needed before conception to: a) Promote adequate expansion of the blood volume b) Reduce nausea and vomiting in the first trimester c) Limit depletion of calcium from the mother's teeth d) Reduce the risk for fetal neural tube defects - CORRECT ANSWER-d) Reduce the risk for fetal neural tube defects After 6 weeks gestation, fetal red blood cells are manufactured in the: a) Yolk sac b) Liver c) Bone marrow d) Placenta - CORRECT ANSWER-b) Liver The primary function of Wharton's jelly is to: a) Keep the three placental blood vessels separated to improve blood flow b) Prevent penetration of a fertilized ovum c) Move sperm through the cervix and the uterus and into the fallopian tubes d) Carry fetal waste products back to the placenta - CORRECT ANSWER-a) Keep the three placental blood vessels separated to improve blood flow Most fetal blood bypasses circulation to the lungs via the: a) Ductus venosus b) Foramen ovale c) Umbilical vein d) Umbilical artery - CORRECT ANSWER-b) Foramen ovale A woman can keep a diary of her menstrual cycles to help determine her fertile period. She understands that after ovulation she will remain fertile for: a) 2 hours b) 24 hours c) 3 to 5 days d) 7 to 14 days - CORRECT ANSWER-b) 24 hours The muscular layer of the uterus that is the functional unit in pregnancy and labor is the: a) Perimetrium b) Myometrium c) Endometrium d) Cervix - CORRECT ANSWER-b) Myometrium The nurse is leading a class discussing ovulation and menstruation. The nurse explains that ovulation occurs: a) 14 days after the last menstrual period b) 14 days before the next menstrual period C) On the sixteenth day of a 32-day menstrual cycle d) 1 week before menses occurs - CORRECT ANSWER-b) 14 days before the next menstrual period The fetal circulatory structure that carries blood with the lowest oxygen saturation is the: a) Umbilical vein b) Umbilical artery c) Ductus venosus d) Ductus arteriosus - CORRECT ANSWER-b) Umbilical artery The primary purpose of amniotic fluid is to: a) Speed maturation of fetal lungs b) Prevent cold stress after birth c) Protect the fetus during development d) Produce hormones to maintain pregnancy - CORRECT ANSWER-c) Protect the fetus during development Fetal waste products are disposed of by the: a) Fetal liver b) Placenta c) Yolk sac d) Endoderm - CORRECT ANSWER-b) Placenta Which of the following is a common discomfort of pregnancy? a) Hot flashes b) Diarrhea c) Nausea d) Ballottement - CORRECT ANSWER-c) Nausea Pregnant women need to consume how many additional calories per day in the second trimester? a) 100 calories b) 340 calories c) 500 calories d) 1000 calories - CORRECT ANSWER-b) 340 calories The child's sex is determined by the: a) Dominance of either the X or the Y chromosome b) Number of X chromosomes in the ovum c) Ovum that contributes either an X or a Y chromosome d) Sperm that contributes either an X or a Y chromosome - CORRECT ANSWER-d) Sperm that contributes either an X or a Y chromosome When a couple has unprotected sexual intercourse 6 days before the woman ovulates, the risk of the woman becoming pregnant is: a) Limited because the ova lives only for 24 hours b) Very high because both the ova and the sperm are capable of fertilizing at that time c) Unknown d) Very low because that is not the woman's fertile period - CORRECT ANSWER-d) Very low because that is not the woman's fertile period When a pregnant woman stands up suddenly, she may become dizzy because of: a) Orthostatic hypotension b) Tachycardia c) Increased venous return to the heart d) Vasoconstriction - CORRECT ANSWER-a) Orthostatic hypotension The three phases of pregnancy are: a) Primipara, gravida, and primigravida b) Dilation, expulsion, and recovery c) First trimester, second trimester, and third trimester d) Antepartum, intrapartum, and postpartum - CORRECT ANSWER-d) Antepartum, intrapartum, and postpartum Dizygotic twins result when: a) They develop from a single fertilized ovum b) Two sperm fertilize one ovum c) The embryonic disc does not divide completely d) Two sperm fertilize two ova - CORRECT ANSWER-d) Two sperm fertilize two ova The sex of monozygotic twins: a) Is always the same b) May or may not be the same c) Is always different d) Is not predictable - CORRECT ANSWER-a) Is always the same The onset of quickening is an important event to record because it: a) Verifies gestational age b) Verifies that the fetus is developing properly c) Can be used as a tool to determine fetal position d) Signals the second phase of pregnancy - CORRECT ANSWER-a) Verifies gestational age Naegele's rule is used to determine the: a) Sex of the fetus b) Fetal presentation c) Fundal height d) Estimated date of delivery - CORRECT ANSWER-d) Estimated date of delivery After what age is a mother who becomes pregnant for the first time called an "elderly primipara"? a) 25 years b) 30 years c) 35 years d) 40 years - CORRECT ANSWER-c) 35 years The gland that secretes follicle-stimulating hormone and luteinizing hormones is: a) Posterior pituitary gland b) Thyroid gland c) Anterior pituitary gland d) Parathyroid gland - CORRECT ANSWER-c) Anterior pituitary gland The regular menstrual cycle is established within 6 months to 1 year of: a) Maturation b) Ovulation c) Menarche d) Menopause - CORRECT ANSWER-c) Menarche The inner layer of the uterus that is functional during both menstruation and the implantation of a fertilized ovum is the: a) Perineum b) Myometrium c) Endometrium d) Perimetrium - CORRECT ANSWER-c) Endometrium A woman arrives in the clinic for her prenatal visit. She states that she is currently 28 weeks pregnant with twins, she has a 5-year-old son who was delivered at 39 weeks gestation and a 3-year-old daughter delivered at 34 weeks gestation, and her last pregnancy terminated at 16 weeks gestation. The nurse will interpret her obstetric history as: a) G4 T2 P2 A1 L4 b) G3 T2 P0 A1 L2 c) G5 T1 P1 A1 L2 d) G4 T1 P1 A1 L2 - CORRECT ANSWER-d) G4 T1 P1 A1 L2 During a prenatal examination at 30 weeks gestation, a woman is lying on her back on the examining table. She suddenly complains of dizziness and feeling faint. The most appropriate response of the nurse would be to: a) Reassure the woman and take measures to reduce her anxiety level b) Offer the woman some orange juice or other rapidly absorbed form of glucose c) Place a pillow under the woman's head d) Turn the woman onto her side - CORRECT ANSWER-d) Turn the woman onto her side The three germ layers of the embryo are