A client who is actually hallucinating, is brought to the hospital by friends. They say that the client used either lysergic acid diethylamide (LSD) or angel dust ( phencyclidine (PCP) at a concert. Which of the following common assessment findings indicate that the client may have ingested PCP? A) Dilated pupils B) Nystagmus C) Paranoia D) Altered mood ANSWER: B After completing chemical detoxification and a 12 step program to treat crack addiction, a client is being prepared for discharge. Which remark by the client indicates a realistic view of the future? A) I'm never going to use crack again B) I know what I have to do. I have to limit my crack use C) I'm going to take one day at a time. I'm not making any promises. D) I cant touch crack again, but I sure could use a drink. I've earned it. ANSWER: C A client is admitted for detoxification after cocaine overdose. The client tells the nurse that he frequently uses cocaine but he can control his use if he chooses. Which coping mechanism is he using? A) Withdrawal B) Logical thinking C) Repression D) Denial ANSWER: D A client voluntarily admits himself to the substance abuse unit. He confesses that he drinks 1gt or more of vodka each day and uses cocaine occasionally. Later that afternoon, he begins to show signs of alcohol withdrawal. What are some early signs of this condition? A) Vomiting, diarrhea and bradycardia B) Dehydration, temperature above 101Farenheit and pruritus C) Hypertension, diaphoresis and seizures D) Diaphoresis,tremors and nervousness ANSWER: D A client is being treated for alcoholism. After a family meeting the client's spouse asks the nurse about ways to help the family deal with the effects of alcoholism. The nurse should suggest that they join which organization? A) Al Anon B) Make Today Count C) Emotions anonymous D) Alcoholic anonymous ANSWER: A A client is admitted to the substance abuse for alcoholic detoxification. Which of the following medications is the nurse most likely to administer to reduce the symptoms of alcohol withdrawal? A) Naloxone B) Haloperidol C) Magnesium sulfate D) Chlordiazepoxide ANSWER: D A client is admitted to the inpatient adolescent unit after being arrested for attempting to sell cocaine to an undercover police officer. The nurse plans to write a behavioral contract. To best promote compliance, the contract should be written A) Abstractly B) By the client alone C) Jointly by the client and the nurse ANSWER: C a client with a reported history of social drinking displays these vital signs. Temperature 101.6 farenheit, heart rate 126 beats per minute, respiratory rate 24 breaths per minute and blood pressure 140/96 mmHg. The client exhibits gross hand tremors and is asking for someone to kill the bugs in the beD) The nurse should suspect A) A preoperative infection B) Alcohol withdrawal C) Acute sepsis D) Pneumonia ANSWER: B A client who reportedly consumes a qrt. Of vodka daily is admitted for alcohol detoxiciation . To try to prevent alcohol withdrawal symptoms, the physician is most likely to prescribe which drug? A) Clozapine B) Thioxeten C) Lorazepam D) Lithium ANSWER: C A client voluntarily admits himself to the substance abuse unit. He confesses that he drinks I qrt or more of vodka each day and uses cocaine occasionally. Later that afternoon, he begins to show signs of alcohol withdrawal. What are some early signs of this condition? A) Vomiting, diarrhea and bradycardia B) dehydration, temperature above 101 farenheit and pruritus C) Hypertension, diaphoresis and seizures D) Diaphoresis, tremors and nervousness ANSWER: D During which alcoholic phase of alcoholism is loss of control and physiologic dependence evident? A) Pre alcoholic phase B) Early alcoholic phase C) Crucial phase D) Chronic phase ANSWER: C A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is A) Psychotherapy B) Total abstinence C) Alcoholic's Anonymous D) Aversion therapy ANSWER: B A client is admitted to the psychiatric unit with a diagnosis of alcohol intoxication and suspected alcohol dependence. Other assessment findings include an enlarged liver, jaundice, lethargy and rumbling incoherent speech. No other information about the client is available. After the nurse completes initial assessment, what is the first priority? A) Instituting seizure precautions. Obtaining frequent vital signs and sending fluid intake and output B) Checking the client's medical records for health history information about the client C) Attempting to contact the clients family to obtain more information about the client D) Restricting fluids and leaving the client alone to sleep off the episode ANSWER: A A client recently admitted to the hospital with sharp, substernal chest-pain suddenly complains of