NURS 355 Final Exam FALL 2025 (MUST KNOW TO
PASS) 100%VERIFIED Cassandra Cummings
ORIGINAL BLUEPRINT
Ch. 1: Infant Mortality Rate
Infant mortality rate
- Common indicator of the adequacy of prenatal care and the health of a nation as a whole
- Black infants have 2.3 times the infant mortality rate as white infants
- Increased rate of survival during the neonatal period have resulted largely from high-quality prenatal
care and improvement in perinatal services, including technologic advances in neonatal intensive care
and obstetrics
Ch 14: Immunizations during pregnancy
Immunizations
•Immunizations that can be given during pregnancy -> Inactivated flu shot, Tdap, Hep B, and COVID19
•Live attenuated immunizations are contraindicated - MMR, Varicella
Ch 15: Folic Acid
Folic acid intake
◦0.4 mg (400 mcg) recommended daily for all adolescents and women capable of becoming pregnant as
well as dietary sources of folate
◦Neural tube defects can occur with poor intake (e.g. spina bifida, anencephaly)
Desirable body weight reduces maternal and fetal risks
Ch 16: Stage of labor
First
•Onset of uterine contractions → full effacement of and dilation of cervix
•Divided into 2 phases: Latent (early) phase & Active phase
•During this stage we will encourage the patient to change positions frequently
Second
•Cervix Fully dilated → birth of the infant
2 phases:
•Latent (passive descent)- fetus descends through the birth canal and rotates to an anterior position
•Active pushing- the strong urge to bear down as the fetus descends and presses on the stretch
receptors of the pelvic floor.
Third
•Birth of the infant → delivery of the placenta
,•Placenta separates within about 3-4 contractions and is delivered within the next contraction.
Fourth
•Delivery of the placenta → until woman’s condition is considered stable in the immediate postpartum
period (usually within 1 hour after birth)
•Mother begins to recover physically from birth and is observed for complications (such as abnormal
bleeding)
Ch. 2: Families
Family
◦Primary unit of socialization
◦Basic structural unit within a community
Family organization
◦Nuclear family- traditional American family (husband, wife and their children) living as an independent
unit, sharing roles, responsibilities and economic resources
◦Extended family- grandparents, aunts or uncles or others related by blood living in the same household
with the nuclear family
-> Becoming more common as society ages
Multigenerational family
◦Three or more generations in one household; grandparents supporting children and grandchildren or
grandparents as the sole caregivers for their grandchildren
◦"Sandwich generation"
Nonbiologic-parent families
◦Children live independently in foster or kinship care (living with a family member that is not their
parent)
Married-blended family
◦Formed as a result of divorce and remarriage - consist of unrelated family members who join to create
a new household (stepparents, stepchildren, stepsiblings)
Cohabiting-parent family
◦Children live with two unmarried biologic or adoptive parents
◦Hispanic children more than twice as likely as Black children, who are 4 times more likely than White
children to live in this family arrangement
Single-parent family
◦Unmarried biologic or adoptive parent
◦Death, divorce, unplanned pregnancy, adoption by an unmarried woman or man
◦Tends to be part of the vulnerable population (economically and socially)
, Ch 18: FHT
Tocotransducer - Placed over the fundus above the umbilicus (measures contractions)
External Fetal Monitoring - Records baby's heart rate so lower on the belly, where baby's heart would be
if head down
•Normal range for term fetus in 110-160 BPM
Variability:
•Absent – FHR fluctuations not detectable to the unaided eye
•Minimal – amplitude range of 5 BPM or less
•Moderate – considered normal – FHR not affected by interruption of fetal oxygenation
•Marked- significance is unknown; likely represents a normal variation
•Sinusoidal- uncommon pattern not included in variability that is seen with chorioamnionitis, fetal
sepsis, administration of opioids, and fetal anemia
Ch 18: Decels
Early
•Gradual decrease in and return to baseline associated with UCs
-> Onset to lowest point > or equal to 30 sec
•Normal, benign finding (r/t transient head compression)
•Onset, nadir (lowest point), and recovery correspond to the beginning, peak, and end of the
contraction
•Mirror image of the UC
Late
•Visually apparent decrease and return to baseline of FHR during UCs
•Begins after contraction started and nadir (lowest point) occurs after the peak of the contraction
•Returns to baseline after contraction is over
Causes:
•Maternal hypotension
•Uterine tachysystole (excessively frequent uterine contractions)
•Hypertensive disorders
•Placenta previa/abruption
•Maternal diabetes
Clinical significance: reflects fetal response to transient or chronic uteroplacental insufficiency
Nursing Interventions:
•D/C Pitocin: Uterine tachysystole
•Change position (more to side-lying)
•If hypotension – elevate legs
•Increase maintenance IV fluid rate
•Palpate uterus to assess for tachysystole
