Nursing Final Exam Questions with Answers, Exams of Nursing

Download Nursing Final Exam Questions with Answers and more Exams Nursing in PDF only on Docsity! NURSING FINAL EXAM QUESTIONS WITH ANSWERS LATEST UPDATE 2023-2024  Question 1 The perinatal nurse prepares the laboring woman for an epidural anesthesia insertion. In order to prevent maternal hypotension, the nurse: ANSWER: Administer an intravenous infusion of 500 mL of normal saline.  Question 2 At 1 minute after birth the nurse assesses the infant and notes a heart rate of 80 beats/min., some flexion of extremities, a weak cry, slight grimacing, and a pink body but blue extremities. What is the Apgar score the nurse will calculate? ANSWER: 5  Question 3 A patient with hypertension who is receiving intravenous magnesium sulfate therapy has requested an epidural anesthetic. The perinatal nurse should first review the patient’s complete blood count (CBC) results for: ANSWER: results for evidence of a decreased platelet count  Question 4 After a precipitous birth the nurse encourages the woman to breastfeed her newborn. The primary purpose of this activity to do what? ANSWER: Stimulate the uterus to contract  Question 5 Page 1 of 16 Early this morning, an infant boy was circumcised using the PlastiBell method. The nurse Page 2 of 16 the nurse? ANSWER: One fetal movement noted in 1 hour of assessment by the mother  Question 14 A young primigravida in latent phase of labor is requesting something for pain. Her BP is 110/70, P 90, R 18, T, 97.6. Fetal heart rate is 140 with moderate variability and is contracting irregularly every 3 - 5 minutes, palpates mild. Vaginal exam is 3cm, 90% effaced and - 2 with intact membranes. What non pharmacological management could you use? (select all that apply:)  Question 15 The pThe perinatal nurse notes a rapid decrease in the fetal heart rate (FHR) that does not recover immediately following an amniotomy. What action should the nurse perform first? ANSWER: Perform a vaginal examination. * The nurse needs to assess the fetal heart rate immediately before and after the artificial rupture of the membranes. Changes such as transient fetal tachycardia may occur and are common. However, other fetal heart rate patterns, such as bradycardia and variable decelerations, may be indicative of cord compression or prolapse. The nurse should perform a vaginal examination to assess for cord prolapse. Administering oxygen may or may not be needed. Maternal temperature is assessed every 2 hours after artificial rupture of membranes but is not related to this situation. The nurse should not wait 30 minutes prior to doing anything  Question 16 A G2 TPAL 2002 patient experienced a precipitous birth 90 minutes ago. Her infant weighed 4200 grams and a repair of a second-degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that the patient’s uterus is boggy and deviated to the right. Furthermore, it is noted that the patient’s vaginal bleeding has increased. The nurse’s most appropriate first action is to: ANSWER: Massage the uterine fundus with continual lower-segment support. Page 5 of 16 *As the primary caregiver, the registered nurse may be the first person to identify excessive blood loss and to initiate immediate actions. While another member of the team calls the physician or nurse-midwife, the nurse should first locate the uterine fundus and initiate fundal massage.  Question 17 The nurse caring for the laboring woman should understand that early decelerations are caused by which of the following? ANSWER: Altered fetal cerebral blood flow. Early decelerations are the fetus's response to fetal head compression  Question 18 A client with Diabetes Mellitus gives birth to a 9 pound, 10 ounce neonate at 39 weeks gestation. Which of the neonate's serum levels should be assessed immediately after birth. Answer Feedback: Meconium for drug screen  Question 19 A newborn is place under a radiant heat warmer, and the nurse evaluates the infant's body temperature every hour. Maintaining the newborn's body temperature is important for preventing what risk? ANSWER: Cold stress.  Question 20 Page 6 of 16 What is the most critical nursing action in caring for the newborn immediately after birth? ANSWER: Keeping the airway clear * The care given immediately after the birth focuses on assessing and stabilizing the newborn. Although fostering parent-newborn attachment is an important task for the nurse, it is not the most critical nursing action in caring for the newborn immediately after birth. The care given immediately after birth focuses on assessing and stabilizing the newborn. The nursing activities are (in order of importance) to maintain a patent airway, to support respiratory effort, and to prevent cold stress by drying the newborn and covering him or her with a warmed blanket or placing the newborn under a radiant warmer. After the newborn has been stabilized, the nurse assesses the newborn's physical condition, weighs and measures the newborn, administers prophylactic eye ointment and a vitamin K injection, affixes an identification bracelet, wraps the newborn in warm blankets, and then gives the newborn to the partner or to the mother of the infant.  Question 21 A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. What signs and symptoms should the nurse include in her discussion? Choose all that apply ANSWER: a. Breast tenderness b. Warmth in the breast c. An area of redness on the breast often resembling the shape of a pie wedge e. Fever and flulike symptoms * Breast tenderness, warmth in the breast, redness on the breast, and fever and flulike symptoms are commonly associated with mastitis and should be included in the nurse's discussion of mastitis. A small white blister on the tip of the nipple generally is not associated with mastitis. It is commonly seen in women who have a plugged milk duct. Page 7 of 16 nursing action is to: ANSWER: perform a vaginal examination every shift * Vaginal examinations should not be done routinely on a client with premature rupture of the membranes because of the risk of infection.  