NUR 353 FINAL EXAM QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026

NUR 353 FINAL EXAM QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026 1 month Infant: Social/ emotional - Answers quiets when hears a voice 1 month: cognitive/ language - Answers makes comfort sounds during feeding Cries to express displeasure 1 month: Fine Motor - Answers Strong grasp reflex 1 month: Gross motor - Answers Has marked head lag back rounded in sitting position 10 months: additional info - Answers Introduce meats and egg yolk 12 months- Cognitive/ Language - Answers Says mama & dada for parents and 3-5 other words Imitates animal sounds Shows emotion (shakes head for no; waves bye) Understands simple verbal commands ("give it to me") 12 months: Fine motor - Answers Releases cube in cup Picks up things like cereal o's b/t thumb and index finger (neat pincher) Turns pages of book- many at a time Can follow rapidly moving object 12 months: Gross motor - Answers Gets to sitting position from standing w/o help Walks holding onto furniture (cruising) Walks with one hand held Sit to stand w/o help 12 months: Immunizations - Answers Hib PCV HepB IPV MMR Varicella 12 months: Social/ emotional - Answers Clings to parent in new situations Has favorite objects Gives hugs and kisses 18 months: additional info. - Answers Immunization: DTAP Autism more common (18- 36 months) 18 months: Cognitive/ Language - Answers Says 10 or more words Points to common objects 18 months: Fine motor - Answers Builds tower 3-4 cubes 18 months: Gross motor - Answers Can stand w/o support Walks upstairs with one hand held Throws ball overhead Walks 18 months: Self help - Answers Feeds self w/ spoon Takes off socks, shoes, unzips 18 months: Social/ emotional - Answers Has temper tantrums Great imitator, domestic mimicry such as pretending to feed doll 1st trimester discomforts - Answers Breast changes (enlargement, pain, tingling, tenderness); Urination- urgency, frequency; Languor & malaise; fatigue; N/V- morning sickness; Ptyalism (excessive salivation); Gingivitis and epulis; Nasal stuffiness, epistaxis; Leukorrhea; Psychosocial dynamics ( mood swings, mixed feelings) 2 months- Social/emotional - Answers Social smile Vocalizes distinct from crying Calms self briefly 2 months: additional info - Answers Immunizations: -Hib -PCV -Hep B -DTAP -IPV -Rotavirus 2 months: Cognitive/ Language - Answers Turns head towards sound Crying differentiated Coos 2 months: Fine motor - Answers Begins to follow things Brings hand to mouth Hands often open Grasp reflex fading 2 months: Gross motor - Answers Less flexed position when prone Can lift head when prone 2 years: Cognitive/ Language - Answers Vocabulary of 300 words Uses 2-3 word phrases Understands directional commands Knows first name 2 years: Fine motor - Answers Builds tower of 6-7 cubes Turns pages of a book one at a time 2 years: Gross motor - Answers Runs well Kicks a ball Goes up and down stairs w/ 2 feet on each step (w/o assistance) 2 years: Self help - Answers Dresses self in simple clothing Turns doorknob; unscrews a lid 2 years: Social/ emotional - Answers Increased independence from parent Plays alongside other children (parallel play) 24-28 week labs - Answers Hbg/Hct GCT (140) (glucose tolerance) Rhogam if indicated 2nd trimester discomforts - Answers Pigmentation deepens, acne, oily skin; Spider nevi (angiomas); Palmar erythema; Pruritis (noninflammatory); Palpitations; Supine hypotension; Faintness, syncope (rare)- orthostatic hypotension; Food cravings; heartburn; constipation; Flatulence with bloating and belching; varicose veins; Leukorrhea; headaches (to wk. 26); Carpal tunnel syndrome; periodic numbness/tingling of fingers; round ligament pain; joint pain, backache, pelvic pressure; joint hypermobility 3 years: Gross motor - Answers Rides a tricycle Jumps off bottom step Stands on one foot for a few seconds 3rd trimester discomforts - Answers Shortness of breath, dyspnea; Insomnia; psychosocial responses; gingivitis & epulis; urinary frequency and urgency return; perineal discomfort/ pressure; leg cramps; non-pitting ankle edema; 4 months: Additional info - Answers Develops nocturnal sleep (9-11 hrs.) Immunizations: -Hib -PCV -DTAP -IPV -Rotavirus 4 months: Cognitive/ Language - Answers Makes constant sounds Laughs 4 months: Fine motor - Answers Inspects and plays w/ hands Grasps objects with both hands 4 months: Gross motor - Answers Lifts heasd & chest while on stomach Rolls back to side Balances head in sitting position 4 months: Self help - Answers Tries to reach for objects Anticipates feeding when see bottle or breast 4 months: social/ emotional - Answers Becomes bored if left alone Enjoys social interaction 4 years: Gross motor - Answers Skips & hops on one foot Throws ball Catches ball reliably Picky eater phase 5 years: gross motor - Answers Jumps rope Walks backwards Throws and catches ball w/ ease 6 month: Social/ emotional - Answers Recognizes familiar faces Holds arms out to be picked up 6 months: Additional info - Answers Iron fortified Introduce cereals Water w. adequate fluoride or supplements at 6 months (to 3 yrs) Immunizations: -Hib -PCV -DTAP -Rotavirus 6 months: Cognitive/ Language - Answers Has definite likes/ dislikes Begins to imitate sound Babbling resembles one syllable (ma, mu, da, di, hi) 6 months: Fine motor - Answers Grasps feet and pulls to mouth Holds bottle Rakes objects 6 months: Gross motor - Answers Rolls back to abdomen Lifts chest when prone and bears weight on hands Sits with support 6 months: Self help - Answers Begins to look for things that are hidden (object permanence) 9 months: Cognitive/ Language - Answers Responds to simple commands Comprehends "no no" 9 months: Fine motor - Answers Picks up things like cereal o's b/t thumb and 2 fingers (crude pincher) Preference for use of dominant hand 9 months: Gross motor - Answers Sits steadily w/o help Crawls on hands and knees Pulls to standing 9 months: self help - Answers Puts arms in front of face to avoid having it washed 9 months: Social/ emotional - Answers Begins to show fear Stranger anxiety Adolescent (12-18): Cognitive - Answers Growig capacity abstract thought Mostly interested in present with limited thought to the future in the beginning but later will think of the future Deeper moral thinking Adolescent: Health promotion - Answers Adequate sleep important due to rapid physical growth Spend more time w/ sports than any other time- good time for physicals Body conscious teenagers need hygiene guidance Vision screens Adolescent: Nutrition - Answers Need for healthy eating due to growth Calorie needs increase (2800- boys; 2200- girls) Calcium, iron, zinc, & Vit. D usually fall short but needed for growing body Adolescent: Pt. education - Answers Goals (assess cognitive ability): -Younger more concrete, emphasize immediate risks or benefits -Older with hypothetical reasoning, more symbolic and long-term implications Should be able to: -Perform health care needs with instructions -Understand medication action and side effects -Identify the severity of symptoms, treat and know how to contact healthcare provider -Meet with an adult routinely (at least once a week) -Rational thought processes may be abandoned due to peer pressure, time constraints, and personal stressors Adolescent: Safety - Answers Sports injury Teen drivers (new driver/ distractions) Dating violence Cyber bullying Suicide Sun and tanning Adolescent: Social/ emotional - Answers Struggle with sense of identity Initially emotional instability which moves toward stability Realize parents are not perfect and; increase parent conflict Increase influence of peer group Rule and limit testing Personal fable and imaginary audience Alpha-Fetoprotein (MSAFP) screening at 16 to 18 weeks - Answers high level screening tool for neural tube defects. Low level screening MSAFP associated with down syndrome Antepartum hypertension management disorders - Answers 37+ weeks: Induce labor by cervical ripening 36 weeks or less: Mild gesational HTN or preeclampsia maned at home with frequent checkups. Complete or partial bed rest recommended. Diet can be regular and sould include 60-70 g protein, 600 mcg folic acid, 11-12 mg zinc, 1.5 g Sodium, and adequate fluids Severe HTN: treated as severe preeclampsia. Hospitalize, place on mag. sulfate. Monitor urine output, cerebral status, BP, epigastric pain, bleeding, liver