BATTLE OF THE

BRAIN
EASY ROUND
A pregnant woman who is at term is admitted to the birthing unit in
active labor. The client has only progressed from 2cm to 3 cm in 8
hours. She is diagnosed with hypotonic dystocia and the physician
ordered Oxytocin (Pitocin) to augment her contractions. Which of the
following is the most important aspect of nursing intervention at this
time?

a. Timing and recording length of contractions.

b. Monitoring.
c. Preparing for an emergency cesarean birth.
d. Checking the perineum for bulging.
In evaluating the effectiveness of IV Pitocin for a
client with secondary dystocia. the nurse should
expect:

a. A painless delivery
b. Cervical effacement
c. Infrequent contractions
d. Progressive cervical dilation
A nurse is performing an assessment of a client who is scheduled for
cesarean delivery. Which assessment finding would indicate a need
to contact the physician?

a. Fetal heart rate of 180 beats per minute

b. White blood cell count of 12.000
c. Maternal pulse rate of 85 beats per minute
d. Hemoglobin of 11.0 g/dL
A 25-year-old primigravid client is in the active phase of the first stage of labor
when her membranes rupture. The nurse notes a decrease in the fetal heart rate on
the electronic monitor. Upon inspection of the perineum, the nurse observes that the
umbilical cord is protruding through
the vagina. Which action is most appropriate for the nurse to take initially?

a. Turn the client on the left side.

b. Notify the physician of the findings.
c. Place the client in Trendelenburg’s position.
d. Prepare a sterile field for delivery of the baby.
A 32-year-old, gravida 2, para 1, term 1, preterm 0, abortion 0, living 1,
is admitted to the labor room. Her previous delivery was a normal,
spontaneous vaginal delivery without complications. She has been
having contractions for four hours at home. The registered nurse
examines her and determines that she is 4-cm dilated and 70% effaced.
The fetus is in the breech position. She calls for the nurse saying, “My
water just broke!” What should the practical nurse do initially?

a. Notify the physician.

b. Do a vaginal exam.
c. Check the fetal heart rate.
d. Prepare for delivery.
What abnormal placental implantation is described
as, "chorionic villi that penetrates beyond the
myometrium into the entire uterine wall and
possibly to other adjacent organs such as the
bladder"?
a. Placenta circumvallate
b. Placenta Increta
c. Placenta Accreta
d. Placenta Percreta
 A nurse complete a health history of a client from a
couple with history of infertility. What are the two
assessment possibilities?

a) Testicular biopsy and culdoscopy

b) Hysteroscopy and sperm penetration assay
c) Semen analysis and cervical mucus observation
d) Laparoscopy and hormonal studies
Which of the following is the BEST intervention for a
client experiencing premature cervical dilatation?

a) Isolate the client

b) Complete bed rest
c) Restrain the client so she cannot leave the hospital
d) Walk slowly every morning
 The following are the causes of inversion
of the uterus, EXCEPT;

a) Straining or coughing while the uterus is relaxed

b) Forceful pulling of the umbilical cord to hasten delivery
c) Spontaneous rupture of the bag of water
d) Fundal pressure on uncontracted uterus
DIFFICULT ROUND
A patient with terminal cancer is prescribed
hydromorphone (Dilaudid) 0.015 mg/kg for pain management. The
patient weighs 150 pounds. The nurse has on hand hydromorphone
4mg/mL. How many milliliters should the nurse administer?
At 3 am started D5LR 1000cc to run at 30
gtts/min. compute for number of hours
consumed and time consumed
8 am starter D5 0.3 NaCl 1L 20 gtts/min.
Compute for number of hours consumed
and time consumed
The patient has an order for 100ml of NS to
infuse in 30 minutes. The gtt factor is 15.
How many gtt/min will the patient receive?
The patient is to receive 3000ml of D5W
at 125 ml/hr. The gtt factor is 60. At how
many gtts/min will you regulate the IV?
The physician has ordered 1500 ml of
LR to infuse in 12 hours. The gtt factor
is 15. Calculate the flow rate to deliver
the volume in the prescribed time
frame?
The physician has ordered Timentin
3.1gm to be administered. Timentin is
diluted in 100 ml of NS and is to be
administered over 45 minutes. Available
is buretrol. At what rate will you
regulate the IV?
ROUND 2
EASY ROUND
Antibiotics best to give to postpartum patients to treat
urinary tract infection as it is safe for breastfeeding is:

