ABSN Hybrid Summer -NURS428 Reassessment 1 EBR Roseman University of Health Sciences School of Nursing.
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Free ABSN Hybrid Summer -NURS428 Reassessment 1 EBR Roseman University of Health Sciences School of Nursing. Questions
The nurse is educating a client who has been menopausal for 2 years and reports physical changes and vasomotor symptoms. What information should the nurse include when educating the client?
- You should consider hormone replacement because it has no risks.
- You can use light pads for any bleeding you may experience.
- You can use an acidic lotion for the oily skin you may experience.
- You may want to take calcium supplements to decrease bone loss.
Explanation
Explanation
Correct Answer: D) You may want to take calcium supplements to decrease bone loss.
During menopause, declining estrogen levels accelerate bone resorption, significantly increasing the risk of osteoporosis and fractures. Calcium supplementation (along with Vitamin D) is a key evidence-based recommendation to help preserve bone mineral density in menopausal clients.
Hormone replacement therapy (HRT) does carry risks including increased risk of breast cancer, blood clots, stroke, and cardiovascular events — stating it has no risks (A) is factually incorrect and dangerous. Postmenopausal clients should not experience regular bleeding — any postmenopausal bleeding is abnormal and requires provider evaluation, not management with pads (B). Menopause typically causes dry skin due to decreased estrogen, not oily skin, and an acidic lotion recommendation (C) is inappropriate and inaccurate.
The nurse is caring for a gravida 7 para 5 client admitted 3 hours ago who is now 9 cm dilated, 90% effaced, and is at a +1 station. What is the priority nursing action?
- Instruct client to reposition every 3 hours
- Instruct the client to push with the next contraction
- Provide initial labor education to the family
- Prepare supplies for the anticipated delivery
Explanation
Explanation
Correct Answer: D) Prepare supplies for the anticipated delivery
The client is in the transition phase of labor and approaching full dilation, indicating that delivery is imminent. The priority is to prepare for birth to ensure a safe and timely delivery.
Instructing pushing should occur at full dilation, repositioning every 3 hours is not relevant at this stage, and education is not a priority during imminent delivery.
The nurse is caring for a client at 32 weeks gestation with uterine contractions who is receiving nifedipine. What will the nurse consider the priority assessment finding related to nifedipine therapy that requires further action?
- 2 contractions/hour
- Pulmonary edema
- Decreased pulse
- Blood pressure 84/60 mmHg
Explanation
Explanation
Correct Answer: D) Blood pressure 84/60 mmHg
Nifedipine is a calcium channel blocker that can cause hypotension. A blood pressure of 84/60 mmHg is dangerously low and requires immediate intervention to prevent decreased placental perfusion.
The other findings are either expected or less immediately life-threatening compared to severe hypotension.
A client at 38 weeks gestation presents to OB triage complaining of contractions for 2 hours. How can the nurse best assess for true labor? (Select all that apply)
- Assess for fetal lightening
- Ask the client about relief with ambulation
- Assess contraction frequency
- Check for cervical change
Explanation
Explanation
Correct Answers: B) Ask the client about relief with ambulation, C) Assess contraction frequency, and D) Check for cervical change
True labor is distinguished from false labor (Braxton Hicks) by three key assessments. True labor contractions do not subside with walking — asking about relief with ambulation helps differentiate, as false labor often improves with movement. Contraction frequency, duration, and regularity are hallmarks of true labor — true contractions become regular and progressively closer together. Most definitively, cervical change (effacement and dilation) confirms true labor, as Braxton Hicks contractions do not produce cervical change.
Fetal lightening — the descent of the fetal head into the pelvis — occurs weeks before labor in primiparas and is not a reliable real-time indicator of true versus false labor at the time of triage assessment.
The nurse is reviewing the laboratory results of a client who is being assessed at their 28-week gestation antepartum appointment. The laboratory result reveals that the client has gestational diabetes mellitus (GDM). What information is the priority for the nurse to include when educating the client about GDM?
- It is important to watch your blood glucose carefully to prevent pulmonary hypertension.
- It is important to maintain your glucose levels during pregnancy to prevent sepsis.
- It is important to control your glucose to prevent neonatal hypoglycemia at birth.
- It is important to increase your glucose intake to help increase your baby’s weight at birth.
Explanation
Explanation
Correct Answer: C) It is important to control your glucose to prevent neonatal hypoglycemia at birth.
In gestational diabetes, maternal hyperglycemia leads to increased fetal insulin production. After birth, the sudden removal of maternal glucose can result in neonatal hypoglycemia. Maintaining controlled maternal glucose levels reduces this risk and supports better neonatal outcomes.
Pulmonary hypertension and sepsis are not primary complications of GDM, and increasing glucose intake would worsen hyperglycemia and increase risks such as macrosomia and birth complications.
The nurse is caring for a client who asks why their newborn needs a Vitamin K injection. What is the nurse's best response?
- "Most mothers have a diet deficient in vitamin K, which results in the infant being deficient."
- "Vitamin K prevents the synthesis of prothrombin in the liver and must be given by injection."
- "Newborns cannot synthesize their own vitamin K which increases their risk of bleeding."