palpitations. The nurse notes a rise int eh clients arterial blood pressure and a heart rate of 144 beats / min . On further questioning, the client admits to having used cocaine recently after previously denying use of the drug. The nurse concludes that the client is at risk for which complication of cocaine use? A) Coronary artery spasm B) Bradyarrhythmias C) Neurobehavioral deficits D) Panic Disorder ANSWER: A A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but he can't control his use if he chooses. Which coping mechanism is he using? A) Withdrawal B) Logical thinking C) Repression D) Denial ANSWER: D A client is admitted to the inpatient adolescent unit after being arrested for attempting to sell cocaine to an undercover police officer. The nurse plans to write a behavioral contract. To best promote compliance, the contract should be written A) Abstractly B) By the client alone C) Jointly by the client and nurse ANSWER: C A client who is actually hallucinating is brought to the hospital by friends. They say that the client used either lysergic acid diethylamide [LSD] or angel dust [Phencyclidine (PCP]. At a concert. Which of the following common assessment findings indicates that the client may have ingested PCP? A) Dilated pupils B) Nystagmus C) Paranoia D) Altered mood ANSWER: B After completing chemical detoxification and a 12 step program to treat crack addiction, a client is being prepared for discharge, Which remark by the client indicates a realistic view of the future? A) I'm never going to use crack again B) I know what I have to do. I have to limit my crack use. C) I'm going to take 1 day at a tie. I'm not making any promises D) I can't touch crack again, but I sure could use a drink . I've earned it. ANSWER: C After taking an overdose of Phenobarbital, a client is admitted to the emergency department. The physician prescribes activated charcoal to be administered by mouth immediately. Before administering the dose, the nurse verifies the dosage ordereD) What is the usual minimum dose of activated charcoal? A) 5 g mixed in 250 ml of water B) 15 g mixed in 250 ml of water C) 30 g mixed in 250 ml water D) 60 g mixed in 500 ml of water ANSWER: C Morning sickness is attributed to increased levels of which of the following hormones? A) Human chorionic gonadotropin B) Leutenizing hormone C) Progesterone D) Estrogen ANSWER: A Which of the following functions would the nurse expect to be unrelated to the placenta? A) Production of estrogen and progesterone B) Ditoxification of some druga and chemicals C) Exchange site for food, gases and waste D) Production of maternal antibodies ANSWER: B A client who's 3 months pregnant with her first child reports that she has had increasing morning sickness for the past month. Nursing assessment reveals a fundal height of 20cm and no audilable fetal heart tones. The nurse should suspect which complication of pregnancy? A) Fetal demise B) Ectopic pregnancy C) Hyperemesis gravidarum D) Gestational trophoblastic disease ANSWER: D A client makes a routine visit to the prenatal clinic. Although she's 14 weeks pregnant, the size of her uterus approximates that in an 18-20 weeks pregnancy. The physician diagnosis gestational trophoblastic disease and orders sonography. The nurse expects ultrasonography to reveal A) An empty gestational sac B) Grapelike clusters C) Severely malformed fetus D) An extrauterine pregnancy ANSWER: A Early detection of an ectopic pregnancy is paramount in preventing life threatening rupture. Which symptoms should alert the woman to the probability of an ectopic pregnancy? A) Abdominal pain, vaginal bleeding and a positive pregnancy test B) Hyperemsis and weight loss C) Ammenorrhea and a negative pregnancy test D) Copious discharge of clear mucous and prolonged epigastric pain ANSWER: A At twenty-eight week gestation, a patient was admitted to the hospital for Mild Congestive Heart failure. Why was the patient ordered complete bed rest? A) Increase the venous blood flow B) Decrease the nutrient and oxygen needs of the muscles C) Increase the volume of both tidal and residual air D) Decrease protein catabolism and urinary protein secretion ANSWER: B A client with pregnancy induced HPN probably exhibits which of the following symptoms? A) Proteinuria, headaches and vaginal bleeding B) Headaches, double vision and vaginal bleeding C) Proteinuria, headaches and double vision D) Proteinuria, double vision and uterine contractions ANSWER: C What signs would a pregnant woman first notice in developing toxemia? A) High blood pressure, albuminuria B) Sudden weight gain, edema of the hands C) Heaches, spots before the eyes D) Epigastric pain, anuria ANSWER: A A patient who is considered a severe preeclamptic