NR Study Vault

OB NCLEX Qs Intrapartum When caring for a client in the first stage of labor, the nurse documents cervical dilation of 9 cm and intense contractions lasting 45 to 60 seconds and occurring about every 2 minutes. Based on these findings, the nurse should recognize that the client is in which phase of labor? 1. Active phase 2. Latent phase 3. Descent phase 4. Transitional phase RATIONALES: In the transitional phase, the cervix dilates from 8 to 10 cm, and intense co...

Nursing: Medical-Surgical Review Which method elicits the most accurate information during a physical assessment of an older adult? A. use reliable assessment tools for older adults B. Review the past medical record for medications C. Ask the client to recount one's health history D. Obtain the client's information from a caregiver Specific assessment tools (D) for an older adult, such as Older Adult Resource Services Center Instrument, mini-mental assessment, fall risk, depression,...

ATI Med-surg: Perioperative Nursing What should the nurse do before witnessing the client signing an informed consent who has expressed fears of the surgery? - Ask the surgeon to speak to the client for clarification Medication history: which medicine puts the client at risk for complications with anesthetic? - captopril (ace inhibitor) Jehovah's witnesses are not allowed to accept - blood Surgical suites are kept at cool temps with low humidity because it helps reduce risk of ____ ...

The nurse who is employed in a prenatal clinic is performing prenatal assessments on clients who are in their first trimester of pregnancy. The nurse is concerned with identifying clients who may be at risk for the development of postpartum complications. Which clients would be at most risk for development of postpartum thromboembolic disorders? Select all that apply. - 1. A 39-year-old woman who reports that she smokes 4. A 37-year-old woman in her fourth pregnancy who is overweight 5. A 2...

Intrapartum Intrapartum Intrapartum The nurse in a maternity unit is reviewing the clients' records. Which clients should the nurse identify as being at the most risk for developing disseminated intravascular coagulation (DIC)? Select all that apply. - 3. A gravida II who has just been diagnosed with dead fetus syndrome 5. A primigravida at 29 weeks of gestation who was recently diagnosed with severe preeclampsia The nurse is caring for a client in labor. Which assessment findings...

Saunders NCLEX Postpartum Questions A rubella titer result of a 1-day postpartum client is less than 1:8, and a rubella virus vaccine is prescribed to be administered before discharge. The nurse provides which information to the client about the vaccine? Select all that apply. 1. Breast-feeding needs to be stopped for 3 months. 2. Pregnancy needs to be avoided for 1 to 3 months. 3. The vaccine is administered by the subcutaneous route. 4. Exposure to immunosuppressed indiv...

NCLEX Postpartum The nurse is caring for the postpartum client who is diagnosed with a low-lying placenta. The nurse monitors the client carefully for which complication? - Postpartum hemorrhage The client received epidural anesthesia during labor and had a forceps delivery after pushing for 2 hours. At 6 hours postpartum, the client's systolic blood pressure (BP) dropped 20 points, the diastolic BP dropped 10 points, and her pulse is 120 beats per minute. The client is very anxious and...

Maternity Exam - Questions and Answers On the second postpartum day, a client complains of burning, urgency, and frequency of urination. A urinalysis is obtained, and the results indicate the presence of a urinary tract infection. The nurse instructs the client regarding which measures to take for the prevention and treatment of the infection? Select all that apply. - 1.Urinate frequently throughout the day. 2. Fluid intake should be increased to at least 3000 mL/day. 3. Prescribed medica...

Families Module 4 Exam - Questions and Answers with Rationales The nurse is closely monitoring a child with increased intracranial pressure who has been exhibiting decorticate (flexor) posturing. The nurse notes that the child suddenly exhibits decerebrate (extensor) posturing and interprets that this change in the child's condition indicates which finding? A. An insignificant finding B. An improvement in condition C. Decreasing intracranial pressure D. Deteriorating neurological functio...

Families Module 3 Exam-Questions and Answers with Rationales While performing physical assessment of a 12 month-old, the nurse notes that the infant's anterior fontanel is still slightly open. Which of the following is the nurse's most appropriate action? A. Notify the physician immediately because there is a problem. B. Perform an intensive neurological examination. C. Perform an intensive developmental examination. D. Do nothing because this is a normal finding for the age. Rati...

