MILESTONE - FAMILY
Question 1
After the nurse teaches a local woman's group about postpartum affective disorders, which statement by the group indicates that the teaching was successful?
"Postpartum blues usually resolves by the 4th or 5th postpartum day."
"Postpartum depression develops gradually, appearing within the first 6 weeks."
"Postpartum psychosis usually appears soon after the woman comes home."
"Postpartum psychosis usually involves psychotropic drugs but not hospitalization."
Question 2
The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount?
1000
500
750
300
Question 3
Various medications are available to help control hemorrhage in the postpartum client. When reviewing the client's history, the nurse notes she has a history of asthma. Which medication if prescribed would the nurse question?
carboprost
methylergonovine
oxytocin
misoprostol
Question 4
The physician orders fluorescent antibody testing for a child with suspected respiratory syncytial virus infection. The nurse would obtain the specimen for testing from:
arterial blood.
nasopharyngeal secretions.
sweat
sputum
Question 5
The nurse has provided instructions to the parent of a child with sickle cell disease regarding measures that will prevent a sickle cell crisis. Which statement by the parent indicates an understanding of these measures?
"My child needs to avoid any exercise."
"My child needs to avoid increasing any fluid intake."
"My child needs to avoid going outdoors in warm weather."
"My child needs to avoid situations that may lead to an infection."
Question 6
A 10-year-old child has been diagnosed with type 1 diabetes mellitus, and the nurse prepares to educate the family. The child is very active socially and often is away from the parents. Which is the best focus of the nurse's teaching for this client?
The parents are instructed to always be available to monitor the child's insulin requirements.
The child is taught how to monitor insulin requirements and how to self-administer the insulin.
All of the friends and family involved with the child's activities should be involved in monitoring the child's insulin requirements.
The child's schoolteacher needs instruction on how to assist the child to monitor insulin requirements and how to oversee the child's self-administration of insulin.
Question 7
During a woman's 38-week prenatal visit, the nurse assesses the fetal heart rate to be 180 beats/minute. What might the nurse suspect as the most likely cause of this tachycardia?
Maternal infection
Gestational hypertension
Gestational diabetes mellitus
Consumption of recent high-sugar snack
Question 8
The nurse is assessing a client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which findings would the nurse expect to note if abruptio placentae is present? Select all that apply.
Soft uterus
Abdominal pain
Nontender uterus
Firm uterus by palpation
Painless vaginal bleeding
Question 9
The nurse in the labor room is caring for a client in the active stage of the first phase of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. What is the most appropriate nursing action?
Administer oxygen via face mask.
Place the client in a supine position.
Increase the rate of the oxytocin intravenous infusion.
Document the findings and continue to monitor the fetal patterns.
Question 10
The nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which is noted on the external monitor tracing during a contraction?
Early decelerations
Variability
Accelerations
Variable decelerations
Question 11
The nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which action is most appropriate?
Notify the primary health care provider of the findings.
Reposition the client and check the monitor for changes in the fetal tracing.
Take the client's vital signs and tell the client that bed rest is required to conserve oxygen.
Document the findings and tell the client that the pattern on the monitor indicates fetal well-being.
Question 12
On assessment of the fetal heart rate (FHR) of a laboring client, the nurse discovers decelerations that have a gradual onset, last longer than 30 seconds, and return to the baseline rate with the completion of each contraction. The nurse plans care, knowing that this identifies which category of decelerations?
Episodic, late decelerations that indicate uteroplacental insufficiency
Periodic, early decelerations that indicate fetal head compression
Periodic, variable decelerations that indicate cord compression
Episodic, early decelerations that may be a result of maternal hypotension
Question 13
The nurse in the labor room is caring for a client who is in the first stage of labor. On assessing the fetal patterns, the nurse notes an early deceleration of the fetal heart rate (FHR) on the monitor strip. Based on this finding, which is the appropriate nursing action?
Place the client in Trendelenburg's position.
Administer oxygen to the client by face mask.
Contact the primary health care provider (PHCP).
Document the findings and continue to monitor fetal patterns.
Question 14
The nurse is caring for a client in the active stage of labor. The nurse notes that the fetal pattern shows a late deceleration on the monitor strip. Based on this finding, the nurse would prepare for which appropriate nursing action?
Administering oxygen via face mask
Placing the client in a supine position
Increasing the rate of the intravenous (IV) oxytocin infusion
Documenting the findings and continuing to monitor the fetal patterns
Question 15
Which newborn is most at risk for a brachial plexus injury?
