OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023, Exams of Nursing

Download OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 and more Exams Nursing in PDF only on Docsity! OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 Week 3: Ch 13 NCLEX 1. The nurse is preparing an antenatal patient for an initial assessment. What is the first task that the nurse should perform? b. Instruct the client to provide a clean urine specimen. 2. The nurse in the prenatal clinic is planning care for a pregnant 15-year-old client. The nurse knows that this adolescent is at risk for which maternal complication? d. Pre-eclampsia. 3. The nurse has completed the initial assessment on four prenatal clients. Which client is at greatest risk for a spontaneous preterm birth? d. A 19-year-old client with twins. 4. The nurse is assessing the fundal height of a client at 26 weeks’ gestation. The nurse should expect the fundus to be: a. At 26 cm. 5. A nurse is completing an assessment on a first-trimester antepartum client. Which of the following statements would indicate a psychological risk factor and a need to evaluate further for possible intervention? d. “My boyfriend said it better be a boy.” 6. An antepartum client tells the nurse her last period was May 18. The nurse uses Naegele’s rule to compute the client’s expected date of birth, and tells the client that the correct date of birth will be: c. February 25 (of the next year). 7. An antepartal client at 29 weeks’ gestation is assessed in the prenatal clinic. All assessment data are within normal limits. When should the nurse schedule the client’s next appointment? a. In 2 weeks. 8. A nurse assesses four clients in the prenatal clinic. Which client will present with the most accurate fundal height related to gestational age? b. The client who develops hypertension. 9. A client who is 8 weeks pregnant gives the following pregnancy history to the nurse: This is her fourth pregnancy; she had one abortion at 12 weeks, she had a girl born at home at 35 weeks, and she gave birth to a stillborn at 38 weeks. Which of the following is the correct documentation for this client's obstetric history? b. Gravida 4 para 1111. OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 Week 3: Ch 14 NCLEX 1.A client in the prenatal clinic complains of nausea and vomiting. Which intervention should the nurse suggest? Eat dry crackers or toast before arising in the morning 2.A second-trimester client in the prenatal clinic complains of ankle edema. Which intervention should the nurse suggest? Elevate legs when sitting 3.A prenatal client at 10 weeks’ gestation is complaining of urinary frequency. Which self-care strategy should the nurse teach? Empty the bladder when the urge is felt 4.A prenatal client in the third trimester of pregnancy is diagnosed with varicosities in the vulva and perineum. Which self-care strategy should the nurse teach? Elevate legs level with hips while sitting or lying down. 5.A pregnant client complains of severe heartburn. The nurse suggests which of the following relief measures for heartburn? Avoid fried and highly spiced foods. 6.The nurse is teaching a group of prenatal clients about care of the breasts during pregnancy. Which self-care measure might be effective for women with inverted nipples? Breast shields 7.A client at 38 weeks’ gestation tells the nurse, “I had white liquid leaking out of my nipples while warm water was running over my breasts in the shower last night.” The nurse explains that “The liquid was colostrum, just removed with warm water.” 8.A nurse is teaching a group of prenatal clients about hazards in the workplace during pregnancy. The nurse correctly teaches that pregnant women who have jobs requiring long periods of standing have higher incidences of: Preterm birth 9.A nurse is teaching a group of prenatal clients about the importance of exercise during pregnancy. Which client would be the best candidate to continue with her exercise regime? A client with a diagnosis of diabetes. 10.The pregnant woman who is over the age of 35 years has risks related to pregnancy outcome. Which statement about increased risk in this age group is true? Amniocentesis is recommended for all women 35 years and older OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 7. A nurse is caring for a client during an amnioinfusion. Which fetal heart rate (FHR) pattern would be an expected outcome of a successful amnioinfusion? c. A decrease in variable decelerations. (Variable decelerations should decrease, not increase, following an amnioinfusion, because the fluid buffers the cord from being compressed) 8. A nurse is reviewing the charts of four clients in the birthing unit. Which client has an increased risk for an episiotomy? c. The client with a fetus in an occiput-posterior position. 