NUR 418 / NUR 415 Final Exam V3 | NUR
418 / NUR 415 Nursing Care of the
Childbearing & Childrearing Family |
Actual Q&A with Rationale
(NUR418/NUR415 Final Exam) | Concordia
1. A nurse is assessing a pregnant client at 34 weeks gestation who presents with sudden,
painless vaginal bleeding. Which of the following conditions should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Preterm labor
D. Placenta previa
Correct Answer: D
Explanation; Placenta previa is characterized by painless, bright red vaginal bleeding
during the second or third trimester. This occurs when the placenta covers the internal os
of the cervix. The lack of abdominal pain or tenderness distinguishes it from placental
abruption, which is typically painful.
2. A 28-year-old multigravida client at 38 weeks gestation is admitted to the labor and
delivery unit. The nurse notes late decelerations on the fetal monitor. What is the priority
nursing action?
A. Administer oxygen via non-rebreather mask at 8-10 L/min.
,B. Position the client on her left side.
C. Increase the rate of the intravenous infusion.
D. Prepare for immediate cesarean birth.
Correct Answer: B
Explanation; Late decelerations are indicative of uteroplacental insufficiency, which poses
a risk for fetal hypoxia. The initial intervention is to reposition the client to the lateral side
to improve blood flow to the placenta. While oxygen administration and IV fluids are part
of the intrauterine resuscitation protocol, repositioning is the most immediate priority to
relieve pressure on the vena cava.
3. A nurse is providing discharge instructions to a new mother regarding newborn safety.
Which of the following statements by the mother indicates a need for further teaching?
A. “I will place my baby on their back to sleep.”
B. “I will make sure the crib mattress is firm and fits the frame tightly.”
C. “I will keep the room temperature warm and use a heavy blanket to keep the baby cozy.”
D. “I will remove all stuffed animals and bumpers from the crib.”
Correct Answer: C
Explanation; Overheating and the use of soft bedding or heavy blankets are significant risk
factors for Sudden Infant Death Syndrome (SIDS). The infant should be dressed in light
,clothing or a sleep sack, and the environment should remain free of loose items. Placing the
baby on their back on a firm mattress is the safest recommended sleep practice.
4. A toddler is admitted to the pediatric unit with a diagnosis of croup
(laryngotracheobronchitis). Which clinical manifestation should the nurse expect to find?
A. Expiratory wheezing and productive cough
B. High fever and drooling
C. Barking cough and inspiratory stridor
D. Severe substernal retractions and cyanosis
Correct Answer: C
Explanation; Croup is an upper airway infection that causes swelling of the larynx and
trachea, leading to a characteristic ‘seal-like’ barking cough. Inspiratory stridor occurs as
air is pulled through the narrowed airway. Expiratory wheezing is more typical of lower
airway issues like bronchiolitis or asthma.
5. The nurse is assessing a client in the fourth stage of labor. The client’s fundus is boggy and
displaced to the right of the midline. Which action should the nurse take first?
A. Assist the client to void or catheterize if necessary.
B. Massage the fundus until firm.
C. Increase the Pitocin infusion rate.
D. Notify the primary healthcare provider.
, Correct Answer: A
Explanation; A fundus that is displaced to the right of the midline is a classic sign of
bladder distention. A full bladder prevents the uterus from contracting effectively, leading
to uterine atony and potential hemorrhage. Once the bladder is emptied, the nurse should
then reassess and massage the fundus if it remains boggy.
6. Which of the following interventions are appropriate for a child with Tetralogy of Fallot
experiencing a ‘tet spell’ or hypercyanotic episode? (Select All That Apply)
A. Place the child in the knee-chest position.
B. Administer 100% oxygen via face mask.
C. Provide a calm, quiet environment.
D. Administer morphine sulfate as ordered.
E. Encourage the child to walk to improve circulation.
Correct Answer: A,B,C,D
Explanation; The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt in Tetralogy of Fallot. Oxygen and morphine are used to
improve oxygenation and reduce infundibular spasms and anxiety. Walking or exertion
would increase oxygen demand and worsen the cyanosis, so it is contraindicated.
7. A nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which finding
should the nurse report to the provider immediately?
