OB PEDIATRIC FINAL REVIEW 2026 QUESTIONS
AND SOLUTIONS GRADED A+
▶ A client has a urinary tract infection. Which assessment by the nurse is
most helpful?
A) Palpating and percussing the kidneys and bladder
B) Performing a bladder scan to assess post-void residual
C) Assessing medical history and current medical problems
D) Inquiring about recent travel to foreign countries. Answer: C
Clients who are severely immune compromised or who have diabetes
mellitus are more prone to fungal urinary tract infection. The nurse should
assess for these factors. A physical examination and a post-void residual
may be needed, but not until further information is obtained. Travel to
foreign countries probably would not be as important, because even if
exposed, the client needs some degree of immune compromise to develop
a fungal urinary tract infection.
▶ When a diabetic patient asks about maintaining adequate blood glucose
levels, which of the following statements by the nurse relates most directly
to the necessity of maintaining blood glucose levels no lower than about 74
mg/dl?
A) "Without a minimum level of glucose circulating in the blood,
erythrocytes cannot produce ATP."
B) "The presence of glucose in the blood counteracts the formation of lactic
acid and prevents acidosis."
C) "The central nervous system cannot store glucose and needs a
continuous supply of glucose for fuel."
D) "Glucose is the only type of fuel used by body cells to produce the
energy needed for physiologic activity.". Answer: C
The brain cannot synthesize or store significant amounts of glucose; thus a
continuous supply from the body's circulation is needed to meet the fuel
demands of the central nervous system.
,▶ The nurse is caring for an overweight client who gained 10 pounds
during the previous 2 weeks. The client states that she is hungry all the
time and doesn't understand why. Which assessment finding could explain
the client's weight gain and hunger?
A) The client's glycosylated hemoglobin level is 6%.
B) The client started taking dexamethasone (Decadron) daily.
C) The client started taking naproxen sodium (Naprosyn) daily.
D) The client's thyroxine (T4) level is 8 mcg/dL.. Answer: B
Dexamethasone is a corticosteroid. These drugs alter carbohydrate,
protein, and lipid metabolism, predisposing the client to obesity when taken
on a long-term basis. In addition, corticosteroids increase the client's
appetite. Naprosyn is an NSAID, which can lead to gastric upset and
ulceration and decreased appetite and weight loss. The client's
glycosylated hemoglobin and thyroid levels are within normal limits and
would not explain the hunger and weight gain.
▶ The nurse is prioritizing care to prevent pressure sores for a client who is
immobilized. Which interventions are appropriate? (Select all that apply.)
A) Use a rubber ring to decrease sacral pressure when up in the chair.
B) Place a small pillow between bony surfaces.
C) Keep the heels off the bed surfaces.
D) Use a lift sheet to assist with repositioning.
E) Reposition the client who is in a chair every 2 hours.
F) Elevate the head of the bed to 45 degrees.
G) Limit fluids and proteins in the diet.. Answer: B,C,D
A small pillow decreases the risk for pressure between bony prominences,
a lift sheet decreases friction and shear, and heels have poor circulation
and are at high risk for pressure sores, so they should be kept off hard
surfaces. Head of the bed elevation greater than 30 degrees increases
pressure on pelvic soft tissues. Fluids and proteins are important for
maintaining tissue integrity. Clients should be repositioned every hour while
sitting in a chair. A rubber ring impairs capillary blood flow, increasing the
risk for a pressure sore.
,▶ A client who first experienced symptoms related to a confirmed
thrombotic stroke 2 hours ago is brought to the intensive care unit. Which
prescribed medication does the nurse prepare to administer?
A) Tissue plasminogen activator
B) Heparin sodium
C) Warfarin (Coumadin)
D) Gabapentin (Neurontin). Answer: A
The client who has had a thrombotic stroke has a 3-hour time frame from
the onset of symptoms to receive recombinant tissue plasminogen activator
(rt-PA) to dissolve the cerebral artery occlusion and re-establish blood flow.
Clients must meet eligibility criteria for administration of this therapy. The
other medications do not assist in the re-establishment of blood flow for a
client with a confirmed thrombotic stroke.
▶ A nurse is about to administer the first dose of captopril (Capoten) to a
client with hypertension. Which is the priority nursing intervention?
A) Place the client in Trendelenburg position to facilitate blood flow to the
heart.
B) Take the client's apical pulse for 1 full minute before drug administration.
C) Instruct the client to drink 3 L of fluid daily when taking this medication.
