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Exam 2 : NUR230 / NUR 230 (Latest
2026/2027 Update) Concepts of Nursing: The
Childbearing/Child Caring Family |
Questions & Answers | 100% Correct | Galen
A breastfeeding client is day 4 post Cesarean delivery. Current VS are temp. 99.8, RR 20, HR 88, and BP 118/60. What is the priority in this scenario? A. Massage the fundus B. Notify the physician C. Reassess thr client's temp in 30 minutes D. Assess the client's breasts for engorgement. D During a postpartum assessment, a cluster of hemorrhoids are noted in a G1P1 who delivered vaginally with a superficial perineal laceration. Which of the following would be appropriate for the nurse to include in the women's health teaching? SATA A. The client should use a site bath three times a day for relief. B. The client should apply a topical anesthetic as a relief measure. C. The client should massage the hemorrhoids daily. D. The client should be advised that the hemorrhoids will increase in size and number with each subsequent pregnancy. E. The client can use the side lying position to relieve pressure on the hemorrhoids. F. The client should use witch hazel pads to soothe the area. A, B, E, F
Which is the best intervention to help prevent development of postpartum thrombophlebitis after an uncomplicated vaginal delivery? A. Promote adequate oral fluid intake B. Promote early and frequent ambulation C. Place sequential compression devices on all patients D. Administer subcutaneous low molecular weight heparin B A G6 P4114 is 1/2 hour post spontaneous vaginal delivery of a 440 grams baby. Initially, which complication should the nurse monitor considering this patient scenario? A. Maternal hypoglycemia B. Maternal hyperglycemia C. Maternal VTE D. Maternal uterine atony D The nurse is teaching a postpartum mother about changes in the postpartum period. The nurse recognized the mother needs additional teaching when the mother states: SATA A. I need to begin sitz baths within 12 hours of birth if I have an episiotomy or a repaired laceration. B. Tylenol is the preferred pain medication for breastfeeding mothers. C. I should void spontaneously within 6-8 hours after birth. D. I need an additional 1000 kcal/day as a breastfeeding mother. A, B, D Which of the following is NOT a symptom of a vaginal hematoma? A. Normal-apprearing vulva with either no lacerations or normal-appearing, repaired laceration/episiotomy.
C. Assess the client's temp and recommend blood cultures be ordered and drawn D. Start an IV fluid boils with LR and notify HCP D A nurse is estimating blood loss on a postpartum client. The scales read 2.3 kg with a saturated pad and chux. The dry weight of the pad and chux is 500 g. What is the blood loss in ml's? Report the number only. A. 130 B. 1, C. 1, D. 1. B Upon examining a patient on day 2 after spontaneous vaginal delivery, a nurse finds the peri pad to be completely saturated with bright red blood over the last hour. The priority in this scenario is: A. Start a second IV line of normal saline B. Notify the primary health care provider C. Massage the fundus D. Assess vital signs C The nurse takes a newborn to a primipara for a feeding. The mother holds the baby em face, strokes his cheek, and states that this is the first newborn she has ever held. Which of the following assessments is most appropriate? A. Positive bonding and the client requires little teaching. B. Poor bonding and referral to the social worker C. Poor bonding but there is potential for positive mothering
D. Positive bonding but teaching related to newborn care is needed D After completing the Ballard Assessment, the nurse determines that infant's weight is at the 95%; height 95%; and head circumference at the 95%. What is the classification and what problem should the nurse anticipate? A. AGA, no apparent problem B. SGA, hyperglycemia C. LGA, hypoglycemia D. Symmetrical IUGR, neurological deficits C Which of the following assessments would alert the nurse to complications associated with hyperbilirubinemia? A. Yellow sclera and head at 18 hours of birth B. Elevated bilirubin level on day 3 C. Yellow skin on day 4 D. Increased sleepiness 12 hours after birth A Which of the following would alert the nurse that an infant is currently experiencing respiratory distress? A. Acrocyanosis B. Intercostal retractions C. Apnea lasting 15 seconds D. Fire rhonchi in the upper lobes B
A full-term neonate has brown adipose fat tissue stores that were deposited during the latter part of the third trimester. What does the nurse understand in the function of this type of fat? A. To promote melanin production in the neonatal period B. To provide heat production when the baby is hypothermic. C. To protect the bony structures of the body from injury D. To provide calories for neonatal growth B A nurse is visiting a breastfeeding client at home 2 weeks post cesarean delivery of infant boy. The loggia is series with a midline fundus palpated as firm in the symphysis pubis area. Her nipples are cracked. The client is crying and reports her uterine cramping and nippy pain as 6/10. The baby has been crying throughout the visit when the mother suddenly shouts at the baby to stop crying and says "you're getting on my last nerve". What is the nursing priority in this scenario? A. Perform an assessment on the newborn B. Encourage the client to join a postpartum support group. C. Educate the client to take Ibuprofen (Motrin) around the clock D. Evaluate the client's latching on and latching off procedures A Which infant should NOT receive a circumcision today? SATA A. 34 week preterm male B. 39 week male with epispadius C. 40 week male with edematous scrotum from breech birth D. 39 week male whose mother has eclampsia A, B