9. While the nurse is assisting the physician with a forceps-assisted birth, the fetal heart rate drops. The client’s husband asks if there is concern for the fetus. To respond appropriately, which of the following must the nurse do? Select all that apply. a. Assess if the drop occurs during traction applied with the forceps. b. Assess for other indications of fetal distress. c. Assess the severity and duration of the heart rate drop. 10. A nurse is caring for a preoperative cesarean birth client. The surgery is scheduled and is not an emergency. The patient has never been hospitalized, has never had surgery, and is very anxious. In planning care, which nursing action takes top priority? c. Sit and talk with the patient. Week 3: Ch 28 NCLEX 1. The nurse knows that the first 24 hours in the life of a newborn are critical during the transition from intrauterine to extrauterine life. The statement that best supports this phenomenon is: c. The risk of mortality and morbidity is statistically high during this period. 2. A newborn appears large for its gestational age, while a lower score for neurological maturation is noted on the gestational exam. The nurse knows that which cause can best explain this outcome? b. Maternal diabetes. 3. According to gestational dates of the mother, it is estimated that the newborn is slightly over 42 weeks’ gestation. What is the highest-priority nursing diagnosis for the newborn during delivery? d. At Risk for Injury (An infant estimated to be at 42 weeks’ gestation will be obviously larger in size, making At Risk for Injury the highest-priority nursing diagnosis listed) 4. The nurse is assessing for breast tissue in a newborn. The nurse knows that which of the following are true? Select all that apply. b. A large breast tissue mass can be unrelated to gestational age. d. At term gestation, the tissue measures between 0.5 and 1 cm (5–10 mm). 5. Which is the best explanation of how a nurse can elicit the “square window sign”? then release them. OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 d. Flex the newborn’s hand to the ventral forearm until resistance is felt. Measure the angle formed at the wrist. 6. Which of the following is true of a 38-weeks’-gestation newborn when testing for head lag? a. The newborn can support his head momentarily. (Total lag is common in newborns at up to 34 weeks’ gestation, whereas post-term newborns (42-plus weeks) hold their heads in front of their body lines. Full-term newborns can support their heads momentarily.) 7. The nurse weighs a 1-day-old newborn. It is noted that the newborn has lost 10 grams from the previous day. Which response from the nurse to the parents is most appropriate? b. “This is acceptable, and your newborn more than likely will continue to lose close to 10% of the birth weight over the next few days, but then regain the weight by 2 weeks.” 8. Which is the preferred method of taking a newborn's temperature? b. Axillary. 9. Clinical manifestations that indicate a newborn might be experiencing overheating include which of the following? d. Increased restlessness and perspiration. (Newborns can respond to overheating with increased restlessness and, eventually, perspiration. The perspiration appears initially on the head and face and then the chest. Vital sign variations are not always indicators of overheating) 10. What is the most appropriate nursing intervention for a newborn experiencing acrocyanosis? c. Assess temperature. (Acrocyanosis is caused by poor peripheral circulation; Decreased temperature can decrease peripheral perfusion and worsen acrocyanosis. If the temperature is decreased, measures can be instituted to warm the infant and improve perfusion) Week 3: Ch. 29 NCLEX 1.A newborn is born at 38 weeks’ gestation weighing 2,250 grams. Which is the most appropriate nursing diagnosis? Risk for Altered Body Temperature 2.What would be important abnormal information to note upon the initial physical assessment of the newborn? A two vessel cord 3.To assist the nurse in providing comprehensive maternal-newborn care, which of the following subjective data is pertinent to document? Available support system 4.Blood glucose evaluation is clinically indicated in which of the following newborn scenarios? An infant who is large for gestational age A newborn with jitteriness OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 5.Before giving a newborn his first sponge bath, the nurse must first do which of the following? Check the temperature 6.To facilitate family-newborn attachment, the nurse does which of the following? Select all that apply. Assists with an interactive bath. Encourages sibling visitation whenever possible 7.What are significant symptoms of respiratory distress in the newborn? Select all that apply. Changes in color or activity. Facial grimacing. Chest retractions 8.When signs of fatigue occur in the newborn, such as loss of eye contact, decreased muscle tension, and closure of the eyelids, the nurse should immediately: Discourage parent tactile stimulation 9.The nurse should remove the cord clamp within 24 hours to: Decrease the chance of tension injury to the area 10. It is important that the newborn screen be drawn after 24 hours from the time of delivery. What rationale supports this? It is well documented that there is a decrease in sensitivity of the screening if obtained before 24 hours of life, resulting in underdiagnosing of PKU. Week 3: Ch 33 NCLEX 1. Which woman who has unprotected sexual relations is at greatest risk for an unintentional pregnancy during the postpartum period? c. A non-nursing mother who is 5 weeks postpartum. 