Title: NUR1411CFinalExamPart1
Course: NUR 1411C Nursing Care for the Family Part 1 > Section: Module 5

Q: Neonatal mortality is the number of deaths of :
- Infants < than 28 days of age per 1,000 live births.
- Infants < than 1 years of age per 1,000 live births
- Infants < than 28 days of age per 10,000 live births
- Infants < than 1 year of age per 10,000 live births.
A: Infants < than 28 days of age per 1,000 live births.

Q: During discharge teaching on a postpartum client the nurse knows the essential areas to assess prior to beginning a teaching session include:
- Assess the learner
- Evaluation of oneself
- Examining the setting
- All of the above.
A: All of the above.

Q: A breastfeeding mother experiences nipple pain every time she nurses. It is important for the nurse to assess the client's knowledge about her breastfeeding technique, including (SELECT ALL THAT APPLY):
- Proper hygiene focused on hand washing and nipple care.
- Proper positioning of the newborn.
- Correct attachement of baby's mouth to nipple.
- Formula preparation.
A: Proper hygiene focused on hand washing and nipple care.; Proper positioning of the newborn.; Correct attachement of baby's mouth to nipple.

Q: Which of the following responses by the nurse would be correct when educating a breastfeeding client regarding birth control options after the postpartum follow up visit with her practitioner?
- "Oral contraceptives continues to be the choice of young women."
- "As long as you breastfeed successfully, you should not have any concerns."
- "The sponge is often a desired method during this time because of the easy insertion process."
- "You have so many children, you should have a tubal ligation"
A: "The sponge is often a desired method during this time because of the easy insertion process."

Q: You are beginning your postpartum assessment on a 12 hour post delivery client. The client's uterus is not firm, you should now:
- Have the client go to the bathroom, then re-assess her bladder.
- Attempt to express clots, then gently massage the fundus.
- Gently massage the fundus, then reassess the results.
- Call the physician immediately to report your findings.
A: Gently massage the fundus, then reassess the results.

Q: A C/S client is bottle feeding her baby. On postpartum day number 3, she is experiencing breast engorgement. Which method would you recommend to relieve her discomfort in addition to taking analgesics?
- Express some milk to relieve the distention.
- Remove her ace wrap to relieve pressure from her sensitive breasts.
- Apply ice packs to the breast.
- Instruct her to take a warm shower with the water aimed at the nipple.
A: Apply ice packs to the breast.

Q: A C/S client is experiencing some tenderness and localized heat on her left leg below her knee where you assess a varicosity. Her vital signs are 125/82, P- 87, R-19, T-100. As a result of these symptoms, she probably will be:
- Administered Methergine
- Assisted to ambulate frequenlty
- Closely observed for pulmonary embolisms
- Provided with SCDs.
A: Closely observed for pulmonary embolisms

Q: If a baby is diagnosed with PKU, the nurse will be teaching the parents about a diet that is:
- Low in Tyrosine
- Low in Phenylalanine
- High in Tyrosine
- High in Phenylalanine
A: Low in Phenylalanine

Q: Which newborn is at an increased risk for jaundice?
- Premature or Septic
- Asians
- Breast Feeders
- All of the above
A: All of the above

Q: Which birth defect often creates a more extreme parental response requiring immediate nursing support?
- Choanal atresia
- Esophageal atresia
- Imperforate anus
- Cleft lip & palate
A: Cleft lip & palate

Q: Which of the following newborn heart defects are cyanotic? (SELECT ALL THAT APPLY)
- Tetralogy of Fallot
- Pulmonary stenosis
- Trasposition of hte great arteries
- patent ductus arteriosus
A: Tetralogy of Fallot; Trasposition of hte great arteries

Q: A pre-term newborn, 2 days old, has a serum bilirubin level of 10 mg/dL. You anticipate treatment to include:
- Phototherapy
- Drug therapy
- Exchange transfusion
- Recheck as an outpatient at one week of age
A: Phototherapy

