NUR 404_Exam One
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Free NUR 404_Exam One Questions
A woman who began breastfeeding develops sore nipples. The nurse bases her response on which of the following?
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She will have to discontinue breastfeeding
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To prevent getting an infection, she will need an antibiotic prescribed.
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Exposing her nipples to air after each feeding should help
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Allowing the infant to suck for longer periods during each feeding will toughen her nipples.
Explanation
Correct Answer:
C. Exposing her nipples to air after each feeding should help.
Explanation of Correct Answer
Sore nipples are common in the first days of breastfeeding and can be alleviated by proper latch technique and allowing nipples to air-dry after each feeding. This promotes healing and prevents maceration or irritation. Discontinuing breastfeeding or prolonging feeding is unnecessary, and antibiotics are only needed if there is evidence of infection (e.g., mastitis or fungal infection).
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.
On the first day postpartum, a new mother is concerned that her milk has not yet "come in." The nurse would explain to her that:
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Most mothers do have milk by 1 day postpartum.
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She will not have breast milk until 7 days postpartum.
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Her infant must not be sucking well or she would have milk by now
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Breast milk normally comes in on the third or fourth postpartum day
Explanation
Correct Answer:
D. Breast milk normally comes in on the third or fourth postpartum day.
Explanation of Correct Answer
After birth, mothers first produce colostrum, a nutrient-rich, antibody-dense fluid. Mature breast milk typically "comes in" between postpartum days 3–4 as hormonal changes stimulate milk production. This is a normal physiologic process and not a sign of poor infant feeding or maternal inadequacy. By reassuring the mother, the nurse supports breastfeeding confidence and education.
Immediately following an epidural block, a client's blood pressure falls to 90/50. Which priority action would the nurse take?
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Administer Oxytocin
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Administer 6L oxygen via face mask
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Turn client on their left side and increase intravenous fluids
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Raise the head of the bed and elevate the patient's legs
Explanation
Correct Answer:
C Turn client on their left side and increase intravenous fluids
Explanation of Correct Answer
The priority action for hypotension following an epidural block is to position the client on their left side to enhance venous return and improve uteroplacental perfusion, while also increasing IV fluids to correct hypovolemia. This directly addresses the cause of low blood pressure and prevents fetal compromise. Oxygen may be added later if needed, but repositioning and fluid bolus come first in management.
Which of the following correctly identifies the daily caloric requirement per pound for a newborn?
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50 to 55
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100 to 120
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150 to 170
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200 to 225
Explanation
Correct Answer:
A. 50 to 55
Explanation of Correct Answer
Newborns require approximately 50–55 calories per pound per day to meet their rapid growth and high energy demands. This ensures adequate nutrition to support weight gain, brain development, and organ growth. In metric measurements, this equates to about 100–120 calories per kilogram per day. Options B, C, and D reflect higher ranges that are either incorrectly converted or excessive for a newborn’s needs.
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.
A new parent is distraught and asks the nurse, "Is there something wrong with my newborn? My newborn has a white discharge coming from the breasts." What will the nurse explain to the parent about this discharge?
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It is caused by exposure to cool air.
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It is caused by the pregnant client's hormones.
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The newborn may need chromosomal studies
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It is a sign that the newborn has a pituitary tumor.
Explanation
Correct Answer:
B. It is caused by the pregnant client's hormones.
Explanation of Correct Answer
A white, milky discharge from a newborn’s breasts, sometimes called “witch’s milk,” is a normal finding. It is caused by the transfer of maternal hormones (especially estrogen and prolactin) across the placenta before birth. This discharge is benign, self-limiting, and requires no treatment. It is not linked to environmental exposure, chromosomal problems, or pituitary tumors.
A 40 week primipara client is currently being monitored by external fetal monitoring. The monitor alerts for an ominous sign of fetal hypoxia, the nurse is assessing the strip. Based on the following strip how would the nurse document the fetal heart rate?
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Bradycardia, Moderate variability, Present accelerations, Late decelerations
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Normal baseline, Moderate variability, Absent accelerations, Early decelerations
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Normal baseline, Minimal variability, Present accelerations, Early decelerations
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Normal baseline, Minimal variability, Absent accelerations, Late decelerations
Explanation
Correct Answer:
A Bradycardia, Moderate variability, Present accelerations, Late decelerations
Explanation of Correct Answer
The strip demonstrates a baseline fetal heart rate below 110 bpm, indicating bradycardia. Variability is present and moderate, showing ongoing fetal responsiveness. Accelerations are observed, but most concerning are the late decelerations, which occur after the peak of contractions and are a hallmark sign of uteroplacental insufficiency and fetal hypoxia. This makes option A the correct interpretation.
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.
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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