NUR 404 Exam 2 SU25 Community Health Nursing
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Free NUR 404 Exam 2 SU25 Community Health Nursing Questions
Progress Nete
June 24. 2025 10am
Vital signs: T 98.6 HR 88 BP 12B/B0 02 99 RR 22
Firm furdus palpated 1 firger breadth above umbilicus and deviated to the left. Small amount of lochia rubra noted on the perineal pad.
XXX, RN
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Firmly massage the fundus
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Ask the client to empty their bladder and reassess
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Elevate the head of bed
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Notify the healthcare provider
Explanation
Correct Answer B. Ask the client to empty their bladder and reassess
Explanation:
A fundus that is deviated from midline and elevated (even if firm) is often caused by a full bladder, which displaces the uterus and can interfere with involution and increase the risk of bleeding. The first intervention is to have the client empty their bladder, which usually helps the uterus return to the midline and descend appropriately.
Why the Other Options Are Wrong:
A. Firmly massage the fundus
The fundus is already described as firm, so massage is not necessary and could cause discomfort or uterine irritability.
C. Elevate the head of bed
There is no indication that this position change will address uterine deviation or fundal height. It does not resolve the underlying cause.
D. Notify the healthcare provider
This is not necessary at this stage. The nurse should first attempt a nursing intervention (bladder emptying) before escalating.
When visiting a friend, you see an 18-month-old toddler pull a scalding cup of tea off a table onto himself. Your first action should be to
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Apply butter to soothe the injured skin
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Wrap him in a blanket and rush him to the nearest hospital
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Remove his shirt and apply burn ointment
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Pour cool water over the skin area where the coffee spilled
Explanation
Correct Answer D. Pour cool water over the skin area where the coffee spilled
Explanation:
The first action in burn first aid is to cool the burn immediately by running cool (not cold) water over the affected area for at least 10–20 minutes. This helps reduce skin damage, pain, and swelling. It's the most effective and safe initial response before any further treatment or transport.
Why the Other Options Are Wrong:
A. Apply butter to soothe the injured skin
This is outdated and harmful. Butter can trap heat and bacteria, increasing the risk of infection.
B. Wrap him in a blanket and rush him to the nearest hospital
While medical attention may be needed, cooling the burn immediately is the priority before transport. Delaying cooling worsens tissue damage.
C. Remove his shirt and apply burn ointment
Clothing may need to be removed if not stuck to the skin, but ointments should not be applied immediately, especially before cooling and evaluation by medical personnel.
. If the fetal monitor demonstrates the following pattern, which action would the nurse perform first?
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Prepare for vaginal delivery
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Administer oxygen at 3–4 liters via nasal cannula
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Turn the client or ask the client to turn on their side
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Perform a vaginal exam to assess for the umbilical cord
Explanation
Correct Answer C. Turn the client or ask the client to turn on their side
Explanation:
The image shows variable decelerations, which are abrupt drops in fetal heart rate and are often caused by umbilical cord compression. The first nursing action is to reposition the client, typically to a side-lying position, to relieve cord pressure and improve fetal oxygenation. This is a rapid and non-invasive intervention that can immediately impact fetal status.
Why the Other Options Are Wrong:
A. Prepare for vaginal delivery
This is premature. Delivery may be necessary if the condition persists, but initial interventions to relieve the decelerations must be attempted first.
B. Administer oxygen at 3–4 liters via nasal cannula
Oxygen may be helpful, but repositioning is more immediate and effective in relieving cord compression, making it the priority action.
D. Perform a vaginal exam to assess for the umbilical cord
This is appropriate after repositioning, especially if variable decelerations persist or worsen, to rule out cord prolapse. However, it's not the first step.
When assessing the fundus in a postpartum client, which palpation method is recommended
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Placing one hand on the fundus, one on the perineum
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Palpating the fundus with only fingertip pressure
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Placing one hand at the base of the uterus, one on the fundus
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Resting both hands on the fundus
Explanation
Correct Answer C. Placing one hand at the base of the uterus, one on the fundus
Explanation:
The recommended method for assessing the postpartum fundus involves placing one hand just above the symphysis pubis to support the base of the uterus, while the other hand palpates the fundus. This technique prevents uterine inversion and ensures accurate assessment of tone and position.
Why the Other Options Are Wrong:
A. Placing one hand on the fundus, one on the perineum
Placing a hand on the perineum during fundal assessment is not standard practice and offers no benefit in stabilizing the uterus.
B. Palpating the fundus with only fingertip pressure
Using only fingertip pressure may be too light to accurately assess fundal tone and position. Moderate pressure is needed for a proper assessment.
D. Resting both hands on the fundus
This does not provide stabilization and can increase the risk of pushing the uterus downward, potentially leading to uterine prolapse or inversion.
After assisting the provider with an amniotomy on a laboring client, what is the nurse's priority action
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Adjust the intravenous fluid infusion rate
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Provide clean gown and linens for the client
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Assess the fetal heart rate
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Assist the client to wash the perineum
Explanation
Correct Answer C. Assess the fetal heart rate
Explanation:
The priority nursing action after an amniotomy (artificial rupture of membranes) is to assess the fetal heart rate (FHR). This is critical because cord prolapse or fetal distress can occur when the membranes rupture, and the FHR may reveal signs such as bradycardia or variable decelerations that indicate complications.
Why the Other Options Are Wrong:
A. Adjust the intravenous fluid infusion rate
This may be necessary depending on labor progression, but it is not the immediate priority following membrane rupture.
B. Provide clean gown and linens for the client
This is part of routine comfort care after ensuring fetal well-being, not a priority over FHR assessment.