•Notify OB/HCP
PASS) 100%VERIFIED Cassandra Cummings
ORIGINAL BLUEPRINT
Ch. 1: Infant Mortality Rate
Infant mortality rate
- Common indicator of the adequacy of prenatal care and the health of a nation as a whole
- Black infants have 2.3 times the infant mortality rate as white infants
- Increased rate of survival during the neonatal period have resulted largely from high-quality prenatal
care and improvement in perinatal services, including technologic advances in neonatal intensive care
and obstetrics
Ch 14: Immunizations during pregnancy
Immunizations
•Immunizations that can be given during pregnancy -> Inactivated flu shot, Tdap, Hep B, and COVID19
•Live attenuated immunizations are contraindicated - MMR, Varicella
Ch 15: Folic Acid
Folic acid intake
◦0.4 mg (400 mcg) recommended daily for all adolescents and women capable of becoming pregnant as
well as dietary sources of folate
◦Neural tube defects can occur with poor intake (e.g. spina bifida, anencephaly)
Desirable body weight reduces maternal and fetal risks
Ch 16: Stage of labor
First
•Onset of uterine contractions → full effacement of and dilation of cervix
•Divided into 2 phases: Latent (early) phase & Active phase
•During this stage we will encourage the patient to change positions frequently
Second
•Cervix Fully dilated → birth of the infant
2 phases:
•Latent (passive descent)- fetus descends through the birth canal and rotates to an anterior position
•Active pushing- the strong urge to bear down as the fetus descends and presses on the stretch
receptors of the pelvic floor.
Third
•Birth of the infant → delivery of the placenta
,•Placenta separates within about 3-4 contractions and is delivered within the next contraction.
Fourth
•Delivery of the placenta → until woman’s condition is considered stable in the immediate postpartum
period (usually within 1 hour after birth)
•Mother begins to recover physically from birth and is observed for complications (such as abnormal
bleeding)
Ch. 2: Families
Family
◦Primary unit of socialization
◦Basic structural unit within a community
Family organization
◦Nuclear family- traditional American family (husband, wife and their children) living as an independent
unit, sharing roles, responsibilities and economic resources
◦Extended family- grandparents, aunts or uncles or others related by blood living in the same household
with the nuclear family
-> Becoming more common as society ages
Multigenerational family
◦Three or more generations in one household; grandparents supporting children and grandchildren or
grandparents as the sole caregivers for their grandchildren
◦"Sandwich generation"
Nonbiologic-parent families
◦Children live independently in foster or kinship care (living with a family member that is not their
parent)
Married-blended family
◦Formed as a result of divorce and remarriage - consist of unrelated family members who join to create
a new household (stepparents, stepchildren, stepsiblings)
Cohabiting-parent family
◦Children live with two unmarried biologic or adoptive parents
◦Hispanic children more than twice as likely as Black children, who are 4 times more likely than White
children to live in this family arrangement
Single-parent family
◦Unmarried biologic or adoptive parent
◦Death, divorce, unplanned pregnancy, adoption by an unmarried woman or man
◦Tends to be part of the vulnerable population (economically and socially)
, Ch 18: FHT
Tocotransducer - Placed over the fundus above the umbilicus (measures contractions)
External Fetal Monitoring - Records baby's heart rate so lower on the belly, where baby's heart would be
if head down
•Normal range for term fetus in 110-160 BPM
Variability:
•Absent – FHR fluctuations not detectable to the unaided eye
•Minimal – amplitude range of 5 BPM or less
•Moderate – considered normal – FHR not affected by interruption of fetal oxygenation
•Marked- significance is unknown; likely represents a normal variation
•Sinusoidal- uncommon pattern not included in variability that is seen with chorioamnionitis, fetal
sepsis, administration of opioids, and fetal anemia
Ch 18: Decels
Early
•Gradual decrease in and return to baseline associated with UCs
-> Onset to lowest point > or equal to 30 sec
•Normal, benign finding (r/t transient head compression)
•Onset, nadir (lowest point), and recovery correspond to the beginning, peak, and end of the
contraction
•Mirror image of the UC
Late
•Visually apparent decrease and return to baseline of FHR during UCs
•Begins after contraction started and nadir (lowest point) occurs after the peak of the contraction
•Returns to baseline after contraction is over
Causes:
•Maternal hypotension
•Uterine tachysystole (excessively frequent uterine contractions)
•Hypertensive disorders
•Placenta previa/abruption
•Maternal diabetes
Clinical significance: reflects fetal response to transient or chronic uteroplacental insufficiency
Nursing Interventions:
•D/C Pitocin: Uterine tachysystole
•Change position (more to side-lying)
•If hypotension – elevate legs
•Increase maintenance IV fluid rate
•Palpate uterus to assess for tachysystole
•Notify OB/HCP