should be closely observed for which of the following complication of pregnancy? A) Abruptio placenta B) Placenta previa C) Hydramnios D) Hyperemesis gravidarum ANSWER: A For which of the following is least likely to apply to a severe preeclapmtic patient during her hospitalization? A) Fluid volume excess B) Injury, potential C) Skin integrity, impairment D) Tissue perfusion, alteration in ANSWER: C At eight and one-half month gestation, a patient is admitted due to vaginal bleeding. She is diagnosed as placenta previA) What symptoms would the patient most likely exhibit? A) Painless vaginal bleeding with firm board-like fundus B) Abdominal pain and rigidity with concealed bleeding C) Sudden episode of vomiting D) Alteration of contraction pattern ANSWER: D A multiparous client is admitted to the labor and delivery area with painless vaginal bleeding. Ultrasonography shows that an edge of her placenta meets but does not occlude the rim of the cervical os. This finding suggests A) Partial placenta previa B) Low-lying placenta C) Marginal placenta previa D) Abruptio placenta ANSWER: C The nurse is caring for a client with mild active bleeding from placenta previa. Which assessment factor indicates an emergency cesarian section may be necessary? A) Increased maternal blood pressure of [150/90] mmHg B) Decreased amount of vaginal bleeding C) Fetal heart rate of 80 beats per min D) Maternal heart rate of 65 beats per min ANSWER: C What is a characteristic of abruption placenta? A) Painless bleeding B) Rigid abdomen C) Lack of uterine activity D) Early rupture of the amnion ANSWER: B A client's membrane ruptured during the 36 weeks of pregnancy. Eighteen hours later, the nurse measures the client's temperature at 38celsius After initiating prescribed antibiotic therapy, the nurse should prepare the client for A) Amniocentesis B) Delivery C) Sonography D) Tocolytic therapy ANSWER: B After developing severe hydramnios, a primigravid client exhibits dyspnea along with edema of legs .Which procedure should the nurse expect her to undergo and why? A) Artificial rupture of the membranes to uterine pressure B) Amniocenesis performed to relieve discomfort C) IV oxytocin administered to induce labor D) Cesarian delivery to prevent further fetal change ANSWER: A The nurse is providing care for a pregnant client with gestational diabetes.The client asks the nurse if her gestational diabetes will affect her delivery.The nurse should know that A) The delivery may need to be induced early B) The delivery must be by cesarian section C) The mother will carry to term safely D) Its too early to tell ANSWER: A A client with active genital herpes is admitted to the labor and delivery area during the first stage of labor. Which type of birth should the nurse anticipate for this client? A) Mid forceps B) Low forceps C) Induction D) Cesarian ANSWER: D After admission to the labor room, a pregnant woman undergoes routine tests, including a complete blood count, urinalysis, venereal disease lab test and gonorrhea culture. The gonorrhea culrure is positive. Although the client lacks symptoms and signs of this disease. What is the significance of this finding? A) Maternal gonorrhea may cause a neural defect B) Maternal gonorrhea may cause an eye infection in the neonate C) maternal gonorrhea may cause acute liver changes in the fetus D) Maternal gonorrheamay cause anemia in the neonate ANSWER: B A primigravida patient, age 20, has first completed a difficult, forceps assisted delivery of twins. Her labor was unusually long and required oxytocin augmentation. The nurse who's caring for her should stay alert following conditions A) Uterine inversion B) Uterine atony C) Uterine involution D) Cervical lacerstion ANSWER: B When assessing a client 1 hour after delivery, the nurse notes blood gushing from the vagina, pallor and a rapid , thready pulse. What do these findings suggest? A) Uterine involution B) Cervical laceration C) Placental separation D) Postpartum hemorrhage ANSWER: D The physician decides to artificially rupture the membranes. Following this procedure, the nurse checks the fetal heart tones for which of the following reasons? A) To determine fetal well-being B) Assess for prolapsed cord C) To assess fetal position D) To prepare for an imminent delivery ANSWER: D The nurse is caring in the labor and delivery areas. Which condition would place the client at risk for DIC? A) Intrauterine fetal death B) Placenta accrete C) Dysfunctional labor D) Premature rupture of membranes ANSWER: A Before a postpartum client is discharged, the nurse checks her hormone levels of human chorionic gonadotropine during the postpartum perioD) What becomes of the human chorionic gonadotropin in the postpartum