NURS 217 Fall 25 at Baton Rouge Community College
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Free NURS 217 Fall 25 at Baton Rouge Community College Questions
1. A 16-year-old is admitted for two weeks of IV antibiotic therapy. Which action by the nurse will most enhance this patient’s psychosocial development?
- Set limits on phone use and texting while in the hospital
- Have the parent bring homework and missed classroom work to the hospital
- Encourage the teen’s friends to visit during hospitalization
- Allow time to walk around the unit or outside
Explanation
According to Erikson’s stages of psychosocial development, adolescents (ages 12–18) are in the stage of identity versus role confusion. Peer relationships are crucial for developing a sense of self and belonging. Encouraging visits from friends supports social connection, emotional well-being, and a sense of normalcy during hospitalization, which promotes healthy psychosocial adjustment and self-identity.
2. A nurse is discussing postpartum depression with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of this condition?
- “Postpartum depression usually begins 48 hours after childbirth.”
- “The most common manifestation of postpartum depression is harming the infant.”
- “It’s common for clients who have postpartum depression to exhibit psychotic behavior.”
- “Postpartum depression is more likely to occur in women who have a history of depression.”
Explanation
Postpartum depression (PPD) is a mood disorder that typically develops within 2 to 6 weeks after delivery, though it can appear anytime within the first year postpartum. Women with a personal or family history of depression or mood disorders are at a significantly higher risk. Other risk factors include lack of social support, hormonal changes, and stressful life events. Early recognition and treatment are critical to prevent worsening symptoms and to support maternal–infant bonding.
3. What distinguishing manifestation of spasmodic croup should parents be taught to identify?
- Dysphagia
- Audible wheezing
- High fever
- Harsh, barking cough
Explanation
Spasmodic croup is a viral respiratory condition that causes inflammation and swelling of the larynx and trachea, leading to airway obstruction. Its most distinctive feature is a sudden onset of a harsh, barking cough, often described as “seal-like.” It typically occurs at night, with minimal or no fever, and may be accompanied by hoarseness and inspiratory stridor. The episodes often resolve spontaneously or improve with exposure to cool or humidified air.
4. A newborn is 12 hours old and is being assessed in the nursery. The nurse is reviewing risk factors for hyperbilirubinemia and preparing to educate the parents. Which infant is at highest risk for developing hyperbilirubinemia?
- Breastfed immediately after birth
- Mother is Rh positive
- Developed a cephalhematoma during delivery
- Delivered at 39 weeks gestation
Explanation
A cephalhematoma is a collection of blood between the skull and the periosteum that results from birth trauma. As the pooled blood breaks down, excess bilirubin is released into the bloodstream, increasing the risk for hyperbilirubinemia. The immature newborn liver may be unable to process this large bilirubin load, leading to visible jaundice. These infants require close monitoring for rising bilirubin levels and may need phototherapy if bilirubin becomes excessive.
5. A 20-year-old primigravida at 34 weeks gestation is admitted to the labor and delivery unit with severe preeclampsia. Assessment findings: Blood pressure: 168/110 mmHg Pulse: 92 bpm Edema: Severe in hands, face, and lower extremities Complaints: Severe headache, blurred vision, right upper quadrant pain Fetal heart rate: 150 bpm, reactive but baseline variability decreased The provider orders magnesium sulfate infusion for seizure prophylaxis and antihypertensive therapy. Which nursing interventions are appropriate for this patient? Select all that apply.
- Encourage ambulation to reduce edema
- Administer magnesium sulfate as prescribed
- Monitor vital signs and deep tendon reflexes frequently
- Pad bed rails for seizure precautions
- Maintain quiet environment, low-stimulus room
Explanation
B. Administer magnesium sulfate as prescribed
Magnesium sulfate is the drug of choice for seizure prophylaxis in severe preeclampsia. It depresses the central nervous system, helping to prevent eclamptic seizures. The nurse must ensure correct infusion rates and monitor for signs of toxicity such as loss of reflexes, respiratory depression, or decreased urine output.
C. Monitor vital signs and deep tendon reflexes frequently
Frequent monitoring of vital signs, reflexes, and urine output is crucial because magnesium sulfate can cause respiratory depression, hypotension, and CNS depression if levels become toxic. The nurse should also assess for decreasing reflexes, which can be an early indicator of toxicity.
D. Pad bed rails for seizure precautions
Severe preeclampsia can progress to eclampsia, characterized by seizures. Padding the side rails and keeping emergency airway equipment nearby helps ensure patient safety if a seizure occurs.
E. Maintain quiet environment, low-stimulus room
A quiet, dark, low-stimulation environment reduces sensory overload that can precipitate seizures in patients with preeclampsia. Reducing noise and light helps calm the central nervous system.
