NUR 221 Final Exam Study Guide & Practice
Questions (2024–2025 Edition) Comprehensive Review
for Adult Health Nursing II: Cardiovascular,
Respiratory, Renal, Endocrine, GI, Neuro, Hematology,
Oncology, Fluid & Electrolyte Balance, Pharmacology,
Critical Thinking, and NCLEX-Style Practice
What is the purpose of Universal Newborn Screening?
To screen for 34 core disorders and 26 secondary disorders. The core disorders
include hemoglobinopathies (e.g., sickle cell disease), inborn errors of metabolism
(e.g., phenylketonuria [PKU], galactosemia), severe combined immunodeficiency,
hearing loss, and critical congenital heart disease.
What are the first line interventions for Shoulder Dystocia?
The McRoberts maneuver and suprapubic pressure.
What are the common indicators for cesarean birth?
1.) Maternal: Specific cardiac disease (e.g., Marfan syndrome with dilated aortic
root)
2.) Fetal: Nonreassuring fetal status, malpresentation (breach or transverse lie),
active maternal herpes infection
3.) Maternal-Fetal: Cephalopelvic disproportion, placental abruption, placenta
previa, history of previous cesarean birth, cesarean birth on maternal request
What are the risk factors and causes of Postpartum Hemorrhage?
,Uterine atony (overdistended uterus, large fetus (>4g), multiple fetuses,
hydramnios, distention with clots), anesthesia (general or halogenated
anesthesia), previous history of uterine atony, high parity, obesity, prolonged
labor, oxytocin induced labor, trauma during labor and birth (forceps assisted
birth, vacuum assisted birth, cesarean birth), unrepaired lacerations of the birth
canal, retained placental fragments, ruptured uterus, inversion of the uterus,
placenta accreta, increta, percreta, coagulation disorders, placental abruption,
placenta previa, manual removal of a retained placenta, magnesium sulfate
administration during labor or postpartum period, chorioamnionitis and uterine
subinvolution.
What is the initial intervention in management of excessive postpartum
bleeding due to uterine atony?
Firm massage of the uterine fundus. Expression of any clots in the uterus,
elimination of bladder distention, and continuous IV infusion of 10 to 40 units of
oxytocin added to 1000 mL of lactated ringer's or normal saline solution also are
primary interventions.
How is Postpartum Hemorrhage often defined?
By the loss of 500 mL or more of blood after vaginal birth or 1000 mL or more
after cesarean birth.
What is the APGAR score?
A test done at 1 and 5 minutes after birth which permits a rapid assessment of the
newborns transition to extrauterine life based on five signs that indicate the
physiologic state of the neonate: heart rate, respiratory effort, muscle tone, reflex
irritability and generalized skin color.
APGAR Score - Heart rate
0 - Absent
1 - Slow (<100/min)
2 - >100/min
APGAR Score - Respiratory effort
, 0 - Absent
1 - Slow, weak cry
2 - Good cry
APGAR Score - Muscle tone
0 - Flaccid
1 - Some flexion of extremities
2 - Well flexed
APGAR Score - Reflex irritability
0 - No response
1 - Grimace
2 - Cry
APGAR Score - Color
0 - Blue, pale
1 - Body pink, extremities blue
2 - Completely pink
What should you teach parents regarding infant safe sleep?
1.) Always lay the baby flat in bed (in the bassinet or crib) on his or her back for
sleep, for naps, and at night. Do not place your infant on the abdomen for sleep.
2.) Room sharing, but not bed sharing, is recommended during the early weeks.
3.) There should be no bumper pads, blankets, stuffed toys, or other soft objects
in the baby's crib because of the risk for suffocation.
4.) Do not cover the baby with blankets or quilts; dress the baby in light sleep
clothing such as a sleep sack or one piece sleeper.
SAFETY ALERT (pg. 597):
Infants and toddlers should use a rear facing car seat at least until the age of 2
years. The safest area is in the back seat. A car safety seat that faces the rear gives
the best protection for an infant's disproportionately weak neck and heavy head.
