RN- NCLEX Exam Questions With New
Update Solutions
/1. I can wait 3 to 4 days after intercourse to start taking these to prevent pregnancy.
Plan B is a series of contraceptive pills similar in composition to birth control pills that
have been used for the past 30 years. Plan B is the brand name for levonorgestrel 0.75
mg. Pills are most effective if taken immediately after unprotected intercourse and then
again 12 hours later. Males can purchase this contraceptive as long as they are over 18
years of age. Common side effects include nausea, breast tenderness, vertigo, and
stomach pain. - Answer-A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets)
as emergency contraception. After unprotected intercourse , the client calls the clinic to
ask questions about taking the contraceptives. The nurse realizes the client needs
further explanation when she makes which of the following responses?
/.3. Breast - or bottle-feeding plan.
Birth control plans are influenced primarily by whether the mother is breast- or bottle-
feeding her infant. The maternal milk supply must be well established prior to the
initiation of most hormonal birth control methods. Low-dose oral contraceptives would
be the exception. Use of estrogen-/progesterone-based pills and progesterone-only pills
are commonly initiated from 4 to 6 weeks postpartum because the milk supply is well
established by this time. Prior experiences with birth control methods have an impact on
the method chosen as do to preferences of the client's partner; however, they are not
the most influential factors. Desire to have another child in two years would make some
methods, such as an IUD, less attractive but would still be secondary to the choice to
breast-feed. - Answer-An antenatal G2, T1, P0, Ab0, L1 client is discussing her
postpartum plans for birth control with her health care provider. In analyzing the
available choices, which of the following factors has the greatest impact on her birth
control options?
/.4. If there is discharge from my nipples, I should call my health care provider.
The nurse determines that the client has understood the instructions when the client
says that she will notify her primary health care provider if she notices discharge or
bleeding because this may be symptomatic of underlying disease. Ideally, breast self-
examination should be performed about 1 week after the onset of menses because
hormonal influences on breast tissue are at a low ebb at this time. The client should
perform breast self-examination on the same day each month only if she has stopped
menstruating (as with menopause). The client's breasts should mirror each other. If one
breast is significantly larger than the other, or if there is "pitting" of breast tissue, a tumor
may be present. - Answer-After the nurse instructs a 20 year old nulligravid client on
how to perform a breast self-examination, which of the following client statements
indicates that the teaching has been successful?
,/.3. Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the
next menstrual cycle.
For a client with a typical menstrual cycle of 28 days, ovulation usually occurs on day
14, plus or minus 2 days, before the onset of the next menstrual cycle. Stated another
way, the menstrual period begins about 2 weeks after ovulation has occurred. Ovulation
does not usually occur during the menses component of the cycle when the uterine
lining is being shed. In most women, the ovum survives for about 12 to 24 hours after
ovulation, during which time conception is possible. The basal body temperature rises
0.5 F to 1.0 F (0.28 C to 0.56 C) when ovulation occurs. Although some women
experience some pelvic discomfort during ovulation (mittelschmerz), severe or unusual
pain is rare. After ovulation, the cervical mucus is thin and copious. - Answer-Which of
the following would be important to include in the teaching plan for the client who wants
more information on ovulation and fertility management?
/.1. Take a mild analgesic if needed for menstrual pain.
The nurse should instruct the client to take a mild analgesic, such as ibuprofen, if
menstrual pain or "cramps" are present. The client should also eat foods rich in iron and
should continue moderate exercise during menstruation, which increases abdominal
tone. Avoiding cold foods will not decrease dysmenorrhea. Sexual intercourse is not
prohibited during menstruation, but the male partner should wear condom to prevent
expose to blood. - Answer-Which of the following instructions about activities during
menstruation would the nurse include when counseling an adolescent who has just
begun to menstruate?
/.1. Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in
pregnancy.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes. This is an
important point to make with adolescents who may be sexually active. Many people
believe that the time interval is much longer and that they can wait until after intercourse
to take steps to prevent conception. Without protection, pregnancy and sexually
transmitted diseases can occur. When using the abstinence or calendar method, the
couple should abstain from intercourse on the days of menstrual cycle when the woman
is most likely to conceive. Using a 28-day cycle as an example, a couple should abstain
from coitus 3 to 4 days before ovulation (days 10 through 14) and 3 to 4 days after after
ovulation (days 15 through 18). Sperm from a healthy male can remain viable for 24 to
72 hours in the female reproductive tract. If the female client ovu - Answer-After
conducting a class for female adolescents about human reproduction, which of the
following statements indicates that the school nurse's teaching has been effective?
/.3. Cervical mucus is carefully monitored for changes.
The symptothermal method is a natural method of fertility management that depends on
knowing when ovulation has occurred. Because regular menstrual cycles can vary by 1
or 2 days in either direction, the symptothermal method requires daily basal body
temperature assessments plus close monitoring of cervical mucus changes. The
method relies on abstinence during the period of ovulation, which occurs approximately
14 days before the beginning of the next cycle. Abstinence from coitus for 5 days after
, menses is unnecessary because it is unlikely that ovulation will occur during this time
period (days 1 through 10). Typically, the failure rate for this method is between 10%
and 20 %. Although a condom may increase the effectiveness of this method, most
clients who choose natural methods are not interested in chemical or barrier types of
family planning. - Answer-A 20-year-old nulligravid client expresses a desire to learn
more about the symptothermal method of family planning. Which of the following would
the nurse include in the teaching plan?
