NUR 404_Exam One
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Free NUR 404_Exam One Questions
What are presumptive signs of pregnancy that the nurse would expect when assessing a client at 10 weeks gestation? Select all that apply.
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Abdominal enlargement
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Breast changes
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Positive urine pregnancy test
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Goodell sign
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Fetal heart tones
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Urinary frequency
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Amenorrhea
Explanation
Correct Answers:
B Breast changes
F Urinary frequency
G Amenorrhea
Explanation of Correct Answers
B Breast changes
Breast tenderness, fullness, and areolar darkening are common presumptive signs of pregnancy due to hormonal changes, particularly increased estrogen and progesterone. These changes are subjective and often reported by the woman early in pregnancy, but they are not diagnostic because similar changes can occur with hormonal fluctuations or contraceptive use.
F Urinary frequency
Frequent urination is a presumptive sign caused by the growing uterus exerting pressure on the bladder, especially during the first trimester. This is a subjective experience reported by the woman and cannot definitively confirm pregnancy, as urinary frequency can also be caused by infection or other conditions.
G Amenorrhea
The absence of menstruation is often the first presumptive sign noticed by many women. It occurs because hormonal changes prevent ovulation and menstruation during pregnancy. However, it is presumptive rather than diagnostic, as amenorrhea can also result from stress, illness, or endocrine disorders.
The nurse is inspecting a male newborn's genitalia. Which action should the nurse avoid when conducting this assessment?
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Inspecting the genital area for irritated skin
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Inspecting if the urethral opening appears circular
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Palpating if testes are descended into the scrotal sac
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Retracting the foreskin over the glans to assess for secretions
Explanation
Correct Answer:
D. Retracting the foreskin over the glans to assess for secretions
Explanation of Correct Answer
In newborn males, the foreskin is normally adherent and not retractable. Attempting to retract it can cause pain, bleeding, or injury. Appropriate assessment includes inspecting for skin irritation, verifying the urethral opening is midline and circular, and palpating the testes to confirm they are descended into the scrotum. Retraction of the foreskin should be avoided until it naturally becomes retractable later in childhood.
A client who is in labor and planning to breastfeed the newborn asks the nurse, "I am really excited to breastfeed my newborn. When can I do it?" Which response by the nurse is appropriate?
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"You can breastfeed within 1 hour of your newborn's birth."
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"You can start once the newborn has been allowed to rest."
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"For the first 24 hours, your newborn will get water and then you can breastfeed."
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"Breastfeeding can start after your newborn has had one feeding of formula."
Explanation
Correct Answer:
A. "You can breastfeed within 1 hour of your newborn's birth."
Explanation of Correct Answer
Breastfeeding should be initiated as soon as possible, ideally within the first hour after birth, often called the "golden hour." Early initiation promotes bonding, stimulates milk production, and helps regulate the newborn’s temperature and blood glucose. Waiting to rest, giving water, or formula before breastfeeding is unnecessary and may interfere with establishing successful breastfeeding.
During a home visit, a new mother is concerned that, after three meconium stools, her newborn has had a bright green stool. What should the nurse explain to the mother?
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This is a normal finding.
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This is most likely a symptom of diarrhea.
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The baby may be developing an allergy to breast milk
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The child will need to be isolated until the stool can be cultured.
Explanation
Correct Answer:
A. This is a normal finding.
Explanation of Correct Answer
After the first few meconium stools, it is normal for a newborn’s stools to transition to a greenish color before eventually becoming yellow (for breastfed infants) or tan (for formula-fed infants). This reflects normal gastrointestinal adaptation as the baby begins digesting milk. Bright green transitional stools are not diarrhea, do not indicate an allergy to breast milk, and do not require isolation or culturing.
During a well-child visit, a nurse is evaluating a 12-month-old baby. Which of the following conclusions ought to be shared with the provider by the nurse?
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Closed anterior fontanel
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Eruption of six teeth
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Birth weight doubled
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Birth length increased by 50%
Explanation
Correct Answer:
c) Birth weight doubled
Explanation of Correct Answer
By 12 months of age, an infant’s birth weight should have tripled, not just doubled. Doubling typically occurs around 5 to 6 months. If a 12-month-old has only doubled their birth weight, this is below expected growth standards and should be reported to the provider for further evaluation.
