NURS 201 Complete Study Guide (updated 2020) Evolve – Rasmussen College | NURS201 Complete Study Guide (updated 2020) Evolve

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NURS 201 Complete Study Guide (updated 2020) Evolve – Rasmussen College Jennifer is a community health nurse in a large metropolitan area. According to the American Nurses Association's Code of E... thics (2001), community health nurses must align themselves with public health programs that promote and preserve the health of populations by influencing: sociocultural issues. After a suprapubic prostatectomy, a client's plan of care will include the prevention of postoperative deep vein thrombosis. The nurse recalls that this can be achieved best by increasing the: Velocity of the venous return For which clinical indicator should a nurse monitor a client with end-stage renal disease? Azotemia Mary is a nursing student doing her senior project in community health. Part of her assignment is to conduct an activity that illustrates "social health" within a group in her community. The most appropriate activity for Mary to organize would be a: food bank in a local church. It has been estimated that individual behaviors and environmental factors are responsible for what percentage of all premature deaths in the United States? 50% Early public health nurse Lillian Wald and her associates were successful in addressing health and disease in the immigrant community by: supporting political activities to improve social and environmental conditions of immigrant families. Disease prevention activities protect people from disease and the effects of disease. An example of primary disease prevention is: administering vaccines to children before kindergarten Every 10 years, the U.S. Department of Health and Human Services publishes a national prevention initiative titled Healthy People. One of the new objectives for Healthy People 2020 is to: improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident. Which of the following is an example of "community health nursing" rather than "community-based nursing"? An RN reviewing school clinic records to determine which children are not up to date on their immunizations Which of the following entities strives to improve the health of all the public by promoting healthy lifestyles, preventing disease and injury, and protecting the health of communities? Public health system A variety of health indicators are used by health providers, policy makers, and community health nurses to measure the health of the community. Indicators that illustrate the health status of a community and may be useful in analyzing health patterns over time include: (Select all that apply.) morbidity mortality life expectansy cancer incidence rates Public health efforts focus on prevention and promotion of population health. The local level of the health care system provides direct services to community members through community and personal health services. An example of a health service that targets the larger community, rather than individuals, is: (Select all that apply.) a mobile immunization clinic. condemning or repairing unsafe housing. airing a weekly public service announcement to remind women to do breast self-examination. Which of the following statements is NOT true about the "thinking upstream" model of community health nursing practice? It focuses the nurse on short-term, individual-based nursing interventions. A microscopic approach to the community health problem of childhood obesity would focus on: asking an obese child and his or her parent(s) to complete a 24-hour food diary. Which of the following theories is based on the assumption that individual needs and related activities are the focus of nursing care? Orem's self-care deficit theory A community health nurse explores a group of teenagers' beliefs about the seriousness of eating disorders and their related susceptibility. The nurse is applying principles from which theory? The health belief model A major limitation of the health belief model is that the burden of action related to health behaviors is exclusively on the aggregate. False The belief that health deficits result from an imbalance between the population's health needs and its health-sustaining resources is the premise of which theory? Milio's framework The community health nurse is teaching a prenatal class and includes the societal cost of fetal alcohol syndrome in one of the educational sessions. The nurse is demonstrating an understanding of: critical theoretical perspective Which of the following nurse leaders formulated the first theory-based conceptual model for nursing care? Florence Nightingale Using theory to guide community health nursing practice serves to: (Select all that apply.) guide data collection and interpretation in a clear and organized manner improve community health nursing practice focus the student on factors that are critical to understanding the situation The use of theory in population-focused community health nursing encourages which of the following? (Select all that apply.) A proactive approach to care Development of population-focused programs Receiving immunizations, regular health screenings, and physical exams is an example of: health protection. Which of the following "determinants of health" refers to factors that are experienced with the senses-things that can be seen, touched, heard, and smelled? Physical environment Which of the following "determinants of health" would include predisposition to prostate cancer and a history of