A. Respiratory rate of 10 breaths per minute
418 / NUR 415 Nursing Care of the
Childbearing & Childrearing Family |
Actual Q&A with Rationale
(NUR418/NUR415 Final Exam) | Concordia
1. A nurse is assessing a pregnant client at 34 weeks gestation who presents with sudden,
painless vaginal bleeding. Which of the following conditions should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Preterm labor
D. Placenta previa
Correct Answer: D
Explanation; Placenta previa is characterized by painless, bright red vaginal bleeding
during the second or third trimester. This occurs when the placenta covers the internal os
of the cervix. The lack of abdominal pain or tenderness distinguishes it from placental
abruption, which is typically painful.
2. A 28-year-old multigravida client at 38 weeks gestation is admitted to the labor and
delivery unit. The nurse notes late decelerations on the fetal monitor. What is the priority
nursing action?
A. Administer oxygen via non-rebreather mask at 8-10 L/min.
,B. Position the client on her left side.
C. Increase the rate of the intravenous infusion.
D. Prepare for immediate cesarean birth.
Correct Answer: B
Explanation; Late decelerations are indicative of uteroplacental insufficiency, which poses
a risk for fetal hypoxia. The initial intervention is to reposition the client to the lateral side
to improve blood flow to the placenta. While oxygen administration and IV fluids are part
of the intrauterine resuscitation protocol, repositioning is the most immediate priority to
relieve pressure on the vena cava.
3. A nurse is providing discharge instructions to a new mother regarding newborn safety.
Which of the following statements by the mother indicates a need for further teaching?
A. “I will place my baby on their back to sleep.”
B. “I will make sure the crib mattress is firm and fits the frame tightly.”
C. “I will keep the room temperature warm and use a heavy blanket to keep the baby cozy.”
D. “I will remove all stuffed animals and bumpers from the crib.”
Correct Answer: C
Explanation; Overheating and the use of soft bedding or heavy blankets are significant risk
factors for Sudden Infant Death Syndrome (SIDS). The infant should be dressed in light
,clothing or a sleep sack, and the environment should remain free of loose items. Placing the
baby on their back on a firm mattress is the safest recommended sleep practice.
4. A toddler is admitted to the pediatric unit with a diagnosis of croup
(laryngotracheobronchitis). Which clinical manifestation should the nurse expect to find?
A. Expiratory wheezing and productive cough
B. High fever and drooling
C. Barking cough and inspiratory stridor
D. Severe substernal retractions and cyanosis
Correct Answer: C
Explanation; Croup is an upper airway infection that causes swelling of the larynx and
trachea, leading to a characteristic ‘seal-like’ barking cough. Inspiratory stridor occurs as
air is pulled through the narrowed airway. Expiratory wheezing is more typical of lower
airway issues like bronchiolitis or asthma.
5. The nurse is assessing a client in the fourth stage of labor. The client’s fundus is boggy and
displaced to the right of the midline. Which action should the nurse take first?
A. Assist the client to void or catheterize if necessary.
B. Massage the fundus until firm.
C. Increase the Pitocin infusion rate.
D. Notify the primary healthcare provider.
, Correct Answer: A
Explanation; A fundus that is displaced to the right of the midline is a classic sign of
bladder distention. A full bladder prevents the uterus from contracting effectively, leading
to uterine atony and potential hemorrhage. Once the bladder is emptied, the nurse should
then reassess and massage the fundus if it remains boggy.
6. Which of the following interventions are appropriate for a child with Tetralogy of Fallot
experiencing a ‘tet spell’ or hypercyanotic episode? (Select All That Apply)
A. Place the child in the knee-chest position.
B. Administer 100% oxygen via face mask.
C. Provide a calm, quiet environment.
D. Administer morphine sulfate as ordered.
E. Encourage the child to walk to improve circulation.
Correct Answer: A,B,C,D
Explanation; The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt in Tetralogy of Fallot. Oxygen and morphine are used to
improve oxygenation and reduce infundibular spasms and anxiety. Walking or exertion
would increase oxygen demand and worsen the cyanosis, so it is contraindicated.
7. A nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which finding
should the nurse report to the provider immediately?
A. Respiratory rate of 10 breaths per minute
