NURS 240 MATERNAL FINAL EXAM|COMPLETE
RATIONALE Q&A GUARATEED A+ (2024/2025)
1. Apri
mi gra
v i
dais17we e
ks’g es
tat
ionan
da s
ksthenu r
seho wlon
gitwil
lbeu
nti
lsh
efe
elst
heb
abymo
ve.Th
ebe
st
r
esp
on s
eb ythen ur
seis
:
) “
a Someb abiesdon’
tmov eunti
lthesi
xthmon thofpregna
ncy”
.
b)“ Yous houldhavefe
lttheb ab
ymo vebyn ow”
) “
c Wi t
hinthenextf
ewwe eksyousho
uldfee
laflut
te
rin
gs en
sat
ion”
.
d)“ Theb abyismoving
,bu tyoucan’
tfee
lit
.”
2. Acli
entwhoisinher34thweekofgest
ationisconc
ernedabou th
erwe ightgai
no f25pou
nds.
Then
urs
e’sb
est
r
esp
on s
eis
:
) “
a Youhavegain
eda na ppr
opria
teamo untfort
h enumbe rofwe ekso fyourpreg
nanc
y”
b)“ Youhavenotgai
nede noughweightforth
en umberofwe ekso fyou
rp re
gn an
cy”
) “
c Yous
houldt
rytodecrea
seyouramountofweigh
tg a
info
rthene xt6-7we eks ”
d)“ Youshoul
dnotgainanymor eweightunti
lyoureachthethi
rdt ri
meste”
r
3. Anu
rseisteac
hingaclientt
h ati
s16we eksp r
egnantandHIVpo s
it
iv
eaboutHI
Vtrea
tment
.Wh
ichs
tat
eme
ntma
de
b
yth
ec l
ienti
ndic
atesthatshen e
e dsmoreteac
hing
?
) “
a Myb abywillgetZidov u
d i
n e(ZVD)b ymo uthr
ighta
fterbi
rt
h”
b)“Durin
gl abo
r,Iwi l
lcon t
inuet oge
tZi d
ovudine(ZVD)throu
ghmyI V”
) “
c WithoutHIVtreatme n
t,transmis
siontomyb abyis100%”
d)“Duri
ngp r
egnancy,Iwillt
a kemyZi dovudi
ne(ZVD)tabl
etatt
hesameti
meeve
ryda”
y
4. Anu r
seisca r
ingforacl
ientwhodidnotgetpre
natalcareandis38weeksgest
ati
o n
.Thecl
ientre
po r
tsmoder
ater
ed
v
aginalblee
dingthats
tar
tedint
hemo r
ningandisnota c
comp a
niedbyco
n t
rac
ti
o n
s.Thecl
ie
ntisnotindis
tr
essa
nd
s
tat
esshec an“fee
lthebabymovin
g.”Anu l
tra
soundiss c
h e
dule
ds t
at
.Thenurseshoul
dexpl
ai
nt othecl
ien
ttha
tthe
ul
tr
asoun disbeingdonetodayt
oa ss
essfo
rwh icho fthefol
lowing
?
a
) Fe ta
llungma turi
ty
b) Pl
a c
e nt
ap r
evia
c
) Fe taldi
stre
ss
d) Ne u
r a
ltubed ef
ect
s
5. Awo mana r
rivesatt
heobs t
et
rici
an’so ffic
ef orherfr
istprenat
alvis
it
.Shed oesnots
peakEngl
ish.Whatac
ti
onsb
yth
e
n
ursepr
ovi
deth ebes
tcar
e?(Sel
ecta
llthata p
p l
y)
a
) Al l
owt hec l
ie
nttobeinter
viewe dwi thherpa r
t nerpres
enttopromotefamil
y-ce
nter
edca
re.
b) Askaboutc ul
tur
alpract
ice
sth atsh ewo uldexpe cttobepartofpregnancy
,labo
r,andde
li
very
.
c
) As kherwh ereshei
scu r
rentl
ywo r
ki ngtoa s
sesswo rkh az
ardsort
erat
o g
ens.
d) Cal
lforatransl
at
ortogetanac c
u r
ateh is
tory.
e
) Obt a
ininformati
onaboutpotent
iali n t
imatep ar
t nerviol
enceinpri
vat
eu si
ngopen-e
ndedquest
ions
.
