NUR 166 Exam 2 Hondros Family-Centered Nursing for the Practical Nurse Comprehensive Questions with Verified Answers and Detailed Rationales

INSTANT PDF DOWNLOAD — This comprehensive exam preparation resource for NUR 166 Exam 2 at Hondros College of Nursing covers Family-Centered Nursing for the Practical Nurse (LPN) program. It features verified questions and answers with detailed rationales in multiple-choice, select-all-that-apply (SATA), ordered response, and clinical scenario formats aligned with the Ohio Board of Nursing LPN scope of practice. This resource focuses on maternal-newborn nursing, intrapartum care, postpartum care, newborn assessment and care, breastfeeding, and complications of pregnancy, labor, and delivery. MATERNAL-NEWBORN NURSING (EXAM 2 FOCUS) INTRAPARTUM CARE (LABOR AND DELIVERY) Stages 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, contractions mild to moderate (frequency 5-30 minutes, duration 15-45 seconds, intensity mild), lasts approximately 6-8 hours (nulliparous) or 4-6 hours (multiparous). Nursing interventions: encourage rest, ambulation if no contraindications, provide comfort measures (back rub, breathing techniques), offer clear liquids, encourage voiding q2h. Active Phase (6-8 cm) – Cervical dilation 6-8 cm, contractions moderate to strong (frequency 3-5 minutes, duration 45-60 seconds, intensity moderate), lasts approximately 2-4 hours (nulliparous) or 1-3 hours (multiparous). Nursing interventions: coach with breathing techniques (slow-paced breathing, modified-paced breathing), provide pain relief, monitor FHR q15-30 minutes, position changes. Transition Phase (8-10 cm) – Cervical dilation 8-10 cm, contractions strong to very strong (frequency 1.5-2.5 minutes, duration 60-90 seconds, intensity strong), lasts approximately 1-3 hours (nulliparous) or 30-60 minutes (multiparous). Nursing interventions: intense support, coach with patterned-paced breathing, provide encouragement, avoid pushing until fully dilated, monitor FHR q15 minutes (q5 minutes if high risk), prepare for delivery. Stage 2: Expulsion (Full Dilation 10 cm to Birth of Fetus) – Cervix fully dilated, descent of presenting part, Ferguson reflex (urge to push). Contractions: frequency 1.5-2.5 minutes, duration 60-90 seconds, intensity strong. Duration: nulliparous 30 minutes-3 hours, multiparous 5-30 minutes. Nursing interventions: coach effective pushing (open glottis pushing, avoid prolonged breath-holding), assess perineum for crowning, assist provider, monitor FHR q5 minutes. Positioning for labor: upright positions (sitting, squatting, side-lying, hands-and-knees) improve pelvic outlet diameter, gravity assists descent. Stage 3: Placental Delivery (Birth of Fetus to Delivery of Placenta) – Signs of placental separation: umbilical cord lengthens, uterus becomes firm and globular, sudden gush of blood, uterus rises in abdomen. Duration: typically 5-30 minutes. Normal blood loss: 500 mL vaginal delivery. Nursing interventions: administer Pitocin (oxytocin) 10 units IM after delivery of placenta (if ordered), massage fundus, inspect placenta for completeness (all cotyledons and membranes), monitor for hemorrhage. Stage 4: Immediate Postpartum Recovery (1-4 Hours Postpartum) – Maternal stabilization: monitor vital signs q15 minutes x1 hour, then q30 minutes x1 hour, then q1 hour. Assess fundus (should be firm, midline, at umbilicus), lochia (rubra, moderate flow, no clots 1 cm), bladder (encourage voiding within 4 hours), perineum (REEDA: redness, edema, ecchymosis, discharge, approximation). Newborn transition (first 2 hours of life): skin-to-skin contact, initiate breastfeeding, monitor respiratory status, temperature, blood glucose.