ECON 351 NEW UPDATED EXAM QUESTIONS AND ANSWERS SOLUTION FOR ATI CAPSTONE OBSTETRICS

ECON 351 NEW UPDATED EXAM QUESTIONS AND ANSWERS SOLUTION FOR ATI CAPSTONE OBSTETRICS 1. The nurse is caring for a postmenopausal pt prescribed the aromatase inhibitor, anastrozole for the tx of breast cancer, what should the nurse inform the pt she may experience - CORRECT ANSWER muscle and joint pain 2. The nurse is caring for a pt who reports unrelieved episiotomy pain 8hr following a vaginal birth, what action should the nurse take - CORRECT ANSWER apply an ice pack to the affected area 3. T/F, for breast engourgement, fresh cabbage leaves placed inside the bra can help alleviate pain - CORRECT ANSWER F apply cold compress cabbage leaves must be cold 4. The nurse is caring for a pt 2 hours after a spontaneous vaginal birth and the pt has saturated 2 perineal pads with blood in a 30 min period, what priority nursing intervention should be given at this time - CORRECT ANSWER palpate the pt's uterine fundus 5. The nurse is caring for a newborn with hyperbilirubinemia, what intervention should be taken during phototherapy - CORRECT ANSWER maintain an eye mask over the newborn's eyes 6. a laboring pt received meperidine IV one hour prior to delivery, what med should the nurse have available to counteract this med - CORRECT ANSWER naloxone 7. The nurse is caring for a pt who is 1 day postpartum and is taking a sitz bath, determine the pt's tolerance of the procedure, what assessment should the nurse perform - CORRECT ANSWER pulse rate 8. prior to an amniocentesis, what action by the pt will need to be completed - CORRECT ANSWER empty the bladder 9. The nurse in a clinic is caring for a pt who is 3 weeks postpartum following the birth of a healthy newborn, the pt reports feeling down and sad, having no energy, and wanting to cry, what priority action should be taken by the nurse - CORRECT ANSWER ask the client if she has considered harming the newborn 10. The nurse is teaching the parent of a newborn about bottle feeding, what indicates need for further instruction - CORRECT ANSWER i will tip the nipple so air is present as my baby sucks 11. The nurse is caring for a laboring client and notes that the fetal heart rate begins to decelerate after the contraction has started, the lowest point of decel occurs after the peak of the contraction, what is the priority nursing action - CORRECT ANSWER change the pt's position 12. The nurse is assessing a newborn following a vaccum assisted delivery, what finding should the nurse report - CORRECT ANSWER poor sucking 13. a postpartum pts fundus is firm, 3cm above the umbilicus and displaced to the right, what interventions should the nurse take? - CORRECT ANSWER assist the pt to void then reassess the fundus 14. The nurse is caring for a pt who is experiencing urinary incontinence, what recommendations should the nurse plan to teach - CORRECT ANSWER reduce intake of caffeinated and carbonated beverages 15. The nurse is caring for a pt who has just delivered her first newborn, the nurse anticipates hyperbilirubinemia due to the incompatibility, the nurse should understand that hyperbilirubinemia occurs with Rh incompatability for which of the following reasons? - CORRECT ANSWER the client's blood does not contain the Rh factor, so she produces anti- Rh antibodies that cross the placental barrier and cause hemolysis of red blood cells in newborns 16. which of the following would increase a client's risk of ovarian cancer - CORRECT ANSWER endometriosis 17. during a breast examination on a 24 year old pt the nurse notes the following findings, what is of most concern and should be reported to the provider - CORRECT ANSWER an irregularly shaped, nontender lump is palpable in the right breast 18. a pregnant client's last menstrual period was May4th 2018, what is this client's estimated delivery date using Naegeles Rule - CORRECT ANSWER February 11th, 2019 19. a pt has been prescribed raloxiphine, as the nurse you know that raloxiphine is used to treat - CORRECT ANSWER osteoporosis 20. a home care nurse is following up with a postpartum pt, what is a risk factor that places this client at risk for postpartum depression - CORRECT ANSWER hormonal changes with a rapid decline in estrogen and progesterone levels 21. The nurse is planning care for a newborn who is small for gestational age (SGA), what is the priority intervention the nurse should include in the newborn's plan of care - CORRECT ANSWER monitor blood