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Which of the following breast changes is a pregnant client most likely to notice?
The client is pregnant for the third time. She has a 5-year-old and had a missed abortion at 10 weeks of gestation. Which one of the options is the correct gravida and para for this client?
What is the estimated date of confinement of a client whose first day of menstruation was April 7, 2022?
A pregnant client needs additional iron during her pregnancy. The nurse instructs the client to take the iron with which of the following beverages to promote maximum absorption?
The nurse is caring for a primigravida at about 2 months and 1 week gestation. The client has a correct understanding of the self-care measures for common discomforts of pregnancy when she says which statement?
The nurse is providing health teaching to a client with preeclampsia. What are the maternal factors that increases risk for developing preeclampsia? Select all that apply
A client has been diagnosed with pregnancy induced hypertension. Which of the following medications would the nurse expect to administer to the client if the client develops magnesium toxicity?
Early detection of an ectopic pregnancy is important in preventing rupture. Which symptoms should alert the nurse to the possibility of an ectopic pregnancy in the client?
When planning the nursing care for a client with abruptio placenta, the nurse should include careful assessment for which signs and symptoms?
The client is brought to the emergency room following a vehicular accident. The client is on her 4th week of pregnancy. Her abdomen is getting bigger, is rigid on palpation, and her pain is severe. Acute fetal distress was present upon fetal monitoring. Which of the following complications is the client experiencing?
The client complains that she hardly feels her baby moving. The nurse attaches fetal monitoring and sees a variable deceleration pattern. Which action should be the nurse’s priority?
A client in labor reports that she feels something soft coming out of her vagina. The sees a pale looking membrane that looks like an intestine upon visual inspection. Which of the following should the nurse do first?
A couple have just had their second child. The mother’s blood type is O, Rh-negative, and the father’s blood type is AB, Rh-positive. The nurse knows that Rh incompatibility was once a leading cause of kernicterus and a significant cause of neonatal death and prepares for the administration of Rhogam. Administering RhoD immune globulin (RhoGam) to the mother serves should follow which regimen?
The nurse notes that a woman’s fundus is 2 finger breadths above the umbilicus 6 hours after delivery. It is also deviated to the right of the midline. The nurse should further assess the woman for which of the following?
The nurse should be able to feel the top of the uterus at which position immediately after the client’s delivery?
The nurse is assessing a client who gave birth yesterday. The nurse should expect to find the top of the client’s fundus at which location today?
The nurse is caring for a client on her second postpartum day. The nurse should expect the client’s lochia to be which color and pattern at this time?
A client is bottle feeding her baby after giving birth to a male infant. On the third day postpartum, the client develops engorgement in both breasts. What advice should the nurse give this client?
A client is experiencing calcium deficiency after initiating breastfeeding for her first child. The nurse knows that good dietary sources of calcium include which of the following food choices? Select all that apply
The client decides to bottle feed her infant. The nurse assesses the mother’s readiness for discharge after a teaching session. Which of the following statements from the mother indicates to the nurse that the client needs further instruction?
Which of the following findings would the nurse most likely expect to observe when assessing a pregnant client suspected to have an abruptio placenta?
The recovery room nurse suspects that DIC (Disseminated Intravascular Coagulation) has occurred as a complication for a client who had an abruptio placenta. Which observation is suggestive of DIC?
The nurse suspects that the client may be suffering from postpartum depression. Which of the following behaviors would indicate that the nurse’s suspicion may be correct?
A nurse suspects that a newborn has toxoplasmosis. How and when may toxoplasmosis have been transmitted to the newborn?
After reviewing the Primary Healthcare Provider’s explanation of amniocentesis with a multigravida client, which of the following risks of the procedure will indicate successful teaching if identified by the client?
A new mother asks the nurse how to care for her baby’s umbilical cord stump. Which information should the nurse teach the mother?
The client’s young parents express concern that their 5-year-old is wetting the bed several times a month at a routine visit. What is the nurse’s best response?
The nurse teaches the mother about the expected developmental changes for a toddler. Which statement by shows that she understands the child’s developmental needs?
Which of these developmental achievements would the nurse anticipate that the child would be able to perform at 8-months-old?
Which of the following is the best approach by the nurse when planning to give a toddler digoxin?
The client’s mother asks the nurse’s advice about the child’s screaming every time the family gets ready to leave the hospital room. The client is just 3 years old. What is the best response by the nurse?
The parent of a 5-year-old client consults the nurse for guidance in how to answer the question, “Where do babies come from?” What is the nurse’s best response to the parent?
The parents have numerous questions regarding the normal growth and development of an infant. Which of the following parameters is of most concern to the nurse?
A pediatric client who was diagnosed with a Tetralogy of Fallot has a hypoxic episode. What is the most appropriate action for the nurse to take?
Sodium salicylate is prescribed for a pediatric client with rheumatic fever. What should the nurse assess the client for when given this medication?
A pediatric client has been admitted to the hospital with a diagnosis of rheumatic fever. The client is to remain on complete bed rest with activity restrictions. Why would the nurse restrict activity during the acute phase of the client’s illness?
The nurse is assessing a child who having respiratory difficulty due to epiglottitis. Which of the following is the nurse most likely to assess in the child?
The child with epiglottitis would be most likely to assume which of the following positions?
The nurse is performing assessment for a pediatric client who has recently been diagnosed with cystic fibrosis. Which later finding of this disease would the nurse not expect to see at this time?
