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 new father wants to know what medication was put into his infant’s eyes and why it is needed. The nurse explains the purpose of Erythromycin is to:
- Erythromycin prevents potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes
- Erythromycin ophthalmic ointment destroys an infectious exudate caused by Staphylococcus that could make the infant blind
- This ointment prevents the infant's eyelids from sticking together and helps the infant see
- This ophthalmic ointment prevents gonorrheal infection of the infant's eyes, potentially acquired from the birth canal
Explanation
Erythromycin ophthalmic ointment is administered to all newborns within 1–2 hours after birth as a prophylactic treatment to prevent ophthalmia neonatorum, an eye infection caused primarily by Neisseria gonorrhoeae and, to a lesser extent, Chlamydia trachomatis. These infections can be transmitted as the baby passes through the birth canal and, if untreated, can lead to severe conjunctivitis and blindness. The ointment provides protection regardless of the mother’s known infection status.
A 37-week primigravida tells the nurse, "I feel like my baby dropped. I can finally take a deep breath again, but now I have to go to the bathroom all the time." Which nursing response is most appropriate?
- "This is a normal sign that your body is getting ready for labor."
- "You may have a urinary tract infection."
- "You should go to the hospital right away."
- "You should avoid walking to prevent preterm labor."
Explanation
The client is describing lightening, a normal event that occurs near term (around 37 weeks) when the fetus descends into the pelvis in preparation for birth. This shift relieves pressure on the diaphragm—making it easier to breathe—but increases pressure on the bladder, leading to more frequent urination. Lightening is a reassuring sign that the body is preparing for labor and does not require medical intervention.
A labor and delivery nurse is caring for a 26-year-old G1P0 client who was admitted in active labor. The provider has ordered vaginal exams as indicated. In which of the following situations would the nurse appropriately perform a vaginal exam?
- Before administering analgesic or anesthetic medications
- When the membranes rupture or an abnormal fetal heart rate pattern is observed
- On admission to determine baseline cervical dilation and effacement
- Every hour to check for progression of labor
- The client is positive for GBS
Explanation
B. When the membranes rupture or an abnormal fetal heart rate pattern is observed: A vaginal exam is appropriate when membranes rupture to assess for cord prolapse and confirm fetal presenting part engagement. It is also indicated when an abnormal fetal heart rate pattern occurs to identify possible cord compression or rapid labor progression.
C. On admission to determine baseline cervical dilation and effacement: A vaginal exam upon admission establishes a baseline cervical status (dilation, effacement, and fetal station). This information guides labor management and helps determine whether the client is in true labor.
Ten minutes after placental delivery, the nurse notes a soft, boggy uterus and a steady trickle of bright red blood. What is the nurse’s first action?
- Notify the provider immediately
- Begin fundal massage
- Prepare the client for surgery
- Administer IV Pitocin
Explanation
A soft, boggy uterus after placental delivery indicates uterine atony, the leading cause of postpartum hemorrhage. The first nursing action is to massage the fundus firmly until it becomes firm and contracted. This stimulates uterine contraction, compresses open blood vessels at the placental site, and helps control bleeding. After massaging, the nurse reassesses uterine tone and amount of bleeding before proceeding with additional interventions.
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 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 assesses a client’s uterus during contractions and notes that it becomes firm with each contraction, lasting 45 seconds, and softens completely between contractions. Cervical change from 4 cm to 6 cm is noted. What does this indicate?
- False labor
- Placental abruption
- Uterine tachystole
- True labor
Explanation
True labor is characterized by regular uterine contractions that increase in frequency, duration, and intensity and lead to progressive cervical change (dilation and effacement). In this case, the uterus becomes firm with contractions lasting 45 seconds, softens between contractions, and the cervix has changed from 4 cm to 6 cm—clear evidence that the labor is active and genuine. True labor contractions result in the descent of the fetus and cervical dilation.
A newborn is lying in a crib near an exterior wall and large window in winter. The infant's temperature is 97.0°F (36.1°C). Which heat loss mechanism is responsible?
- Convection
- Radiation
- Evaporation
- Conduction
Explanation
Radiation heat loss occurs when heat transfers from the newborn’s warm body to cooler solid objects nearby, such as cold walls or windows, even without direct contact. In this case, the infant is losing body heat to the cold window and wall surfaces due to the temperature difference. Radiation can be prevented by keeping the crib away from exterior walls or windows and maintaining a warm room temperature.
The nurse is assessing an infant’s heart rate who woke up crying for 5 minutes. The infant’s heart rate is 170 bpm. When would it be appropriate for the nurse to reassess the infant’s heart rate?
- During the next deep sleep cycle
- After the infant is in a quiet alert state
- Immediately
- 2 hours later
Explanation
An infant’s heart rate temporarily increases with crying, activity, or agitation. A heart rate of 170 bpm during crying is within normal limits for an active newborn (normal resting HR: 110–160 bpm). The nurse should reassess once the infant has calmed down and entered a quiet alert state, when the heart rate will more accurately reflect the baseline resting rate. This ensures a valid assessment free from transient activity-related changes.
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.
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