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Ati Capstone test bank_Question And Answers Latest Fall 2020.

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1. A nurse is updating a plan of care after an evaluation of a client who has dysphagia. Which of the following interventions should the nurse include in the plan? a) Ask the client to tilt their head... back when swallowing. b) Have the client sit upright for 1 hr. following meals. c) Administer liquids to the client using a syringe. d) Allow the client to rest for 10 min prior to eating. 2. A nurse is assessing the IV infusion site of a client who report pain at the site. The site is red and there is warmth along the course of the vein. Which of the following actions should the nurse take? a) Initiate a new IV line below the original insertion site. b) Discontinue the infusion c) Raise the head of the bed d) Obtain a culture from the area of the insertion site. 3. A nurse is preparing to perform a routine abdominal assessment for a client. Which of the following actions should the nurse take? a) Document shiny, taut skin as an expected finding. b) Perform palpitation after auscultation. c) Listen for 1 min before documenting absent bowel sounds d) Perform auscultation immediately after the client has consumed a meal. 4. A nurse is discussing immunity with a client who has received an immunization. The nurse should identify that an immunization functions as a part of the which of the following types of immunity? a) Passive immunity b) Active immunity c) Cellular immunity d) Acquired immunity 5. A nurse is reviewing the medical records of a group of older adult clients. The nurse should identify that which of the following is a risk factor that places older clients at an increased risk for developing infections? a) Overproduction of lymphocytes b) Elevated albumin levels c) Lowered immune system function d) Increased body fat 6. A nurse is teaching a client who has asthma the use of a metered dose inhaler. Which of the following instructions should the nurse include in the teaching? a) Hold your breath for 6 seconds after inhaling the medication. b) Inhale the medication deeply for 5 seconds. c) Do not shake the medication in the inhaler d) Hold the inhaler 3 inches away from your mouth. 7. A nurse is performing a focused assessment on a client who has a history of COPD and is experiencing dyspnea. Which of the following findings should the nurse expect? a) Pulse oximetry reading of 95 % b) Decreased depth of respirations c) Flaring of the nostrils d) Respiratory rate of 16/min 8. A nurse is teaching a client about the correct use of a cane. Which of the following instruction should the nurse include in the teaching? (Selected all that apply) a) Ensure the cane has a rubber cap. b) Hold the cane on the weaker side. c) Flex the elbow slightly when using the cane. d) Move the cane and stronger leg forward simultaneously e) Use a quad cane for increased support. 9. A nurse is teaching a group of assistive personnel about the expected integumentary changes in older adult clients. Which of the following findings should the nurse include in the teaching? a) Increase in subcutaneous tissue b) Decrease in pigmentation c) Increase in moisture levels d) Decrease in elasticity 16. A nurse s providing teaching about measures to promote sleep with a client who has insomnia. Which of the following client statements indicates an understanding of the teaching? a) “I can exercise as late as 2 hours before bedtime.” b) “I should reduce my fluid intake 2 hours before bedtime “ c) “I should take a 1 hours nap each day” d) “I can eat a large meal as late as 1 hours before bedtime” 17. A nurse is assessing the pain level of a client who has dementia and difficulty communicating. Which of the following pain assessment techniques should the nurse use? a) Numerical pain scale b) Verbal description c) Faces pain scale d) Behavioral indicators 18. A nurse in an emergency department is monitoring the hydration status of a client who is receiving oral rehydration. Which of the following findings should the nurse identify as requiring further interventions? a) Heart rate 120/min b) BP 121/74 mm Hg c) Temperature 37.78 C (100 F) d) Urine specific gravity 1.020 19. A nurse in a provider’s office is assessing the motor skill development of a 15 month old toddler during a well child visit. Which of the following gross motor skills should the nurse expect? a) Takes several steps on tip toes b) Walks without assistance using a wide stance c) Has an accentuated cervical curvature when standing d) Stands with the feet turned slightly inward. 