Families Module 2 Exam A postpartum nurse is preparing to care for a woman who has just delivered a healthy newborn infant. In the immediate postpartum period the nurse plans to take the woman's vital signs: A. Every 30 minutes during the first hour and then every hour for the next two hours. B. Every 15 minutes during the first hour and then every 30 minutes for the next two hours. C. Every hour for the first 2 hours and then every 4 hours D. Every 5 minutes for the first 30 minutes a...

Families Module 1 Exam A client at 36 weeks gestation is scheduled for a routine ultrasound prior to an amniocentesis. After teaching the client about the purpose for the ultrasound, which of the following client statements would indicate to the nurse in charge that the client needs further instruction? A. The ultrasound will help to locate the placenta B. The ultrasound identifies blood flow through the umbilical cord C. The test will determine where to insert the needle D. The ultra...

The nurse is performing telephone triage with a client at 38 weeks gestation who thinks she may be in labor. Which questions would help the nurse determine whether the client is in labor? Select all that apply. 1. "Do you feel like the contractions are getting stronger?" 2. "Does anything you do make the pain better?" 3. "Have you lost your mucous plug?" 4. "How frequent are the contractions?" 5. "Where do you feel the contraction pain most?" The obstetric nurse is revi...

UWORLD 9 1.Emergency medical service personnel are transporting a near-drowning victim who is currently hypothermic. Based on anticipated vital signs, the nurse needs to prepare for which interventions? Select all that apply. 1. Covering client with warm blankets 2. Logrolling the client from side to side frequently 3. Mechanical ventilation 4. Warmed blood administration 5. Warmed IV fluids - 1,3,5 Warmed humidified oxygen can also be given. 2.Clients with ...

Antepartum A client at 38 weeks gestation is brought to the emergency department after a motor vehicle crash. She reports severe, continuous abdominal pain. The nurse notes frequent uterine contractions and mild, dark vaginal bleeding. What actions should the nurse take? Select all that apply. 1. Anticipate emergent cesarean birth. 2. Apply continuous external fetal monitoring. 3. Assess routine vital signs every 4 hours. 4. Draw blood for type and crossmatch. 5. Initiate IV access wit...

UW: 4 Maternal and Newborn Health 1.A practical nurse is collaborating with the registered nurse to form a care plan for a client diagnosed with placenta previa at 33 weeks gestation. What does the nurse anticipate being included in the plan of care? Select all that apply. - Nonstress test 1 or 2 times a week - Prepare for cesarean birth at any time - Type and screen blood Explanation: In placenta previa, the placenta is implanted over or very near the cervix. As a result, placenta...

Maternal Newborn Final An expectant father tells the nurse that he feels resentful of the added attention others are giving to his wife since the pregnancy was first announced several weeks ago. What is the most therapeutic nursing response to the father? - "These feelings are very common to expectant fathers in early pregnancy." A nurse checks a postpartum client's peripad and finds a large amount of lochia rubra with several clots. What is the priority nursing action? - Check the fund...

Elsiver NCLEX Critical Care. A client is being weaned from parenteral nutrition (PN) and is expected to begin taking solid food today. The ongoing solution rate has been 100 mL/hour. The nurse anticipates that which prescription regarding the PN solution will accompany the diet prescription? 1. Discontinue the PN. 2. Decrease PN rate to 50 mL/hour. 3. Start 0.9% normal saline at 25 mL/hour. 4. Continue current infusion rate prescriptions for PN. - Decrease PN rate to 50 mL/hour....

ATI Pharmacology Medication Affecting Reproductive System General Keypoints about reproductive drugs - • Testosterone produced by testes, ovaries, and adrenal cortex. Primary androgen in both genders. • ♀: Primary estrogen and progestional are estradiol and progesterone. Both made in ovaries --> maturation of ♀ reproductive organs & 2º sex characteristics. • Menstruation results from increased progesterone toward end of cycle • Menopausal symptoms result from decreased estr...

Elsevier NCLEX OB The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply. 1. "The ductus arteriosus allows blood to bypass the fetal lungs. 2. "One vein carries oxygenated blood from the placenta to the fetus." 3. "The normal fetal heart tone range is 140 to 160 beats per minute in early pregnancy." 4. "Two arteries carry deoxygenated blood and waste products away from th...