Q: A 32 week gestation, male, shows signs of RDS. The nurses would expect this newborn to demonstrate (SELECT ALL THAT APPLY):
- Nasal Flaring
- Acrocyanosis
- Expiratory grunting
- Retractions
A: Nasal Flaring; Expiratory grunting; Retractions

Q: The metabolic consequences of cold stress in the newborn include:
- Decreased oxygen requirements
- Decreased glucose utilization
- Increased oxygen storage requirements
- Increased glucose utilization
A: Increased glucose utilization

Q: A 18 year old G2P0 presents in L & D, and precipitously delivers a 35 week gestation, female baby. Initial management immediately after birth, in conjunction w/ respiratory assessment will include:
- ABG's
- Quick and efficient drying of the infant
- Placing an IV access
- Feeding the newborn 10% glucose H2
A: Quick and efficient drying of the infant

Q: A couple delivered a IUFD (Intra Uterine Fetal Demise) on your shift. Appropriate nursing interventions for the couple would include (SELECT ALL THAT APPLY):
- Allowing the family to hold, bathe, and dress the baby
- Discouraging the visitation of family until the baby is taken away.
- Offering support services to the couple.
- Asking the couple if they plan to pursue legal action regarding the death of the baby.
A: Allowing the family to hold, bathe, and dress the baby; Offering support services to the couple.

Q: The preterm infant requires continuous assessment of adequate fluid and nutrition. Parameters that will help assist you in this determination would include:
- Presence of hyperglycemia
- Blood & Urea pH
- Volume of urine output
- Serum bilirubin levels
A: Volume of urine output

Q: Your client has just ruptured her membranes spontaneously and states that she needs to urinate. She has not received pain medications, and her labor is not being augmented. Her examination reveals 5cms/ 100% / 0 station, and the fetal heart rate reveals a reactive trace. What should you do?
- Get her up to the restroom to relieve her bladder
- Straight cath. x 1 now
- Place a bedpan under her
- Ask the client what she prefers to do
A: Ask the client what she prefers to do

Q: The RN who is sensitive to culture awareness understands cultural responses to pain vary, but generally include:
- Japanese women may be stoic about pain, but may request medication when the pain becomes severe.
- African-American women may use remedies from indigenous plants.
- Hispanic women consider impolite to accept something the first time it is offered.
- Chinese women may express pain openly.
A: Japanese women may be stoic about pain, but may request medication when the pain becomes severe.

Q: The client has premature rupture of membranes. When compared to the normal laboring process, a need for increased frequency in monitoring vital signs will occur, especially assessment of:
- Fetal heart rate patterns
- Maternal blood pressure & respirations
- Contraction strength & frequency
- Maternal temperature & pulse
A: Maternal temperature & pulse

Q: A G2P1 client at 40 weeks presents with copious, painless, vaginal bleeding, and decreased fetal movement. She has not had prenatal care. In order of priority, what should the nurse do next?
- Have the physician paged and obtain fetal heart tones.
- Perform a vaginal exam to determine how far dilated the client is
- Perform a BPP
- Perform an ultrasound to determine placental position, and number of fetuses
A: Have the physician paged and obtain fetal heart tones.

Q: The nurse is performing a vaginal exam on a 39 week client when her water breaks spontaneously, and the umbilical cord descends into her hands from the vagina. What should the nurse do next?
- Leave the room to call the doctor
- Place the client in Trendelenburg position
- Place oxygen on the client, and shave prep for a C/Section
- Manually replace the cord
A: Place the client in Trendelenburg position

Q: Immediately after the administration of an epidural the nurse notes the client's systolic BP dropped from 135 mm Hg to 90mm Hg. The nurse's 1st action should be:
- Administer ephedrine IV
- Recheck the BP
- Call the birth attendant
- Increase the IV rate & apply O2 via mask
A: Increase the IV rate & apply O2 via mask