D. Assist the client to wash the perineum
Perineal care is important for hygiene but is not urgent. It follows after confirming there are no complications for the fetus.
To prevent thromboembolism following a cesarean birth, which of the following would be the most important intervention to implement
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Encourage the client to ambulate
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Instruct the client to press inward on their abdomen periodically
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Urge the client to cough and take deep breaths
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Urge the client not to dislodge the IV fluid line
Explanation
Correct Answer A. Encourage the client to ambulate
Explanation:
Early ambulation is the most effective intervention to prevent thromboembolism after cesarean birth. Movement promotes circulation and venous return, which helps prevent the formation of blood clots in the legs. It’s especially important because cesarean delivery increases the risk of thromboembolic events due to surgery and postpartum immobility.
Why the Other Options Are Wrong:
B. Instruct the client to press inward on their abdomen periodically
This may be done to support the incision when moving or coughing, but it does not prevent blood clots and is not a key thromboembolism intervention.
C. Urge the client to cough and take deep breaths
This helps prevent respiratory complications, like atelectasis or pneumonia, not thromboembolism.
D. Urge the client not to dislodge the IV fluid line
While important for maintaining therapy, this has no effect on preventing blood clots or promoting circulation.
A postpartum client has been diagnosed with postpartum depression. Which of the following symptoms would the nurse anticipate the client was exhibiting, aiding in the diagnosis
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Insomnia
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Intermittent crying in the first 1 week postpartum, now resolved
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Delusions
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Induced vomiting
Explanation
Correct Answer A. Insomnia
Explanation:
Insomnia is a common symptom of postpartum depression. It may persist even when the baby is sleeping, and is often accompanied by fatigue, feelings of hopelessness, irritability, and difficulty bonding with the baby. It is a red flag when paired with other mood symptoms beyond the typical “baby blues.”
Why the Other Options Are Wrong:
B. Intermittent crying in the first 1 week postpartum, now resolved
This describes postpartum blues, which is temporary and self-resolving. It is not considered postpartum depression unless symptoms last longer than 2 weeks or worsen.
C. Delusions
Delusions are more indicative of postpartum psychosis, a severe and rare condition that is a psychiatric emergency, not postpartum depression.
D. Induced vomiting
This behavior is more consistent with an eating disorder, such as bulimia nervosa, and is not characteristic of postpartum depression.
What information would the nurse document regarding a patient's reported allergies
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Family history of allergies
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Type of allergic reaction
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Medication names
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Epi Pen use for allergic reactions
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Date of allergic reaction
Explanation
Correct Answers:
B. Type of allergic reaction
C. Medication names
D. Epi Pen use for allergic reactions
Explanation of Correct Answers:
B. Type of allergic reaction
It is essential to document what kind of reaction the patient experiences (e.g., rash, anaphylaxis, nausea). This helps differentiate true allergies from side effects.
C. Medication names
The nurse must document the specific medications or substances the patient is allergic to in order to prevent future exposure.
D. Epi Pen use for allergic reactions
If a patient has used or carries an Epi Pen, this suggests a history of severe allergic reactions (e.g., anaphylaxis), which is critical information for care planning.
Explanation of Incorrect Answers:
A. Family history of allergies
While useful, family history is not directly relevant when documenting the patient’s personal allergies. The focus should be on the patient's own reactions.
E. Date of allergic reaction
The exact date is not always known or necessary. The type and severity of the reaction are more clinically significant for documentation and safety.
Which stressors are commonly observed in hospitalized toddlers
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Social isolation
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Interrupted routines
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Fear of being hurt
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Sleep disturbances
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Self-concept disturbances
Explanation
Correct Answers:
B. Interrupted routines
C. Fear of being hurt
D. Sleep disturbances
Explanation of Correct Answers:
B. Interrupted routines
Toddlers thrive on consistent routines. Hospitalization disrupts their normal patterns for eating, sleeping, and playing, which can cause anxiety, irritability, and regression.
C. Fear of being hurt
Toddlers do not fully understand medical procedures and often fear pain from needles, exams, or treatments. This is a common and significant stressor.
D. Sleep disturbances
Strange environments, noises, and frequent interruptions in the hospital often lead to poor sleep, which increases stress and affects emotional regulation.
Explanation of Incorrect Answers:
A. Social isolation
Social isolation is more relevant to older children and adolescents. Toddlers primarily miss parents or primary caregivers rather than peers or broader social contact.
E. Self-concept disturbances
Toddlers are still developing their sense of self. Self-concept issues are not commonly recognized stressors at this developmental stage; this concern is more typical in school-aged children and adolescents.
After delivery of the placenta, a client's uterus is slow to contract. Which of the following is a priority nursing intervention
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Measure blood pressure hourly
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Prepare to administer blood products as prescribed
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Administer intravenous fluids
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Initiate oxytocin infusion as prescribed
Explanation
Correct Answer D. Initiate oxytocin infusion as prescribed
Explanation:
The priority action when the uterus is slow to contract after placental delivery is to stimulate uterine contraction to prevent postpartum hemorrhage. Oxytocin is the first-line uterotonic medication prescribed for this purpose. It promotes uterine muscle contraction, helping to reduce bleeding and promote involution.
Why the Other Options Are Wrong:
A. Measure blood pressure hourly
Monitoring vital signs is important but not the immediate intervention to address uterine atony or bleeding.
B. Prepare to administer blood products as prescribed
This may be necessary if bleeding is severe, but the first step is to address the cause—in this case, poor uterine contraction—by giving oxytocin.
C. Administer intravenous fluids
Fluids may support circulation if bleeding occurs, but they do not treat uterine atony directly. Oxytocin must be given to stop the bleeding source.
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