NUR 404_Exam One
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Free NUR 404_Exam One Questions
Which of the following is an advantage of breastfeeding for the infant?
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Breast milk is more difficult to digest, so it makes the infant feel fuller longer.
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Breast milk contains antibodies and thus decreases the possibility of gastrointestinal illnesses.
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It takes less effort for an infant to suck at a breast than from a bottle.
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Breast milk leads to firmer stools, increasing bowel tone
Explanation
Correct Answer:
B. Breast milk contains antibodies and thus decreases the possibility of gastrointestinal illnesses.
Explanation of Correct Answer
Breast milk provides immunologic protection through antibodies (especially IgA), which help prevent gastrointestinal and respiratory infections in the infant. Breast milk is also easily digested (contrary to A), requires more effort to suck than a bottle (opposite of C), and typically produces softer stools (contrary to D), which are normal for healthy breastfed infants.
A client who has just given birth to her first baby asks the nurse for help with breastfeeding. Which nursing diagnosis would be the most appropriate for the client at this time?
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Powerlessness
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Health-seeking behaviors
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Readiness for enhanced coping
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Anxiety related to breastfeeding
Explanation
Correct Answer:
B. Health-seeking behaviors
Explanation of Correct Answer
The client is actively asking for assistance with breastfeeding, which demonstrates health-seeking behaviors. This diagnosis reflects a positive and proactive approach to learning new skills for infant care. Powerlessness and anxiety would suggest negative emotions or lack of control, which are not evident in this scenario. "Readiness for enhanced coping" is too broad and not specific to the immediate situation of learning breastfeeding techniques.
During the postpartum period, a client with heart disease and type 2 diabetes asks the nurse, "Which contraceptive will I be able to use to prevent pregnancy in the near future?" What is the best response by the nurse?
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You have little to worry about regarding becoming pregnant in the near future, because of your illness
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You should use foam with a condom to prevent pregnancy; this is the safest method
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You may use oral hormonal contraceptives; they are very effective in preventing pregnancy
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The intrauterine device may be a good choice because of its high effectiveness and ease of use
Explanation
Correct Answer:
D The intrauterine device may be a good choice because of its high effectiveness and ease of use
Explanation of Correct Answer
For postpartum clients with heart disease and type 2 diabetes, the safest contraceptive method is one that does not increase cardiovascular risk or interfere with glucose metabolism. Intrauterine devices (IUDs) provide long-term, highly effective contraception without systemic hormones that could complicate existing health conditions. Unlike oral contraceptives, which may increase thromboembolic risk in clients with heart disease, or spermicides, which are less effective, the IUD offers both safety and efficacy, making it the best recommendation in this scenario.
The fetal monitor strip below is from a client receiving oxytocin augmentation for labor. What would the nurse do first for this client?
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Continue to monitor contraction duration every 1 hour
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Discontinue the oxytocin infusion
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Slow the infusion until a decrease in contractions are seen
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Increase the flow rate of the fluid line infusion
Explanation
Correct Answer:
B Discontinue the oxytocin infusion
Explanation of Correct Answer
The fetal strip shows repetitive late decelerations, which are associated with uteroplacental insufficiency and fetal hypoxia. Since oxytocin stimulates uterine contractions, it can worsen fetal compromise by reducing placental perfusion. The nurse’s first action is to stop the oxytocin infusion immediately to remove the cause. Secondary interventions may include repositioning the mother, administering oxygen, and increasing IV fluids—but discontinuing oxytocin is the priority initial step.
Which of the following claims regarding breastfeeding is accurate?
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Breastfeeding increases the risk of breast cancer.
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Breastfeeding offers a good chance for bonding with the infant.
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Uterine involution is slowed by breastfeeding.
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Breastfeeding mothers have a decreased risk of developing thrombophlebitis.
