NUR 404_Exam One
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Free NUR 404_Exam One Questions
During a home visit, a new mother tells the nurse that her nipples are sore from breastfeeding. What should the nurse instruct the mother at this time? Select all that apply.
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Insert plastic liners into the nursing bra.
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Apply petroleum jelly to the nipples before feeding.
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Expose the nipples to air so the nipple dries.
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Position the baby differently for each feeding.
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Massage a few drops of breast milk to the areola.
Explanation
Correct Answers:
C. Expose the nipples to air so the nipple dries.
D. Position the baby differently for each feeding.
E. Massage a few drops of breast milk to the areola.
Explanation of Correct Answers
C. Expose the nipples to air so the nipple dries.
Allowing nipples to air-dry after breastfeeding promotes healing and reduces irritation.
D. Position the baby differently for each feeding.
Adjusting the infant’s latch and position helps prevent pressure on the same areas and reduces soreness.
E. Massage a few drops of breast milk to the areola.
Breast milk contains healing properties that can soothe and protect irritated nipples.
The nurse is giving report to a student about a newborn they suspect has toxoplasmosis. Which statement by the student on how and when the infection was transmitted to the newborn does not require further teaching?
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Through a prolonged rupture of membranes
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In the postpartum period through infected droplets
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During birth as the fetus was expelled through the vaginal canal
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In utero through the placenta
Explanation
Correct Answer:
D In utero through the placenta
Explanation of Correct Answer
Toxoplasmosis is a congenital infection transmitted when the mother acquires the parasite Toxoplasma gondii during pregnancy. The organism crosses the placenta and infects the fetus in utero. Transmission does not occur through droplets, prolonged rupture of membranes, or exposure in the birth canal. Placental transfer is the classic and only correct mode of congenital toxoplasmosis transmission, which can lead to fetal complications such as hydrocephalus, chorioretinitis, and intracranial calcifications
A new mother is ambivalent about breastfeeding and agrees to do it for at least 3 months. What response should the nurse provide to the client at this time that would support the 2030 National Health Goals?
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Breastfeeding helps the mother return to prepregnancy weight faster.
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Three months is the recommended time frame for the baby's nutrition.
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Breast milk can be donated so that preterm infants can have additional nutrition.
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Six months to 1 year of age is the best time frame to support
Explanation
Correct Answer:
D. Six months to 1 year of age is the best time frame to support
Explanation of Correct Answer
The 2030 National Health Goals emphasize exclusive breastfeeding for the first 6 months of life and continued breastfeeding along with complementary foods up to 1 year or longer. Encouraging the mother to aim for 6–12 months supports optimal infant nutrition, immunity, and bonding. While breastfeeding may help maternal weight loss (A) or allow milk donation (C), the primary public health goal focuses on the duration and exclusivity of breastfeeding. Option B (3 months) is shorter than recommended.
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 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.
A breastfeeding mother asks the nurse how long her baby should breastfeed at each breast after she is home. What would be the nurse's best answer?
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No longer than 3 minutes each feeding to prevent soreness
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The average baby empties a breast in 15 minutes
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At least a half-hour at each breast to ensure emptying
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1 or 2 minutes is an average time interval
Explanation
Correct Answer:
B. The average baby empties a breast in 15 minutes.
Explanation of Correct Answer
Most infants effectively empty one breast in about 15 minutes, though this can vary depending on the infant’s sucking pattern and the mother’s milk flow. This ensures the baby receives both foremilk (for hydration) and hindmilk (rich in fat and calories). Very short feeding times (1–3 minutes) are insufficient, while insisting on 30 minutes per breast is unnecessary and may lead to maternal fatigue or nipple soreness.
A nurse is performing a developmental screening on a 10-month-old infant. Which of the following fine motor skills should the nurse expect the infant to perform? (Select all that apply)
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Grasp a rattle by the handle
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Try building a two-block tower
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Use a crude pincer grasp
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Place objects into a container
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Walks with one hand held
Explanation
Correct Answers:
a) Grasp a rattle by the handle
c) Use a crude pincer grasp
Explanation of Correct Answers
a) Grasp a rattle by the handle
By around 10 months, infants can pick up and hold a rattle by the handle, showing improved hand-eye coordination and grip strength.
c) Use a crude pincer grasp
At 9–10 months, infants begin using a crude pincer grasp (thumb and index finger) to pick up small objects, a key developmental milestone in fine motor skills.
A new mother asks the nurse, "Are there any medicines that I can or cannot take since I'm breastfeeding?" Which response by the nurse would be best?
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"Always check with your provider because almost all drugs are excreted to some extent in breast milk."
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"You can take medicines but stop breastfeeding for 1 week after taking it."
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"It shouldn't be a problem if you take any common over-the-counter medicines."
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"You need to stay away from any opioid pain medicines and sedatives while breastfeeding."
Explanation
Correct Answer:
A. "Always check with your provider because almost all drugs are excreted to some extent in breast milk."
Explanation of Correct Answer
Most medications pass into breast milk to some degree, and their safety depends on the specific drug, dosage, and timing. Mothers should always consult their healthcare provider before taking any medication while breastfeeding. Blanket statements about over-the-counter drugs (C) or avoiding opioids and sedatives (D) are incomplete, and stopping breastfeeding for a week (B) is unnecessary for most medications. Individual evaluation ensures infant safety.
The nurse assesses a newborn's Apgar score at birth and documents that it is normal. Which score did the nurse most likely record?
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1
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4
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8
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13
Explanation
Correct Answer:
C. 8
Explanation of Correct Answer
The Apgar score ranges from 0 to 10, with five categories (appearance, pulse, grimace, activity, and respiration) each scored 0–2. A score of 7 to 10 is considered normal and indicates the newborn is making a good transition to extrauterine life. A score of 1 or 4 suggests distress requiring intervention, while 13 is impossible since the maximum score is 10
A client who is pregnant is screened for Group B streptococcus. Which steps would the nurse include in the plan of care related to the screening and management of this disorder? Select all that apply.
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Provide intravenous penicillin during labor
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Offer intravenous prophylaxis to those clients not screened
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Withhold treatment for clients with cesarean sections if their membranes ruptured
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Provide ten days of antibiotics to clients postpartum
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Schedule oral antibiotics to the neonate
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Screen all clients at 35-38 weeks' gestation
Explanation
Correct Answers:
A Provide intravenous penicillin during labor
B Offer intravenous prophylaxis to those clients not screened
F Screen all clients at 35-38 weeks' gestation
Explanation of Correct Answers
A Provide intravenous penicillin during labor
Intrapartum IV penicillin is the gold standard for preventing early-onset neonatal GBS infection. Administering antibiotics during labor reduces vertical transmission by suppressing bacterial colonization in the birth canal at the time of delivery.
B Offer intravenous prophylaxis to those clients not screened
If a client’s GBS status is unknown at the onset of labor, prophylactic antibiotics are recommended due to the risk of neonatal infection. This approach prevents delays in protection and reduces morbidity associated with undetected colonization.
F Screen all clients at 35-38 weeks' gestation
Universal screening during late pregnancy identifies colonized women at the time closest to delivery, improving the accuracy of results. Screening at 35–37 weeks (up to 38 in some protocols) ensures that prophylaxis is directed to those truly at risk.
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