depression? Biology According to the health belief model, the inconvenience of driving to a gym to exercise is an example of a: perceived barrier. A man has been smoking for 20 of his 40 years. He smokes a pack of cigarettes daily and states, "My dad smoked two packs a day and lived to be almost 90. Besides, I'm going to die from something anyway, so why quit"? He is in which "stage of change" in the transtheoretical model? Precontemplation A smoking cessation class stresses increased lung function, money saved that is not spent on cigarettes, and smelling clean and fresh as benefits to quitting smoking. These support which of the following concepts? Decisional balance A risk factor refers to a(n): exposure that is associated with a disease What is the most common chemical dependence in the United States? Nicotine A 22-year-old college student explains to the nurse at the health clinic that she drinks four to five beers when she goes out with friends on Saturday nights. Otherwise, she rarely drinks during the week because of her classes, studying, and part-time job. This would be considered: binge drinking. Which of the following is an example of a modifiable risk factor? (Select all that apply.) Cigarette smoking Sexual practices Diet Pregnancy, Labor, Childbirth, Postpartum - Uncomplicated A client at 11 weeks' gestation reports having to urinate more often. The nurse explains that urinary frequency often occurs because bladder capacity during pregnancy is diminished by: ► Compression by the enlarging uterus Immediately after the third stage of labor a nurse administers the prescribed oxytocin (Pitocin) infusion. Why is this medication administered? ►To help the uterus contract Which position does the nurse teach the client to avoid when she experiences back pain during labor? ►Supine position During a counseling discussion of nutrition, a nurse explains to a pregnant client that she will need additional calcium during pregnancy and that the best source is milk. The client states, "I never drink milk or eat milk products. They turn my stomach." What is the nurse's best reply? "Your practitioner can prescribe calcium supplements." A nurse is preparing a pregnant client for an amniocentesis. What should nursing care include? Encouraging her to void before the test A nurse assesses the frequency of a client's contractions by timing them from the beginning of a contraction until the: Beginning of the next contraction A nurse is assessing a primigravida who was admitted in early labor after her membranes ruptured. She is at 41 weeks' gestation. Her contractions are irregular and her cervix is dilated 3 cm. The fetal head is at station 0 and the fetal heart rate tracing is reactive. How can the nurse help the client facilitate labor? Take a walk around the unit with her. A nurse plans to assess a postpartum client's uterine fundus. What should the nurse ask the client to do before this assessment? Empty her bladder. A 16-year-old adolescent at 24 weeks' gestation visits the prenatal clinic for the first time. After the physical examination she tells the nurse, "I can't believe how big I am. Will I get much bigger?" What information about adolescent growth and development does the nurse need to know before responding? Body image is very important to adolescents, so pregnant teenagers are concerned about body size. A 29-year-old gravida 3 para 3, was admitted to the recovery unit 2 hours after the birth of a 9-lb baby girl. The nurse assesses the client an hour later and finds her fundus, which is slightly boggy, three fingerbreadths above the umbilicus and displaced to the right. The peripad, which was changed before the client's transfer, is now saturated. The nurse recognizes: A distended bladder A nurse is obtaining the health history of a woman who is visiting the prenatal clinic for the first time. She states that she is 5 months pregnant. For what positive sign of pregnancy should the nurse look in this patient? Audible fetal heartbeat A woman at 40 weeks' gestation is having contractions. Wondering whether she is in true labor, she asks, "How will you know if I'm really in labor?" What knowledge must the nurse have before responding? The cervix dilates and becomes effaced in true labor. A pregnant client is visiting her health care provider for a routine prenatal visit. The nurse measures the client's fundal height at 37 cm. At her last routine visit the fundal height was 32 cm, which correlated directly with her gestation. What is the nurse's next action? Asking the client whether she has emptied her bladder recently The nurse is caring for a gravida 2 para 2 client who gave birth the previous day. During the morning assessment the nurse notes that the lochia is rubra and moderately heavy. The picture indicates where the fundus is located. What should the nurse do next? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - A nurse assesses a newborn and observes central cyanosis. What type of congenital heart defect usually causes central cyanosis? Shunting of blood from right to left One minute after birth a newborn of 30 weeks' gestation has a heart rate of 86 beats/min and slow, irregular respirations. The infant grimaces in response to suctioning, is cyanotic, and has flaccid muscle tone. What is the first Apgar score? 