A pediatric client has just been diagnosed with cystic fibrosis. The client’s father asks the nurse “What is our major concern now regarding this diagnosis, and what will we have to deal with in the future?” Which of the following is the best response by the nurse?
The nurse was approached by a young couple who are planning on having a child. The couple is anxious because of a history of cystic fibrosis in both of their families. A genetic test has confirmed that both partners are carriers of the disease. The nurse would correctly tell the couple which information?
The parents of a newborn with cleft lip repeatedly ask the nurse when the cleft lip can be repaired. The nurse correctly shares with them which information?
Which of the following statements if made by the mother, indicates to the nurse a satisfactory teaching about the care of a child with celiac disease?
A client who has gluten sensitive enteropathy (Celiac Disease). In reviewing the client’s meal plan, the nurse would order which of the following meals for the client?
A very young client was brought to the recovery room after a tonsillectomy. Which of the following actions should the nurse include in the client’s plan of care?
The nurse is preparing s preschool client who is scheduled tonsillectomy and adenoidectomy. The parents are about the child’s reaction to impending surgery. Which nursing intervention would be best to help prepare the client?
The nurse is caring for a pediatric client who is being discharged following a tonsillectomy. Which of the following instructions is appropriate for the nurse to teach the parents?
Assessment of an infant with hydrocephalus includes increased head circumference and several other signs and symptoms. Which of the following is not expected to be seen in a client with hydrocephalus?
A client has a tentative diagnosis of Wilms’s tumor. The nurse would be most concerned about which statement by the client’s mother?
What consideration should the nurse keep in mind when planning care for a newborn who was infected with HIV in utero?
A client is receiving blood transfusion. The client reports itching and hives on his chest and abdomen that occurred a few minutes after starting the transfusion. Which of the following actions should the nurse take first?
A client’s nursing diagnosis is Deficient Fluid Volume related to excessive fluid loss. Which action related to this client’s fluid management can be delegated to an Unlicensed Assistive Personnel by the nurse?
The client with deficient fluid volume also has the nursing diagnosis Decreased Cardiac Output related to decrease plasma volume. Which finding on assessment is consistent with this nursing diagnosis?
The nursing care plan for the elderly client with dehydration includes interventions for maintaining oral health. Which interventions are within the scope of practice for the LPN/LVN being supervised by the nurse? Select all that apply
Which team is the most appropriate for an assignment of covering the triage area in the emergency department?
Several clients approach the triage desk at the same time while you are working in the triage area of the emergency department. In what order should the following clients be assessed?
In conducting a primary survey on a client with trauma, the nurse knows that which of the following is considered one of the priority elements of the primary survey?
A client presents in triage with left-sided chest pain, diaphoresis, and dizziness. Into which category should the client be prioritized in?
The Primary Healthcare Provider has ordered cooling measures for a pediatric client with fever. The client is likely to be discharged when the temperature comes down. Which of the following would be appropriate to delegate to the Unlicensed Assistive Personnel?
The nurse was assigned to care for a client with a seizure disorder. Which of these nursing actions will the nurse implement first if the client has a seizure?
Which information obtained during the chart review and assessment of a client who was recently started on phenytoin (Dilantin) therapy will be of greatest concern?
The nurse is preparing to discharge a client with chronic low back pain. Which statement by the client indicates that some additional teaching is necessary?
A client complains about a severe throbbing headache that suddenly started a short time ago. Assessment of the client reveals a spinal cold injury, increased blood pressure (178/104 mm Hg) and decreased heart rate (52/minute), discomfort, diaphoresis, and flushing of the face and neck. The nurse suspects that the client is experiencing autonomic dysreflexia. What action should the nurse take first?
A client has a nursing diagnosis of Activity Intolerance related to weakness and anemia. Which nursing activities is most appropriate to delegate to an Unlicensed Assistive Personnel?
A blood transfusion been infusing for 5 minutes when the client becomes flushed and tachypneic and says, “I am having chills. I feel cold. Please get me a blanket.” Which action should the nurse take first?
A group of clients is assigned to an RN-LPN/LVN team. The LPN/LVN is most likely to be assigned by the RN to administer medications and provide client care to which of these clients?
Which information has the most immediate implications for the client’s care for a client who was admitted with multiple myeloma?
The nurse in the outpatient clinic is assessing a 20-year-old client with a history of a recent splenectomy after a motor vehicle accident. Which information obtained during the client assessment will be of most immediate concern to the nurse?
Which client is at greater risk for respiratory depression while receiving opioids for analgesia?
A client appears upset and tearful but denies pain and refuses pain medication. When asked by the nurse, the client replies, “My sibling is a drug addict and has ruined our lives.” What is the priority intervention for this client?
The nurse is watchful for signs of withdrawal for a client who is being weaned off opioids. What is of the following is one the first signs of opioid withdrawal?
Which task is most appropriate to delegate to the Unlicensed Assistive Personnel?
The Primary Healthcare Provider has ordered a placebo for a client with chronic pain. The new nurse feels very uncomfortable administering the medication. What is the first action that the nurse should take?
The nurse receives a phone call requesting information about a client and observes that the client requested a do not publish order on any information regarding the client’s condition or presence in the hospital. Which response by the nurse would be appropriate?
Which of the following herbal medicines would the nurse identify as something that could alleviate mild depression?