NUR 230
EXAMS 1-4
OB/Peds
Actual Questions w/Correct Answers
Galen College of Nursing
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,Table of Contents
NUR 230 Exam 1 ............................................................... 2
NUR 230 Exam 2 ............................................................. 23
NUR 230 Exam 3 ............................................................. 43
NUR 230 Exam 4 ............................................................. 64
NUR 230 Exam 1
1. The nurse is teaching a client who is in the 10th week of pregnancy about
morning sickness. Which of the following should the nurse include in the
teaching?
A. Eat small, frequent meals throughout the day
B. Avoid all fluids during meals to prevent nausea
C. Take antiemetic medication immediately upon waking
D. Increase intake of spicy and fatty foods to settle the stomach
Correct Answer:
A. Eat small, frequent meals throughout the day
Expert Rationale:
Small, frequent meals help prevent an empty stomach, which can worsen nausea
during early pregnancy. The client should avoid spicy and fatty foods, keep crackers at
the bedside before rising, and maintain hydration. Antiemetics are not first-line unless
prescribed for severe symptoms.
2. The nurse is teaching a client about symptoms to report during pregnancy.
Which statement by the client indicates correct understanding?
A. “I’ll report increased frequency of urination.”
,B. “Nausea
B. “Nauseashould shouldbe bereported
reportedimmediately.”
immediately.”
C. “If
C. “If II have
haveany anyfluid
fluidleaking
leakingfrom
frommy
myvagina,
vagina,I must
I must call
call the
the clinic
clinic immediately.”
immediately.”
D. “If
“If II feel
feel tired
tired after
after resting,
resting,IIshould
shouldreport
reportititimmediately.”
immediately.”
Correct Answer:
Correct Answer:
C. “If
C. “IfIIhave
haveany
anyfluid
fluidleaking
leakingfrom
frommy
myvagina,
vagina, I must
I must call
call thethe clinic
clinic immediately.”
immediately.”
Expert Rationale:
Expert Rationale:
Vaginal fluid
Vaginal fluid leakage
leakagemaymayindicate
indicaterupture
ruptureofofmembranes,
membranes,which
whichincreases
increasesthethe risk
risk forfor
requires prompt
infection or preterm labor and requires prompt evaluation.
evaluation.Urinary
Urinaryfrequency,
frequency,mild
mild
nausea,and
nausea, andfatigue
fatigueare
arecommon
commonpregnancy
pregnancydiscomforts
discomfortsunless
unless severe
severe or or accompanied
accompanied
danger signs.
by danger signs.
Thecharge
3. The chargenurse
nurseisisdiscussing
discussing probable
probable signs
signs of pregnancy
of pregnancy with with a newly
a newly hiredhired
nurse. Which
nurse. Whichfinding
findingisisa aprobable
probable sign
sign of of pregnancy?
pregnancy?
A. Fetal
A. Fetalheart
heartrate
ratedetected
detectedbybyDoppler
Doppler
B. Goodell
B. Goodellsign
sign
C. Breast
C. Breasttenderness
tenderness
D. Negative
D. Negativeserum
serumpregnancy
pregnancytesttest
Correct Answer:
Correct Answer:
B. Goodell
B. Goodellsign
sign
Expert Rationale:
Expert Rationale:
Goodell sign
Goodell signisissoftening
softeningofofthe
thecervix
cervixand
andisisconsidered
considered a probable
a probable signsign of pregnancy.
of pregnancy.
Breast tenderness
Breast tendernessisisaapresumptive
presumptivesign.
sign.Fetal
Fetal heart
heart rate
rate detection
detection is aispositive
a positive
signsign
of of
pregnancy. AA negative
negativepregnancy
pregnancytesttestdoes
doesnot notsupport
supportpregnancy.
pregnancy.
Thenurse
4. The nurseisispreparing
preparingtototeach
teach a client
a client about
about physiological
physiological changes
changes during
during
pregnancy. Which
pregnancy. Whichchange
changeshould
shouldthethe nurse
nurse identify
identify as as increased
increased during
during
pregnancy?
pregnancy?
A. Gastrointestinal
A. Gastrointestinalcontractility
contractility
B. Bloodpressure
B. Blood pressure
C. Systemicvascular
C. Systemic vascular resistance
resistance
D. Cardiac
Cardiacoutput
output
Correct Answer:
Correct Answer:
D. Cardiac
D. Cardiacoutput
output
,Expert Rationale:
Expert Rationale:
Cardiacoutput
Cardiac output increases
increasesduring
duringpregnancy
pregnancytotomeetmeetthe
theincreased
increased metabolic
metabolic needs
needs of of
the mother and fetus.
fetus. Gastrointestinal
Gastrointestinalmotility
motilitydecreases,
decreases,contributing
contributingtotoconstipation.
constipation.
pressureoften
Blood pressure oftenstays
staysthe
thesame
sameororslightly
slightlydecreases
decreases during
during mid-pregnancy
mid-pregnancy duedue
to to
decreased systemicvascular
decreased systemic vascularresistance.
resistance.
Thenurse
5. The nursehas
hasprovided
provided dietary
dietary teaching
teaching forfor a pregnant
a pregnant client
client with
with iron-
iron-
deficiencyanemia.
deficiency anemia.Which
Whichmeal
mealchoice
choice indicates
indicates understanding?
understanding?
A. Red
A. Redbeans
beanswith
withwhole
wholegrain
grainand
andmixed
mixed greens
greens
B. Toasted
B. Toastedcheese
cheesesandwich
sandwichwith
withcelery
celery sticks
sticks
C. Oatmeal,
C. Oatmeal,whole
wholewheat
wheattoast,
toast,and
andjelly
jelly
D. Chicken
D. Chickensalad
saladsandwich
sandwich withalmonds
with almonds andand raisins
raisins
Correct Answer:
Correct Answer:
A. Red
A. Redbeans
beanswith
withwhole
wholegrain
grain and
and mixed
mixed greens
greens
Expert Rationale:
Expert Rationale:
Red beans
Red beansand
andleafy
leafygreens
greensprovide
provide non-heme
non-heme iron,
iron, andand greens
greens maymay
alsoalso provide
provide
C,which
vitamin C, whichimproves
improvesiron
ironabsorption.
absorption.Cheese
Cheese and
and dairy
dairy cancan interfere
interfere with
with iron
iron
The other
absorption. The other meals
mealsprovide
provideless
lessiron
ironororlack
lack strong
strong iron-supporting
iron-supporting
components.
components.