3 Assessment of a newborn reveals congenital cataracts, microcephaly, deafness, and cardiac anomalies. Which infection does the nurse suspect that the newborn's mother contracted during her pregnancy? Rubella A nurse suspects that a preterm neonate, who is being fed by means of gavage, may have necrotizing enterocolitis (NEC). What clinical manifestation of NEC did the nurse identify? Large amounts of residual formula withdrawn before a feeding A mother who is formula feeding her 1-month-old infant asks the nurse whether any vitamin or mineral supplements are absent from the ready-to-use formulas. The nurse responds that the supplement that is not in ready-to-use formulas is: Fluoride Absence or weakness of which of the following reflexes during the newborn assessment should the nurse report to the health care provider? Gag A nurse in the neonatal intensive care unit is caring for a preterm newborn with respiratory distress syndrome (RDS). What clinical finding does the nurse expect? Diminished breath sounds A nurse assessing a newborn identifies several characteristics of Turner syndrome. Which features did the nurse observe? Select all that apply. Webbed neck Female sex organs Widely spaced nipples The nurse is caring for a preterm infant in the neonatal intensive care unit. What early sign of neonatal sepsis should the nurse report to the health care provider? Temperature instability A neonate is tested for phenylketonuria (PKU) after formula feedings are initiated. The nurse explains to the parents that this is done to prevent Cognitive impairment The nurse, providing discharge instructions to the parents of a male newborn, asks them to repeat the findings that should prompt them to call the health care provider. Which finding indicates a need for further education? A yellowish exudate around the incision A nurse is performing a newborn assessment. What characteristics cause the nurse to suspect that the newborn has Down syndrome? Select all that apply. Protruding tongue Epicanthal eye folds One transverse palmar crease The laboratory results of a woman in labor indicate the presence of cocaine and alcohol. Which characteristics should cause the nurse to recognize fetal alcohol syndrome (FAS) in the newborn? Select all that apply. Hypotonia Hypoplastic maxilla Small, upturned nose While reviewing the health history of a newborn with suspected jaundice, the nurse recalls that some risk factors place infants at a higher risk developing jaundice. Which conditions are risk factors for jaundice? Select all that apply. Infection Prematurity Breastfeeding Maternal diabetes When a nurse brings a newborn to a mother, the mother comments about the milia on her infant's face. What information should the nurse include when responding? Avoid squeezing them and don't try to wash them off. Two days after birth a neonate's head circumference is 16 inches (40 cm) and the chest circumference is 13 inches (32.5 cm). What does the nurse infer from these measurements? Enlarged head A mother is breastfeeding her newborn. She asks a nurse when she can safely switch her baby to a cup. At what age should the nurse recommend that this be done? 6 months The nurse is performing a gestational age assessment, using the New Ballard Scale. According to the following information and graph, at how many weeks gestation is the newborn? 38 When checking a newborn's reflexes, the nurse is unable to elicit one reflex response that is often absent in neonates born vaginally in the breech presentation. How should the nurse attempt to elicit this response? Holding the infant in the upright position while pressing the feet flat on the crib mattress A nurse inserts a nasogastric tube into a preterm infant's esophagus for feedings. Which assessment findings signify correct placement of the tube? Select all that apply. Aspiration produces a small quantity of light-yellow or light-green liquid. Testing of the aspirate with the use of a Nitrazine strip reveals that the gastric fluid is acidic. A neonate born at 35 weeks' gestation has Apgar scores of 8 and 9. At 4 hours of age the newborn begins to experience respiratory distress, has a below-normal temperature in a warm environment, and has a low blood glucose level. What problem does the nurse suspect? Bacterial sepsis After hyperbilirubinemia develops in a neonate, phototherapy is prescribed. What should the plan of care for an infant undergoing phototherapy include? Administering additional fluids every 2 hours What characteristic does the nurse expect in the newborn of a mother with diabetes? Flushed skin A primipara has just given birth at 37 weeks' gestation. What should the nurse do to help promote the attachment process between the mother and her newborn? Encourage continuous rooming-in. On admission to the nursery a newborn is found to be experiencing cold stress. What is the nurse's goal at this time? Prevent metabolism of fat stores. A nurse must meet the hydration needs of a preterm infant. What should the nurse consider about the preterm infant's kidney function? Large amounts of urine are excreted. When a nurse who is carrying a newborn to the mother enters the room, a visitor asks to hold the infant. The visitor is sneezing and coughing. What is the most important measure for the nurse to take? Having the visitor step outside the room A parent of a newborn asks, "Why do I have to scrub my baby's formula bottles?" What information about a newborn should the nurse consider before replying in language that the parent will understand? Gastric acidity is low and does not provide bacteriostatic protection. A nurse is estimating a newborn's gestational age. What parameters should the nurse assess? Select all that apply. Breast size Genital development A nurse has inserted a nasogastric tube to gavage feed a preterm newborn. Place in order the steps the nurse will take to perform the gavage. Connect the barrel of a syringe to the gavage tube. Clamp the tube. Pour the prescribed amount of formula into the syringe. Allow the feeding to flow at a rate of 1 mL/min. Connect the barrel of a syringe to the gavage tube What should be included in the teaching plan for the mother of a newborn with exstrophy of the bladder? Protecting the skin surrounding the exposed bladder At 1 minute after birth the nurse determines that an infant is crying, has a heart rate of 140 beats/min, has blue hands and feet, resists the suction catheter, and keeps the legs flexed and the arms extended. What Apgar score should the nurse assign? 