NUR 2502 EXAM 2 COMPREHENSIVE TEST
SCRIPT 2026 FULL QUESTIONS AND
SOLUTIONS VERIFIED A+
◉ Manifestations of acute pain in the neonate
Behavioral responses;. Answer: • Vocalizations • Crying •
Whimpering • Groaning • Facial expression • Grimaces • Brow
furrowed • Chin quivering • Eyes tightly closed • Mouth open and
squarish • Body movements and posture • Limb withdrawal •
Thrashing • Rigidity • Flaccidity • Fist clenching • Changes in state •
Changes in sleep-wake cycles • Changes in feeding behavior •
Changes in activity level • Fussiness, irritability • Listlessness
◉ assessment of neonatal pain. Answer: • Neonatal Infant Pain Scale
(NIPS) (Lawrence, Alcock, McGrath, et al., 1993) • Premature Infant
Pain Profile (PIPP) (Stevens, Johnston, Petryshen, et al., 1996) •
Neonatal Pain Agitation and Sedation Scale (NPASS) (Hummel,
Puchalski, Creech, et al., 2008) • CRIES (Krechel & Bildner, 1995)
(Table 23.5)
◉ Non pharmacological treatment of neonatal pain. Answer:
swaddling, tucking, pacifier, oral sucrose with or without a pacifier,
skin to skin contact with mom, breastfeeding and breast milk, oral,
,visual, auditory distractions, sensorial saturation (speaking softly,
gently massaging face, providing oral sucrose on the tongue).
◉ Pharmacological treatment of neonatal pain. Answer: Local
anesthesia is routinely used during procedures such as circumcision.
Topical anesthesia is used for circumcision, lumbar puncture,
venipuncture, and heelsticks. Nonopioid analgesia (oral liquid
acetaminophen) is effective for mild to moderate pain from
inflammatory conditions. Morphine and fentanyl are the most
widely used opioid analgesics for pharmacologic management of
neonatal pain. Continuous or bolus IV infusion of opioids provides
effective and safe pain control. Other methods for managing
neonatal pain are epidural infusion, local and regional nerve blocks,
and intradermal or topical anesthetics (Gardner et al., 2016).
◉ Nonstress test (NST). Answer: for antepartum evaluation of fetal
well being performed during third trimester. noninvasive test that
monitors the fhr to fetal movement. a doppler transducer(used to
monitor the fhr) and a tocotransducer(used to monitor uterine
contractions) are attached externally to a client's abdomen to obtain
tracing strips. client pushes a button when she feels the fetus move.
◉ Findings in the first stage of labor. Answer: considered to last
from the onset of regular uterine contractions to full dilation of the
cervix. Commonly the onset of labor is difficult to establish because
the woman may be admitted to the labor unit just before birth and
the beginning of labor may be only an estimate. The first stage is
, much longer than the second and third combined. However, great
variability is the rule, the first stage of labor is now divided into only
two phases, latent (early) and active (Kilpatrick & Garrison, 2017).
During the latent phase, there is more progress in effacement of the
cervix and little increase in descent. During the active phase, there is
more rapid dilation of the cervix and increased rate of descent of the
presenting part.
◉ Reactive NST. Answer: two accelerations in a 20 min period.
15bpm above baseline lasting for 15 seconds or longer
◉ Non reactive NST. Answer: NO fetal heart rate accelerations of
accelerations less than 15 beats/min or lasting less than 15 seconds
throughout any fetal movement during the testing period;
if the test does not meet reactive criteria listed above after 40 min
the test is considered non-reactive
◉ fetal physiological adaptation to labor. Answer: FHR-temporary
accelerations and slight early decelerations of the FHR can be
expected in response to spontaneous fetal movement, vaginal
examination, fundal pressure, uterine contractions, abdominal
palpation, and fetal head compression. Stresses to the
uterofetoplacental unit result in characteristic FHR patterns (see
Chapter 15 for further discussion).