Thenurse
6. The nurseisisteaching
teachinga aclient
clientwhowho is is
18 18 weeks
weeks pregnant
pregnant aboutabout preparing
preparing her her
7- 7-
year-old daughter
year-old daughterforforaanew
newsibling.
sibling.Which
Which recommendation
recommendation is best
is best basedbased on the
on the
child’sage?
child’s age?
A. “Wait
A. “Waitto
todiscuss
discussthe
thebirth
birthuntil
untilyour
yourdaughter
daughterasks asksabout
aboutit.”it.”
B. “Use
B. “Useyour
yourpregnancy
pregnancyasasa a way
way to to begin
begin basic
basic humanhuman sexuality
sexuality teaching.”
teaching.”
C. “Teach
C. “Teachyour
yourdaughter
daughterhowhowtotohold
holdandandtalk
talktotothe
thebaby
babyusing
using her
her favorite
favorite doll.”
doll.”
D. “Avoid
D. “Avoiddiscussing
discussingthe
thebaby
babyuntil
untilcloser
closertoto delivery.”
delivery.”
Correct Answer:
Correct Answer:
C. “Teach
C. “Teachyour
yourdaughter
daughterhow
howtoto hold
hold and
and talk
talk to to
thethe baby
baby using
using herher favorite
favorite doll.”
doll.”
Expert Rationale:
Expert Rationale:
7-year-oldschool-age
A 7-year-old school-agechild
childbenefits
benefitsfrom
fromconcrete,
concrete, age-appropriate
age-appropriate involvement.
involvement.
Practicing with aadoll
Practicing with dollcan
candecrease
decreaseanxiety
anxiety and
and help
help thethe child
child feel
feel included
included in the
in the newnew
sibling’s arrival.
sibling’s arrival.
, NUR 230
NUR 230Exam
Exam2 2
Thenurse
1. The nurseisisteaching
teachinga aclient
client with
with type
type 1 diabetes
1 diabetes mellitus
mellitus whowhojustjust delivered
delivered a a
baby. Which
healthy baby. Whichinformation
informationshould
shouldthe thenurse
nurse include
include in in
thethe client’s
client’s
teaching?
teaching?
A. Feed
A. Feedthe
thebaby
babyformula
formulabecause
because insulin
insulin through
through breastfeeding
breastfeeding maymay cause
cause lowlow blood
blood
sugar
B. Due
B. Duetotohormonal
hormonalchanges
changesafter
afterdelivery,
delivery,the
theneed
needforforinsulin
insulinmay
may decrease
decrease
C. Urine
C. Urineshould
shouldbebechecked
checkedforforketones
ketones every
every time
time thethe client
client voids
voids
D. Change
D. Changetotooral
oralhypoglycemic
hypoglycemicmedications
medications because
because theythey control
control blood
blood sugar
sugar better
better
than insulin
Correct Answer:
Correct Answer:
B. Due
B. Duetotohormonal
hormonalchanges
changes after
after delivery,
delivery, the
the need
need forfor insulin
insulin maymay decrease
decrease
Expert Rationale:
Expert Rationale:
delivery, placental
After delivery, placentalhormones
hormonesrapidly
rapidlydecrease,
decrease,which
which lowers
lowers insulin
insulin resistance.
resistance.
Clients with
Clients with type
type11diabetes
diabetesmay
mayneed
needless
less insulin
insulin postpartum
postpartum and
and should
should bebe monitored
monitored
closely for
closely for hypoglycemia.
hypoglycemia.
Thenurse
2. The nurseisiscaring
caringforforseveral
several clients
clients ononthethe postpartum
postpartum unit.
unit. Which
Which client
client
shouldthe
should thenurse
nurseseeseefirst?
first?
A. Primipara
A. Primiparawho
whodelivered
delivered33hours
hoursago
agoand
andis is having
having difficulty
difficulty getting
getting thethe newborn
newborn to to
latch
B. Multipara
B. Multipara who
who saturated
saturated22perineal
perinealpads
padsinin1 1hour
hour
C. Multipara
C. Multipara who
whodelivered
delivered16 16hours
hoursago
agoand
andreports
reportsabdominal
abdominal cramping
cramping and
and sweating
sweating
D. Primipara
D. Primipararequesting
requestinghelphelprepositioning
repositioningher
herbaby
babyafter
afteraacesarean
cesarean birth
birth
Correct Answer:
Correct Answer:
B. Multipara
B. Multipara who
whosaturated
saturated22perineal
perinealpads
padsinin 1 hour
1 hour
Expert Rationale:
Expert Rationale:
Saturating 22 pads
padsinin11hour
hourmay
mayindicate
indicatepostpartum
postpartumhemorrhage
hemorrhageand
andrequires
requires
, assessment.Breastfeeding
immediate assessment. Breastfeedingdifficulty,
difficulty,afterpains,
afterpains,sweating,
sweating, and
and positioning
positioning
concerns are
concerns areimportant
important but
but are
arenot
notthe
thepriority
priority over
overpossible
possiblehemorrhage.
hemorrhage.
Thenurse
3. The nursereceives
receiveschange-of-shift
change-of-shift report
report forfor clients
clients who who delivered
delivered within
within the the
24 hours.
last 24 hours.Which
Whichclient
clientshould
shouldthethe nurse
nurse assess
assess first?
first?
A. The
A. Theclient
clientwho
whoreports
reportsdiscomfort
discomfortininthetheperineal
perinealarea
areafrom
fromananepisiotomy
episiotomy
B. The
B. Theclient
clientwith
withan
anoral
oraltemperature
temperatureofof100.3°F
100.3°F
C. The
C. Theclient
clientwhose
whosepulse
pulseincreased
increased from
from 76/min
76/min to to 100/min
100/min
D. The
D. Theclient
clientwho
whoreports
reportspassing
passinga adime-sized
dime-sized clot
clot with
with thethe last
last void
void
Correct Answer:
Correct Answer:
C. The
C. Theclient
clientwhose
whosepulse
pulse increased
increased from
from 76/min
76/min to 100/min
to 100/min
Expert Rationale:
Expert Rationale:
pulse in
A rising pulse in the
thepostpartum
postpartumperiod
periodcan
canbe beananearly
earlysign
signofofhemorrhage
hemorrhage oror infection.
infection.