20. A nurse is teaching a group of parents and guardians about safety risks for adolescents. Which of the following statements should the nurse include in the teaching? a) “Exploring the environment commonly leads to injuries for this age group.” b) “Most injuries sustained during this time of life are caused by developing motor skills.” c) “At this age, peer influence to participate in high -risk behaviors can lead to injury” d) The risk for injuries sustained during this age are often a result of a changes in cognitive function” 21. A nurse is caring for a client who expresses anxiety about an upcoming surgery. Which of the following actions should the nurse take? a) Ask the client to describe their feelings b) Discuss the competency of the surgeon with the client c) Inform the client that others have had the procedure without problems. d) Ask the client why they are experiencing anxiety. 22. A nurse is reviewing information about advance directives with a newly admitted client. Which of the following statements by the client indicates an understanding of the teaching? a) “I need to have an attorney sign my advance directives” b) “I have a living will that outlines my wishes if I am unable to make decisions” c) “I must have a family member appointed to make my health care decisions” d) “I will need to sign a document stating that I want to be resuscitated if I required CPR.” 23. A nurse is planning a community education program about colorectal cancer. Which of the following risk factors should the nurse identify as modifiable? (Select all that apply) a) Smoking b) Alcohol consumption c) Inflammatory bowel disease d) High-fat diet e) Colorectal polyps 24. A nurse is reviewing the laboratory report of a client who has been experiencing a fever for the last 3 days. Which of the following laboratory results indicates the client is experiencing fluid volume deficit? a) Decreased blood urea nitrogen (BUN) b) Increased hematocrit c) Decreased urine specific gravity d) Increased calcium level 25. A charge nurse discovered that a nurse did not notify the provider that a client’s condition had changed. The charge nurse should identify that the nurse is accountable for which of the following torts? a) Negligence b) Slander c) Invasion of privacy d) Libel 26. A nurse is performing a cultural assessment of a group of clients to maintain respect for their value systems and beliefs. Which of the following should the nurse identify as examples of cultural variables? (Select all that apply). a) Eye contact b) Personal space c) Level of education d) Touch e) Blood Type 27. A nurse is admitting a client who has recently developed fever, confusion, and a decreased level of consciousness. Which of the following actions should the nurse take first after obtaining the client’s history and assessment? a) Insert an intravenous catheter to begin fluid therapy b) Develop actions to address the client’s manifestations c) Identify the client’s needs d) Determine the effectiveness of treatment. 28. A nurse is planning to administer several medications to a client through a nasogastric (NG) tube. Which of the following actions should the nurse take? a) Mix the medications together and administer through the NG tube . b) Crush the sublingual medication into powder form c) Dissolve crushed tablet medications in sterile water. d) Flush the tube with 5 ml saline between each medication. 29. A nurse is preparing to perform a sterile dressing change for a client who has surgical wound. Which of the following actions should the nurse take to prevent contamination during the dressing change? a) Remove a piece of the new dressing that falls 5cm(2in) from the edge of the sterile field during the dressing change. b) Begin the dressing change by applying sterile gloves and removing the existing dressing c) Restart the procedure if the sterile solution splashes onto the sterile flied when pouring the solution into the dressing tray d) Place the existing dressing on the outermost portion of the sterile field and discard it when the dressing change is finished. 31. A nurse is reviewing the health history of an older adult client who has a hip fracture . The nurse should identify that which of the following findings places the client at risk for developing a pressure injury? a) Osteoporosis b) Urinary incontinence c) Macular degeneration d) Psoriasis 32. A nurse is performing a focused assessment for a client who has dysrhythmia. Which of the following indicates ineffective cardiac contractions? a) Carotid bruit b) Heart murmur c) Pulse deficit d) Bounding radial pulse 33. A nurse is preparing to transfer a client from a chair to the client’s bed. The client can bear partial weight and has upper body strength. Which of the following devices should the nurse to transfer the client? a) A stand-assist lift b) A footboard c) A slide boards d) A mechanical lift with a full body sling 34. A charge nurse is making assignments for the upcoming shift. Which of the following client assignments should the charge nurse assign to a licensed practical nurse (LPN) a) A client who is to received moderate (conscious) sedation. b) A client who was just admitted with multiple rib fractures c) A client who is scheduled for a bone marrow transplant d) A client who has dehydration and inflammatory bowel disease. 