NationalCouncilLicensureExamination

NationalCouncilLicensureExamination

NCLEX-RN

QUESTION1

A25-year-oldclientbelievesshemaybepregnantwithherfirstchild.Sheschedulesanobstetricexaminationwiththenursepractitionertodeterminethestatusof herpossiblepregnancy.HerlastmenstrualperiodbeganMay20,andherestimateddateofconfinementusingNägele'srule

is:

A.March27 B.February1 C.February27 D.January3

CorrectAnswer:C

Section:(none)

Explanation

Explanation/Reference:

Explanation:

(A)March27isamiscalculation.(B)February1isamiscalculation.(C)February27isthecorrectanswer.Tocalculatetheestimateddateofconfinementusing Nagele'srule,subtract3monthsfromthedatethatthelastmenstrualcyclebeganandthenadd7daystotheresult.(D)January3isamiscalculation.

QUESTION2

Thenursepractitionerdeterminesthataclientisapproximately9weeks'gestation.Duringthevisit,thepractitionerinformstheclientaboutsymptomsofphysical

changesthatshewillexperienceduringherfirsttrimester,suchas:

A.Nauseaandvomiting B.Quickening C.A68lbweightgain D.Abdominalenlargement

CorrectAnswer:A

Section:(none)

Explanation

Explanation/Reference:

Explanation:

(A)Nauseaandvomitingareexperiencedbyalmosthalfofallpregnantwomenduringthefirst3monthsofpregnancyasaresultofelevatedhumanchorionic gonadotropinlevelsandchangedcarbohydratemetabolism.(B)Quickeningisthemother'sperceptionoffetalmovementandgenerallydoesnotoccuruntil1820 2 / 4

weeksafterthelastmenstrualperiodinprimigravidas,butitmayoccurasearlyas16weeksinmultigravidas.(C)Duringthefirsttrimesterthereshouldbeonlya modestweightgainof24lb.Itisnotuncommonforwomentoloseweightduringthefirsttrimesterowingtonauseaand/orvomiting.(D)Physicalchangesarenot apparentuntilthesecondtrimester,whentheuterusrisesoutofthepelvis.

QUESTION3

A38-year-oldpregnantwomanvisitshernursepractitionerforherregularprenatalcheckup.Sheis30weeks'gestation.Thenurseshouldbealerttowhich conditionrelatedtoherage?A.Iron-deficiencyanemia B.Sexuallytransmitteddisease(STD) C.Intrauterinegrowthretardation D.Pregnancy-inducedhypertension(PIH)

CorrectAnswer:D

Section:(none)

Explanation

Explanation/Reference:

Explanation:

(A)Iron-deficiencyanemiacanoccurthroughoutpregnancyandisnotagerelated.(B)STDscanoccurpriortoorduringpregnancyandarenotagerelated.(C) Intrauterinegrowthretardationisanabnormalprocesswherefetaldevelopmentandmaturationaredelayed.Itisnotagerelated.(D)Physicalrisksforthepregnant clientolderthan35includeincreasedriskforPIH,cesareandelivery,fetalandneonatalmortality,andtrisomy.

QUESTION4

Aclientreturnsforher6-monthprenatalcheckupandhasgained10lbin2months.Theresultsofherphysicalexaminationarenormal.Howdoesthenurse interprettheeffectivenessoftheinstructionaboutdietandweightcontrol?A.Sheiscompliantwithherdietaspreviouslytaught.B.Sheneedsfurtherinstructionandreinforcement.C.Sheneedstoincreasehercaloricintake. 3 / 4

D.Sheneedstobeplacedonarestrictivedietimmediately.

CorrectAnswer:B

Section:(none)

Explanation

Explanation/Reference:

Explanation:

(A)Sheisprobablynotcompliantwithherdietandexerciseprogram.Recommendedweightgainduringsecondandthirdtrimestersisapproximately12lb.(B) Becauseofherexcessiveweightgainof10lbin2months,sheneedsre-evaluationofhereatinghabitsandreinforcementofproperdietaryhabitsforpregnancy.A 2200-caloriedietisrecommendedformostpregnantwomenwithaweightgainof2730lboverthe9-monthperiod.Withrapidandexcessiveweightgain,PIH shouldalsobesuspected.(C)Shedoesnotneedtoincreasehercaloricintake,butshedoesneedtore-evaluatedietaryhabits.Tenpoundsin2monthsis excessiveweightgainduringpregnancy,andhealthteachingiswarranted.(D)Restrictivedietingisnotrecommendedduringpregnancy.

QUESTION5

Diabetesduringpregnancyrequirestightmetaboliccontrolofglucoselevelstopreventperinatalmortality.Whenevaluatingthepregnantclient,thenurseknows

therecommendedserumglucoserangeduringpregnancyis:

A.70mg/dLand120mg/dL B.100mg/dLand200mg/dL C.40mg/dLand130mg/dL D.90mg/dLand200mg/dL

CorrectAnswer:A

Section:(none)

Explanation

Explanation/Reference:

Explanation:

(A)Therecommendedrangeis70120mg/dLtoreducetheriskofperinatalmortality.(B,C,D)Theselevelsarenotrecommended.Thehigherthebloodglucose, theworsetheprognosisforthefetus.Hypoglycemiacanalsohavedetrimentaleffectsonthefetus.

QUESTION6

Whenassessingfetalheartratestatusduringlabor,themonitordisplayslatedecelerationswithtachycardiaanddecreasingvariability.Whatactionshouldthe nursetake?A.Continuemonitoringbecausethisisanormaloccurrence.B.Turnclientonrightside.

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