Explanation
Correct Answer:
B. Breastfeeding offers a good chance for bonding with the infant.
Explanation of Correct Answer
Breastfeeding promotes maternal-infant bonding through skin-to-skin contact and the release of oxytocin, which fosters emotional attachment. Contrary to option A, breastfeeding actually reduces the risk of breast and ovarian cancer. It accelerates uterine involution due to oxytocin-mediated uterine contractions (opposite of C). While breastfeeding has many health benefits, it is not specifically protective against thrombophlebitis (D).
The fetal monitor demonstrates a pattern that reflects uteroplacental insufficiency. What is the priority action by the labor nurse?
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Move client to the operating room for a cesarean
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Administer oxygen via face mask to the client
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Turn the client or ask the client to turn to their left side
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Increase the client’s intravenous Lactated Ringer's
Explanation
Correct Answer:
C Turn the client or ask the client to turn to their left side
Explanation of Correct Answer
When uteroplacental insufficiency is suspected, the priority nursing action is to improve uterine and placental blood flow. Repositioning the client, particularly to the left side, relieves pressure from the gravid uterus on the inferior vena cava, thereby enhancing maternal cardiac output and uteroplacental perfusion. While oxygen administration and IV fluids are also appropriate interventions, they are secondary. Moving immediately to cesarean delivery is not the first response; intrauterine resuscitation is attempted before surgical action.
A newborn infant has loose, yellow stools. Although the infant is healthy, his mother is concerned that this means he is allergic to breast milk. The nurse would explain to her that:
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She might try burping the infant more frequently.
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The stools of breastfed infants are normally loose.
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She might consider changing to a soybean formula
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Her child may need to be investigated for bile duct disease.
Explanation
Correct Answer:
B. The stools of breastfed infants are normally loose.
Explanation of Correct Answer
Loose, yellow stools are a normal finding in healthy breastfed infants due to the composition of breast milk and rapid intestinal transit. This does not indicate an allergy to breast milk. Burping, formula changes, or medical investigations for bile duct disease are unnecessary unless other symptoms, such as blood in the stool, poor weight gain, or signs of illness, are present.
When examining a newborn's eyes, the nurse would expect which assessment?
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Follows your finger a full 180 degrees
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Has a white rather than a red reflex
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Follows a light to the midline
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Produces tears when he cries
Explanation
Correct Answer:
C. Follows a light to the midline
Explanation of Correct Answer
A newborn can briefly track or follow objects such as a light to the midline, but not through a full 180-degree arc. A red reflex is expected, while a white reflex is abnormal and may indicate retinoblastoma or cataract. Tear production is immature in newborns and typically begins at 2–3 months of age. Thus, tracking to the midline is the normal expected finding.
In a prenatal education session, the nurse is instructing a group of customers. Which of the following statements made by a pregnant client suggests that the client needs more instruction regarding the kind of activity they should do?
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Half sit-ups
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Pelvic tilt
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Pelvic rocking
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Kegel exercises
Explanation
Correct Answer:
A Half sit-ups
Explanation of Correct Answer
Half sit-ups, or abdominal curl-type exercises, are not recommended during pregnancy because they can place unnecessary strain on the abdominal muscles, especially the rectus abdominis, which is already stretched and weakened. They may contribute to or worsen diastasis recti (separation of abdominal muscles) and cause discomfort or injury. Instead, recommended exercises include pelvic tilts, pelvic rocking, and Kegel exercises, all of which strengthen supportive muscles, reduce back discomfort, and prepare the body for labor and postpartum recovery.
A nurse is assessing a 6-month-old infant. Which of the following reflexes should the infant exhibit?
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Moro
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Plantar grasp
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Stepping
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Tonic neck
Explanation
Correct Answer:
b) Plantar grasp
Explanation of Correct Answer
At 6 months, the plantar grasp reflex is still present and is considered a normal finding. When the sole of the infant’s foot is touched near the toes, the toes curl downward. This reflex typically disappears around 8 to 10 months of age as voluntary motor control develops.
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