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    Exam Review

    1. A nurse is assessing a newborn who is 2 hours old. Which of the following findings is an indication of hypoglycemia?(SATA)
      A)Temperature instability.
      B)Acrocyanosis.
      C)Jitteriness.
      D)Hypotonia.
      E)Abdominal distention.
    2. A nurse is caring for a client in labor who has an epidural in place and is on continuous internal monitoring with a fetal scalp electrode and intrauterine pressure catheter. The nurse notes a strong contraction on the monitor and the client reports nausea accompanied by an urgent need to have a bowel movement. Which of the following assessments is the nurse's highest priority?
      A)Determine the client's temperature, heart rate, and blood pressure.
      B)Determine the fetal heart rate in relationship to the contraction.
      C)Examine the vaginal discharge for the presence of meconium.
      D)Perform a vaginal examination to assess labor progress.
    3. A nurse is assessing the lifestyle practices of a pregnant client. Which of the following lifestyle factors indicates an increased risk for high-risk pregnancy?
      A)Consuming 27 mg of iron daily.
      B)Consuming 300 mg of caffeine daily.
      C)Consuming 3 L (101 oz) of water daily.
      D)Consuming 400 mcg of folate daily.
    4. A nurse is caring for a client who is 9 hours postpartum following a cesarean birth with a quantitative blood loss of 1200 mL. Which of the following findings indicates the client is experiencing a fluid volume deficit?
      A)900 mL of urine output since the birth.
      B)Temperature 37.6° C (99.6° F).
      C)Reports of excessive sweating.
      D)Blood pressure 80/55 mm Hg.
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    Exam Review

    1. A nurse is caring for a client who is receiving an epidural for continuous labor analgesia. Which of the following findings should indicate to the nurse that the treatment is effective?
      A)The client reports slight pressure with contractions.
      B)The client has bladder distention.
      C)The client's systolic blood pressure decreases by 20 mm Hg.
      D)The client is unable to move their legs or feet.
    2. A nurse is caring for a client who is at 36 weeks of gestation and has a confirmed intrauterine fetal demise. Which of the following treatment options should the nurse anticipate the provider to discuss with the client?
      A)Immediate cesarean birth.
      B)Administration of methotrexate.
      C)Scheduled induction of labor.
      D)Dilation with suction curettage.
    3. A nurse is performing a nutritional assessment for a client during their first prenatal visit at 12 weeks of gestation. Which of the following findings indicates that the client should be referred to a registered dietician?
      A)The client reports that they are nauseous most mornings.
      B)The client reports a 4.5 kg (10 lb) weight gain since their positive pregnancy test.
      C)The client reports that they take a multivitamin daily.
      D)The client reports that they eat prunes to help manage their constipation.
    4. A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect? (Select all that apply.)(SATA)
      A)Acrocyanosis.
      B)Hypotonia.
      C)Exaggerated Moro reflex.
      D)Tachypnea.
      E)Shrill-pitched cry.
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    Exam Review

    1. A nurse is reviewing signs of effective breastfeeding with a client who is 5 days postpartum. Which of the following information should the nurse include in the teaching?
      A)Your baby's urine should appear dark and concentrated.
      B)Your breasts should stay firm after the baby breastfeeds.
      C)You should feel a tugging sensation when the baby is sucking.
      D)You should expect your baby to have two to three wet diapers in a 24-hour period.
    2. A nurse is caring for a postpartum client who recently had an indwelling urinary catheter removed. Which of the following findings indicates that the client is able to void effectively?
      A)The bladder is distended upon palpation.
      B)The uterine fundus is 2 cm above the umbilicus.
      C)The client does not feel the urge to urinate.
      D)The client urinates 30 mL/hr.
    3. A nurse is performing a nonstress test for a client who is at 38 weeks of gestation. The fetal monitor tracing reveals a series of late decelerations. Which of the following interventions should the nurse implement first?
      A)Place the client in a lateral position.
      B)Administer lactated Ringer's via IV bolus.
      C)Prepare the client for a cesarean birth.
      D)Elevate the client's legs.
    4. A nurse is teaching the parents of a newborn about the critical congenital heart disease screening. Which of the following statements should the nurse include in the teaching?
      A)The test will be performed when your newborn is between 6 and 12 hours of age.
      B)It will take 1 to 2 weeks to obtain the results of your newborn's test.
      C)The test compares the oxygen saturation in your newborn's upper and lower extremities.
      D)To perform the test, I will collect a blood sample from your newborn's heel.
    Page 3 of 16

