FA25 NUR 404 W Exam Two at Massachusetts College of Pharmacy and Health Sciences
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Free FA25 NUR 404 W Exam Two at Massachusetts College of Pharmacy and Health Sciences Questions
1. A single pregnant adolescent has decided to continue the pregnancy and keep the baby. Which intervention would the nurse use?
- Explore other problems that the client may be experiencing
- Praise and give approval for making a wise decision
- Making an appointment for the client to visit a prenatal clinic
- Provide information about resources and assistance
Explanation
The priority nursing role when caring for a pregnant adolescent is to support, educate, and connect them to resources. Adolescents often lack financial, emotional, and social support systems. Providing access to community resources, parenting programs, financial support services, prenatal care services, and support groups helps promote maternal and fetal well-being and encourages a healthy transition into parenthood.
2. A primigravida at 39 weeks' gestation has dark red vaginal bleeding and complains of pain continuing between contractions. The nurse palpates the abdomen, which is firm and shows no sign of relaxation. Which complication does the nurse suspect?
- Preterm labor
- Placenta previa
- Abruptio placentae
- Placenta accreta
Explanation
Abruptio placentae involves premature separation of the placenta from the uterine wall, causing dark red bleeding, constant abdominal pain, and a firm, board-like uterus that does not relax between contractions. These characteristics distinguish it from other causes of third-trimester bleeding. It is a medical emergency due to the risk of fetal hypoxia and maternal hemorrhage, requiring rapid evaluation and intervention.
3. 4 g/hr. What is the starting rate of the infusion? Record numerical answer only. Round to the nearest whole number.
- 50
- 67
- 100
- 120
Explanation
The concentration is 60 g in 1000 mL. 60 g ÷ 1000 mL = 0.06 g/mL Desired dose: 4 g/hr 4 g ÷ 0.06 g/mL = 66.67 mL/hr Rounded to nearest whole number = 67 mL/hr
4. A client in post-term labor is receiving oxytocin. The health care provider orders the oxytocin infusion to infuse at 4 mU/min. The oxytocin concentration available is 20 units in 1000 mL lactated Ringer’s. How many mL/hr will the infusion run? Record numerical answer only. Round to the nearest whole number.
- 6
- 12
- 24
- 48
Explanation
20 units = 20,000 milliunits (mU) in 1000 mL → 20 mU/mL. Ordered rate: 4 mU/min. mL/min = 4 mU/min ÷ 20 mU/mL = 0.2 mL/min. Convert to mL/hr: 0.2 × 60 = 12 mL/hr. Rounded to the nearest whole number = 12.
5. A client at 31 week's gestation is admitted in preterm labor. Which medication would the nurse provide education for?
- An analgesic
- A corticosteroid
- A tocolytic
- An oxytocic
Explanation
A tocolytic is given in preterm labor to suppress uterine contractions and delay delivery, typically to allow time for fetal lung maturity interventions such as corticosteroids. At 31 weeks gestation, delaying labor can significantly improve neonatal outcomes by reducing the risks of respiratory distress syndrome, intraventricular hemorrhage, and other prematurity-related complications.
6. The nurse is concerned that a pregnant client is developing polyhydramnios in the second trimester. What assessment findings are not a concern? Select all that apply.
- Fundal height significantly larger than expected for gestational age
- Maternal shortness of breath and difficulty breathing
- Fetal parts difficult to palpate on abdominal exam
- Scant amniotic fluid visualized on ultrasound
Explanation
D. Scant amniotic fluid visualized on ultrasound This finding is associated with oligohydramnios, not polyhydramnios. Polyhydramnios involves an excess of amniotic fluid, whereas oligohydramnios means there is too little fluid. Therefore, scant fluid on ultrasound does not suggest polyhydramnios and is not a concern in the context of this condition.
7. After an emergency cesarean birth, the client tells the nurse that she was hoping for a natural childbirth but is glad that she and her baby are healthy. Which postpartum phase of adjustment does this statement reflect?
- Taking-in
- Taking-hold
- Working-through
- Letting-go
Explanation
The letting-go phase occurs when the mother reconciles her birth experience with her expectations and begins to accept her new role. In this stage, the mother processes emotions about how birth occurred (e.g., grieving a desired natural birth) while simultaneously expressing gratitude for her and her baby’s well-being. Acceptance and emotional adjustment to the reality of childbirth and motherhood define this phase.
8. A primigravida client with severe preeclampsia is ordered magnesium sulfate: 30 g in 500 mL LR, infuse at 6 g/hr. How many mL/hr should the infusion run? Record numerical answer only. Round to the nearest whole number.
- 75
- 150
- 100
- 50
Explanation
Concentration = 30 g / 500 mL = 0.06 g/mL. Required volume per hour = 6 g ÷ 0.06 g/mL = 100 mL/hr. Rounded = 100.
9. Which healthcare provider order for a client with cephalopelvic disproportion would the nurse question?
- Start a peripheral intravenous infusion of normal saline at 100mL/hr
- Record fetal heart tones every 15 minutes
- Maintain clear liquid diet status
- Titrate oxytocin infusion per protocol
Explanation
Oxytocin increases the strength and frequency of uterine contractions. In a client with cephalopelvic disproportion (CPD), the fetus cannot pass safely through the maternal pelvis, so stimulating labor further increases the risk of fetal distress, uterine rupture, and maternal injury. CPD most often requires cesarean delivery rather than labor augmentation. Therefore, oxytocin administration is unsafe and must be questioned.
10. A pregnant client has a history of chronic hypertensive disease. Which medication would the nurse not question for this client?
- Labetalol
- Digoxin
- Warfarin
- Nitroglycerin
Explanation
Labetalol is a commonly prescribed antihypertensive medication considered safe for use during pregnancy. It is a first-line choice for managing chronic hypertension in pregnant clients because it effectively lowers blood pressure without reducing uteroplacental blood flow. Using safe, pregnancy-approved antihypertensives like labetalol helps prevent maternal complications such as stroke and preeclampsia while supporting fetal well-being.
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