2. Which woman is at greatest risk for bladder distention after a normal vaginal delivery? c. A woman who had epidural anesthesia. (the biggest risk factor is anesthesia, which affects the sensory nerves, because the woman is unaware of the need to empty her bladder. Nerve blocks also can affect motor nerves, making micturition difficult.) 3. What is the nurse’s chief concern when a mother who delivered 2 hours ago has a blood pressure change from 112/70 to 142/94? c. Developing pre-eclampsia. 4. The nurse is assessing a postpartum client who gave birth 10 hours ago. What assessment finding would need further investigation by the nurse? c. Fundus is deviated to the right. OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 that it is contracted; a firm, midline fundus indicates normal involution; (2) the amount and character of lochia, excessive or foul-smelling lochia indicates problems.) Week 3: Ch 35 NCLEX 1. The community health nurse is demonstrating different positions for holding the newborn. Which hold best facilitates shampooing the baby’s hair? a. Football hold. (The football hold allows the parent to have a free hand to shampoo the hair while still having a firm hold on the baby.) 2. The community health nurse is planning to visit four postpartum mothers who initiated breastfeeding after birth. Which client is most at risk for possible breastfeeding problems? b. The client who had twins. 3. The community health nurse is educating parents about the different infant sleep-awake states. During which state would it be most appropriate to run the dishwasher? c. Deep sleep. (The newborn will respond only to very intense stimuli during deep sleep, so household noises would not disturb the newborn during this sleep stage.) 4. The parents of an 8-day-old newborn call the community health nurse stating that the umbilical cord stump has fallen off. What is the most appropriate response by the nurse? c. It is normal for the cord stump to fall off in 7–14 days. 5. What is the first intervention the community health nurse should implement when working with a mother who complains of nipple cracking and soreness? d. Watch while the mother feeds the infant. 6. During a home visit, a nurse assesses a three-day postpartum client who complains of constipation. What should the nurse do first? a. Evaluate the client’s diet. (Assessing the diet and increasing fluids may help relieve constipation.) 7. Which of the following assessments on a 48-hour postpartum client requires immediate follow-up with a physician or nurse-midwife? b. Total weight loss of 4 pounds. (Maternal weight loss of only 4 pounds could indicate fluid retention possibly connected with PIH and requires immediate referral to the physician or midwife. Weight loss in the first two days should be about 12–20 pounds.) 8. The nurse is reviewing newborn skin care with parents. Which intervention would be most appropriate for dry skin in the newborn? b. Apply A&D ointment to cracked areas. 9. The community health nurse plans to see four postpartum clients. Which client should the nurse visit first? c. A primipara who was discharged three weeks before her 32-weeks’-gestation male infant. OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 (The premature infant has the most needs in terms of oxygenation status and nutrition) 10. The community health nurse obtains a weight of 9 pounds, 8 ounces on an infant. How many grams would the nurse document? 4,318 g (The child is 9.5 pounds. One kilogram is 2.2 pounds. 9.5 divided by 2.2 equals 4.318. To convert kilograms to grams, move the decimal point 3 places. The child is 4,318 grams) Week 4: NCLEX Ch. 23 1.A G1P0 client’s cervix is 4 cm dilated. She tells the nurse, “I’m in pain, but I’m afraid that medication might harm my baby.” Which response is the most therapeutic regarding pain medication during labor? “Even though pain medications affect the baby, the stress you are feeling from the pain can also affect the baby.” 2.A nurse is caring for a laboring client who just received systemic medication for labor pain. Which fetal heart rate pattern would require further action? Decreased FHR variability and late decelerations. 