NCLEX EXAM 2 MERGED WITH LECTURE AUDIO -
COMPLETED| FROM QUESTION TO PERFECTION| STUDY
WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027
Duration: 2 Hours
Total Marks: 70%
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,What is Hyperemesis Gravidarum? Answer: A condition characterized by persistent, severe
nausea and vomiting during pregnancy, leading to dehydration, weight loss, and electrolyte
imbalance (sodium and potassium).
What are the potential causes of Hyperemesis Gravidarum? Answer: Possibly related to
elevated hCG levels that are prolonged or excessive throughout the pregnancy.
Reduced sodium, potassium, and chloride levels due to low intake.
Common Findings
Weight loss >5%, ketonuria, dehydration, decreased sodium and potassium levels, increased
pulse rate, decreased blood pressure, poor skin turgor, and dry mucous membranes.
Causes of Low Amniotic Fluid Answer: Birth defects: Fetal kidney or urinary issues reduce
urine output.
Placental problems: Poor blood flow limits fluid production.
Leaky/ruptured membranes: Fluid loss from the amniotic sac.
Post-date pregnancy: Fluid naturally decreases after 41 weeks.
Maternal health: Conditions like hypertension or dehydration.
Medications: Some drugs lower fetal urine production.
What are the risk factors associated with Hyperemesis Gravidarum? Answer: Intrauterine
growth restriction (IUGR), small for gestational age (SGA), and preterm birth if the condition
persists.
What is the most important initial laboratory test for Hyperemesis Gravidarum? Answer:
Urinalysis for ketones and acetones.
LAB TEST Antepartum Answer: Urinalysis: Presence of ketones and acetones due to
breakdown of protein and fat; elevated urine specific gravity.
Comprehensive Metabolic Panel (CMP): Reveals electrolyte imbalances.
Electrolytes: Sodium (Na), Potassium (K), and Chloride (Cl) levels are decreased due to poor
intake.
Acid-Base Balance:
Metabolic acidosis secondary to starvation.
Metabolic alkalosis due to excessive vomiting.
Liver Function Tests: Elevated liver enzymes.
Bilirubin: Increased levels; bilirubin is a yellow pigment produced when red blood cells break
down. High levels may indicate liver damage.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, Thyroid Function: May indicate hyperthyroidism.
Complete Blood Count (CBC): Elevated hematocrit (Hct) concentration due to fluid loss and
hemoconcentration.
What is a common nursing care intervention for Hyperemesis Gravidarum? Answer: •Monitor I
&O
•Assess skin turgor and mucous membrane
•Monitor Vital Signs
•Monitor Weight
•NPO until vomiting stops
•IV fluids
•Antiemetics
•Small Meals
•Urine ketones
What dietary advice or education is given to patients after vomiting has stopped in Hyperemesis
Gravidarum? Answer: Advance diet from clear liquids to bland foods, starting with dry toast
and crackers.
What is an Ectopic Pregnancy? Answer: A condition where a fertilized ovum implants outside
the uterus, commonly in the fallopian tube, potentially causing tubal rupture and fetal
hemorrhage. Second most frequent cause of bleeding in early pregnancy and leading cause of
infertility.
Risk Factors
Compromised tubal patency due to STIs, assisted reproductive technologies, tubal surgery, and
intrauterine devices (IUDs).
Ectopic Pregnancy Care & Labs Answer: Nursing Care / Patient Centered Care
•Replace fluids and maintain electrolyte balance
•Provide client education and psychological support
•Administer medications as prescribed
•Prepare client for surgery and postoperative nursing care
•Provide emotional care and support
•Provide referral for client and partner to pregnancy loss support groups
•Obtain serum HCG and progesterone levels, liver and renal function studies CBC, type screen
and Rh.•
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
COMPLETED| FROM QUESTION TO PERFECTION| STUDY
WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027
Duration: 2 Hours
Total Marks: 70%
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,What is Hyperemesis Gravidarum? Answer: A condition characterized by persistent, severe
nausea and vomiting during pregnancy, leading to dehydration, weight loss, and electrolyte
imbalance (sodium and potassium).
What are the potential causes of Hyperemesis Gravidarum? Answer: Possibly related to
elevated hCG levels that are prolonged or excessive throughout the pregnancy.
Reduced sodium, potassium, and chloride levels due to low intake.
Common Findings
Weight loss >5%, ketonuria, dehydration, decreased sodium and potassium levels, increased
pulse rate, decreased blood pressure, poor skin turgor, and dry mucous membranes.
Causes of Low Amniotic Fluid Answer: Birth defects: Fetal kidney or urinary issues reduce
urine output.
Placental problems: Poor blood flow limits fluid production.
Leaky/ruptured membranes: Fluid loss from the amniotic sac.
Post-date pregnancy: Fluid naturally decreases after 41 weeks.
Maternal health: Conditions like hypertension or dehydration.
Medications: Some drugs lower fetal urine production.
What are the risk factors associated with Hyperemesis Gravidarum? Answer: Intrauterine
growth restriction (IUGR), small for gestational age (SGA), and preterm birth if the condition
persists.
What is the most important initial laboratory test for Hyperemesis Gravidarum? Answer:
Urinalysis for ketones and acetones.
LAB TEST Antepartum Answer: Urinalysis: Presence of ketones and acetones due to
breakdown of protein and fat; elevated urine specific gravity.
Comprehensive Metabolic Panel (CMP): Reveals electrolyte imbalances.
Electrolytes: Sodium (Na), Potassium (K), and Chloride (Cl) levels are decreased due to poor
intake.
Acid-Base Balance:
Metabolic acidosis secondary to starvation.
Metabolic alkalosis due to excessive vomiting.
Liver Function Tests: Elevated liver enzymes.
Bilirubin: Increased levels; bilirubin is a yellow pigment produced when red blood cells break
down. High levels may indicate liver damage.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, Thyroid Function: May indicate hyperthyroidism.
Complete Blood Count (CBC): Elevated hematocrit (Hct) concentration due to fluid loss and
hemoconcentration.
What is a common nursing care intervention for Hyperemesis Gravidarum? Answer: •Monitor I
&O
•Assess skin turgor and mucous membrane
•Monitor Vital Signs
•Monitor Weight
•NPO until vomiting stops
•IV fluids
•Antiemetics
•Small Meals
•Urine ketones
What dietary advice or education is given to patients after vomiting has stopped in Hyperemesis
Gravidarum? Answer: Advance diet from clear liquids to bland foods, starting with dry toast
and crackers.
What is an Ectopic Pregnancy? Answer: A condition where a fertilized ovum implants outside
the uterus, commonly in the fallopian tube, potentially causing tubal rupture and fetal
hemorrhage. Second most frequent cause of bleeding in early pregnancy and leading cause of
infertility.
Risk Factors
Compromised tubal patency due to STIs, assisted reproductive technologies, tubal surgery, and
intrauterine devices (IUDs).
Ectopic Pregnancy Care & Labs Answer: Nursing Care / Patient Centered Care
•Replace fluids and maintain electrolyte balance
•Provide client education and psychological support
•Administer medications as prescribed
•Prepare client for surgery and postoperative nursing care
•Provide emotional care and support
•Provide referral for client and partner to pregnancy loss support groups
•Obtain serum HCG and progesterone levels, liver and renal function studies CBC, type screen
and Rh.•
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