6. Thest
uden tn urs
eisprepa
ringap r
esen t
at
iononthen
utri
ti
onalne
edso
fpregna
ntt
een
s.Wh
ichi
te
mss
houl
dbe
i
ncl
udedinh ert
eachi
ngplan?(Sel
ectallt
hatapp
ly)
a) Dono tg ainmo r
ethan1 5poundsi npre
gnancyduet
ob o
d yi
magesi
ssu
es
b) Avoi
da lcohol
,toba
cco,andd r
u g
s
c) Avoi
de a ti
ngconta
ini
ngh ighl
evelsofme r
cury
d)I n
crease scalor
ici
ntakeb y100ad a
y
e) Li
mitca fe
inebev
era
gesto1-2ad ay
,7. An u
rsei
sspeaki
ngwithacl
ientwhois1
1we e
ks’ges
tat
ion
.Thecl
ie
ntt
el
lst
henu
rset
hats
hesmo
kes1pac
kpe
rda
y
buti
stry
ingtoqui
t.Thenurs
es hou
ldex
pla
inthatn
ewb or
nsbor
ntowomenwhosmokear
eatr
is
kfor
:
a
) Vi si
onloss
b) Gest
ati
onaldi
abet
es
c
) Co ngeni
talhe
artdef
ect
s
d)I nt
raut
eri
negrowt
hr e
str
ict
ion
8. Duri
ngthei
n i
ti
alv is
itwit
hthenurs
ea tth
ef e
rtil
it
ycli
nic
,thepat
ie
ntas kswh ate
fec
tci
gar
et
tes
moki
ngo
rhe
avy
al
coholi
nta
k eha sont heabi
li
tytoco nce
ive.Wh atist
hen ur
se’
sbe s tr e
sponse
?
a) “Onlyi
fy ous mo kemorethanon epackad aywi l
lyouhavedi
ffic ult
y”
.
b)“ Smoki
n gan dal ar
geal
coholi
n t
akecana fe
ctthequan
tit
yofsper m. ”
c) “Smoki
n go rh eavyal
coholusehasn oefect
.”
d)“ Aft
eryourfir
s tsemenanal
ysis
,wewi llseeifther
ewillbeanyd iffic
ult
y”
.
9. Apr
egn
antc
li
entt
el
lsthenu
rset
hatherLMPwas3monthsagoa
ndbeg
ano nAug
ust1
5.Usin
gNage’
lsr
ule
,ca
lcu
lat
e
t
hec
li
en’
tse
sti
mat
ed a
teofdel
iv
ery?Fil
liny
oura
nswe
rwi t
hmonths
pell
edouta
nddate(
examp
le:Mar
ch10)
10. Acli
entad
mitte
dt oL&Dwi t
hap osi
ti
veGBSs t
atus,i
sab ou
ttorecei
veananti
biot
ic
.Hermoth
er,t
hecl
ie
nt’
ssu
ppo
rt
pe
rson,as
ksthen urs,“
e whyd oe
smyd a u
g h
tern ee
da na nt
ibi
otic?
) “
a Iwil
lgettheanti
b i
oti
cdisc
on t
inue
db ythed oc
torbecauseId o
n ’
tth
inkiti
sn e
eded
.”
b)“ Thi
sisasexu a
ll
yt r
ansmit
tedinf
ectionandmu stbetr
eate
di nyourdaught
er”
.
) “
c Theant
ibi
oticwillt
reatt
heinfec
ti
oni nyo urdaughter
,sotheinf
ecti
onisnotpas
sedt
othebaby
.”
d)“ Thebab
ywi llbeb or
ns o
ons oIwilldelayg i
vin
gth eant
ibio
tictoyourdaugh
ter
.”