period? A) The circulating human chorionic gonadotropin level remains high for 2-4 week B) The serum human chorionic gonadotropin level diminishes over 6 week C) Circulating human chorionic gonadotropin level disappears within 24 hours D)The serum human chorionic gonadotropin level remains high until the clients next pregnancy Annswer C Nora Santos was tested positive for Raphadex test.her baby was given Hepa B immunoglobulin 4 hours after delivery and Anti heap B vaccine after 18 hours What was the purpose for giving the Hepa B immunoglobulin early to the baby? A) To stimulate the baby's immune system to produce antibodies B) To enhance the immune system of the baby C) To give the baby an immediate protection against heap B virus D) To potentiate the effect of the Anti-Hepa B vaccine ANSWER: C A baby Boy was delivered with heavy meconium stain in a lying-in hospital. When should the nurse suction the baby? A) After the umbilical cord is cut B) After the upper torso is delivered C) As soon as the head passes through the perineum D) As soon as the baby gasps for the first time ANSWER: C The pathologic ring of Bandl is often the result of obstructed labor. The nurse should prepare for which of the following? A) Cesarian section B) Spontaneous vaginal delivery C) Forceps delivery D) Vacuum assisted delivery ANSWER: A Three statements concerning the Hydatidiform mole are true. Which is false? A) There is an increase blood pressure on weight gain B) There is pernicious vomiting due to hormonal alteration. C) There is rapid increase in the size of the uterus. D) The level of human chorionic gonadotrophin decrease ANSWER: D At 37 weeks, Diana calls the office to say she awoke in a pool of blood and is dizzy and nauseateD) But she denies any abdominal pain or cramping. On the basis of this assessment, the nurse suggests she go to the hospital immediately and meet the doctor. The nurse establishes a nursing diagnosis of potential fluid volume deficit associated with which of the following? A) Placenta previa B) Abruptio placenta C) Preeclampsia D) Uterine rupture ANSWER: A Doris is considered a severe preeclamptic. Close observation and continuous nursing assessment are necessary to facilitate prompt identification and management of which of the following? A) Abruptio placenta B) Placenta previa C) Hydramnios D) Hyperemesis gravidarum ANSWER: A The distinctive symptoms of severe abruption placenta are: A) Lower abdominal pain and vaginal bleeding B) Painless, bright red vaginal bleeding and premature rupture of the membranes C) Concealed painless uterine bleeding and oliguria D) Abnormal engagement of the presenting part and prolonged labor ANSWER: A A client is admitted to the labor and delivery department in preterm labor. To help manage preterm labor, the nurse would expect to administer which drug? A) Ritodrine B) Bromocriptine C) magnesium sulfate D) Betamethasone ANSWER: A A client at 26 weeks gestation is complaining of contractions. Following admission and hydration, the physician writes an order for the nurse to give 12 mg betamethasone IM. This medication is given to do which of the following? A) Slow contractions B) Enhance fetal growth C) Prevent infection D) Promote fetal lung maturity ANSWER: D A client's membrane ruptured during the 36 weeks of pregnancy. Eighteen hours later, the nurse measures the client's temperature at 38celsius. After initiating prescribed antibiotic therapy, the nurse should prepare the client for which of the following? A) Amniocentesis B) Delivery C) Sonography D) Tocolytic therapy ANSWER: B A client with pregnancy induced hypertension receives MgSO4 4 g in 50percent solution IV over 20 minutes . What is the purpose of administering magnesium sulfate to this patient? A) To lower blood pressure B) To prevent seizures C) To inhibit labor D) To block dopamine receptors ANSWER: B After developing severe hydramnios, a primigravid client exhibits dyspnea along with edema of legs .Which procedure should the nurse expect her to undergo and why? A) Artificial rupture of the membranes to uterine pressure B) Amniocenesis performed to relieve discomfort C) IV oxytocin administered to induce labor D) Cesarian delivery to prevent further fetal change ANSWER: A Appropriate prenatal assessments are based on the nurse's understanding of the normal physiology of pregnancy and the interactive effects of coexisting disorders during pregnancy. For which of the following complications of pregnancy are mothers who are Rh(-) at risk of? A) Spontaneous abortion B) Preeclampsia C) Dystocia D) Erythroblastosis fetalis ANSWER: D A patient has blood type O, Rh positive. Her husband is A, Rh positive. The newborn is type A, Rh positive. This was their first child. Within 