NUR 231 Exam 2 Finger Lakes Community College
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Free NUR 231 Exam 2 Finger Lakes Community College Questions
The parents of a newborn born at 26 weeks gestation are coming to visit for the first time in the neonatal intensive care unit (NICU). Treatment for the newborn includes continuous monitoring, mechanical ventilation, intravenous fluids and medication. Which action by the nurse would be most appropriate at this time?
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Begin the discharge teaching process
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Suggest limited visitation to reduce the risk of infection.
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Explain the long term goals of neonate's care.
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Encourage the parents to touch their preterm newborn.
Explanation
On the first visit to the NICU, the most appropriate and therapeutic nursing action is to encourage parental involvement through touch. Even with a critically ill 26-week premature infant on mechanical ventilation, gentle touching and skin-to-skin contact (when medically stable enough) promotes parental bonding, reduces parental anxiety, and supports the infant's neurodevelopmental outcomes. Family-centered care is a cornerstone of NICU nursing, and encouraging parents to participate in their baby's care from the very first visit is essential for both infant and family wellbeing.
Why the other options are incorrect:
A. Begin the discharge teaching process — Discharge teaching is entirely premature and inappropriate on the first NICU visit for a 26-week premature neonate who requires mechanical ventilation and intensive support. The family is just beginning to process the situation and needs immediate emotional support and orientation to the NICU environment, not discharge planning.
B. Suggest limited visitation to reduce the risk of infection — Current evidence-based NICU care strongly supports unrestricted parental visitation. Parents are not considered infection risks and their presence is beneficial to the infant's outcomes. Restricting parental visitation is an outdated practice that undermines bonding and family-centered care.
C. Explain the long term goals of neonate's care — While education about the care plan is important, providing complex long-term care goals on the first visit may be overwhelming for parents who are in an acute state of shock and grief. The immediate priority is to connect the parents with their baby emotionally through touch and presence.
Call the primary care provider.
Explanation
Using the formula: Percentage of weight loss = [(Birth weight − Current weight) ÷ Birth weight] × 100
First, convert to ounces for consistency: Birth weight: 7 lbs 3 oz = (7 × 16) + 3 = 115 ounces Current weight: 6 lbs 8 oz = (6 × 16) + 8 = 104 ounces
Weight lost: 115 − 104 = 11 ounces
Percentage of weight loss: (11 ÷ 115) × 100 = 9.565%, which rounds to 9.6%
This is clinically significant because a weight loss exceeding 10% in a neonate warrants close evaluation for feeding adequacy, dehydration, and potential intervention before discharge. At 9.6%, this neonate is approaching that threshold and should be carefully assessed prior to discharge.
Which information will the nurse stress to workers at a daycare center about respiratory syncytial virus (RSV)?
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Frequent hand washing can decrease the spread of the virus.
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RSV is transmitted through particles in the air.
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RSV can live on skin or paper for up to a few seconds after contact.
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RSV can survive on nonporous surfaces for about one hour.
Explanation
RSV is primarily transmitted through direct contact with infected secretions and through touching contaminated surfaces followed by touching the face, eyes, or mouth. Frequent and thorough hand washing is the single most effective infection control measure to reduce RSV transmission in a daycare setting where children and caregivers are in close contact with shared surfaces and objects. This is the most actionable and evidence-based teaching point for daycare workers.
Why the other options are incorrect:
B. RSV is transmitted through particles in the air — While RSV can spread through large respiratory droplets during close contact (within about 6 feet), it is not primarily an airborne pathogen transmitted through small aerosolized particles like measles or tuberculosis. Framing it as airborne transmission is inaccurate and could create unnecessary fear or incorrect infection control practices.
C. RSV can live on skin or paper for up to a few seconds after contact — This significantly underestimates RSV's environmental survival. RSV can survive on skin for approximately 30 minutes and on nonporous surfaces for several hours, making this statement dangerously misleading for infection control purposes.
D. RSV can survive on nonporous surfaces for about one hour — While closer to accurate than option C, research shows RSV can actually survive on nonporous surfaces for up to 6 hours or more. This underestimation could lead to inadequate surface disinfection practices in the daycare setting.
