N326 Final Exam Practice Questions with 100

N326 Final Exam Practice Questions with 100% Correct Answers 100% When caring for a woman with mild preeclampsia, it is critical that during assessment the nurse be alert for signs of progress to severe preeclampsia. Progress to severe preeclampsia is indicated by

this assessment finding:

• Proteinuria greater than 2+, in two specimens collected 6 hours apart
• Platelet count of 180,000/mm3
• Positive ankle clonus
• Blood pressure of 154/94 and 156/100, 6 hours apart - Correct Answer C. Positive ankle clonus

Rationale: Think about the effects on the CNS, specifically hyperreflexia.

The primary expected outcome for nursing care associated with the administration of magnesium

sulfate would be met if which assessment finding is present? The woman:

• Exhibits a decrease in both systolic and diastolic blood pressure
• Experiences no seizures
• States that she feels more relaxed and calm
• Urinates more frequently resulting in a decrease in pathologic edema - Correct Answer B.

Experiences no seizures A woman with severe preeclampsia is receiving nifedipine (Procardia). She asks the nurse what this

medication is far. The nurse should tell her that nifedipine is used to:

• Prevent seizures
• Relieve the headache she is beginning to have.
• Decrease her blood pressure.
• Reduce the edema in her hands and legs - Correct Answer C. Decrease her blood pressure.

A woman's preeclampsia has advanced to the severe stage. She is admitted to the hospital and her primary health care provider has ordered an infusion of magnesium sulfate be started. In implementing this order, the nurse should: (Select all that apply.) 1 / 4

• Prepare a solution of 20g of magnesium sulfate in 100 mL of 5% glucose in water
• Monitor maternal vital signs FHR patterns and uterine contractions
• Expect the maintenance dose to be approximately 2g/hr
• Administer a loading dose of 4 to 6 g over 15 to 30 minutes
• Prepare to administer Apresoline if signs of toxicity appear
• Report a respiratory rate of 12 breaths or less to the Primary health care provider immediately -

Correct Answer B. Monitor maternal vital signs FHR patterns and uterine contractions

• Expect the maintenance dose to be approximately 2g/hr
• Administer a loading dose of 4 to 6 g over 15 to 30 minutes
• Report a respiratory rate of 12 breaths or less to the Primary health care provider immediately

Following vaginal birth 2 hours ago a woman with preeclampsia is experiencing a heavy flow as a result of a boggy uterus. It is determined that she will require medication to reduce the amount of blood loss. Which medication would the nurse anticipate administering?

• Methylergonovine (Methergine)
• Calcium gluconate
• Oxytocin (Pitocin)
• Labetalol (Normodyne) - Correct Answer C. Oxytocin (Pitocin)

A woman at 35 weeks of gestation with preeclampsia, has a seizure. Immediately after the seizure,

the nurse's priority action is to:

• Evaluate FHR and pattern for signs of decreasing variability, late decelerations, or bradycardia
• Assess status of the maternal airway, respiratory effort, and pulse
• Determine if membranes have ruptured and if the amniotic fluids contain meconium
• Prepare to increase the amount of magnesium sulfate being infused from 1g/hr to 2g/hr - Correct

Answer B. Assess status of the maternal airway, respiratory effort, and pulse A nurse in a health clinic is reviewing contraceptive use with a group of clients. Which of the following client statements demonstrates understanding? 2 / 4

• "A water-soluble lubricant should be used with condoms."
• "A diaphragm should be removed 2 hours after intercourse."
• "Oral contraceptives can worsen a case of acne."
• "A contraceptive patch is replaced once a month." - Correct Answer A. "A water-soluble lubricant

should be used with condoms." A nurse is instructing a client who is taking oral contraceptives about manifestations to report to the provider. Which of the following manifestations should the nurse include?

• Reduced menstrual flow
• Breast tenderness
• Shortness of breath
• Increased appetite - Correct Answer C. Shortness of breath

A nurse in an obstetrical clinic is teaching a client about using an IUD for contraception. Which of the following statements by the client indicates an understanding of the teaching?

• "An IUD should be replaced annually during a pelvic exam."
• "I cannot get an IUD until after I've had a child."
• "I should plan on regaining fertility 5 months after the IUD is removed"
• "I will check to be sure the strings of the IUD are still present after my periods" - Correct Answer D.

"I will check to be sure the strings of the IUD are still present after my periods" A nurse is teaching a client about potential adverse effects of implantable progestins. Which of the following adverse effects should the nurse include? (Select all that apply.)

• Tinnitus
• Irregular vaginal bleeding
• Weight gain
• Nausea
• Gingival hyperplasia - Correct Answer B. Irregular vaginal bleeding
• Weight gain
• Nausea 3 / 4

A nurse in a clinic is teaching a client about a new prescription for medroxyprogesterone. Which of the following information should the nurse include in the teaching? (Select all that apply.)

• "Weight fluctuations can occur."
• "You are protected against STIs."
• "You should increase your intake of calcium."
• "You should avoid taking antibiotics."
• "Irregular vaginal spotting can occur." - Correct Answer A. "Weight fluctuations can occur."
• "You should increase your intake of calcium."
• "Irregular vaginal spotting can occur."

A nurse is admitting a client who is in labor and has HIV. Which of the following interventions should the nurse identify as contraindicated for this client? (Select all that apply.)

• Vacuum extractor
• Oxytocin infusion
• The use of forceps during delivery should be avoided due to the risk of fetal bleeding
• Cesarean birth
• Internal fetal monitoring - Correct Answer A. Vacuum extractor
• The use of forceps during delivery should be avoided due to the risk of fetal bleeding
• Internal fetal monitoring

Rationale: The use of a vacuum extractor should be avoided due to risk of exposing the fetus to maternal blood. The use of forceps during delivery and internal fetal monitoring should be avoided due to the risk of fetal bleeding.A nurse in an antepartum clinic is assessing a client who has a TORCH infection. Which off the following findings should the nurse expect? (Select all that apply.)

• Joint pain
• Malaise
• Rash
• / 4