A mild temperature elevation
elevation during
during the
the first
first 24
24hours
hourscan
canbeberelated
relatedtotodehydration.
dehydration.
Perineal discomfort and
Perineal discomfort andsmall
smallclots
clotscan
canbebeexpected
expected findings.
findings.
Thenurse
4. The nurseisiscaring
caringforfora a client
client whowho gave
gave birth
birth 18 18 hours
hours ago.ago.
TheThe client
client reports
reports
nipple tenderness
nipple tendernessand andstates
statesthat thatthe
thebaby
babyisisnotnot breastfeeding
breastfeeding well.
well. Which
Which
responseby
response bythe thenurse
nurseisis appropriate?
appropriate?
A. “Wait
A. “Waituntil
until the
the baby
babyisiscrying
cryingbefore
beforebreastfeeding.”
breastfeeding.”
B. “Try
B. “Tryremoving
removingthe theinfant’s
infant’sclothing
clothingand
andplacing
placingthethebaby
babyskin-to-skin
skin-to-skinonon your
your chest.”
chest.”
C. “Applyaalarge
C. “Apply largeamount
amountofoftopical
topicalbreast
breastcream
cream before
before every
every feeding.”
feeding.”
D. “Limit
“Limit breastfeeding
breastfeedinguntil until your
yournipples
nipplesare
arenonolonger
longertender.”
tender.”
Correct Answer:
Correct Answer:
B. “Try
B. “Tryremoving
removingthe
theinfant’s
infant’sclothing
clothing and
and placing
placing thethe baby
baby skin-to-skin
skin-to-skin on your
on your
chest.”
chest.”
Expert Rationale:
Expert Rationale:
Skin-to-skincontact
Skin-to-skin contactpromotes
promotesnewborn
newbornrooting,
rooting,latch,
latch,bonding,
bonding,and
andbreastfeeding
breastfeeding
success.Waiting
success. Waitinguntil
untilthe
theinfant
infantcries
criescan
canmake
make latching
latching more
more difficult
difficult because
because crying
crying is is
late hunger
a late hunger cue.
cue.
Thenurse
5. The nurseisiscaring
caringforfora a client
client who
who ishour
is 1 1 hour postpartum.
postpartum. TheThe
nursenurse observes
observes
lochiarubra
moderate lochia rubraandandseveral
severalsmall
smallclots
clots
onon
thethe perineal
perineal pad.
pad. TheThe fundus
fundus is is
midline, and
firm, midline, and at
at the
the umbilicus.
umbilicus.Which
Whichaction
action should
should thethe nurse
nurse implement?
implement?
, NUR 230
NUR 230Exam
Exam3 3
Thenurse
1. The nurseisisperforming
performingananassessment
assessment onon
an an adolescent
adolescent client.
client. Which
Which
behavior suggests
behavior suggestsappropriate
appropriatepsychosocial
psychosocial development
development in this
in this client?
client?
A. Shows
A. Showsexcessive
excessive dependence
dependence onon parents
parents
B. Avoids
B. Avoidsdiscussing
discussingfeelings
feelingsororthoughts
thoughts
C. Thinks
C. Thinksabout
aboutpeers’
peers’opinions
opinionsofofthem
them
D. Prefers
D. Preferstotospend
spendtime
timealone
alone
Correct Answer:
Correct Answer:
C. Thinks
C. Thinksabout
aboutpeers’
peers’ opinions
opinions of of them
them
Expert Rationale:
Expert Rationale:
Adolescentsare
Adolescents aredeveloping
developingidentity
identityand
andare
arehighly
highlyinfluenced
influenced
byby peer
peer acceptance.
acceptance.
Concernabout
Concern aboutpeers’
peers’opinions
opinionsisisdevelopmentally
developmentally expected
expected and
and reflects
reflects normal
normal
psychosocialgrowth
psychosocial growthduring
duringadolescence.
adolescence.
Thenurse
2. The nurseisisperforming
performinga anutritional
nutritionalassessment
assessment onon an an adolescent
adolescent client.
client.
Which statement
Which statement best
bestindicates
indicatesthatthatthe
theclient’s
client’s diet
diet is is healthy?
healthy?
A. “I“I rarely
A. rarelyeat
eatbreakfast
breakfastbecause
becauseI’m I’m
notnot hungry.”
hungry.”
B. “My
B. “My parents
parentsmake
makesure
sureI drink
I drink88glasses
glasses of of water
water daily.”
daily.”
C. “I“I avoid
C. avoidvegetables
vegetablesbecause
because I don’t
I don’t like
like them.”
them.”
D. “I“I drink
D. drink four
four glasses
glassesofofwater
waterdaily.”
daily.”
Correct Answer:
Correct Answer:
B. “My
B. “Myparents
parentsmake
makesure
sureI drink
I drink8 8 glasses
glasses of water
of water daily.”
daily.”
Expert Rationale:
Expert Rationale:
Adequate hydration
Adequate hydration isisan
animportant
importantcomponent
componentof ofadolescent
adolescentnutrition.
nutrition.Skipping
Skipping
and avoiding
breakfast and avoidingvegetables
vegetablessuggest
suggestpoorpoornutritional
nutritionalhabits.
habits.Four
Four glasses
glasses of water
of water
be inadequate
may be inadequatedepending
dependingon onactivity
activitylevel
leveland
andhealth
health status.
status.
, Thenurse
3. The nurseisiseducating
educatingnew new parents
parents about
about immunizations
immunizations and and immunity.
immunity. Which
Which
indicatesthe
statement indicates theneed
needfor
foradditional
additionalteaching?
teaching?
A. “Passive
A. “Passiveimmunity
immunityprovides
providesimmediate
immediatebut buttemporary
temporaryprotection.”
protection.”
B. “Some
B. “Someimmunizations
immunizationsrequire
requiremultiple
multipledoses
dosestotobebeeffective.”
effective.”
C. “Active
C. “Activeimmunity
immunityisiswhat
whatmymychild
childgets
getsfrom
fromme meandand
is is short-term
short-term protection.”
protection.”