Question 27 A nurse is reviewing the physician’s orders for a client admitted for premature rupture of membranes. Gestational age of the fetus is determined to be 37 weeks. Which physician’s order should the nurse question? ANSWER:  Question 28 What would the nurse expect when evaluating the effectiveness of oxytocin (pitocin) induction? ANSWER: Contractions lasting 40 to 90 seconds, 2 to 3 minutes apart.  Question 29 A wo A woman is receiving oxytocin (Pitocin) via infusion. The nurse assesses the following: uterine contractions lasting 100 seconds every 1.5 minutes, uterine resting tone 36 mm Hg, baseline fetal heart rate (FHR) 108 beats/minute with absent variability. What action by the nurse takes priority? ANSWER: Stop the infusion. Response Feedback: Oxytocin can cause uterine tachysystole, and the nurse’s assessments are consistent with this condition. The priority action by the nurse is to stop the infusion. The nurse should notify the provider. Documentation should be thorough. Reassessment should be driven by a written protocol. Page 10 of 16  Question 30 When a woman is diagnosed with postpartum depression (PPD) with psychotic features what behavior is a serious concern by the nurse? ANSWER: Harm her infant.  Question 31 The nurse expects to administer an oxytocic (e.g. Pitocin, Methergine) to a woman after expulsion of her placenta. What affect will this medication have on the patient? ANSWER: Stimulate uterine contraction  Question 32 After a precipitous delivery a nurse notes that the new mother is passive and only touches her newborn infant briefly with her fingertips. The nurse should do which of the following to help the woman process what has happened? ANSWER: Support the mother in her reaction to the newborn infant. * Precipitous labor is labor that lasts 3 hours or less. Women who have experienced precipitous labor often describe feelings of disbelief that their labor progressed so rapidly. To assist the client to process what has happened, the best option is to support the client in her reaction to the newborn infant. Options 1, 3, and 4 do not acknowledge the client's feelings.  Question 33 In assessing a newborn the APGAR score is essential to determine the ability of the newborn to transition to extra uterine life. What does the APGAR score assess? (select all that apply) ANSWER: HEART RATE Page 11 of 16 RESPIRATORY RATE MUSCLE TONE REFLEX IRRITABILITY COLOR  Question 34 What three measures should the nurse implement to provide intrauterine resuscitation? Select the response that best indicates the priority of actions that should be taken? ANSWER: Reposition the mother, increase intravenous (IV) fluid, and provide oxygen via face mask.  Question 35 The nurse is assessing a fetus using an external fetal monitor. The nurse notes that the fetus has a baseline heart rate of 125-135. The nurse would document this as: ANSWER: normal finding  Question 36 The nurse has received a report about a woman in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and -2. What is the nurses interpretation of this report? ANSWER: Page 12 of 16 A laboring woman received Meperidine (Demerol) intravenously 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate? ANSWER: Naloxone Narcan  Question 45 A nurse has provided discharge instructions to a client who delivered a healthy infant by cesarean section. Which statement made by the client indicates a need for further instruction? ANSWER: "I will begin abdominal exercises immediately." * A cesarean delivery requires an incision made through the abdominal wall and into the uterus. Abdominal exercises should not start immediately after abdominal surgery; the client should wait at least 3 to 4 weeks postoperatively to allow for healing of the incision. Options 2, 3, and 4 are appropriate instructions for the client after a cesarean delivery.  Question 46 The perinatal nurse providing care to a laboring woman recognizes a non-reassuring fetal heart rate tracing. An appropriate initial action is to ANSWER: Assist the woman to a left lateral position. *Because nonreassuring fetal heart rate patterns constitute a risk indicator for cesarean birth, the nurse and all members of the health-care team must be ready for this outcome at all times. The nurse should change the woman's position to her side to increase oxygen flow to the fetus. The rate of the IV solution can be increased. Documentation should always be thorough. Fetal scalp electrodes may or may not need to be placed  Question 47 A newborn goes through many changes at the time of delivery when transitioning to extrauterine life. What is the normal change that the nurse will observe? ANSWER: Page 15 of 16  Question 48 A nurse is assessing a newborn born to a mother who is addicted to drugs. Which assessment finding would the nurse expect to note during the assessment of this newborn? ANSWER: Constant crying * A newborn of a woman using drugs is irritable. The infant is overloaded easily by sensory stimulation. The infant may cry incessantly and be difficult to console. The infant would hyperextend and posture rather than cuddle when being held.  Question 49 Pain should be assessed regularly in all newborn infants. If the infant is displaying physiologic or behavioral cues indicating pain, measures should b taken to manage the pain. Examples of nonpharmacologic pain management techniques include the following. (select all that apply) ANSWER: Swaddling. Nonnutritive sucking. Skin-to-skin contact with the mother. Sucrose.  Question 50 The perinatal nurse is providing care to a 25-year-old G1 TPAL 0000 woman hospitalized with severe hypertension at 33 weeks’ gestation. The nurse is preparing to administer the second dose of b-methasone prescribed by the physician. The patient asks: “What is this injection for again?” The nurse’s best response is: ANSWER: "This is to help your baby's lungs to mature." Page 16 of 16