ATI PN Maternal Newborn Proctored Exam 2020 - Version 1

1. A nurse is providing discharge teaching to a client following tubal ligation (occlusion). Which of the following statement by the client indicates an understanding of the teaching? A. “Premenstrual tension will no longer be present.” B. “Ovulation will remain the same.” C. “Hormone replacements will be needed following this procedure.” D. “My monthly menstrual period will be shorter.” 2. A nurse is assessing a newborn following forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method? A. Hypoglycemia B. Polycythemia C. Facial Palsy D. Bronchopulmonary dysplasia 3. A nurse is providing teaching about terbutaline to a client who is experiencing preterm labor. Which of the following statements by the client indicates understanding of the teaching? A. “This medication could cause me to experience heart palpitations.” B. “This medication could cause me to experience blurred vision.” C. “This medication could cause me to experience ringing in my ears.” D. “This medication could cause me to experience frequent urination.” 4. A nurse is caring for a client who is in labor and requests nonpharmacological pain management. Which of the following nursing actions promotes client comfort? A. Assisting the client into squatting position B. Having the client lie in a supine position C. Applying fundal pressure during contractions D. Encouraging the client to void every 6 hrs. 5. A nurse caring for a client who is at 20 weeks of gestation and has trichomoniasis. Whichof the following findings should the nurse expect? A. Thick, White Vaginal Discharge B. Urinary Frequency C. Vulva Lesions D. Malodorous Discharge 6. A nurse is caring for a client who is at 14 weeks of gestation. At which of the following locations should the nurse place the doppler device when assessing the fetal heart rate? A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis B. Left Upper Abdomen C. Two fingerbreadths above the umbilicus D. Lateral at the Xiphoid Process 7. A nurse is assessing a client who is at 27 weeks of gestation and has preeclampsia. Which of the following findings should the nurse report to the provider? A. Urine protein concentration 200 mg/24 hr. B. Creatinine 0.8 mg/dL C. Hemoglobin 14.8 g/dL D. Platelet Count 60,000/mm3 lOMoARcPSD| 8. A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effect should the nurse include? A. Tinnitus B. Urinary Frequency C. Breast Tenderness D. Chills 9. A nurse is assessing a newborn upon admission to the nursery. Which of the following should the nurse expect? A. Bulging Fontanels B. Nasal Flaring C. Length from head to heel of 40 cm (15.7 in) D. Chest circumference 2 cm (0.8 in) smaller than the head circumference 10. A nurse is planning care for a newborn who has neonatal abstinence syndrome. Which of the following interventions should the nurse include in the plan of care? A. Increase the newborn’s visual stimulation B. Weigh the newborn every other day C. Discourage parental interaction until after a social evaluation D. Swaddle the newborn in a flexed position 11. A nurse is caring for a newborn who is 6 hrs. old and has a bedside glucometer reading of 65 mg/dL. The newborn’s mother has type 2 diabetes mellitus. Which of the following actions should the nurse take? A. Obtain a blood sample for a serum glucose level B. Feed the newborn immediately C. Administer 50 mL of dextrose solution IV D. Reassess the blood glucose level prior to the next feeding. 12. A nurse is providing teaching to a client about exercise safety during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply). A. “I will limit my time in the hot tub to 30 minutes after exercise.” B. “I should consume three 8-ounce glasses of water after I exercise.” C. “I will check my heart rate every 15 minutes during exercise sessions.” D. “I should limit exercise sessions to 30 minutes when the weather is humid.” E. “I should rest by lying on my side for 10 minutes following exercise.” 13. A charge nurse is teaching a group of staff nurses about fetal monitoring during labor. Which of the following findings should the charge nurse instruct the staff members to report to the provider? A. Contraction durations of 95 to 100 seconds B. Contraction frequency of 2 to 3 min apart C. Absent early deceleration of fetal heart rate D. Fetal heart rate is 140/min 14. A nurse in a woman’s health clinic is obtaining a health history from a client. Which of the following findings should the nurse identify as increasing the client’s risk for developing pelvic inflammatory disease (PID)? A. Recurrent Cystitis B. Frequent Alcohol Use C. Use of Oral Contraceptives D. Chlamydia Infection lOMoARcPSD| 15. A nurse is teaching a prenatal class about immunizations that newborns receive following birth. Which of the following immunizations should the nurse include in the teaching? A. Hepatitis B B. Rotavirus C. Pneumococcal D. Varicella 16. A nurse is providing nutritional guidance to a client who is pregnant and follows a vegan diet. The client asks the nurse which foods she should eat to ensure adequate calcium intake. The nurse should instruct the client that which of the following foods has the highest amount of calcium? A. ½ cup cubed avocado B. 1 large banana C. 1 medium potato D. 1 cup cooked broccoli 17. A nurse in a provider’s office is assessing a client at her first antepartum visit. The client states that the first day of her last menstrual period was March 8. Use Nagele’s rule to calculate the estimated date of delivery. (Use the MMDD format with four numerals and no spaces or punctuation.) ANS: 1215 March – 3 months = December. 