a. Clindamycin
b. Cephalexin
c. Cephalosporin
d. Amoxicillin
 Postpartum patients are at risk for developing
thrombophlebitis. This is a condition where:
a. There is inflammation with the formation of blood clots, usually an
extension of an
endometrial infection
b. There is trauma to the tissue that may leave lacerations or fissures for
easy entry of
infection
c. The uterus was explored after birth for retained fragments causing
infection
d. There is a deficiency in clotting ability resulting in decreased fibrinogen
levels
Thrombophlebitis tends to occur
because of the following except:
a. Woman who smokes cigarettes
b. Vasoconstriction of lower extremity veins still present as a
result of fetal head pressure
during pregnancy & birth
c. Fibrinogen level still elevated from pregnancy, leading to
increased blood clotting
d. Obesity from increased weight before pregnancy &
pregnancy weight gain
Which of the following is a contributing factor
of thrombophlebitis?

a. Underweight women
b. Primigravida
c. History of varicosities
d. Less than 35 years of age
In femoral thrombophlebitis the veins
involved are the following except:

a. Femoral
b. Saphenous
c. Popliteal
d. Brachial
During a nurse & visit to the client & home, the
client states, “I have pain in my right knee.” The
nurse assesses the client & right knee. This is a

a. Focused assessment
b. Spiritual assessment
c. Social assessment
d. Comprehensive assessment
What is one purpose of documentation of the
health assessment?

a. to identify the nurse role in healthcare

b. to identify actual and potential health problems
c. to expand nursing knowledge and skills
d. to provide a basis for evidence-based nursing
A nurse is using inspection as an assessment technique.
What does the nurse use during inspection?

a. equipment such as a stethoscope

b. both hands to produce sounds
c. light palpation to detect surfaces
d. senses of vision, hearing, and smell
A nurse assesses a client for blood pressure. Which
technique would be used for this assessment?

a. Inspection
b. Percussion
c. Palpation
d. Auscultation
What would a nurse ensure before
beginning a health assessment?
a. that the time needed for the assessment fits into the nurse work
schedule
b. that the room is private, quiet, warm, and has adequate light
c. that family members are present to answer specific questions
d. that there is a written physician order for the assessment
A nurse is using inspection as an assessment
technique. What does the nurse use during
inspection?

a. equipment such as a stethoscope

b. light palpation to detect surfaces
c. both hands to produce sounds
d. senses of vision, hearing, smell
What is the essential requirement for performing proper
inspection of patient during the physical
examination?

a. Stethoscope
b. Ophthalmoscope
c. Good lighting
d. Sphygmomanometer
Which of the following can a nurse assess
by palpation?

a. heart sounds, lung sounds, blood pressure

b. vision, hearing, cranial nerves
c. temperature, turgor, moisture
d. tissue density, gait, reflexes
 The nurse is performing a general survey. Which action
is a component of the general survey?

a. Observing the patient’s body status.

b. Observing specific body systems while performing the physical
assessment.
c. Interpreting the subjective information the patient has reported.
d. Measuring the patients temperature, pulse, respirations, and the
blood pressure
During an examination, the nurse can assess
mental status by which activity?

a. Examining the patients electroencephalogram

b. Observing the patient as he or she performs an
intelligence quotient (IQ) test
c. Observing the patient and inferring health
dysfunction
d. Examining the patients response to a specific set of
questions
DIFFICULT ROUND
You are to administer 1000 ml of RL over
4 hours. An infusion pump is available. At
what rate would you set the pump?
An IV of 500 ml's is infusing at 100ml/hr...
How long will it take the IV to infuse?
The IV has 875 ml left. If the rate is
75ml/hr, how long will the infusion last?
Zosyn 3.375gm is ordred IV qoh. The IVPB
contains 50 ml of NS and is to infuse over 45
minutes. Using a microdrop calculate the rate of
flow. Using the information calculate the rate of
flow using an infusion pump.
Gentamycin 60 mg is to be diluted in 20 l
using a buretrol. If the medication is to
infuse over 45 minutes. What is the correct
infusion rate?
Phenytoin (Dilantin), 24,000 mg PO, is
ordered to be given through a nasogastric
tube. Phenytoin is available as 13 g / 12
mL. How much would the nurse
administer?
Solumedrol 2.5 mg/kg is ordered for a
child weighing 8 kg. Solumedrol is
available as 125 mg / 1 mL is available.
How many mL must the nurse administer?
1.1 cm = ___________ mm
455 mm = ___________ cm