- "The supply of vitamin K is inadequate for at least the first year and must be supplemented."
Explanation
Explanation
Correct Answer: C) "Newborns cannot synthesize their own vitamin K which increases their risk of bleeding."
Newborns are born with very low levels of vitamin K because it does not cross the placenta well, and their gut has not yet been colonized by the bacteria that produce vitamin K. Since vitamin K is essential for the synthesis of clotting factors (II, VII, IX, X), deficiency places newborns at risk for Vitamin K Deficiency Bleeding (VKDB), a potentially life-threatening condition. The intramuscular injection at birth prevents this.
Maternal dietary deficiency is not the primary reason — the issue is the newborn's own inability to produce sufficient vitamin K. Vitamin K actually promotes (not prevents) prothrombin synthesis, making option B factually incorrect. The supplementation is not required for the entire first year — a single injection at birth is sufficient for most newborns.
The nurse is assessing a client who gave birth 72 hours ago to a healthy infant and is formula-feeding only. The nurse notices that both of the client's breasts are swollen, warm, and tender on palpation. What is the most appropriate nursing intervention for this client?
- Run warm water on the breasts during a shower.
- Apply ice compresses and or cabbage leaves to the breasts.
- Express small amounts of milk from the breasts to relieve pressure.
- Instruct client to wear a loose-fitting bra to prevent nipple irritation.
Explanation
Explanation
Correct Answer: B) Apply ice compresses and/or cabbage leaves to the breasts
This client is experiencing breast engorgement secondary to milk coming in while not breastfeeding. For non-breastfeeding clients, the goal is to suppress lactation — not stimulate further milk production. Ice compresses reduce swelling, pain, and inflammation, while cabbage leaves (a well-supported evidence-based remedy) contain compounds that help reduce engorgement and suppress milk production when applied to the breasts.
Warm water or heat on the breasts (A) stimulates milk letdown and would worsen engorgement — contraindicated for a non-breastfeeding client. Expressing milk (C) signals the body to produce more milk, perpetuating the problem. A well-fitting, supportive bra — not a loose one (D) — provides compression that helps suppress lactation and reduce discomfort.
A client presents to their first prenatal visit at 6 weeks gestation. How will the nurse educate the client about the development of the baby at this stage?
- "Your baby is called an embryo, and its organs are in a rapid stage of development."
- "Your baby is called a blastocyst, and it is in the process of developing germ layers."
- "Your baby is called a fetus, and it is starting to look like a little human."
- "Your baby is called a morula, and its cells are starting to divide."
Explanation
Explanation
Correct Answer: A) "Your baby is called an embryo, and its organs are in a rapid stage of development."
At 6 weeks gestation, the developing baby is in the embryonic stage (weeks 3–8), during which organogenesis — the rapid formation of all major organ systems — is occurring. This is the most critical period of development, as the heart, brain, spinal cord, and other vital structures are forming rapidly, making this period highly sensitive to teratogens.
The blastocyst stage occurs during weeks 1–2 after fertilization, before implantation (B is too early). The fetal stage begins at approximately 9 weeks and continues until birth (C is too late). The morula is a stage occurring in the first few days after fertilization, well before 6 weeks (D is far too early).
A nurse is assessing a 38-year-old pregnant client (R.B.) with complaints that may suggest a hypertensive disorder of pregnancy. Which assessments and tests should the nurse prioritize? (Select all that apply)
- Glucose tolerance test
- Deep tendon reflexes
- Non-stress test (NST)
- Complete blood count (CBC)
- Vaginal exam
- Urine dipstick
Explanation
Explanation
Correct Answer: B) Deep tendon reflexes, C) Non-stress test (NST), D) Complete blood count (CBC), F) Urine dipstick
In a client suspected of having a hypertensive disorder such as preeclampsia, the nurse prioritizes assessments that evaluate maternal and fetal status. Deep tendon reflexes help identify neurologic irritability and risk for seizures. A urine dipstick assesses for proteinuria, a key diagnostic finding. A CBC evaluates for hemoconcentration and platelet levels, which are important in severe disease. A non-stress test assesses fetal well-being and oxygenation.
A glucose tolerance test is used to screen for gestational diabetes, not hypertensive disorders. A vaginal exam is not a priority unless there are labor-related concerns.
The nurse is making recommendations to a school district about how to best provide sexuality education to their students. Which statement should be included in the recommendation?
- "Sexuality education should be left to the parents to be addressed in the home."
- "Comprehensive sexuality education should contain medically accurate information."
- "Abstinence should be taught, since this will lower pregnancy and infection rates."
- "Sexuality education is best conducted by peers who are aware of cultural trends."
Explanation
Explanation
Correct Answer: B) "Comprehensive sexuality education should contain medically accurate information."
Comprehensive sexuality education is most effective when it is evidence-based, medically accurate, and developmentally appropriate. It provides students with reliable information about anatomy, contraception, STI prevention, and healthy relationships, which supports informed decision-making and reduces risky behaviors.
Option A excludes the important role of schools in public health education. Option C focuses only on abstinence, which has not been shown to be as effective as comprehensive programs. Option D may support engagement but lacks the clinical accuracy and structure required for safe and effective education.
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