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Exam (elaborations)

NCLEX

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Exam of 13 pages for the course NCLEX RN at NCLEX RN (NCLEX)

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NCLEX RN
Course
NCLEX RN

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NCLEX Questions
A client is in the eighth month of pregnancy. To enhance cardiac output and renal function, the nurse should
advise her to use which body position? - ANSWER: Left lateral


During her fourth clinic visit, a client who's 5 months pregnant tells the nurse she was exposed to rubella
during the past week and asks whether she can be immunized now. How should the nurse respond? -
ANSWER: No. Because the live viral vaccine is contraindicated during pregnancy.


A client and her spouse, both 25 years old, are having trouble conceiving. Infertility in this couple is defined as:
- ANSWER: inability to conceive after 1year of unprotected attempts.


When evaluating a pregnant client's fundal height, the nurse should measure in which way? - ANSWER: from
symphysis pubis notch to highest level of fundus.


Which of the following client statements indicates the need for further teaching about percutaneous umbilical
blood sampling (PUBS) to assess fetal hemoglobin and hematocrit? - ANSWER: "I will lie on my back in a
cylinder-type machine."


When explaining the risk for having a child with cystic fibrosis to a husband and wife, the nurse should tell
them: - ANSWER: the risk is greatest when both clients have the recessive gene.


A nurse is caring for a client whose membranes ruptured prematurely 12 hours ago. When assessing this
client, the nurse's highest priority is to evaluate: - ANSWER: maternal vital signs and fetal heart rate (FHR).


A 34-year-old multiparous client at 16 weeks' gestation who received regular prenatal care for all of her
previous pregnancies tells the nurse that she has already felt the baby move. How does the nurse interpret
this finding? - ANSWER: normal because multiparous clients can experience quickening between 14 and 20
weeks' gestation


When developing the plan of care for a multigravid client with class III heart disease, the nurse should expect
to assess the client frequently for which problem? - ANSWER: Tachycardia

, A client at 37 weeks gestation is at a prenatal visit and states that she sometimes feels dizzy when lying
directly on her back. Which of the following is the nurse's best response? - ANSWER: "This may be due to the
uterus putting pressure on a blood vessel."


A client is a 43-year-old G2 P1 at 16 weeks' gestation that has completed prenatal testing for chromosomal
abnormalities. The results reveal the infant is a female with Down syndrome. The parents are seeking
information about this syndrome. What should the nurse tell the parents? Select all that apply. - ANSWER: •
Down syndrome can occur in mothers of any age.
• Down syndrome occurs more frequently with advanced maternal age.
• Down syndrome results from a trisomy of chromosome 21.


Which task may a nurse delegate to a nursing assistant? - ANSWER: Assisting a client who had surgery to
ambulate in the hallway


A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial
pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg;
and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects: - ANSWER: respiratory
alkalosis.


A client with a tentative diagnosis of myasthenia gravis is admitted for a diagnostic workup. Myasthenia gravis
is confirmed by: - ANSWER: a positive edrophonium test.


A nurse is caring for a client admitted to the unit with a seizure disorder. The client seems upset and asks the
nurse, "What will they do to me? I'm scared of the tests and of what they'll find out." The nurse should focus
her teaching plans on which diagnostic tests? - ANSWER: EEG, blood cultures, and neuroimaging studies


A client with schizophrenia comes to the outpatient mental health clinic 5 days after being discharged from
the hospital. The client was given a 1-week supply of clozapine. The client tells the nurse that she has too
much saliva and frequently needs to spit. The nurse interprets the client's statement as being consistent with
which factor? - ANSWER: expected adverse effect of clozapine


Which of the following statements indicates that a new graduate nurse understands central venous pressure
(CVP) measurement when used on a client? - ANSWER: "It will assess pressure and volume changes in the right
atrium."

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NCLEX RN
Course
NCLEX RN

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