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 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?
- A. Auscultate lungs and make preparations for placement in a mist tent
- B. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation
- C. Examine oral pharynx and report to the physician
- D. 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).
2. What nursing care should be included in the patient teaching plan for the parents of a 3-month-old diagnosed with gastroesophageal reflux?
- A. Supplementation of Pedialyte to decrease acid production
- B. Teach various post-feeding positions
- C. Discontinuing breast-feeding will minimize reflux episodes
- D. Insertion of gavage feeding tube for feedings
Explanation
For infants with gastroesophageal reflux (GER), the key nursing teaching focuses on positioning and feeding techniques to minimize regurgitation. Parents should be instructed to keep the infant upright for 20–30 minutes after feeding and avoid placing the baby flat immediately after eating. The infant should also be fed in a semi-upright position and provided smaller, more frequent feedings. These measures help prevent stomach contents from flowing back into the esophagus, reducing discomfort and spit-up episodes.
3. A patient reports abdominal cramping due to dysmenorrhea. Which analgesic would the nurse expect the physician to prescribe?
- A. Demerol
- B. Ibuprofen
- C. Acetaminophen
- D. Aspirin
Explanation
The drug of choice for dysmenorrhea (painful menstruation) is an NSAID such as ibuprofen. Ibuprofen works by inhibiting prostaglandin synthesis, which decreases uterine contractions and relieves cramping and pain. It is most effective when taken at the onset of menstrual discomfort or before symptoms begin.
4. The nurse is performing a respiratory assessment on a 4-month-old. What assessment finding(s) would the nurse document as abnormal?
- A. Unlabored breathing
- B. Rapid rate of 30 breaths per minute
- C. 2–3 seconds of no breathing noted during first minute of auscultation
- D. Flaring of nares and pale discoloration to lips
Explanation
Nasal flaring and pale or bluish discoloration of the lips are abnormal respiratory findings in an infant. They indicate increased work of breathing and possible hypoxemia. Nasal flaring is a compensatory mechanism to increase oxygen intake, while pallor or cyanosis suggests inadequate oxygenation. These signs require immediate nursing intervention—positioning, airway clearance, and possibly supplemental oxygen—to prevent respiratory failure.
5. What should the nurse recognize as the difference between pathologic jaundice and physiologic jaundice?
- A. Nonphysiological jaundice usually results in kernicterus.
- B. Nonphysiological jaundice appears on the head and progresses down the body.
- C. Nonphysiological jaundice appears during the first 24 hours of life.
- D. Nonphysiological jaundice results from breakdown of excessive erythrocytes not needed after birth.
Explanation
Pathologic (nonphysiologic) jaundice is distinguished from normal newborn jaundice by its early onset—appearing within the first 24 hours after birth—and its rapid rise in bilirubin levels. It often results from underlying conditions such as hemolytic disease (Rh or ABO incompatibility), infection, or liver dysfunction. This form of jaundice is abnormal and can progress quickly to bilirubin encephalopathy (kernicterus) if untreated. In contrast, physiologic jaundice typically appears after 24 hours of life (usually days 2–3), peaks by day 3–5, and resolves within a week in term infants. It results from the normal breakdown of fetal red blood cells and the immature neonatal liver’s temporary inability to conjugate bilirubin efficiently.
6. The nurse is preparing to assess a patient who is noted to have a history of dysmenorrhea. The nurse predicts the patient will report which potential symptom during the examination?
- A. Breast tenderness
- B. Intermittent, sharp suprapubic pain
- C. Abnormally long heavy menstrual periods
- D. Chronic pelvic pain
Explanation
Dysmenorrhea refers to painful menstruation resulting from uterine contractions caused by prostaglandin release during the menstrual cycle. The hallmark symptom is cramp-like, intermittent pain located in the suprapubic area (lower abdomen) that may radiate to the lower back or thighs. It typically occurs just before or at the onset of menstruation and lasts 1–3 days. The pain subsides as menstrual flow decreases.
7.
The nurse is caring for a G1P0 patient in labor. How would the nurse interpret the following FHR (Fetal Heart Rate) strip?
- A. Late deceleration
- B. Acceleration
- C. Early deceleration
- D. Variable deceleration
Explanation
The FHR strip shows a temporary increase in fetal heart rate from the baseline that returns to normal after a short period. Accelerations are defined as an increase of at least 15 beats per minute lasting for at least 15 seconds (in fetuses >32 weeks). This pattern indicates fetal well-being and adequate oxygenation, often in response to fetal movement or uterine contractions. Accelerations are reassuring and do not require any intervention.
8. A nurse is caring for a patient during the first trimester of pregnancy. After reviewing the patient’s blood work, the nurse notices she does not have immunity to rubella. Which of the following is the appropriate time for the mother to receive a rubella immunization?
