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NUR 353 Exam 2 PEDS ALL 500 QUESTIONS AND CORRECT ANSWERS LATEST UPDATE THIS YEAR

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Page 1 of 159



NUR 353 Exam 2 PEDS ALL 500 QUESTIONS
AND CORRECT ANSWERS LATEST UPDATE
THIS YEAR
QUESTION: The nurse is preparing to discharge a 30-year-old woman who has experienced a
miscarriage at 10 weeks of gestation. Which statement by the woman would indicate a correct
understanding of the discharge instructions?




a. "I will not experience mood swings since I was only at 10 weeks of gestation."

b. "I will avoid sexual intercourse for 6 weeks and pregnancy for 6 months."

c. "I should eat foods that are high in iron and protein to help my body heal."

d. "I should expect the bleeding to be heavy and bright red for at least 1 week." - ANSWER-C
(After a miscarriage a woman may experience mood swings and depression from the reduction
of hormones and the grieving process. Sexual intercourse should be avoided for 2 weeks or
until the bleeding has stopped and should avoid pregnancy for 2 months. A woman who has
experienced a miscarriage should be advised to eat foods that are high in iron and protein to
help replenish her body after the loss. The woman should not experience bright red, heavy,
profuse bleeding; this should be reported to the health care provider.)




QUESTION: A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The
nurse becomes concerned after assessment when the woman exhibits:




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a. a sleepy, sedated affect.

b. a respiratory rate of 10 breaths/min.

c. deep tendon reflexes of 2+.

d. absent ankle clonus. - ANSWER-B (Because magnesium sulfate is a central nervous system
(CNS) depressant, the client will most likely become sedated when the infusion is initiated. A
respiratory rate of 10 breaths/min indicates that the client is experiencing respiratory
depression (bradypnea) from magnesium toxicity. Deep tendon reflexes of 2+ are a normal
finding. Absent ankle clonus is a normal finding.)




QUESTION: A woman with severe preeclampsia is being treated with an IV infusion of
magnesium sulfate. This treatment is considered successful if:




a. blood pressure is reduced to prepregnant baseline.

b. seizures do not occur.

c. deep tendon reflexes become hypotonic.

d. diuresis reduces fluid retention. - ANSWER-B (A temporary decrease in blood pressure can
occur; however, this is not the purpose of administering this medication. Magnesium sulfate is
a central nervous system (CNS) depressant given primarily to prevent seizures. Hypotonia is a
sign of an excessive serum level of magnesium. It is critical that calcium gluconate be on hand
to counteract the depressant effects of magnesium toxicity. Diuresis is not an expected
outcome of magnesium sulfate administration.)




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QUESTION: A woman with severe preeclampsia has been receiving magnesium sulfate by IV
infusion for 8 hours. The nurse assesses the woman and documents the following findings:
temperature 37.1° C, pulse rate 96 beats/min, respiratory rate 24 breaths/min, blood pressure
155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. The nurse calls the physician,
anticipating an order for:




a. hydralazine.

b. magnesium sulfate bolus

c. diazepam.

d. calcium gluconate. - ANSWER-A (Hydralazine is an antihypertensive commonly used to treat
hypertension in severe preeclampsia. An additional bolus of magnesium sulfate may be ordered
for increasing signs of central nervous system irritability related to severe preeclampsia (e.g.,
clonus) or if eclampsia develops. Diazepam sometimes is used to stop or shorten eclamptic
seizures. Calcium gluconate is used as the antidote for magnesium sulfate toxicity. The client is
not currently displaying any signs or symptoms of magnesium toxicity.)




QUESTION: The most prevalent clinical manifestation of abruptio placentae (as opposed to
placenta previa) is:




a. bleeding.

b. intense abdominal pain.

c. uterine activity.




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d. cramping. - ANSWER-B (Bleeding may be present in varying degrees for both placental
conditions. Pain is absent with placenta previa and may be agonizing with abruptio placentae.
Uterine activity may be present with both placental conditions. Cramping is a form of uterine
activity that may be present in both placental conditions.)




QUESTION: A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the
labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2
minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset
of:




a. eclamptic seizure.

b. rupture of the uterus.

c. placenta previa.

d. placental abruption. - ANSWER-D (Eclamptic seizures are evidenced by the presence of
generalized tonic-clonic convulsions. Uterine rupture presents as hypotonic uterine activity,
signs of hypovolemia, and in many cases the absence of pain. Placenta previa presents with
bright red, painless vaginal bleeding. Uterine tenderness in the presence of increasing tone may
be the earliest finding of premature separation of the placenta (abruptio placentae or placental
abruption). Women with hypertension are at increased risk for an abruption.)




QUESTION: Signs of a threatened abortion (miscarriage) are noted in a woman at 8 weeks of
gestation. What is an appropriate management approach for this type of abortion?




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