Practice Examination And 100%
Correct Answers 2025-2026 Latest
Edition.
After a client received an epidural anesthesia, a nurse should make which of these assessments
first?
· Determine whether the client has bladder distention
· Determine whether the client has sensory impairment in the legs
· Determine the frequency of the client's contractions
Determine the clients blood pressure - Answer The nurse should determine the client's blood
pressure first. Since epidural anesthesia may cause the blood pressure to drop, it is important to
ensure there is adequate blood flow to the baby. The other options may be subsequent
assessments the nurse would make, but should not be the first assessment.
The client who is 16 weeks pregnant attends the antepartal clinic. She makes all of these
comments to a nurse. Which of these comments by this client requires FURTHER discussion by
the nurse?
· I drink about 2.5 quarts of fluids every day
· I've gained about 7 pounds so far. I'll probably gain another 20 pounds by the time I deliver
· I had a problem with hemorrhoids with my other pregnancy, so now I eat a large serving of
bran every evening
· I'm being careful to eat mostly salt-free and to use no salt in my cooking - Answer The fourth
statement requires further discussion. Sodium requirements increase during pregnancy.
However, the sodium provided by the average diet is likely to be adequate for expectant
mothers. Use of additional salt is rarely warranted.
A nurse teaches pregnancy exercises to a group of pregnant women. The nurse should include
an explanation that pelvic rock will be helpful at any time in their lives should the women
develop which of these conditions?
· Hemorrhoids
· Intestinal flatus
· Lower back pain
· Leg cramps - Answer Pelvic rock helps to relieve lower back pains. Pelvic rocking helps to
relieve a sore back by stretching the lower back muscles. Pelvic rocking also helps stimulate the
, A client who is in active labor has a vaginal examination which reveals she is 5cm dilated and
100% effaced at a -1 station. At the peak of a contraction, the amniotic fluid ruptures. Which of
these actions should a nurse take first?
· Records the findings and notify the provider
· Change the linen and make the client comfortable
· Check the perineal area and assess for crowning
· Assess the fetal heart rate and check for regularity - Answer After rupture of the membranes,
there is a danger of cord prolapse; therefore, the nurse should assess the fetal heart rate for
regularity. Variable decelerations can occur as a result of cord compression secondary to cord
prolapse. There is also a risk for infection after membrane rupture.
After teaching a class about relieving leg cramps during pregnancy, a nurse evaluates the
effectiveness of the instructions. Which of these comments, if made by the participants, would
require FURTHER instruction?
· When I get a leg cramps in the middle of the night, my husband presses on my knee and
pushes my foot toward my leg
· Sometimes when I'm sitting at my typewriter, I get a horrible leg cramp. First, I stand and bear
weight on my leg in the middle of the night
· I take a heating pad to bed with me so that I can use it if I get a leg cramp in the middle of the
night
· When I get a leg cramp while sitting at my desk, I flex my knee and extend my foot - Answer
The fourth comment would require further education. With leg cramps, the leg should be
straightened and toes should be flexed toward the shin.
A client who is scheduled for a cesarean delivery has the following written preoperative orders.
Which should the nurse question?
· Nothing by mouth after midnight
· Atropine sulfate 0.4mg IM on call
· Indwelling urinary catheter to be inserted in the morning
· Cleansing enema this evening - Answer The order for a cleansing enema in the evening
should be discussed with the physician. A cleansing enema is not usually done prior to a
cesarean section.
A client who is G1P0 is receiving IV oxytocin injection for labor augmentation. Because of the
effects of Pitocin, a nurse should assess the client for which of these adverse effects of Pitocin?
· Bradypnea and diarrhea