11. Anur
sei sreviewi
ngthepren
ata
lrec
o r
do facl
ienta
t37wee
ks’ge
sta
ti
on.Thewoman’
shis
tor
yre
vea
ls:t
heb
irt
hof
t
wingir
lsat3 9we e
ks:an
das po
ntaneo
usa bo
rti
onat10we
eks.Ac
cordi
ngtot
heGra
vidaPar
aTPALsyst
emwhi
chof
t
hef
ol
lowingd es
cri
best
hecl
i
en’
tspr
es
entsi
tu
ati
on?
a
) 3 -
1 -
1 -
0 -
1 -
2
b)2 -
1 -
2 -
0 -
1 -
2
c
) 4 -
1 -
0 -
2 -
1 -
2
d)3 -
1 -
1 -
2 -
1 -
2
12. Acli
ent
,af
terat
te
mp t
in
gtogetpr
egn
antf
oro
ver1y
ear
,isd
ete
rmi
nedt
obea
novu
lat
ory
.Wh
ichme
dic
ati
ons
hou
lda
nur
seant
ici
pat
eb e
ingord
ere
d ?
a
) Cl o
miphenecit
rat
e
b) Oxyt
ocin
c
) Ca l
ciu
mg lucon
ate
d) Rhoga
m
13. Amn i
oti
cfu
li
ds er
veswhic
ho fthef
o l
lowin
gf un
cti
ons
:(Se
lec
tal
lth
ata
ppl
y)
a) All
owsf oror
ganandti
ss
u egro
wt hofthef
etus
.
b) Pro
videsa d
equat
eres
pirat
ionforthefe
tus.
c) Pro
videsap r
ote
cti
vecus
hionforthefe
tus.
d) Contr
o l
sthefe
tus’
sen
vir
o nment
altempera
ture
.
e) Pre
ven t
ster
atog
ensfr
omc ross
ingtheplac
enta
14. Ane
wbornwei
ghs24
00gr
ams
.Thehea
lt
hcar
epro
vid
erha
sorder
ed0.2mg/
kg.
ofat
rop
ines
ulf
at
ein
tot
he
e
ndo
tra
chea
ltu
be.Bas
edo
nth
ela
b e
lbel
ow.
Ho wmuchwil
lth
en ur
seadmi
ni
st
eri
nml?
,15. Anur
seiscari
ngforanadol
esc
e n
tcli
entwh ois20weeksp
reg
nan
t.Sh
est
at
est
hath
erp
are
ntsd
on’
tkn
owa
bou
tth
e
pr
egn
ancy.Theappropr
iat
erespons
eb ythen ur
seis
:
) “
a Ify
o uwantmetoIc a
ntellyou
rp ar
ents”
.
b)“Yourparent
swil
lhavetoknowe ve
ntuall
y”.
) “
c Yous e
emh esi
ta
nttote
llyourpar
ents”.
d)“Giveyourparen
tsachance.Theywillunders
tan”
d.
16. Apregnantwoma nc o mestotheobstet
ri
cia
n’sofficewithcompl
aint
sofnasalconge
sti
onandepi
sta
xis
.Wh a
tist
he
c
orr
ecti
nterpr
e tat
iono fth
esesymptomsbythenurse ?
a
) Th es
ec on d i
ti
o nsareabnormal.Refe
rpatie
ntt oe ar
,nosean
dt h
roatspe
c i
al
ist
.
b) Est
rogeni n c
reasesbloodsuppl
yt othemu c
ou sme mbra
nesandres
ult
sinc on
gest
ionandnos
ebl
eeds.
c
) Es t
rogenr elaxesthesmo o
thmu scl
esintheres pir
at
o r
ytr
act
,soconges
ti
ona ndepi
staxi
sar
ecommon.
d) Nasalst
uffinessandno sebl
eedsarecausedbyad e
c r
eas
einproge
ster
one.
17. Thecl
ient
,wh ois36we eksg est
at
ion,hasjus
thadab i
ophys
ica
lprofil
ewiththesc
oreof2.Wh
icho
fth
efol
lo
win
g
nur
sin
gin t
erv
e n
tionswou ldb emo s
tapp r
opri
ate
?
a) Recogni
zethisasa nequivocalt
estandn o
tif
ytheheal
thca
repro vide
r.
b) Thi
sr e
sul
tdo esnotindic
a t
efet
aldis
tres
sther
efo
renofurt
heri
nte rve
ntio
na r
eneed
e d
.
c) Tel
lthemo t
herthatthisindi
cate
sfetalwel
l-bei
ng.
d) Consul
ttheMDa sthisscoreisi
n d
icati
veoffe
tald
ist
res
s.
