NRSG 112 Exam 4 V1 NRSG 112 Exam 4
V1 NRSG 112 Exam 4 V1 NRSG 112 Exam
4 V1
1. A nurse is assessing a client who is 2 hours postpartum and notes a boggy uterus displaced
to the right of the midline. Which of the following actions should the nurse take first?
A. Assist the client to void.
B. Massage the fundus until it is firm.
C. Administer oxytocin via intravenous infusion.
D. Assess the client’s blood pressure.
Correct Answer: A
A displaced uterus to the right is a classic sign of a distended bladder which prevents the
uterus from contracting properly. Assisting the client to empty their bladder allows the
uterus to return to the midline and contract effectively. This is a primary nursing
intervention to prevent postpartum hemorrhage caused by uterine atony.
2. Which of the following findings in a newborn should the nurse report to the provider
immediately?
A. Acrocyanosis of the hands and feet
B. Milia on the bridge of the nose
C. Small blue-black spots on the sacrum
,D. Vernix caseosa in the skin folds
E. Generalized petechiae over the trunk
Correct Answer: E
Generalized petechiae can indicate a serious underlying condition such as a clotting
disorder or infection and must be reported immediately. Acrocyanosis and milia are
normal findings in a newborn during the first 24 to 48 hours. Mongolian spots (blue-black
spots) are also normal variations and do not require urgent intervention.
3. A nurse is providing teaching to a parent of a child who has been diagnosed with
pediculosis capitis. Which of the following instructions should the nurse include?
A. Wash all bed linens in cold water.
B. Discard all of the child’s stuffed animals.
C. Seal non-washable items in a plastic bag for 48 hours.
D. Remove nits from the hair shaft with a fine-toothed comb after treatment.
Correct Answer: D
Mechanical removal of nits is a crucial step in the treatment of head lice to prevent re-
infestation. Linens should be washed in hot water and dried on a high heat setting. Non-
washable items should be sealed in a bag for 14 days to ensure any surviving lice or nits are
dead.
, 4. A nurse is caring for an infant who has developmental dysplasia of the hip (DDH). Which of
the following clinical manifestations should the nurse expect?
A. Symmetrical gluteal folds
B. Lengthening of the affected limb
C. Asymmetry of the gluteal and thigh folds
D. Inward rotation of the foot
Correct Answer: C
Asymmetry of the gluteal folds is a classic assessment finding in infants with DDH. The
nurse might also observe a shortening of the affected limb rather than lengthening. Early
detection is vital for the success of non-surgical treatments like the Pavlik harness.
5. A nurse is assessing a child with suspected epiglottitis. Which of the following actions is a
priority for the nurse?
A. Obtain a throat culture.
B. Ensure emergency intubation equipment is at the bedside.
C. Inspect the throat with a tongue blade.
D. Place the child in a supine position.
Correct Answer: B
Epiglottitis is a medical emergency that can lead to sudden airway obstruction. Any
attempt to visualize the throat or obtain a culture can trigger a laryngospasm and complete
V1 NRSG 112 Exam 4 V1 NRSG 112 Exam
4 V1
1. A nurse is assessing a client who is 2 hours postpartum and notes a boggy uterus displaced
to the right of the midline. Which of the following actions should the nurse take first?
A. Assist the client to void.
B. Massage the fundus until it is firm.
C. Administer oxytocin via intravenous infusion.
D. Assess the client’s blood pressure.
Correct Answer: A
A displaced uterus to the right is a classic sign of a distended bladder which prevents the
uterus from contracting properly. Assisting the client to empty their bladder allows the
uterus to return to the midline and contract effectively. This is a primary nursing
intervention to prevent postpartum hemorrhage caused by uterine atony.
2. Which of the following findings in a newborn should the nurse report to the provider
immediately?
A. Acrocyanosis of the hands and feet
B. Milia on the bridge of the nose
C. Small blue-black spots on the sacrum
,D. Vernix caseosa in the skin folds
E. Generalized petechiae over the trunk
Correct Answer: E
Generalized petechiae can indicate a serious underlying condition such as a clotting
disorder or infection and must be reported immediately. Acrocyanosis and milia are
normal findings in a newborn during the first 24 to 48 hours. Mongolian spots (blue-black
spots) are also normal variations and do not require urgent intervention.
3. A nurse is providing teaching to a parent of a child who has been diagnosed with
pediculosis capitis. Which of the following instructions should the nurse include?
A. Wash all bed linens in cold water.
B. Discard all of the child’s stuffed animals.
C. Seal non-washable items in a plastic bag for 48 hours.
D. Remove nits from the hair shaft with a fine-toothed comb after treatment.
Correct Answer: D
Mechanical removal of nits is a crucial step in the treatment of head lice to prevent re-
infestation. Linens should be washed in hot water and dried on a high heat setting. Non-
washable items should be sealed in a bag for 14 days to ensure any surviving lice or nits are
dead.
, 4. A nurse is caring for an infant who has developmental dysplasia of the hip (DDH). Which of
the following clinical manifestations should the nurse expect?
A. Symmetrical gluteal folds
B. Lengthening of the affected limb
C. Asymmetry of the gluteal and thigh folds
D. Inward rotation of the foot
Correct Answer: C
Asymmetry of the gluteal folds is a classic assessment finding in infants with DDH. The
nurse might also observe a shortening of the affected limb rather than lengthening. Early
detection is vital for the success of non-surgical treatments like the Pavlik harness.
5. A nurse is assessing a child with suspected epiglottitis. Which of the following actions is a
priority for the nurse?
A. Obtain a throat culture.
B. Ensure emergency intubation equipment is at the bedside.
C. Inspect the throat with a tongue blade.
D. Place the child in a supine position.
Correct Answer: B
Epiglottitis is a medical emergency that can lead to sudden airway obstruction. Any
attempt to visualize the throat or obtain a culture can trigger a laryngospasm and complete