A term infant with a history of a forceps-assisted delivery
A term infant delivered via primary cesarean section for malpresentation
A large for gestational age infant with a history of shoulder dystocia at delivery
A 36-week preterm infant delivered vaginally after preterm rupture of membranes
Question 16
The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which sign, if noted, would be an early sign of excessive blood loss?
A temperature of 100.4° F (38° C)
An increase in the pulse rate from 88 to 102 beats/minute
A blood pressure change from 130/88 to 124/80 mm Hg
An increase in the respiratory rate from 18 to 22 breaths/minute
Question 17
On assessment of a postpartum client, the nurse notes that the uterus feels soft and boggy. The nurse would take which initial action?
Massage the fundus.
Document the findings.
Contact the obstetrician.
Assist the client to ambulate.
Question 18
The nurse is checking lochia discharge in a client in the immediate postpartum period. The nurse notes that the lochia is bright red and contains some small clots. Based on these data, the nurse would make which interpretation?
The client is hemorrhaging.
The client needs to increase oral fluids.
The client is experiencing normal lochia discharge.
The client's primary health care provider (PHCP) needs to be notified of the finding.
Question 19
The nurse visits at home a client who delivered a healthy newborn 2 days ago. The client is complaining of breast/chest discomfort. The nurse notes that the client is experiencing engorgement. Which instructions would the nurse provide to the client regarding relief of the engorgement? Select all that apply.
Wear a supportive bra between feedings.
Apply moist heat to both breasts/chest area for about 20 minutes before a feeding.
Feed the infant at least every 2 hours for 15 to 20 minutes on each side.
Bottle-feed rather than breast/chest-feed during the time of breast engorgement.
Massage the breasts/chest area gently during a feeding, from the outer areas to the nipples.
Question 20
The nurse is caring for an infant with a diagnosis of tetralogy of Fallot. The infant suddenly becomes cyanotic, and the nurse recognizes that the infant is experiencing a hypercyanotic spell (blue or tet spell). The nurse immediately places the infant in what position?
Prone position
Knee-chest position
High-Fowler's position
Reverse Trendelenburg's position
Question 21
The nurse is caring for an infant with a diagnosis of congenital heart disease. Which finding, on physical assessment, does the nurse attribute to chronic hypoxia?
Tachypnea
Tachycardia
Sucking on the fingers
Clubbing of the fingers
Question 22
A child is hospitalized because of persistent vomiting. The nurse would monitor the child closely for which priority problem?
Diarrhea
Metabolic acidosis
Metabolic alkalosis
Hyperactive bowel sounds
Question 23
A 1-year-old child is diagnosed with intussusception, and the parent of the child asks the student nurse to describe the disorder. Which statement by the student nurse indicates correct understanding of this disorder?
"It is an acute bowel obstruction."
"It is a condition that causes an acute inflammatory process in the bowel."
"It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel."
"It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."
Question 24
A 2-year-old child with acute diarrhea has been diagnosed with mild dehydration. Which rehydration methods would the nurse expect the pediatrician to prescribe?
Increase intake of water with a diet high in carbohydrates.
Consume oral rehydration fluid, advancing to a regular diet.
Begin fluid replacement immediately with intravenous fluids.
Begin a diet of bananas, rice, apples, pears, and toast with juice.
Question 25
The pediatric nursing instructor asks a nursing student to prioritize care for a child diagnosed with sickle cell disease. Which student response correctly identifies the priority of care?
Fatigue
Hypoxia
Delayed growth
Avascular necrosis
Question 26
The nurse is providing home care instructions to the parent of an infant who has just been found to have hemophilia. The nurse would tell the parent that care of the infant would include which appropriate measure?
Use aspirin for pain relief.
Pad hard surfaces and table corners.
Use a soft toothbrush for dental hygiene.
Use a generous amount of lubricant when taking a temperature rectally.
Question 27
A 3-year-old child is being admitted to the hospital with intussusception. Which findings would the nurse expect to note on assessment? Select all that apply.
Lethargy
Vomiting
Distended abdomen
Acute abdominal pain
Drawing knees to chest
Red currant jelly–like stool
Question 28
The nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which action is most appropriate?
Notify the primary health care provider of the findings.
Reposition the client and check the monitor for changes in the fetal tracing.
Take the client's vital signs and tell the client that bed rest is required to conserve oxygen.
Document the findings and tell the client that the pattern on the monitor indicates fetal well-being.
Question 29
The nurse is preparing to perform an assessment on a child being admitted to the hospital with a diagnosis of sickle cell crisis, vaso-occlusive crisis. Which findings would the nurse expect to note on assessment of the child? Select all that apply.
Pallor
Fever
Joint swelling
Blurred vision
Abdominal pain