35. A nurse is caring for a client who has a prescription for a narcotic medication. After the medication is administered, the nurse is left with an unused portion. Which of the following actions should the nurse take? a) Discard the medication with another nurse as a witness b) Send the remaining medication back to pharmacy c) Place the unused portion of the medication in the sharp’s container. d) Dispose of the unused portion of the medication in the trash. 37. A nurse is caring for an older adult client who has a nonpalpable skin lesion that is less than 0.5cm (0.2 in) in diameter. Which of the following terms should the nurse use to document this finding? a) Papule b) Vesicle c) Nodule d) Macule Capstone Med Surg 1. A nurse is teaching a client about using a continuous positive airway pressure (CPAP) device to treat obstructive sleep apnea. Which of the following information should the nurse include in the teaching? It delivers a present amount of inspiratory pressure at the beginning of each breath It has a continuous adjustment feature that charges the airway pressure throughout the cycle. It delivers a present amount of airway pressure throughout the breathing cycle It delivers positive pressure at the end of each breath 2. A nurse is providing discharge teaching to a client following a heart transplant. Which of the following information should the nurse include in the teaching? Immunosuppressant medications need to be taken for up to 1 year. Shortness of breath might be an indication of transplant rejection The surgical site will heal in 3 to 4 weeks after surgery 3. A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is receiving 3 % sodium chloride via continuous IV. Which of the following laboratory finding should the nurse identify as an indication that the SIADH is resolving? Urine specific gravity 1. 020 Sodium 119 mEq/L No tiene pregunta 4. A nurse is teaching a client About fecal occult blood testing (FOBT) for the screening of colorectal cancer. Which of the following statements should the nurse include in the teaching? Your provider will use stool from your digital rectal examination to perform the test Your provider will prescribe a stimulant laxative prior to the procedure to You should begin annual fecal occult blood testing for colorectal cancer screening at 40 years old 5. A nurse is preparing a client for a colonoscopy. Which of the following medications should the nurse anticipate the provider to prescribe as an anesthetic for the procedure? Propofol Pancuronium 6. No se ve la pregunta 7. A nurse is reviewing the medical record of a client who has unstable angina. Which of the findings should the nurse report to the provider? Breath Sounds Temperature 8. A nurse is caring for a client eho has burn injuries covering their upper body and is concerned about thei altered appearance .Which of the following statements should the nurse make ? No aparece la respuesta 9. Anurse is developing a plan of care for a client who will be placed in halo traction following surgical repair of the cervical spine .Which of the following interventions should the nurse include in the plan ? Inspect thi pin site every 48 hr Monitor the client skin under the alo vest . Ensure two personnel hold the halo device when repositioning the client . 10. A nurse is caring for a client who has a traumatic brain injury . Which of the following finding should indicate to the nurse the need for inmediate intervention ¿ Axillary temperature 37.2 C (99F) Apical pulse 100/min Respiratory rate 30/min 11. A nurse is assessing a client who has meningitis. The nurse should edentify which of the following finding as a positive Kerning s sign ? After stroking the lateral área of the foot , the clients toes contract and draw together. After hip flexion, the client is unable to extend their leg complety without pain 12. A nurse is providing discharge teaching to a client who has heart failure an a prescription for furosemide 20 mg PO two time daily. Which of the following instructions should the nurse include in the teaching? Monitor for increased blood pressure Increase intake of high-potassium foods Expect an increase in swelling in the hands and feet. 13. A nurse is providing discharge instructions to a client who has GERD. Which of the following statements by the client demostrates an understanting of the teaching?