NUR166/NUR 166 Exam 2 V2 | Concepts of
Family Centered Nursing for the Practical
Nurse Q&A with Rationale | Hondros
College of Nursing
1. A nurse is assessing a 4-month-old infant during a routine check-up. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Rolling from back to side
B. Sitting up without support
C. Using a pincer grasp
D. Walking while holding onto furniture
Correct Answer: A
Rationale: At 4 months of age, an infant is expected to roll from their back to their side.
Sitting without support usually occurs around 6 months, while the pincer grasp develops
closer to 9 months. Walking with furniture, or cruising, typically happens around 11 to 12
months.
2. A pregnant client at 32 weeks gestation presents with painless, bright red vaginal bleeding.
Which condition should the nurse suspect?
A. Abruptio placentae
B. Preterm labor
,C. Ectopic pregnancy
D. Placenta previa
Correct Answer: D
Rationale: Placenta previa is characterized by the painless onset of bright red vaginal
bleeding during the second or third trimester. This occurs because the placenta is
implanted in the lower uterine segment, covering the cervical os. In contrast, abruptio
placentae involves painful, dark red bleeding and uterine tenderness.
3. A nurse is providing education to a new mother regarding the prevention of Sudden Infant
Death Syndrome (SIDS). Which instruction is most important to include?
A. Place the infant on their side to sleep
B. Use a soft mattress with bumper pads
C. Place the infant on their back to sleep
D. Keep the infant’s room temperature very warm
Correct Answer: C
Rationale: The ‘Back to Sleep’ campaign recommends that all infants be placed on their
backs to sleep to reduce the risk of SIDS. The sleeping surface should be firm and free of
soft objects like pillows or bumper pads. Maintaining a cool, comfortable room
temperature is also advised to prevent overheating.
, 4. A nurse is evaluating a client in the second stage of labor. Which clinical manifestation
indicates that the client is entering this stage?
A. The cervix is dilated to 3 cm
B. The client experiences an uncontrollable urge to push
C. The rupture of membranes occurs
D. The expulsion of the placenta
Correct Answer: B
Rationale: The second stage of labor begins when the cervix is fully dilated at 10 cm and
ends with the birth of the baby. During this stage, the mother often feels an intense,
involuntary urge to push or bear down. The expulsion of the placenta characterizes the
third stage of labor.
5. Which immunization is typically administered to a newborn within the first 24 hours of
birth?
A. Inactivated Poliovirus (IPV)
B. Hepatitis B (HepB)
C. Measles, Mumps, and Rubella (MMR)
D. Rotavirus (RV)
Correct Answer: B
Family Centered Nursing for the Practical
Nurse Q&A with Rationale | Hondros
College of Nursing
1. A nurse is assessing a 4-month-old infant during a routine check-up. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Rolling from back to side
B. Sitting up without support
C. Using a pincer grasp
D. Walking while holding onto furniture
Correct Answer: A
Rationale: At 4 months of age, an infant is expected to roll from their back to their side.
Sitting without support usually occurs around 6 months, while the pincer grasp develops
closer to 9 months. Walking with furniture, or cruising, typically happens around 11 to 12
months.
2. A pregnant client at 32 weeks gestation presents with painless, bright red vaginal bleeding.
Which condition should the nurse suspect?
A. Abruptio placentae
B. Preterm labor
,C. Ectopic pregnancy
D. Placenta previa
Correct Answer: D
Rationale: Placenta previa is characterized by the painless onset of bright red vaginal
bleeding during the second or third trimester. This occurs because the placenta is
implanted in the lower uterine segment, covering the cervical os. In contrast, abruptio
placentae involves painful, dark red bleeding and uterine tenderness.
3. A nurse is providing education to a new mother regarding the prevention of Sudden Infant
Death Syndrome (SIDS). Which instruction is most important to include?
A. Place the infant on their side to sleep
B. Use a soft mattress with bumper pads
C. Place the infant on their back to sleep
D. Keep the infant’s room temperature very warm
Correct Answer: C
Rationale: The ‘Back to Sleep’ campaign recommends that all infants be placed on their
backs to sleep to reduce the risk of SIDS. The sleeping surface should be firm and free of
soft objects like pillows or bumper pads. Maintaining a cool, comfortable room
temperature is also advised to prevent overheating.
, 4. A nurse is evaluating a client in the second stage of labor. Which clinical manifestation
indicates that the client is entering this stage?
A. The cervix is dilated to 3 cm
B. The client experiences an uncontrollable urge to push
C. The rupture of membranes occurs
D. The expulsion of the placenta
Correct Answer: B
Rationale: The second stage of labor begins when the cervix is fully dilated at 10 cm and
ends with the birth of the baby. During this stage, the mother often feels an intense,
involuntary urge to push or bear down. The expulsion of the placenta characterizes the
third stage of labor.
5. Which immunization is typically administered to a newborn within the first 24 hours of
birth?
A. Inactivated Poliovirus (IPV)
B. Hepatitis B (HepB)
C. Measles, Mumps, and Rubella (MMR)
D. Rotavirus (RV)
Correct Answer: B
