Kaplan Maternity Integrated Exam-with 100% verified solutions-2024.docx | Exams Nursing | Docsity (2024)

Download Kaplan Maternity Integrated Exam-with 100% verified solutions-2024.docx and more Exams Nursing in PDF only on Docsity! 1 Kaplan Maternity Integrated Exam-with 100% verified solutions-2024 A client comes to the prenatal clinic for her first visit. The nursing history reveals that the client's last menstrual period was five months ago, and the client is sure she is pregnant because she has been feeling the baby move. Which of the following responses by the nurse is BEST? 1. "Since you have felt the fetal movement, I am sure that you are pregnant." 2. "Lie down so that I can listen for fetal heart tones with the Doppler." 3. "We'll collect a urine specimen for testing to confirm that you are pregnant." 4. "Have you noticed feeling more fatigued lately?" "Lie down so that I can listen for fetal heart tones with the Doppler." A woman complains to the nurse that during the client's menstrual period she gains weight and gets muscle cramps. The nurse should suggest which of the following measure to alleviate the client's symptoms? 1. Take OTC analgesics, restrict caffeine, exercise moderately 2. Avoid analgesics and exercise 3. Restrict fluid intake, exercise moderately, increase caffeine intake. 4. Restrict sodium intake, restrict exercise, sedatives Take OTC analgesics, restrict caffeine, exercise moderately The nurse in the prenatal clinic assesses a client at 31 weeks gestation. The client's BP is 150/96, edema of the face and hands is noted, 3+ protein in the urine, and serum albumin level is 3 gm/dL. Which of the following instructions by the nurse is MOST important? 1. The client should decrease caloric intake 2. The client should eliminate all salt from her diet 3. The client should ensure adequate protein 4. The client should increase her intake of iron The client should ensure adequate protein Client has preclampsia; bedrest on left side. proteins restore osmotic pressure. The nurse cares for the client immediately after a normal vagin*l delivery. Which action should the nurse take FIRST? 1. Observe the lochial flow 2. Palpate the fundus 3. Obtain a warming blanket 4. Obtain vital signs. Observe the lochial flow 2 The nurse notes that a 2 day old infant shows a tendency to bleed. The nurse understands this is MOST likely caused by which of the following? 1. Hemophilia 2. Absence of intestinal bacteria needed for the production of Vitamin K 3. Immature liver that is unable to synthesize clotting factors 4. Excessive breakdown of RBC's coupled with a delayed production of new ones. Absence of intestinal bacteria needed for the production of Vitamin K newborns don't produce Vitamin K until the 8th day. The woman tells the nurse that she has always had a heavy menstrual flow and needs extra iron. The nurse should recommend the client eat which food? 1. chicken livers 2. pork 3. hamburger 4. tofu chicken livers liver is an excellent source of iron. The nurse observes four newborns. Which of the following characteristics, if noted by the nurse, are MOST common in a preterm infant? 1. Red, wrinkled skin, lanugo, and hypotonic muscles 2. Vernix caseosa, silky hair, and faical edema 3. Absent nose bridge, depressed fontanels, and absent lanugo 4. Mottled skin, meconium stools, and hypertonic muscles Red, wrinkled skin, lanugo, and hypotonic muscles vernix is the white substance covering baby's skin. Meconium stool is normal. herptonia is not seen with preterm infants. The nurse instructs a patient who recently had a modified radical mastectomy. The nurse states that it is important that the patient exercise her arm postoperatively to 1. increase muscle strength and diameter 2. maintain body balance 3. limit full range of motion 4. prevent lymphedema prevent lymphedema The nurse instructs the woman about how to prevent conception using the basal body temp method. The nurse explains that during ovulation, the woman's basal body temp will change in which direction? 5 1. infection and pain 2. hemorrhage and shock 3. hemorrhage and pain management 4. dehydration and infection hemorrhage and shock An infant is born by vagin*l delivery. At birth, the infant is crying and respiration and pulse rate are good. One minute after birth, the baby is noted to have slightly cyanotic extremities. At five minutes after birth, the extremities are pink. The nurse should record the baby's one-minute and five-minute Apgar scores a which of the following? 1. 8 and 9 respectively 2. 8 and 10 respectively 3. 9 and 10 respectively 4. 9 and 7 respectively 9 and 10 respectively The nurse care for a woman in labor. Which method should the nurse use to measure the frequency of a uterine contraction? 1. timing the contractions from end of one contraction to the end of the next contraction. 2. Timing the contraction from beginning of one to end of same contraction 3. Timing the contraction from peak of one to the beginning of next 4. Timing the contraction from beginning of one to beginning of next Timing the contraction from beginning of one to beginning of next A nurse accidentally bumps into a newborn's bassinet. The newborn jumps and pulls the extremities into the trunk. The nurse identifies the newborn is demonstrating which of the following reflexes? 