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NURS 351 exam 2 Review prepu questions well answered already passed
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NURS 351 exam 2 Review prepuquestions well answered already passed
The nurse is assessing the external fetal monitor and notes the following: fetal heart rate of 175
beats/min, decrease in variability, and late decelerations. Which action should the nurse tale first? -
correct answer ✔✔Have the client change position.
Rationale
Fetal tachycardia, decreased variability, and late decelerations are possible indications of cord
compression. The first step is to ask the client to change position to see if that will take the pressure off
the cord. The health care provider should be notified, especially if a change of position is ineffective. The
nurse should continue to monitor the pattern continuously until the situation is changed and to evaluate
the effectiveness of interventions. This could be an ominous sign indicating the need for further
interventions to include cesarean birth.
A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse
identifies this technique as: - correct answer ✔✔effleurage
Effleurage is a light, stroking, superficial touch of the abdomen in rhythm with breathing during
contractions. Acupressure involves the application of a finger or massage at a trigger point to reduce the
pain sensation. Patterned breathing involves controlled breathing techniques to reduce pain through a
stimulus-response conditioning. Therapeutic touch involves light or firm touch to the energy field of the
body using the hands to redirect the energy fields that lead to pain.
The nurse tests the pH of fluid found on the vaginal exam and determines that the woman's membranes
have ruptured based on which result? - correct answer ✔✔6.5
rationale:
Amniotic fluid is alkaline, so the membranes are probably ruptured if the pH ranges from 6.5 to 7.5.
A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the
likely cause of delay in dilation (dilatation) is cephalopelvic disproportion. Which intervention should the
nurse most expect in this case? - correct answer ✔✔cesarean birth
, If the cause of the delay in dilation (dilatation) is fetal malposition or cephalopelvic disproportion (CPD),
cesarean birth may be necessary. Oxytocin would be administered to augment labor only if CPD were
ruled out. Administration of morphine sulfate (an analgesic) and darkening room lights and decreasing
noise and stimulation are used in the management of a prolonged latent phase caused by hypertonic
contractions. These measures would not help in the case of CPD
During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease
(CVD). Which assessment would be priority for the newborn? - correct answer ✔✔respiratory function
rationale:
The nurse should identify respiratory distress syndrome as a major risk that can be faced by the offspring
of a client with cardiovascular disease. While the other assessments are important, they are not priority
A novice nurse asks to be assigned to the least complex antepartum client. Which condition would
necessitate the least complex care requirements? - correct answer ✔✔gestational hypertension
Hypertensive disorders represent the most common complication of pregnancy. Gestational
hypertension is elevated blood pressure without proteinuria, other signs of preeclampsia, or preexisting
hypertension. Placental abruption (abruptio placentae), a separation of the placenta from the uterine
wall; placenta previa (placenta covering the cervical os); and preeclampsia are high-risk, potentially life-
threatening conditions for the fetus and mother during labor and birth.
A 24-year-old client presents in labor. The nurse notes there is an order to administer Rho(D) immune
globulin after the birth of her infant. When asked by the client the reason for this injection, which reason
should the nurse point out? - correct answer ✔✔prevent maternal D antibody formation.
Because Rho(D) immune globulin contains passive antibodies, the solution will prevent the woman from
forming long-lasting antibodies which may harm a future fetus. The administration of Rho(D) immune
globulin does not promote the formation of maternal D antibodies; it does not stimulate maternal D
immune antigens or prevent fetal Rh blood formation.
A nurse is providing care to a pregnant woman with preterm prelabor rupture of membranes (PPROM).
On admission, the client's baseline information was as follows: temperature, 97.6°F (36.5°C); pulse, 76
beats/minute; fetal heart rate, 136 beats/minute; white blood cell count, 7 x 103cells/mm3 (7.0 x 109/L).
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