An infant is acrocyanotic, slightly flexed; HR 90 and decreasing; RR 18 and decreasing; and the infant is not crying. Based on the following APGAR score, the nurse will most likely: A. Chart APGAR score and continue to monitor B. Administer intramuscular Narcan/naloxone C. Assist with intubation and begin chest compressions D. Provide supplemental oxygen and consider bag and mask procedure D Which of the following assessments would alert the nurse that hyperbilirubinemia is at a critical state in a term infant? A. Yellow skin and sclera in a 2-day-old newborn. B. Preterm newborn at 4 days of age with a serum bilirubin level of 8. C. Preterm newborn at 36 hours after birth with serum bilirubin of 11. D. Term newborn at 12 hours after birth with a serum bilirubin of 12. D The best way to prevent hypothermia in the newborn directly after delivery is A. Place the infant under the radiant warmer for 30 minutes B. Bathe the infant while under the radiant warmer C. Place the baby on the mother's chest and dry with warm blankets D. Wrap the baby in 2 warm blankets with a hat on the head. C Which of the following babies is at greatest risk of developing hyperbilirubinemia? A. A Caucasian baby at 39 weeks gestation with cephalohematoma B. Native American baby born at 36 weeks whose mother is having difficulty breastfeeding. C. African American baby born at 40 weeks whose mother is having difficulty breastfeeding.
E. Two to three loose blankets are recommended during sleep time F. Over and under-heating should be avoided B, C, F Four pregnant women indicate to the nurse that they wish to breastfeed their babies. Which mother should be advised to bottle feed her child? A. A mother with a current and active history of heroin use. B. A mother who received the Rubella vaccination. C. A mother who received the RhoGAM injection. D. A mother who plans to smoke outside of the house A A breastfeeding woman has been educated on how to avoid engorgement. Which of the following actions by the mother shows that teaching was effective? A. She pumps her breast's after each feeding. B. She feeds her baby every 2-3 hours. C. She feeds her baby 10 minutes on each side. D. She wears cabbage leaves for 24 hours a day. B A woman is diagnosed with an autosomal recessive disease. Her husband does not have the disease but is a carrier. The nurse can advise the couple that any of their children will have the disease is: SATA A. 50% of the children will express the disease B. 100% of the children will express the disease C. 50% of the children will be carriers for the disease D. 100% of the children will be disease free
E. 25% of the children will express the disease F. 75% of the children will express the disease A, C While interacting with a couple, the nurse learns that they are planning to conceive. Which action would help the clients either prepare for or prevent genetic disorders in the newborn? A. Collecting a medical history of the couple and their parents B. Collecting the family history of the couple during the preconception period C. Advising the couple to seek genetic testing during the second trimester D. Advising the couple to seek genetic testing as soon as possible B A client is 22 years old, 5'2", weight 95 lbs., and tells a nurse that her last menstrual periods occurred on Jan 1, Mar 30, and June 30. She has no cramps. Is the client ovulating? Are her periods likely to be light or heavy? A. Yes, light B. Yes, heavy C. No, light D. No, heavy C Which of the following best describes Asherman's syndrome? A. Secondary amenorrhea due to pituitary dysfunction B. Secondary amenorrhea due to hypothalamic dysfunction C. Secondary amenorrhea due to overly-vigorously scraping of the endometrium after surgical procedures. D. Secondary amenorrhea due to ovarian dysfunction.
Which STI is the most commonly reported bacterial STI in the U.S, according to the CDC A. Chlamydia B. Gonorrhea C. Syphilis D. HSV A The most common symptom associated with chlamydia in women is: A. Pelvic Inflammatory Disease B. Mucopurulent cervicitis C. Vaginal discharge D. No symptoms D Which nursing instruction is appropriate for a woman who has completed half of the prescribed course of antibiotics to treat a chlamydial infection who reports being completely asymptomatic? A. "You may stop the medication now but be sure to resume treatment if your symptoms come back". B. "You must take all of the prescribed medication, even if you no longer have symptoms". C. "If the symptoms do not come back in the next 3 days, you may stop treatment". D. "Since your symptoms are gone, you may stop taking the medication today". B A nurse is teaching an 18-year-old client with her 2nd STI in 6 months about treatment and screening. The nurse recognizes the need for additional teaching when the client states: A. I need to abstain from intercourse for 7 days after the single-dose of medicine I will receive from the clinic today.