1. Tonic neck 2. Moro's 3. Babinski's 4. Rooting Moro's The nurse cares for a patient after a breast biopsy. After the procedure, it is MOST important for the nurse to take which of the following actions? 1. apply ice to area 2. preposition the patient for comfort 3. carefully transport the specimen to the lab 4. observe for bleeding observe for 6 bleeding 7 The nurse cares for a patient in labor. The patient suddenly shouts, "I have to push! I have to push!" The nurse determines that the patient is 8 cm dilated. Which of the following actions should the nurse take first? 1. instruct the patient to take a deep breath and bear down 2. apply pressure to the patient's fundus 3. coach the patient in relaxation techniques 4. encourage the patient to pant with pursed lips encourage the patient to pant with pursed lips (pant to prevent pushing...) A 25 y/o primigravida diagnosed with type 1 diabetes mellitus reviews insulin regimen with the nurse. The nurse reinforces the importance of regular prenatal care and explains changes in insulin requirements will include which of the following? 1. insulin requirements will increase during pregnancy and decrease after delivery 2. insulin requirements will decrease during pregnancy and increase after delivery 3. insulin requirements will increase during pregnancy and remain increased after delivery. 4. insulin requirements decrease during pregnancy and remain decreased after delivery. insulin requirements will increase during pregnancy and decrease after delivery A woman is in active labor. As labor progresses, she becomes irritable and complains of feeling increasingly uncomfortable. She is 8 cm dilated. Which of these actions should the nurse take first? 1. contact the physician 2. coach the patient, in proper breathing and relaxation techniques 3. administer and analgesic 4. remove the fetal monitor to allow the client to move around coach the patient, in proper breathing and relaxation techniques When administering phototherapy to a newborn with jaundice, it is MOST important for the nurse to take which of the following actions? 1. expose only the infant's back to the light 2. remove the infant from the light for 15 mins each hour 3. cover the infant's eyes with protective pads during therapy 4. check the infant's temp every hour cover the infant's eyes with protective pads during therapy A woman comes to the clinic pregnant with her second child. She questions the nurse about the amount of exercise that is acceptable for her to perform during her pregnancy. Which of the following is MOST 10 A nurse teaches the client about birth control methods. How long should the nurse advise the client to leave a diaphragm in place after intercourse? 1. 6hrs 2. 8hrs 3. 10hrs 4. 12hrs 6hrs The nurse performs a home care visit on a mother who delivered a baby three days ago. The client expresses alarm when she hears that her baby has lost 8oz. Which of the following responses by the nurse is MOST appropriate? 1. Perhaps you don't have enough milk for the baby and need to supplement the diet with formula 2. That is normal weight loss. Sometimes babies lose as much as 10% of the birth weight. 3. Babies usually lose some weight, but that's more than usual. He may need an intravenous infusion. 4. Most babies immediately lose their intrauterine water deposits and 20% of their birth weight. That is normal weight loss. Sometimes babies lose as much as 10% of the birth weight. The parents of a preterm infant visit the infant in the newborn nursery. They see their infant resting comfortably in the isolette and express concern about disturbing the baby. Which of the following responses by the nurse is BEST? 1. Preterm infants have an immature immune system and handling them increases the risk of an infection 2. Preterm infants need to conserve their strength, so it is best if you do not pick the infant up 3. Preterm infants need to develop a sense of trust and security and holding the infant promotes this 4. Preterm infants can become irritable if handled while sleeping, so first wake the infant up. Preterm infants need to develop a sense of trust and security and holding the infant promotes this The home care nurse visits a 17 y/o who delivered a full term infant 2 wks ago. Although the client appears mature, the nurse knows the client's age may interfere with positive mothering because of which of the following ? 1. The client is not in a stable relationship with the father 2. The client has yet to finish school 3. The client's parents want her to place the baby in foster care 4. The client is still experiencing the dependency of childhood The client is still experiencing the dependency of childhood The nurse cares for a client diagnosed with cervical cancer. The nurse notes that the client appears to have a poor appetite. Which of the following interventions by the nurse is BEST? 1. provide high fat snacks 11 2. provide small, frequent feedings 3. provide additional fluid at meals 4. provide food when the client requests it. provide small, frequent feedings The 20 y/o woman arrives at the hospital in active labor. The client asks the nurse what is the purpose of fetal monitoring. Which response by the nurse is BEST? 1. The purpose of the fetal monitor is to evaluate the progress of labor 2. the purpose is to assess the strength and duration of contractions 3. The purpose is to determine if the fetus is receiving adequate amounts of oxygen 4. The purpose is to allow the health care provider to decide if an oxytocin drip should be started. The purpose is to determine if the fetus is receiving adequate amounts of oxygen Which of the following measures is MOST effective in protecting the nursing staff from harmful exposure to radiation when caring for a patient with a radiation implant? 