Nội dung text RECALLS 12 - NP2 - SC
3 | Page 29. Alysa has been reported to spend her time daydreaming in her room, causing concern for her parents. The least helpful response from Nurse Karen would be: A. Do not worry. This is a normal behavior at this stage of development. B. Would you feel comfortable in discussing your observation? C. She may have some problems in school. Has she ever related to you about it? D. Was there any stressful event in your home lately? 30. Which of the following is least likely to be characteristic of Carl during puberty? A. Enlargement of the prostate. B. Nocturnal emission. C. Enlargement of the testes. D. Change in voice quality. Situation: Mrs. Pokwang, 28 years old and married for 4 years, delayed pregnancy to focus on her career as a lawyer. She consulted an obstetrician due to vaginal spotting and to explore options for conception. After undergoing various diagnostic tests, she was diagnosed with endometriosis. 31. Which statement BEST describes endometriosis? A. It is caused by growth of endometrial tissues outside the uterus. B. It Is a major cause of primary dysmenorrhea. C. It is an infection of the endometrium. D. It is caused by abnormal proliferation of the endometrial lining. 32. The nurse conducts an assessment on Mrs. Pokwang. Which findings would suggest the presence of endometriosis? Select all that apply. 1. Spotting after intercourse 2. Menorrhagia 3. Persistent dysmenorrhea 4. Mass felt on palpation. 5. Dyspareunia 6. Yellow purulent discharge A. 2, 3 and 4 B. 3, 4 and 5 C. 1, 2 and 3 D. 4, 5 and 6 33. The physician prescribes Danazol (Danocrine) for Mrs. Pokwang. The nurse should inform her that while on this medication, she will likely experience all of the following symptoms EXCEPT? A. Diminished menstrual flow. B. Cessation of her menses. C. Anovulation. D. Weight gain and edema. 34. Endometriosis interferes with fertility because. A. Of tubal blockage of endometrial tissues. B. The ovaries stop producing adequate estrogen. C. The uterine cervix becomes inflamed and swollen. D. Of pressure on the pituitary that leads to decreased FHS levels. 35. Mrs. Pokwang is scheduled for laparoscopy. What is the correct instruction the nurse should provide? A. Do not drink carbonated beverages 48 hours after the procedure. B. The dressing can be removed the next day and the incision must be exposed to air. C. The dye which will be used will color your urine blue for the first few voiding’s. D. Notify the physician if you feel pain on your shoulders. Situation: Nurse Yana's obstetrical history reveals that Michelle, who is 21 and currently pregnant, experienced her first pregnancy at age 19, which ended in a 21-week stillbirth. Her subsequent pregnancy successfully delivered healthy identical twins. 36. Which of the following statements accurately reflects Michelle's obstetrical history? A. Michelle is G4P3. B. Since there has been a twin, Michelle is G5 P4. C. Since there was an abortion, Michelle is G3P3. D. Michelle is G3P2. 37. Michelle is currently in the second stage of labor, with her cervix dilated to 8 cm. Nurse Yana places her in the lithotomy position. One of the potential risks of this position that Nurse Yana should monitor for in Michelle is: A. Supine hypotension. B. Supine hypertension. C. Supine tachypnea. D. Supine hyperventilation 38. If Michelle experiences a prolonged second stage of labor and remains in the lithotomy position for an extended period, Nurse Yana should take various safety measures, EXCEPT: A. Put 2 pillows under her head. B. Wrap legs with elastic bandages. C. Place a small pad under her sacral area. D. Put a rolled towel under the Michelle's right hip. 39. Nurse Yana recognizes that Michelle requires additional support and encouragement during the peak and most painful phase of uterine contractions, known as the: A. Acme. B. Decrescendo. C. Increment. D. Decrement. 40. Before performing the initial vaginal examination, commonly known as an internal examination, what should Nurse Yana check first? A. Abdominal palpation for fetal lie and position. B. Blood pressure for hypo/hypertension. C. Heart rate of Michelle for chest compressions. D. Abdominal palpation for signs of fetal distress. Situation: Trixie delivered a 3,203.5 g (7 lb, 1 oz) baby boy via cesarean section 20 minutes ago. She had reached 39 weeks of a healthy pregnancy. She and her husband, Limuel, are now prepared to hold their newborn son. 41. When the couple touches the newborn's shoulders and finds the skin warm, the nurse explains that the newborn's best form of insulation is: A. Brown fat. B. Glucose. C. Glycogen. D. Lanugo. 42. To help keep the baby warm, the nurse advises Trixie to keep a blanket wrapped around him. The nurse explains that thermoregulation can be challenging for newborns because: A. The thin layer subcutaneous fat provides poor insulation. B. The flexed position of the newborn encourages heat loss. C. The liver Isn't fully developed. D. The production of glucose is inadequate. 43. In addition to ensuring the airway remains open, the nurse's top priority while the neonate is in the nursery is to: _________. A. Maintain a neutral thermal environment. B. Prevent infection. C. Initiate the first feeding. D. Facilitate parent-neonate interaction. 44. Which of the following would the nurse recognize as a key goal of newborn care during the initial postpartum period? A. To identify actual or potential problems requiring immediate or emergency attention.