3.A nurse is caring for a laboring client who just received an epidural block. What is the major adverse effect for which the nurse should observe? Hypotension 4.Butorphanol tartrate has been ordered for pain for a laboring client. What should be the nurse’s first action prior to administering the medication? Assess for allergies 5.The nurse is administering diphenhydramine per standing order to treat which commonly occurring side effect during epidural infusion? Pruritus 6.The nurse is to administer naloxone intravenously. Which medication order would be the most appropriate initial dose to counteract a narcotic-induced maternal respiratory depression? 0.4 mg 7.A nurse is caring for a client who received a spinal block for a cesarean birth. The client asks the nurse when she can get up to go to the nursery. The nurse’s best response is: “You will need to remain in bed for at least .” 6-12 hours OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 8.Immediately after a cesarean section birth, the anesthesiologist plans to inject a narcotic into the epidural space to provide analgesia for approximately 24 hours. Which opioid should the nurse anticipate that the physician will use? Duramorph 9.The birthing unit has 4 laboring clients. For which of these clients would an epidural block be contraindicated? G1P0 dilated 2–3 cm with platelet count of 90,000. (bc of risk of bleeding!!) 10. The nurse is caring for a laboring client who is scheduled for an epidural block. What action prior to the epidural placement would decrease the chance of maternal hypotension? Infuse an IV bolus of 500–1,000 mL of normal saline Week 5: Ch 16 NCLEX 1. A nurse working in the prenatal clinic is evaluating the nutritional status of four adolescents. Which adolescents have nutrition-related risk factors? Select all that apply. a. The adolescent who smokes. b. The adolescent who is 10 pounds underweight. d. The adolescent who is diabetic. 2. A nurse is evaluating client teaching about nutrition. The nurse knows the teaching has been effective when the client states: b. “I should take my iron right after a meal.” 3. The nurse’s teaching plan for the prenatal client who is a vegan should pay particular attention to which of the following? Select all that apply. a. Need for nutritional supplements. c. Suggestions for ensuring adequate caloric intake. d. Plant sources of complete protein. 4. A gravida 2 para 1 prenatal client’s ultrasound reveals twins. Her prepregnant weight is within normal limits. What is the pattern of weight gain that the nurse should recommend to the client during the second and third trimesters? d. 1.5 pounds per week. 5. A prenatal client asks the nurse, “How much weight should I gain, and when?” What is the best response by the nurse regarding the pattern of weight gain? c. “Gain 3.5–5 pounds in the first trimester and 1 pound per week in the last two trimesters.” 6. An adolescent at 18 weeks’ gestation complains to the nurse in the prenatal clinic about her 15-pound weight gain. What is the best response by the nurse? d. “You should continue to gain weight, but at a slower rate.” 7. A nurse is teaching a prenatal nutrition class. Which meal is highest in protein? a. Sausage, eggs with cheese, toast, and coffee. OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 6.A nurse is working with a pregnant teenager in the prenatal clinic. What would be the most important nursing action to help this teen meet the third-trimester developmental tasks of pregnancy? Assess the client for discomforts of pregnancy 7.Which of the following nursing statements made to a 17-year-old pregnant client at the initial prenatal visit would be most effective in developing a trusting nurse–client relationship? “Since this is your first pelvic exam, I’d like to explain what will be happening” 8.The nurse assesses for complications of pregnancy in a 19-year-old client. Which of the following data might indicate a complication associated with adolescent pregnancy? Hypertension, proteinuria, edema. 9.A nurse is planning a prenatal program for a group of adolescents. Which teaching techniques will be most appropriate for this age group? Select all that apply. Use a variety of teaching methods Include infant growth and development content 9.The nurse is planning a community program to decrease adolescent pregnancy. According to research, successful community teen pregnancy prevention programs use which approaches? Address societal issues of poverty and education. 