enzymes, creatinine, platelets, continuous fetal monitoring, fetal growth, amniotic fluid. APGAR - Answers babinski reflex - Answers when the foot is stroked, the big toe points toward the top of the foot and the other toes fan out ballottment - Answers passive movement of the unengaged fetus Barrier method - Answers contraceptive and protection against STIs Diaphram: silicone device with a flexible rim that covers the cervix, put spermicide in it Cervical cap: cap fits snugly around the base of the cervix close to the junction of the cervix and vaginal fornices Sponge: The vaginal sponge is a small, round, polyurethane sponge that contains N-9 spermicide. It is designed to fit over the cervix Spermicide Caloric needs during pregnancy - Answers First Trimester: minimal, variable Second Trimester: 340 extra calories per day Third Trimester: 452 extra calories per day cardiovascular changes in pregnancy - Answers cardiac output increases 30-50% blood volume increases 30-45% HR increases 10-15 bpm more clotting factors slight cardiac hypertrophy murmurs more common Care plan for GDM- maintain euglycemia - Answers -Get up, go to bed, take insulin, eat & exercise at the same time each day -Take BG frequently to determine how well the major components of therapy ( diet, insulin, exercise) are working together to control BG levels Chadwick's sign - Answers violet-bluish color of the vaginal mucosa and cervix Chronic HTN - Answers In pregnant women- present before pregnancy or diagnosed before 20 weeks and persists 12 months after pregnancy Clinical manifestations of VTE - Answers Deep vein thrombosis is more common during pregnancy than in the postpartum period and is characterized by unilateral leg pain, calf tenderness, and swelling. Physical examination may reveal redness and warmth, but women can have a large clot with few symptoms. A positive Homans' sign may be present CS nursing management and care - Answers Post Op: pain relief remove foley catheter TEDS/SCDs The nurse assesses the woman's vital signs, incision, fundus, and lochia according to hospital policies, procedures, or protocols. Breath sounds, bowel sounds, circulatory status of lower extremities, and urinary and bowel elimination patterns also are assessed. Define antenatal glucocorticoid medication and it's purpose. - Answers Medication used to stimulate fetal lung maturity Betamethasone/Dextamethosone (glucocorticoid) Define tocolytic and give some examples - Answers Medication that stops uterine contractions Mag Sulfate (CNS depressant, smooth muscle relaxant) Terbutaline (smoooth muscle relaxant) Prostaglandin inhibitor (NSAID) Nifedipine (Ca channel blocker, stops Ca from going into muscle cell) Define Trial of Labor (TOL) and nursing care related to it - Answers is the observance of a woman and her fetus for a reasonable period (e.g., 4 to 6 hours) of spontaneous active labor to assess the safety of vaginal birth for the mother and infant. Normally after a CS nurse assesses maternal vital signs and FHR and pattern and is alert for signs of potential complications. Plans for potential complication and reports to provider Define Trial of Labor for Vaginal Birth After Cesarean (TOL/VBAC) - Answers HELP!!!!!!!!!!!! VBAC: having a vaginal birth after having a C-section with the previous child. TOL: Attempt to have a vaginal birth after having a C-section with the previous child; observance of a woman and her fetus for a reasonable period (e.g., 4 to 6 hours) of spontaneous active labor to assess the safety of vaginal birth for the mother and infant Define uterine tachysystole - Answers 6 contractions in a 10-minute period Describe the menstral cycle? - Answers Diagnostic testing - Answers 3 hour GTT Amniocentesis or CVS (Chorionic villus sampling) amniocentesis, nonstress test (NST), biophysical profile (BPP), and ultrasound examination Nuchael translucency Celphry DNA Do insulin and glucose cross the placenta? - Answers No, only glucose crosses the placenta Do insulin needs increase or decrease during the duration of pregnancy - Answers Insulin needs are minimal during the first trimester Drastic increase in insulin needs during the 2nd and 3rd trimesters until birth endocrine