NCLEX-PN Test Prep Exam

2022/2023 NCLEX-PN Test Prep Exam

3(THREE)

Questions and Answers with Explanations

• A papular lesion is noted on the perineum of the laboring client. Which

initial action is most appropriate? A. Document the finding

• Report the finding to the doctor
• Prepare the client for a C-section
• Continue primary care as prescribed

Answer B: Any lesion should be reported to the doctor. This can indicate a

herpes lesion. Clients with open lesions related to herpes are delivered by Cesarean section because there is a possibility of transmission of the infection to the fetus with direct contact to lesions. It is not enough to document the finding, so answer A is incorrect. The physician must make the decision to perform a C-section, making answer C incorrect. It is not enough to continue primary care, so answer D is incorrect.

• A client with a diagnosis of human papillomavirus (HPV) is at risk for

which of the following?

• Lymphoma
• Cervical and vaginal cancer
• Leukemia
• Systemic lupus

Answer B: The client with HPV is at higher risk for cervical and vaginal

cancer related to this STI. She is not at higher risk for the other cancers mentioned in answers A, C, and D, so those are incorrect.

• The client seen in the family planning clinic tells the nurse that she has a

painful lesion on the perineum. The nurse is aware that the most likely source

of the lesion is:

• Syphilis
• Herpes
• Candidiasis
• Condylomata

Answer B: A lesion that is painful is most likely a herpetic lesion. A chancre

lesion associated with syphilis is not painful, so answer A is incorrect. In answer C, candidiasis is a yeast infection and does not present with a lesion, but it is exhibited by a white, cheesy discharge. Condylomata lesions are painless warts, so answer D is incorrect.

• A client visiting a family planning clinic is suspected of having an STI.

The most diagnostic test for treponema pallidum is:

• Venereal Disease Research Lab (VDRL)
• Rapid plasma reagin (RPR)
• Florescent treponemal antibody (FTA)
• Thayer-Martin culture (TMC)

Answer C: FTA is the only answer choice for treponema pallidum. Answers A

and B are incorrect because VDRL and RPR are screening tests for syphilis but are not conclusive of the disease; they only indicate exposure to the disease. The Thayer-Martin culture is a test for gonorrhea, so answer D is incorrect.

• Which laboratory finding is associated with HELLP syndrome in the

obstetric client? A. Elevated blood glucose

• Elevated platelet count
• Elevated creatinine clearance
• Elevated hepatic enzymes

Answer D: The criteria for HELLP is hemolysis, elevated liver enzymes, and

low platelet count. In answer A, an elevated blood glucose level is not associated with HELLP. Platelets are decreased in HELLP syndrome, not elevated, as stated in answer B. The creatinine levels are elevated in renal disease and are not associated with HELLP syndrome, as stated in answer C.

• The nurse is assessing the deep tendon reflexes of the client with

hypomagnesemia. Which method is used to elicit the biceps reflex?

• The nurse places her thumb on the muscle inset in the antecubital

space and taps the thumb briskly with the reflex hammer.

• The nurse loosely suspends the client’s arm in an open hand while

tapping the back of the client’s elbow.

• The nurse instructs the client to dangle her legs as the nurse strikes the

area below the patella with the blunt side of the reflex hammer.

• The nurse instructs the client to place her arms loosely at her side as

the nurse strikes the muscle insert just above the wrist.

Answer A: The answer can only be A because the other methods elicit

different reflexes. Answer B elicits the triceps reflex, answer C elicits the patella reflex, and answer D elicits the radial nerve.

• Which medication should be used with caution in the obstetric client with

diabetes?

• Magnesium sulfate
• Brethine
• Stadol
• Ancef

Answer B: Brethine is used cautiously because it raises the blood glucose

levels. Answers A, C, and D are all medications that are commonly used in the diabetic client, so there is no need to question the order for these medications.

• A multigravida is scheduled for an amniocentesis at 32 weeks gestation to

determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1.

The nurse’s assessment of this data is:

• The infant is at low risk for congenital anomalies.
• The infant is at high risk for intrauterine growth retardation.
• The infant is at high risk for respiratory distress syndrome. D. The infant is

at high risk for birth trauma.

Answer C: When the L/S ratio reaches 2:1, the lungs are considered to be mature. The infant will most likely be small for gestational age and will not be at risk for birth trauma, so answer B is incorrect. The L/S ratio does not indicate congenital anomalies, as stated in answer A, and the infant is not at risk for intrauterine growth retardation, as stated in answer D.

• Which observation in the newborn of a mother who is alcohol dependent

would require immediate nursing intervention?

• Crying
• Wakefulness
• Jitteriness
• Yawning

Answer C: Jitteriness is a sign of seizure in the neonate. Answers A, B, and D

are incorrect because crying, wakefulness, and yawning are expected in the newborn.

• The nurse caring for a client receiving magnesium sulfate must closely

observe for side effects associated with drug therapy. An expected side effect

of magnesium sulfate is:

• Decreased urinary output
• Hypersomnolence
• Absence of knee jerk reflex
• Decreased respiratory rate

Answer B: The client is expected to become sleepy, have hot flashes, and

experience lethargy. A decreasing urinary output, absence of the knee jerk reflex, and decreased respirations are signs of toxicity and are not expected side effects of magnesium sulfate. Therefore, answers A, C, and D are incorrect.

• The 57-year-old male client has elected to have epidural anesthesia as the

anesthetic during a hernia repair. If the client experiences hypotension, the

nurse would:

• Place him in the Trendelenburg position
• Obtain an order for Benedryl
• Administer oxygen per nasal cannula
• Speed the IV infusion of normal saline