8 A mother who is formula feeding her 1-month-old infant asks the nurse whether any vitamin or mineral supplements are required. The nurse bases the reply on the knowledge that infants who are fed with ready-to-use formula do require a supplement. What supplement is required? Fluoride A couple arrives at the newborn nursery asking to take their newborn grandson to his mother's room. What is the best response by the nurse? "Please go on to see your daughter. I'll bring the baby to her room." The parents of a newborn are concerned about red pinpoint dots on their infant's face and neck. How should the nurse explain the finding? The cause is an increased intravascular pressure during birth. One minute after birth a newborn is crying vigorously and has an apical pulse of 130 beats/min. The nurse notes acrocyanosis and flexion of the extremities. What is the newborn's Apgar score? 9 A nurse determines that a newborn is in respiratory distress. Which signs confirm this assessment? Select all that apply. Cyanosis Tachypnea Retractions While performing bag-and-mask ventilation on a newborn, a nurse does not see the newborn's chest rise. Place the following interventions in order of their priority. Suction the mouth if there are secretions. Reposition the head. Open the mouth slightly. Apply the mask for a better seal. Assess the neonate's response to these measures. During the initial assessment of a newborn the nurse suspects a congenital heart defect. Which clinical manifestations support this suspicion? Select all that apply. Nasal flaring Sternal retractions Grunting respirations The nurse concludes that a couple with a newborn with Erb's palsy has an accurate understanding of the infant's prognosis. Which statement confirms this conclusion? Recovery usually occurs in about 3 months." A newborn of 30 weeks' gestation has a heart rate of 86 beats/min and slow, irregular respirations. The infant grimaces in response to suctioning, is cyanotic, and has flaccid muscle tone. What Apgar score should the nurse assign to this neonate? 3 One minute after birth a nurse assesses a newborn and auscultates a heart rate of 90 beats/min. The newborn has a strong, loud cry; moves all extremities well; and has acrocyanosis but is otherwise pink. What is this neonate's Apgar score? 8 A nurse in the newborn nursery observes a yellowish skin coloration in an infant who was delivered in a cesarean birth. What is the immediate nursing action? Ascertaining how many hours ago the neonate was born A nurse is estimating an infant's gestational age. What parameter is most likely to indicate gestational age? Size of breast tissue and genitalia As a client who has just given birth examines her newborn, she notes a nevus vasculosus on her infant's mid thigh and becomes upset. How should the nurse respond? "These areas usually spread and then regress." A newborn experiences a hypothermic period while being bathed and having clothing changed. Once the hypothermic episode has been identified and treated, what is the next nursing action? Feeding the infant A nurse is assessing a newborn with a myelomeningocele. What clinical findings prompt the nurse to suspect hydrocephalus? Select all that apply. Tense fontanels High-pitched crying A defect in the lumbosacral area What should the nurse discuss with new parents to help them prepare for infant care? Learning specific behaviors involving states of wakefulness to promote positive interactions A client had a rubella infection (German measles) during the fourth month of pregnancy. At the time of the infant's birth, the nurse places the newborn in the isolation nursery. What type of infection control precautions should the nurse institute? Droplet Typical signs of neonatal abstinence syndrome related to opioid withdrawal usually begin within 24 hours after birth. What characteristics should the nurse anticipate in the infant of a suspected or known drug abuser? Select all that apply. Tremors Hyperactivity Neonates have difficulty maintaining their body temperature, but their bodies have several mechanisms to help them do so. Which ones should a nurse remember when caring for a newborn? Select all that apply. Flexed fetal position Brown fat metabolism Peripheral vasoconstriction The nurse is caring for a client who has a newborn with a neurological impairment. What is the most important nursing action? Assisting the client with the grieving process A preterm newborn is given oxygen by way of a hood. What should the plan of care for this neonate include? Ensuring that the oxygen is continuously warmed and humidified While assessing a neonate the nurse observes ecchymotic-appearing areas on the buttocks and sacrum. The nurse concludes that this discoloration is probably related to the neonate's: Skin color [Show More]

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