8 + 7 = 15. (December 15) 18. A nurse is caring for a client who is in the second stage of labor. Which of the following manifestations should the nurse expect? A. The client expels the placenta. B. The client experiences gradual dilation of the cervix C. The client begins to have regular contractions. D. The client delivers the newborn. 19. A nurse is assessing a client who is at 37 weeks (about 8 and a half months) of gestation. Which of the following statement by the client requires immediate intervention by the nurse? A. “It burns when I urinate.” B. “My feet are really swollen today.” C. “I didn’t have lunch today, but I have breakfasted this morning.” D. “I have been seeing spot this morning.” 20. A nurse is providing discharge teaching to a new parent about car seat safety. Which of the following statements by the parent indicates an understanding of the teaching? A. “I should position my baby’s car seat at a 45-degree angle in the car.” B. “I should place the car seat rear facing until my baby is 12 months old.” C. “I should place the harness snugly in a slot above my baby’s shoulders.” D. “I should position the retainer clip at the top of my baby’s abdomen.” 21. A nurse is developing an educational program about hemolytic diseases in newborns for a group of newly licensed nurses. Which of the following genetic information should the nurse include in the program as a cause of hemolytic disease? A. The mother is Rh positive, and the father is Rh negative. B. The mother is Rh negative, and the father is Rh positive. C. The mother and the father are both Rh positive. D. The mother and the father are both Rh negative. lOMoARcPSD| 22. A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following clients should the nurse assess first? A. A client who has diabetes mellitus and an HbA1c of 5.8% B. A client who has preeclampsia and a creatinine level of 1.1 mg/ dL C. A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L D. A client who has placenta previa and a hematocrit of 36% 23. A nurse is assessing a newborn immediately following a vaginal birth. For which of the following findings should the nurse intervene? A. Molding B. Vernix Caseosa C. Acrocyanosis D. Sternal retractions 24. A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider? A. A client who has a urinary output of 300 ml in 8 hr. B. A client who reports abdominal cramping during breastfeeding C. A client who is receiving magnesium sulfate and has absent deep tendon reflexes. D. A client who reports lochia rubra requiring changing perineal pads every 3 hr. 25. A nurse is caring for a client who has active genital herpes simplex virus type 2. Which ofthe following medications should the nurse plan to administer? A. Metronidazole B. Penicillin C. Acyclovir D. Gentamicin 26. A nurse is caring for a client following an amniocentesis. The nurse should observe the client for which of the following complications? A. Hyperemesis B. Proteinuria C. Hypoxia D. Hemorrhage 27. A nurse is planning care for a client who is receiving oxytocin by continuous IV infusion for labor induction. Which of the following interventions should the nurse include in the plan? A. Increase the infusion rate every 30 to 60 min. B. Maintain the client in a supine position. C. Titrate the infusion rate by 4 milliunits/min. D. Limit IV intake to 4 L per 24 hr. 28. A nurse is caring for a 2-day-old newborn who was born at 35 weeks of gestation. Which of the following actions should the nurse take? (Click on the “Exhibit” Button for additional information about the newborn. There are three tabs that contain separate categories of date.) A. Administer nitric oxide inhalation therapy to the newborn B. Insert an orogastric decompression tube with low wall suction. C. Provide the newborn with an iron-rich formula containing vitamin B12 every 2 hr. D. Measure the abdominal circumference at the level of the newborn’s umbilicus every 2 hr. ***(The other doc has 12 hrs) lOMoARcPSD| 29. A nurse is caring for a client who is receiving oxytocin for induction of labor and notes late decelerations of the fetal heart rate on the monitor Tracing. Which of the following action should the nurse take? A. Decrease maintenance IV solution infusion rate. B. Place the client in lateral position. C. Administer misoprostol 25 mcg vaginally D. Administer oxygen via face mask at 2 L/min 30. A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care? A. Instruct the client to stop taking the antiretroviral medication at 32 weeks of gestation. B. Use a fetal scalp electrode during labor and delivery. C. Administer a pneumococcal immunization to the newborn within 4 hours following birth. D. Bathe the newborn before initiating skin-to-skin contact 31. A nurse is preparing to administer