NUR 404_Exam One
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Free NUR 404_Exam One Questions
A 36 year old client with a gestational age of 11 weeks has been referred to genetic counseling based on a family history of an inheritable problem and advanced maternal age. The client is concerned because they believe that genetic counseling will favor abortion if studies reveal a defective fetus. Which response would the nurse provide to the client regarding genetic counseling?
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Abortion is suggested only when the fetus is found to have a severe defect that is not compatible with life
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Recommendations are made to consider adoption when defects are predicted
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After the probability of a defect is determined, the couple's own primary health care provider helps the couple decide on the appropriate action
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Families are counseled to understand the diagnosis, the probable cause and how the condition can be managed
Explanation
Correct Answer:
D Families are counseled to understand the diagnosis, the probable cause and how the condition can be managed
Explanation of Correct Answer
Genetic counseling is a non-directive process intended to help families understand medical information about inherited conditions, their possible causes, recurrence risks, and management options. The goal is not to pressure clients toward abortion or adoption, but to provide knowledge so the family can make informed choices that align with their values and circumstances. Counselors support decision-making by clarifying options, not prescribing a specific outcome.
A newborn is being breastfed. To evaluate nutritional adequacy, you should be aware that breast milk contains an average of how many calories?
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12 calories per ounce
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20 calories per ounce
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24 calories per ounce
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30 calories per ounce
Explanation
Correct Answer:
B. 20 calories per ounce
Explanation of Correct Answer
Human breast milk provides about 20 calories per ounce, which is the standard caloric density used to estimate infant feeding needs. This balance of carbohydrates, fats, and proteins is ideal for newborn growth and development. Formula is also designed to provide about 20 calories per ounce for consistency. Options A, C, and D either underestimate or overestimate the actual caloric content of breast milk
The nurse is preparing to administer oxytocin to a laboring client. The nurse notes the patient's oxytocin infusion is set at 10 mL/hr. The IV bag contains 20 units of oxytocin mixed in 500 mL Lactated Ringer's. How many mU/min of oxytocin is the patient receiving? Round to the nearest tenths place. Record numerical answers only.
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6.7 mU/min
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5.5 mU/min
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7.2 mU/min
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8.0 mU/min
Explanation
Correct Answer:
A 6.7 mU/min
Explanation of Correct Answer
Step 1: Convert oxytocin to milliunits per mL.
20 units = 20,000 mU in 500 mL → 20,000 ÷ 500 = 40 mU/mL.
Step 2: Calculate dose delivered at 10 mL/hr.
10 mL/hr × 40 mU/mL = 400 mU/hr.
Step 3: Convert to mU/min.
400 mU/hr ÷ 60 = 6.7 mU/min.
Therefore, the patient is receiving 6.7 mU/min of oxytocin.
The nurse is explaining the process of breast milk production with a client pregnant with her first child. What should the nurse include when providing this teaching? Select all that apply.
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Breast milk is thin, yellow, and watery.
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For the first 3 to 4 days, the breast milk is colostrum.
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Uterine cramping is a contraindication to breastfeeding.
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True breast milk comes in by the 10th day after giving birth.
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Most mothers have breast milk by the first day after giving birth.
Explanation
Correct Answers:
B. For the first 3 to 4 days, the breast milk is colostrum.
D. True breast milk comes in by the 10th day after giving birth.
Explanation of Correct Answers
B. For the first 3 to 4 days, the breast milk is colostrum.
Colostrum is produced in the initial postpartum period and is rich in antibodies, nutrients, and immune factors. It provides essential protection and nutrition to the newborn before mature milk is available.
D. True breast milk comes in by the 10th day after giving birth.
Mature breast milk typically replaces colostrum by around the 10th day postpartum. This transition provides the newborn with higher volumes of milk containing adequate fat, protein, and calories necessary for growth and development.
A nurse is conducting a well-baby visit with a 4-month-old infant. Which of the following immunizations should the nurse plan to administer to the infant? (Select all that apply)
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MMR
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Polio (IPV)
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Pneumococcal vaccine (PCV)
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Varicella
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Rotavirus vaccine (RV)
Explanation
Correct Answers:
b) Polio (IPV)
c) Pneumococcal vaccine (PCV)
e) Rotavirus vaccine (RV)
Explanation of Correct Answers
b) Polio (IPV)
The inactivated poliovirus vaccine is given at 2 months, 4 months, and again at later intervals. At the 4-month visit, IPV is part of the recommended immunization series.
c) Pneumococcal vaccine (PCV)
The pneumococcal conjugate vaccine is administered at 2 months, 4 months, 6 months, and 12–15 months. The 4-month visit includes this dose to build immunity against Streptococcus pneumoniae.
e) Rotavirus vaccine (RV)
Rotavirus immunization is given orally at 2 months and 4 months (some series also include a 6-month dose, depending on the vaccine brand). The 4-month visit includes this scheduled dose.
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 nurse is teaching a new mother about the nutritional value of breast milk. What information should the nurse include about the number of calories in a fluid ounce?
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12
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20
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24
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30
Explanation
Correct Answer:
B. 20
Explanation of Correct Answer
Human breast milk provides approximately 20 calories per ounce, which supplies the energy needed for growth, metabolism, and development in newborns. This caloric content is the standard used to estimate infant intake and compare with formula. Options A, C, and D either underestimate or overestimate the actual caloric density of breast milk.
A mother asks you how she can judge that her infant is receiving sufficient breast milk. What would be the most appropriate response?
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"You need to weigh the infant before and after each feeding."
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"The infant should sleep at least 3 hours between feedings."
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"The infant should gain weight and have six wet diapers daily."
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"The infant should not become constipated."
Explanation
Correct Answer:
C. "The infant should gain weight and have six wet diapers daily."
Explanation of Correct Answer
Adequate breastfeeding can be assessed by appropriate weight gain and urine output, typically at least six wet diapers per day after the first few days of life. This indicates sufficient milk intake. Weighing before and after feeds (A) is not routinely necessary. Sleeping 3 hours between feeds (B) or avoiding constipation (D) alone are not reliable indicators of adequate milk intake.
During a home visit, the nurse learns that a new mother is experiencing breast engorgement. What should the nurse recommend to help alleviate this problem?
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Discontinuing breastfeeding for 24 hours
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Having her apply lanolin cream to each breast
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Encouraging her to wear a firm-fitting bra
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Decreasing her fluid intake to below 500 ml per 24 hours
Explanation
Correct Answer:
C. Encouraging her to wear a firm-fitting bra
Explanation of Correct Answer
Breast engorgement occurs when the breasts are overly full, often around days 3–5 postpartum. A firm-fitting supportive bra helps relieve discomfort by supporting the breasts and reducing swelling. Discontinuing breastfeeding can worsen engorgement (A), lanolin cream soothes sore nipples but does not reduce engorgement (B), and fluid restriction (D) is unsafe and ineffective. Additional measures include frequent breastfeeding or pumping and warm compresses before feeding to ease milk flow.
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.
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