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Exam 2: NUR230/ NUR 230 (Latest 2026/ 2027 Update) Childbearing Child Caring Family Nursing: OB/Mother-Baby Review| Test Bank| Grade A| 100% Correct – Galen

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INSTANT PDF DOWNLOAD — This official test bank for NUR 230 Exam 2 at Galen College of Nursing covers Childbearing Child Caring Family Nursing (OB/Mother-Baby) for the 2026/2027 academic year second examination. It contains verified questions and answers with detailed rationales in multiple-choice, select-all-that-apply (SATA), ordered response, and clinical scenario formats aligned with nursing program standards. INTRAPARTUM CARE (LABOR AND DELIVERY) Stages and Phases of Labor Stage 1: Cervical Dilation (Onset of True Labor to Full Dilation at 10 cm) – Subdivided into three phases: Latent Phase (0-6 cm) – Cervical dilation 0-6 cm, effacement 0-40% (primip) or 0-80% (multip). Contractions: mild to moderate intensity, frequency q5-30 minutes (irregular initially, becoming more regular), duration 15-45 seconds. Duration: nulliparous average 6-12 hours (up to 20 hours may be normal), multiparous average 4-8 hours (up to 14 hours may be normal). Nursing interventions: encourage rest and relaxation (save energy for active labor), upright positions and ambulation if no contraindications (promotes descent, improves contractions, increases comfort), comfort measures (back rub, breathing techniques, position changes, warm shower/bath if membranes intact and not contraindicated), hydration and light snacks (clear liquids, broth, juice, popsicles, hard candy) if not at risk for aspiration and anesthesia not imminent (depends on facility policy), encourage voiding q2h (full bladder impedes descent, can cause uterine atony, postpartum hemorrhage). Encourage partner/support person involvement (coach breathing, comfort measures, advocate). Provide education on labor process, what to expect, when to return to hospital (if early labor admitted, latent phase may be slow; discuss options). Active Phase (6-8 cm) – Cervical dilation 6-8 cm, effacement 40-80% (primip) or 80% complete (multip). Contractions: moderate to strong intensity, frequency q3-5 minutes, duration 45-60 seconds. Duration: nulliparous average 2-4 hours, multiparous average 1-3 hours. Nursing interventions: provide continuous labor support (one-to-one nurse or doula support reduces cesarean delivery, operative vaginal delivery, use of analgesia/anesthesia, shorter labor, higher satisfaction scores – ACOG recommendation), encourage position changes (upright positions, side-lying, hands-knees, squatting, pelvic rocking – gravity aids descent, improves pelvic outlet diameters, reduces back pain), encourage voiding q1-2 hours, pain management options (non-pharmacologic: hydrotherapy, massage, counterpressure, sterile water papules for back labor, TENS unit, aromatherapy, relaxation, breathing techniques, positioning; pharmacologic: IV opioids (fentanyl, morphine, meperidine (Demerol) – less commonly used now due to neuroactive metabolite normeperidine (can cause seizures, CNS excitation, accumulates with repeated doses, crosses placenta rapidly, may cause neonatal respiratory depression, sedation (avoid within 2-4 hours of delivery), monitor maternal respiratory rate (12 → hold dose, may need reversal with naloxone if severe), epidural analgesia (most effective pain relief, does not increase cesarean delivery rate, may increase operative vaginal delivery rate, increases duration of second stage, can cause maternal hypotension (preload with IV fluids, position lateral, monitor BP frequently, treat hypotension with fluids, ephedrine, phenylephrine), fever (38°C or higher, associated with increased neonatal sepsis evaluation, but may not represent true infection – monitor fetal HR, maternal WBC, consider antibiotics), urinary retention, pruritus (opioids in epidural – treat with diphenhydramine, nalbuphine), headache (post-dural puncture headache – risk factors: young age, female, lower BMI, larger gauge needle, traumatic insertion, multiple attempts; treatment: epidural blood patch, caffeine, hydration, bedrest), respiratory depression (rare with low-dose epidural, monitor). FHR monitoring: continuous electronic fetal monitoring (EFM) or intermittent auscultation (depending on risk status, facility policy). Encourage support person to assist with comfort measures, advocate for patient. Monitor for signs of transition (increased anxiety, irritability, restlessness, feeling of loss of control, nausea/vomiting, increased rectal pressure, shaking legs, increased bloody show, irritability with touch).