10. The nurse is working with a pregnant adolescent. The client is experiencing morning sickness and has not been able to eat regular meals. What would be the priority nursing diagnosis? Altered Nutrition: Less than Body Requirements Week 6: Ch 17 NCLEX 1.A client who has admitted to heavy alcohol use throughout her pregnancy just delivered a 6- pound baby. Which signs and symptoms in the mother should the nurse anticipate in the 12–48- hour postpartum period? Select all that apply. Seizures Delirium tremens 2.A postpartum client who admits to heavy alcohol use asks the nurse about breastfeeding her baby. The nurse correctly teaches this client that excessive alcohol consumption while breastfeeding can: Decrease the maternal milk letdown reflex 3.The nurse is teaching a client with diabetes about insulin requirements during pregnancy. Which statement should the nurse include regarding insulin requirements? Insulin needs increase in the second trimester OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 4.A prenatal client with insulin-dependent diabetes asks the nurse about pregnancy-related complications from diabetes for her baby. The nurse responds that the baby is at risk for which of the following when the mother has insulin-dependent diabetes? Select all that apply. Congenital anomalies Macrosomia Respiratory distress syndrome 5.The nurse is caring for a laboring client with Type I diabetes. What are the signs and symptoms of hypoglycemia for which the nurse should assess? Diaphoresis and disorientation 6.A client with Type I diabetes is admitted to the labor and birthing unit. What nursing actions should take priority in the intrapartal management of the patient with diabetes? Select all that apply. Hourly monitoring of blood sugar level Maintaining two patent IV lines 7.The nurse is counseling a prenatal client regarding the need to take folic acid supplements during pregnancy. The nurse also encourages the client to eat foods high in folic cid, such as: Fresh green, leafy veggies and legumes 8.The nurse is caring for a laboring client with sickle-cell anemia. Which therapy should the nurse anticipate the physician ordering? Oxygen: to decrease the chance of cells sickling when there's decreased O2 9.The nurse is completing a history for a new client in the prenatal clinic. The client states that she had a ventricular septal defect successfully repaired with no further problems. The nurse anticipates what order for this client? Antibiotic Prophylaxis 10. The nurse is providing prenatal care to an asymptomatic HIV-infected client. Which nursing interventions should take priority? Select all that apply Take the clients temperature Performing a vision test Skin assessment Week 6: Ch 18 NCLEX 1.The nurse is reviewing the lab tests of four prenatal clients. Which lab finding would support the diagnosis of hyperemesis gravidarum? Hypokalemia 2.If a client does not respond to standard home treatment for severe hyperemesis gravidarum, the nurse will anticipate adding which therapy on an outpatient basis? OB EXAM 2 NCLEX WEEKLY- QUIZ WITH VERIFIED SOLUTIONS 2023 IV fluids 3.A client at 30 weeks’ gestation is admitted to the maternity unit with vaginal bleeding. What should be the nurse’s initial nursing action? Assess Blood Pressure and Pulse 4.A prenatal client at 16 weeks’ gestation presents to the clinic with unexplained bright red bleeding, cramping, and backache, which she has had for the past two days. A pelvic exam reveals a closed cervix. What type of abortion does this indicate? Threatened 5.The client asks for information about ectopic pregnancy. The nurse correctly responds by saying ectopic pregnancy is caused by: (Select all that apply.) a. Pelvic inflammatory disease (PID). b. Presence of an IUD. c. In utero exposure to diethylstilbestrol (DES). d. Endometriosis. 6.A client presents to the physician’s office with complaints of right-sided abdominal pain, dizziness, and vaginal bleeding. A pelvic exam determines adnexal tenderness. What diagnosis should the nurse suspect? Ectopic Pregnancy 7.A client at 15 weeks’ gestation presents to the prenatal clinic with “prune juice”-like vaginal bleeding. Other assessment data include a hematocrit of 10 and complaints of severe nausea and vomiting. What diagnosis should the nurse suspect? Hydatidiform Mole 8.A client is being maintained at home with a diagnosis of mild pre-eclampsia. Which of the following complaints require further evaluation? Select all that apply Headache Blurred Vision 9.During a prenatal visit, a client states, “Sometimes my boyfriend hits me, but it is just when he is stressed at work. I know he loves the baby and me; it’s just hard right now. He wouldn’t really hurt me.” The nurse’s first priority is to: Determines the client’s immediate safety 10. Which of the following client statements indicate a need for additional education regarding avoidance of perinatal infection? Select all that apply. “If I have beta strep in labor, I will most likely need a C-section.” (bc she can still have vag delivery) “I will not let the cat sleep in our bed now that I am pregnant.” (just dont deal with feces, but cat may be around)