18. Ap r
egnan
tpati
entenj
oysexercis
ingatalo
calhea
lths
paonceawee
k.Whichpa
ti
entc
omme
nti
ndi
cat
est
oth
enu
rse
t
hatadd
it
iona
lheal
thteachi
ngisn e
eded?
) “
a Idon’
tswimi nthepo olbecaus
eIa mafra
idtha
tth
ewa t
erwil
lhu
rtth
eb a
by”
.
b)“ Thegymg etshotandstufybymid-morn
ing
.”
) “
c Iwasarou
ndt heindoortrac
k.”
d)“ Il
imite
xerci
singtolow-imp ac
taerobi
cs”
.
19. A3 2-year
-ol
dG3 P2c l
ie
ntisret
u r
ningforherpr
enata
lvi
si
tat26wee
ks.Herp r
ena
talla
bso nrec
orda re
:Type&Rh=
An ega
ti
ve.An ti
bodys cr
eenno r
ma l.RapidPlas
maRe agi
n(RPR)=negat
ive.Huma nimmu nodeficie
ncyVirus(
HIV)=
nega
ti
ve.Rubel
latit
er1:6.
Cervicalsmearsneg
ati
veforGonor
rhe
a&Ch l
amyd i
a.Hemo g
lobin/
hemacr it=9mg /
dlan
d
2
9%.Ge st
ati
onaldia
bete
sscr
een.26we eks–withi
nnormall
i
mits
.Uri
nea
naly
sis(
UA)neg a
ti
ve.Toda
yh e rplano
f
c
ares
houl
dinc
lud
e:(Se
lec
tal
lth
atappl
y)
a) Ad minis
terRub el
lavaccineIM
b) Star
tclie
nto na nir
ons uppl
e me nt
c) Inst
ructcl
ientons i
gnsan ds y
mp t
omso fpre
termlabor
d) Ad mini
sterRh ogamIM
e) Ob t
ainaGr o u
pBe taStrepc u
lture
20. Thenurs
ewh oisass
ess
ingaG2P1cl
ien
tpal
patest
hefund
alh
eigh
tatt
hexi
pho
idpr
oce
ss.
Thenu
rsec
onc
lud
est
hat
t
hefe
tusise
qualtowhi
choft
hef
oll
owi
ngges
tat
io
nala
ge?
a) 28-
30we eks
b)1 4-
16we eks
c) 18-
20we eks
d)3 6-
38we eks
21. Anur
seiscar
ingfo
ran e
wbornwhos
emoth
eri
sp o
sit
i
vefort
hehep
ati
ti
sBsur
fac
ea n
ti
g e
n.Whi
choft
hef
oll
owi
ng
s
hou
ldth
einfan
trec
eiv
e?
a
) Hepati
ti
sBi mmuneglob
uli
nat1we
ekfol
lo
we dbyh
ep a
ti
ti
sBvacci
nemont
hlyfor6mon
ths
, b) He
pat
it
isBva
cci
nemonthl
yunti
lthen
ewb or
ntest
snega
ti
vefo
rthehepa
ti
ti
sBsur
fac
eant
ig
en
c
) Hepat
it
isBva
cci
neat24hrfo
llo
wedbyh e
pati
ti
sBi mmunegl
obul
ineve
ry12h
rfor3da
ys
d) He
pat
it
isBi
mmuneglo
b u
lina
ndh e
pat
it
isBvacci
newit
hin12hro
fb i
rt
h
22. Anursei
scari
ngforacli
entwhoisi
npret
erml
abo
rwi
thac
urr
entL/
Sra
ti
oof1
:1,
Whi
cho
fth
efo
llo
win
gac
ti
ons
s
hou l
dthenursetake
?
a
) Ad mini
st
erh y
dral
azine25mgIV.
b) Admini
st
erbetamet
hasone12mgIM
c
) Prepar
ethecli
entf
orimme di
at
edel
i
very
d)Infus
eabo l
usofIVflu
id
23. Anewb
o r
nwhowei
ghs3000gra
msi st
orec
eiv
e3mg
/kgo
fGe
nta
myc
inq1
2ho
urs
.Ba
sedo
nth
ela
belb
elo
w.Ho
w
mu
chwi
llt
hen
urs
ead
mini
st
erinmlev
ery12ho
urs
?