methylergonovine 0.2 mg orally to a client who is 2 hrs. postpartum and has a boggy uterus. For which of the following assessment findings should the nurse withhold the medication? A. Blood pressure 142/92 mm Hg B. Urine output 100 mL in hr. C. Pulse 58/min D. Respiratory rate 14/min 32. A nurse is reviewing laboratory results for client who is pregnant. The Nurse should expect which of the following laboratory values to increase? A. RBC count B. Bilirubin C. Fasting blood glucose D. Bun 33. A nurse is caring for a client who is experiencing preterm labor and has a prescription for 4 doses of dexamethasone 6 mg IM 12 hr. Available in dexamethasone 10 mg/mL. How many mL of dexamethasone should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use trailing zero.) ANS: 0.6 mL 34. A nurse is caring for four clients. For which of the following clients should the nurse auscultate the fetal heart rate during the prenatal visit? A. A client who has an ultrasound that confirms a molar pregnancy B. A client who has a crown-rump length of 7 weeks gestation C. A client who has a positive urine pregnancy test 1 week after missed menses D. A client who has felt quickening for the first time. 35. A nurse is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the nurse include in the plan of care? A. Dress the newborn in lightweight clothing. B. Avoid using lotion or ointment on the newborn skin. C. Keep the newborn supine throughout treatment D. Measure the newborn’s temperature every 8hr lOMoARcPSD| 36. A nurse is receiving laboratory results for a term newborn who is 24 hrs. old. Which of the following results require intervention by the nurse? A. WBC count 10,000/mm3 B. Platelets 180,000/mm3 C. Hemoglobin 20g/dL D. Glucose 20 mg/dL 37. A nurse is assessing a client following an amniocentesis. Which of the following findings should the nurse recognize as complications? (select all that apply). A. Amnionitis B. Urinary tract infection C. Polyhydramnios D. Leakage of amniotic fluid E. Preterm labor 38. A nurse on a labor and delivery unit is reviewing infection control standards with a newly licensed nurse. The nurse should instruct the newly licensed nurse to don gloves for which of the following procedures? A. Assisting a mother with breastfeeding B. Performing a newborn’s initial bath C. Administering the measles, mumps, rubella vaccine D. Performing umbilical cord care 39. A nurse is providing teaching to a client who has mild preeclampsia and will be caring for herself at home during the last 2 months of pregnancy. Which of the following statementsby the client indicates an understanding of the teaching? A. “I will count baby’s kicks every other day.” B. “I will alternate the arm use to check my blood pressure.” C. “I will check my urine for protein daily.” D. “I will consume 50 grams of protein daily.” 40. A nurse is caring for four newborns. Which of the following newborns should the nurse assess first? A. Newborn who has nasal flaring B. Newborn who has subconjunctival hemorrhage of the left eye C. A newborn who has overlapping suture lines D. A newborn who has not rust-stained urine 41. A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors places the client at risk for infection. A. Meconium-stained fluid B. Placenta previa C. Midline episiotomy D. Gestational hypertension 42. A nurse is caring for a client who is 4 hrs. postpartum and is experiencing hypovolemic shock. Which of the following actions should the nurse take? A. Administer indomethacin orally B. Insert a second IV using a 22-gauge IV catheter, C. Insert an indwelling urinary catheter. D. Administer oxygen at 2 L/min via nasal cannula. *****(The other doc has 4 L/min) lOMoARcPSD| 43. A nurse is teaching a client who is 28 weeks of gestation and not up to date on current immunization. Which of the following immunizations should the nurse inform the client to anticipate receiving following birth? A. Pneumococcal B. Hepatitis B C. Human papillomavirus D. Rubella 44. A nurse is caring for a newborn who is 24 hrs. old. Which of the following Laboratory findings should the nurse report to the provider? A. Hgb 20 g/dL B. Bilirubin 2mg/dL C. Platelets 200,000/mm3 D. WBC count 32,000/mm3 45. A nurse is caring for newborn who is 1 hr. old and has a respiratory rate of 50/min, a heart rate of 130/min, and an axillary temperature of 36.1 C (97F). Which of the following actions should the nurse take? A. Give the newborn a warm bath. B. Apply a cap to the newborn head. C. Reposition the newborn. D. Obtain an oxygen saturation level. 46. A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan? A. Apply a thin layer of lotion to the newborn skin every 8 hrs. B. Give the newborn 1oz of glucose water every 4 hrs. C. Ensure the newborn eyes are closed beneath the shield. D. Dress the newborn in a thin layer of clothing during therapy 47. A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statement should the nurse make? A. “You can bathe and dress your baby if you’d like to.” B. “If you don’t hold the baby, it will make letting go much harder.” C. “You should name the baby so she can have an identity.” D. “I’m sure you will be able to have another baby when you’re ready.” 