D. “Vaccines
D. “Vaccineshelp
helpmy
mychild
childdevelop
develop immunity
immunity byby stimulating
stimulating their
their own
own immune
immune system.”
system.”
Correct Answer:
Correct Answer:
C. “Active
C. “Activeimmunity
immunityisiswhat
whatmy
my child
child gets
gets from
from meme and
and is short-term
is short-term protection.”
protection.”
Expert Rationale:
Expert Rationale:
Active immunity
Active immunity occurs
occurswhen
whenthethechild’s
child’sown
ownimmune
immunesystem
system responds
responds to to
anan antigen,
antigen,
such as
such asthrough
through vaccination
vaccinationororinfection.
infection.Passive
Passive immunity
immunity is is transferred
transferred from
from another
another
source, such
source, suchasasmaternal
maternalantibodies,
antibodies,andandprovides
provides temporary
temporary protection.
protection.
Thenurse
4. The nursehas
hasadministered
administereda a prescribed
prescribed analgesic
analgesic to atopreschool
a preschool child.
child. WhichWhich
action should
action shouldthethenurse
nursetake
taketotoassess
assessthethe effectiveness
effectiveness of the
of the medication?
medication?
A. Wait
A. Wait33hours
hoursbefore
beforereassessing
reassessing comfort
comfort
B. Usethe
B. Use theWong-Baker
Wong-BakerFACES FACES Pain
Pain Rating
Rating ScaleScale
C. Observe
C. Observechanges
changesininvital
vital signs
signs only
only
D. Ask
D. Askthe
thechild
childtotodescribe
describethetheexact
exactpain
pain pathway
pathway
Correct Answer:
Correct Answer:
B. Use
B. Usethe
theWong-Baker
Wong-BakerFACES
FACES Pain
Pain Rating
Rating Scale
Scale
Expert Rationale:
Expert Rationale:
The Wong-Baker
The Wong-BakerFACES
FACES scale
scale is appropriate
is appropriate for preschool
for preschool children
children because
because it allows
it allows
using facial
them to identify pain intensity using facialexpressions.
expressions.Vital
Vitalsigns
signs alone
alone areare
notnot reliable
reliable
evaluate pain
enough to evaluate painrelief.
relief.
A parent
5. A parent brings
bringsaachild
childtotoemergency
emergency triage
triage and
and states,
states, “I think
“I think sheshe
gotgot
intointo
my my
mother’s medicine.”
mother’s medicine.”After
Afterdetermining
determiningthe
themedication
medication ingested,
ingested, which
which action
action
shouldthe
should thenurse
nursetake
takenext?
next?
A. Induce
A. Inducevomiting
vomiting
B. Administer
B. Administer activated
activatedcharcoal
charcoalimmediately
immediately
C. Contactthe
C. Contact thepoison
poisoncontrol
controlcenter
center
D. Observe
Observethe
thechild
childfor
forsymptoms
symptomsonlyonly
, NUR 230
NUR 230Exam
Exam4 4
Thenurse
1. The nurseisiscaring
caringfor fora a child
child who
who hashas leukemia
leukemia with
with a white
a white blood
blood cellcell
countcount
lessthan
less than1,000/mm³.
1,000/mm³.Which Whichintervention
interventionshould
should the
the nurse
nurse include
include in the
in the child’s
child’s
plan of
of care?
care?
A. Allow the
A. Allow thechild
childtotoplay
playwith
withother
otherchildren
childrenwho
whodo
donot
nothave
havea afever
fever
B. Assignthe
B. Assign thechild
childtotoaaroom
roomwithwithother
otherchildren
children
C. Use
C. Usesterile
steriletechnique
techniquefor forprocedures
procedures
D. Administer
D. Administer aalive
liveinfluenza
influenzavaccination
vaccination
Correct Answer:
Correct Answer:
C. Use
C. Usesterile
steriletechnique
techniquefor
forprocedures
procedures
Expert Rationale:
Expert Rationale:
WBCcount
A WBC countless
lessthan
than1,000/mm³
1,000/mm³ indicates
indicates severe
severe immunosuppression
immunosuppression andand
highhigh
Thenurse
infection risk. The nurseshould
shoulduse
usestrict
strictinfection-control
infection-controlmeasures,
measures, including
including sterile
sterile
when appropriate.
technique when appropriate. The
Thechild
childshould
shouldnotnotbebeplaced
placed withother
with otherchildren
childrenoror
exposed to
exposed to group
group play
playbecause
becauseeven
evenmild
mildinfections
infections can
can bebe dangerous.
dangerous.
Thenurse
2. The nurseisisproviding
providing teaching
teaching toto healthcare
healthcare staff
staff about
about osteosarcoma.
osteosarcoma. Which
Which
statement by an an attendee
attendee indicates
indicatesaaneed needfor foradditional
additional teaching?
teaching?
A. “Children
A. “Childrentypically
typicallyexperience
experiencepainpainatatthe
the primary
primary tumorsite.”
tumor site.”
B. “The
B. “Thesternum
sternumisisthe
themost
mostcommon
commonsite siteofofthis
thissarcoma.”
sarcoma.”
C. “A
C. “Acommon
commonmanifestation
manifestationisislimping
limpingififaaweight-bearing
weight-bearinglimb limbisisaffected.”
affected.”
D. “Early
D. “Earlysymptoms
symptomsmay maybebemistaken
mistaken forfor normalgrowing
normal growingpains.”
pains.”
Correct Answer:
Correct Answer:
B. “The
B. “Thesternum
sternumisisthe
themost
most common
common site
site of this
of this sarcoma.”
sarcoma.”
Expert Rationale:
Expert Rationale:
Osteosarcomamost
Osteosarcoma mostcommonly
commonlyoccurs
occursininthe
thelong
longbones,
bones, especially
especially around
around thethe knee,
knee,
such as
such asthe
thedistal
distalfemur
femurand
andproximal
proximaltibia.
tibia.Pain,
Pain,swelling,
swelling, and
and limping
limping maymay occur.
occur. Early
Early
canbe
symptoms can bemistaken
mistakenfor
forgrowing
growingpains,
pains,delaying
delayingdiagnosis.
diagnosis.