D) Educate the client to sit on the side of the bed for a few minutes before
rising.. Answer: D
Angiotensin-converting enzyme (ACE) inhibitors such as captopril can
cause severe hypotension with initial use. The client should be instructed to
rise slowly and sit on the side of the bed for a few minutes to prevent
hypotension-induced falls. No indication is known for assessment of the
apical pulse for 1 full minute before taking captopril. Placing the client in a
Trendelenburg position is not indicated. In case of a precipitous drop in
blood pressure, a modified Trendelenburg position may be used. Adequate
fluid intake is necessary but is not the priority in this situation.
▶ A client who had a stroke is receiving clopidogrel (Plavix). Which
adverse effect does the nurse monitor for in this client?
A) New-onset confusion
B) Repeated syncope
, C) Abdominal distention
D) Spontaneous ecchymosis. Answer: D
Clopidogrel (Plavix) is an antiplatelet medication that can cause bleeding,
bruising, and liver dysfunction. The nurse should be alert for signs of
bleeding, such as ecchymosis, bleeding gums, and tarry stools. Plavix does
not cause syncope, confusion, or abdominal distention.
▶ A client receiving intravenous chemotherapy asks the nurse the reason
for wearing a mask, gloves, and gown while administering drugs to the
client. What is the nurse's best response?
A) "I am preventing the spread of infection from you to me or any other
client here."
B) "The clothing protects me from accidentally absorbing these drugs."
C) "The policy is for any nurse giving these drugs to wear a gown, gloves,
and mask."
D) "These coverings protect you from getting an infection from me.".
Answer: B
Most chemotherapy drugs are absorbed through the skin and mucous
membranes. As a result, health care workers who prepare or give these
drugs, especially nurses and pharmacists, are at risk for absorbing them.
Even at low doses, chronic exposure to chemotherapy drugs can affect
health. The Oncology Nursing Society and the Occupational Safety and
Health Administration (OSHA) have specific guidelines for using caution
and wearing protective clothing whenever preparing, giving, or disposing of
chemotherapy drugs.
▶ The earliest and most sensitive assessment finding that would indicate
an alteration in intracranial regulation would be:
A) change in level of consciousness.
B) unequal pupil size.
C) loss of primitive reflexes.
D) inability to focus visually.. Answer: A
A change in level of consciousness is the earliest and most sensitive
indication of a change in intracranial processing. This is assessed with the
Glasgow Coma Scale (GCS), which assesses eye opening and verbal and
AND SOLUTIONS GRADED A+
▶ A client has a urinary tract infection. Which assessment by the nurse is
most helpful?
A) Palpating and percussing the kidneys and bladder
B) Performing a bladder scan to assess post-void residual
C) Assessing medical history and current medical problems
D) Inquiring about recent travel to foreign countries. Answer: C
Clients who are severely immune compromised or who have diabetes
mellitus are more prone to fungal urinary tract infection. The nurse should
assess for these factors. A physical examination and a post-void residual
may be needed, but not until further information is obtained. Travel to
foreign countries probably would not be as important, because even if
exposed, the client needs some degree of immune compromise to develop
a fungal urinary tract infection.
▶ When a diabetic patient asks about maintaining adequate blood glucose
levels, which of the following statements by the nurse relates most directly
to the necessity of maintaining blood glucose levels no lower than about 74
mg/dl?
A) "Without a minimum level of glucose circulating in the blood,
erythrocytes cannot produce ATP."
B) "The presence of glucose in the blood counteracts the formation of lactic
acid and prevents acidosis."
C) "The central nervous system cannot store glucose and needs a
continuous supply of glucose for fuel."
D) "Glucose is the only type of fuel used by body cells to produce the
energy needed for physiologic activity.". Answer: C
The brain cannot synthesize or store significant amounts of glucose; thus a
continuous supply from the body's circulation is needed to meet the fuel
demands of the central nervous system.
,▶ The nurse is caring for an overweight client who gained 10 pounds
during the previous 2 weeks. The client states that she is hungry all the
time and doesn't understand why. Which assessment finding could explain
the client's weight gain and hunger?
A) The client's glycosylated hemoglobin level is 6%.
B) The client started taking dexamethasone (Decadron) daily.
C) The client started taking naproxen sodium (Naprosyn) daily.
D) The client's thyroxine (T4) level is 8 mcg/dL.. Answer: B
Dexamethasone is a corticosteroid. These drugs alter carbohydrate,
protein, and lipid metabolism, predisposing the client to obesity when taken
on a long-term basis. In addition, corticosteroids increase the client's
appetite. Naprosyn is an NSAID, which can lead to gastric upset and
ulceration and decreased appetite and weight loss. The client's
glycosylated hemoglobin and thyroid levels are within normal limits and
would not explain the hunger and weight gain.