48. A nurse is providing teaching to a client who is at 38 weeks of gestation and has a prescription to receive misoprostol intravaginally. Which of the following statement should the nurse make? A. “You will need to stay in a side-lying position for 30 minutes after each dose.” B. “You will receive an IV infusion of oxytocin 1 hour after your last dose.” C. “You will receive a magnesium supplement immediately following therapy.” D. “You will need to have a full bladder before the therapy begins.” 49. A nurse is assessing a newborn who was born post-term. Which of the following findings should the nurse expect? A. Nails extending over tips of fingers B. Large deposits of subcutaneous fat C. Pale, translucent skin D. Thin covering of fine hair on shoulders and back lOMoARcPSD| 50. A nurse is planning to teach a group of clients who are pregnant about breastfeeding after returning to work. Which of the following information should the nurse include in the teaching? A. “Thawed (defrosted) breast milk can be refrigerated for up to 72 hours.” B. “Breast milk can be stored in a deep freezer for 12 months.” C. “Breast milk can be stored at room temperature for up to 12 hours.” D. “Thawed breast milk that is unused can be refrozen.” 51. A nurse on postpartum unit caring for four clients. Which of the following clients should receive Rh, (D) Immune globulin to prevent Rh- is immunization? A. A Rh-negative mother who has a Rh-positive infant B. A Rh-positive mother who has a Rh-negative infant C. A Rh-positive mother who has a Rh-positive infant D. A Rh-negative mother who has a Rh-negative infant 52. A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take? A. Provide a stimulating environment B. Monitor blood glucose level every hr. C. Initiate seizure precautions. D. Place the infants on his back with legs extended. 53. A nurse is reviewing signs of effective breastfeeding with a client who is 5 days postpartum. Which of the following information should the nurse include in the teaching? A. “You should feel a tugging (pulling) sensation when the baby is sucking. B. You should expect your baby to have two to three wet diapers in 24 hours period C. “Your baby’s urine should appear dark and concentrated”. D. “Your breast should stay firm after the baby breastfeeds”. 54. A nurse is teaching a client who is at 41 weeks of gestation about a non-stress test. Which of the following information should the nurse include in the teaching? A. “This test will confirm fetal lung maturity “. B. “This test will determine adequacy of placental perfusion”. C. “This test will detect fetal infection”. D. “This test will predict maternal readiness for labor”. 55. A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for an induction of labor with misoprostol? A. A client who has active genital herpes B. A client who has gestational diabetes mellitus C. A client who has a previous uterine incision D. A client who has placenta previa 56. A nurse is monitoring a client who has preeclampsia and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings should the nurse reports to the provider? A. Blood pressure 148/94 mmHg B. Respiratory rate 14 breath/min C. Urinary output 20 mL/hr. D. 2+ deep tendon reflexes 57. A nurse is caring for a client who is in the transition phase of labor and reports a pain level of 7 on a scale of 0 to 10. Which of the following actions should the nurse take? lOMoARcPSD| D. Hyperglycemia A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication? a) Polyuria b) Hypotension c) Hyperglycemia A. Instruct the client to use effleurage B. Apply counter pressure to the client sacral. C. Assist the client with patterned-paced breathing. D. Teach the client the technique of biofeedback. 58. A nurse is caring for newborn immediately following birth and notes a large amount of mucus in the newborn’s mouth and nose. Identify the sequence the nurse should follow when performing suction with a bulb syringe. (Move the steps into the box on the placing them in the selected order of performance. Use all the steps.) 1. Compress the bulb syringe 2. Place the bulb syringe in the newborn’s mouth 3. Use the bulb syringe to suction the newborn’s nose 4. Assess the newborn for reflex bradycardia 59. A community health nurse is providing education on gestational diabetes mellitus (GDM)to a group of clients who are pregnant when discussing risk factors, which of the following ethnicities should the nurse identify as having the lowest incidence of GDM? A. Asian B. Non-Hispanic White American C. Hispanic D. African American 60. A nurse is providing teaching about expected changes during pregnancy to a client who is at 24 weeks of gestation. Which of the following information should the nurse include? A. “Your stomach will empty rapidly” B. “You should expect your uterus to double in size” C. “You should anticipate nasal stuffiness” D. “Your nipples will become lighter in color” 61. A nurse is teaching a prenatal class regarding false labor. Which of the following information should the nurse include? A. “Your contraction will become more intense when walking” B. “You will have dilation and effacement of the cervix” C. “You will have bloody show” D. “Your contraction will