NUR 404 Exam 2 SU25 Community Health Nursing
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Free NUR 404 Exam 2 SU25 Community Health Nursing Questions
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.
A nurse is taking care of a post-operative cesarean section patient who underwent an emergency cesarean section due to a category III fetal heart tracing 12 hours ago. The patient is upset as a cesarean section was not part of their birth plan and wants to know if they will be able to have a vaginal delivery with their next pregnancy. The best response by the nurse would be
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This is not something you should worry about right now
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There are no contraindications to a vaginal delivery in the future during the surgery
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Unfortunately you will need a cesarean section for all your future pregnancies
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The largest contributing factor to method of delivery with any future pregnancies is the type of incision the physician performed on your uterus
Explanation
Correct Answer D. The largest contributing factor to method of delivery with any future pregnancies is the type of incision the physician performed on your uterus
Explanation:
This response provides factual, non-judgmental information. The type of uterine incision (low transverse vs. classical/vertical) determines the safety of attempting a vaginal birth after cesarean (VBAC). A low transverse incision is often compatible with a VBAC in future pregnancies, while a classical incision carries higher risk and usually requires repeat cesarean.
Why the Other Options Are Wrong:
A. This is not something you should worry about right now
This dismisses the patient’s concern and undermines their right to ask about future care. It is not therapeutic or supportive.
B. There are no contraindications to a vaginal delivery in the future during the surgery
This statement is overly broad and inaccurate. It assumes surgical details that may not apply and does not take the uterine incision type into account.
C. Unfortunately you will need a cesarean section for all your future pregnancies
This is not always true. Many patients can be candidates for VBAC depending on the type of uterine incision and other clinical factors. It's too definitive and discouraging.
During discharge education of a patient diagnosed with pediculosis capitis, the nurse instructs the parents on what treatment
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Throw away all stuffed animals
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Change bed linen every 12 hours
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Seal all non-washable items in airtight bags
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Soak all hair items in alcohol
Explanation
Correct Answer C. Seal all non-washable items in airtight bags
Explanation:
For pediculosis capitis (head lice), non-washable items such as stuffed animals or pillows should be sealed in airtight plastic bags for 2 weeks to kill lice and nits through suffocation, as lice cannot survive long without a host. This method is effective and avoids unnecessary disposal of items.
Why the Other Options Are Wrong:
A. Throw away all stuffed animals
This is unnecessary. Items can be safely stored in sealed bags rather than discarded, which is more practical and cost-effective.
B. Change bed linen every 12 hours
While laundering is essential, changing linens every 12 hours is excessive. Once daily washing of bedding and clothing in hot water is sufficient.
D. Soak all hair items in alcohol
Hair accessories should be soaked in hot water (at least 130°F or 54°C) for 5–10 minutes, not alcohol. Alcohol is not a recommended or effective disinfectant for lice.
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.
What is the expected language skill level for the 2-3 year old toddler? The toddler would
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Not speak but be able to follow commands
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Speak in two-word sentences using both a noun and verb
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Speak clearly with all words understandable
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Know 800-900 words by age 2
Explanation
Correct Answer B. Speak in two-word sentences using both a noun and verb
Explanation:
By age 2 to 3, toddlers are expected to begin forming simple two-word sentences such as "want juice" or "go park," often combining a noun and a verb. This stage marks a major developmental milestone in expressive language and indicates growing communication skills.
Why the Other Options Are Wrong:
A. Not speak but be able to follow commands
This is more typical of a child closer to 12–18 months. By age 2, children are generally using spoken words and phrases.
C. Speak clearly with all words understandable
Clarity of speech improves over time. At age 2–3, many toddlers still mispronounce words. Full clarity is not expected until around age 4.
D. Know 800–900 words by age 2
While vocabulary grows rapidly, the average 2-year-old typically knows about 200–300 words. Knowing 800–900 words is more aligned with children closer to age 3–4.
The nurse is assessing a client who is 2 weeks postpartum. The nurse would be concerned about mastitis if which of the following were noted
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Urinary frequency
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Flu-like symptoms
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Unilateral breast tenderness
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Unilateral breast erythema
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Uterine tenderness
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Bilateral breast firmness
Explanation
Correct Answers:
B. Flu-like symptoms
C. Unilateral breast tenderness
D. Unilateral breast erythema
Explanation of Correct Answers:
B. Flu-like symptoms
Clients with mastitis often experience fever, chills, fatigue, and body aches, which mimic flu symptoms. These are systemic signs of infection.
C. Unilateral breast tenderness
Mastitis usually affects one breast and causes localized pain or tenderness. This is a common early symptom.
D. Unilateral breast erythema
Redness or warmth over one breast is a hallmark of mastitis, often indicating inflammation or infection in a localized area.
Explanation of Incorrect Answers:
A. Urinary frequency
This symptom is more commonly associated with a urinary tract infection (UTI) and is not related to mastitis.
