NUR 404_Exam One
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Free NUR 404_Exam One Questions
A 39 week and 2 day client is currently in the second stage of labor. The nurse is explaining to the client and support partner what is seen on the external fetal monitor. What deceleration pattern is a normal finding in the second stage of labor?
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Early deceleration indicative of fetal increased intracranial pressure
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Present decelerations indicative of passage through the cervix
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Absent deceleration indicative good fetal movement
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Variable deceleration indicative of umbilical cord compression
Explanation
Correct Answer:
A Early deceleration indicative of fetal increased intracranial pressure
Explanation of Correct Answer
Early decelerations are considered a normal finding during the second stage of labor. They occur due to fetal head compression as the baby descends through the birth canal. This compression temporarily increases intracranial pressure, leading to a vagal response that causes a gradual decrease in the fetal heart rate. They mirror uterine contractions and are not associated with fetal distress. This is expected and reassuring in the second stage of labor.
The nurse notices that a newborn has a white discharge from his breasts. The nurse would explain to his parents that this is:
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Caused by his mother's hormones.
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A suggestion he may need chromosomal studies.
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A sign that he has a pituitary tumor
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Caused by exposure to cool air.
Explanation
Correct Answer:
A. Caused by his mother's hormones.
Explanation of Correct Answer
A small amount of white, milky breast discharge in newborns, sometimes called “witch’s milk,” is a benign and expected finding. It occurs due to the influence of maternal hormones (estrogen and prolactin) that crossed the placenta before birth. This usually resolves spontaneously within a few weeks and does not require treatment. It is not linked to chromosomal issues, tumors, or temperature changes.
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
When caring for a newborn several hours after birth, what would the nurse assess as a normal newborn's respiratory rate?
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12 to 16 breaths/min
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16 to 20 breaths/min
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20 to 30 breaths/min
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30 to 60 breaths/min
Explanation
Correct Answer:
D. 30 to 60 breaths/min
Explanation of Correct Answer
The normal respiratory rate for a newborn is 30 to 60 breaths per minute, often irregular with periods of apnea lasting less than 20 seconds. This reflects the newborn’s immature respiratory control. Rates below 30 may indicate respiratory depression, while sustained rates above 60 suggest tachypnea, often linked to respiratory distress or infection.
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.
A nurse is educating the caregiver of a 9-month-old baby about dental hygiene and teething. Which of the caregiver's statements below best reflects their comprehension of the lesson?
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"I can give my baby a warm teething ring to relieve discomfort"
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"I should clean my baby's teeth with a cool, wet wash cloth"
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"I can give Advil for up to 5 days while my baby is teething"
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"I should place diluted juice in the bottle my baby drinks while falling asleep"
Explanation
Correct Answer:
b) "I should clean my baby's teeth with a cool, wet wash cloth"
Explanation of Correct Answer
Using a cool, wet washcloth to clean a 9-month-old’s teeth and gums is appropriate oral care and helps maintain hygiene while soothing discomfort from teething. It is a safe and recommended method before introducing a toothbrush.
Warm teething rings are discouraged (cold is preferred for comfort), ibuprofen (Advil) should not be given to infants under 6 months and never for extended unsupervised use, and juice in a bedtime bottle increases the risk of dental caries.
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.
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.
Which question is most important to ask a client who arrives to the birthing unit with birth imminent?
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When did your contractions begin
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When is your baby's expected due date
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Have your membranes ruptured
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Is this your first pregnancy
Explanation
Correct Answer:
C Have your membranes ruptured
Explanation of Correct Answer
When birth is imminent, determining whether the membranes have ruptured is a priority because ruptured membranes increase the risk of infection and may lead to cord prolapse, especially if the presenting part is not engaged. This assessment directly affects immediate care decisions to ensure both maternal and fetal safety. While contraction history, due date, and parity are relevant, they are not as urgent in the critical moment of an imminent delivery.
The nurse is visiting a new mother who has been home with a new infant for 4 days. Which observation indicates that the mother's home environment was inadequately assessed prior to being discharged from the hospital?
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The baby has a changing area.
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The kitchen has a refrigerator
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The windows are covered with screens.
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The baby sleeps with the mother in bed.
Explanation
Correct Answer:
D. The baby sleeps with the mother in bed.
Explanation of Correct Answer
Safe sleep practices recommend that newborns sleep in their own crib, bassinet, or safe sleep surface, placed on their back, without pillows or blankets, to reduce the risk of sudden infant death syndrome (SIDS) and suffocation. Observing that the baby sleeps with the mother in bed indicates that safe sleep guidance was not adequately addressed before hospital discharge. The other observations reflect an adequate and safe home environment.
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