become temporally regular” 62. A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication? A. Hypnosis B. Polyuria C. Bilateral crackles lOMoARcPSD| d) Bilateral crackles 63. A nurse is caring for a client who is receiving prenatal care and is at her 24-week appointment. Which of the following laboratory tests should the nurse plans to conduct? A. Group B strep culture B. 1-hr glucose tolerance test C. Rubella titer D. Blood type and Rh 64. A nurse is caring for a client who has bacterial vaginosis. Which of the following medication should the nurse expect to administer? A. Metronidazole B. Fluconazole C. Acyclovir 65. A nurse is caring for a client who is experiencing sore nipples from breastfeeding. Which of the following actions should the nurse take? A. Place a snug dressing on the client’s nipple when not breastfeeding. B. Ensure the newborn’s mouth is wide open before latching to the breast. C. Encourage the client to limit the newborn’s feeding to 10 min on each breast. D. Instruct the client to begin the feeding with the nipple that is most tender. 66. A nurse is assessing a preterm newborn who is at 32 weeks of gestation. Which of the following finding should the nurse expect? A. Minimal arm recoil B. Popliteal angle of less than 90 C. Creases over the entire sole D. Sparse (thin) lanugo 67. A nurse on a labor and delivery unit is providing teaching to a client who plans to use hypnosis to control labor pain. Which of the following information should the nurse include? A. “Focusing on controlling body functions” B. “Synchronized breathing will be required during hypnosis” C. “Hypnosis can be beneficial in you practiced it during the prenatal period” D. “Hypnosis does not work for controlling pain associated with labor”. 68. A nurse is caring for client who is in active labor. Following epidural placement, the nurse a maternal blood pressure of 98/58 mmHg and minimal FHR variability on the fetal monitor. Which of the following images indicates the action the nurse should take? lOMoARcPSD| ANS: Turn the client to her side before calling the health care provider (HCP) 69. A nurse is caring for a client who has hyperemesis gravidarum. Which of the following laboratory tests should the nurse anticipate? A. Urine Ketones B. Rapid plasma regain C. Prothrombin time D. Urine culture 70. A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect? A. Scant lochia B. Uterine tenderness C. Temperature 37.4 0C (99.30 F) D. WBC 9,000/mm ATI Maternal Newborn 2019~ Version 2 1. A client who is 16 weeks of gestation asks the nurse how to prepare her father to a younger sibling. Which of the following statements should the nurse make? a. You should hold your newborn in your arms when you introduce him to your toddler b. You should move your toddler out of her crib 2 weeks prior to your due date c. You should give your toddler a gift from the baby when she visit you in the facility d. You should place your toddler in timeout if she exhibits regressive Behavior after the baby is born 2. A nurse is observing an adolescent client who is offering her newborn a bottle while he is laying in the bassinet. When the nurse offers to pick the newborn up and place them in the client's arms, the mother States “ No, the baby is too tired to be held”. Which of the following actions should the nurse take? lOMoARcPSD| a. Insist that the mother pick up the newborn to feed him b. Demonstrate how to hold a newborn and allow the client to practice c. Persuade the client to breastfeed the newborn to promote bonding d. Offer to take the newborn to the nursery to finish his feeding 3. A nurse is assessing a client who is in preterm labor and has a new prescription or terbutaline 0.25 mg subcutaneous. For which of the following findings should the nurse Withhold the medication and Report to the provider? a. fasting blood glucose 75 mg / DL b. blood pressure 88/58 mmhg c. urinary output 40 ml /hr d. FHR 120/min 4. A nurse is providing teaching to the parents of a newborn about the plastibell circumcision technique. Which of the following? a. The plastibell will be removed 4 hours after the procedure b. Notify the provider is the end of your penis appears dark red c. Make sure the newborn's diaper is snug d. Yellow exudate will form at the surgical site in 24 hours 5. A nurse is planning care immediately following birth for a newborn who has Myelomeningocele that is cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care? a. Administer broad-spectrum antibiotics b. Cleanse the site with Povidone iodine c. Monitor the rectal temperature every 4 hours d. Prepare for surgical closure after 72 hours 6. A nurse is caring for four enter-partum clients. Which of the following clients should the nurse assess first? a. A client who is at 7 weeks of gestation and reports urinary frequency b. A client who is at 32 weeks of gestation and reports seeing floating spots c. A client who is 38 weeks of gestation and reports leg cramps d. A client who is at 20 weeks of gestation and reports periodic numbness in her fingers 7. A nurse is caring for a client who has placenta previa. Which of the following findings should the nurse expect? a. Firm rigid abdomen b. Painless, vaginal bleeding c. Uterine hypertonicity d. Persistent headache 8. A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include? a. Expect 2 to 4 wet diapers every 24 hours b. Allow the baby to feed at least every 3 hours c. Offer the newborn 30 ml (1 oz.) a water between feedings d. Feed the newborn 5 to 10 minutes per breast 9. A nurse is assessing a client during her first prenatal visit the client reports March 20th us her last menstrual.. Use Niagele’s rule to calculate the estimated date of delivery. Use the mmdd lOMoARcPSD| format with four numerals and no spaces or punctuation. 