Q: A variable deceleration pattern on a fetal monitor strip may indicate:
- Fetal well being
- Fetal distress
- Cord compression
- The need to begin pushing
A: Cord compression

Q: When a late deceleration is observed consistently of a fetal strip the nurse understands this as a sign of:
- Fetal head compression
- Cord compression
- Fetal well being
- Utero placental insufficiency
A: Utero placental insufficiency

Q: Which of the following clients is at high-risk for postpartum hemorrhage?
The client who/whose:
- delivered a 8lb 3 oz baby.
- delivered vaginally after 4 hours of natural labor.
- delivered twins at 37 weeks gestation.
- membranes ruptured 2 hours before birth.
A: delivered twins at 37 weeks gestation.

Q: A woman's obstetric history states: three children, all of whom are living. One was born at 39 weeks gestation, another at 34 weeks gestation, and another at 35 weeks gestation. She is currently pregnant. Chose the correct gravity and parity using the GFPAL system?
- 4-1-1-1-3
- 4-1-2-0-3
- 3-0-3-0-3
- 4-2-1-0-3
A: 4-1-2-0-3

Q: Which of the following positions would be best for a client's right arm when she returns to her room after a right radical mastectomy?
- Left arm across her chest wall
- Right arm at her side resting on the mattress
- In the position that affords her the greatest comfort
- On pillows with her right arm higher than her heart
A: On pillows with her right arm higher than her heart

Q: Teaching has been effective when the client diagnosed with endometriosis describes the condition as:
- Endometrial cells growing in the uterus
- Collections of endometrial cells outside the uterus
- Small, solid tumors within the uterine wall
- Tiny pockets of blood throughout the pelvis
A: Collections of endometrial cells outside the uterus

Q: The primary fetal risk when the mother has any type of anemia is for:
- LGA baby
- Elevated bilirubin
- Limited infection defense
- Reduced oxygen delivery
A: Reduced oxygen delivery

Q: The feature that distinguishes preeclampsia from eclampsia is:
- Amount of blood pressure elevation
- Edema of the face and fingers
- Presence of 4+ proteinuria
- Onset of one or more seizures.
A: Onset of one or more seizures.

Q: Your client is about 30 weeks pregnant. The height from the symphysis pubis to the fundus is 24 cm. Based on this data you estimate the fetal growth to be:
- normal for this gestation
- intrauterine growth restriction (IUGR)
- suspicious of a multiple pregnancy
- unable to determine by fundal height
A: intrauterine growth restriction (IUGR)

Q: A client who delivered 3 days ago is complaining of nausea, frequency and pain with urination. Her temp is 102. Which intervention has priority?
- Increase fluids and reassess the temperature in 1 hour.
- Call the physician to obtain an order for a urine C&S
- Reassure client this is a normal finding and not to worry.
- Administer analgesic.
A: Call the physician to obtain an order for a urine C&S

Q: The client experiencing menopause notices changes caused by lack of which of the following hormones?
- Estrogen
- Progesterone
- Luteinizing hormone
- Follicle-stimulating hormone
A: Estrogen

Q: A 45-year old client has just been admitted to the hospital for an abdominal hysterectomy for uterine cancer. Results of lab tests indicate that the client's WBC is 7,800/cu mm. The most appropriate intervention is to:
- Call the operating room and cancel the surgery
- Notify the surgeon immediately
- Take no action as this is a normal value
- Call the lab and have the test repeated
A: Take no action as this is a normal value

Q: The nurse is assessing a client who is 32 weeks' gestation and would suspect preeclampsia if what characteristic signs and symptoms are present?
- Tinnitus and vertigo
- Mental confusion and seizures
- Hypotension and hyponatremia
- Increased blood pressure and proteinuria
A: Increased blood pressure and proteinuria

Q: A pregnant woman at 34 weeks gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Your 1st action would be to:
- measure the woman's blood pressure and pulse.
- have the woman breathe into a paper bag.
- raise the woman's legs to William's position.
- turn the woman to her side.
A: turn the woman to her side.