the: a) Ectoderm, mesoderm, and endoderm b) Ectoderm, autoderm, and endoderm c) Mesoderm, teratogen, and chorion d) Chorion, placenta, and amniotic sac - CORRECT ANSWER-a) Ectoderm, mesoderm, and endoderm Substances that can damage a growing fetus are called: a) Surfactants b) Autosomes c) Teratogens d) Chorions - CORRECT ANSWER-c) Teratogens The process of mitosis in the sperm is called: a) Spermatogenesis b) Oogenesis c) Meiosis d) Epigenesis - CORRECT ANSWER-a) Spermatogenesis Two arteries and one vein form the: a) Autosome b) Blastomere c) Oocyte d) Umbilical cord - CORRECT ANSWER-d) Umbilical cord A woman who is 20 weeks pregnant is expected to experience: a) Nausea and vomiting b) Movement of the fetus c) Burning during urination d) Yellowish vaginal discharge - CORRECT ANSWER-b) Movement of the fetus Chromosomes are made up of one pair of sex chromosomes and 22 pairs of: a) Deoxyribonucleic acid b) Chorion c) Autosomes d) Oocytes - CORRECT ANSWER-c) Autosomes The point at which the fetus can survive outside the uterus is the: a) In-utero survival age b) Age of viability c) Age of maturity d) Fourteenth week of gestation - CORRECT ANSWER-b) Age of viability The sac that is formed from the chorion and the amnion is the: a) Amniotic sac b) Synovial sac c) Lacrimal sac d) Air sac - CORRECT ANSWER-a) Amniotic sac Twins formed from two separate ova and two separate sperm are: a) Identical twins b) Monozygotic twins c) Conjoined twins d) Dizygotic twins - CORRECT ANSWER-d) Dizygotic twins A woman's emotional reaction during the second trimester of pregnancy may be characterized by: a) Fear for her safety during labor b) Passive and dependent behavior c) Fantasies about the baby's appearance d) Dramatic changes in the moods - CORRECT ANSWER-c) Fantasies about the baby's appearance The moment when a sperm penetrates an ovum and unites with it is called: a) Embryonic development b) Implantation c) Fertilization d) Meiosis - CORRECT ANSWER-c) Fertilization The decidua basalis develops into what structure? a) Placenta b) Zygote c) Mesoderm d) Yolk sac - CORRECT ANSWER-a) Placenta The nurse is responsible to examine the umbilical cord of the newborn infant. The nurse knows that: (Select all that apply) a) The umbilical cord has 2 veins and 1 artery b) The umbilical cord has 2 arteries and 1 vein c) The umbilical cord has 2 arteries and 2 veins d) Umbilical arteries carry blood away from the fetus e) Umbilical arteries carry blood to the fetus - CORRECT ANSWER-b) The umbilical cord has 2 arteries and 1 vein d) Umbilical arteries carry blood away from the fetus A nurse is explaining probable signs of pregnancy to a group of women. Probable signs of pregnancy include: (Select all that apply) a) Fetal heart beat b) Abdominal striae c) Amenorrhea d) Braxton Hicks contractions - CORRECT ANSWER-b) Abdominal striae d) Braxton Hicks contractions Nursing the newborn promotes uterine involution because it: a) Uses maternal fat stores accumulated during pregnancy b) Stimulates additional secretion of colostrum c) Causes the pituitary to secrete oxytocin to contract the uterus d) Promotes maternal formation of antibodies - CORRECT ANSWER-c) Causes the pituitary to secrete oxytocin to contract the uterus The best way to maintain the newborn's temperature immediately after birth is to: a) Dry the newborn thoroughly, including the hair b) Give the newborn a bath using warm water c) Feed 1 to 2 ounces of warmed formula d) Limit the length of time that parents hold the newborn - CORRECT ANSWER-a) Dry the newborn thoroughly, including the hair Eight hours postpartum the woman states she prefers the nurse to take care of the newborn. The woman talks in detail about her birthing experience on the phone and to anyone who enters the room. She complains of being hungry, thirsty, and sleepy and is unable to focus on the newborn care teaching offered to her. The nurse would interpret this behavior as: a) Inability to bond with the newborn b) Development of postpartum psychosis c) The normal taking-in phase of the puerperium d) Inability to assume the parenting role - CORRECT ANSWER-c) The normal taking-in phase of the puerperium A woman has an incomplete abortion following by vacuum aspiration. She is now in the recovery room with her husband and is crying softly. What is the most appropriate nursing action? a) Leave the couple alone except for necessary recovery-room care b) Tell the couple that most abortions are for the best because the infant would have been abnormal c) Tell the couple that spontaneous abortion is very common and does not mean that they cannot have other children d) Express your regret at their loss and remain nearby if they want to talk about it - CORRECT ANSWER-d) Express your regret at their loss and remain nearby if they want to talk about it A woman who has gestational trophoblastic disease (hydatidiform mole) should continue to receive follow-up medical care after initial treatment because: a) Choriocarcinoma sometimes occurs after initial treatment b) She has lower levels of immune factors and is vulnerable to infection c)Anemia complicates most cases of hydatidiform mole d) Permanent elevation of her blood pressure is more likely - CORRECT ANSWER-a) Choriocarcinoma sometimes occurs after initial treatment The primary difference between the symptoms of placenta previa and abruptio placentae is: a) Fetal presentation b) Presence of pain c) Abnormal blood clotting d) Presence of bleeding - CORRECT ANSWER-b) Presence of pain During a prenatal clinic visit, your intervention with an abused woman is successful if you have assessed the status of the woman and: a) Persuaded her to leave her abusive partner b) Informed her of her safety options c) Convinced her to notify the police d) laced her in a shelter for abused women - CORRECT ANSWER-b) Informed her of her safety options The primary means of identifying hemorrhage after vaginal birth is to: a) Assess vital signs frequently b) Observe the uterine fundus and lochia c) Keep an ice pack on the perineum d) Have the woman urinate every 2 hours - CORRECT ANSWER-b) Observe the uterine fundus and lochia The term infant may be placed in skin-to-skin contact with the mother immediately after birth primarily for the purpose of: a) Breastfeeding while the baby is alert b) Maintaining the infant's temperature c) Promoting early parent-infant attachment d) Stimulating expulsion of the placenta - CORRECT ANSWER-b) Maintaining the infant's