NUR 325 Nursing Services Childbearing Family

NUR 325 Nursing Services Childbearing Family

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Does NUR 325 Nursing Services Childbearing Family exam stress you out? Conquer it with our proven practice questions.

Free NUR 325 Nursing Services Childbearing Family Questions

1. 79. A patient is concerned about having a baby with trisomy 21 (Down’s Syndrome). Which of the following tests might the doctor order for this patient? (Select all that apply.)
  • A. Amniotic Fluid Indexing (AFI)
  • B. Fetal Fibronectin (FFN)
  • C. Maternal Serum Alpha-Fetoprotein (MSAFP)
  • D. Chorionic Villus Sampling (CVS)

Explanation

C. Maternal Serum Alpha-Fetoprotein (MSAFP):
This blood test is part of the quadruple screen performed between 15–20 weeks of gestation. Abnormally low MSAFP levels can indicate chromosomal abnormalities such as Down’s Syndrome (Trisomy 21). It helps assess the need for further diagnostic testing.
D. Chorionic Villus Sampling (CVS):
CVS is a diagnostic test performed between 10–13 weeks of pregnancy that directly analyzes fetal chromosomes from placental tissue. It provides a definitive diagnosis for genetic conditions like Down’s Syndrome early in pregnancy.
2.

What is the best way for the nurse to support thermoregulation in the newborn immediately after birth

  • Dry the baby in an open crib then double wrap.

  • Place the newborn with his extremities extended.

  • Double wrap the baby and place a hat on the head.

  • Dry the baby and place its skin to skin with the mother.

Explanation

Correct Answer D: Dry the baby and place its skin to skin with the mother

D. Dry the baby and place its skin to skin with the mother

Skin-to-skin contact with the mother is the most effective way to support thermoregulation immediately after birth. It stabilizes the newborn’s temperature, heart rate, and breathing, and promotes bonding. Drying the baby first helps prevent heat loss through evaporation, while maternal body heat provides warmth.

Why the Other Options Are Incorrect:

A. Dry the baby in an open crib then double wrap.

Drying is appropriate, but placing the baby in an open crib provides less effective thermal support compared to skin-to-skin contact.

B. Place the newborn with his extremities extended.

Newborns naturally adopt a flexed position to conserve heat. Keeping the extremities extended increases surface area for heat loss and is not recommended.

C. Double wrap the baby and place a hat on the head.

While this helps prevent heat loss, skin-to-skin contact remains superior for thermoregulation, especially immediately after birth. Wrapping should follow after initial drying and bonding.


3. 82. The nurse is assessing a fetal heart rate tracing and notices a FHR of 155 bpm with moderate variability, accelerations, and early decelerations. The nurse will chart this as a:
  • A. Category 1 tracing
  • B. Category 2 tracing
  • C. Category 3 tracing
  • D. Category 4 tracing

Explanation

A Category 1 fetal heart rate tracing is considered normal and reassuring. It includes a baseline fetal heart rate between 110–160 bpm, moderate variability (6–25 bpm), and may include accelerations and early decelerations, which are benign and related to fetal head compression during contractions. These findings indicate adequate fetal oxygenation and well-being. No interventions are necessary other than continued observation and routine monitoring.
4.

You perform a vaginal examination and you detect a prolapsed cord. Your number one nursing priority would be to

  • Place the client in a knee chest position.

  • Place 8L of O₂ by mask on the patient.

  • With your hand, during the vaginal exam, keep the fetal head from compressing the cord.

  • Obtain a consent for an immediate C-section.

Explanation

Correct Answer C: With your hand, during the vaginal exam, keep the fetal head from compressing the cord.

C. With your hand, during the vaginal exam, keep the fetal head from compressing the cord.

The immediate priority with a prolapsed umbilical cord is to relieve pressure on the cord to maintain fetal oxygenation. This is done by using a gloved hand to manually lift the presenting part off the cord. This intervention helps preserve blood flow through the cord until emergency delivery can be performed.

Why the Other Options Are Incorrect:

A. Place the client in a knee chest position.

This position helps reduce pressure on the cord, but it is secondary to manual elevation of the presenting part, which is the most direct and immediate action to restore circulation.

B. Place 8L of O₂ by mask on the patient.

Oxygen may help increase maternal and fetal oxygenation, but it does not address the mechanical compression of the cord, which is the critical threat.

D. Obtain a consent for an immediate C-section.

An emergency C-section will likely be necessary, but the immediate nursing priority is to prevent fetal hypoxia by relieving pressure on the prolapsed cord. Consent and preparation follow urgent stabilization.


5. 85. Amniotic fluid is important for maintaining fetal well-being. The nurse knows teaching needs to be reinforced when the nurse hears a woman making which statement to her husband:
  • A. "Amniotic fluid helps maintain our baby's temperature."
  • B. "Amniotic fluid protects the baby from injury."
  • C. "Amniotic fluid protects our baby from toxic substances."
  • D. "Amniotic fluid allows our baby to move freely."