The nurse is explaining to a student how to assess a client via internal fetal monitoring. What would the nurse include as characteristics of this practice? Select all that apply.
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Intensity of the contraction
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Resting tone between contractions
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Client's position during contraction and labor
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Fetal heart rate during labor
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Frequency of the contraction
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Client's response to the contraction
Explanation
Correct Answers:
A Intensity of the contraction
B Resting tone between contractions
D Fetal heart rate during labor
E Frequency of the contraction
Explanation of Correct Answers
A Intensity of the contraction
Internal monitoring using an intrauterine pressure catheter (IUPC) provides objective measurement of contraction strength in millimeters of mercury (mmHg). This allows the care team to evaluate uterine performance during labor.
B Resting tone between contractions
The IUPC can measure uterine resting tone between contractions, giving insight into whether the uterus is adequately relaxing. Inadequate relaxation may compromise uteroplacental perfusion and fetal oxygenation.
D Fetal heart rate during labor
Internal fetal monitoring with a scalp electrode provides continuous, accurate data on the fetal heart rate. It reduces artifact from maternal movement or obesity compared to external monitoring.
E Frequency of the contraction
Internal monitoring shows the timing of contractions, including their onset and frequency. When combined with intensity and resting tone, this provides a complete picture of uterine activity.
The client is inquiring to the health care provider about what pelvis is rounded, forward facing, with a wide pubic arch ideal for childbirth. Place the correct pelvis from the possible answers row into the correct pelvis based on the description.
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Android -
Anthropoid -
Gynecoid -
Platypelloid
Explanation
Correct Answer:
C. Gynecoid
Explanation of Correct Answer
The gynecoid pelvis is the most common and is considered the ideal pelvic shape for childbirth. It is characterized by a rounded inlet, forward orientation, and a wide pubic arch, which provides ample space for the fetal head to descend. This shape minimizes the risk of obstructed labor and is associated with favorable birth outcomes.
The other pelvic shapes (android, anthropoid, and platypelloid) may pose varying degrees of difficulty during labor and delivery, but the gynecoid pelvis (picture 3) is the correct and ideal one described.
The nurse records a newborn's Apgar score at birth. A normal 1-minute Apgar score is:
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1 to 2
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5 to 9
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7 to 10
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12 to 15
Explanation
Correct Answer:
C. 7 to 10
Explanation of Correct Answer
The Apgar score evaluates a newborn’s condition at 1 and 5 minutes after birth, assessing heart rate, respiratory effort, muscle tone, reflex irritability, and color. A score of 7–10 at 1 minute indicates that the newborn is adjusting well to extrauterine life and requires only routine care. Scores below 7 suggest some degree of compromise and the need for closer monitoring or intervention.
A new mother asks the nurse how soon she can breastfeed after delivery. Which of the following would be the nurse's best answer (barring unforeseen complications)?
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Immediately after birth
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After the infant is allowed to rest
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Once the infant has a first feeding of formula
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In 24 hours after her infant is given water
Explanation
Correct Answer:
A. Immediately after birth
Explanation of Correct Answer
Breastfeeding should begin immediately after birth, ideally within the first hour, as recommended by the World Health Organization (WHO) and the American Academy of Pediatrics (AAP). Early initiation promotes bonding, stimulates milk production, helps the newborn regulate temperature and blood glucose, and provides colostrum rich in antibodies. Formula, water, or delayed initiation is unnecessary and may interfere with successful breastfeeding.
When teaching a woman about ingesting drugs while breastfeeding, which statement is most accurate?
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Almost all drugs are excreted to some extent in breast milk.
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A mother can plan on taking common over-the-counter drugs without difficulty
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A mother has to limit her exposure to opioids and sedatives while breastfeeding
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A mother should halt breastfeeding for 1 week after taking any drug
Explanation
Correct Answer:
A. Almost all drugs are excreted to some extent in breast milk.
Explanation of Correct Answer
Most medications pass into breast milk to some degree, though the amount and clinical significance vary depending on the drug’s properties, dose, and timing. While some over-the-counter drugs are generally safe, not all are safe (contrary to B). Opioids and sedatives require caution (C), but the blanket statement about halting breastfeeding for a week (D) is unnecessary. Nurses should assess each drug individually and consult reliable references.
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