EXAMS 1-4
OB/Peds
Actual Questions w/Correct Answers
Galen College of Nursing
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,Table of Contents
NUR 230 Exam 1 ............................................................... 2
NUR 230 Exam 2 ............................................................. 23
NUR 230 Exam 3 ............................................................. 43
NUR 230 Exam 4 ............................................................. 64
NUR 230 Exam 1
1. The nurse is teaching a client who is in the 10th week of pregnancy about
morning sickness. Which of the following should the nurse include in the
teaching?
A. Eat small, frequent meals throughout the day
B. Avoid all fluids during meals to prevent nausea
C. Take antiemetic medication immediately upon waking
D. Increase intake of spicy and fatty foods to settle the stomach
Correct Answer:
A. Eat small, frequent meals throughout the day
Expert Rationale:
Small, frequent meals help prevent an empty stomach, which can worsen nausea
during early pregnancy. The client should avoid spicy and fatty foods, keep crackers at
the bedside before rising, and maintain hydration. Antiemetics are not first-line unless
prescribed for severe symptoms.
2. The nurse is teaching a client about symptoms to report during pregnancy.
Which statement by the client indicates correct understanding?
A. “I’ll report increased frequency of urination.”
,B. “Nausea
B. “Nauseashould shouldbe bereported
reportedimmediately.”
immediately.”
C. “If
C. “If II have
haveany anyfluid
fluidleaking
leakingfrom
frommy
myvagina,
vagina,I must
I must call
call the
the clinic
clinic immediately.”
immediately.”
D. “If
“If II feel
feel tired
tired after
after resting,
resting,IIshould
shouldreport
reportititimmediately.”
immediately.”
Correct Answer:
Correct Answer:
C. “If
C. “IfIIhave
haveany
anyfluid
fluidleaking
leakingfrom
frommy
myvagina,
vagina, I must
I must call
call thethe clinic
clinic immediately.”
immediately.”
Expert Rationale:
Expert Rationale:
Vaginal fluid
Vaginal fluid leakage
leakagemaymayindicate
indicaterupture
ruptureofofmembranes,
membranes,which
whichincreases
increasesthethe risk
risk forfor
requires prompt
infection or preterm labor and requires prompt evaluation.
evaluation.Urinary
Urinaryfrequency,
frequency,mild
mild
nausea,and
nausea, andfatigue
fatigueare
arecommon
commonpregnancy
pregnancydiscomforts
discomfortsunless
unless severe
severe or or accompanied
accompanied
danger signs.
by danger signs.
Thecharge
3. The chargenurse
nurseisisdiscussing
discussing probable
probable signs
signs of pregnancy
of pregnancy with with a newly
a newly hiredhired
nurse. Which
nurse. Whichfinding
findingisisa aprobable
probable sign
sign of of pregnancy?
pregnancy?
A. Fetal
A. Fetalheart
heartrate
ratedetected
detectedbybyDoppler
Doppler
B. Goodell
B. Goodellsign
sign
C. Breast
C. Breasttenderness
tenderness
D. Negative
D. Negativeserum
serumpregnancy
pregnancytesttest
Correct Answer:
Correct Answer:
B. Goodell
B. Goodellsign
sign
Expert Rationale:
Expert Rationale:
Goodell sign
Goodell signisissoftening
softeningofofthe
thecervix
cervixand
andisisconsidered
considered a probable
a probable signsign of pregnancy.
of pregnancy.
Breast tenderness
Breast tendernessisisaapresumptive
presumptivesign.
sign.Fetal
Fetal heart
heart rate
rate detection
detection is aispositive
a positive
signsign
of of
pregnancy. AA negative
negativepregnancy
pregnancytesttestdoes
doesnot notsupport
supportpregnancy.
pregnancy.
Thenurse
4. The nurseisispreparing
preparingtototeach
teach a client
a client about
about physiological
physiological changes
changes during
during
pregnancy. Which
pregnancy. Whichchange
changeshould
shouldthethe nurse
nurse identify
identify as as increased
increased during
during
pregnancy?
pregnancy?
A. Gastrointestinal
A. Gastrointestinalcontractility
contractility
B. Bloodpressure
B. Blood pressure
C. Systemicvascular
C. Systemic vascular resistance
resistance
D. Cardiac
Cardiacoutput
output
Correct Answer:
Correct Answer:
D. Cardiac
D. Cardiacoutput
output
,Expert Rationale:
Expert Rationale:
Cardiacoutput
Cardiac output increases
increasesduring
duringpregnancy
pregnancytotomeetmeetthe
theincreased
increased metabolic
metabolic needs
needs of of
the mother and fetus.
fetus. Gastrointestinal
Gastrointestinalmotility
motilitydecreases,
decreases,contributing
contributingtotoconstipation.
constipation.
pressureoften
Blood pressure oftenstays
staysthe
thesame
sameororslightly
slightlydecreases
decreases during
during mid-pregnancy
mid-pregnancy duedue
to to
decreased systemicvascular
decreased systemic vascularresistance.
resistance.
Thenurse
5. The nursehas
hasprovided
provided dietary
dietary teaching
teaching forfor a pregnant
a pregnant client
client with
with iron-
iron-
deficiencyanemia.
deficiency anemia.Which
Whichmeal
mealchoice
choice indicates
indicates understanding?
understanding?
A. Red
A. Redbeans
beanswith
withwhole
wholegrain
grainand
andmixed
mixed greens
greens
B. Toasted
B. Toastedcheese
cheesesandwich
sandwichwith
withcelery
celery sticks
sticks
C. Oatmeal,
C. Oatmeal,whole
wholewheat
wheattoast,
toast,and
andjelly
jelly
D. Chicken
D. Chickensalad
saladsandwich
sandwich withalmonds
with almonds andand raisins
raisins
Correct Answer:
Correct Answer:
A. Red
A. Redbeans
beanswith
withwhole
wholegrain
grain and
and mixed
mixed greens
greens
Expert Rationale:
Expert Rationale:
Red beans
Red beansand
andleafy
leafygreens
greensprovide
provide non-heme
non-heme iron,
iron, andand greens
greens maymay
alsoalso provide
provide
C,which
vitamin C, whichimproves
improvesiron
ironabsorption.
absorption.Cheese
Cheese and
and dairy
dairy cancan interfere
interfere with
with iron
iron
The other
absorption. The other meals
mealsprovide
provideless
lessiron
ironororlack
lack strong
strong iron-supporting
iron-supporting
components.
components.