24 hours after birth, the baby becomes jaundiceD) The diagnosis is ABO incompatibility. Exchange transfusion was ordered . All blood groups below are available. The blood of choice is: A) group A, Rh positive B) group A, Rh negative C) group O, Rh psotive D) group O , Rh negative After admission to the labor room, a child undergoes routine tests, including a complete blood count, urinalysis, venereal disease lab test and gonorrhea culture. The gonorrhea culture is positive. Although the client lacks symptoms and signs of this disease. What is the significance of this finding? A) Maternal gonorrhea may cause a neural defect B) Maternal gonorrhea may cause an eye infection in the neonate C) maternal gonorrhea may cause acute liver changes in the fetus D) Maternal gonorrheamay cause anemia in the neonate ANSWER: B A client with active genital herpes is admitted to the labor and delivery area during the first stage of labor. Which type of birth should the nurse anticipate for this client? A) Mid forceps B) Low forceps C) Induction D) Cesarian ANSWER: D A former secretary gets pregnant. She also has a vaginal discharge which is thick, white, cheeselike and pruritic. The nurse therapeutic and educational actions should be based on which of the following theories? A) No action needed. This is normal leucorrhea of pregnancy. B) Metronidazole is the drug of choice in this condition C) Even if untreated, this condition presents no hazard to the neonate. D) This condition is more likely to occur in women who are pregnant or taking oral contraceptives or antibiotics or who are diabetic ANSWER: D Which of the following actions is least likely to be included in the plan of care for a new cardiac mother? A) Administering fluids [oral or parenteral] slowly for the first few days B) Pushing fluids so her water metabolism returns to normal more quickly C) Minimizing blood loss D) Monitoring vital signs and condition continuously during the first hour postpartum ANSWER: D Which of these normal physiologic changes has greater implications for a pregnant woman with a history of rheumatic heart disease and requires more teaching about danger signs requiring prompt medical evaluation? A) Increased venous pressure in lower extremities B) Placental production of HPL C) Increased cardiac output D) Relaxation of the cardiac sphincter ANSWER: C A patient 26 weeks pregnant, has been followed closely at the prenatal clinic because she has Class 11 cardiac disease. You should instruct her to report immediately the occurrence of which of the following signs and symptoms? A) Increased urinary output B) Increased pedal edema C) increased PR during exertion D) Increased dyspnea during exertion ANSWER: D The physiologic change imposed by pregnancy can cause cardiac decompensation in patients with cardiac abnormality. Of the following , which is better tolerated? A) Cardiac abnormality associated with pulmonary hypertension B) Right to left shunt C) mitral stenosis D) Left to right shunting ANSWER: D Mrs. Pecson, a school teacher was diagnosed with thyrotoxicosis on the first month of pregnancy. What would be the treatment of choice? A) PTU B) Iodine C) Radio isotope D) Levothyroxine ANSWER: A Mrs Garcia gave birth spontaneously to a live baby girl weighing 6 pounds. You noticed that the Baby girl Garcia has a large caput succedaneum. How would you explain this to the mother? You would say the following except which? A) Your baby has edema of the scalp B) This is going to disappear within 48 to 72 hours C) Your baby needs no treatment D) Indicates brain injury ANSWER: D The nurse is providing care for a pregnant client with gestational diabetes. The client asks the nurse if her gestational diabetes will affect her delivery. What would be the nurse' probable ANSWER:? A) The delivery may need to be induced early B) The delivery must be by cesarian section C) The mother will carry to term safely D) Its too early to tell ANSWER: B Which of the following is the important similarity between premature infants, diabetic infants and infants born by cesarian section? A) Poor sucking reflex B) Delayed development of reflexes C) Hyaline membrane disease D) Hyperbilrubinemia ANSWER: C A diabetic client is in labor tells the nurse she had trouble controlling her blood glucose level recently. She says she didn't take her insulin when the contraction began because she felt nauseated; about an hour later, when she felt better , she ate some soup and crackers but didn't take insulin. Now she reports increased nausea and flushed feeling. The nurse notes a fruity odor to her breath. What do these findings suggest? A) Diabetic ketoacidosis B) Hypoglcemia C) Infection D) Transition to the active phase of labor ANSWER: A