- A. Immediately
- B. In the third trimester
- C. Shortly after giving birth
- D. During her next attempt to get pregnant
Explanation
The rubella (MMR) vaccine is a live attenuated vaccine and therefore contraindicated during pregnancy because it poses a potential risk of fetal infection and congenital rubella syndrome. If a pregnant woman is found to be non-immune, she should be vaccinated postpartum—shortly after delivery and before hospital discharge. This ensures immunity before subsequent pregnancies. Women are advised to avoid pregnancy for at least 1 month after vaccination.
9. A nurse is teaching a group of expectant parents about fetal circulation. The parents ask about the pathways that allow blood to bypass the fetal lungs in utero. Which structures allow blood to bypass the nonfunctional fetal lungs and ensure oxygen-rich blood reaches vital organs? Select all that apply.
- A. Ductus arteriosus
- B. Pulmonary veins
- C. Umbilical artery
- D. Foramen ovale
- E. Umbilical vein
Explanation
A. Ductus arteriosus
The ductus arteriosus is a vital fetal blood vessel that connects the pulmonary artery to the aorta, allowing most blood from the right ventricle to bypass the nonfunctional lungs and flow directly into the systemic circulation. After birth, this structure closes as the newborn begins to breathe and oxygen levels rise.
D. Foramen ovale
The foramen ovale is an opening between the right and left atria of the fetal heart. It allows oxygen-rich blood from the umbilical vein (via the inferior vena cava) to pass directly from the right atrium to the left atrium, bypassing the fetal lungs. After birth, increased left atrial pressure causes it to close and become the fossa ovalis.
E. Umbilical vein
The umbilical vein carries oxygenated blood from the placenta to the fetus, delivering nutrients and oxygen to vital organs. It works in coordination with fetal shunts to ensure that the most oxygen-rich blood reaches the heart and brain.
The ductus arteriosus is a vital fetal blood vessel that connects the pulmonary artery to the aorta, allowing most blood from the right ventricle to bypass the nonfunctional lungs and flow directly into the systemic circulation. After birth, this structure closes as the newborn begins to breathe and oxygen levels rise.
D. Foramen ovale
The foramen ovale is an opening between the right and left atria of the fetal heart. It allows oxygen-rich blood from the umbilical vein (via the inferior vena cava) to pass directly from the right atrium to the left atrium, bypassing the fetal lungs. After birth, increased left atrial pressure causes it to close and become the fossa ovalis.
E. Umbilical vein
The umbilical vein carries oxygenated blood from the placenta to the fetus, delivering nutrients and oxygen to vital organs. It works in coordination with fetal shunts to ensure that the most oxygen-rich blood reaches the heart and brain.
10. A child with a six-day history of an upper respiratory infection is brought to the urgent care center. The health care provider believes the child has bacterial pneumonia. As the nurse reviews the electronic health record, which signs/symptoms would be associated with this disorder? Select all that apply.
- A. Barky cough
- B. Chest pain
- C. Coarse breath sounds
- D. High fever
- E. Chest X-ray indicates infiltrates
- F. Significant drooling
Explanation
B. Chest pain
Chest pain is a common symptom of bacterial pneumonia due to inflammation of lung tissue and the pleura, leading to discomfort or pain that worsens with deep breathing or coughing.
C. Coarse breath sounds
Children with bacterial pneumonia typically exhibit abnormal breath sounds, including crackles, rhonchi, or decreased breath sounds over areas of consolidation from infection and mucus buildup.
D. High fever
A sudden onset of high fever (≥ 102°F or 39°C) is characteristic of bacterial pneumonia, distinguishing it from viral infections, which tend to cause lower-grade fevers.
E. Chest X-ray indicates infiltrates
An X-ray showing patchy or lobar infiltrates confirms bacterial pneumonia, indicating consolidation or pus-filled alveoli in the affected lung segment.
Chest pain is a common symptom of bacterial pneumonia due to inflammation of lung tissue and the pleura, leading to discomfort or pain that worsens with deep breathing or coughing.
C. Coarse breath sounds
Children with bacterial pneumonia typically exhibit abnormal breath sounds, including crackles, rhonchi, or decreased breath sounds over areas of consolidation from infection and mucus buildup.
D. High fever
A sudden onset of high fever (≥ 102°F or 39°C) is characteristic of bacterial pneumonia, distinguishing it from viral infections, which tend to cause lower-grade fevers.
E. Chest X-ray indicates infiltrates
An X-ray showing patchy or lobar infiltrates confirms bacterial pneumonia, indicating consolidation or pus-filled alveoli in the affected lung segment.
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