NUR 376 COMPREHENSIVE EXAM
(HIGH DIFFICULTY) QUESTIONS AND
ANSWERS
1. A patient at 34 weeks gestation presents with a sudden onset of severe abdominal pain
and a board-like abdomen. The nurse notes dark red vaginal bleeding. Which condition
should the nurse suspect?
A. Placenta previa
B. Uterine rupture
C. Abruptio placentae
D. Ectopic pregnancy
Answer: C
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
and a rigid, board-like abdomen due to the premature separation of the placenta from the
uterine wall.
2. When monitoring a fetal heart rate (FHR) tracing, the nurse notes late decelerations. What
is the priority nursing intervention?
A. Administer oxygen via non-rebreather mask and reposition the mother
,B. Perform a vaginal exam to check for cord prolapse
C. Increase the rate of the oxytocin infusion
D. Instruct the mother to begin pushing
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation and blood flow to the fetus by giving oxygen and
repositioning the mother (usually to the left side).
3. A nurse is caring for an infant with Tetralogy of Fallot who suddenly becomes cyanotic and
tachypneic. Which action should the nurse take first?
A. Place the infant in the knee-chest position
B. Administer 100% oxygen via blow-by
C. Prepare for immediate administration of morphine
D. Start an intravenous line for fluid resuscitation
Answer: A
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which decreases the right-to-left shunt and improves oxygenation during a ‘Tet’ spell.
4. A child is admitted with suspected epiglottitis. Which of the following nursing actions is
contraindicated?
A. Allowing the child to remain in a position of comfort
, B. Visualizing the throat with a tongue depressor
C. Preparing for emergency intubation
D. Administering humidified oxygen
Answer: B
Conceptual Explanation: Using a tongue depressor to visualize the throat in a patient with
epiglottitis can trigger a laryngospasm and complete airway obstruction.
5. A client in active labor is receiving an oxytocin infusion. The nurse notes contractions
lasting 100 seconds and occurring every 90 seconds. What is the next action?
A. Increase the oxytocin rate to accelerate labor
B. Continue to monitor the contraction pattern
C. Discontinue the oxytocin infusion
D. Notify the provider that labor is progressing well
Answer: C
Conceptual Explanation: Tachysystole (contractions lasting >90 seconds or occurring <2
minutes apart) can lead to fetal distress; the oxytocin must be stopped immediately.
6. A 6-year-old child is diagnosed with Nephrotic Syndrome. Which clinical manifestation
should the nurse expect to find?
A. Gross hematuria and hypertension
B. Ketonuria and weight loss
(HIGH DIFFICULTY) QUESTIONS AND
ANSWERS
1. A patient at 34 weeks gestation presents with a sudden onset of severe abdominal pain
and a board-like abdomen. The nurse notes dark red vaginal bleeding. Which condition
should the nurse suspect?
A. Placenta previa
B. Uterine rupture
C. Abruptio placentae
D. Ectopic pregnancy
Answer: C
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
and a rigid, board-like abdomen due to the premature separation of the placenta from the
uterine wall.
2. When monitoring a fetal heart rate (FHR) tracing, the nurse notes late decelerations. What
is the priority nursing intervention?
A. Administer oxygen via non-rebreather mask and reposition the mother
,B. Perform a vaginal exam to check for cord prolapse
C. Increase the rate of the oxytocin infusion
D. Instruct the mother to begin pushing
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation and blood flow to the fetus by giving oxygen and
repositioning the mother (usually to the left side).
3. A nurse is caring for an infant with Tetralogy of Fallot who suddenly becomes cyanotic and
tachypneic. Which action should the nurse take first?
A. Place the infant in the knee-chest position
B. Administer 100% oxygen via blow-by
C. Prepare for immediate administration of morphine
D. Start an intravenous line for fluid resuscitation
Answer: A
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which decreases the right-to-left shunt and improves oxygenation during a ‘Tet’ spell.
4. A child is admitted with suspected epiglottitis. Which of the following nursing actions is
contraindicated?
A. Allowing the child to remain in a position of comfort
, B. Visualizing the throat with a tongue depressor
C. Preparing for emergency intubation
D. Administering humidified oxygen
Answer: B
Conceptual Explanation: Using a tongue depressor to visualize the throat in a patient with
epiglottitis can trigger a laryngospasm and complete airway obstruction.
5. A client in active labor is receiving an oxytocin infusion. The nurse notes contractions
lasting 100 seconds and occurring every 90 seconds. What is the next action?
A. Increase the oxytocin rate to accelerate labor
B. Continue to monitor the contraction pattern
C. Discontinue the oxytocin infusion
D. Notify the provider that labor is progressing well
Answer: C
Conceptual Explanation: Tachysystole (contractions lasting >90 seconds or occurring <2
minutes apart) can lead to fetal distress; the oxytocin must be stopped immediately.
6. A 6-year-old child is diagnosed with Nephrotic Syndrome. Which clinical manifestation
should the nurse expect to find?
A. Gross hematuria and hypertension
B. Ketonuria and weight loss
