Mosby's NCLEX-MATERNITY Exam Tested Questions With Revised Correct Detailed Answers & Rationales Latest Update

Mosby's NCLEX-MATERNITY Exam Tested Questions With Revised Correct Detailed Answers & Rationales Latest Update 1. When taking the health history of a client who is admitted for repair of a cystocele and rectocele, the nurse should expect the client to report the occurrence of: 1. white vaginal discharge and itching. 2. sporadic bleeding and abdominal pain. 3. elevated temperature and intractable diarrhea. 4. stress incontinence and low abdominal pressure. - ANSWER drops, the vaginal wall relaxes. When the bladder 4 As the uterus herniates into the vagina (cystocele) and the rectal wall herniates into the vagina (rectocele), the individual feels pressure or pain in the lower back and/or pelvis. When there is an increase in intraabdominal pressure in the presence of a cystocele, incontinence results. 1 A white vaginal discharge (leukorrhea) and vaginal itching (pruritus) do notindicate cystocele and rectocele; they are common with a vaginal infection. 2 Sporadic bleeding is not expected with cystocele and rectocele. 3 These are not expected with cystocele and rectocele; a fever would indicate an infection; constipation, not diarrhea, is more likely to occur 2. A client who is scheduled to have an abdominal panhysterectomy asks how the surgery will affect her periods. How should the nurse respond? 1. "You will not have any more periods." 2. "Your periods will become more regular." 3. "Your periods will become lighter until they disappear." 4. "You will notice that the time between periods will be longer. - ANSWER An panhysterectomy in the premenopausal woman produces artificial onset of menopause. 2, 3, 4 Because the uterus is removed, there will be no uterine endometrial proliferation and no desquamation 3. A nurse at the prenatal clinic examines a client and determines that her 1 uterus has risen out of the pelvis and is now an abdominal organ. At what week of gestation does this occur? 1. 8th week of pregnancy 2. 10th week of pregnancy 3. 12th week of pregnancy 4. 18th week of pregnancy - ANSWER have grown, expanding the size of 3 By this time the fetus and placenta the uterus. The enlarged uterus extends into the abdominal cavity. 1, 2 At this time the uterus is still within the pelvic area. 4 At this time the uterus has already risen out of the pelvis and is extending farther into the abdominal area. 4. A client has several tests during pregnancy. Place the tests in the order they should be performed during pregnancy. 1. _____ Fetal movement test 2. _____ Sickle cell screening 3. _____ Group B streptococcus culture 4. _____ Serum glucose for gestational diabetes 5. _____ Alpha-fetoprotein (AFP) testing for neural tube defects - ANSWER Answer: 2, 5, 4, 1, 3. 2 Sickle cell screening, particularly for black women, should be done on the initial visit. 5 Alpha-fetoprotein (AFP) testing for neural tube defects should be done between 14 and 16 weeks. 4 Serum glucose testing for gestational diabetes should be done between 26 and 28 weeks. 1 Fetal movement tests can begin at 28 weeks gestation because the fetus' pattern of movement becomes stabilized at this time. 3 5. What change does a nurse expect in a client's hematologic system during the second trimester of pregnancy? 1. An increase in hematocrit 2. An increase in blood volume 3. A decrease in sedimentation rate 4. A decrease in white blood cells - ANSWER approximately 50% during pregnancy. 2 The blood volume increases by Peak blood volume occurs between 30 and 34 weeks' gestation. 1 The hematocrit decreases as a result of hemodilution. 3 The sedimentation rate increases because of a decrease in plasma proteins. 4 WBC values remain stable during the antepartum period. 6. During a physical in the prenatal clinic the client's vaginal mucosa is observed to have a purplish discoloration. What sign should the nurse document in the client's clinical record? 1. Hegar 2. Goodell 3. Chadwick 4. Braxton Hick - ANSWER vascularity and blood 3 A purplish color results from the increased vessel engorgement of the vagina. 1 This is softening of the lower uterine segment. 2 This is softening of the cervix. 4 After the fourth month of pregnancy, uterine contractions can be felt through the abdominal wall. They are irregular and painless, and they increase blood flow to the placenta. 7. A pregnant woman reports nausea and vomiting during the first trimester of pregnancy. An increase in which hormone should the nurse explain is the precipitating cause of the nausea and vomiting? 1. Estrogen 2. Progesterone 3. Luteinizing hormone 4 Chorionic gonadotropin, secreted in 4. Chorionic gonadotropin - ANSWER large amounts by the placenta during gestation, and the metabolic changes associated with pregnancy can precipitate nausea and vomiting in early pregnancy; usually the manifestations of morning sickness disappear after the first trimester. 8. Apregnant woman tells a nurse in the prenatal clinic that she knows that folic acid is very important during pregnancy and she is taking a prescribed supplement. She asks the nurse what foods contain folic acid (folate) so she can add them to her diet in its natural form. Which foods should the nurserecommend? Select all that apply. 1. Beef and fish 2. Milk and cheese 3. Chicken and turkey 4. Black and pinto beans 5. Enriched bread and pasta - ANSWER Answer: 4, 5. 1 Beef and fish do not contain an adequate amount of folate. 2 Milk and cheese do not contain an adequate amount of folate. 3 Fowl does not contain an adequate amount of folate. 4 Legumes contain large amounts of folate. 5 Enriched grain products contain large amounts of folate 9. A nurse is planning a prenatal class about the changes that occur during pregnancy and the necessity of routine health care supervision throughout pregnancy. Which cardiovascular compensatory mechanisms should the nurse explain will occur? Select all that apply. 1. Systemic vasodilation 2. Increased blood volume 3. Elevated blood pressure 4. Increased cardiac output 5. Enlargement of the heart - ANSWER Answer: 2, 4, 5. 1 Systemic vasodilation is not expected. 2 Blood volume is increased to meet the metabolic demands of pregnancy. 3 There is little variation in bloodpressure with a slight decrease during the second trimester. 4 An increased cardiac output is necessary to accommodate the increased blood volume needed to meet the demands of the growing fetus. 5 Cardiac hypertrophy is a result of the demands made by the increased blood volume and cardiac output. 6 Erythrocyte production increases; because the plasma volume increases more than the RBCs, the hematocrit is lower.