( no aparece la respuesta ) I should take my medicine with orange juice . Abedtime snack will prevent heartburn 14. A nurse at a provide office is interviewing a client who has multiple sclerosis and has been taking dantrolone for several months . Which of the following client statements should the nurse identify as an indication that the medication is effective ? I dont have muscle spasms as frequently I havent gotten any colds , even throught it is flu season 15. A nurse is assessing a client who reports a posible exposure to HIV. Which of the following finding should the nurse identify as an early manifestation of HIV infection? Stomatitis Fatigue Wasting Syndrome 16. A nurse is teaching a client who has type 1 diabetes mellitus about hypoglycemia .which of the following statements by the client indicates an understanting of the teaching? Exercise reduces the risk for hypoglyemia I can skip my insulin when I dont eat I can drink 4 ounces of soda if my blood sugar is low 17. A nure is teaching a client who has hypertension about dietary modifications to help control blood pressure . Which of the following food choices should the nurse recommend as the client to include in their diet ? 1 packet of reconstituted dry onion soup 3 oz of lean cured ham 3 oz of chicken breast 18. A nurse is planning care for a client who as acute pancreatitis .Which of the following interventions should the nurse include in the clients plan? Initiate insulin drip Monitor blood glucose levels Continue regular diet as tolerated Mantain NPO status until pain free Manage acute pain Capstone Mental health 1- A nurse is creating a plan of care for a client who has panic disorder. Which of the following interventions should the nurse include. Use simple words to describe procedures to the client 2- A nurse is caring for a client is experiencing visual hallucinations followed by impaired consciousness as a result of alcohol withdrawal. Which of the following conditions should the nurse identify as causing these manifiestations? Delirium 3- A nurse is teaching male client who has a depressive disorder about sertraline. Which of the following information should the nurse include in the teaching? "This medication may cause an inability to orgasm." 4- A nurse is conducting a child maltreatment screening of a family who has a toddier. Which of the following finding indicator of possible child neglect? The child has had no immunizations since birth. 5- A nurse is preparing to teach a client who has major depressive disorder and is scheduled to undergo electroconvulsive therapy (ECT). Which of the following statements should the nurse include in the teaching? ECT is delivered through electrodes attached to the head 6- A charge nurse is planning an in-service for newly licensed nurses on tort law in mental health care. Which of the following scenarios should charge nurse provide as an example of an unintentional tort? A nurse did not clarify a client prescription that was difficult to read resulting in a medication error. 7- A nurse is reviewing the medical records of a group of clients. For which of the following clients should the nurse recommend a referral for assertive community treatment (ACT)? A client who has repeated acute care admissions due to schizophrenia 8- A nurse is assessing a client who has delirium as a result of sepsis. Which of the following is apply. Rapid mood changes hallucinations Restiessness 9- Nurse is admitting a client to an alcohol abuse program. The client states, Im here because of my boss. It was part of my job to go to parties id drink with clients. The client's statement is an example of which of the following defense mechanisms? Rationalization 10- A charge nurse in a community mental health clinic is discussing ethical concepts of client care with a newly licensed nurse. The charge nurse should use which of the following situations as an Example of fidelity? Attending an educational conference on identifying client at risk suicide 11- A nurse on an inpatient mental health unit is caring for a client who has major depressive disorder and malnutrition. Which of the following actions should the nurse take to improve the client nutritional status. Weigh the client at the same time every morning. 12- A nurse is caring for a client who is receiving haloperidol 2 mg IM every 6 hr. Available is haloperidol 5 mg/ml. how many ml should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Respuesta 0.4 ml 13- A nurse on an inpatient eating disorders unit is caring for a client who has anorexia nervosa and has a body mass index of 17.2. Which of the following actions should the nurse take? Select all that apply. Provide the client with small meals frequenty Monitor the client weight daily Allow the client to choose the meals she wilf eat Stay with the client during meals and for 1 hr afterward Ofter specific privileges for sustained weight gain. 14- A nurse is caring for a client who has bipolar disorder. The client says to the nurse. Give me your pen to should identify that the client is at risk for which of the following. Self- mutilation 15- A nurse is caring for a client who has dementia and insists a doll is her infant child. Which should the nurse use when interacting with the client? Validation therapy 16- A nurse is discharging a client who was admitted for the treatment of alcohol withdrawal. Which of the following resources recommend to the client. Reach to recovery A 12 step program Al-Anon Light therapy 17- A nurse is conducting an admission assessment for a client is experiencing a manic episode of bipolar disorder. Which of the following behavior should the nurse expect. Select all that apply . Grandiosity Flight of ideas Hyperactivity PHARMACOLOGY fotos en word 1-A nurse is assessing a client who started taking furosemide 2 days ago and has a potassium level 3.1. Which of the following findings should the nurse expected? Depressed deep tendon reflexes. 