NR 602/ NR602 (Primary Care of the
Childbearing and Childrearing Family
Guide| Questions & Answers| Grade A|
100% Correct (Verified Solutions)-
Chamberlain
A steady trickle of bright red blood from the vagina in the presence of a firm
fundus suggests? - ANSWER>>Laceration to the genital tract.
A postpartum client would be at increased risk for postpartum hemorrhage if: -
ANSWER>>She delivered a 6.5lb infant after a 2-hr labor.
If nonsurgical treatment for subinvolution (uterus does not return to its normal
size s/p birth) is ineffective, which surgical procedure is appropriate to correct the
cause of this condition? - ANSWER>>Dilation and curettage (D&C).
Which nursing measure would be appropriate to prevent thrombophlebitis in the
recovery period following a cesarean birth? - ANSWER>>Assist the client in
performing leg exercises every 2 hours.
A white blood cell (WBC) count of 35,000 cells/mm3 on the morning of the first
postpartum day indicates: - ANSWER>>Possible infection
The client who is being treated for endometritis (inflammation of the
endometrium / lining of the uterus) is placed in the Fowler position because it: -
ANSWER>>Facilitates drainage of lochia.
,Following a difficult vaginal birth of a singleton pregnancy, the client starts
bleeding heavily. Clots are expressed, and a foley catheter is inserted to empty
the bladder, because the uterine fundus is soft, and displaced laterally from
midline.
Vital signs are 99.8 F, pulse 90 beats/min, respirations 20 breaths/min, and BP
130/90 mm Hg.
Which pharmacologic intervention is indicated? - ANSWER>>Administration of
prostaglandin analogue to reduce r/o hemorrhaging
Following a vaginal birth, a client has lost a significant amount of blood and is
starting to experience signs of hypovolemic shock.
Which clinical signs would be consistent with this clinical diagnosis? -
ANSWER>>Compensatory response of tachycardia and decreased pulse pressure.
The nurse recognizes that infection may be present in her postpartum client when
the client exhibits: - ANSWER>>A temperature of 100.4 on the second postpartum
day and 100.8 on the fourth.
To determine an adverse response to carboprost tromethamine (Hemabate)
{used to treat postpartum uterine hemorrhage}, the nurse should frequently
assess: - ANSWER>>Breath sounds.
What data in the client's history should the nurse recognize as being pertinent to
a possible diagnosis of postpartum depression? - ANSWER>>Teenage depression
episode.
The nurse notes that the fundus of a postpartum patient is boggy, shifted to the
left of the midline, and 2cm above the umbilicus.
What is the nurse's priority action? - ANSWER>>Massage the fundus of the
uterus.
,The parent of a colicky infant asks about using a probiotic medication.
What will you tell them? - ANSWER>>There is no conclusive evidence about using
probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor
weight gain. A barium swallow study reveals a normal esophagus.
What will the primary care pediatric nurse practitioner consider next to manage
this child's nutritional needs? - ANSWER>>Video fluoroscopy swallowing study
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and
diarrhea. An assessment reveals an irritable child with dry mucous membranes, 3
second capillary refill, 2 second recoil of skin, mild tachycardia and tachypnea,
and cool hands and feet. The child has had two wet diapers in the past 24 hours.
What will the primary care pediatric nurse practitioner recommend? -
ANSWER>>Oral rehydration solution with follow-up in 24 hours.
A 9-year-old girl has a history of frequent vomiting, and her mother has frequent
migraine headaches. The child has recently begun having more frequent and
prolonged episodes accompanied by headaches. An exam reveals abnormal eye
movements and mild ataxia.
What is the correct action? - ANSWER>>Refer to a pediatric gastroenterologist for
further workup.
The parent of a 3-month-old reports that the infant arches and gags while feeding
and spits up undigested formula frequently. The infant's weight gain has dropped
to the 5th percentile from the 12 th percentile.
, What is the best course of treatment for this infant? - ANSWER>>Begin a trial of
extensively hydrolyzed protein formula for 2-4 weeks.
A school age child has a 3-month history of dull, aching epigastric pain that
worsens with eating and awakens the child from sleep. A complete blood count
shows a hemoglobin of 8 mg/dL.
What is the next step in management? - ANSWER>>Refer for EGD.
A 2-month-old infant cries up to 4 hours each day and, according to the parents, is
inconsolable during crying episodes with fists and legs noted to be tense and stiff.
The infant is breastfeeding frequently but is often fussy during feedings. The
physical exam is normal, and the infant is gaining weight normally.
What will the primary care pediatric nurse practitioner recommend? -
ANSWER>>Eliminating certain foods from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract
shows a 6 mm cylindrical object in the child's stomach. The child is able to
swallow without difficulty and is not experiencing pain.
What is the correct course of treatment? - ANSWER>>Have the parents watch for
the object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child
vomited once today and then experienced relief from pain followed by an
increased fever.
