Practice Test Flashcards

As the client reaches 8 cm dilation, the nurse notes late decelerations on the fetal monitor. The FHR baseline is 165–175 bpm with variability of 0–2bpm. What is the most likely explanation of this pattern?

Answer: There is uteroplacental insufficiency.

Late decelerations, characterized by a gradual decrease in fetal heart rate that begins after the peak of the contraction and returns to baseline after the contraction ends, are a classic sign of uteroplacental insufficiency. This indicates that the fetus is experiencing hypoxia due to inadequate oxygen exchange across the placenta. The baseline tachycardia and minimal variability further support fetal distress, requiring immediate intervention.

A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:

Answer: Luteinizing hormone is high.

Conception is most likely to occur around the time of ovulation. A surge in luteinizing hormone (LH) is the hormonal trigger for ovulation, which is the release of a mature egg from the ovary. Therefore, when luteinizing hormone levels are high, ovulation is imminent or occurring, marking the most fertile period for conception.

A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:

Answer: The presence of fetal heart tones

Definitive (positive) signs of pregnancy are those that are directly attributable to the fetus and cannot be confused with other conditions. The presence of fetal heart tones, either heard by auscultation or visualized on ultrasound, is a positive sign. Other signs like elevated hCG or uterine enlargement are presumptive or probable, as they can have other causes.

In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia, the nurse should expect:

Answer: Progressive cervical dilation

Pitocin (oxytocin) is administered to stimulate uterine contractions and promote labor progression. For a client with secondary dystocia, an effective response to Pitocin would be evidence of progressive cervical dilation and effacement. This indicates that the contractions are effectively thinning and opening the cervix, leading towards a successful delivery.

The home health nurse is planning for the day’s visits. Which client should be seen first?

Answer: The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

The client with multiple sclerosis receiving cortisone via a centrally placed venous catheter is the highest priority. Cortisone is an immunosuppressant, and a central line poses a significant risk for infection, which could be life-threatening in an immunocompromised patient. This client requires immediate assessment for signs of infection or catheter complications, making it the most urgent visit.

A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:

Answer: Regularity of the menses

The rhythm method of birth control relies on tracking the menstrual cycle to predict ovulation and avoid intercourse during fertile periods. Its success is highly dependent on the client having a regular and predictable menstrual cycle. Irregular cycles make it very difficult to accurately estimate the fertile window, significantly reducing the method's effectiveness.

The client with hyperemesis gravidarum is at risk for developing:

Answer: Metabolic acidosis with dehydration

Hyperemesis gravidarum involves severe, persistent nausea and vomiting, leading to significant fluid and electrolyte imbalances. Prolonged vomiting causes a loss of gastric acid, which can initially lead to metabolic alkalosis. However, with severe dehydration and starvation, the body starts breaking down fats for energy, producing ketones and resulting in metabolic acidosis. Dehydration is a direct consequence of the excessive fluid loss.

A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:

Answer: Her contractions are 5 minutes apart.

True labor is characterized by regular, progressive uterine contractions that lead to cervical changes. While other signs like back pain or bloody show can occur, the most reliable indicator for a client to come to the hospital is when contractions become regular, strong, and occur at consistent, relatively close intervals, such as every 5 minutes, indicating active labor progression.

The emergency room is flooded with clients injured in a tornado. Which clients can be assigned to share a room in the emergency department during the disaster?

Answer: The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm

In a disaster situation, clients are triaged and assigned rooms based on their acuity and potential for cross-contamination or further harm. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm are both stable enough to share a room without immediate risk of infection or critical deterioration. This pairing prioritizes safety and efficient use of limited resources during an emergency, unlike other options that involve clients with higher acuity, infectious risks, or potential for agitation.

She decides to illustrate the organizational structure. Which of the following elements is NOT included?

Answer: Unity of direction

An organizational structure chart visually depicts the formal reporting relationships and hierarchy within an organization. It typically includes elements like the level of authority (who reports to whom), lines of communication (how information flows), and span of control (the number of subordinates a manager supervises). Unity of direction, while a crucial management principle, refers to the alignment of efforts towards a common goal and is not a visual component illustrated on a standard organizational chart.

She plans of assigning competent people to fill the roles designed in the hierarchy. Which process refers to this?

Answer: Staffing

Staffing is the management function that involves recruiting, selecting, assigning, and developing competent individuals to fill the various roles within an organization. Its primary goal is to ensure that the right people with the necessary skills are in the right positions to achieve organizational objectives. Scheduling focuses on creating work timetables, recruitment is the process of attracting candidates, and induction is the initial orientation for new employees.

She checks the documentary requirements for the applicants for staff nurse position. Which one is NOT necessary?

Answer: Record of related learning experience (RLE)

When applying for a staff nurse position, essential documentary requirements typically include proof of previous employment, a professional identification card (licensure), and often membership in accredited professional organizations. A Record of Related Learning Experience (RLE) is part of academic transcripts from nursing school, which are usually reviewed during the initial application or interview process to verify clinical experience, but it is not typically a separate, post-licensure document required for a job application itself.

Which phase of the employment process includes getting on the payroll and completing documentary requirements?

Answer: Induction

Induction is the formal process of introducing new employees to the organization, its policies, procedures, and culture. This phase typically includes completing all necessary paperwork for payroll, benefits, and human resources, ensuring the employee is officially integrated into the system. Orientation is a broader term that can encompass induction but also includes ongoing training, while selection and recruitment precede the hiring process.

She tries to design an organizational structure that allows communication to flow in all directions and involve workers in decision making. Which form of organizational structure is this?

Answer: Decentralized

A decentralized organizational structure distributes decision-making authority throughout various levels, rather than concentrating it at the top. This design encourages open communication in all directions and promotes greater involvement of workers in decision-making processes. It fosters autonomy, responsiveness, and a more collaborative environment, which are hallmarks of such a structure.

In a horizontal chart, the lowest level worker is located at the

Answer: Rightmost box

In a horizontal organizational chart, the hierarchy typically flows from left to right, with the highest authority figures or top management positioned on the leftmost side. As the chart moves to the right, it depicts progressively lower levels of authority and responsibility. Therefore, the lowest level worker would be found in the rightmost box, indicating their position at the bottom of the organizational hierarchy.

She decides to have a decentralized staffing system. Which of the following is an advantage of this system of staffing?

Answer: Promotes better interpersonal relationship

A decentralized staffing system grants individual units or departments more autonomy in managing their own staffing needs. This localized control often leads to improved communication and collaboration within the unit, as staff and managers work closely to address scheduling and workload. This direct interaction and shared responsibility can foster stronger interpersonal relationships and a greater sense of team cohesion.