2-A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of the following client laboratory test should the nurse monitor to detect an adverse effect of the medication? Creatinine 3- A nurse is administering bumetanide to a client who has ascites. The nurse should recognize that which of the following findings is an expected therapeutic effect this medication? Increase urinary output 4- A nurse is providing teaching to a client who has fibromyalgia and a new prescription for pregabalin. Which of the following instruction should the nurse include in the teaching? You should notify your provider if you experience facial swelling. 5- A nurse is assessing a client who is in preterm labor and is receiving magnesium via continuous IV infusion. Which of the following findings should the nurse identify as the priority? Deep tendon reflexes 1 6-A nurse is caring for a client who has a systemic fungal infection and is receiving IV amphotericin B deoxycholate. During previous infusion? Adm diphenhydramine prior to administration. 7- A nurse is providing teaching to a client who has rheumatoid arthritis and is starting to take hydroxychloroquine. Which of the following client statement indicates an understanding of the teaching? I will need to have regular eye exams while taking this medication 8-a nurse is monitoring a client who is receiving a continuous IV infusion of dopamine. Which of the following findings requires immediate intervention by the nurse? Infiltration of peripheral IV 9-A nurse is providing discharge instruction to a client who has a new prescription for omeprazole for the treatment of GERD. Which of the following statements by the client indicates an understanding of the teaching? This medication reduces stomach acid 10- A nurse is providing teaching to a client who has prostate cancer and a new prescription for leuprolide. The nurse should explain to the client that leuprolide treats prostate cancer by which of the following actions? Leuprolide decrease the production of testosterone 11-A nurse is reviewing laboratory data for a client who is taking niacin to correct plasm lipid levels. Which of the following’s findings should the nurse identify as an adverse effect of this therapy? Elevated Alanine Aminotransferase (ALT) 12-A nurse is caring for a client who requires a transfusion of one unit of packed RBC. The nurse received the following prescription diphenhydramine 50mg by mouth once, one hour to transfusion. The nurse should identify this as which of the following types of prescription? Single prescription 13- A nurse is caring for a client who has hyperlipidemia and a new prescription for colesevelam. The nurse should monitor the client foe which of the following manifestations s an adverse of COLESEVELAM Constipation. 14- A nurse is caring for older adult client who is confirmed positive for HIV and will begin medication therapy. Which of the following instructions should the nurse give the client? SATA You will be prescribed more than one medication to fight the virus. Your medication plan can also include an antibiotic medication. You will need to take medication for the rest of your life 15- A nurse is completing an admission assessment for a client who has been taking ST John’s worst. The nurse should identify that which of the following medications can interact with St John worst? Citalopram 16- The first action the nurse should take is to assess the client for injury due to medication error. Assess the client 17- A nurse is providing teaching to a client who has angina and a new prescription for sublingual nitroglycerine tablets. Which of the following instructions should the nurse include in the teaching? Store used tablet a room temperature 18- A nurse is teaching a client who has a new prescription for benzonatate. Which of the following statements by the client indication understanding of the teaching? I should not drive while taking this medication 19- A nurse is assessing a client who has diabetes insipidus and is starting intranasal desmopressin. Which of the following findings should indicates to nurse that medication in effective? The client’s 24 hr urine is 1256ml 20- A