temperature The first nursing action if a visibly prolapsed umbilical cord occurs is to: a) Call the health care provider b) Palpate the cord for a pulse c) Apply the internal fetal monitor d) Relieve pressure on the cord - CORRECT ANSWER-d) Relieve pressure on the cord The most serious potential problem if a woman's bladder is distended in the early postpartum period is: a) Infection b) Discomfort c) Vomiting d) Hemorrhage - CORRECT ANSWER-d) Hemorrhage Which woman is most likely to have afterpains? a) 1 pregnancy, 1 birth, 6.5-pound newborn b) 3 pregnancies, 1 birth, 7-pound newborn c) 1 pregnancy, 1 birth, twins weighing 3.5 and 4.5 pounds d) 4 pregnancies, 4 births, 9.5-pound newborn - CORRECT ANSWER-d) 4 pregnancies, 4 births, 9.5-pound newborn Two hours after a woman's uncomplicated vaginal birth requiring no anesthesia, the nurse notes that her uterus is firm, two finger-widths above her umbilicus, and deviated slightly to her right side. The most appropriate nursing action at this time is to: a) Assess for shock or hemorrhage b) Massage her uterus continuously c) Insert an indwelling catheter d) Help her walk to the bathroom to urinate - CORRECT ANSWER-d) Help her walk to the bathroom to urinate Choose the situation that describes appropriate administration of Rh0 (D) immune globulin (RhoGAM). a) Rh-negative newborn, Rh-negative mother, given intravenously to the newborn within 12 hours of birth b) Rh-positive newborn, Rh-negative mother, given intravenously to the mother within 1 week of birth c) Rh-positive newborn, Rh-negative mother, given intramuscularly to the mother within 72 hours of birth d) Rh-negative newborn, Rh-positive mother, given intramuscularly to the mother within 72 hours of birth - CORRECT ANSWER-c) Rh-positive newborn, Rh-negative mother, given intramuscularly to the mother within 72 hours of birth A pregnant woman with type 1 diabetes mellitus asks the nurse why she has needed several increases in her insulin dose during pregnancy. The best answer is that the: a) Pregnancy changes decrease the secretion of insulin from the pancreas b) Placenta secretes substances that reduce the effectiveness of insulin c) Fetus does not yet secrete insulin and needs more from the mother d) Pancreas secretes progressively less insulin as pregnancy progresses - CORRECT ANSWER-b) Placenta secretes substances that reduce the effectiveness of insulin The purpose of the biophysical profile is to: a) Assess any Rh blood incompatibility between mother and fetus b) Determine if the fetal lungs are mature enough to survive extrauterine life c) Determine if the placenta is functioning well enough to support fetal life d) Identify serious congenital abnormalities during early pregnancy - CORRECT ANSWER-d) Identify serious congenital abnormalities during early pregnancy Which fetal or neonatal problem should the nurse anticipate if a woman has persistent hyperemesis gravidarum? a) Multiple vitamin and mineral deficiencies b) Poor attachment behaviors at birth c) Smaller than expected birth weight d) Neonatal sepsis - CORRECT ANSWER-c) Smaller than expected birth weight What maternal sign or symptom is most characteristic of hypovolemic shock associated with blood loss in a pregnant woman? a) Oral temperature below 36.1 degrees Celsius (97 degrees Fahrenheit) b) Abnormal uterine contractions c) Urine output of 100 milliliters per hour d) Weak pulse that increases in rate - CORRECT ANSWER-d) Weak pulse that increases in rate The nurse should emphasize the importance of long-term follow-up care for the woman who has had evacuation of a hydatidiform mole to detect the occurrence of: a) Recurrent pregnancy b) Choriocarcinoma c) Hypertension d) Continued bleeding - CORRECT ANSWER-b) Choriocarcinoma Parents should be taught that the safest position for their term newborn in the crib is: a) With the head elevated b) Side-lying with head down c) On their back d) Prone with head elevated - CORRECT ANSWER-c) On their back At her two-week postpartum appointment, the woman's uterus should be: a) Two finger-widths above the umbilicus b) Two finger-widths below the umbilicus c) Just above the symphysis pubis d) No longer palpable through the abdomen - CORRECT ANSWER-d) No longer palpable through the abdomen Diuresis in the early postpartum period indicates: a) Urinary tract infection b) Retention of body fluids c) Excretion of excess fluid d) Edema near the urinary meatus - CORRECT ANSWER-c) Excretion of excess fluid The earliest time when sexual intercourse can usually be resumed after birth is: a) At 2 weeks postpartum b) When a laceration heals c) When lochia alba is present d) After a ten-week postpartum appointment - CORRECT ANSWER-b) When a laceration heals Which is the best nursing measure to increase the woman's perineal comfort during their first hour after vaginal birth with a midline episiotomy? a) Help her take a warm sitz bath b) Give her an oral analgesic drug c) Apply topical anesthetic ointment d) Place an ice pack on the area - CORRECT ANSWER-d) Place an ice pack on the area Which lochia characteristic should the nurse teach the woman to report? a) Change from red to pink-brown to white b) Cessation of flow by 4 weeks postpartum c) Return of red flow at 12 days postpartum d) Presence of a menstrual-like odor - CORRECT ANSWER-c) Return of red flow at 12 days postpartum A significant difference between the signs of abruptio placentae and those of placenta previa is that abruptio placentae involves: a) Dark or concealed bleeding b) Some uterine irritation c) Infection d) Vomiting - CORRECT ANSWER-a) Dark or concealed bleeding A woman who is hospitalized with severe pre-eclampsia should be closely observed for the onset of: a) Seizures b) Decreased uric acid levels c) Hypotension d) Polyuria - CORRECT ANSWER-a) Seizures The nurse should expect to teach the pregnant woman with gestational diabetes to monitor her glucose by: a) Assessing blood glucose levels several times a day b) Determining glucose levels in the urine twice a day c) Recording monthly glycosylated hemoglobin levels d) Keeping a written record of hypoglycemic symptoms - CORRECT ANSWER-a) Assessing blood glucose levels several times a day To improve circulation to the placenta in a pregnant woman who has been in a serious car accident, the nurse should: a) Place the woman in a slightly head-down position on a horizontal surface b) Give all intravenous fluids by pump to reduce fluid overload on her heart