Exam 1: NUR202 / NUR 202 (Latest 2025 /
2026 Update) Maternal-Newborn Nursing |
Questions with Verified Answers|100%
Correct | Grade A – Fortis.
Question:
A client has intra-arterial blood pressure monitoring after a myocardial
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
infarction. The nurse notes that the client's heart rate has increased from
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
88 to 110 beats/min, and the blood pressure dropped from 120/82 to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
100/60 mm Hg. What action by the nurse is
i,- i,- i,- i,- i,- i,- i,- i,- i,-
most appropriate? i,-
a. Allow the client to rest quietly.
i,- i,- i,- i,- i,- i,-
b. Assess the client for bleeding.
i,- i,- i,- i,- i,-
c. Document the findings in the chart.
i,- i,- i,- i,- i,- i,-
d. Medicate the client for pain.?
i,- i,- i,- i,- i,-
Answer:
ANS: B i,-
A major complication related to intra-arterial blood pressure monitoring is
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
hemorrhage from the insertion site. Since these vital signs are out of the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
normal range, are a change, and are consistent with blood loss, the nurse
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
would assess the client for any bleeding associated with the arterial line.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
The nurse would document the findings after a full assessment. The client
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
,may or may not need pain medication and rest; the nurse first needs to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
rule out any emergent bleeding.
i,- i,- i,- i,-
REDUCTION OF RISK i,- i,-
Question:
A client is in the preoperative holding area prior to an emergency
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
coronary artery bypass graft (CABG). The client is yelling at family
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
members and tells the doctor to "just get this over with" when asked to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
sign the consent form. What action by the nurse is best?
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
a. Ask the family members to wait in the waiting area.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
b. Inform the client that this behavior is unacceptable.
i,- i,- i,- i,- i,- i,- i,- i,-
c. Stay out of the room to decrease the client's stress levels.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
d. Tell the client that anxiety is common and that you can help?
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Answer:
ANS: D Preoperative fear and anxiety are common prior to cardiac
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
surgery, especially in emergent situations. The client is exhibiting anxiety,
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
and the nurse would reassure the client that fear is common and offer to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
help. The other actions will not reduce the client's anxiety
i,- i,- i,- i,- i,- i,- i,- i,- i,-
PSYCHOSOCIAL INTEGRITY i,-
Question:
,A client is in the clinic a month after having a myocardial infarction. The
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
client reports sleeping well since moving into the guest bedroom. What
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
response by the nurse is best? i,- i,- i,- i,- i,-
a. "Do you have any concerns about sexuality?"
i,- i,- i,- i,- i,- i,- i,-
b. "I'm glad to hear you are sleeping well now."
i,- i,- i,- i,- i,- i,- i,- i,- i,-
c. "Sleep near your spouse in case of emergency."
i,- i,- i,- i,- i,- i,- i,- i,-
d. "Why would you move into the guest room?"?
i,- i,- i,- i,- i,- i,- i,- i,-
Answer:
ANS: A i,-
Concerns about resuming sexual activity are common after cardiac events.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
The nurse would gently inquire if this is the issue. While
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
it is good that the client is sleeping well, the nurse would investigate the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
reason for the move. The other two responses are likely to cause the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
client to be defensive
i,- i,- i,-
PSYCHOSOCIAL INTEGRITY i,-
Question:
A client in the cardiac stepdown unit reports severe, crushing chest pain
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
accompanied by nausea and vomiting. What action by the nurse takes i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
priority? a. Administer an aspirin. i,- i,- i,- i,- i,-
b. Call for an electrocardiogram (ECG). c. Maintain airway patency.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
d. Notify the provider?
i,- i,- i,-
Answer:
ANS: C i,-
, Airway always is the priority. The other actions are important in this
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
situation as well, but the nurse would stay with the client and
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
ensure that the airway remains patent (especially if vomiting occurs) while
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
another person calls the primary health care provider (or Rapid Response
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Team) and facilitates getting an ECG done. Aspirin will probably be
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
administered, depending on the primary i,- i,- i,- i,- i,-
health care provider's prescription and the client's current medications
i,- i,- i,- i,- i,- i,- i,- i,-
MANAGMENT OF CARE i,- i,-
Question:
An older adult is on cardiac monitoring after a myocardial infarction. The
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
client shows frequent dysrhythmias. What action by the nurse is most
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
appropriate?
a. Assess for any hemodynamic effects of the rhythm.
i,- i,- i,- i,- i,- i,- i,- i,-
b. Prepare to administer antidysrhythmic medication.
i,- i,- i,- i,- i,-
c. Notify the primary health care provider or call the Rapid Response Team.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
d. Turn the alarms off on the cardiac monitor.?
i,- i,- i,- i,- i,- i,- i,- i,-
Answer:
ANS: A i,-
Older clients may have dysrhythmias due to age-related changes in the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
cardiac conduction system. Or this client's dysrhythmias could be a
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
consequence of the myocardial infarction. They may or may not havei,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
significant hemodynamic effects. The nurse would
i,- i,- i,- i,- i,- i,-
2026 Update) Maternal-Newborn Nursing |
Questions with Verified Answers|100%
Correct | Grade A – Fortis.