1. rotate the staff members assigned to the patient 2. wear a gown and mask when in contact with the patient 3. leave the patients room at least every 10 mins 4. place the patient in a room with private bathroom rotate the staff members assigned to the patient The nurse instructs a group of expectant mothers about the advantages of breastfeeding. The nurse should intervene if an expectant mother makes which of the following statements? 1. My baby will grow faster and sleep more with breast milk 2. My baby will receive protective immune factors from the breast milk 3. My baby will not need any other foods or milk until he is four months old 4. At first, I may feed my baby about 10x/day My baby will grow faster and sleep more with breast milk The nurse observes a staff member palpate uterine contractions. The nurse determines the staff member is using the correct technique if which of the following is observed? 1. place the palm of one hand on the fundus and move the palm of the other hand around the abdomen during contractions. 2. Place the heels of both hands on the lower abdomen and press lightly 3. Place one hand on the abdomen over the fundus and with the fingertips press gently 4. Place the palms of the hands on either side of the abdomen and press firmly. Place one hand on the abdomen over the fundus and with the fingertips press gently Meconium stained amniotic fluid should alert the nurse to the possibility of which? 12 1. fetal distress and perinatal asphyxia 2. fetal distress and hyperbilirubinemia 3. abruptio placenta and asphyxia 4. placenta previa and perinatal sepsis fetal distress and perinatal asphyxia A 28 y/o woman delivers a baby boy. In order to monitor complications, the nurse should be MOST alert to which of the following findings? 1. complaints of pain 2. changes in blood pressure and pulse 3. ambivalent feelings about being a mother 4. the number of previous delivers changes in blood pressure and pulse A woman asks the nurse if she can safely drink wine while nursing her baby. Which of the following is the BEST response by the nurse? 1. The wine you drink will not be present in the breast milk 2. A moderate amount of wine will help you relax 3. Alcohol has a CNS depressant effect on the baby 4. Drink beer rather than wine while you are breastfeeding Alcohol has a CNS depressant effect on the baby The nurse prepares a client for a cesarean section. The client asks how the anesthesia is going to affect her baby. Which answer by the nurse is best? 1. The overall dosage of anesthesia is lower for a client undergoing cesarean section 2. The dosages of sedatives and hypnotics are lower for a client undergoing cesarean section 3. The amount of narcotic given is decreased in a client undergoing cesarean section 4. all medications are routinely withheld prior to the cesarean section. The amount of narcotic given is decreased in a client undergoing cesarean section A client contacts the nurse and describes some soft and movable masses she felt in her breasts that become enlarged during menstruation. The nurse should be aware that the client is most likely describing which of the following? 1. cancer of the breast 2. fibroids of the breast 3. fibrocystic disease of the breast 4. hyperplasia of the breast fibrocystic disease of the 15 the FHR slows early in the contraction, which is a normal finding (deceleration occurs when the FHR falls below baseline for 15 s or more, followed by a return; early deceleration occurs before the peak of the contraction is is a reassuring fetal heart pattern) The nurse instructs a prenatal client about the warning signs of pregnancy. The determines that teaching is successful if the client states the following? 1. I should contact the physician if I notice swelling in my face and fingers. 2. It's not unusual that I might have a little vagin*l spotting 3. As long as my headaches go away after I take aspirin, I'm okay 4. I should report any uterine contractions that I may feel I should contact the physician if I notice swelling in my face and fingers. The nurse cares for a client receiving magnesium sulfate IV, and the nurse notes that the client's deep tendon reflexes are decreased. Which action should the nurse take first? 1. document the results in the client's chart 2. place the call light within reach of the client 3. dim the lights prior to leaving the room 4. discontinue the IV infusion discontinue the IV infusion The nurse cares for 6lb, 7oz baby girl delivered two hours ago. The nurse knows which of the following occurrences initiates the changes that take place in the newborn circulatory system after birth? 