c) Take vital signs every 15 minutes if her condition is not stable d) Place a small pillow under one hip if she must lie on her back - CORRECT ANSWER-d) Place a small pillow under one hip if she must lie on her back Which findings are expected 24 hours after birth? (Select all that apply) a) Scant amount of lochia alba on the perineal pad b) Fundus firm and in the midline of the abdomen c) Breasts distended and hard with flat nipples d) Bradycardia - CORRECT ANSWER-b) Fundus firm and in the midline of the abdomen d) Bradycardia If a pregnant woman is admitted to the emergency department in shock after an accident, the nurse would help relieve the effect of shock by: (Select all that apply) a) Placing her in Trendelenburg position b) Placing her flat in bed in a supine position c) Placing a small pillow under her left hip d) Closely observing and documenting fetal heart rate and contractions - CORRECT ANSWER-c) Placing a small pillow under her left hip d) Closely observing and documenting fetal heart rate and contractions The earliest finding in postpartum hypovolemic shock is usually: a) Low blood pressure b) Rapid heart rate c) Pale skin color d) Soft uterus - CORRECT ANSWER-b) Rapid heart rate A bleeding laceration is typically manifested by: a) A soft uterus that is difficult to locate. b) Low pulse rate and blood pressure c) Bright red bleeding and a firm uterus d) Profuse dark red bleeding and large clots - CORRECT ANSWER-c) Bright red bleeding and a firm uterus During the postpartum period the white blood cell (leukocyte) count is normally: a) Higher than normal b) Lower than normal c) Unchanged d) Unimportant - CORRECT ANSWER-a) Higher than normal A postpartum mother who is breastfeeding has developed mastitis. She states that she does not think it is good for her infant to drink milk from her infected breast. The best response from the nurse would be to: a) Instruct her to nurse the infant from only the unaffected breast until the infection clears up b) Suggest that she discontinue breastfeeding and start the infant on formula c) Encourage breastfeeding the infant to prevent engorgement d) Apply a tight breast binder to the infected breast until the infection subsides - CORRECT ANSWER-c) Encourage breastfeeding the infant to prevent engorgement What is the correct teaching for a breast self-examination? a) Monthly breast self-examinations eliminates the need for a professional examination until after the age of 40 years b) Breast self-examinations should be done 1 week after the beginning of each menstrual period c) Dry fingers make it easier to feel very small lumps that are just under the skin d) Use the palm of the hand to palpate the breast - CORRECT ANSWER-b) Breast selfexaminations should be done 1 week after the beginning of each menstrual period To relieve or reduce symptoms of premenstrual dysphoric disorder, what should the nurse recommend that the woman do? a) Avoid simple sugars and caffeine consumption b) Use oral contraceptive medication c) Avoid physical exercise d) Limit water intake to 1000 milliliters per day - CORRECT ANSWER-a) Avoid simple sugars and caffeine consumption If the nurse finds that a new mother's uterus is soft, the appropriate initial action is to: a) Insert an indwelling catheter b) Massage the fundus c) Check the mother's vital signs d) Increase the rate of intravenous fluid - CORRECT ANSWER-b) Massage the fundus When teaching a woman following vaginal birth 24 hours ago, the nurse should tell her to report: a) Pink vaginal drainage followed by red drainage b) Menstrual-like odor of vaginal discharge c) Uterine cramping when the newborn nurses d) Excretion of large quantities of dilute urine - CORRECT ANSWER-a) Pink vaginal drainage followed by red drainage What is the most appropriate intervention to prevent deep venous thrombosis in a woman who is 1 day post-cesarean birth? a) Encourage her to walk several times each day b) Provide her with increased fluids that she enjoys c) Take her temperature to identify an elevation d) Instruct her to stay in bed most of the day - CORRECT ANSWER-a) Encourage her to walk several times each day The nurse is teaching a 25-year-old woman about breast self-examination. The correct teaching is that breast self-examination: a) Detects malignancy more often than professional examinations b) Allow her to delay the need for mammography until she is 50 years old c) Helps her learn the normal characteristics of her own breasts d) Is more accurate that a yearly mammogram - CORRECT ANSWER-c) Helps her learn the normal characteristics of her own breasts What is the correct teaching for a breast self-examination? a) Use the palms of the hand to press the breast tissue firmly against the ribs b) Palpate each breast systematically, using the pads of the fingers c) Palpate the underarm area only if the breasts are very large or sagging d) Squeeze the breast tissue between the thumb and index finger - CORRECT ANSWER-b) Palpate each breast systematically, using the pads of the fingers What is the correct teaching for relief of symptoms associated with premenstrual dysphoric disorder? a) Eat chocolate candies several times a day to reduce fluid retention and weight gain b) Reduce fluid intake during the first half of the menstrual cycle c) Plan the most stressful activities during the last half of the menstrual cycle d) Exercise individually or with others several times each week - CORRECT ANSWERd) Exercise individually or with others several times each week Which nursing assessment suggests that a postpartum woman has cystitis? a) Burning with every urination b) High fever accompanied by chills c) Fever with nausea and vomiting d) Voiding large amounts of urine - CORRECT ANSWER-a) Burning with every urination A woman who is 3 days postpartum comes to the emergency clinic because she is having pain and burning discomfort when she urinates. She denies that she has had any fever and states that her lochia is "light pink". The nurse should expect an initial order for: a) Bladder analgesics b) Intravenous antibiotics c) Culture of vaginal discharge d) Clean-catch urine specimen - CORRECT ANSWER-d) Clean-catch urine specimen A woman is 5 days postpartum and breastfeeding. She telephones the nurse at the clinic and says that her breasts feel very heavy and one of them is tender. She says the newborn nurses "fair". The nurse should tell the woman that: a) Her symptoms should go away when the newborn begins nursing