Question:
A client has intra-arterial blood pressure monitoring after a myocardial
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
infarction. The nurse notes that the client's heart rate has increased from
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
88 to 110 beats/min, and the blood pressure dropped from 120/82 to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
100/60 mm Hg. What action by the nurse is
i,- i,- i,- i,- i,- i,- i,- i,- i,-
most appropriate? i,-
a. Allow the client to rest quietly.
i,- i,- i,- i,- i,- i,-
b. Assess the client for bleeding.
i,- i,- i,- i,- i,-
c. Document the findings in the chart.
i,- i,- i,- i,- i,- i,-
d. Medicate the client for pain.?
i,- i,- i,- i,- i,-
Answer:
ANS: B i,-
A major complication related to intra-arterial blood pressure monitoring is
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
hemorrhage from the insertion site. Since these vital signs are out of the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
normal range, are a change, and are consistent with blood loss, the nurse
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
would assess the client for any bleeding associated with the arterial line.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
The nurse would document the findings after a full assessment. The client
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
,may or may not need pain medication and rest; the nurse first needs to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
rule out any emergent bleeding.
i,- i,- i,- i,-
REDUCTION OF RISK i,- i,-
Question:
A client is in the preoperative holding area prior to an emergency
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
coronary artery bypass graft (CABG). The client is yelling at family
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
members and tells the doctor to "just get this over with" when asked to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
sign the consent form. What action by the nurse is best?
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
a. Ask the family members to wait in the waiting area.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
b. Inform the client that this behavior is unacceptable.
i,- i,- i,- i,- i,- i,- i,- i,-
c. Stay out of the room to decrease the client's stress levels.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
d. Tell the client that anxiety is common and that you can help?
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Answer:
ANS: D Preoperative fear and anxiety are common prior to cardiac
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
surgery, especially in emergent situations. The client is exhibiting anxiety,
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
and the nurse would reassure the client that fear is common and offer to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
help. The other actions will not reduce the client's anxiety
i,- i,- i,- i,- i,- i,- i,- i,- i,-
PSYCHOSOCIAL INTEGRITY i,-
Question:
,A client is in the clinic a month after having a myocardial infarction. The
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
client reports sleeping well since moving into the guest bedroom. What
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
response by the nurse is best? i,- i,- i,- i,- i,-
a. "Do you have any concerns about sexuality?"
i,- i,- i,- i,- i,- i,- i,-
b. "I'm glad to hear you are sleeping well now."
i,- i,- i,- i,- i,- i,- i,- i,- i,-
c. "Sleep near your spouse in case of emergency."
i,- i,- i,- i,- i,- i,- i,- i,-
d. "Why would you move into the guest room?"?
i,- i,- i,- i,- i,- i,- i,- i,-
Answer:
ANS: A i,-
Concerns about resuming sexual activity are common after cardiac events.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
The nurse would gently inquire if this is the issue. While
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
it is good that the client is sleeping well, the nurse would investigate the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
reason for the move. The other two responses are likely to cause the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
client to be defensive
i,- i,- i,-
PSYCHOSOCIAL INTEGRITY i,-
Question:
A client in the cardiac stepdown unit reports severe, crushing chest pain
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
accompanied by nausea and vomiting. What action by the nurse takes i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
priority? a. Administer an aspirin. i,- i,- i,- i,- i,-
b. Call for an electrocardiogram (ECG). c. Maintain airway patency.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
d. Notify the provider?
i,- i,- i,-
Answer:
ANS: C i,-
, Airway always is the priority. The other actions are important in this
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
situation as well, but the nurse would stay with the client and
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
ensure that the airway remains patent (especially if vomiting occurs) while
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
another person calls the primary health care provider (or Rapid Response
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Team) and facilitates getting an ECG done. Aspirin will probably be
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
administered, depending on the primary i,- i,- i,- i,- i,-
health care provider's prescription and the client's current medications
i,- i,- i,- i,- i,- i,- i,- i,-
MANAGMENT OF CARE i,- i,-
Question:
An older adult is on cardiac monitoring after a myocardial infarction. The
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
client shows frequent dysrhythmias. What action by the nurse is most
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
appropriate?
a. Assess for any hemodynamic effects of the rhythm.
i,- i,- i,- i,- i,- i,- i,- i,-
b. Prepare to administer antidysrhythmic medication.
i,- i,- i,- i,- i,-
c. Notify the primary health care provider or call the Rapid Response Team.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
d. Turn the alarms off on the cardiac monitor.?
i,- i,- i,- i,- i,- i,- i,- i,-
Answer:
ANS: A i,-
Older clients may have dysrhythmias due to age-related changes in the
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
cardiac conduction system. Or this client's dysrhythmias could be a
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
consequence of the myocardial infarction. They may or may not havei,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
significant hemodynamic effects. The nurse would
i,- i,- i,- i,- i,- i,-