4 | Page B. To facilitate development of a close parent-newborn relationship. C. To assist parents in developing healthy attitudes about children’s practices. D. To provide the parents of the newborn with information about well-baby programs. 45. Which of the following nursing diagnoses would be the top priority for a newborn delivered via cesarean section? A. Impaired gas exchange. B. RISK of infection. C. Ineffective thermoregulation. D. Altered nutrition- less than body requirements. Situation: Nurse Makidato works in the Pediatric ward, where she cares for many toddlers and preschoolers with non-communicable diseases. She focuses on effectively communicating each child's needs for diagnosis, treatment, and care. 46. A 2-year-old client named Glenn was admitted for bronchiolitis, with his mother and older sister taking turns caring for him. When Nurse Makidato offers medication, Glenn shakes his head, covers his mouth, and says, "I do not like it." How should Nurse Makidato address Glenn's refusal? A. Limit questions and offer options. B. Do a nonverbal approach by distracting him with some food. C. Tell him that you will be angry if he will not drink his drug. D. Ask the child if he wants it to be mixed with milk. 47. Pre-schoolers Aaron and Silver are having a fight over a toy provided by the ward. How will Nurse Makidato respond to the situation A. She asks: "Tell me what happened". B. She demands: "Explain to me why you did this?" C. She threatens the two saying:"You are both in a lot of trouble." D. She asks: "How many fights have you two had today?" 48. Four-year-old Mhaecy, who is able to walk, is crying and tugging at his hospital gown while holding a teddy bear. How should Nurse Makidato respond to Mhaecy's behavior? A. "I Know you feel scared. This must be your special teddy bear." B. "If you will not stop crying I will put your teddy bear in the trash bin.' C. "Please stop crying nobody will hurt you." D. "Hello, I am Nurse. Rizza, let us go to the play room." 49. When Nurse Makidato brings a dinner tray, Mhaecy says, "I am too sick to feed myself." How should Nurse Makidato respond? A. "Wait for few minutes and I will be back to help you." B. "Try to eat as much as you can." C. "You can eat later when you feel better." D. "You are a big boy now and you are able to feed yourself." 50. A mother voices her concern to the nurse about Mhaecy spending a lot of time playing with imaginary friends. How should Nurse Makidato respond? A. "Imaginary playmates are his way to release his tension and anxiety. B. "You have a reason to be concern as this is not a typical behavior. C. "I suggest psychological counseling." D. "That is the effect of absentee parent. Situation: Nurse Austria is conducting a cephalocaudal assessment on a 6-month-old infant during a routine well-child visit. As part of the assessment, Nurse Austria focuses on evaluating the infant’s head and its development. 51.The anterior fontanelle is characterized as: A. 3-4 cm antero-posterior diameter and 2-3 cm transverse diameter and diamond shape B. 2-3 cm antero-posterior diameter act. 3-4 cm: transverse diameter and: diamond shape: C. 2-3 cm in both antero-posterior and transverse diameter and diamond shape D. none of the above 52. Nurse Austria is developing a care plan for a newborn with fetal alcohol syndrome. What priority interventions should be included in the plan? A. Allow the newborn infant to establish own sleep-rest pattern. B. Maintain the newborn infant in a brightly lighted area of the nursery. C. Encourage frequent handling of the newborn infant by staff and' parents. D. Monitor the newborn Infant's response to feedings and weight gain pattern. 53. Nurse Austria is caring for an infant diagnosed with hydrocephalus. A key preoperative nursing intervention is to: A. Test the urine for protein. B. Reposition the infant frequently. C. Provide a stimulating environment. D. Obtain blood pressures every 30 minutes Situation: Nurse Matic is conducting a routine assessment of different children confined at the pediatric clinic. As part of the assessment, Nurse Matic focuses on evaluating patient’s sensory development, including his hearing, vision, and touch responses. 54. Nurse Matic is observing a 2-year-old child and suspects the child might have strabismus. What signs should the nurse look for to indicate this condition? A. The child has difficulty hearing. B. The child consistently tilts the head to see. C. The child consistently turns the head to see. D. The child does not respond when spoken to. 55. Baby Moco was born with Down syndrome. During a physical assessment, the nurse should pay close attention to the infant's: A. Heart sounds B. Lung expansion C. Gluteal fold D. Normal reflexes 56. Nurse Matic is caring for a newborn with tracheoesophageal fistula. What should be the priority nursing diagnosis? A. Risk for dehydration B. Ineffective airway clearance C. Altered nutrition D. Risk for Injury 57. Nurse Matic is caring for a child who has just returned from surgery after a tonsillectomy and adenoidectomy. What is the appropriate action for the nurse to take? A. Offer Ice cream every 2 hours B. Place the child in a supine position C. Allow the child' to drink through a straw D. Observe swallowing patterns Situation: A pregnant client named Mrs. Zarinna has been diagnosed with Deep Vein Thrombosis (DVT) and has been admitted for potential treatment. This is Nurse Pantig's first experience managing such a case, and she feels that it will contribute to her professional growth. 58. Nurse Pantig recalls that as part of the inflammation process and edema, the client's skin will be stretched making it shiny and white known as "milk leg" and this is medically termed as_. A. Phlegmasia Alba Dolens. B. Hyperfibrinogenemia.