nurse is transcribing a telephone prescription for acetaminophen 650mg by mouth daily at bedtime. The nurse should identify that which of the following abbrevations are acceptable to use when transcribing the prescription Abbreviate by mouth as PO 21- A nurse is reviewing the medical record of a client who takes lithium. Which of the following findings is the priority to report to use the provider? Sodium 130 22- adverse effect of iron preparation Monitor your child for constipation (increase fluid) 23- A nurse is teaching a client who has a seizure disorder and has a new prescription for phenytoin. Which of the following client statements indicates an understanding of the teaching? I will have my blood checked to monitor the medication levels 25- A nurse is reviewing the medical record of a client who has asthma and takes albuterol. Which of the following findings should the nurse identify as an adverse effect of albuterol? Heart rate 110bpm 26- A nurse is assessing a client who has a prescription for haloperidol 0.5mg PO three times daily. The medication administration record shows that the client received 5 mg per dose on the previous day. Which of the following manifestations is the nurse’s priority to assess? Muscle stiffness 27- A nurse is teaching a client who has a new prescription for isoniazid to treat tuberculosis. Which of the following information should the nurse include in the teaching You will have frequent sputum test to monitor the effectiveness of this medication 28- A nurse is assessing a client who received ondansetron 1 hr ago, Which of the following finding should the nurse identify as a therapeutic effect Suppressed emesis 29- A nurse is caring for a client who is at risk for alcohol withdrawal delirium. Which of the following medications should the nurse expect the provider to prescribe? Chlordiazepoxide 30- A nurse is providing teaching to a client who has erectile dysfunction and has a new prescription for tadalafil. Which of the following client statement indicates an understanding of the teaching? This medication can decrease BP 31- A nurse is assessing a group of clients. Which of the following findings is the priority to reports to the provider? A client who is receiving continuous IV lidocaine and has a respiratory rate of 10min 32- Maternal Newborn Assessment 1. A nurse is reviewing the laboratory results for a client who is at 29 weeks.… the provider? WBC count 11,000/mm³ Hgb 11,2 g/dL Hct 34% Platelets 140,000/mm³ 2. A nurse is admitting a client who is at 33 weeks of gestation and has preeclampsia with severe features. Which of the following actions should the nurse take? Restrict protein intake to less than 40 g/day. Initiate seizure precautions for the client. Initiate an infusion of 0.9% sodium chloride at 150 mL/hr. Encourage the client to ambulate twice per day. 3. A nurse is caring for a client who is in the transition phase of labor. Which of the following… Assist the client to void every 3 hr. Monitor contractions every 30 min. Place the client into a lithotomy position. Encourage the client to use a pant-blow breathing pattern. 4. A nurse is teaching the parents of a newborn how to care for their child’s uncircumcised penis. Which of the following instructions should the nurse include? Retract the foreskin until you feel resistance. Use a cotton swab to clean under the foreskin. Apply petroleum jelly to the foreskin. Wash the penis once per day with soup and water. 5. A nurse is assessing a client who is at 31 weeks of gestation. Which of the following findings show potential prenatal complication? Periodic tingling of fingers Absence of clonus Leg cramps Blurred vision 6. A nurse is performing a vaginal exam on a client who is in active labor. The nurse notes the umbilical cord protruding through the cervix. Which of the following actions should the nurse take? Administer oxytocin to the client via intravenous infusion. Apply oxygen at 2 L/min via nasal cannula. Prepare for insertion of an intrauterine pressure catheter. Assist the client into the knee-chest position. 7. A nurse is providing dietary teaching for a client who is at 29 weeks of gestation and has phenylketonuria. Which of the following suggested foods should the nurse include in the teaching? A peanut butter sandwich on wheat bread. A sliced apple and red grapes. A chocolate chip cookie with a glass of skim milk. A scrambled egg with cheddar cheese. 