AS Associate Of Science In Nursing 4 — Questions and Answers
Question 1: A laboring patient's fetal heart rate monitor shows late decelerations with each contraction. Which intervention should the nurse perform first?
- Administer oxygen via face mask at 8–10 L/min
- Reposition the patient to the left lateral position (Correct answer)
- Increase the IV fluid infusion rate
- Discontinue oxytocin if infusing
Correct answer: Reposition the patient to the left lateral position
Repositioning to the left lateral position relieves aortocaval compression and is the first-line response to late decelerations.
Question 2: Which finding is a normal expected change during pregnancy?
- Increased blood pressure throughout gestation
- Decreased heart rate by 10–15 bpm
- Increased cardiac output by 30–50% (Correct answer)
- Decreased respiratory rate
Correct answer: Increased cardiac output by 30–50%
Cardiac output increases by 30–50% during pregnancy to meet the metabolic demands of the mother and fetus.
Question 3: A nurse is caring for a newborn at 10 minutes of age. Which APGAR component is being assessed when the nurse checks the infant's response to a catheter in the nostril?
- Appearance
- Grimace (reflex irritability) (Correct answer)
- Activity (muscle tone)
- Respiration
Correct answer: Grimace (reflex irritability)
Reflex irritability (grimace) is assessed by observing the newborn's response to a stimulus such as a catheter in the nostril.
Question 4: Which instruction is most important when teaching a patient about warfarin therapy?
- Take the medication with a full glass of milk to prevent GI upset
- Avoid foods high in vitamin K such as leafy green vegetables (Correct answer)
- Double the dose if a dose is missed
- Avoid all physical activity to prevent bruising
Correct answer: Avoid foods high in vitamin K such as leafy green vegetables
Vitamin K antagonizes warfarin's anticoagulant effect, so consistent intake of vitamin K–rich foods is critical to maintaining stable INR levels.
Question 5: A patient with chronic renal failure is most likely to experience which acid-base imbalance?
- Respiratory alkalosis
- Metabolic alkalosis
- Respiratory acidosis
- Metabolic acidosis (Correct answer)
Correct answer: Metabolic acidosis
Failed kidneys cannot excrete hydrogen ions or reabsorb bicarbonate, leading to metabolic acidosis.
Question 6: When assessing a patient for deep vein thrombosis (DVT), the nurse knows that which clinical sign, though unreliable, is classically associated with DVT?
- Homans' sign (calf pain with dorsiflexion) (Correct answer)
- Kernig's sign (resistance to knee extension)
- Chvostek's sign (facial muscle twitching)
- Trousseau's sign (carpal spasm with cuff inflation)
Correct answer: Homans' sign (calf pain with dorsiflexion)
Homans' sign — calf pain on dorsiflexion — is classically associated with DVT, though its sensitivity and specificity are low.
Question 7: A nurse is preparing discharge teaching for a patient newly diagnosed with type 1 diabetes. Which topic is the highest priority?
- Long-term dietary modification and carb counting
- Recognition and treatment of hypoglycemia (Correct answer)
- Exercise recommendations for blood glucose control
- Foot care and daily inspection techniques
Correct answer: Recognition and treatment of hypoglycemia
Hypoglycemia can rapidly become life-threatening, making recognition and immediate treatment the highest priority safety topic for new insulin users.
AS Associate Of Science In Nursing 4
A laboring patient's fetal heart rate monitor shows late decelerations with each contraction.
Which intervention should the nurse perform first?