NUR 418 / NUR 415 Exam 2 V1 | NUR 418 /
NUR 415 Nursing Care of the Childbearing
& Childrearing Family | Actual Q&A with
Rationale (NUR418/NUR415 Exam 2) |
Concordia
1. A nurse is monitoring a client in labor and observes late decelerations on the fetal monitor
strip. Which of the following actions should the nurse perform first?
A. Administer oxygen via a non-rebreather face mask.
B. Increase the rate of the intravenous infusion.
C. Notify the primary healthcare provider.
D. Reposition the client to a side-lying position.
Correct Answer: D
Explanation; Late decelerations indicate uteroplacental insufficiency and fetal distress.
The first priority is to improve placental perfusion by repositioning the client to a lateral
(side-lying) position to relieve pressure on the vena cava. After repositioning, the nurse
should then administer oxygen and increase IV fluids as part of intrauterine resuscitation.
2. A postpartum nurse is caring for a client who gave birth 4 hours ago. Which of the
following assessment findings is the most concerning and requires immediate intervention?
A. Firm fundus at the level of the umbilicus.
,B. Saturated perineal pad in 15 minutes.
C. Moderate amount of lochia rubra.
D. Pulse rate of 60 beats per minute.
Correct Answer: B
Explanation; Saturating a perineal pad in 15 minutes or less is a sign of excessive bleeding
or postpartum hemorrhage. A firm fundus at the umbilicus and moderate lochia are normal
findings 4 hours after delivery. Bradycardia is also a common physiological finding in the
early postpartum period due to hemodynamic changes.
3. A nurse is teaching a group of parents about infant safety. Which of the following
instructions should be included regarding SIDS prevention? (Select All That Apply)
A. Place the infant on their back to sleep.
B. Use a firm sleep surface without soft objects.
C. Allow the infant to sleep in the parent’s bed.
D. Offer a pacifier at naptime and bedtime.
E. Avoid over-bundling or overheating the infant.
F. Maintain a smoke-free environment.
Correct Answer: A, B, D, E, F
Explanation; Back-to-sleep is the primary recommendation for SIDS prevention. Soft
objects, loose bedding, and co-sleeping increase the risk of suffocation and SIDS. Pacifier
, use and avoiding overheating are evidence-based protective factors against sudden infant
death.
4. A nurse is assessing a 4-year-old child for developmental milestones. Which of the
following findings indicates the child is meeting expectations for this age?
A. The child can jump rope and tie shoelaces.
B. The child uses 4-word to 5-word sentences.
C. The child can name at least four colors.
D. The child is able to balance on one foot for 5 seconds.
Correct Answer: C
Explanation; Naming colors is a cognitive milestone typically achieved by age 4. While a 4-
year-old can use several words in a sentence, tying shoelaces is a fine motor skill more
common in 5- to 6-year-olds. Balancing on one foot for 5 seconds is also typically a skill
seen as children progress toward age 5.
5. A client at 32 weeks gestation is admitted with a diagnosis of severe preeclampsia. Which
of the following medications should the nurse expect to administer to prevent seizures?
A. Magnesium Sulfate
B. Nifedipine
C. Labetalol
D. Terbutaline
NUR 415 Nursing Care of the Childbearing
& Childrearing Family | Actual Q&A with
Rationale (NUR418/NUR415 Exam 2) |
Concordia
1. A nurse is monitoring a client in labor and observes late decelerations on the fetal monitor
strip. Which of the following actions should the nurse perform first?
A. Administer oxygen via a non-rebreather face mask.
B. Increase the rate of the intravenous infusion.
C. Notify the primary healthcare provider.
D. Reposition the client to a side-lying position.
Correct Answer: D
Explanation; Late decelerations indicate uteroplacental insufficiency and fetal distress.
The first priority is to improve placental perfusion by repositioning the client to a lateral
(side-lying) position to relieve pressure on the vena cava. After repositioning, the nurse
should then administer oxygen and increase IV fluids as part of intrauterine resuscitation.
2. A postpartum nurse is caring for a client who gave birth 4 hours ago. Which of the
following assessment findings is the most concerning and requires immediate intervention?
A. Firm fundus at the level of the umbilicus.
,B. Saturated perineal pad in 15 minutes.
C. Moderate amount of lochia rubra.
D. Pulse rate of 60 beats per minute.
Correct Answer: B
Explanation; Saturating a perineal pad in 15 minutes or less is a sign of excessive bleeding
or postpartum hemorrhage. A firm fundus at the umbilicus and moderate lochia are normal
findings 4 hours after delivery. Bradycardia is also a common physiological finding in the
early postpartum period due to hemodynamic changes.
3. A nurse is teaching a group of parents about infant safety. Which of the following
instructions should be included regarding SIDS prevention? (Select All That Apply)
A. Place the infant on their back to sleep.
B. Use a firm sleep surface without soft objects.
C. Allow the infant to sleep in the parent’s bed.
D. Offer a pacifier at naptime and bedtime.
E. Avoid over-bundling or overheating the infant.
F. Maintain a smoke-free environment.
Correct Answer: A, B, D, E, F
Explanation; Back-to-sleep is the primary recommendation for SIDS prevention. Soft
objects, loose bedding, and co-sleeping increase the risk of suffocation and SIDS. Pacifier
, use and avoiding overheating are evidence-based protective factors against sudden infant
death.
4. A nurse is assessing a 4-year-old child for developmental milestones. Which of the
following findings indicates the child is meeting expectations for this age?
A. The child can jump rope and tie shoelaces.
B. The child uses 4-word to 5-word sentences.
C. The child can name at least four colors.
D. The child is able to balance on one foot for 5 seconds.
Correct Answer: C
Explanation; Naming colors is a cognitive milestone typically achieved by age 4. While a 4-
year-old can use several words in a sentence, tying shoelaces is a fine motor skill more
common in 5- to 6-year-olds. Balancing on one foot for 5 seconds is also typically a skill
seen as children progress toward age 5.
5. A client at 32 weeks gestation is admitted with a diagnosis of severe preeclampsia. Which
of the following medications should the nurse expect to administer to prevent seizures?
A. Magnesium Sulfate
B. Nifedipine
C. Labetalol
D. Terbutaline