Thenurse
6. The nurseisisteaching
teachinga aclient
clientwhowho is is
18 18 weeks
weeks pregnant
pregnant aboutabout preparing
preparing her her
7- 7-
year-old daughter
year-old daughterforforaanew
newsibling.
sibling.Which
Which recommendation
recommendation is best
is best basedbased on the
on the
child’sage?
child’s age?
A. “Wait
A. “Waitto
todiscuss
discussthe
thebirth
birthuntil
untilyour
yourdaughter
daughterasks asksabout
aboutit.”it.”
B. “Use
B. “Useyour
yourpregnancy
pregnancyasasa a way
way to to begin
begin basic
basic humanhuman sexuality
sexuality teaching.”
teaching.”
C. “Teach
C. “Teachyour
yourdaughter
daughterhowhowtotohold
holdandandtalk
talktotothe
thebaby
babyusing
using her
her favorite
favorite doll.”
doll.”
D. “Avoid
D. “Avoiddiscussing
discussingthe
thebaby
babyuntil
untilcloser
closertoto delivery.”
delivery.”
Correct Answer:
Correct Answer:
C. “Teach
C. “Teachyour
yourdaughter
daughterhow
howtoto hold
hold and
and talk
talk to to
thethe baby
baby using
using herher favorite
favorite doll.”
doll.”
Expert Rationale:
Expert Rationale:
7-year-oldschool-age
A 7-year-old school-agechild
childbenefits
benefitsfrom
fromconcrete,
concrete, age-appropriate
age-appropriate involvement.
involvement.
Practicing with aadoll
Practicing with dollcan
candecrease
decreaseanxiety
anxiety and
and help
help thethe child
child feel
feel included
included in the
in the newnew
sibling’s arrival.
sibling’s arrival.
, NUR 230
NUR 230Exam
Exam2 2
Thenurse
1. The nurseisisteaching
teachinga aclient
client with
with type
type 1 diabetes
1 diabetes mellitus
mellitus whowhojustjust delivered
delivered a a
baby. Which
healthy baby. Whichinformation
informationshould
shouldthe thenurse
nurse include
include in in
thethe client’s
client’s
teaching?
teaching?
A. Feed
A. Feedthe
thebaby
babyformula
formulabecause
because insulin
insulin through
through breastfeeding
breastfeeding maymay cause
cause lowlow blood
blood
sugar
B. Due
B. Duetotohormonal
hormonalchanges
changesafter
afterdelivery,
delivery,the
theneed
needforforinsulin
insulinmay
may decrease
decrease
C. Urine
C. Urineshould
shouldbebechecked
checkedforforketones
ketones every
every time
time thethe client
client voids
voids
D. Change
D. Changetotooral
oralhypoglycemic
hypoglycemicmedications
medications because
because theythey control
control blood
blood sugar
sugar better
better
than insulin
Correct Answer:
Correct Answer:
B. Due
B. Duetotohormonal
hormonalchanges
changes after
after delivery,
delivery, the
the need
need forfor insulin
insulin maymay decrease
decrease
Expert Rationale:
Expert Rationale:
delivery, placental
After delivery, placentalhormones
hormonesrapidly
rapidlydecrease,
decrease,which
which lowers
lowers insulin
insulin resistance.
resistance.
Clients with
Clients with type
type11diabetes
diabetesmay
mayneed
needless
less insulin
insulin postpartum
postpartum and
and should
should bebe monitored
monitored
closely for
closely for hypoglycemia.
hypoglycemia.
Thenurse
2. The nurseisiscaring
caringforforseveral
several clients
clients ononthethe postpartum
postpartum unit.
unit. Which
Which client
client
shouldthe
should thenurse
nurseseeseefirst?
first?
A. Primipara
A. Primiparawho
whodelivered
delivered33hours
hoursago
agoand
andis is having
having difficulty
difficulty getting
getting thethe newborn
newborn to to
latch
B. Multipara
B. Multipara who
who saturated
saturated22perineal
perinealpads
padsinin1 1hour
hour
C. Multipara
C. Multipara who
whodelivered
delivered16 16hours
hoursago
agoand
andreports
reportsabdominal
abdominal cramping
cramping and
and sweating
sweating
D. Primipara
D. Primipararequesting
requestinghelphelprepositioning
repositioningher
herbaby
babyafter
afteraacesarean
cesarean birth
birth
Correct Answer:
Correct Answer:
B. Multipara
B. Multipara who
whosaturated
saturated22perineal
perinealpads
padsinin 1 hour
1 hour
Expert Rationale:
Expert Rationale:
Saturating 22 pads
padsinin11hour
hourmay
mayindicate
indicatepostpartum
postpartumhemorrhage
hemorrhageand
andrequires
requires
, assessment.Breastfeeding
immediate assessment. Breastfeedingdifficulty,
difficulty,afterpains,
afterpains,sweating,
sweating, and
and positioning
positioning
concerns are
concerns areimportant
important but
but are
arenot
notthe
thepriority
priority over
overpossible
possiblehemorrhage.
hemorrhage.
Thenurse
3. The nursereceives
receiveschange-of-shift
change-of-shift report
report forfor clients
clients who who delivered
delivered within
within the the
24 hours.
last 24 hours.Which
Whichclient
clientshould
shouldthethe nurse
nurse assess
assess first?
first?
A. The
A. Theclient
clientwho
whoreports
reportsdiscomfort
discomfortininthetheperineal
perinealarea
areafrom
fromananepisiotomy
episiotomy
B. The
B. Theclient
clientwith
withan
anoral
oraltemperature
temperatureofof100.3°F
100.3°F
C. The
C. Theclient
clientwhose
whosepulse
pulseincreased
increased from
from 76/min
76/min to to 100/min
100/min
D. The
D. Theclient
clientwho
whoreports
reportspassing
passinga adime-sized
dime-sized clot
clot with
with thethe last
last void
void
Correct Answer:
Correct Answer:
C. The
C. Theclient
clientwhose
whosepulse
pulse increased
increased from
from 76/min
76/min to 100/min
to 100/min
Expert Rationale:
Expert Rationale:
pulse in
A rising pulse in the
thepostpartum
postpartumperiod
periodcan
canbe beananearly
earlysign
signofofhemorrhage
hemorrhage oror infection.
infection.