better b) Breastfeeding should be stopped until the pain goes away c) A cold pack between feedings should reduce the pain d) She should come to the clinic for evaluation of her symptoms - CORRECT ANSWERd) She should come to the clinic for evaluation of her symptoms Methylergonovine (Methergine) should be avoided if the woman has: a) Uterine atony b) Retained placenta c) Hypertension d) Endometritis - CORRECT ANSWER-c) Hypertension When teaching about the use of tampons, the nurse should emphasize replacing them at least every 4 hours to prevent: a) Pelvic inflammatory disease b) Vasomotor symptoms c) Sexually transmitted infections d) Toxic shock syndrome - CORRECT ANSWER-d) Toxic shock syndrome A friend asks you what she can do because she is troubled by repeated "yeast" infections. As a nurse, your best advice for her is to: a) Keep over-the-counter medications on hand so she can begin treatment immediately b) See her medical caregiver if she has another infection to identify possible causes c) Increase her intake of fluids to include at least eight glasses of water each day d) Avoid sexual intercourse for 1 month to see if that reduces the infections - CORRECT ANSWER-b) See her medical caregiver if she has another infection to identify possible causes The long-term risk of an infection with the human papillomavirus is for: a) Cervical cancer b) Ectopic pregnancy c) Endometriosis d) Nerve damage - CORRECT ANSWER-a) Cervical cancer Other than abstinence, the best way to prevent sexually transmitted infection with the human immunodeficiency virus is: a) Douching within 30 minutes of sexual intercourse b) Avoiding intercourse during midcycle c) Use of condom for all episodes of sexual intercourse d) Taking prophylactic antibiotics after unprotected intercourse - CORRECT ANSWERc) Use of condom for all episodes of sexual intercourse What is the most appropriate teaching for the woman who is prescribed with a multiphasic oral contraceptive medication? a) The menstrual period begins when the first week of pills is completed b) Cigarette smoking should be limited to no more than 20 per day c) Limit intake of foods that are high in iron or calcium d) Take the pills at the same time of day and in order - CORRECT ANSWER-d) Take the pills at the same time of day and in order Which woman should not take oral contraceptives? a) A woman who has multiple sexual partners b) A 38 year old woman who smokes a pack of cigarettes daily c) A 19 year old woman who is formula-feeding her 2-month-old baby d) A woman who is being discharged after a spontaneous abortion - CORRECT ANSWER-b) A 38 year old woman who smokes a pack of cigarettes daily A woman has been taking oral contraceptives for 4 months. She is concerned because her periods are much lighter than before she started the pills. How should the nurse counsel this woman? a) "You will probably have to stop the pill unless your periods become more like they were before" b) "We can switch you to a barrier contraceptive; your periods should return to normal in a few months" c) "Lighter periods are expected when you are on the pill, but you should tell us if they stop entirely" d) "Stop taking the pills immediately. We want to do a pregnancy test before you resume them" - CORRECT ANSWER-c) "Lighter periods are expected when you are on the pill, but you should tell us if they stop entirely" What is the correct patient teaching for intrauterine devices? a) You should not use this contraception if you smoke or are older than age 35 b) Check for the strings monthly c) Do not use tampons when you have your menstrual period d) Use another form of contraception for the first month after insertion - CORRECT ANSWER-b) Check for the strings monthly Which woman is at greatest risk for bleeding from a vaginal wall laceration? a) Vaginal birth assisted with vacuum extractor b) First newborn who weighs 3632 grams (8 pounds) c) History of uterine atony with previous birth d) Oxytocin (Pitocin) used to induce labor - CORRECT ANSWER-a) Vaginal birth assisted with vacuum extractor Which foods are highest in iron? a) Citrus fruits, apricots, and tomatoes b) Sweet or white potatoes, corn, and dried beans c) Enriched bread and dark green, leafy vegetables d) Milk, cheeses, and legumes - CORRECT ANSWER-c) Enriched bread and dark green, leafy vegetables A woman comes to the clinic for her 6 week postpartum check after having her first baby. She says to the nurse, "I'm exhausted all the time, but I can't seem to sleep when I have the chance". The nurse should: a) Reassure here that the demands of being a mother can seem overwhelming, especially with her first baby b) Ask her if her partner, family members, or friends can help her with care of the baby and her home so she can rest c) Explain that women lose more blood at birth than they expect, and a slight anemia often leads to these symptoms d) Find a quiet place to talk with her about her feelings related to her new role as a mother - CORRECT ANSWER-d) Find a quiet place to talk with her about her feelings related to her new role as a mother Postpartum bipolar disorder is characterized by: a) Periods of letdown feelings but with general enjoyment of life b) Impaired reality characterized by euphoria alternating with depression c) Alternate periods of overeating and lack of interest in food and drink d) Prolonged feelings of worthlessness or guilt - CORRECT ANSWER-b) Impaired reality characterized by euphoria alternating with depression What contraceptive method provides the best protection against sexually transmitted infections? a) Female condom b) Hormone injection c) Intrauterine device d) Oral contraceptives - CORRECT ANSWER-a) Female condom When teaching a woman the cervical mucus method to identify ovulation, the nurse teaches her that the normal characteristic of the mucus near ovulation is: a) Thin and slippery b) Yellowish with a distinct odor c) Cloudy and sticky d) Thick, sticky, and clear - CORRECT ANSWER-a) Thin and slippery Appropriate patient teaching following vasectomy is to: a) Apply heat to the operative area for 20 minutes at a time b) Abstain from intercourse for at least 6 weeks after the surgery c) Limit frequency of sexual intercourse for the first month d) Place an ice pack on the operative area to reduce discomfort - CORRECT ANSWERd) Place an ice pack on the operative area to reduce discomfort A friend tells you that she is "having periods again". She thought she had her last menstrual period 