NUR 4455 Care of Families- Childbearing Nursing Exam 2 Fall 2025 at Florida International University
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Free NUR 4455 Care of Families- Childbearing Nursing Exam 2 Fall 2025 at Florida International University Questions
A nurse is caring for a newborn immediately following birth. After establishing a patent airway, what is the next priority nursing action?
- Administer vitamin K
- Dry and stimulate the newborn
- Administer eye prophylaxis
- Place an identification bracelet on the newborn and mom
Explanation
After ensuring the newborn’s airway is clear and patent, the next priority is to dry and stimulate the newborn. Drying prevents heat loss through evaporation, which is a major risk immediately after birth, as newborns cannot regulate body temperature effectively. Stimulating the infant by rubbing the back or soles helps initiate spontaneous respirations and maintain a healthy heart rate and oxygenation. This step supports both thermoregulation and respiratory adaptation, which are essential for neonatal survival.
When educating a postpartum mother about changes she may experience, the nurse explains that which of the following is a normal adaptation?
- Lochia serosa in 24 hours
- Persistent pain at the episiotomy site for 3 weeks
- Regular bowel habits will return by 3 days postpartum
- Constant elevated blood pressure
Explanation
After delivery, bowel function typically returns within 2–3 days postpartum as peristalsis resumes and abdominal pressure normalizes. Stool softeners, hydration, and ambulation are encouraged to prevent constipation, especially in women with episiotomies or perineal trauma. This is a normal and expected physiological change as the gastrointestinal system recovers from the effects of pregnancy and delivery.
The nurse teaches new parents about normal healing after circumcision. Which observation should the parents report to the provider?
- Slight swelling or redness around the site
- No urine output within 12 hours after procedure
- Yellow crust or film forming over the glans
- A few drops of blood on the diaper
Explanation
After circumcision, the newborn should urinate within 6–12 hours. Failure to void within this time frame may indicate urethral obstruction, swelling, or urinary retention, which requires immediate medical evaluation. Early identification prevents complications such as infection or bladder distention. The nurse should instruct parents to closely monitor for urination after the procedure.
A client 40 weeks in early labor tells the nurse she feels wet. The nurse observes spontaneous rupture of membranes (SROM) with clear fluid. Which nursing action is priority?
- Assist client to the bathroom
- Document uterine contraction pattern
- Prepare the client for delivery
- Evaluate fetal heart tracing
Explanation
After rupture of membranes, the priority nursing action is to assess the fetal heart rate (FHR) to detect signs of fetal distress that may indicate umbilical cord prolapse—a potentially life-threatening emergency. Clear fluid is normal, but the nurse must immediately ensure the cord has not been compressed and that the fetus remains well-oxygenated. Continuous FHR monitoring after SROM helps ensure fetal safety before proceeding with other assessments or documentation.
A nurse is assisting a client who is postpartum with her first breastfeeding experience. When the client asks how much of the nipple she should put into the newborn's mouth, which of the following responses should the nurse make?
- "Your baby's mouth is rather small so the baby will only place their mouth on the nipple."
- "You should place your nipple and the areola into the newborn's mouth."
- "You can supplement with formula since you're having a difficult time."
- "Babies know instinctively how much of the nipple to take into their mouth."
Explanation
For effective breastfeeding, the newborn should latch onto both the nipple and a large portion of the areola, not just the nipple. This deep latch allows the baby’s tongue and gums to compress the lactiferous sinuses beneath the areola, facilitating efficient milk transfer and reducing maternal nipple soreness or damage. The baby’s lips should be flanged outward, and the chin should touch the breast. This ensures a proper seal and effective milk removal.
When assessing a multiparous woman who has just given birth to an 8-pound boy 15 minutes ago, the nurse notes that the woman's fundus has become globular in shape and a gush of dark red blood comes from her vagina. What is the nurse's interpretation of these findings?
- A cervical tear occurred during the birth
- The placenta has separated
- Clots have formed in the upper uterine segment
- The woman is beginning to hemorrhage
Explanation
A globular-shaped uterus, lengthening of the umbilical cord, and a gush of dark red blood are classic signs that the placenta has separated from the uterine wall—a normal and expected event in the third stage of labor. The dark color of the blood indicates it is from placental separation, not active bleeding. The nurse should assist with controlled cord traction as prescribed and monitor for complete placental delivery and firm uterine contraction afterward.
A postpartum client delivered by cesarean section 1 day ago. The mother’s blood type is O negative and the newborn’s blood type is B positive. Which of the interventions should the nurse perform?
- Administer Rhogam within 72 hours
- Keep client NPO
- Document the blood types and take no action
- Prepare a blood transfusion to be administered
Explanation
Because the mother is Rh-negative (O−) and the newborn is Rh-positive (B+), the mother is at risk for developing Rh antibodies against the baby’s red blood cells. To prevent this, the nurse must administer Rh immune globulin (Rhogam) within 72 hours after delivery. Rhogam prevents maternal sensitization by destroying fetal Rh-positive red blood cells that may have entered the mother’s circulation, thereby protecting future pregnancies from hemolytic disease of the newborn.
A nurse is caring for a client who is breastfeeding and states that her nipples are sore. Which of the following interventions should the nurse recommend?
- Teach proper breastfeeding techniques and positions
- Keep the nipples covered between breastfeeding sessions
- Apply petroleum jelly to the nipples between feedings
- Advise mother to stop breastfeeding until nipple soreness resolves
Explanation
Nipple soreness is most often caused by improper latch or positioning during breastfeeding. The priority nursing intervention is to teach and correct breastfeeding techniques—ensuring the baby takes in both the nipple and part of the areola for a deep latch. Changing feeding positions (e.g., football hold, cradle hold, side-lying) also helps distribute pressure on the nipples. The nurse can additionally recommend expressing colostrum or breast milk and letting it air-dry on the nipples to promote healing.
A laboring woman experienced SROM (spontaneous rupture of membranes) 18 hours ago. Her temperature is now 100.8°F (38.2°C), and the amniotic fluid has a foul odor. What complication should the nurse suspect?
- Uterine atony
- Placental abruption
- Fetal acidosis
- Chorioamnionitis
Explanation
Chorioamnionitis is an infection of the amniotic fluid, membranes, placenta, or decidua that typically develops after prolonged rupture of membranes (PROM or SROM >18 hours). Bacteria ascend from the vagina into the uterine cavity, leading to infection. Common signs include maternal fever (≥100.4°F or 38°C), uterine tenderness, maternal or fetal tachycardia, and foul-smelling amniotic fluid. This is a serious condition requiring broad-spectrum IV antibiotics and close monitoring of both mother and fetus.
A nurse is caring for a postpartum client and is explaining the process of involution. Which of the following statements is true?
- Postpartum uterus returns to its pre-pregnancy size by 8 weeks postpartum
- At the end of the third stage of labor, the postpartum uterus is positioned 3 cm above the umbilicus
- The decline of estrogen and progesterone causes self-destruction of excess uterine tissue
- After 2 weeks postpartum, the uterus can be palpated above the symphysis pubis
Explanation
Involution is the process by which the uterus returns to its pre-pregnancy size and condition after childbirth. The drop in estrogen and progesterone levels after delivery triggers autolysis, a process where excess hypertrophied uterine muscle cells self-digest and shrink. This hormonal shift enables the uterus to contract, decrease in size, and shed remaining tissue. By about 6 weeks postpartum, the uterus has typically returned to its pre-pregnancy size.
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