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. The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant’s postoperative care include which of the following?
  • Cleansing suture line, treating pain, elbow restraints
  • Mouth irrigations, prone position, cleansing suture line
  • Arm restraints, postural drainage, mouth irrigations
  • Supine and side-lying positions, postural drainage, straws for feeding

Explanation

After cleft lip repair (cheiloplasty), the priority nursing goals are to protect the surgical site, maintain cleanliness, and prevent tension or trauma to the incision line. The suture line should be gently cleansed with sterile saline or prescribed solution to prevent crust formation and infection. Pain control is essential to reduce crying, which can strain the incision. Elbow restraints (No-No’s) are used to prevent the infant from touching or rubbing the surgical site. The restraints should be removed periodically for skin checks and range-of-motion exercises.
2. A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments is the nurse's priority immediately after admission?
  • Auscultating the rate and characteristics of the child's heart sounds.
  • Identifying the degree of parental anxiety related to the diagnosis.
  • Assessing the client's erythematous rash.
  • Using a pain-rating tool to determine the severity of the joint pain.

Explanation

The priority assessment in a child with acute rheumatic fever (ARF) is to evaluate for cardiac involvement, which can lead to rheumatic carditis—a potentially life-threatening complication. Rheumatic carditis causes inflammation of the heart valves, myocardium, and pericardium, which can result in new heart murmurs, tachycardia, pericardial friction rub, or signs of heart failure. Immediate cardiac assessment allows early detection and intervention to prevent permanent damage (rheumatic heart disease).
3. 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.
  • Ductus arteriosus
  • Pulmonary veins
  • Umbilical artery
  • Foramen ovale
  • 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.
4. When the nurse is communicating with pediatric patients, which factor is important to consider?
  • Presence or absence of the child’s parent
  • Nonverbal behaviors of the child
  • The child’s physical condition
  • Developmental level of the child

Explanation

When communicating with children, the developmental level is the most important factor to consider because it determines the child’s ability to understand language, express needs, and interpret information. Communication strategies must be tailored to match the child’s cognitive, emotional, and language abilities. For example, a toddler requires simple words and play-based interaction, while a school-age child benefits from concrete explanations and reassurance. Adolescents, on the other hand, need respect for privacy and opportunities for autonomy.
5. Which of the following should the nurse recommend to prevent urinary tract infections in young girls?
  • Limit bathing as much as possible.
  • Wear cotton underpants.
  • Cleanse perineum with water after voiding.
  • Increase fluids; decrease salt intake.

Explanation

The nurse should teach parents and young girls that wearing cotton underpants helps prevent urinary tract infections (UTIs) by allowing better air circulation and moisture absorption, keeping the perineal area dry and reducing bacterial growth. Synthetic fabrics trap heat and moisture, creating an ideal environment for bacteria such as E. coli to multiply. Encouraging proper hygiene and cotton underwear are key prevention strategies.
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?
  • Breast tenderness
  • Intermittent, sharp suprapubic pain
  • Abnormally long heavy menstrual periods
  • 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. A teen patient with cystic fibrosis asks why they need to take vitamins A, D, E, and K daily. Which statement by the patient indicates the best understanding of the teaching?
  • "These vitamins are naturally deficient in most people with my disease."
  • "These vitamins are lost from the body every day, and they need to be supplemented each day."
  • "I lack enzymes which means that these vitamins are not absorbed into my intestines."
  • "The lung part of my disease drains my body of the stores of these vitamins because I make so much mucus."

Explanation

Children and teens with cystic fibrosis (CF) have pancreatic insufficiency, meaning their pancreas does not secrete enough digestive enzymes needed to absorb fat and fat-soluble vitamins (A, D, E, and K). These vitamins are essential for vision, bone health, immune function, and blood clotting. Because fat digestion is impaired, daily supplementation with fat-soluble vitamins in a water-miscible (easily absorbed) form is necessary.
8. 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.
9. The nurse is caring for a patient who is diagnosed with preterm premature rupture of the membranes. Which medication would the nurse anticipate to be ordered IM?
  • Meperidine
  • Oxytocin
  • Ferrous sulfate
  • Betamethasone

Explanation

Betamethasone, a corticosteroid, is administered intramuscularly (IM) to pregnant patients with preterm premature rupture of membranes (PPROM) or risk of preterm delivery (typically between 24–34 weeks gestation). Its purpose is to accelerate fetal lung maturity by stimulating surfactant production in the fetal lungs. This reduces the risk of respiratory distress syndrome (RDS), intraventricular hemorrhage, and neonatal mortality.
10. The parents of a child with Tetralogy of Fallot ask the nurse why the child squats so much. What is the most appropriate response?
  • Will result in reduction of generalized edema
  • It decreases the apical pulse rate.
  • Squatting helps by increasing cardiac demands.
  • This is the body's way of increasing circulation to vital organs.

Explanation

Children with Tetralogy of Fallot (TOF) often experience “tet spells”—episodes of cyanosis and dyspnea caused by decreased oxygenation during exertion. Squatting is an instinctive compensatory mechanism that increases systemic vascular resistance, which helps redirect blood flow from the right-to-left shunt back into the pulmonary circulation. This improves oxygenation and increases blood flow to vital organs, particularly the brain and heart.

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