▶ The nurse is prioritizing care to prevent pressure sores for a client who is
immobilized. Which interventions are appropriate? (Select all that apply.)
A) Use a rubber ring to decrease sacral pressure when up in the chair.
B) Place a small pillow between bony surfaces.
C) Keep the heels off the bed surfaces.
D) Use a lift sheet to assist with repositioning.
E) Reposition the client who is in a chair every 2 hours.
F) Elevate the head of the bed to 45 degrees.
G) Limit fluids and proteins in the diet.. Answer: B,C,D
A small pillow decreases the risk for pressure between bony prominences,
a lift sheet decreases friction and shear, and heels have poor circulation
and are at high risk for pressure sores, so they should be kept off hard
surfaces. Head of the bed elevation greater than 30 degrees increases
pressure on pelvic soft tissues. Fluids and proteins are important for
maintaining tissue integrity. Clients should be repositioned every hour while
sitting in a chair. A rubber ring impairs capillary blood flow, increasing the
risk for a pressure sore.
,▶ A client who first experienced symptoms related to a confirmed
thrombotic stroke 2 hours ago is brought to the intensive care unit. Which
prescribed medication does the nurse prepare to administer?
A) Tissue plasminogen activator
B) Heparin sodium
C) Warfarin (Coumadin)
D) Gabapentin (Neurontin). Answer: A
The client who has had a thrombotic stroke has a 3-hour time frame from
the onset of symptoms to receive recombinant tissue plasminogen activator
(rt-PA) to dissolve the cerebral artery occlusion and re-establish blood flow.
Clients must meet eligibility criteria for administration of this therapy. The
other medications do not assist in the re-establishment of blood flow for a
client with a confirmed thrombotic stroke.
▶ A nurse is about to administer the first dose of captopril (Capoten) to a
client with hypertension. Which is the priority nursing intervention?
A) Place the client in Trendelenburg position to facilitate blood flow to the
heart.
B) Take the client's apical pulse for 1 full minute before drug administration.
C) Instruct the client to drink 3 L of fluid daily when taking this medication.
D) Educate the client to sit on the side of the bed for a few minutes before
rising.. Answer: D
Angiotensin-converting enzyme (ACE) inhibitors such as captopril can
cause severe hypotension with initial use. The client should be instructed to
rise slowly and sit on the side of the bed for a few minutes to prevent
hypotension-induced falls. No indication is known for assessment of the
apical pulse for 1 full minute before taking captopril. Placing the client in a
Trendelenburg position is not indicated. In case of a precipitous drop in
blood pressure, a modified Trendelenburg position may be used. Adequate
fluid intake is necessary but is not the priority in this situation.
▶ A client who had a stroke is receiving clopidogrel (Plavix). Which
adverse effect does the nurse monitor for in this client?
A) New-onset confusion
B) Repeated syncope
, C) Abdominal distention
D) Spontaneous ecchymosis. Answer: D
Clopidogrel (Plavix) is an antiplatelet medication that can cause bleeding,
bruising, and liver dysfunction. The nurse should be alert for signs of
bleeding, such as ecchymosis, bleeding gums, and tarry stools. Plavix does
not cause syncope, confusion, or abdominal distention.
▶ A client receiving intravenous chemotherapy asks the nurse the reason
for wearing a mask, gloves, and gown while administering drugs to the
client. What is the nurse's best response?
A) "I am preventing the spread of infection from you to me or any other
client here."
B) "The clothing protects me from accidentally absorbing these drugs."
C) "The policy is for any nurse giving these drugs to wear a gown, gloves,
and mask."
D) "These coverings protect you from getting an infection from me.".
Answer: B
Most chemotherapy drugs are absorbed through the skin and mucous
membranes. As a result, health care workers who prepare or give these
drugs, especially nurses and pharmacists, are at risk for absorbing them.
Even at low doses, chronic exposure to chemotherapy drugs can affect
health. The Oncology Nursing Society and the Occupational Safety and
Health Administration (OSHA) have specific guidelines for using caution
and wearing protective clothing whenever preparing, giving, or disposing of
chemotherapy drugs.
▶ The earliest and most sensitive assessment finding that would indicate
an alteration in intracranial regulation would be:
A) change in level of consciousness.
B) unequal pupil size.
C) loss of primitive reflexes.
D) inability to focus visually.. Answer: A
A change in level of consciousness is the earliest and most sensitive
indication of a change in intracranial processing. This is assessed with the
Glasgow Coma Scale (GCS), which assesses eye opening and verbal and