1227 10. A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client which of the following vaccinations? Select all the apply a. Varicella b. Human papillomavirus c. Diphtheria - acellular pertussis d. inactivated influenza e. Measles, mumps, and rubella 11. A nurse is caring for a client who has preterm labor and receiving magnesium sulfate by continuous IV infusion. Which of the following laboratory values should the nurse review during tocolytic therapy? a. Indirect Coombs test b. Liver enzymes c. Uric acid level d. Serum medication level 12. A nurse is caring for a client who reports spontaneous rupture. The nurse observed fetal bradycardia in the FHR tracing and notices the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following should the nurse take next? a. Initiate an infusion of IV fluids for the client b. Perform vaginal examination by applying upward pressure on the presenting part d. Administer oxygen via non rebreather mask at 8L/ min. D. Cover the umbilical cord with sterile saline saturated towel. 13. A nurse is caring for a client who is 36 weeks gestation and has MRSA. Which of the following isolation precautions should the nurse initiate? a. Droplet b. Contact c. Airborne d. Protective environment 14. A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include? a. You should use an oil based vaginal lubricant when inserting your diaphragm b. You should store your diaphragm in sterile water after each use c. you should keep the diaphragm in place for at least 4 hours after intercourse d. You should have your provider refit you for a new diaphragm 15. A nurse is caring for a client who has gestational diabetes mellitus. Which of the following clinical findings should indicate to the nurse the client has hyperglycemia? a. Double vision b. Increased urination c. Sweating d. Dizziness 16. A nurse is reviewing the laboratory results of a newborn. Which of the following findings should the nurse report to the provider? a. Blood glucose 58 mg / DL lOMoARcPSD| b. Hematocrit 48% c. Platelets 100,000/ mm 3 d. Hemoglobin 16 G / DL 17. A nurse is using Niagele’s rule to calculate the expected delivery date of a client who reports the first day of the last menstrual cycle was July 28th. Which of the following dates should the nurse document as a client expected delivery date? 07/28 a. April 21st b. April 4th a. May 5th c. May 21st 18. The nurse is teaching a client and her partner about the technique of counter pressure during labor. Which of the following statements by the nurse is appropriate? a. Your partner will apply upward pressure on your lower abdomen between contractions b. Your partner will apply continuous from pressure between your thumb and index finger c. Your partner will apply pressure to the top of your uterus during contractions d. Your partner will apply steady pressure with a tennis ball to your lower back 19. A nurse is caring for a client who is 6 weeks of gestation and reports nausea and vomiting. Which of the following recommendations should the nurse make? a. Avoid eating snacks before bedtime b. Eat high-fat snack before getting out of bed c. Drink additional liquids with each meal d. Consume food served at cool temperatures 20. A nurse is providing teaching to a client who is receiving medroxyprogesterone IM for contraception. Which of the following statements by the client indicates an understanding of the teaching? a. I should discontinue this medication if I experience spotting b. I will need to return to the clinic in the next eight weeks for my next injection c. I should increase my calcium intake while taking this medication d. I will get two shots each time I receive this medication 21. A nurse is preparing to perform a fundal massage for a postpartum client with hearing seeing uterine atony. In which order should the nurse plan to perform the following actions? (molded steps into the box on the right. Placing them in order of performance use all steps ) 1. Ask the client to lie on her back in with her knees flexed. 2. Position one hand around the top of the client’s when fundus in one hand just above the client's symphysis pubis. 3. Rotate the upper hand to massage that clients uterus while using slight downward pressure to compress the fundus. 4. observe the client's perineum for the passage of clots and the amount of bleeding. 