ACTUAL COMPLETE REAL EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) ALREADY
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A client with gestational diabetes is undergoing a non-stress
test at 34 weeks gestation. Fetal heart beat is 144 beats / min.
The client is instructed to mark the fetal monitor paper by
pressing each time the baby moves. After 20 mins the nurse
evaluates the fetal monitor strip
A. The mother perceives and marks at least four fetal
movements
B. Fetal movements must be elicited with a vibroacoustic
stimulator
C. Two fetal heart accelerations of 15 beats/ min x 15 seconds
are recorded D. No FHR late decelerations occur in response
to fetal movement - ANSWER-
D. Two FHR accelerations of 15 beats/minute x 15 seconds
are recorded.
A client at 35-weeks gestation complains of a "pain whenever
the baby moves." On assessment, the nurse notes the client's
temperature to be 101.2F, with severe abdominal or uterine
tenderness on palpation. The nurse knows that these findings
are indicative of what condition?
A. Round ligament strain
,B. Chorioamnionitis
C. Abruptio placenta
D. Viral infection. - ANSWER-B. Chorioamnionitis
A male infant with a 2-day history of fever and diarrhea is
brought to a clinic by his mother who tells the nurse that the
child refuses to drink anything. The nurse determines that the
child has a weak cry with no tears. Which prescription is most
important to implement?
A. Provide a bottle of electrolyte solution
B. Infuse normal saline intravenously
C. Administer an antipyretic rectally
D. Apply external cooling blanket - ANSWER-B. Infuse normal
saline intravenously
A 6-month old child who had a cleft-lip repair has elbow
restraints in place.
What nursing intervention should the nurse plan
to implement?
A. remove restraints q4h for 30 minutes and place gloves on
the child's hands B. record observations of the restraints q2h
and ensure that they are in place at all times
C. obtain the HCP advice as to when the restraints should
be removed D. remove restraints one at a time to provide
ROM exercises - ANSWER-D.
remove restraints one at a time to provide ROM exercises
,A new mother calls the nurse stating that she wants to start
feeding her 6month-old child something besides breast milk,
but is concerned that the infant is too young to start eating
solid foods. How should the nurse respond?
A. encourage the mother to schedule a developmental
assessment of the infant B. advise the mother to wait at least
another month before starting any solid foods
C. instruct the mother to offer a few spoons of 2-3 pureed fruit
at each meal
D. reassure the mother that the infant is old enough to eat iron-
fortified cereal - ANSWER-D. reassure the mother that the
infant is old enough to eat ironfortified cereal
While caring for a laboring client on continuous fetal monitoring,
the nurse notes
a fetal heart rate pattern that falls and rises abruptly with
a "V" shaped
appearance. What action should the nurse
take first?
A. Prepare for a potential
cesarean B. Allow the client
to begin pushing
C. Administer oxygen at 10/L
by mask
D. Change the maternal position - ANSWER-D. Change the
maternal position
, A postpartum client who is Rh-negative refuses to receive
Rho (D) immune
globulin (RhoGam) after delivery of an infant who is Rh-
positive. Which
information should the nure provide
this client?
A. RhoGam is not necessary unless all her pregnancies are Rh-
positive
B. The R-positive factor from the fetus threatens her blood cells
C. The mother should receive RhoGam when the baby is Rh-
negative
D. RhoGam prevents maternal antibody formation for future Rh-
positive babies - ANSWER-D. RhoGam prevents maternal
antibody formation for future Rhpositive babies
A 6-week-old infant diagnosed with pyloric stenosis has
recently developed projectile vomiting. Which assessment
finding indicates to the nurse that the infant is becoming
dehydrated?
A. Weak cry without any tears
B. Bulging fontanel
C. Visible peristaltic wave.
D. Palpable mass in the right upper quadrant - ANSWER-A.
Weak cry without any tears
A full-term, 24-hour-old infant in the nursery regurgitates
and suddenly turns cyanotic. What should the nurse do
first? A. Suction the oral and nasal passages