1. the space constraints of the uterus are removed 2. the infant begins pulmonary ventilation 3. the infant is exposed to excessive sensory stimuli 4. the ambient temperature of the infant is reduced. the infant begins pulmonary ventilation The nurse knows that a preterm infant is at greatest risk for developing which disorder? 1. hypoglycemia 2. respiratory distress syndrome 3. hydrocephalus 4. scoliosis respiratory distress syndrome The nurse prepares a client for placement of internal radiation, The nurse understands the client will receive and indwelling foley catheter and a tap water enema for which of the following reasons? 16 1. prevent displacement of the implant 2. make the patient more comfortable during the treatment 3. maintain an uncontaminated work area 4. avoid excessive bladder and bowel irradiation prevent displacement of the implant A multipara woman in her fifth month of pregnancy complains to the nurse that her breasts are sensitive and sore. The nurse should make which of the following suggestions? 1. apply a warm compress and take aspirin 2. gently massage with lotion twice a day and wear loose fitting, comfortable clothing 3. apply cold compresses and wear a well fitting, supportive bra 4. take a diuretic once a day apply cold compresses and wear a well fitting, supportive bra A nurse counsels a couple who have had difficulty conceiving a child. The nurse explains infertility is defined as which of the following? 1. inability to conceive after at least three months of unprotected intercourse 2. inability to conceive after at least six months of unprotected intercourse 3. inability to conceive after at least one year of unprotected intercourse 4. inability to conceive after at least two years of unprotected intercourse inability to conceive after at least one year of unprotected intercourse On the evening before a modified radical mastectomy, a 29 y/o patient tells the nurse she is afraid that her husband will not find her sexually attractive if her breasts are removed. Which of the following responses by the nurse is BEST? 1. You shouldn't think about that tonight, you have plenty to worry about. 2. If your husband really lovers you, it won't bother him. 3. You're worried about how he'll react to the change in your body. 4. Reconstructive surgery can be done so that your breast will look the same. You're worried about how he'll react to the change in your body. The nurse palpates the fundus of a woman after the third stage of labor. The nurse should expect the fundus to be... 1. soft and discoid 2. firm and discoid 3. soft and globular 4. firm and globular firm and globular 17 The nurse instructs a pregnant woman with gestational diabetes about her diet. The nurse determines that teaching is effective is the client selects which of the following desserts? 1. apple pie 2. ice cream 3. cheese and fresh fruit 4. granola bar and milk cheese and fresh fruit The nurse explains to a client at 6 wks gestation which of the following periods of pregnancy is the most critical time for fetal development? 1. first two weeks 2. first three months 3. fourth through sixth month 4. the last month first three months A young mother delivers a healthy 7lb 12oz boy. She confides to the nurse that she concerned about the two "soft spots" she found on her baby's head. The nurse's response should be based on which of the following? 1. both the baby's fontanels should close within the first month 2. both the baby's fontanels should close within six months 3. The baby's posterior fontanel should close after one year 4. The baby's anterior fontanel should close after about a year and a half. The baby's anterior fontanel should close after about a year and a half. The nurse instructs a group of expectant mothers about how to recognize the onset of labor. The nurse knows that further teaching is necessary if a client makes which statement? 1. My baby will move more when I go into labor 2. I may feel a gush of water at the beginning of labor 3. I may have blood tinged vagin*l discharge 4. I will have regular uterine contractions that become stronger My baby will move more when I go into labor A patient is admitted to the hospital and is scheduled to have a modified radical mastectomy. The patient asks the nurse about the surgical procedure. Which of the following explanations should the nurse give? 1. only the tissue is removed, leaving all the muscles and lymph nodes 2. the breast, axillary nodes and superior apical nodes are removed but he muscles are preserved. 3. the breast, axillary nodes, and the major and minor pectoral muscles are preserved. 20 1. More calories, protein, and calcium are needed during lactation than are needed during pregnancy. 2. More calories but the same amount of protein, calcium, and fluids are needed. 3. Fewer calories and less protein are needed during lactation than are needed during pregnancy, but more calcium is needed. 4. Only more fat is needed during lactation than is needed during pregnancy. More calories but the same amount of protein, calcium, and fluids are needed. The nurse teaches a class about gonorrhea. Which of the following statements, if made by a client, indicates that teaching is successful? 