NCLEXRNPREDICTIONACTUALEXAMREAL
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NCLEX-RN 1 / 4
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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