22. A nurse is providing discharge teaching to a postpartum client about caring for her five-year 5- day old male newborn at home. Which of the following statements should the nurse make to the client? a. Retract the foreskin to clean your baby's penis during each bath b. Use triple antibiotic ointment on your baby's umbilical cord twice per day c. Swaddle your baby tightly with legs extended before laying him down to sleep d. Notify your baby's pediatrician if he urinates less than 6 times per day lOMoARcPSD| 23. A nurse is assessing a newborn whose mother had a primary cytomegalovirus (CMV) infection during pregnancy. The newborn acquired CMV trans placenta Lee. Which of the following findings should the nurse expect the newborn to exhibit? a. Urinary tract infection b. Hearing loss c. Macrosomia d. Cataracts 24. A nurse is assessing a full-term newborn arm admission to the nursery. Which of the following clinical findings should the nurse report to the provider? a. Transient circumoral cyanosis b. Single Palmar creases c. Subconjunctival hemorrhage d. Rust-stain urine 25. A nurse is caring for a client who is receiving oxytocin to induce labor. The nurse should discontinue the oxytocin if which of the following occurs? a. Contractions last 60 Seconds b. Non-repetitive early decelerations c. 6 contractions in 10 minutes d. Moderate variability of the fetal heart rate 26. A nurse is planning care for a client following a chorionic villus sampling. The nurse should recognize that the client is at risk for developing which of the following complications? a. Late decelerations b. Infection c. Anemia d. Placental insufficiency 27. A nurse is providing dietary teaching to a client who is 32 weeks of gestation and has cholelithiasis. Which of the following foods should the nurse recommend for the client to include in her diet? a. Baked chicken b. Whole milk c. French fries d. Bacon cheeseburger 28. A nurse is providing teaching to a client who is primigravid and is scheduled to have an abdominal ultrasound. Which of the following statements by the client indicates an understanding of the teaching? a. I need to take a stool softener the night before the test b. I can't have anything to eat after midnight c. I won't apply perfumed lotion to my abdomen before the test d. I will drink water before the test until my bladder feels full 29. A nurse is performing an assessment of a newborn's Babinski reflex. Which of the following findings should the nurse expect? a. Flexion of the forearm b. Extension of the leg c. Downward curl of the toes d. Dorsiflexion of the greater toes lOMoARcPSD| 30. A nurse is caring for a client who received epidural analgesia during labor and is 4 hours for postpartum. Which of the following client reports should the nurse address first? a. Itching b. Inability to void c. Abdominal cramps d. Tingling in the legs 31. A nurse is caring for a client who is at 30 weeks of gestation and receiving magnesium sulfate for preeclampsia. The nurse should recognize which of the following manifestations as an adverse reaction to the medication? a. Respiratory rate a 16/minutes b. Hypertension c. Urine output 20 ml/hour d. Hyperglycemia 32. A nurse is performing a iron Heel stick on a newborn. Which of the following actions should the nurse take? a. Use an automatic puncture device on the heel b. Puncture the heels of the inner aspect of the foot c. Cleanse the newborns heel with an alcohol swab after the procedure d. Place an ice pack on the newborn's heel 5 minutes before the procedure 33. A nurse is admitting a client to the birthing unit who reports her contractions started 1 hour ago. The nurse determines client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions? a. Ectopic pregnancy b. Postpartum hemorrhage c. Hyperemesis gravidarum d. Incompetent cervix 34. A nurse is assessing a client who is at 32 weeks of gestation and is receiving magnesium sulfate via continuous IV solution. Which of the following findings should the nurse report to the provider? a. Decrease in frequency of contractions b. Absent deep tendon reflexes c. Urinary output 35 ml/hr d. BP 150/100 mmhg 35. A nurse is providing discharge instructions to a client is 24 hours post partum and has decided not to breastfeed. Which of the following instruction should the nurse include in the teaching? a. Wear loose-fitting non-binding bra for 72 hours b. Shower daily allow warm water to run directly over your dress c. Apply ice packs to your breast using a 15 minutes on, 45 minutes off schedule d. Pump your breast twice-daily to relieve discomfort from engorgement 36. A nurse in a newborn nursery is receiving change-of-shift report for four newborns. Which of the following newborn should the nurse assess first? a. Newborn who is 24 hours old and has not had meconium stool b. A newborn who is 10 hours old and has a new onset tachypnea c. Newborn who has a short frenulum and is having difficulty breastfeeding d. A newborn was 30 hours old and has blood-tinged discharge in her diaper lOMoARcPSD| 37. A nurse is assessing the results of a non-stress test for an antepartal client at 35 weeks of gestation. Which of the following findings should indicate to the nurse the need for further diagnostic testing? a. 3 fetal movements perceived by the client in a 20-minute testing period. b. No late deceleration in the fetal heart rate loaded with 3 uterine contractions of 60 seconds in duration within a 10-minute testing period. c. Irregular contractions of 10 to 20 seconds in duration that are not felt by the client. d. An increase in fetal heart rate to 150 / minute above Baseline of 140 minute lasting 10 seconds in response to fetal movement with a 40 minute testing period. 