glucose levels 22. The nurse is providing discharge instructions to parents of a circumcised newborn, to prevent diaper adherence to the penis, what will be recommended to apply during diaper changes - CORRECT ANSWER petroleum jelly 23. The nurse is assessing a pt who is in active labor and notes that the presenting part is at 0 station, what is the correct interpretation of this clinical finding? - CORRECT ANSWER the lowermost portion of the fetus is at the level of the ischial spine 24. the nurse is caring for a pt with uncomplicated gestational hypertension what are expected findings of the disorder? SATA - CORRECT ANSWER BP of 140/90 or above the BP will return to normal after pregnancy 25. following delivery, the nurse places the newborn under a radiant heat warmer, what action is this doing - CORRECT ANSWER preventing cold stress 26. The nurse is caring for a pt who is at 37 weeks of gestation and has placenta previa, the pt asks the nurse why the provider does not do an internal examination, what explanation of the primary reason should the nurse provide - CORRECT ANSWER this could result in profound bleeding 27. The nurse is providing education to a pt in the first trimester of pregnancy, what info should the nurse include regarding the cause of indigestion and heartburn - CORRECT ANSWER progesterone causes relaxation of the cardiac sphincter allowing acid to reflux 28. a laboring pt's membranes have just ruptured, what is the nurse's next action - CORRECT ANSWER assess the fetal HR pattern 29. a postpartum complication a client is at risk for is DVT, what following factor is strongly associated with this complication - CORRECT ANSWER c. section 30. The nurse has provided education to a pt who has been prescribed oral contraception, what statement indicates a need for further instruction - CORRECT ANSWER if i miss three pills i will double up each day until back on schedule (take missed pill asap, if more than one is missed, follow manufacturers instruction and use alternative form of contraception) 31. The nurse is caring for a pt who is pregnant for the 4th time, she delivered 2 full term newborns and had one spontaneous abortion at 10wk of gestation, the ob history is - CORRECT ANSWER G4 P2 32. The nurse is caring for a pt who is in the latent phase of labor, what clinical manifestation should the nurse expect - CORRECT ANSWER talkative 33. The nurse is conducting an infertility assessment for a newly admitted pt, what factor should the nurse identify as affecting the pt's fertility - CORRECT ANSWER premature ovarian failure 34. The nurse is caring for a newborn who has a blood glucose of 45mg/dl, what action should the nurse take - CORRECT ANSWER encourage the mother to breastfeed the newborn 35. The nurse is providing teaching about pain management to a young adult client who has dysmenorrhea, what instructions should the nurse include - CORRECT ANSWER use a heating pad on your lower abdomen when experiencing pain 36. The nurse is caring for a pt who has placenta previa, what interventions should the nurse implement for this pt - CORRECT ANSWER frequently assess the maternal HR initiate bed rest with bathroom privileges have O2 equipment available 37. The nurse is caring for a pt who is at 14 weeks of gestation and has hyperemesis gravidarum, what med should the nurse plan to administer - CORRECT ANSWER vitamin B6 38. The nurse is providing teaching to a pt about depot medroxyprogesterone acetate, what info should the nurse include in the teaching - CORRECT ANSWER loss of bone mineral density can occur 39. The nurse is providing teaching to a pt about pap tests, what information should the nurse include in the teaching - CORRECT ANSWER avoid having sex for 48h prior to the pap test 40. The nurse is caring for a pt who is in active labor and notes late decelerations in the FHR on the external fetal monitor, what actions is the nurse's priority - CORRECT ANSWER change the pt's positions 41. The nurse is caring for a pt who is in active labor and notes early decels of the FHR on the fetal monitor tracing, the nurse should identify that which of the following conditions causes early decels in the FHR - CORRECT ANSWER head compression 42. The nurse is providing teaching to a group of young adult women about risk factors for ovarian cancer, what should the nurse include - CORRECT ANSWER nulliparity high-fat diet hormone replacement therapy 43. The nurse is preparing to administer a repeat dose of butorphanol to a pt who