changes - Answers placenta becomes an endocrine organ, which produces, hCG, progesterone, estrogen, human placental lactogen, prostaglandins Fertility awareness method - Answers identifying fertile period: 5-7 days around the middle of the cycle and several days before and after ovulation failure rate 24% low to no cost, absence of chemicals and hormones, lack of alteration of menstrual cycle need for strict record keeping, unintentional interference from external influences that alter woman's body temp and vaginal secretions, decreased effectiveness in women with irregular cycles, possibility of needing to attend time consuming training classes Fetal jeopardy or intrauterine fetal death S&S - Answers Change in fetal movement; absence of fetal movements after quickening; any unusual change in pattern or amount First stage: active - Answers 4 to 7 cm 3-6 hours Moderate to strong, more regular contractions 3-5 minutes apart, 40-70 seconds Nulliparous +1 to +2, Multiparous +1 to +2 Small to moderate amount of pink to bloody mucus First stage: latent - Answers Through 3 cm 6-8 hours Mild to moderate, irregular contractions 5-30 minutes apart, 30-45 seconds Nulliparous 0, multiparous -2 to 0 Small amount of brownish or pink mucus First stage: transition - Answers 8 to 10 cm 20-40 minutes Strong to very strong, regular contractions 2-3 minutes apart, 45-90 seconds Nulliparous +2 to +3, multiparous +2 to +3 Bloody mucus Functions of the placenta - Answers Metabolic (respiration, nutrition, excretion, and storage) Respiration Nutrition (Water, inorganic salts, carbohydrates, proteins, fats, and vitamins) Excretion Transportation Storage (Carbohydrates, proteins, calcium, and iron) gastrointestinal changes - Answers n/v, appetite fluctuates, gingivitis, excessive salivation (ptyalism), PICA, heartburn, constipation, hemmorhoids GDM Diagnostic - Answers 3 hour OGTT 100 grams of oral glucose given BG tested before oral glucose given and tested each hour after for 3 hours Measures: Fasting /= 95; 1 hr /= 180; 2 hr /= 155; 3 hr. /= 140 Positive for GDM if 2 or more values met or exceeded the measures GDM increased risks to fetus - Answers Spontaneous abortion Infection (urinary/ vaginal) Hydraminos Ketoacidosis Hypoglycemia Hyperglycemia GDM Risk factors - Answers Family hx Previous pregnancy in which the fetus delivered was stillborn or macrosomic; Obesity HTN Glycosuria Maternal age older than 25 GDM Screeening - Answers 1 hour oral glucose tolerance test (OGTT) Between 24 and 28 weeks pregnant 50 grams of oral glucose given and tested one hour later Positive results: BG 130-140 If positive- need to have diagnostic test done GDM- best type of exercise - Answers Aerobic exercise with resistance training for at least 30 minutes most days of the week GDM- Diet - Answers 55% carbohydrate 20% protein 25% fat, with less than 10% as saturated fat. More complex carbs and more simple. GDM: Hyperglycemia findings - Answers Polydipsia, polyphagia, polyuria, nausea, abdominal pain, flushed dry skin, fruity breath, excess weight gain during pregnancy GDM: Hypoglycemia findings - Answers Nervousness, headache, weakness, irritability, hunger, blurred vision, tingling of mouth or extremities, shaking, clammy pale skin, shallow respirations, rapid pulse, vomiting Gestational Diabetes Mellitus S&S - Answers Glycosuria positive glucose tolerance test reaction Gestational HTN - Answers Development of HTN after 20 weeks of pregnancy Greater than 140/90 at least 2 separate times and both tested at least 4-6 hours apart but no more than 1 week apart Only one (either systolic or diastolic needs to be elevated for diagnosis) GI changes in pregnancy - Answers Nausea and vomiting, especially 1st trimester Appetite fluctuates Gingivitis, hypertrophy of gums Ptyalism (excessive salivation) PICA Heartburn Constipation Hemorrhoids Abdominal discomfort Pyrosis (heartburn) Goodell sign - Answers softening of the cervical tip grasp reflex - Answers if the baby's hand is touched they will grasp Gravita - Answers Number of pregnancies Hegar sign - Answers softening and compression of the lower uterine segment HELLP Syndrome - Answers Hemolysis; Elevated Liver enzyme; Low Platelet count