Voorbeeld van de inhoud

1|Page




NUR 230 Exam 2 Concepts of Nursing Childbearing

and Child Caring Family Test Bank with Verified

Answers and Detailed Rationales Grade A – Galen



1. What are the major lymph node locations in the head and neck?

Correct Answer: Preauricular, Postauricular, Occipital, Submental,

Submandibular, Tonsillar (Jugulodigastric), Superficial cervical, Deep

cervical, Posterior cervical, Supraclavicular.

Rationale:

1. Preauricular nodes are located in front of the ear (mastoid bone).

2. Postauricular nodes are located behind the ear.

3. Occipital nodes are at the base of the skull at the back of the head.

4. Submental nodes are under the chin.

5. Submandibular nodes are under the mandible between the jaw and chin.

6. Tonsillar nodes are under the posterior angle of the jaw.

7. Superficial cervical nodes are on the superior aspect of the sternomastoid

muscle under the ears.

8. Deep cervical nodes are along the sternomastoid muscle to the clavicle.

9. Posterior cervical nodes are between the trapezius and sternomastoid muscles

,2|Page


in the lower neck.

10. Supraclavicular nodes are above the clavicle.



2. What is the order of assessment for the head, face, and neck?

Correct Answer: Inspection, Palpation, Auscultation (when examining

carotids or thyroid for bruit).

Rationale:

1. Inspection is always the first assessment technique.

2. Palpation follows inspection.

3. Auscultation is performed when a bruit is suspected (carotids, thyroid).



3. What are common concerns/complaints of the head, face, and neck?

Correct Answer: Head pain or lumps; jaw tightness or pain; head injury;

facial muscle twitching or droop; pain; neck pain or stiffness; neck mass,

lumps, or tenderness.

Rationale:

1. Head pain may indicate tension headache, migraine, or more serious

conditions.

2. Facial droop may indicate Bell's palsy or stroke.

3. Neck masses may indicate lymphadenopathy or thyroid enlargement.

,3|Page




4. How do you inspect and palpate the face?

Correct Answer: Symmetry – compare eyebrows, nasolabial folds, sides

of mouth; head position, trachea. Expression (CN VII – Facial). Ask to

smile, frown, etc. Abnormal facial structures – deformities, nodules,

masses, hair distribution, lesions. Palpation performed when assessing

sinuses or facial glands. Touch sensation of face (CN V – Trigeminal).

Rationale:

1. Facial symmetry is assessed for CN VII function.

2. Expression is controlled by CN VII (Facial nerve).

3. Touch sensation is controlled by CN V (Trigeminal nerve).



5. How do you inspect the neck, trachea, lymph nodes, and thyroid

gland?

Correct Answer: Inspect in neutral position; inspect neck in

hyperextension; inspect neck when swallowing; inspect range of motion;

assess for masses, lesions, limited movements; lymph nodes should not

be visible; palpate for neck suppleness and muscle strength against

resistance; palpate for crepitus; palpate lymph nodes; palpate trachea

, 4|Page


for lateral deviation; palpate thyroid gland for enlargement; auscultate

thyroid for bruit if enlarged.

Rationale:

1. The thyroid moves with swallowing (CN IX – glossopharyngeal).

2. Tracheal deviation indicates a mass or tension pneumothorax.

3. Crepitus indicates air trapped in subcutaneous tissue.



6. What should be assessed during a lymph node examination?

Correct Answer: Size, shape, mobility, consistency (soft or hard),

tenderness, warmth, redness or red streaks, lymphadenopathy.

Rationale:

1. Lymph nodes >1 cm, fixed, irregular, hard, or rubbery require emergency

investigation for cancer.

2. Tender nodes usually indicate infection.

3. Hard, non-tender nodes may indicate malignancy.



7. What are the major lymph node locations in the body?

Correct Answer: Preauricular (in front of ear); Posterior auricular

(behind ear); Occipital (at base of skull); Submental (under chin);

Submandibular (under mandible); Tonsilar (under posterior angle of

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