Exam (elaborations) HESI RN OB Gynecology

At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in the right lower quadrant of her abdomen. The nurse obtains a blood sample and initiates an IV. Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder pain. Assessment findings include diaphoresis, a heart rate of 120 beats/minute, and a blood pressure of 86/48. Which action should the nurse implement next? a. Check the hematocrit results. b. Administer pain medication. c. Increase the rate of IV fluids. d. Monitor client for contractions. - ANSWER c. increase the rate of IV fluids A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask wen she could use a home pregnancy test to diagnose pregnancy. Which response is best? a. a home pregnancy test can be used right after your first missed period b. these tests are most accurate after you have missed your second period c. home pregnancy tests often give false positives and should not be trusted d. the test can provide accurate information when used right after ovulation - ANSWER a. a home pregnancy test can be used right after your first missed period A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse knows that the most likely presenting symptom for a pediatric client with AIDS is: a. shortness of breath b. joint pain c. a persistent cold d. organmegaly - ANSWER c. a persistent cold Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action should the nurse take? a. notify the healthcare provider or anesthesiologist b. continue to assess the blood pressure q5min c. place the woman in a lateral position d. turn off continuous epidural - ANSWER c. place the woman in a lateral position In developing a teaching plan for expectant parents, the nurse plans to include information about when the parents can expect the infant's fontanels to close. The nurse bases the explanation on knowledge that for the normal newborn, the a. anterior fontanel closes at 2 to 4 months and the posterior by the end of the first week b. anterior fontanel closes at 5 to 7 months and the posterior by the end of the week c. anterior fontanel closes at 8 to 11 months and the posterior by the end of the second week d. anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month - ANSWER d. anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month A client in active labor is admitted with preeclampsia. Which assessment finding is most significant in planning this client's care? a. patellar reflex 4+ b. blood pressure 158/80 c. four hour urine output 240 ml d. respiration 12/minute - ANSWER a. patellar reflex 4+ A 4 week old premature infant has been receiving epoetin alfa for the last three weeks. Which assessment finding indicates to the nurse that the drug is effective? a. slowly increasing urine output over the last week b. respiratory rate changes from the 40s to the 60s c. changes in apical heart rate from the 180 to the 140s d. change in indirect bilirubin from 12 mg/dl to 8 mg/dl - ANSWER c. changes in apical rate from the 180s to the 140s A pregnant client tells the nurse that the first day of her last menstrual period was August 2, 2006. Based on Nagele's rule, what is the estimated date of delivery? a. April 25, 2007 b. May 9, 2007 c. May 29, 2007 d. June 2, 2007 - ANSWER b. May 9, 2007