B. Abstain from intercourse until all of my partners are also treated C. If one of my partners received a 7-day antibiotic prescription, I need to abstain from intercourse with that partner until competition of the 7-day course of treatment D. I will be screened annually for STIs. D The most common symptom associated with gonorrhea in women is: A. Pelvic Inflammatory Disease B. Irregular bleeding C. Mucopurulent cervicitis D. No symptoms D A nurse is doing a bimanual exam on a client during a physical exam. Her period ended 1 week ago. The client is very uncomfortable when the nurse gently moves her cervix from side-to-side during the exam. The client says "well, I just finished my period a week ago". What should the nurse do NEXT? A. Continue the examination with more gentle movement. B. Report symptoms to the health care provider immediately C. Ask the woman to breathe deeply and bear down D. Reschedule the bimanual examination for a later date. B Pain with cervical motion may be a sign of cervicitis or PID d/t STI; notify provider Which of the following statements about genital herpes (HSV-II) are TRUE? SATA A Most infections are transmitted by people who don't know they are infected. B. Recurrent infections are usually more severe than initial infections
C. Rash over trunk of body D. Muscle weakness and visual changes A Which assessment finding is anticipated for a patient diagnosed with secondary syphilis? SATA A. Gummas B. Mucous patches in the mouth C. Rash over trunk of body D. Muscle weakness and visual changes B,C Which aspects of STI prevention and detection are appropriate to include during nursing education for every sexually active woman, regardless of infection status? SATA A. Methods of contraception that can prevent STIs B. Circumstances in which testing may be necessary C. Diagnostic and screening tests that can help diagnose STIs D. How STI's may impact future childbearing E. Specific signs and symptoms that require medical attention C. A,B,C,E A nurse is teaching a client about abnormal uterine bleeding. The client displays adequate knowledge of this topic when she identifies possible causes of AUB as all of the following except: A. Menopause B. Menarche C. Uterine Infection D. Coagulopathy
E. Uterine cancer D AUB is irregular, sometimes heavy, sometimes light, bleeding. HMB is regular, but always heavy, bleeding. Coagulopathy causes HMB A client tells a nurse that her last menstrual periods occurred on Jan1, Feb 28, May 2, and May
- Her periods are heavy, requiring double protection, and lasting 9-13 days. She has no cramps. Is the client ovulating? A. Yes B. No B Which of the following are most likely to experience AUB? SATA A. Jenny, age 12; began periods 2 months ago. B. Sally, age 24;coming off birth control pills to become pregnant C. Alisha, age 50, with occasional hot flashes and night sweats. A,C Janey has periods as follows: Jan 1, Feb 12, Mar 1, May 15, and June 7. She only needs to change her pad one time per day for her entire period. Is Janey ovulating? A. Yes B. No B Which statement is consistent with the diagnosis of endometriosis? A. Endometriosis is associated with higher incidence of cervical cancer.
B
Which findings must be included for the diagnosis of premenstrual syndrome (PMS), according to the American College of Obstetricians and Gynecologists (ACOG, 2015)? SATA A. Symptoms must end within 4 days after menses begins B. Symptoms must include primary dysmenorrhea C. Symptoms must interfere with some of the woman's normal activities. D. The woman's symptoms must be present 5 days before menses begins. E. At least one of the woman's symptoms must be irritability or labile mood. A,C,D A nurse is teaching a client with PMS about interventions which may help this condition. It is evident that the client needs more education when she states: A. I should eat a diet rich in complex carbohydrates, calcium rich foods, and reduce my intake of fat, salt, and sugar. B. I should consider moderately increasing my caffeine intake to help with fatigue. C. I should eat 6 small meals per day D. Regular aerobic exercise may lessen my PMS symptoms. B A nurse is educating a pregnant client about kick counts. The client demonstrates a need for additional teaching when she states: A. I should begin kick counts at 24 weeks gestation. B. There are a lot of different ways to do kick counts. C. It is normal for babies to love less as they approach term D. I may need a non-stress test if I feel fewer than 3 movements in one hour. C
A nurse is leaning about the use of ultrasonography in pregnancy. The nurse had a good understanding of the use of third trimester uses for ultrasonography when he identifies all of the following uses except: A. Determine placental position B. Evaluation of the fetus' other structures during chorionic villus sampling C. Detect congenital abnormalities D. Determine fetal position B A client asks the nurse about my Hal translucency screening. The nurse is correct when she identifies this as: SATA A. an ultrasound measurement of the fluid at the nape of the fetal neck B. Performer between 20-24 weeks gestation C. Identifies increased risk of Trisomy 13, 18, and 21 D. >3mm is considered abnormal A,C,D Which of the following is NOT a maternal or fetal indication for antepartal testing? A. Chronic hypertension B. Post-term pregnancy C. Decreased fetal movement D. Preterm pre-labor rupture of membranes E. Increased fetal activity E