1. I've heard that having gonorrhea can make you unable to have children 2. They say this disease can affect your brain and make you go crazy 3. I've heard you can't get rid of gonorrhea. You keep getting it over and over again 4. My mother said that you need to have cesarean deliveries after this infection. I've heard that having gonorrhea can make you unable to have children The nurse cares for newborn delivered by a mother addicted to narcotics. During which of the following times is the nurse MOST likely observe symptoms of narcotic withdrawal? 1. immediately at birth 2. within 12 hours after birth 3. within 24-72 hours after birth 4. after 2 weeks within 24-72 hours after birth The nurse cares for 4lb, 10oz infant delivered at 32 weeks gestation. The nurse notes the infant has mottling of the skin, and lab values indicate metabolic and respiratory acidosis. The nurse recognized these findings are signs of which of the following? 1. Respiratory distress syndrome 2. cold stress 3. perinatal asphyxia 4. hypovolemia cold stress The nurse cares for a patient 12 hours after delivery of a 3,200 g infant. The nurse notes that the fundus is approximately 1 cm above the umbilicus. It is most important for the nurse to take which of the following actions? 1. encourage the client to void 2. assess for the amount and character of the lochia 3. bring the infant to the mother for breastfeeding 4. chart the results in the patient's chart 21 chart the results in the patient's chart During auscultation of the fetal heart rate (FHR) during labor. The nurse assesses a rate of 59 beats/min. Which actions should the nurse take FIRST? 1. Turn the mother on her right side, open the IV line and call the HCP 2. Turn the mother on her left side, administer O2 NC and start and IV 3. Call the HCP 4. Place the mother in Trendelenburg, administer O2 and force fluids. Turn the mother on her left side, administer O2 NC and start and IV The nurse counsels clients in the prenatal clinic. The nurse is MOST concerned if the client makes which statement? 1. I take my dog for a 30 min walk every other day 2. I plan to take an 8 hour car trip next week 3. I drink 3 liters of liquids every day 4. I clean the cat's litter box daily I clean the cat's litter box daily (Toxoplasmosis [protozoan infection] caused by eating infected undercooked meat or after handling infected kitty litter) The nurse cares for the client six hours after a vagin*l delivery and assists the client to perform perineal care. Fifteen mins later the nurse notes that the perineal pad is soaked and there is blood underneath the client's buttocks. Which action should the nurse perform first? 1. obtain the client's BP 2. notify the HCP 3. assess the fundus 4. administer O2 8-10L/min assess the fundus A nurse prepares a client for a gynecological examination. The nurse explains that the physician will perform a pelvis examination will obtain a Pap smear. The nurse explains the Pap smear is 1. taken from exudates of the vagin* and cervix 2. a sample of tissue used to locate a lesion 3. an xray film taken from various angles 4. a specimen of cells used to identify abnormal cells a specimen of cells used to identify abnormal cells 22 A woman has a simple vulvectomy. Postop, the nurse instructs her to take a sitz bath and keep the area clean and dry. The nurse understands the reason for these measures is 1. to debride the area and prevent wound infection 2. to increase circulation to the area and promote wound healing 3. to prevent selling of the surround lymph nodes 4. to cleans the area and diminish the possibility of postop bleeding. to increase circulation to the area and promote wound healing A 32 y/o woman is pregnant for the third time. She has one living child and had one abortion. Which description does the nurse record? 1. gravida III, para II 2. gravida II, para II 3. gravida III, para I 4. gravida II, para III gravida III, para I Gravida = pregnancies Para = full term fetus The nurse understands that the physician is most likely to prescribe which of the following drugs to a client diagnosed with gonorrhea? 1. penicillin vagin*l suppositories 2. penicillin G benzthine intramuscularly in divided doses once a week 3. ceftriazone IM plus doxycycline for seven days, PO 4. ampicillin, PO ceftriazone IM plus doxycycline for seven days, PO During labor induction with oxytocin, the nurse should stop the infusion if which of the following occurs? 1. contractions are at 3 min intervals and last more than 60 secs 2. contractions are at 2 min intervals and last more than 90 secs 3. contractions are at 2.5 min intervals and last more than 90 secs 4. contractions are at 2 min intervals and last more than 60 secs contractions are at 2 min intervals and last more than 90 secs The nurse instructs a new mother about how to care for her newborn's umbilical cord. The nurse determines teaching is effective if the client makes which statement? 1. I am going to bathe my baby in the new tub tomorrow 2. I will keep the cord covered with the diaper 3. I will clean the cord and skin around it with water