Explanation

Teaching needs reinforcement because amniotic fluid does not protect the fetus from toxic substances. Harmful agents such as alcohol, drugs, and certain medications can cross the placenta and enter the amniotic fluid, posing risks to the fetus. In contrast, amniotic fluid does maintain fetal temperature, cushion against trauma, and allow for free movement—supporting musculoskeletal development and overall fetal comfort within the uterus.
6. 65. When caring for a laboring mother, late decelerations are noted on the fetal heart rate monitor. What actions should the nurse take? (Select all that apply.)
  • A. Turn the patient to her side
  • B. Provide 2–3 liters of oxygen via mask
  • C. Notify the health care provider
  • D. Stop the oxytocin

Explanation

A. Turn the patient to her side:
Repositioning the mother to her side relieves pressure on the inferior vena cava and aorta, improving uteroplacental blood flow. This helps increase oxygen delivery to the fetus and may reduce or eliminate late decelerations caused by decreased perfusion.
B. Provide 2–3 liters of oxygen via mask:
Administering oxygen enhances maternal oxygenation, thereby increasing the oxygen available to the fetus. This intervention helps correct fetal hypoxia and stabilizes the fetal heart rate pattern.
C. Notify the health care provider:
Late decelerations are a sign of potential fetal distress. The nurse must notify the provider immediately so further medical interventions, such as intrauterine resuscitation or expedited delivery, can be initiated to prevent fetal complications.
D. Stop the oxytocin:
Oxytocin increases uterine contractions, which can further compromise placental blood flow. Discontinuing oxytocin allows the uterus to relax, improving oxygen exchange between mother and fetus and preventing worsening of late decelerations.
7. 75. A client tells the nurse she is to have a cerclage and wants to know why the doctor is going to do this. The nurse provides education about a cerclage. Which statement indicates teaching needs to be reinforced?
  • A. "A cerclage is a suture placed on the cervix."
  • B. "A cerclage will prevent preterm labor."
  • C. "A cerclage is done to help prevent the cervix from dilating too early."
  • D. "A cerclage is done because I have had spontaneous abortions in the past because my cervix opened too early."

Explanation

Teaching needs reinforcement because a cerclage does not prevent preterm labor; it prevents premature cervical dilation caused by cervical insufficiency. The purpose of a cerclage is to mechanically support the cervix and keep it closed until the pregnancy reaches viability, reducing the risk of miscarriage or preterm birth due to cervical weakness. Preterm labor involves uterine contractions, which a cerclage cannot stop. Medications and monitoring are required to manage preterm labor itself.
8.

A newborn is diagnosed with jaundice at 48 hours when the nurse is doing the discharge teaching. The newborn is treated with a biliblanket and frequent feedings.
What type of jaundice did the newborn probably have

  • Kernicterus

  • Physiologic Jaundice

  • Pathological Jaundice

  • Erythroblastosis Fetalis

Explanation

Correct Answer B: Physiologic Jaundice

Explanation:

B. Physiologic Jaundice

Physiologic jaundice typically appears after the first 24 hours of life, often peaking between 48 to 72 hours. It is a normal response to the newborn’s immature liver and increased red blood cell breakdown. Treatment includes phototherapy (such as a biliblanket) and frequent feedings to promote bilirubin excretion.

Why the Other Options Are Incorrect:

A. Kernicterus

Kernicterus is a rare, severe complication of untreated high bilirubin levels that can cause brain damage. It is not a type of jaundice but rather a result of extreme hyperbilirubinemia.

C. Pathological Jaundice

Pathological jaundice appears within the first 24 hours of life and is usually more severe, often requiring immediate and aggressive treatment. Jaundice appearing at 48 hours does not fit this timing.

D. Erythroblastosis Fetalis

This is a form of hemolytic disease of the newborn due to Rh incompatibility, leading to severe anemia and jaundice within the first 24 hours. Again, the timing and mild treatment used here (biliblanket) suggest physiologic, not immune-mediated jaundice.


9. 77. Which of the following ideas would the nurse not include in a teaching plan on preconception health?
  • A. Taking prenatal vitamins with 400 mcg of folic acid
  • B. Normalizing HgA1c levels, if diabetic, prior to conception
  • C. Consuming a nutritional diet with 300 kcal more than normal
  • D. Going to the dentist for a routine check-up and cleaning

Explanation

A woman planning pregnancy should focus on a balanced diet but does not need to increase calorie intake before conception. The recommendation to consume an additional 300 calories per day applies after pregnancy begins, particularly during the second and third trimesters, to support fetal growth. Preconception care emphasizes folic acid supplementation, managing chronic conditions such as diabetes, and maintaining overall health—including dental care—to prepare for a healthy pregnancy.
10. 86. The nurse is caring for a woman hospitalized for hyperemesis gravidarum. Which would be the most appropriate intervention for this patient?
  • A. Total parenteral nutrition or IV hydration
  • B. A high-protein diet rich in kilocalories
  • C. A 24-hour urine collection to check for protein
  • D. Fasting blood sugar and one-hour postprandial

Explanation

Hyperemesis gravidarum is characterized by severe, persistent nausea and vomiting leading to dehydration, electrolyte imbalance, and nutritional deficiencies. The priority nursing intervention is restoring hydration and electrolyte balance using IV fluids or total parenteral nutrition (TPN) if oral intake is not tolerated. This stabilizes the patient and prevents complications such as ketosis or weight loss. Dietary changes and additional tests can follow once the patient is stabilized.

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