8. A nurse on a postpartum unit is receiving change-of-shift report for four clients. Which of the following….. A client who gave a birth 1 day ago and needs Rh˳(D) immune globulin. A client who gave a birth 3 days ago and reports breath fullness. A client who gave a birth 12 hr. ago and reports and increase in urinary output. A client who gave a birth 8 hr. ago and is saturating a perineal pad every hour. 9. A nurse is assessing a newborn who is 48 hours old and has a maternal history of methadone use during pregnancy. Which of the following manifestations should the nurse identify as an indication of neonatal abstinence syndrome? Hyporeactivity Excessive high-pitched cry Acrocyanosis Respiratory rate of 50/min 10. A nurse is caring for a client who is receiving oxytocin to augment labor. The nurse notes recurrent variable decelerations…Which of the following actions should the nurse take first? Prepare the equipment necessary to initiate an amnioinfusion. Administer oxygen at 10 L/min via nonrebreather face mask. Discontinue the infusion of oxytocin. Place the client in a left lateral position. 11. A nurse is admitting a client who is at 35 weeks of gestation and is experiencing mild vaginal bleeding due to placenta previa. Which of the following actions should the nurse plan to take? Initiate continuous monitoring of the FHR. Administer a dose of betamethasone. Check the cervix for dilation every 8 hr. Request that the provider prescribe misoprostol PRN. 12. A nurse is reviewing a laboratory results for a client who is at 33 weeks of gestation and has preeclampsia. Which of the following laboratory results should the nurse report to the provider? BUN 35 mg/dL Hgb 15 mg/dL Bilirubin 0.6 mg/dL Hct 37% 13. A nurse is assessing a newborn who was born vaginally with vacuum extractor assistance … that crosses the suture line. The nurse should identify the swellings as which of the following….? Nevus flammeus Caput succedaneum Cephalohematoma Erythema toxicum 14. A nurse is assessing a newborn who is 48 hours old and is experiencing opioid withdrawals. Which of the following findings should the nurse expect? Hypotonicity Moderate tremors of the extremities Axillary temperature 36.1°C (96.9° F) Excessive sleeping 15. A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion? Contraction frequency every 3 min Contraction duration of 100 seconds Fetal heart rate with moderate variability Fetal heart rate of 118/min 16. A nurse is providing teaching to a group of women about risk factors for ovarian cancer. Which of the following should the nurse include? (Select all that apply.) (Revisar las respuestas) Nulliparity History of breastfeeding (???) Previous use of oral contraceptives History of breast cancer Hormone replacement therapy 17. A nurse is caring for a client who is in active labor and notes late decelerations in the FRH on the external fetal…. Which of the following actions should the nurse take first? Change the client’s position. Palpate the uterus to assess for tachysystole. Increase the client’s IV infusion rate. Administer oxygen at 10 L/min via nonrebreather mask. 18. A nurse is caring for a client who is in labor and has an epidural for pain control. Which of the following clinical … effect of epidural anesthesia? Polyuria Hypertension Pruritus Dry mouth 19. A nurse is caring for a client who is in labor and has a diagnosis of group B streptococcus B-hemolytic infection. Which of the following medications should the nurse plan to administer? Ampicillin Azithromycin Ceftriaxone Acyclovir CAPSTONE PEDIATRY 1. A nurse on a pediatric unit is receiving change-of-shift report a group of clients. Which of the Following………………..aqui no se ve la question. -A child who had a cardiac catheterization using the femoral artery and has blanching of the toes. 2. A nurse is providing teaching to an adolescent who has a new prescription for cefazolin, For which oh the following nurse instruct the adolescent to monitor and report to the provider? Dry mouth Constipation Back Pain -Urticaria 3. A nurse in the emergency department is caring for a preschooler who has epiglottitis. Which of the following action take the nurse? Place the child in a left lateral position. Obtain a specimen from the child’s throat for culture. Inspect the child’s throat with a padded tongue depressor. (Esta marcada esta)revisen Initiate droplet precaution for the child. 4. A nurse is caring for an infant who has gastroesophageal reflux (GER). Which of the following actions should the nurse take to prevent regurgitation? Select all that Apply. Thicken the infant’s formula wit cereal. Avoid giving the infant citrus juices. Position the child with their head elevated after meals. 