What is the likely diagnosis? - ANSWER>>Appendicitis with perforation
An 18-month-old child has a 1 day history of intermittent, cramping abdominal
pain with nonbilious vomiting. The child is observed to scream and draw up his
Childbearing and Childrearing Family
Guide| Questions & Answers| Grade A|
100% Correct (Verified Solutions)-
Chamberlain
A steady trickle of bright red blood from the vagina in the presence of a firm
fundus suggests? - ANSWER>>Laceration to the genital tract.
A postpartum client would be at increased risk for postpartum hemorrhage if: -
ANSWER>>She delivered a 6.5lb infant after a 2-hr labor.
If nonsurgical treatment for subinvolution (uterus does not return to its normal
size s/p birth) is ineffective, which surgical procedure is appropriate to correct the
cause of this condition? - ANSWER>>Dilation and curettage (D&C).
Which nursing measure would be appropriate to prevent thrombophlebitis in the
recovery period following a cesarean birth? - ANSWER>>Assist the client in
performing leg exercises every 2 hours.
A white blood cell (WBC) count of 35,000 cells/mm3 on the morning of the first
postpartum day indicates: - ANSWER>>Possible infection
The client who is being treated for endometritis (inflammation of the
endometrium / lining of the uterus) is placed in the Fowler position because it: -
ANSWER>>Facilitates drainage of lochia.
,Following a difficult vaginal birth of a singleton pregnancy, the client starts
bleeding heavily. Clots are expressed, and a foley catheter is inserted to empty
the bladder, because the uterine fundus is soft, and displaced laterally from
midline.
Vital signs are 99.8 F, pulse 90 beats/min, respirations 20 breaths/min, and BP
130/90 mm Hg.
Which pharmacologic intervention is indicated? - ANSWER>>Administration of
prostaglandin analogue to reduce r/o hemorrhaging
Following a vaginal birth, a client has lost a significant amount of blood and is
starting to experience signs of hypovolemic shock.
Which clinical signs would be consistent with this clinical diagnosis? -
ANSWER>>Compensatory response of tachycardia and decreased pulse pressure.
The nurse recognizes that infection may be present in her postpartum client when
the client exhibits: - ANSWER>>A temperature of 100.4 on the second postpartum
day and 100.8 on the fourth.
To determine an adverse response to carboprost tromethamine (Hemabate)
{used to treat postpartum uterine hemorrhage}, the nurse should frequently
assess: - ANSWER>>Breath sounds.
What data in the client's history should the nurse recognize as being pertinent to
a possible diagnosis of postpartum depression? - ANSWER>>Teenage depression
episode.
The nurse notes that the fundus of a postpartum patient is boggy, shifted to the
left of the midline, and 2cm above the umbilicus.
What is the nurse's priority action? - ANSWER>>Massage the fundus of the
uterus.
,The parent of a colicky infant asks about using a probiotic medication.
What will you tell them? - ANSWER>>There is no conclusive evidence about using
probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor
weight gain. A barium swallow study reveals a normal esophagus.
What will the primary care pediatric nurse practitioner consider next to manage
this child's nutritional needs? - ANSWER>>Video fluoroscopy swallowing study
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and
diarrhea. An assessment reveals an irritable child with dry mucous membranes, 3
second capillary refill, 2 second recoil of skin, mild tachycardia and tachypnea,
and cool hands and feet. The child has had two wet diapers in the past 24 hours.
What will the primary care pediatric nurse practitioner recommend? -
ANSWER>>Oral rehydration solution with follow-up in 24 hours.
A 9-year-old girl has a history of frequent vomiting, and her mother has frequent
migraine headaches. The child has recently begun having more frequent and
prolonged episodes accompanied by headaches. An exam reveals abnormal eye
movements and mild ataxia.
What is the correct action? - ANSWER>>Refer to a pediatric gastroenterologist for
further workup.
The parent of a 3-month-old reports that the infant arches and gags while feeding
and spits up undigested formula frequently. The infant's weight gain has dropped
to the 5th percentile from the 12 th percentile.
, What is the best course of treatment for this infant? - ANSWER>>Begin a trial of
extensively hydrolyzed protein formula for 2-4 weeks.
A school age child has a 3-month history of dull, aching epigastric pain that
worsens with eating and awakens the child from sleep. A complete blood count
shows a hemoglobin of 8 mg/dL.
What is the next step in management? - ANSWER>>Refer for EGD.
A 2-month-old infant cries up to 4 hours each day and, according to the parents, is
inconsolable during crying episodes with fists and legs noted to be tense and stiff.
The infant is breastfeeding frequently but is often fussy during feedings. The
physical exam is normal, and the infant is gaining weight normally.
What will the primary care pediatric nurse practitioner recommend? -
ANSWER>>Eliminating certain foods from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract
shows a 6 mm cylindrical object in the child's stomach. The child is able to
swallow without difficulty and is not experiencing pain.
What is the correct course of treatment? - ANSWER>>Have the parents watch for
the object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child
vomited once today and then experienced relief from pain followed by an
increased fever.
What is the likely diagnosis? - ANSWER>>Appendicitis with perforation
An 18-month-old child has a 1 day history of intermittent, cramping abdominal
pain with nonbilious vomiting. The child is observed to scream and draw up his
