NURS 217 Fall 25 at Baton Rouge Community College
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Free NURS 217 Fall 25 at Baton Rouge Community College Questions
A patient has delivered an infant by cesarean section. At one minute the heart rate is 90, the infant’s cry is weak, and the limbs are well flexed. The trunk is pink with blue hands and feet. During suctioning, the infant begins to cough. What APGAR score would the nurse assign at one minute?
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9
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7
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10
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6
Explanation
| Category | Finding | Score |
|---|---|---|
| Heart Rate | 90 bpm → Below 100 | 1 |
| Respiratory Effort | Weak cry | 1 |
| Muscle Tone | Well flexed | 2 |
| Reflex Irritability | Coughs with suctioning | 2 |
| Color | Pink trunk, blue extremities (acrocyanosis) | 1 |
Total Score = 1 + 1 + 2 + 2 + 1 = 7
An APGAR score of 7 indicates that the infant is in good condition but may require mild stimulation and continued observation. Scores of 7–10 are considered normal for newborns adjusting to extrauterine life.
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?
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Auscultating the rate and characteristics of the child's heart sounds.
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Identifying the degree of parental anxiety related to the diagnosis.
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Assessing the client's erythematous rash.
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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).
What nursing care should be included in the patient teaching plan for the parents of a 3-month-old diagnosed with gastroesophageal reflux?
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Supplementation of Pedialyte to decrease acid production
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Teach various post-feeding positions
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Discontinuing breast-feeding will minimize reflux episodes
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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.
When a nurse is assessing a patient in the first stage of labor, what is the most conclusive sign that the uterine contractions are effective?
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Increase in the bloody show
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Dilation of the cervix
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Descent of the fetus
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Rupture of the amniotic membranes
Explanation
During the first stage of labor, the primary goal of uterine contractions is cervical effacement and dilation. The most conclusive indicator that contractions are effective is progressive cervical dilation, which confirms that the uterus is contracting with enough strength and regularity to cause mechanical changes in the cervix. As the cervix dilates from 0 to 10 cm, labor progresses toward the second stage.
A physician orders Zithromax for a child that weighs 99 lb. The safe dose range for this medication is 10–12 mg/kg/day. Calculate the safe dosage range the patient can receive per day.
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225–270 mg per day
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225–540 mg per day
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990–1188 mg per day
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450–540 mg per day
Explanation
99 lb ÷ 2.2 = 45 kg (rounded)
Step 2: Multiply weight in kg by the safe dose range.
Low end: 10 mg × 45 kg = 450 mg/day
High end: 12 mg × 45 kg = 540 mg/day
So the safe daily dosage range is 450–540 mg per day.
When the nurse is communicating with pediatric patients, which factor is important to consider?
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Presence or absence of the child’s parent
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Nonverbal behaviors of the child
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The child’s physical condition
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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.
Prescribed: Ibuprofen 60 mg for an infant who weighs 18 pounds (round kg to the nearest hundredth place). Recommended dose: ibuprofen 5–10 mg/kg/dose. What is the minimum safe dose? Record your answer in a whole number.
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36 mg
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41 mg
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45 mg
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50 mg
Explanation
Convert the infant’s weight from pounds to kilograms: 18 ÷ 2.2 = 8.18 kg (rounded to the nearest hundredth). The minimum safe dose is calculated using 5 mg/kg. Multiply 5 × 8.18 = 40.9 mg. When rounded to a whole number, the minimum safe dose is 41 mg.
The nurse walks into a room and the patient is sitting up listening to a tape that describes a very peaceful place. What relaxation technique is the patient using?
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Focal point
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Music
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Imagery
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Effleurage
Explanation
Imagery, also called guided imagery or visualization, is a relaxation technique in which a person focuses their mind on calm, peaceful mental images—such as a beach, forest, or other serene setting—to promote relaxation, reduce anxiety, and decrease pain perception. The patient listening to a tape that describes a peaceful place is using guided imagery to create a sense of calm and control, which can help reduce stress and tension during labor or other procedures.
During a vaginal delivery, the infant’s head is delivered but then retracts tightly against the perineum (“turtle sign”). The provider identifies shoulder dystocia and instructs the nurse to apply suprapubic pressure. The nurse understands that suprapubic pressure is performed for which purposes and with what expected outcomes? Select all that apply.
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To slow the delivery process and prevent perineal tearing.
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To relieve pressure on the umbilical cord and improve fetal oxygenation.
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To reposition the fetal head for easier delivery.
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To compress the uterus and reduce postpartum bleeding.
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To assist with delivery of the infant’s shoulders.
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To help dislodge the anterior shoulder from beneath the symphysis pubis.
Explanation
Suprapubic pressure is used specifically during shoulder dystocia to help deliver the impacted shoulders. Applying firm downward pressure just above the maternal pubic bone assists in rotating the fetal shoulders into an oblique angle, facilitating their passage through the birth canal.
F. To help dislodge the anterior shoulder from beneath the symphysis pubis
The “turtle sign” indicates that the anterior shoulder is stuck behind the maternal symphysis pubis. Suprapubic pressure helps dislodge this shoulder, reducing compression on the fetal neck and brachial plexus and allowing safe delivery.
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?
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Set limits on phone use and texting while in the hospital
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Have the parent bring homework and missed classroom work to the hospital
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Encourage the teen’s friends to visit during hospitalization
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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.
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