A mild temperature elevation
elevation during
during the
the first
first 24
24hours
hourscan
canbeberelated
relatedtotodehydration.
dehydration.
Perineal discomfort and
Perineal discomfort andsmall
smallclots
clotscan
canbebeexpected
expected findings.
findings.
Thenurse
4. The nurseisiscaring
caringforfora a client
client whowho gave
gave birth
birth 18 18 hours
hours ago.ago.
TheThe client
client reports
reports
nipple tenderness
nipple tendernessand andstates
statesthat thatthe
thebaby
babyisisnotnot breastfeeding
breastfeeding well.
well. Which
Which
responseby
response bythe thenurse
nurseisis appropriate?
appropriate?
A. “Wait
A. “Waituntil
until the
the baby
babyisiscrying
cryingbefore
beforebreastfeeding.”
breastfeeding.”
B. “Try
B. “Tryremoving
removingthe theinfant’s
infant’sclothing
clothingand
andplacing
placingthethebaby
babyskin-to-skin
skin-to-skinonon your
your chest.”
chest.”
C. “Applyaalarge
C. “Apply largeamount
amountofoftopical
topicalbreast
breastcream
cream before
before every
every feeding.”
feeding.”
D. “Limit
“Limit breastfeeding
breastfeedinguntil until your
yournipples
nipplesare
arenonolonger
longertender.”
tender.”
Correct Answer:
Correct Answer:
B. “Try
B. “Tryremoving
removingthe
theinfant’s
infant’sclothing
clothing and
and placing
placing thethe baby
baby skin-to-skin
skin-to-skin on your
on your
chest.”
chest.”
Expert Rationale:
Expert Rationale:
Skin-to-skincontact
Skin-to-skin contactpromotes
promotesnewborn
newbornrooting,
rooting,latch,
latch,bonding,
bonding,and
andbreastfeeding
breastfeeding
success.Waiting
success. Waitinguntil
untilthe
theinfant
infantcries
criescan
canmake
make latching
latching more
more difficult
difficult because
because crying
crying is is
late hunger
a late hunger cue.
cue.
Thenurse
5. The nurseisiscaring
caringforfora a client
client who
who ishour
is 1 1 hour postpartum.
postpartum. TheThe
nursenurse observes
observes
lochiarubra
moderate lochia rubraandandseveral
severalsmall
smallclots
clots
onon
thethe perineal
perineal pad.
pad. TheThe fundus
fundus is is
midline, and
firm, midline, and at
at the
the umbilicus.
umbilicus.Which
Whichaction
action should
should thethe nurse
nurse implement?
implement?
, NUR 230
NUR 230Exam
Exam3 3
Thenurse
1. The nurseisisperforming
performingananassessment
assessment onon
an an adolescent
adolescent client.
client. Which
Which
behavior suggests
behavior suggestsappropriate
appropriatepsychosocial
psychosocial development
development in this
in this client?
client?
A. Shows
A. Showsexcessive
excessive dependence
dependence onon parents
parents
B. Avoids
B. Avoidsdiscussing
discussingfeelings
feelingsororthoughts
thoughts
C. Thinks
C. Thinksabout
aboutpeers’
peers’opinions
opinionsofofthem
them
D. Prefers
D. Preferstotospend
spendtime
timealone
alone
Correct Answer:
Correct Answer:
C. Thinks
C. Thinksabout
aboutpeers’
peers’ opinions
opinions of of them
them
Expert Rationale:
Expert Rationale:
Adolescentsare
Adolescents aredeveloping
developingidentity
identityand
andare
arehighly
highlyinfluenced
influenced
byby peer
peer acceptance.
acceptance.
Concernabout
Concern aboutpeers’
peers’opinions
opinionsisisdevelopmentally
developmentally expected
expected and
and reflects
reflects normal
normal
psychosocialgrowth
psychosocial growthduring
duringadolescence.
adolescence.
Thenurse
2. The nurseisisperforming
performinga anutritional
nutritionalassessment
assessment onon an an adolescent
adolescent client.
client.
Which statement
Which statement best
bestindicates
indicatesthatthatthe
theclient’s
client’s diet
diet is is healthy?
healthy?
A. “I“I rarely
A. rarelyeat
eatbreakfast
breakfastbecause
becauseI’m I’m
notnot hungry.”
hungry.”
B. “My
B. “My parents
parentsmake
makesure
sureI drink
I drink88glasses
glasses of of water
water daily.”
daily.”
C. “I“I avoid
C. avoidvegetables
vegetablesbecause
because I don’t
I don’t like
like them.”
them.”
D. “I“I drink
D. drink four
four glasses
glassesofofwater
waterdaily.”
daily.”
Correct Answer:
Correct Answer:
B. “My
B. “Myparents
parentsmake
makesure
sureI drink
I drink8 8 glasses
glasses of water
of water daily.”
daily.”
Expert Rationale:
Expert Rationale:
Adequate hydration
Adequate hydration isisan
animportant
importantcomponent
componentof ofadolescent
adolescentnutrition.
nutrition.Skipping
Skipping
and avoiding
breakfast and avoidingvegetables
vegetablessuggest
suggestpoorpoornutritional
nutritionalhabits.
habits.Four
Four glasses
glasses of water
of water
be inadequate
may be inadequatedepending
dependingon onactivity
activitylevel
leveland
andhealth
health status.
status.
, Thenurse
3. The nurseisiseducating
educatingnew new parents
parents about
about immunizations
immunizations and and immunity.
immunity. Which
Which
indicatesthe
statement indicates theneed
needfor
foradditional
additionalteaching?
teaching?
A. “Passive
A. “Passiveimmunity
immunityprovides
providesimmediate
immediatebut buttemporary
temporaryprotection.”
protection.”
B. “Some
B. “Someimmunizations
immunizationsrequire
requiremultiple
multipledoses
dosestotobebeeffective.”
effective.”
C. “Active
C. “Activeimmunity
immunityisiswhat
whatmymychild
childgets
getsfrom
fromme meandand
is is short-term
short-term protection.”
protection.”