5. A nurse is providing teaching to the parent of a child about home care following a cardiac catheterization. Which of the following statements should the nurse include? You should give your child aspirin if they report pain at the site. You can remove the pressure dressing 8 hours after the procedure. Your child can soak in the bathtub 24 hours after the procedure. Your child should avoid strenuous physical activities for several days. No tenía ninguna marcada yo creo es esa chequeen por se debe evitar la infeccion en el sitio de la puncion 6. A nurse is assessing a toddler who is trained and has temporally……………………………………….. Recognize as an indication of urinary tract infection (UTI)? Steatorrhea Jaundice Incontinence Rebound tenderness 7. A nurse on a pediatric unit is reviewing the laboratory results for a group of clients. Which of the following results should the nurse priority.? An adolescent who has iron-deficiency anemia and Hgb level of 11mg/dl. A school-age child who has diabetes mellitus and an HbA1c of 8%. A Toddler who has moderate dehydration and an RBC count of 5.6/mm. A preschooler who has cystic fibrosis-related diabetes and WBC count of 15,000/mm 8. A nurse in a pediatric clinic is discussing the pathophysiology of Reye syndrome with a newly licensed nurse. Which of the newly licensed nurse indicate an understanding of the disorder? Reye syndrome causes fatty changes in the liver. Reye syndrome leads to venous thrombus formation. Reye syndrome is associated with misuse of acetaminophen. Reye syndrome is licked to decreased serum ammonia level. 9. A nurse in a pediatric clinic is performing a history and physical for a toddler who is scheduled to receive immunization. Which of the following findings indicate that the immunization should be withheld? Temperature of 38 C (100.4” F). Family history of sudden infant death syndrome (SIDS). Taking an antihistamine for seasonal allergies. Receiving prednisone for nephrotic syndrome 10. A nurse is teaching the parents of a toddler about strategies to manage temper tantrums. Which of the following instructions should the nurse include in the teaching? Honor the child’s request if she holds her breath. Establish a structured daily routine for the child. Place the child in her room alone until the temper tantrum ends. 11. A nurse is assessing a child who has received the first 50 ml of a blood transf………………. be experiencing an air embolism? Sharp pain in middle of the chest. 12. A nurse is instilling otic drops into an 18-month-old. Which of the following……………………….. Pull the pinna and back. 13. A charge nurse is assisting a newly licensed nurse with the preoperative assessment of a 2 year ……………….. following actions by the newly licensed indicates an understanding of the needed care…………………. Measuring the child’s abdominal circumference. 14. A nurse working on an outpatient surgical unit is providing discharge teaching to the parent of a preschooler following placement of tympanoplasty tubes. The parent asks the nurse, “What should I do if the tubes fall out. Which of the following responses should the nurse make? Gently put the tubes back into de child’s ears. Bring the child to the emergency department immediately. Notify the provider that the tubes have fallen out. The tubes are sutured in place and must be surgically removed. 15. A nurse is caring for 4-month-old infant who is immediately postoperative following cleft repair. Which of the following actions should the nurse take? Give the infant liquids using a small spoon with a long handle. Apply elbow restrains to the infant. Gently check the infant’s suture line using a padded tongue depressor Place the infant in a supine position. 16. A nurse is caring for a child who is experiencing status asthmaticus. Which of the following………………………………………… Initiate an infusion of IV fluids. Obtain a blood specimen for ABG analysis. Administer a close of an IV corticosteroid. Apply humidified oxygen. 17. A nurse is caring for school age child who has metastatic osteosarcoma. The child asks the nurse “Am I going to die?”………………………….. responses should the nurse make. What is your pain level right now? Your doctor will be able to answer your questions tomorrow. It sounds like you are worried. Tell me what you have been told. It’s natural to worry about death, but you should focus you energy on getting better.” 18. A nurse is caring for an infant following a cleft lip and palate repair. Which of the following……………………. Period? Encourage the use of a pacifier. Provide hard toys. Administer analgesic 19. A nurse is providing dietary education to the mother of infant. What recommendation……………………………. Diet should the nurse make. Select all apply Solds can be introduced between 4 and 6 months of age. Iron-fortified rice cereal should be offered firt. New foods should be introduced one at time over a 5 to 7 day period to obse………….. Vegetables or fruit are first started between 6 and 8 months of age. Milk, eggs, wheat, citrus, peanut butter and honey can be given after 6 months…… 20. A nurse is caring for an infant who has congenital heart defect. Which of the following defect………………… flow?.................... Coarctation of the aorta. Patient ductus arteriosus. Tetralogy of Fallot Tricuspid atresia 21. A nurse is caring for a 6-month-old infant following surgery. Which of the following should the nurse………………………………………….. FLACC pain sacle Oucher numeric scale. Wrong-Baker faces pain rating scale. [Show More]

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