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 mother recalls from prenatal class that she should try to feed her newborn daughter when she exhibits feeding readiness cues. Which feeding cue would indicate that the baby is ready to eat?
- Positive Moro reflex
- Crying
- Has the hiccups
- Makes hand-to-mouth motions
Explanation
Early feeding cues indicate that a newborn is ready to eat before becoming distressed. One of the most reliable early signs is when the baby brings hands to the mouth, roots, sucks on fingers, or turns the head toward stimuli (rooting reflex). Feeding at this stage promotes a calm feeding experience and effective latch. Waiting until the baby cries (a late cue) can make feeding more difficult because the infant is often too upset to coordinate sucking and swallowing.
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.
Which client is most likely to experience strong and uncomfortable afterpains?
- A woman who is bottle-feeding her infant
- A woman who experienced oligohydramnios
- A woman whose infant weighed 5 pounds, 3 ounces
- A client who delivered twins
Explanation
Afterpains are intermittent uterine contractions that occur as the uterus involutes (shrinks back to its pre-pregnancy size). They are caused by the release of oxytocin, which stimulates uterine contractions. Afterpains are more intense in women with overdistended uteri, such as those who delivered twins, a large baby, or had polyhydramnios. The uterus must contract more forcefully to regain its normal tone, leading to stronger and more uncomfortable cramping.
The mother who is bottle-feeding should be taught to expect which changes to the condition of the breasts?
- Engorgement lasts for 12 hours
- In nonlactating mothers, colostrum is present for the first few days after childbirth
- Lactogenesis 2 is the first stage to prepare for milk production
- Little change occurs to the breasts in 72 hours
Explanation
Even in nonlactating (bottle-feeding) mothers, the breasts naturally produce colostrum for the first few days after birth due to hormonal changes following delivery. Around day 3 postpartum, the breasts may become engorged—firm, swollen, and tender—as milk production briefly begins. This discomfort typically resolves within 24–48 hours if stimulation is avoided. The nurse should advise the mother to wear a supportive bra, avoid nipple stimulation, apply cold compresses, and not express milk, as this will suppress lactation and relieve symptoms faster.
A nurse is educating a new and excited mother about breastfeeding. The nurse explains that the best time to initiate breastfeeding is:
- Within the first hour after birth which is considered the "golden hour"
- After the newborn’s first bath
- When the newborn is 24 hours old
- When the mother feels fully rested
Explanation
The first hour after birth, known as the “golden hour,” is the optimal time to begin breastfeeding. During this period, the newborn is awake, alert, and has a strong sucking reflex, making it the ideal time to establish the first latch. Early initiation promotes bonding, thermoregulation, and stimulation of oxytocin release, which helps the uterus contract and reduce postpartum bleeding. It also enhances long-term breastfeeding success and colostrum intake for the infant’s immune protection.
Which statement by a newly delivered woman who is breastfeeding indicates that she understands what to expect regarding her menstrual activity after childbirth?
- The client’s first menstrual cycle will be lighter upon return
- The client will not have a menstrual cycle for 6 months after birth
- Breastfeeding with formula supplementation will delay ovulation
- Breastfeeding frequency and duration influences the return of menstruation
Explanation
The return of menstruation after childbirth varies among breastfeeding women and is influenced by how often and how long the infant nurses. Frequent, exclusive breastfeeding delays the return of ovulation and menstruation through suppression of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) due to elevated prolactin levels. However, once breastfeeding frequency decreases or formula is introduced, hormonal suppression lessens, and menstruation may return sooner.
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 giving instructions for formula preparation. Which statement from the client indicates teaching was effective?
- "Formula can last up to 24 hours after being mixed with sterile water."
- "I can store an unopened bottle of formula at room temperature."
- "I can feed the baby leftover formula from the last feeding 3 hours ago."
- "I can warm the formula in the microwave because it's faster."
Explanation
Prepared infant formula should be refrigerated immediately after mixing and can be safely stored for up to 24 hours before feeding. This prevents bacterial growth and ensures nutritional safety for the newborn. Formula should be discarded after 24 hours if unused. When ready to feed, it should be warmed in a bowl of warm water, not microwaved.
The nurse is reviewing bottle-feeding techniques with a new mom. Which statement by the mom indicates additional teaching is needed?
- "I will keep the nipple filled with formula."
- "The baby needs to be upright while bottle feeding."
- "I will use a pillow to hold the bottle upright in the baby's mouth."
- "I will do skin-to-skin while feeding my baby."
Explanation
Using a pillow or prop to hold a bottle is unsafe and indicates a need for further teaching. This practice can cause aspiration, choking, ear infections, and tooth decay, and it prevents bonding between parent and baby. The baby should always be held during feeding, with the bottle manually supported to control the flow of milk and allow for eye contact and interaction.
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.
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