is in labor, what finding should the nurse identify as a contraindication to the administration of the medication - CORRECT ANSWER respiratory rate 11/min 44. The nurse is teaching a pt about using an IUD for contraception, what statement by the pt indicates an understanding - CORRECT ANSWER i should check for the string each month after menstruation 45. The nurse is preparing to administer nalbuphine to a pt who is in active labor, the pt requests a bedpan to have a bowel movement, what should the nurse do first – CORRECT ANSWER evaluate the client's cervix 46. The nurse is caring for a pt who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding, the pt has a history of cocaine use, the nurse should identify that the pt is likely experiencing what complication - CORRECT ANSWER abruptio placentae 47. The nurse is caring for a pt at 39 weeks of gestation who is in active labor and had a positive GBS culture at 36 weeks of gestation, what action should the nurse take - CORRECT ANSWER administer prophylactic antibiotics 48. The nurse is reviewing a pt's medical records and notes that the pt is taking tamoxifen, the pt should identify that this is used to treat - CORRECT ANSWER breast cancer (estrogen receptor blockers) 49. The nurse is assessing a pt who gave birth 1 week ago, the client states "i don't know what's wrong , i love my baby, but i feel so let down, and i seem to cry for no reason" the nurse should identify that this is - CORRECT ANSWER postpartum blues (1-10 days after the birth, depression is 1-12 months after birth) 50. The nurse is teaching the parents of a newborn how to care for their son's uncircumcised penis, what instruction should the nurse include - CORRECT ANSWER wash the penis once per day with soap and water 51. The nurse is planning care for a pt who is in labor and has an active varicella zoster infection with skin lesions, what actions should the nurse include in the plan of care - CORRECT ANSWER administer varicella-zoster immune globulin (VZIG) to the newborn shortly after birth 52. The nurse is perfroming an assessment on a pt who is 24hr postpartum, the nurse palpates the fundus to be boggy, 3cm above the umbilicus, and is displaced to the right, what actions should the nurse take first - CORRECT ANSWER assist the pt to the bathroom to void 53. The nurse is caring for a pt who is receiving oxytocin to augment labor, the pt has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring, what is an indication that the nurse should discontinue the infusion - CORRECT ANSWER contraction duration of 100 seconds 54. The nurse is caring for a pt who is postoperative following a mastectomy, the pt expresses concern about losing her femininity and fears that she will no longer be attractive to her partner, what is a therapeutic response by the nurse - CORRECT ANSWER clarify the pt's concerns about her body image 55. The nurse is providing education about prenatal nutrition with a pt who is at 13 weeks of gestation and has a BMI of 22, what information should the nurse include - CORRECT ANSWER consume about 71g of protein each day during pregnancy 56. The nurse is providing teaching to a pt who is experiencing hot flashes and has a new prescription for hormone therapy with conjugated equine estrogen, what information should the nurse include in the teaching - CORRECT ANSWER estrogen decreases the risk for osteoporosis estrogen use and smoking increases the risk for TBE estrogen therapy can cause break-through vaginal bleeding 57. The nurse is providing teaching to a pt who has fibrocystic breast changes and is experiencing breast discomfort during menstruation, what instructions should the nurse include - CORRECT ANSWER decrease daily intake of caffeine 58. The nurse is assessing a newborn and observes a bluish tinged area on the buttocks, the nurse should document as - CORRECT ANSWER mongolian spots 59. The nurse is caring for a pt who is in the third stage of labor, what actions should the nurse take - CORRECT ANSWER clean the pt's perineum with warm water 60. The nurse is caring for a pt who has a prescription for ibuprofen for postpartum cramping, what question should the nurse ask prior to admin - CORRECT ANSWER are you taking OTC meds do you have a history of gastric problems are you being treated for high BP 61. The nurse is assessing a newborn who is 10hr old, what clinical findings should the nurse report to the provider - CORRECT ANSWER nasal flaring 62. The nurse is caring for a pt who is