Question 5011)
When performing a postpartum assessment on a patient a nurse notes the presence of clots in the lochia. The nurse examines the clots and notes that they are larger than 1 cm which of the following nursing actions is most appropriate:
A. documents the finding
B. notify physician
C. reassess the client in 2 hours
D. encourage increased oral intake of fluids
Answer: B
Explanation: The presence of blood clots larger than 1 cm is indicative of hemorrhage, which needs to be notified to the physician/gynecologist immediately.
Question 5012) The main cause of venous thrombosis in puerperal women is.............
A. increase viscosity of blood due to dehydration
B. decreased viscosity of blood during labor
C. stasis of blood in veins due to late ambulation
D. increase intake of fat in diet
Answer: C
Explanation: Venous stasis in the lower limbs is caused by increased vein distensibility and the gravid uterus acting as a mechanical impediment to venous stasis and vascular damage are a triad of initiating factors for venous thrombosis. In addition, there are increased levels of most of the circulating clotting factors in preparation for placental separation.
Question 5013)
A woman is 37 weeks pregnant and she is bleeding profusely with no pain is suggestive of:
A. Antepartum hemorrhage
B. Unavoidable hemorrhage
C. Accidental hemorrhage
D. Concealed hemorrhage
Answer: A Explanation: Women is 37 weeks pregnant and she is bleeding profusely without pain it is suggestive of antepartum hemorrhage (APH) bleeding from or into the genital tract after 24 weeks of pregnancy but the child birth is known as antepartum hemorrhage.
Question 5014) A client is scheduled for a pap smear. The nurse provides instructions to the client regarding preparation for the test:
A. the test can be performed during menstruation
B. fluids are restricted on the day of the test
C. the test is painless
D. vaginal douching is required 2 hours before the test
Answer: D
Explanation: Vaginal douching is required 2 hours before the test as it will cleanse the cervix and prevent exfoliated or dead tissues in sample.
Question 5015) A nurse needs to check the most important parameter if patient is on magnesium sulphate level is:
A. urine output>30mlfhr
B. presence of knee jerk reflex
C. respiration is > 12 per minute
D. blood pressure < 140/90 mm Hg
Answer: B
Explanation: Diminished/absence of deep tendon reflex is one of the earliest signs of magnesium toxicity when a patient receives MgSO4 therapy the nurse must assess deep tendon reflexes (knee jerk reflex) frequently information from DTRs will help nurses develop judgment about titrating the administration and prevent magnesium toxicity.
Question 5016) Which one of the following anti-tuberculosis drugs cannot be given during pregnancy:
A. Rifampicin
B. Ethambutol
C. Streptomycin
D. INH
Answer: C Explanation: Rifampicin INH and ethambutol are safe during pregnancy streptomycin can cause harmful effects in the fetus as it readily crosses the placental barrier.
Question 5017) Two days after having a cesarean birth a client complains of pain in the right lag what should be the nurse's initial response?
A. Apply warm soaks
B. Massage the affected area
C. Encourage ambulation and exercise
D. Maintain bed rest and notify the practitioner
Answer: D
Explanation: Temporary nerve irritation or injury can occur with anesthesia which might cause leg pain after C - section it is usually resolved within a few days after rest. Applying warm soaks and massaging affected area is not recommended ambulation and post-natal exercise are encouraged as soon as possible but no an appropriate initial response to the complains of pain.
Question 5018) First day of last menstrual period is October 19,2017. What is the expected date of delivery?
A. July 12, 2018
B. July 26, 2018
C. August 12, 2018
D. August 26, 2018
Answer: B
Explanation: Naegele's formula - add 9 calendar month and 7 days to LMP, LMP = 19/10/2017 + 9 month = 19/07/2018 + 7 days , so EDD = July 26, 2018.
Question 5019) The nurse preparing to administer the Rubella vaccine to two days postpartum women. The nurse should caution the client to avoid :
A. Sunlight for 3 days
B. Scratching the injection site
C. Scratching for 2 to 3 months after the vaccination
D. Sexual intercourse for 2 to 3 months after vaccination
Answer: C
Explanation: Pregnancy needs to be avoided for 1 to 3 months as rubella is live vaccine which can give adverse effect on fetus. This is usually administered to the patient who are IgG NEGATIVE.
Question 5020) Before a client with syphilis can be treated the nurse must determine the...........
A. Portal of entry
B. size of the chancre
C. existence of allergies
D. name of sexual contact
Answer: C
Explanation: Penicillin injection is the treatment of syphilis allergic reaction to the penicillin can be life threatening whenever the patient comes for the penicillin injection each time antibiotic sensitivity test is to be repeated and if skin reaction is positive for allergic reaction then the patient can be given alternative therapy as ceftriaxone or erythromycin.
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