NUR 404 Exam 2 SU25 Community Health Nursing
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Free NUR 404 Exam 2 SU25 Community Health Nursing Questions
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 measure would be most effective in aiding bronchodilation in a child with croup (laryngotracheobronchitis)
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Assisting with racemic epinephrine nebulizer therapy
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Teaching the child to take long, slow breaths
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Administering an oral analgesic
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Urging the child to continue to take oral fluids
Explanation
Correct Answer A. Assisting with racemic epinephrine nebulizer therapy
Explanation:
Racemic epinephrine is the most effective treatment for moderate to severe croup. It provides rapid bronchodilation and reduces airway swelling by vasoconstricting the mucosa of the upper airway, improving oxygenation and breathing. It's commonly used in emergency or hospital settings to relieve stridor and respiratory distress.
Why the Other Options Are Wrong:
B. Teaching the child to take long, slow breaths
While calm breathing can help reduce distress, it does not provide actual bronchodilation or reduce airway inflammation, making it insufficient alone for managing croup.
C. Administering an oral analgesic
Analgesics may reduce discomfort or fever, but they have no direct effect on airway constriction or inflammation. They do not assist with bronchodilation.
D. Urging the child to continue to take oral fluids
Maintaining hydration is important but does not directly aid in bronchodilation or reduce airway obstruction, which is the priority in acute croup management.
An 18-month-old girl is diagnosed as having atopic dermatitis. When interviewing her parents, they describe the following care measures. Which one would lead you to think more health teaching is needed
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To dry lesions, the father applies alcohol to lesions daily
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To aid healing, the father applies hydrocortisone cream to the lesions
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After a bath, the mother applies Eucerin cream
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The mother gives her a daily bath without using soap
Explanation
Correct Answer A. To dry lesions, the father applies alcohol to lesions daily
Explanation:
Applying alcohol to lesions is harmful and inappropriate for atopic dermatitis. Alcohol is extremely drying and irritating, which worsens the skin barrier breakdown and increases itching and inflammation. This indicates a lack of understanding of proper skin care for eczema and calls for immediate education.
Why the Other Options Are Wrong:
B. To aid healing, the father applies hydrocortisone cream to the lesions
Hydrocortisone cream is a standard topical treatment for mild to moderate atopic dermatitis and helps reduce inflammation and itching when used as directed.
C. After a bath, the mother applies Eucerin cream
Eucerin is a thick emollient, and applying it after bathing helps lock in moisture — a highly recommended practice in eczema care.
D. The mother gives her a daily bath without using soap
Daily bathing without soap helps hydrate the skin without introducing irritants. It’s a correct approach for children with eczema.
A parent of a toddler asks the nurse the best way to handle the client's new temper tantrums at home. What following action should the nurse suggest
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Ignore the temper tantrums
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Distract the child with an activity
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Explain temper tantrums are not acceptable
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Place the child in their room
Explanation
Correct Answer B. Distract the child with an activity
Explanation:
Distraction is one of the most effective and developmentally appropriate strategies for managing temper tantrums in toddlers. Redirecting the child to a new, engaging activity helps defuse emotional outbursts without reinforcing the behavior. Toddlers respond well to positive attention and redirection rather than discipline.
Why the Other Options Are Wrong:
A. Ignore the temper tantrums
Ignoring might work in certain mild cases, but it can sometimes escalate the situation or lead to safety risks. Distraction is more proactive and positive.
C. Explain temper tantrums are not acceptable
Toddlers have limited language and reasoning skills. Explaining behavior in this way is often ineffective, especially during a tantrum.
D. Place the child in their room
Using isolation may increase frustration and fear. While time-outs can work for older toddlers, distraction is generally the first-line approach for young toddlers
A nurse is caring for a client who had a vaginal birth 2 hours ago. They are currently receiving IV Oxytocin, 20 Units in 1000 ml Lactated Ringers solution infusing at 125 ml/hr. Which of the following findings indicates that the medication is effective
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There is a large amount of bright red lochia with large clots
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Fundus is firm to palpation at the umbilicus
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Fundus is boggy to palpation at the umbilicus
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Lochia is absent
Explanation
Correct Answer B. Fundus is firm to palpation at the umbilicus
Explanation:
Oxytocin promotes uterine contractions to prevent postpartum hemorrhage. A firm uterine fundus at the umbilicus level indicates that the uterus is contracting effectively and minimizing blood loss, showing the medication is working as intended.
Why the Other Options Are Wrong:
A. There is a large amount of bright red lochia with large clots
This suggests excessive bleeding and possible uterine atony, which indicates that the oxytocin is not effective.
C. Fundus is boggy to palpation at the umbilicus
A boggy uterus is soft and indicates poor contraction, increasing the risk for hemorrhage. This is a sign of oxytocin being ineffective.
D. Lochia is absent
Complete absence of lochia may indicate retained products of conception or uterine blockage, which is not a typical or desired outcome after birth. Some lochia is expected postpartum.