scheduled for a hysterosalpingography (HSG), what statement by the pt indicates a contraindication to the procedure - CORRECT ANSWER i am taking medicine for a vaginal infection 63. The nurse is assessing a pt who is at 31 weeks of gestation and is receiving magnesium sulfate via continuous IV infusion for preterm labor, what finding should the nurse report - CORRECT ANSWER respiratory rate 11/min 64. The nurse is caring for a postpartum pt who has DVT and is receiving heparin therapy via subcutaneous injections, what action should the nurse take - CORRECT ANSWER administer the injection in the pt's abdomen 65. The nurse is caring for a pt who is in the transition phase of labor, what action should the nurse take - CORRECT ANSWER encourage the pt to use a rapid pant-blow breathing pattern 66. The nurse is preparing to administer a rubella immunization to a pt who is postpartum and has a titer less than 1:8, what finding is a contraindication to administering this med - CORRECT ANSWER immunosuppressed household members 67. The nurse is caring for a pt who is in labor and has an epidural for pain control, what clinical manifestation is an adverse effect of epidural anesthesia - CORRECT ANSWER pruritus 68. The nurse on a postpartum unit is teaching a pt about techniques for storing breast milk, what info should the nurse include in the teaching - CORRECT ANSWER freshly pumped breast milk can be stored at room temp for up to 8 hours 69. The nurse is assessing a newborn who was born vaginally with vacuum extractor assistance, the nurse notes swelling over the newborn's head that crosses the suture lines, the nurse should identify the swelling as what finding - CORRECT ANSWER caput succedaneum 70. The nurse is teaching a pt about caring for her newborn's umbilical cord, what statement by the pt indicates understanding - CORRECT ANSWER i should wash around the cord with plain water daily 71. The nurse is teaching a pt who is to start using a diaphragm for contraception, what statment by the pt indicates an understanding of the teaching - CORRECT ANSWER I will place 2 teaspoons of spermicide on the inside on the inside of the diaphragm for inserting it 72. The nurse is caring for a pt who had a vaginal birth 2 hours ago and has soaked 2 perineal pads in the past 30 min, what action should the nurse take - CORRECT ANSWER assess the pt's uterine tone 73. The nurse is teaching a pt who is at 10 weeks of gestation about chronic vius sampling (CVS), what information should the nurse include in the teaching - CORRECT ANSWER a CVS test can detect chromosomal anomalies 74. The nurse is caring for a pt who is in labor and has a diagnosis of strep B hemolytic group B infection, what med should the nurse plan to administer - CORRECT ANSWER ampicillin 75. The nurse is caring for a newborn whose father voices concerns about his ability to bond with his baby, what action should the nurse take to facilitate bonding - CORRECT ANSWER point out to the father that the newborn turns toward his voice encourage the father to touch and stroke the newborn's skin demonstrate diapering and swaddling techniques for the father 76. The nurse is teaching a pregnant client who is Rh-negative about Rho(D) immune globulin, what statements by the pt indicate an understanding of the teaching - CORRECT ANSWER the shot may be given after birth to protect future pregnancies 77. The nurse is planning care for a pt who is 2 weeks postpartum and has mastitis, what interventions should the nurse include - CORRECT ANSWER instruct the pt to wash her hands prior to breastfeeding teach the pt about proper latching on technique encourage the pt to allow her nipples to air dry after feedings 78. The nurse is assessing a pt who is receiving oxytocin via continuous IV infusion for labor induction, what actions is the nurse's priority - CORRECT ANSWER perform electronic fetal monitoring 79. The nurse is caring for a pt who requests to have an IUD, what finding is a contraindication to this form of contraception - CORRECT ANSWER the client had a positive chlamydia culture 2 weeks ago 80. The nurse is caring for a pt who requests to have an IUD, what finding is a contraindication to this form of contraception - CORRECT ANSWER the pt had a positive chlamydia culture 2 weeks ago 81. The nurse is caring for a pt who is experiencing preterm labor and has a new prescription for terbutaline, what finding is a contraindication to administration of this medication - CORRECT ANSWER heart disease