A client is experiencing a postpartum hemorrhage 3 hours after delivery. What does the nurse anticipate for assessment findings? (Select all that apply)
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Dizziness
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Hypotension
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Pallor
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Capillary refill less than 3 seconds
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Tachycardia
Explanation
Postpartum hemorrhage causes significant blood loss, leading to hypovolemic shock. Dizziness results from decreased cerebral perfusion as blood volume drops. Hypotension occurs as cardiac output falls due to reduced circulating blood volume — a hallmark sign of hemorrhagic shock. Pallor results from peripheral vasoconstriction and shunting of blood away from the skin to vital organs, as well as from anemia caused by red blood cell loss. Tachycardia is the body's compensatory response to decreased stroke volume, as the heart increases rate to maintain adequate cardiac output and organ perfusion in the setting of significant blood loss.
Why the other options are incorrect:
D. Capillary refill less than 3 seconds — In postpartum hemorrhage and hypovolemic shock, peripheral vasoconstriction occurs as the body shunts blood to vital organs. This results in prolonged capillary refill time — greater than 3 seconds — not less than 3 seconds. A capillary refill of less than 3 seconds is a normal finding indicating adequate peripheral perfusion, which would not be expected in a client experiencing significant hemorrhage.
A nurse documents a patient's cardiac rhythm in the electronic medical record. Based on this partial rhythm strip, what will the nurse chart as an approximate QRS duration, and what does the nurse understand as the meaning of this? (Select 2 answers that apply.)
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0.06
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0.18
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This represents early ventricular repolarization
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This is the time required for depolarization of the ventricles
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It is the time required for the depolarization of the atria
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This represents the time of the electrical impulse to travel from the sinoatrial node to the atrioventricular node
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0.12
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0.20
Explanation
Correct Answer: (A) 0.06 and (D) This is the time required for depolarization of the ventricles.
The QRS complex represents ventricular depolarization — the electrical activation of the ventricles that triggers ventricular contraction. A normal QRS duration ranges from 0.06 to 0.10 seconds. Based on the rhythm strip provided, the QRS complex appears narrow and normal, measuring approximately 0.06 seconds, which falls within the normal range and indicates normal ventricular conduction.
Why Other Options are Incorrect:
B. 0.18 — This value far exceeds the normal QRS duration range of 0.06–0.10 seconds. A QRS of 0.18 would indicate a significant bundle branch block or ventricular conduction abnormality, which is not reflected in this strip.
C. This represents early ventricular repolarization — Early ventricular repolarization is represented by the ST segment and T wave, not the QRS complex.
E. It is the time required for the depolarization of the atria — Atrial depolarization is represented by the P wave, not the QRS complex.
F. This represents the time of the electrical impulse to travel from the sinoatrial node to the atrioventricular node — This description refers to the PR interval, not the QRS complex.
G. 0.12 — While 0.12 is the upper boundary of a normal PR interval, it exceeds the normal QRS duration and would suggest a bundle branch block if charted as the QRS measurement.
H. 0.20 — This value is far beyond normal QRS duration and would represent severe ventricular conduction delay, which is not consistent with what is seen on this rhythm strip.
Administer oxygen via nasal cannula.
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Nifedipine
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Nitroglycerin
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Nelfinavir
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Natalizumab
Explanation
Natalizumab (Tysabri) is a monoclonal antibody used as a disease-modifying therapy for relapsing forms of multiple sclerosis. It works by blocking the movement of potentially damaging immune cells across the blood-brain barrier into the brain and spinal cord. It is administered as an intravenous infusion every four weeks in a certified infusion clinic setting due to the risk of serious side effects including progressive multifocal leukoencephalopathy (PML). Its infusion-only administration route makes it the expected medication in this clinical scenario.
Why the other options are incorrect:
A. Nifedipine — Nifedipine is a calcium channel blocker used to manage hypertension and angina. It has no role in the treatment of multiple sclerosis.
B. Nitroglycerin — Nitroglycerin is a vasodilator used for the management of angina pectoris and acute coronary syndromes. It is not a treatment for multiple sclerosis.
C. Nelfinavir — Nelfinavir is an antiretroviral protease inhibitor used in the treatment of HIV/AIDS. It has no established role in multiple sclerosis management.
The nurse is caring for a newly pregnant client who states her last menstrual period was December 2nd. What is the client's estimated date of delivery using Naegele's rule? Enter the 2 digit month/2 digit day.