A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should provide the following type of fluid to the child
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Water
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Oral Rehydration Solution (ORS)
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Broth
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Seltzer
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Diluted Apple Juice
Explanation
Correct Answer B. Oral Rehydration Solution (ORS)
Explanation:
The recommended fluid for a child with acute gastroenteritis who can tolerate oral intake is Oral Rehydration Solution (ORS). ORS contains the correct balance of electrolytes and glucose, which promotes optimal absorption in the intestines and effectively replaces losses from vomiting or diarrhea. It prevents dehydration and supports recovery.
Why the Other Options Are Wrong:
A. Water
Water alone does not replace lost electrolytes, especially sodium and potassium. Giving plain water can worsen electrolyte imbalances in young children with diarrhea.
C. Broth
Broth may be too high in sodium and lacks a proper balance of glucose and other electrolytes. It does not meet the WHO-recommended criteria for rehydration therapy.
D. Seltzer
Seltzer or carbonated beverages can irritate the stomach and cause bloating or discomfort. It also lacks appropriate electrolytes and is not recommended in rehydration.
E. Diluted Apple Juice
While diluted juices may be tolerated in older children with mild dehydration, they are not superior to ORS and can still contribute to osmotic diarrhea due to sugar content. ORS remains the standard of care.
Which is the most common characteristic associated with Nephrotic syndrome
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Increasing weight loss
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Increased urinary output
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Generalized edema
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Hypertension
Explanation
Correct Answer C. Generalized edema
Explanation:
Generalized edema is the hallmark feature of nephrotic syndrome and is usually the most noticeable clinical sign. It results from massive protein loss in the urine (proteinuria), which reduces oncotic pressure in the blood, causing fluid to shift into interstitial spaces. This leads to swelling in the face, abdomen, and extremities.
Why the Other Options Are Wrong:
A. Increasing weight loss
Children with nephrotic syndrome usually experience weight gain due to fluid retention, not weight loss. Weight loss is not a primary symptom.
B. Increased urinary output
Nephrotic syndrome typically presents with decreased urinary output due to fluid retention and kidney dysfunction. Polyuria is not a common feature.
D. Hypertension
Although high blood pressure can occur in kidney conditions, it is not the most common or defining feature of nephrotic syndrome. Edema is more prominent in early presentation.
A client who gave birth 5 hours ago has completely saturated a perineal pad within 15 minutes. Which action by the nurse should be implemented first
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Assess the fundus
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Begin an IV infusion of Ringer's lactate solution
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Assess vital signs
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Notify the health care provider
Explanation
Correct Answer A. Assess the fundus
Explanation:
The first action is to assess the fundus, as uterine atony (a boggy or soft uterus) is the most common cause of early postpartum hemorrhage. If the fundus is found to be boggy, the nurse should immediately begin fundal massage to stimulate contraction and reduce bleeding. Identifying and treating the source is the priority.
Why the Other Options Are Wrong:
B. Begin an IV infusion of Ringer's lactate solution
Fluids may be necessary if hemorrhage continues, but they are supportive, not diagnostic. The cause of the bleeding must be addressed first.
C. Assess vital signs
While vital signs are important to monitor for shock, they do not address the cause of bleeding and are not the first step.
D. Notify the health care provider
The nurse must assess and intervene immediately. Waiting for the provider without taking action could delay life-saving measures.
The nurse is caring for a client who had a cesarean section birth. Which of the following would be the most important assessment to make
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If signs of infection are present at the incision site
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If they plan to return to work postpartum
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If signs of infection are present at the perineal site
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If their breasts fill by the 1st postpartum day
Explanation
Correct Answer A. If signs of infection are present at the incision site
Explanation:
For a client recovering from a cesarean section, the incision site is a primary area of concern. The nurse must monitor for signs of infection, such as redness, swelling, warmth, drainage, or increased pain, as this can lead to serious complications like wound dehiscence or sepsis if untreated.
Why the Other Options Are Wrong:
B. If they plan to return to work postpartum
While this is important for discharge planning and support, it is not a priority assessment during the immediate post-op recovery period.
C. If signs of infection are present at the perineal site
Perineal assessment is more relevant for vaginal births. After a cesarean, the abdominal incision is the main focus.
D. If their breasts fill by the 1st postpartum day
Breast fullness usually begins around day 2–3 postpartum. While important for lactation assessment, it is not the most urgent concern compared to the risk of surgical site infection.
A toddler is being treated for acetaminophen toxicity after an accidental overdose. The nurse should prepare to administer which medication
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Succimer
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Atropine
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Syrup of Ipecac
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Acetylcysteine
Explanation
Correct Answer D. Acetylcysteine
Explanation:
Acetylcysteine is the antidote for acetaminophen (paracetamol) toxicity. It works by replenishing glutathione, a substance that helps detoxify the harmful metabolite of acetaminophen in the liver. When given early, it can prevent or reduce liver damage. It may be administered orally or IV depending on the situation.
Why the Other Options Are Wrong:
A. Succimer
Succimer is used to treat lead poisoning, not acetaminophen toxicity. It acts as a chelating agent to remove heavy metals.
B. Atropine
Atropine is used in cases of organophosphate poisoning or to treat bradycardia, not for acetaminophen overdose.
C. Syrup of Ipecac
Syrup of Ipecac induces vomiting but is no longer recommended in poisoning cases due to the risk of aspiration and because activated charcoal and antidotes are safer and more effective.
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