2 years ago. As a nurse, you should advise her that she: a) Is probably having reactivation of estrogens that are causing her bleeding b) Should see a health care provider promptly because this is not an expected occurrence c) Should use a contraceptive is she does not want to become pregnant d) Probably has an infection of her vagina or cervix that should be treated - CORRECT ANSWER-b) Should see a health care provider promptly because this is not an expected occurrence "Hot flashes" are probably caused by: a) Anxiety about growing older and one's mortality b) Shifts in a woman's fluid and electrolyte balance c) Instability of the blood pressure d) Reduced estrogen secretion - CORRECT ANSWER-d) Reduced estrogen secretion What is the correct patient teaching for alendronate (Fosamax)? a) Take food or milk within 30 minutes of the medication b) Wash the nose out with saline 30 minutes after using the spray c) Do not lie down for at least 30 minutes after taking the drug d) Take calcium supplements at the same time as the medication - CORRECT ANSWER-c) Do not lie down for at least 30 minutes after taking the drug A woman delivered her newborn several hours previously, and her uterus remains soft and boggy. Which of the following medications should the nurse anticipate that the health care provider would prescribe to increase uterine tone and firm the uterus? (Select all that apply) a) Methylergonovine (Methergine) b) Carboprost (Hemabate) c) Magnesium sulfate d) Oxytocin (Pitocin) - CORRECT ANSWER-a) Methylergonovine (Methergine) b) Carboprost (Hemabate) d) Oxytocin (Pitocin) Factors that change the normal flora of the vagina and predispose a patient to vaginal infection include: (Select all that apply) a) Use of antibiotics b) Douching c) Sexual intercourse d) Daily baths - CORRECT ANSWER-a) Use of antibiotics b) Douching c) Sexual intercourse What is a reliable temporary birth control method? (Select all that apply) a) Douching b) Breastfeeding c) Transdermal patch d) Vasectomy e) Intrauterine device - CORRECT ANSWER-c) Transdermal patch e) Intrauterine device The nurse should teach the woman who is experiencing menopause that: (Select all that apply) a) Calcium is best absorbed when vitamin D intake is adequate b) Weight-bearing exercise is important c) Lying down and resting after each meal is important d) An increased intake of vitamin C will enhance calcium absorption - CORRECT ANSWER-a) Calcium is best absorbed when vitamin D intake is adequate b) Weight-bearing exercise is important Which thought process involves logical thinking for the school-aged child and an understanding of the different stages of development based on the developmental theorists? a) Stage of industry b) Sexual latency c) Concrete operations d) Androgynous - CORRECT ANSWER-c) Concrete operations Latchkey children are those left unsupervised after school because parents or extended family members work outside the home. They are at a higher risk of feeling isolated and subject to a higher rate of: a) Study hours b) After-school activities c) Accidents d) Parental supervision - CORRECT ANSWER-c) Accidents Around what age do infants normally begin to experience separation anxiety? a) 6 months b) 9 months c) 12 months d) 15 months - CORRECT ANSWER-b) 9 months An infant's birthweight is expected to double around what age? a) 4 months b) 6 months c) 9 months d) 10 months - CORRECT ANSWER-b) 6 months Placing infants in the supine position helps to prevent: a) Asthma b) Gastroesophageal reflux disease c) Colic d) Sudden infant death syndrome - CORRECT ANSWER-d) Sudden infant death syndrome One of the best ways to promote the mastery of language in a preschool child is to: a) Engage them in interactive reading b) Limit the number of books in the child's room c) Provide crayons and coloring books d) Allow them to talk with other 3-year-olds - CORRECT ANSWER-a) Engage them in interactive reading Bedtime habits should include: a) Playful activities b) Specific rituals c) Vigorous exercise d) Allowing attention-getting behavior - CORRECT ANSWER-b) Specific rituals A common characteristic of a toddler is: a) Saying yes frequently b) Changing their routine c) Performing rituals d) Taking five naps per day - CORRECT ANSWER-c) Performing rituals The average age when toilet training is complete is: a) 1 to 2 years b) 2 to 3 years c) 3 to 4 years d) 4 to 5 years - CORRECT ANSWER-b) 2 to 3 years Developing intimacy in adolescence is tied to resolving: a) Social development b) Identity c) Sexual orientation d) Body image - CORRECT ANSWER-b) Identity One characteristic of cognitive development during adolescence is the emergence of: a) Egocentrism b) Peer relationships c) A sense of identity d) Abstract thinking - CORRECT ANSWER-d) Abstract thinking Emancipation is critical to the establishment of: a) Identity b) Intimacy c) Menarche d) Adolescence - CORRECT ANSWER-a) Identity Which of the following is an effective guidance for managing toddler behavior issues? a) Withhold naps if the child doesn't want to sleep b) Reward good behavior c) Provide fluid for hydration before bedtime d) Provide time-out when toileting accident occurs - CORRECT ANSWER-b) Reward good behavior Because caloric requirements are decreased in the toddler, the suggested amount of daily milk intake is: a) 6 ounces b) 12 ounces c) 18 ounces d) 24 ounces - CORRECT ANSWER-d) 24 ounces In terms of gender identity, some adults develop a concept of gender identity that includes both masculine and feminine qualities. This is known as: a) Neutrality b) Androgyny c) Assertive sensitivity d) Ambivalence - CORRECT ANSWER-b) Androgyny Which age category is characterized by disorganization and children who are intense, observant, all-knowing, energetic, meddlesome, and argumentative? a) 5 to 7 years b) 8 to 10 years c) 11 to 12 years d) 16 to 18 years - CORRECT ANSWER-c) 11 to 12 years Studies have documented that after the age of 7 years, children can be responsible for care of a family pet and that pets: a) Are time consuming b) Cause disease c) Prevent disease d) Improve medical outcomes after surgery - CORRECT ANSWER-d) Improve medical outcomes after surgery The coordination of index finger and thumb is called the: a) Pincer grasp b) Grasp reflex c) Parachute reflex d) Plantar reflex - CORRECT ANSWER-a) Pincer grasp A technique to soothe an irritable or colicky infant is to: a) Increase environmental stimulation b) Remove blankets and bulky clothing