SCRIPT 2026 FULL QUESTIONS AND
SOLUTIONS VERIFIED A+
◉ Manifestations of acute pain in the neonate
Behavioral responses;. Answer: • Vocalizations • Crying •
Whimpering • Groaning • Facial expression • Grimaces • Brow
furrowed • Chin quivering • Eyes tightly closed • Mouth open and
squarish • Body movements and posture • Limb withdrawal •
Thrashing • Rigidity • Flaccidity • Fist clenching • Changes in state •
Changes in sleep-wake cycles • Changes in feeding behavior •
Changes in activity level • Fussiness, irritability • Listlessness
◉ assessment of neonatal pain. Answer: • Neonatal Infant Pain Scale
(NIPS) (Lawrence, Alcock, McGrath, et al., 1993) • Premature Infant
Pain Profile (PIPP) (Stevens, Johnston, Petryshen, et al., 1996) •
Neonatal Pain Agitation and Sedation Scale (NPASS) (Hummel,
Puchalski, Creech, et al., 2008) • CRIES (Krechel & Bildner, 1995)
(Table 23.5)
◉ Non pharmacological treatment of neonatal pain. Answer:
swaddling, tucking, pacifier, oral sucrose with or without a pacifier,
skin to skin contact with mom, breastfeeding and breast milk, oral,
,visual, auditory distractions, sensorial saturation (speaking softly,
gently massaging face, providing oral sucrose on the tongue).
◉ Pharmacological treatment of neonatal pain. Answer: Local
anesthesia is routinely used during procedures such as circumcision.
Topical anesthesia is used for circumcision, lumbar puncture,
venipuncture, and heelsticks. Nonopioid analgesia (oral liquid
acetaminophen) is effective for mild to moderate pain from
inflammatory conditions. Morphine and fentanyl are the most
widely used opioid analgesics for pharmacologic management of
neonatal pain. Continuous or bolus IV infusion of opioids provides
effective and safe pain control. Other methods for managing
neonatal pain are epidural infusion, local and regional nerve blocks,
and intradermal or topical anesthetics (Gardner et al., 2016).
◉ Nonstress test (NST). Answer: for antepartum evaluation of fetal
well being performed during third trimester. noninvasive test that
monitors the fhr to fetal movement. a doppler transducer(used to
monitor the fhr) and a tocotransducer(used to monitor uterine
contractions) are attached externally to a client's abdomen to obtain
tracing strips. client pushes a button when she feels the fetus move.
◉ Findings in the first stage of labor. Answer: considered to last
from the onset of regular uterine contractions to full dilation of the
cervix. Commonly the onset of labor is difficult to establish because
the woman may be admitted to the labor unit just before birth and
the beginning of labor may be only an estimate. The first stage is
, much longer than the second and third combined. However, great
variability is the rule, the first stage of labor is now divided into only
two phases, latent (early) and active (Kilpatrick & Garrison, 2017).
During the latent phase, there is more progress in effacement of the
cervix and little increase in descent. During the active phase, there is
more rapid dilation of the cervix and increased rate of descent of the
presenting part.
◉ Reactive NST. Answer: two accelerations in a 20 min period.
15bpm above baseline lasting for 15 seconds or longer
◉ Non reactive NST. Answer: NO fetal heart rate accelerations of
accelerations less than 15 beats/min or lasting less than 15 seconds
throughout any fetal movement during the testing period;
if the test does not meet reactive criteria listed above after 40 min
the test is considered non-reactive
◉ fetal physiological adaptation to labor. Answer: FHR-temporary
accelerations and slight early decelerations of the FHR can be
expected in response to spontaneous fetal movement, vaginal
examination, fundal pressure, uterine contractions, abdominal
palpation, and fetal head compression. Stresses to the
uterofetoplacental unit result in characteristic FHR patterns (see
Chapter 15 for further discussion).