24. Thenur
seknowsthatanormalphys
iol
ogi
ca l
te
rat
i onofth
ec i
rc
u l
at
orys
yst
ema
sso
cia
tedwi
tht
hro
mbo
embo
lice
ven
ts
i
npregna
ncyis:
a) I
ncre
asedfb
ir
inogenandd e
cre
asedlys
ingoffib
rin
b)Incre
asedb l
oodvo l
umea ndi
ncrea
sedcardi
ao u
tput
c) Decr
eas
edb loo
dp ress
ureanddecr
easedhemo globi
n
d) Decr
eas
edh ema t
ocri
tandincr
ease
dr e
db l
o odc e
llle
vel(RBC)
25. Anur
seatapr
enat
alcl
i
n i
cisca
rin
gforac li
entwhoisi
nh e
rfir
stt
ri
me s
te
rofpr
egn
ancy
.Thecl
ie
ntt
el
lst
henu
rset
ha
s
heisup s
etbecause
,a l
thoughshea ndh e
rh u
s b
andp lannedthi
spregna
ncy.Shehasbeenha
vingmanydoubt
sand
s
econdthought
sa b
ou tt
h eupcomin gcha n
gesinh e
rli f
e.Wh ichofthef
oll
owingisanappr
opr
iat
eresp
ons
eb yt
he
nurs
e?
a) “Ambival
entfee
lingsar
eq uit
ec o mmo nforwo me ne ar
lyinpregna
ncy”
.
b)“ Pe
rhapsyoushou l
ds e
eat herap i
sttodis
c us
sthe sefeel
ingsfu
rthe
r”
.
c) “Haveyouspokent oyourfami lyab ou
tthesefee l
ings”
?
d)“ Don’t
\’
tworry.Youwi l
lbefn
i eon c
et hebabyisb o r
n.”
26. Thenurseiscari
ngforacli
entwhoissch
e dul
edfo
raQu
adb
loo
dte
sta
t16we
e ’g
ks e
sta
ti
on.Th
enu
rsei
nst
ruc
tst
he
cl
i
entt
hatthi
ste
stsc
ree
nsfo
rthepos
si
bil
it
yof
:
a) Gesta
tiona
ldiabet
esi
nthemo th
er
b)I n
bo r
ne rr
orsofme t
aboli
sminthefe
t u
s
c) RHi ncompati
bil
it
yb e
tweenmo t
herandfet
us
d) Spi
n aldef
ect
sinthefet
us
27. Apreg
n an
tcli
enta s
ksa boutth
efunc
ti
onsofthepla
cent
a.Wh i
chofthefol
lo
win
git
emss
hou
ldt
hen
urs
ein
clu
dei
n
t
hetea
chingplan?
a
) Fetalre
spir
ati
o n,nut
rit
ionandexc
ret
ionar
ecarri
edoutbythepl
acent
a
b) Theplac
entafil
tersfe
taluri
ne
c
) Th eplace
ntaflit
e r
sharmf u
lsub
stanc
esfro
mma t
ern
alblood
d) Fe
talandma t ernalbl
oo dmixi
nthep l
acent
atoexcha
ngenu t
ri
ents
28. Whi
chstat
ementbythepre
gn antcl
ienti
ndi
cat
estothenurs
ea nunders
tandi
ngofTORCHi
nfe
cti
ons
?
) “
a Iwillhav
emyh usbandtakecareofgroo
mingmyc ata n
dt h
elit
terbox”
.
b)“IfIhaveCMVIwi l
lne e
dt ohaveaC-Sec
ti
ontopre
ventbi
rt
hd e
fec
ts
.”
) “
c Ineedtobei
mmun ize
da gains
tsyphi
li
sbeca
usether
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