c) Slowly rock the infant d) Walk or pace while holding the infant - CORRECT ANSWER-c) Slowly rock the infant At what age does the posterior fontanelle close? a) 2 months b) 4 months c) 10 months d) 18 months - CORRECT ANSWER-a) 2 months At what age do children begin to have refined motor skills, such as cutting with scissors? a) 4 years b) 3 years c) 5 years d) 6 years - CORRECT ANSWER-a) 4 years An effective method of encouraging positive behavior involves: a) Strict discipline b) Calling time-outs c) Modeling d) Offering a reward - CORRECT ANSWER-d) Offering a reward A type of play that helps children communicate their feelings by drawing is called: a) Animism b) Art therapy c) Play therapy d) Talk therapy - CORRECT ANSWER-b) Art therapy Which of the following nutrients is an adolescent most likely to receive inadequate amounts of? a) Calcium b) Protein c) Sodium d) Folic acid - CORRECT ANSWER-a) Calcium A PACE interview can assist in determining if an adolescent is: a) Anorexic or bulimic b) Sexually active c) Using drugs or alcohol d) Depressed or suicidal - CORRECT ANSWER-c) Using drugs or alcohol A guideline for amount of solid food per meal for toddlers is: a) 2 cups of liquid b) 0.5% of the child's weight c) 1 tablespoon of solid food per year of age d) 0.25 pound of solid food per year of age - CORRECT ANSWER-c) 1 tablespoon of solid food per year of age The leading cause of death in children is: a) Accidents b) Sudden infant death syndrome c) Poison d) Disease - CORRECT ANSWER-a) Accidents Breastfed babies require feeding more often because: a) Formula contains fewer calories than breast milk b) Formula is more easily digested than breast milk c) Breast milk contains more calories than formula d) Breast milk is more easily digested than formula - CORRECT ANSWER-d) Breast milk is more easily digested than formula Although pet ownership may nurture a sense of responsibility and encourage socialization with shy children, which of the following is essential? a) Choosing a shy domestic animal for the family b) Selecting an appropriate pet for the family c) Providing exposure to farm animals d) Choosing a puppy younger than 1 year old - CORRECT ANSWER-b) Selecting an appropriate pet for the family Which toy would be appropriate for a 4-year-old diagnosed with pneumonia to bring to the hospital? a) Stuffed bear b) Remote-controlled car c) Beach ball d) Crayons and coloring book - CORRECT ANSWER-d) Crayons and coloring book The term that describes daytime wetting is: a) Diurnal b) Echolalia c) Enuresis d) Nocturnal - CORRECT ANSWER-a) Diurnal While playing in school, a 9-year-old child suffers an injury that knocks his tooth out of his mouth. What should the teacher or school nurse do? a) Place the tooth in a cup of clean water and send the child home b) Place the tooth in a cup of milk, and call the parent to take the child to the dentist c) Wrap the tooth in a clean cloth and call the parent to take the child to the dentist d) Risen the child's mouth and place the tooth in an envelope for the child to show his parent - CORRECT ANSWER-b) Place the tooth in a cup of milk, and call the parent to take the child to the dentist A 4-year-old child is in Erikson's stage of: a) Autonomy b) Industry c) Initiative d) Identity - CORRECT ANSWER-c) Initiative The appropriate amount of time to use in a time-out period for a 3-year-old child is: a) 1 minute b) 3 minutes c) 5 minutes d) 10 minutes - CORRECT ANSWER-b) 3 minutes One of the developmental hallmarks of the toddler that most frequently give rise to safety hazards is: a) Brief attention span b) Need for ritual c) Fluctuating appetite d) Need to explore - CORRECT ANSWER-d) Need to explore The startle reflex is also known as the: a) Moro reflex b) Rooting reflex c) Pincer reflex d) Grasp reflex - CORRECT ANSWER-a) Moro reflex To detect allergies when feeding new foods to infants, it is important to: a) Introduce single-ingredient foods b) Mix the food with one the infant likes c) Mix the food with formula d) Offer two new foods at a time - CORRECT ANSWER-a) Introduce single-ingredient foods A parent states she is having a conflict with her toddler, who seems to "always want to do things his way". He insists on putting on his right shoe before his left and has a tantrum if the parent tries to put on the left shoe first. The parent asks the nurse why the child is acting this way. The best response of the nurse would be to: a) Explain to the child that it really doesn't matter which sock and shoe is donned first b) Put the child in a time-out for the appropriate time c) Explain that this is normal ritualistic behavior at this age and should be respected d) Let the child walk barefoot and take the shoes away - CORRECT ANSWER-c) Explain that this is normal ritualistic behavior at this age and should be respected When selecting play activities for a healthy 4-year-old, the parent should be guided to understand that the 4-year-old enjoys: a) Solitary play, sitting next to a friend b) Cooperative play with friends c) Competitive play with teams d) Observing rather than participating - CORRECT ANSWER-b) Cooperative play with friends Puberty can most accurately be defined as the period of life characterized by the: a) Occurrence of sexual maturity and appearance of secondary sex characteristics b) Substitution of adult interest and value systems for child interests c) Most rapid rate of physical and mental growth and development d) Occurrence of sexual feelings and the initiation of sexual experience - CORRECT ANSWER-a) Occurrence of sexual maturity and appearance of secondary sex characteristics One of the tasks of adolescence, as defined by Erikson's stages of development, is: a) Finding an identity b) Sexual latency c) Heterosexuality d) Concrete operations - CORRECT ANSWER-a) Finding an identity During the administration of medications, a 17-year-old patient tells the nurse that he has never had one of these pills before. The best nursing action would be: (Select all that apply) a) Check the patient's identification band again b) Assure the patient that the medication packet has his name on it c) Ask the patient to take the medication since the identification band and the medication administration record match d) Check the health care provider's written orders to confirm if this medication is newly prescribed - CORRECT ANSWER-a) Check the patient's identification band again d) Check the health care provider's written orders to