Explanation
Naegele's Rule formula: subtract 3 months from the first day of the last menstrual period (LMP), then add 7 days, and add 1 year.
LMP: December 2nd Step 1 — Subtract 3 months: December → September Step 2 — Add 7 days: 2 + 7 = 9 Step 3 — Add 1 year
Estimated Date of Delivery: September 9th = 09/09
The nurse is evaluating care provided to a 9-year-old client with cerebral palsy (CP). Which developmentally appropriate activity would the nurse expect the client to engage in?
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The client is able to feed themselves
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The client administers her medications independently
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The client has joined Girl Scouts
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The client returns for follow-up provider appointments as needed
Explanation
Explanation:
Correct Answer: (C) The client has joined Girl Scouts
Joining Girl Scouts is a developmentally appropriate social activity for a 9-year-old. At this age, children are in the industry versus inferiority stage (Erikson) and developmental tasks include forming peer relationships, participating in group activities, and developing a sense of competence and belonging. Girl Scouts provides socialization, skill development, and inclusion regardless of physical ability.
Why Other Options are Incorrect:
A. The client is able to feed themselves — While self-feeding is a developmental milestone, it is expected much earlier (around 2–3 years of age) and is not specifically appropriate as a notable achievement for a 9-year-old unless the child has significant motor impairment.
B. The client administers her medications independently — Independent medication administration requires cognitive and safety skills not expected of a 9-year-old child; medication management is a caregiver responsibility at this age.
D. The client returns for follow-up provider appointments as needed — Attending follow-up appointments is a caregiver responsibility, not a developmentally appropriate activity that reflects the 9-year-old's own engagement and development.
The nurse is caring for a client who sustained a 3rd degree perineal laceration during a vaginal delivery. Which is the optimal nursing intervention to minimize perineal edema?
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Administering pain medications to the client as needed.
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Providing a cushioned pad for the client to sit on.
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Applying ice packs to the client's perineum.
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Educating the client on the use of warm sitz baths.
Explanation
Correct Answer: (C) Applying ice packs to the client's perineum.
In the immediate postpartum period, applying ice packs to the perineum is the optimal intervention to minimize edema following a perineal laceration. Cold therapy causes vasoconstriction, which reduces blood flow to the area, limits swelling, and also provides pain relief. Ice should be applied for the first 24 hours after delivery for maximum effectiveness in reducing perineal edema.
Why the other options are incorrect:
A. Administering pain medications to the client as needed — While pain management is important for comfort, it does not directly address or minimize perineal edema.
B. Providing a cushioned pad for the client to sit on — A cushioned pad provides comfort and pressure relief but does not actively reduce edema or swelling in the perineal area.
D. Educating the client on the use of warm sitz baths — Warm sitz baths are beneficial for perineal healing and comfort after the first 24 hours but are not the optimal intervention for minimizing acute edema in the immediate postpartum period. Heat can initially worsen swelling.
The nurse is caring for a client with hepatitis C. The client's brother states, "I do not want to get this infection, so I'm not going into his hospital room." How would the nurse respond?
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"That is understandable, I can give you an update on your brother's status from here."
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"This virus is only transmitted through a fecal specimen."
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"If you wear a gown and gloves, you will not get this virus."
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"Hepatitis C is not spread through casual contact, so you are safe to go in and visit with him."
Explanation
Hepatitis C is transmitted through blood-to-blood contact, most commonly via sharing needles, contaminated blood products, or unprotected sexual contact with an infected person. It is not transmitted through casual contact such as hugging, talking, sharing food, or being in the same room. The nurse's priority here is therapeutic communication and patient/family education. Reassuring the brother that casual contact poses no risk encourages family support, which is important for the patient's wellbeing.
Why the other options are incorrect:
A. "That is understandable, I can give you an update on your brother's status from here." — While empathetic, this response does not educate the brother about transmission and accepts a misconception that could negatively affect family support and the patient's emotional health.
B. "This virus is only transmitted through a fecal specimen." — This is factually incorrect. Hepatitis A is transmitted via the fecal-oral route. Hepatitis C is transmitted through blood-to-blood contact, not fecal specimens.
C. "If you wear a gown and gloves, you will not get this virus." — This implies that protective equipment is necessary for casual visits, which is false and would further reinforce the brother's unfounded fear of transmission through normal contact.
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