E. Uterine tenderness
Uterine tenderness may suggest endometritis, not mastitis. It involves a different postpartum complication.
F. Bilateral breast firmness
This could be related to engorgement or milk production, which is normal in lactating clients and not specific to mastitis.
A client who is in the transition phase reports the narcotic pain medication they last received 3 hours ago has worn off. The client asks if they can have another dose of the narcotic. How should the nurse respond to the request
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It is too early as the medication should be given only every 4 hours
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I will get permission from your health care provider
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Since it has been over 3 hours, you should be able to have more of the medication
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Your phase of labor makes giving another dose unsafe for the fetus
Explanation
Correct Answer D. Your phase of labor makes giving another dose unsafe for the fetus
Explanation:
During the transition phase of labor (usually 7–10 cm dilation), labor is progressing quickly, and birth is approaching. Giving narcotics at this time can cause respiratory depression in the newborn if birth occurs before the drug wears off. The timing, not just the interval since the last dose, must be considered. Safety of the fetus is the priority.
Why the Other Options Are Wrong:
A. It is too early as the medication should be given only every 4 hours
This assumes a fixed schedule without considering the stage of labor. The issue isn’t only time—it’s the proximity to delivery.
B. I will get permission from your health care provider
While provider input is necessary, this response avoids informing the client about the reason for withholding the medication and delays proper communication.
C. Since it has been over 3 hours, you should be able to have more of the medication
This ignores the critical safety concern about administering narcotics close to delivery. Time alone doesn’t determine appropriateness.
The nurse is caring for a hospitalized toddler. What does the nurse determine is the most appropriate play activity for this client
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Painting a picture
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Playing peek-a-boo
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Listening to music
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Playing with a push-pull toy
Explanation
Correct Answer D. Playing with a push-pull toy
Explanation:
Toddlers (ages 1–3) are in the sensorimotor and early preoperational stages, and they benefit most from gross motor activities that promote movement and coordination. Push-pull toys are developmentally appropriate because they support physical activity, independence, and exploration—key components of toddler play.
Why the Other Options Are Wrong:
A. Painting a picture
This is more suitable for preschoolers, who have better fine motor control and creativity. Toddlers may not yet have the coordination or interest for such structured activity.
B. Playing peek-a-boo
Peek-a-boo is more developmentally appropriate for infants, not toddlers who have typically moved beyond that type of social game.
C. Listening to music
While toddlers may enjoy music, passive activities like this do not provide the same developmental benefits as active play involving movement and interaction.
When assessing a 2.5-year-old, the nurse would expect the toddler to have
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12 deciduous teeth
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20 deciduous teeth
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6 deciduous and 12 permanent teeth
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16 deciduous and 2 permanent teeth
Explanation
Correct Answer B. 20 deciduous teeth
Explanation:
By about 2.5 years of age, most children have a full set of 20 deciduous (primary or baby) teeth—10 on the top and 10 on the bottom. This includes incisors, canines, and molars. This is a normal developmental milestone and is part of routine physical assessment in toddlers.
Why the Other Options Are Wrong:
A. 12 deciduous teeth
By 2.5 years, having only 12 teeth would be considered delayed eruption. Most children have more than 12 by this age.
C. 6 deciduous and 12 permanent teeth
Permanent teeth do not erupt this early. They typically begin to appear around 6 years of age, making this combination inaccurate.
D. 16 deciduous and 2 permanent teeth
This is also incorrect, as no permanent teeth are expected in a toddler. A 2.5-year-old should still have only deciduous teeth.
What should the nurse emphasize as being characteristic of false labor contractions
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False labor contractions do not result in cervical change
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False labor contractions lead to cervical dilation
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False labor contractions will increase in intensity and strength
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False labor contractions often disappear with rest or sleep
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False labor contractions are irregular
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False labor contractions do not increase in frequency and intensity
Explanation
Correct Answers:
A. False labor contractions do not result in cervical change
D. False labor contractions often disappear with rest or sleep
E. False labor contractions are irregular
F False labor contractions do not increase in frequency and intensity
Explanation of Correct Answers:
A. False labor contractions do not result in cervical change
This is correct. One of the key differences between true and false labor is that false labor does not lead to progressive cervical dilation or effacement.
D. False labor contractions often disappear with rest or sleep
This is correct. False labor typically stops with rest, sleep, hydration, or a change in activity, which helps distinguish it from true labor.
E. False labor contractions are irregular
This is correct. False labor contractions lack a consistent pattern in frequency, duration, or intensity.
F. False labor contractions do not increase in frequency and intensity
This is correct. False labor contractions remain mild and inconsistent and do not progressively become more intense or frequent like true labor.
Explanation of Incorrect Answers:
B. False labor contractions lead to cervical dilation
This is incorrect. False labor does not cause cervical changes; only true labor causes the cervix to dilate and efface.
C. False labor contractions will increase in intensity and strength
This is incorrect. False labor contractions do not become progressively stronger or more painful; in fact, they often fade away.
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