Q: Your client has tertiary stage syphilis . You know to assess for:
- neurologic changes
- nothing, it is the "silent" STD
- chancre lesion
- warts on the outside of sex organs
A: neurologic changes

Q: Your client just completed a course of antibiotic treatment. Which of these client comments leads you to suspect a Candida vaginal infection?
- "My period is very heavy."
- "There is a strong smelling, greenish discharge on my underwear."
- "I have a thick, cheesy vaginal discharge."
- "I noticed a foul, fishy odor when I change my panty liner."
A: "I have a thick, cheesy vaginal discharge."

Q: A pregnant client asks you about the purpose of the placenta. You respond that the primary purpose of the placenta is to:
- Maintain body temperature of the fetus
- Protects the baby from excessive sounds
- Provides an exchange of nutrients and waste products between mother and fetus
- Prevent antibodies and viruses from passing to the fetus
A: Provides an exchange of nutrients and waste products between mother and fetus

Q: Your pregnant patient asks her midwife…"is there something to prevent the outbreak of herpes during labor"? The nurse can anticipate that the midwife will write a prescription for:
- Penicillin
- Valtrex
- Nubain
- Betamethasone (BMS)
A: Valtrex

Q: The nurse should emphasize which of these dietary measures for a client diagnosed with dysfunctional uterine bleeding?
- A diet low in fiber
- Foods low in calories
- Adding iron-rich foods
- A high fat, high protein diet
A: Adding iron-rich foods

Q: Which of the following results indicate a need for further investigation? (SELECT ALL THAT APPLY)
- Hemoglobin 6
- Platelets 90,000
- WBC 10,000
- RBC 4,200,000
A: Hemoglobin 6; Platelets 90,000

Q: A 52 y/o client presents in the GYN office and describes the following symptoms. The client is describing perimenopause when she states:
- "for 8 months I have had no period"
- "I missed my period, and then the next month it was heavy."
- "my sex drive has increased lately"
- "I have vaginal dryness and an increased urge to void".
A: "for 8 months I have had no period"

Q: The pregnant client goes into premature labor and is admitted. Which medication would you anticipate will be ordered for this client?
- Magnesium sulfate
- Misoprostol gel
- Evista
- Oxytocin (Pitocin)
A: Magnesium sulfate

Q: While teaching a client when to perform a breast self-examination (BSE), the nurse is correct in telling the client it is best to perform a BSE(SELECT ALL THAT APPLY) :
- While lying down
- In circular motions, then star burst pattern
- On the 7th day post the mensus
- Only after age 40
A: While lying down; In circular motions, then star burst pattern; On the 7th day post the mensus

Q: Alpha fetal protein (AFP) is secreted by the fetal liver. You are sure that the nurse understands the AFP procedure when she tells the client that the sample will be drawn from?
- the umbilical cord at 16-20 weeks gestation
- the fetal circulation at 16-20 weeks gestation
- the placental vein at 16-20 weeks gestation
- the maternal circulation at 16-20 weeks gestation
A: the maternal circulation at 16-20 weeks gestation

Q: The most critical nursing action when caring for the newborn immediately after birth is:
- keeping the newborn's airway clear
- fostering parent-newborn attachment
- administration of aquamephyton
- administering eye drops
A: administration of aquamephyton

Q: When assessing a women in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective enough to cause dilation would be:
- Her screaming in pain
- Her water bag breaking
- Placement of an intra-uterine pressure catheter (IUPC)
- The administration of Pitocin
A: Placement of an intra-uterine pressure catheter (IUPC)

Q: A 31 year old, G4P3 client is brought in via rescue. She is 39 weeks pregnant and has a history of hypertension. You suspect Abruptio Placenta, what are your likely assessment findings on this client?
- an external hemorrhage
- severe abdominal pain
- soft uterus noted by palpation
- lots of fetal movement
A: severe abdominal pain