    Exam Review

    1. A nurse is caring for a postpartum client who recently had an indwelling urinary catheter removed. Which of the following findings indicates that the client is able to void effectively?
      A)The bladder is distended upon palpation.
      B)The uterine fundus is 2 cm above the umbilicus.
      C)The client does not feel the urge to urinate.
      D)The client urinates 30 mL/hr.
    2. A nurse is caring for a client who is receiving epidural anesthesia. The client is hypotensive with decreased placental perfusion. Which of the following actions should the nurse take?
      A)Administer oxygen via nasal cannula at 2 L/min.
      B)Administer lactated Ringer's 500 mL bolus.
      C)Place the client in a knee-chest position.
      D)Monitor the client's blood pressure every 30 min.
    3. A nurse is caring for a client who is receiving 1 milliunit/min of oxytocin for the induction of labor. The provider prescription reads to increase the rate by 1 milliunit per/min every 30 min until the client demonstrates an expected labor pattern. The cervical Bishop score is 2. The monitor indicates contractions every 1 min. Which of the following findings indicates the nurse should titrate the infusion rate to 2 milliunits/min after the first 30 min?
      A)The client's contractions palpate as mild.
      B)The client experiences spontaneous rupture of membranes.
      C)The client's pain level decreases.
      D)The client's blood pressure stabilizes.
    4. A nurse is caring for a client who is at 35 weeks of gestation and has preterm premature rupture of the membranes. Which of the following complications should the nurse monitor the newborn for following delivery?
      A)Meconium aspiration.
      B)Polycythemia.
      C)Sepsis.
      D)Hyperbilirubinemia.
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    Exam Review

    1. A nurse is planning care for a postpartum client who expresses a desire to follow the traditional beliefs regarding the balance of yin and yang for postpartum care. Which of the following actions should the nurse plan to take?
      A)Apply a new ice pack to the client's perineal area every 4 hours.
      B)Maintain a cool environment in the client's room.
      C)Provide the client with a warm beverage.
      D)Assist the client with showering twice daily.
    2. A nurse is caring for a newborn who has herpes simplex virus as a result of in utero transmission. Which of the following actions should the nurse take?
      A)Immediately bathe the newborn.
      B)Initiate contact precautions.
      C)Administer ampicillin IV.
      D)Withhold breastfeeding.
    3. A nurse is assessing a client who is 1 hour postpartum. Which of the following findings should the nurse report to the provider?
      A)Temperature 37.7° C (99.9° F).
      B)Boggy fundus.
      C)Lochia rubra with small clots.
      D)Minimal perineal edema.
    4. A nurse is caring for a client who is in labor and is receiving epidural analgesia. Which of the following changes in the FHR should the nurse report to the provider?
      A)Prolonged period of absent FHR variability.
      B)FHR increase to 150/min.
      C)FHR accelerations of 15/min for 15 seconds.
      D)Early decelerations of the FHR.
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    Exam Review

    1. A nurse is providing vehicle safety education to the parents of a premature newborn. Which of the following statements should the nurse include in the teaching?
      A)"Your newborn will need to have a car seat test prior to discharge.”.
      B)"Position the retainer clip at the level of your newborn's abdomen.”.
      C)"Place your newborn in a front-facing car seat in the back seat of the vehicle.”.
      D)"You should secure your newborn's car seat at a 60-degree angle.”.
    2. A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation. Which of the following findings should the nurse report to the provider?
      A)Hematocrit 37% (37% to 47%).
      B)Creatinine 0.9 mg/dL (0.5 to 1 mg/dL).
      C)WBC count 11,000/mm (5,000 to 10,000/mm).
      D)Fasting blood glucose 180 mg/dL (74 to 106 mg/dL).
    3. A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hours ago. Which of the following findings place the client at risk for postpartum hemorrhage?(SATA)
      A)Vacuum-assisted delivery.
      B)Newborn weight 2.948 kg (6 lb 8 oz).
      C)Labor induction with oxytocin.
      D)History of uterine atony.
      E)History of human papillomavirus.
    4. A nurse is obtaining a medical history from a client who is requesting a copper intrauterine device (IUD). The nurse should identify that which of the following conditions is a contraindication for the use of a copper IUD?
      A)Depression.
      B)Diabetes mellitus.
      C)Cholelithiasis.
      D)Dysmenorrhea.
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