NUR 404 Exam 2 SU25 Community Health Nursing
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Free NUR 404 Exam 2 SU25 Community Health Nursing Questions
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.
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.
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.
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.
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.
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
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.
Which assessment on the third postpartum day would indicate to the nurse that a client is experiencing uterine subinvolution
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The fundus is palpated 3 finger-breadths below the umbilicus after voiding
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Uterine cramping is mild and resolved by NSAIDs
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The fundus is palpated 2 finger-breadths above the pubic symphysis after voiding
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The fundus is palpated at the umbilicus after voiding
Explanation
Correct Answer D. The fundus is palpated at the umbilicus after voiding
Explanation:
By the third postpartum day, the fundus should have descended to about 2–3 finger-breadths (approximately 2–3 cm) below the umbilicus. If it remains at the level of the umbilicus, this suggests uterine subinvolution, or a delay in the uterus returning to its pre-pregnancy size and position.
Why the Other Options Are Wrong:
A. The fundus is palpated 3 finger-breadths below the umbilicus after voiding
This is normal uterine involution for day 3 postpartum, indicating proper healing and descent of the uterus.
B. Uterine cramping is mild and resolved by NSAIDs
This is an expected postpartum symptom known as "afterpains." It does not indicate subinvolution.
C. The fundus is palpated 2 finger-breadths above the pubic symphysis after voiding
This would be appropriate or even slightly lower than expected by day 3, showing continued descent, not delayed involution.
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.
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