CAT 1 KAPLAN 2

1. The nurse performs an assessment on a full-term newborn. Which finding does the nurse report to the health care provider? 1. The client's blood pressure of 70/44 mm Hg. 2. The umbilical cord is whitish gray in color. 3. Bowel sounds cannot be auscultated in the abdomen. 4. The big toe dorsiflexes when the side of the foot is stroked. Ans: 3 2. The nurse in an antepartum clinic has several phone messages from clients. Which client does the nurse call first? 1. The client who is 10 weeks pregnant and reports vomiting after dinner for the past 5 days. 2. The client who is 18 weeks pregnant and reports a headache in the evening for the past 2 days. 3. The client who is 32 weeks pregnant and reports that her feet are swollen in the morning. 4. The client who is 37 weeks pregnant and reports that her membranes have ruptured. Ans: 4 3. The nurse prepares a medication in a prefilled syringe and notes that the syringe does not have a label with the client's name. What action will the nurse take? 1. Notify the pharmacy. 2. Call the health care provider. 3. Label the syringe. 4. Administer the medication. Ans: 1 4. The nurse plans to teach a local community group about chronic obstructive pulmonary disease (COPD). Which information does the nurse include? (Select all that apply.) 1. Uncontrolled COPD can lead to cardiac disease. 2. Asthma in childhood leads to COPD later in life. 3. Cigarette smoking is the leading COPD risk factor. 4. More females are affected by COPD than males. 5. Co-existing illness may cause COPD exacerbation. Ans: 1, 3,5 5. The nurse notes that a client requires protective isolation. Which additional client will the nurse safely pair with the client in protective isolation? 1. Client with a urinary tract infection. 2. Client with a stage 3 sacral pressure ulcer. 3. Client with unstable diabetes mellitus. 4. Client recovering from surgery for a perforated bowel. Ans: 3 6. A client who is pregnant asks the nurse what an elevated serum alpha-fetoprotein (AFP) level indicates. Which information does the nurse provide to the mother? 1. Gestational diabetes. 2. A neural tube defects. 3. Trisomy 21 (Down syndrome). 4. Lack of lung maturity. Ans: 1