D. “Vaccines
D. “Vaccineshelp
helpmy
mychild
childdevelop
develop immunity
immunity byby stimulating
stimulating their
their own
own immune
immune system.”
system.”
Correct Answer:
Correct Answer:
C. “Active
C. “Activeimmunity
immunityisiswhat
whatmy
my child
child gets
gets from
from meme and
and is short-term
is short-term protection.”
protection.”
Expert Rationale:
Expert Rationale:
Active immunity
Active immunity occurs
occurswhen
whenthethechild’s
child’sown
ownimmune
immunesystem
system responds
responds to to
anan antigen,
antigen,
such as
such asthrough
through vaccination
vaccinationororinfection.
infection.Passive
Passive immunity
immunity is is transferred
transferred from
from another
another
source, such
source, suchasasmaternal
maternalantibodies,
antibodies,andandprovides
provides temporary
temporary protection.
protection.
Thenurse
4. The nursehas
hasadministered
administereda a prescribed
prescribed analgesic
analgesic to atopreschool
a preschool child.
child. WhichWhich
action should
action shouldthethenurse
nursetake
taketotoassess
assessthethe effectiveness
effectiveness of the
of the medication?
medication?
A. Wait
A. Wait33hours
hoursbefore
beforereassessing
reassessing comfort
comfort
B. Usethe
B. Use theWong-Baker
Wong-BakerFACES FACES Pain
Pain Rating
Rating ScaleScale
C. Observe
C. Observechanges
changesininvital
vital signs
signs only
only
D. Ask
D. Askthe
thechild
childtotodescribe
describethetheexact
exactpain
pain pathway
pathway
Correct Answer:
Correct Answer:
B. Use
B. Usethe
theWong-Baker
Wong-BakerFACES
FACES Pain
Pain Rating
Rating Scale
Scale
Expert Rationale:
Expert Rationale:
The Wong-Baker
The Wong-BakerFACES
FACES scale
scale is appropriate
is appropriate for preschool
for preschool children
children because
because it allows
it allows
using facial
them to identify pain intensity using facialexpressions.
expressions.Vital
Vitalsigns
signs alone
alone areare
notnot reliable
reliable
evaluate pain
enough to evaluate painrelief.
relief.
A parent
5. A parent brings
bringsaachild
childtotoemergency
emergency triage
triage and
and states,
states, “I think
“I think sheshe
gotgot
intointo
my my
mother’s medicine.”
mother’s medicine.”After
Afterdetermining
determiningthe
themedication
medication ingested,
ingested, which
which action
action
shouldthe
should thenurse
nursetake
takenext?
next?
A. Induce
A. Inducevomiting
vomiting
B. Administer
B. Administer activated
activatedcharcoal
charcoalimmediately
immediately
C. Contactthe
C. Contact thepoison
poisoncontrol
controlcenter
center
D. Observe
Observethe
thechild
childfor
forsymptoms
symptomsonlyonly
, NUR 230
NUR 230Exam
Exam4 4
Thenurse
1. The nurseisiscaring
caringfor fora a child
child who
who hashas leukemia
leukemia with
with a white
a white blood
blood cellcell
countcount
lessthan
less than1,000/mm³.
1,000/mm³.Which Whichintervention
interventionshould
should the
the nurse
nurse include
include in the
in the child’s
child’s
plan of
of care?
care?
A. Allow the
A. Allow thechild
childtotoplay
playwith
withother
otherchildren
childrenwho
whodo
donot
nothave
havea afever
fever
B. Assignthe
B. Assign thechild
childtotoaaroom
roomwithwithother
otherchildren
children
C. Use
C. Usesterile
steriletechnique
techniquefor forprocedures
procedures
D. Administer
D. Administer aalive
liveinfluenza
influenzavaccination
vaccination
Correct Answer:
Correct Answer:
C. Use
C. Usesterile
steriletechnique
techniquefor
forprocedures
procedures
Expert Rationale:
Expert Rationale:
WBCcount
A WBC countless
lessthan
than1,000/mm³
1,000/mm³ indicates
indicates severe
severe immunosuppression
immunosuppression andand
highhigh
Thenurse
infection risk. The nurseshould
shoulduse
usestrict
strictinfection-control
infection-controlmeasures,
measures, including
including sterile
sterile
when appropriate.
technique when appropriate. The
Thechild
childshould
shouldnotnotbebeplaced
placed withother
with otherchildren
childrenoror
exposed to
exposed to group
group play
playbecause
becauseeven
evenmild
mildinfections
infections can
can bebe dangerous.
dangerous.
Thenurse
2. The nurseisisproviding
providing teaching
teaching toto healthcare
healthcare staff
staff about
about osteosarcoma.
osteosarcoma. Which
Which
statement by an an attendee
attendee indicates
indicatesaaneed needfor foradditional
additional teaching?
teaching?
A. “Children
A. “Childrentypically
typicallyexperience
experiencepainpainatatthe
the primary
primary tumorsite.”
tumor site.”
B. “The
B. “Thesternum
sternumisisthe
themost
mostcommon
commonsite siteofofthis
thissarcoma.”
sarcoma.”
C. “A
C. “Acommon
commonmanifestation
manifestationisislimping
limpingififaaweight-bearing
weight-bearinglimb limbisisaffected.”
affected.”
D. “Early
D. “Earlysymptoms
symptomsmay maybebemistaken
mistaken forfor normalgrowing
normal growingpains.”
pains.”
Correct Answer:
Correct Answer:
B. “The
B. “Thesternum
sternumisisthe
themost
most common
common site
site of this
of this sarcoma.”
sarcoma.”
Expert Rationale:
Expert Rationale:
Osteosarcomamost
Osteosarcoma mostcommonly
commonlyoccurs
occursininthe
thelong
longbones,
bones, especially
especially around
around thethe knee,
knee,
such as
such asthe
thedistal
distalfemur
femurand
andproximal
proximaltibia.
tibia.Pain,
Pain,swelling,
swelling, and
and limping
limping maymay occur.
occur. Early
Early
canbe
symptoms can bemistaken
mistakenfor
forgrowing
growingpains,
pains,delaying
delayingdiagnosis.
diagnosis.