Magnesium sulfate is the drug of choice for seizure prophylaxis in severe preeclampsia. It depresses the central nervous system, helping to prevent eclamptic seizures. The nurse must ensure correct infusion rates and monitor for signs of toxicity such as loss of reflexes, respiratory depression, or decreased urine output.
C. Monitor vital signs and deep tendon reflexes frequently
Frequent monitoring of vital signs, reflexes, and urine output is crucial because magnesium sulfate can cause respiratory depression, hypotension, and CNS depression if levels become toxic. The nurse should also assess for decreasing reflexes, which can be an early indicator of toxicity.
D. Pad bed rails for seizure precautions
Severe preeclampsia can progress to eclampsia, characterized by seizures. Padding the side rails and keeping emergency airway equipment nearby helps ensure patient safety if a seizure occurs.
E. Maintain quiet environment, low-stimulus room
A quiet, dark, low-stimulation environment reduces sensory overload that can precipitate seizures in patients with preeclampsia. Reducing noise and light helps calm the central nervous system.
6. A nurse is caring for a patient who is receiving epidural analgesia during labor. Which of the following findings is the nurse’s priority?
- The patient reports weakness of the lower extremities
- Blood pressure 80/56 mm Hg
- The patient reports profuse itching
- Temperature 38.2°C (100.8°F)
Explanation
A blood pressure of 80/56 mm Hg indicates maternal hypotension, the most serious and common complication of epidural analgesia. The local anesthetic can cause vasodilation and decreased venous return, leading to reduced placental perfusion and fetal hypoxia. This makes hypotension an immediate priority because it endangers both the mother and fetus.
The nurse should act promptly by repositioning the patient on her left side, increasing IV fluids, and notifying the provider. If ordered, administer a vasopressor (e.g., ephedrine) and monitor fetal heart rate for signs of distress.
The nurse should act promptly by repositioning the patient on her left side, increasing IV fluids, and notifying the provider. If ordered, administer a vasopressor (e.g., ephedrine) and monitor fetal heart rate for signs of distress.
7. A child has been admitted to the emergency department in status epilepticus. What is the priority nursing intervention?
- Restrain patient for protection
- Administer valium as ordered
- Maintain patent airway
- Begin oxygen therapy
Explanation
In status epilepticus, the child experiences continuous or recurrent seizures without regaining consciousness. The priority is to maintain a patent airway because prolonged seizures can cause hypoxia, aspiration, and respiratory arrest. Ensuring airway patency prevents obstruction from the tongue, secretions, or vomitus and allows for adequate oxygenation before administering medications or other interventions. After securing the airway, oxygen and medication therapy can be initiated as prescribed.
8. The nurse is caring for a 2-year-old child who has a heart defect immediately after a cardiac catheterization. Which of the following actions should the nurse take?
- Elevate the affected extremity
- Perform range of motion
- Palpate pulses below the catheterization site
- Limit fluid intake
Explanation
After a cardiac catheterization, the nurse’s priority is to assess circulation to the extremity used for catheter insertion. This is done by palpating the pulses distal to the insertion site (usually the dorsalis pedis and posterior tibial pulses if the femoral artery was used). Comparing these with the unaffected leg helps detect early signs of arterial obstruction or thrombus formation. The nurse should also monitor the insertion site for bleeding or hematoma formation and keep the affected extremity straight for 4–8 hours post-procedure to prevent complications.
9. A 4-year-old is brought to the emergency room with a “frog-like” croaking sound on inspiration, agitation, drooling, and insisting on sitting upright. The nurse should take which action?
- Auscultate lungs and make preparations for placement in a mist tent
- Notify the physician immediately and be prepared to assist with a tracheostomy or intubation
- Examine oral pharynx and report to the physician
- Administer oxygen via face mask
Explanation
These symptoms—drooling, agitation, dysphonia (croaking sound), and tripod positioning—are classic signs of acute epiglottitis, a life-threatening upper airway obstruction typically caused by Haemophilus influenzae type B (Hib). The nurse’s priority is to maintain airway patency. The child should not be disturbed or forced to lie down, as this can trigger complete airway occlusion. The nurse must immediately notify the physician and prepare for emergency airway management (intubation or tracheostomy).
10. The school nurse is teaching parents about Erikson’s theory of psychosocial development. The school-age child (8 years old) who is struggling academically is at risk for a negative response to which developmental task?
- Self-identity
- Autonomy
- Industry
- Trust
Explanation
According to Erikson’s stage of Industry vs. Inferiority (ages 6–12), school-age children develop a sense of industry by learning new skills, achieving goals, and receiving recognition for their accomplishments. Success in this stage leads to feelings of competence and confidence. However, a child who struggles academically or fails to meet expectations may develop feelings of inferiority, doubting their abilities and self-worth. Encouragement, positive feedback, and support are essential to promote industry and prevent negative self-concept development.
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