/.2. Hypertension.
Before advising a client about oral contraceptives, the nurse needs to assess the client
for signs and symptoms of hypertension. Clients who have hypertension,
thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident are
poor candidates for oral contraceptives. In addition, women who smoke, are older than
40 years of age, or have a history of pulmonary disease should be advised to use a
different method. Iron-deficiency, anemia, dysmenorrhea, and acne are not
contraindications for the use of oral contraceptives. Iron-deficiency anemia is a common
disorder in young women. Oral contraceptives decrease the amount of iron lost through
menses, thereby providing a beneficial effect when used by clients with anemia.Low-
dose oral contraceptives to prevent ovulation may be effective in decreasing the
severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to be ca -
Answer-Before advising a 24-year-old client desiring oral contraceptives for family
planning, the nurse would assess the client for signs and symptoms of which of the
following?
/.4. Ovarian cancer.
The nurse determines that the client needs further instruction when the client says that
one of the adverse effects of oral contraceptive use is ovarian cancer. Some studies
suggest that ovarian and endometrial cancers are reduced in women using oral
contraceptives. Other adverse effects of oral contraceptives include weight gain,
nausea, headache, breakthrough bleeding, and monilial infections. The most serious
adverse effect is thrombophlebitis. - Answer-After instructing a 20-year-old nulligravid
client about adverse effects of oral contraceptives, the nurse determines that further
instruction is needed when the client states which of the following as an adverse effect?
/.1. Using a spermicide with the condom offers added protection against pregnancy.
The typical failure rate of a condom is approximately 12% to 14%. Adding a spermicide
can decrease this potential failure rate because it offers additional protection against
pregnancy. Natural skin condoms do not offer the same protection against sexually
transmitted diseases caused by viruses as latex condoms do. Unlike latex condoms,
natural skin (membrane) condoms do not prevent the passage of viruses. Most condom
users report decreased penile gland sensibility. However, some users do report an
increased sensitivity or allergic reaction (such as a rash) to latex, necessitating the use
of another method of family planning or a switch to a natural skin condom. - Answer-A
22-year-old nulligravid client tells the nurse that she and her husband have been
considering using condoms for family planning. Which of the following instructions
should the nurse include about the use of condoms as a method for family planning?
Update Solutions
/1. I can wait 3 to 4 days after intercourse to start taking these to prevent pregnancy.
Plan B is a series of contraceptive pills similar in composition to birth control pills that
have been used for the past 30 years. Plan B is the brand name for levonorgestrel 0.75
mg. Pills are most effective if taken immediately after unprotected intercourse and then
again 12 hours later. Males can purchase this contraceptive as long as they are over 18
years of age. Common side effects include nausea, breast tenderness, vertigo, and
stomach pain. - Answer-A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets)
as emergency contraception. After unprotected intercourse , the client calls the clinic to
ask questions about taking the contraceptives. The nurse realizes the client needs
further explanation when she makes which of the following responses?
/.3. Breast - or bottle-feeding plan.
Birth control plans are influenced primarily by whether the mother is breast- or bottle-
feeding her infant. The maternal milk supply must be well established prior to the
initiation of most hormonal birth control methods. Low-dose oral contraceptives would
be the exception. Use of estrogen-/progesterone-based pills and progesterone-only pills
are commonly initiated from 4 to 6 weeks postpartum because the milk supply is well
established by this time. Prior experiences with birth control methods have an impact on
the method chosen as do to preferences of the client's partner; however, they are not
the most influential factors. Desire to have another child in two years would make some
methods, such as an IUD, less attractive but would still be secondary to the choice to
breast-feed. - Answer-An antenatal G2, T1, P0, Ab0, L1 client is discussing her
postpartum plans for birth control with her health care provider. In analyzing the
available choices, which of the following factors has the greatest impact on her birth
control options?
/.4. If there is discharge from my nipples, I should call my health care provider.
The nurse determines that the client has understood the instructions when the client
says that she will notify her primary health care provider if she notices discharge or
bleeding because this may be symptomatic of underlying disease. Ideally, breast self-
examination should be performed about 1 week after the onset of menses because
hormonal influences on breast tissue are at a low ebb at this time. The client should
perform breast self-examination on the same day each month only if she has stopped
menstruating (as with menopause). The client's breasts should mirror each other. If one
breast is significantly larger than the other, or if there is "pitting" of breast tissue, a tumor
may be present. - Answer-After the nurse instructs a 20 year old nulligravid client on
how to perform a breast self-examination, which of the following client statements
indicates that the teaching has been successful?
,/.3. Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the
next menstrual cycle.