confirm if this medication is newly prescribed A parent asks the nurse if it is healthy to allow her school-age child to play computer games after school every day. The best response of the nurse would be that computer games: (Select all that apply) a) Interest the school-age child and they will keep him off the streets b) Can challenge the intellect but should be balanced with active play, with no more than 2 hours of screen time per day c) Should only be played on weekends and not on school days d) Some programs teach new skills and are appropriate for school-age children - CORRECT ANSWER-b) Can challenge the intellect but should be balanced with active play, with no more than 2 hours of screen time per day d) Some programs teach new skills and are appropriate for school-age children Which principle should the nurse teach the parent concerning administering liquid iron preparations to the child with iron-deficiency anemia? a) Allow the preparation to mix with saliva and bathe the teeth before swallowing b) Warm the medication before administering c) Administer between meals d) Administer in the bottle of formula - CORRECT ANSWER-c) Administer between meals When administering digoxin (Lanoxin) to an infant, the medication should be withheld and the health care provider notified if the: a) Pulse rate is below 60 beats per minute b) Infant is dyspneic c) Pulse rate is below 100 beats per minute d) Respiratory rate is above 40 breaths per minute - CORRECT ANSWER-c) Pulse rate is below 100 beats per minute Which is a priority nursing diagnosis in a child admitted with acute asthma? a) Risk for infection b) Imbalanced nutrition c) Ineffective breathing pattern d) Disturbed body image - CORRECT ANSWER-c) Ineffective breathing pattern Which sign or symptom observed in a sleeping 2-year-old child immediately after a tonsillectomy necessitates reporting and following-up care? a) A pulse of 110 beats per minute b) A blood pressure of 96/64 millimeters of mercury c) Nausea d) Frequent swallowing - CORRECT ANSWER-d) Frequent swallowing A health care provider is preparing to examine the throat of a child diagnosed with acute epiglottitis. A priority nursing responsibility would be to: a) Have a tracheotomy set at the bedside b) Immobilize the child's head c) Restrain the child's arms d) Have oxygen available - CORRECT ANSWER-a) Have a tracheotomy set at the bedside A yellow bruise is approximately how many days old? a) 2 days b) 5 to 7 days c) 7 to 10 days d) 10 to 14 days - CORRECT ANSWER-c) 7 to 10 days An abnormal s-shaped curvature of the spine seen in school-age children is known as: a) Sclerosis b) Sciatica c) Scabies d) Scoliosis - CORRECT ANSWER-d) Scoliosis A teenager who had a cast applied after a tibia fracture complains that his pain medication is not working and his pain is still 9 on a numeric scale. The nurse notices some edema of the toes and a capillary refill of 6 seconds. The priority action of the nurse would be to: a) Call the health care provider immediately b) Find out if there is an order for a stronger pain medication c) Try nonpharmacological techniques of pain relief d) Explain to the teen that a new fracture is expected to be painful the first day - CORRECT ANSWER-a) Call the health care provider immediately A type of fracture in a young child that may be indicative of child abuse is: a) Greenstick fracture of the tibia b) Spiral fracture of the femur c) Pathological fracture of the fibula d) Aligned fracture of the wrist - CORRECT ANSWER-b) Spiral fracture of the femur The priority nursing intervention when administering phenytoin (Dilantin) to a patient diagnosed with epilepsy is: a) Recording the blood pressure b) Providing detailed oral hygiene c) Encouraging bed rest d) Administering the drug with milk - CORRECT ANSWER-b) Providing detailed oral hygiene Symptoms of an earache in an infant include: a) External drainage, pain, and a decrease in temperature b) Tugging at the ear and rolling the head from side to side c) Crying and pointing to the affected ear d) Redness of the cheeks and cyanosis of the ear - CORRECT ANSWER-b) Tugging at the ear and rolling the head from side to side What information would the nurse give to parents of a young child following surgical insertion of a pressure equalization tube during myringotomy after an eardrum rupture? a) The tube may fall out spontaneously within 6 to 12 months b) Avoid getting water in the child's ear c) Position the child on his back for sleep d) Use cotton swabs to clean the ears - CORRECT ANSWER-a) The tube may fall out spontaneously within 6 to 12 months Early signs of Reye's syndrome include: a) Diarrhea and headache b) Vomiting and lethargy c) Nausea and malaise d) Hyperactivity and vomiting - CORRECT ANSWER-b) Vomiting and lethargy Which factor is most likely to trigger seizures in a child with epilepsy? a) High-fat diet b) Hypothermia c) Sensitivity to light d) Loud noise - CORRECT ANSWER-c) Sensitivity to light The nurse recognizes which as a symptoms of meningitis? a) Intense thirst and stiff neck b) Hyperactivity and vomiting c) Irritability and fever d) Loss of vision and malaise - CORRECT ANSWER-c) Irritability and fever A 7-month-old child had a febrile seizure. Which statement would the nurse give to the infant's parents? a) "Febrile seizures rarely occur before an infant's first birthday" b) "Febrile seizures indicate a permanent, underlying neurologic problem" c) "Febrile seizures are usually controlled with phenobarbital" d) "Febrile seizures rarely develop into epilepsy" - CORRECT ANSWER-d) "Febrile seizures rarely develop into epilepsy" Nursing care for a child following a generalized tonic-clonic seizure would include: a) Attempting to hold the tongue b) Administering oxygen c) Restraining their extremities d) Turning the child onto his or her side - CORRECT ANSWER-d) Turning the child onto his or her side The nurse is teaching parents about the adverse effects of phenytoin (Dilantin) would explain this medication can cause: a) Drowsiness b) Gum overgrowth c) Blurred vision d) Liver toxicity - CORRECT ANSWER-b) Gum overgrowth One of the most common causes of death in a child with muscular dystrophy is: a) Renal failure b) Osteomyelitis c) Cardiac failure d) Liver disease - CORRECT ANSWER-c) Cardiac failure Which type of traction would the nurse expect to be used for a 20-month-old child who has a fractured femur? a) Buck's extension traction b) Bryant's traction c) Russell's traction