38. A nurse in a prenatal clinic is reviewing the laboratory results for a client who is at 12 weeks gestation. Which of the following actions should the nurse take? (Click in the “Exhibit” button for additional information about the client. There are three tabs that contain separate categories of data.) a. Administer ceftriaxone IM b. Administer rubella vaccine c. Obtain a maternal serum alpha-fetoprotein specimen d. Obtain a blood culture 39. A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate. Which of the following clinical findings should the nurse instruct the client to report? a. Increased urinary output b. Increased respiratory rate c. Increased fetal movement d. Increased muscle weakness 40. A nurse is providing prenatal teaching to a client who practices of vegan diet and is trying to increase intake on vitamin 12. Which of the following foods should the nurse recommend? a. Fortified soy milk b. Brown rice c. Fresh citrus fruits d. Raw carrots 41. A nurse is conducting a class for a group of client's about birth control. Which of the following information should the nurse include in the teaching? a. Your fertility will return six months after your provider removes your IUD b. You should use spermicide 3 hours prior to sexual intercourse c. You will not need to use birth control for one month after receiving emergency contraception d. You should have an annual examination to assess your diaphragm 42. A nurse is caring for a newborn who has an exstrophy of the bladder. Which of the following actions should the nurse take prior to the beginning of the surgical correction? a. Keep the newborn in a side-lying position b. Restricted newborns fluid intake c. Exert gentle pressure on the newborn splattered with sterile gauze d. Cover the newborns bladder with a sterile non-adherent dressing lOMoARcPSD| 43. A charge nurse is teaching a newly licensed nurse about fetal monitoring the newly licensed nurse should identify that which of the following images indicates prolonged deceleration? Answer: Option C 44. A nurse is providing teaching to a postpartum client who has a prescription for a rubella immunization. Which of the following client statements indicates an understanding of the teaching? a. I will receive a series of three immunizations and each one will be a month apart b. I should avoid becoming pregnant for at least one month following the immunization c. I should avoid breastfeeding for two weeks following the immunization d. I will report joint pain that develops after the immunization to my provider immediately 45. A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository? a. Vaginal candidiasis b. Third-degree perineal laceration lOMoARcPSD| c. Abdominal distension d. Afterpains 46. A nurse is assessing a newborn was exposed to cocaine in utero. Which of the following findings should the nurse expect? a. High-pitched cry b. Hypotonicity c. Increased head circumference d. Decreased startle response 47. A nurse is caring for a client who is at 32 weeks of gestation and has gestational diabetes mellitus. Which of the following findings should the nurse report to the provider? a. The client has a fundal height of 38 cm b. The client reports 12 fetal movements in 1 hour c. The client has a fasting blood glucose of 90 mg /dL d. The client has non pitting pedal edema 48. A nurse is in a provider's office is caring for a 20 year old client with at 12 weeks of gestation and request and amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make? a. This procedure determines if your baby has genetic or congenital disorders b. Your provider was schedule a chronic villus sampling to determine the sex of your baby c. You cannot have an amniocentesis until you're at least 35 years of age d. We can schedule the procedure for later today if you'd like 49. A nurse is assisting the provider to administer a dinoprostone to induce labor for a client. Which of the following actions should the nurse take? a. Allow the medication to reach room temperature prior to administration b. Verify that informed consent is obtained prior to administration c. Instruct the client to avoid urinary elimination until after administration d. Please to clean and I send my followers position for 1 hour after administration 50. A nurse is caring for a newborn. Which of the following assessment findings should indicate to the nurse that suctioning of the nasopharynx is needed? a. The newborn’s pulse oximeter is 91% b. The newborns respiratory rate is 32/min c. The newborn is beginning to cough d. The newborns respiratory rate is the regular 51. A nurse is caring for a client who was in active labor and has gonorrhea. Which of the following potential complications of Gonorrhea should the nurse monitor? a. Oligohydramnios b. Vaginal laceration during birth c. Excessive bleeding after birth d. Chorioamnionitis 52. A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect? a. Facial petechiae b. Periauricular papillomas