Questions (2024–2025 Edition) Comprehensive Review
for Adult Health Nursing II: Cardiovascular,
Respiratory, Renal, Endocrine, GI, Neuro, Hematology,
Oncology, Fluid & Electrolyte Balance, Pharmacology,
Critical Thinking, and NCLEX-Style Practice
What is the purpose of Universal Newborn Screening?
To screen for 34 core disorders and 26 secondary disorders. The core disorders
include hemoglobinopathies (e.g., sickle cell disease), inborn errors of metabolism
(e.g., phenylketonuria [PKU], galactosemia), severe combined immunodeficiency,
hearing loss, and critical congenital heart disease.
What are the first line interventions for Shoulder Dystocia?
The McRoberts maneuver and suprapubic pressure.
What are the common indicators for cesarean birth?
1.) Maternal: Specific cardiac disease (e.g., Marfan syndrome with dilated aortic
root)
2.) Fetal: Nonreassuring fetal status, malpresentation (breach or transverse lie),
active maternal herpes infection
3.) Maternal-Fetal: Cephalopelvic disproportion, placental abruption, placenta
previa, history of previous cesarean birth, cesarean birth on maternal request
What are the risk factors and causes of Postpartum Hemorrhage?
,Uterine atony (overdistended uterus, large fetus (>4g), multiple fetuses,
hydramnios, distention with clots), anesthesia (general or halogenated
anesthesia), previous history of uterine atony, high parity, obesity, prolonged
labor, oxytocin induced labor, trauma during labor and birth (forceps assisted
birth, vacuum assisted birth, cesarean birth), unrepaired lacerations of the birth
canal, retained placental fragments, ruptured uterus, inversion of the uterus,
placenta accreta, increta, percreta, coagulation disorders, placental abruption,
placenta previa, manual removal of a retained placenta, magnesium sulfate
administration during labor or postpartum period, chorioamnionitis and uterine
subinvolution.
What is the initial intervention in management of excessive postpartum
bleeding due to uterine atony?
Firm massage of the uterine fundus. Expression of any clots in the uterus,
elimination of bladder distention, and continuous IV infusion of 10 to 40 units of
oxytocin added to 1000 mL of lactated ringer's or normal saline solution also are
primary interventions.
How is Postpartum Hemorrhage often defined?
By the loss of 500 mL or more of blood after vaginal birth or 1000 mL or more
after cesarean birth.
What is the APGAR score?
A test done at 1 and 5 minutes after birth which permits a rapid assessment of the
newborns transition to extrauterine life based on five signs that indicate the
physiologic state of the neonate: heart rate, respiratory effort, muscle tone, reflex
irritability and generalized skin color.
APGAR Score - Heart rate
0 - Absent
1 - Slow (<100/min)
2 - >100/min
APGAR Score - Respiratory effort
, 0 - Absent
1 - Slow, weak cry
2 - Good cry
APGAR Score - Muscle tone
0 - Flaccid
1 - Some flexion of extremities
2 - Well flexed
APGAR Score - Reflex irritability
0 - No response
1 - Grimace
2 - Cry
APGAR Score - Color
0 - Blue, pale
1 - Body pink, extremities blue
2 - Completely pink
What should you teach parents regarding infant safe sleep?
1.) Always lay the baby flat in bed (in the bassinet or crib) on his or her back for
sleep, for naps, and at night. Do not place your infant on the abdomen for sleep.
2.) Room sharing, but not bed sharing, is recommended during the early weeks.
3.) There should be no bumper pads, blankets, stuffed toys, or other soft objects
in the baby's crib because of the risk for suffocation.
4.) Do not cover the baby with blankets or quilts; dress the baby in light sleep
clothing such as a sleep sack or one piece sleeper.
SAFETY ALERT (pg. 597):
Infants and toddlers should use a rear facing car seat at least until the age of 2
years. The safest area is in the back seat. A car safety seat that faces the rear gives
the best protection for an infant's disproportionately weak neck and heavy head.