For a client with a typical menstrual cycle of 28 days, ovulation usually occurs on day
14, plus or minus 2 days, before the onset of the next menstrual cycle. Stated another
way, the menstrual period begins about 2 weeks after ovulation has occurred. Ovulation
does not usually occur during the menses component of the cycle when the uterine
lining is being shed. In most women, the ovum survives for about 12 to 24 hours after
ovulation, during which time conception is possible. The basal body temperature rises
0.5 F to 1.0 F (0.28 C to 0.56 C) when ovulation occurs. Although some women
experience some pelvic discomfort during ovulation (mittelschmerz), severe or unusual
pain is rare. After ovulation, the cervical mucus is thin and copious. - Answer-Which of
the following would be important to include in the teaching plan for the client who wants
more information on ovulation and fertility management?
/.1. Take a mild analgesic if needed for menstrual pain.
The nurse should instruct the client to take a mild analgesic, such as ibuprofen, if
menstrual pain or "cramps" are present. The client should also eat foods rich in iron and
should continue moderate exercise during menstruation, which increases abdominal
tone. Avoiding cold foods will not decrease dysmenorrhea. Sexual intercourse is not
prohibited during menstruation, but the male partner should wear condom to prevent
expose to blood. - Answer-Which of the following instructions about activities during
menstruation would the nurse include when counseling an adolescent who has just
begun to menstruate?
/.1. Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in
pregnancy.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes. This is an
important point to make with adolescents who may be sexually active. Many people
believe that the time interval is much longer and that they can wait until after intercourse
to take steps to prevent conception. Without protection, pregnancy and sexually
transmitted diseases can occur. When using the abstinence or calendar method, the
couple should abstain from intercourse on the days of menstrual cycle when the woman
is most likely to conceive. Using a 28-day cycle as an example, a couple should abstain
from coitus 3 to 4 days before ovulation (days 10 through 14) and 3 to 4 days after after
ovulation (days 15 through 18). Sperm from a healthy male can remain viable for 24 to
72 hours in the female reproductive tract. If the female client ovu - Answer-After
conducting a class for female adolescents about human reproduction, which of the
following statements indicates that the school nurse's teaching has been effective?
/.3. Cervical mucus is carefully monitored for changes.
The symptothermal method is a natural method of fertility management that depends on
knowing when ovulation has occurred. Because regular menstrual cycles can vary by 1
or 2 days in either direction, the symptothermal method requires daily basal body
temperature assessments plus close monitoring of cervical mucus changes. The
method relies on abstinence during the period of ovulation, which occurs approximately
14 days before the beginning of the next cycle. Abstinence from coitus for 5 days after
, menses is unnecessary because it is unlikely that ovulation will occur during this time
period (days 1 through 10). Typically, the failure rate for this method is between 10%
and 20 %. Although a condom may increase the effectiveness of this method, most
clients who choose natural methods are not interested in chemical or barrier types of
family planning. - Answer-A 20-year-old nulligravid client expresses a desire to learn
more about the symptothermal method of family planning. Which of the following would
the nurse include in the teaching plan?
/.2. Hypertension.
Before advising a client about oral contraceptives, the nurse needs to assess the client
for signs and symptoms of hypertension. Clients who have hypertension,
thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident are
poor candidates for oral contraceptives. In addition, women who smoke, are older than
40 years of age, or have a history of pulmonary disease should be advised to use a
different method. Iron-deficiency, anemia, dysmenorrhea, and acne are not
contraindications for the use of oral contraceptives. Iron-deficiency anemia is a common
disorder in young women. Oral contraceptives decrease the amount of iron lost through
menses, thereby providing a beneficial effect when used by clients with anemia.Low-
dose oral contraceptives to prevent ovulation may be effective in decreasing the
severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to be ca -
Answer-Before advising a 24-year-old client desiring oral contraceptives for family
planning, the nurse would assess the client for signs and symptoms of which of the
following?
/.4. Ovarian cancer.
The nurse determines that the client needs further instruction when the client says that
one of the adverse effects of oral contraceptive use is ovarian cancer. Some studies
suggest that ovarian and endometrial cancers are reduced in women using oral
contraceptives. Other adverse effects of oral contraceptives include weight gain,
nausea, headache, breakthrough bleeding, and monilial infections. The most serious
adverse effect is thrombophlebitis. - Answer-After instructing a 20-year-old nulligravid
client about adverse effects of oral contraceptives, the nurse determines that further
instruction is needed when the client states which of the following as an adverse effect?
/.1. Using a spermicide with the condom offers added protection against pregnancy.
The typical failure rate of a condom is approximately 12% to 14%. Adding a spermicide
can decrease this potential failure rate because it offers additional protection against
pregnancy. Natural skin condoms do not offer the same protection against sexually
transmitted diseases caused by viruses as latex condoms do. Unlike latex condoms,
natural skin (membrane) condoms do not prevent the passage of viruses. Most condom
users report decreased penile gland sensibility. However, some users do report an
increased sensitivity or allergic reaction (such as a rash) to latex, necessitating the use
of another method of family planning or a switch to a natural skin condom. - Answer-A
22-year-old nulligravid client tells the nurse that she and her husband have been
considering using condoms for family planning. Which of the following instructions
should the nurse include about the use of condoms as a method for family planning?
