NCLEX-RN55Exam55Questions55and55Answers552023
QUESTION551
A5525-year-
old55client55believes55she55may55be55pregnant55with55her55first55child.55She55schedules55an55obstetric55examination55with55the55nurse55practitioner55to55determi
ne55the55status55of55her55possible55pregnancy.55Her55last55menstrual55period55began55May5520,55and55her55estimated55date55of55confinement55using55Näge
le's55rule
is:
A. March5527
B. February551
C. February5527
D. January553
Correct55Answer:5
5C55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)March552755is55a55miscalculation.55(B)55February55155is55a55miscalculation.55(C)55February552755is55the55correct55answer.55To55calculate55the55estimated55dat
e55of55confinement55using55Nagele's55rule,55subtract55355months55from55the55date55that55the55last55menstrual55cycle55began55and55then55add55755days55to55th
e55result.55(D)55January55355is55a55miscalculation.
QUESTION552
The55nurse55practitioner55determines55that55a55client55is55approximately55955weeks'55gestation.55During55the55visit,55the55practitioner55informs55the55client55about5
5symptoms55of55physical55changes55that55she55will55experience55during55her55first55trimester,55such55as:
A. Nausea55and55vomiting
B. Quickening
C. A556855lb55weight55gain
D. Abdominal55enlargement
Correct55Answer:5
5A55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55Nausea55and55vomiting55are55experienced55by55almost55half55of55all55pregnant55women55during55the55first55355months55of55pregnancy55as55a55result55of
55elevated55human55chorionic55gonadotropin55levels55and55changed55carbohydrate55metabolism.55(B)55Quickening55is55the55mother's55perception55of55fetal55mov
ement55and55generally55does55not55occur55until551820
,weeks55after55the55last55menstrual55period55in55primigravidas,55but55it55may55occur55as55early55as551655weeks55in55multigravidas.55(C)55During55the55first55t
rimester55there55should55be55only55a55modest55weight55gain55of552455lb.55It55is55not55uncommon55for55women55to55lose55weight55during55the55first55trimeste
r55owing55to55nausea55and/or55vomiting.55(D)55Physical55changes55are55not55apparent55until55the55second55trimester,55when55the55uterus55rises55out55of55t
he55pelvis.
QUESTION553
A5538-year-
old55pregnant55woman55visits55her55nurse55practitioner55for55her55regular55prenatal55checkup.55She55is553055weeks'55gestation.55The55nurse55should55be55alert
55to55which55condition55related55to55her55age?
A. Iron-deficiency55anemia
B. Sexually55transmitted55disease55(STD)
C. Intrauterine55growth55retardation
D. Pregnancy-induced55hypertension55(PIH)
Correct55Answer:5
5D55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55Iron-
deficiency55anemia55can55occur55throughout55pregnancy55and55is55not55age55related.55(B)55STDs55can55occur55prior55to55or55during55pregnancy55and55are55n
ot55age55related.55(C)55Intrauterine55growth55retardation55is55an55abnormal55process55where55fetal55development55and55maturation55are55delayed.55It55is55not55a
ge55related.55(D)55Physical55risks55for55the55pregnant55client55older55than553555include55increased55risk55for55PIH,55cesarean55delivery,55fetal55and55neonatal55
mortality,55and55trisomy.
QUESTION554
A55client55returns55for55her556-
month55prenatal55checkup55and55has55gained551055lb55in55255months.55The55results55of55her55physical55examination55are55normal.55How55does55the55nurse55i
nterpret55the55effectiveness55of55the55instruction55about55diet55and55weight55control?
A. She55is55compliant55with55her55diet55as55previously55taught.
B. She55needs55further55instruction55and55reinforcement.
C. She55needs55to55increase55her55caloric55intake.
,D. She55needs55to55be55placed55on55a55restrictive55diet55immediately.
Correct55Answer:5
5B55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55She55is55probably55not55compliant55with55her55diet55and55exercise55program.55Recommended55weight55gain55during55second55and55third55trimesters55i
s55approximately551255lb.55(B)55Because55of55her55excessive55weight55gain55of551055lb55in55255months,55she55needs55re-
evaluation55of55her55eating55habits55and55reinforcement55of55proper55dietary55habits55for55pregnancy.55A552200-
calorie55diet55is55recommended55for55most55pregnant55women55with55a55weight55gain55of55273055lb55over55the559-
month55period.55With55rapid55and55excessive55weightgain,55PIH55should55also55be55suspected.55(C)55She55does55not55need55to55increase55her55caloric55int
ake,55but55she55does55need55to55re-
evaluate55dietary55habits.55Ten55pounds55in55255months55is55excessive55weight55gain55during55pregnancy,55and55health55teaching55is55warranted.55(D)55Res
trictive55dieting55is55not55recommended55during55pregnancy.
QUESTION555
Diabetes55during55pregnancy55requires55tight55metabolic55control55of55glucose55levels55to55prevent55perinatal55mortality.55When55evaluating55the55pregnant55cl
ient,55the55nurse55knows55the55recommended55serum55glucose55range55during55pregnancy55is:
A. 7055mg/dL55and5512055mg/dL
B. 10055mg/dL55and5520055mg/dL
C. 4055mg/dL55and5513055mg/dL
D. 9055mg/dL55and5520055mg/dL
Correct55Answer:5
5A55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55The55recommended55range55is557012055mg/dL55to55reduce55the55risk55of55perinatal55mortality.55(B,55C,55D)55These55levels55are55not55recommended.55T
he55higher55the55blood55glucose,55the55worse55the55prognosis55for55the55fetus.55Hypoglycemia55can55also55have55detrimental55effects55on55the55fetus.
QUESTION556
When55assessing55fetal55heart55rate55status55during55labor,55the55monitor55displays55late55decelerations55with55tachycardia55and55decreasing55variability.55Wh
at55action55should55the55nurse55take?
A. Continue55monitoring55because55this55is55a55normal55occurrence.
B. Turn55client55on55right55side.
, C. Decrease55IV55fluids.
D. Report55to55physician55or55midwife.
Correct55Answer:5
5D55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55This55is55not55a55normal55occurrence.55Late55decelerations55need55prompt55intervention55for55immediate55infant55recovery.55(B)55To55increase55O255perf
usion55to55the55unborn55infant,55the55mother55should55be55placed55on55her55left55side.55(C)55IV55fluids55should55be55increased,55not55decreased.55(D)55Imm
ediate55action55is55warranted,55such55as55reporting55findings,55turning55mother55on55left55side,55administering55O2,55discontinuing55oxytocin55(Pitocin),55ass
essing55maternal55blood55pressure55and55the55labor55process,55preparing55for55immediate55cesarean55delivery,55and55explaining55plan55of55action55to55clien
t.
QUESTION557
The55predominant55purpose55of55the55first55Apgar55scoring55of55a55newborn55is55to:
A. Determine55gross55abnormal55motor55function
B. Obtain55a55baseline55for55comparison55with55the55infant's55future55adaptation55to55the55environment
C. Evaluate55the55infant's55vital55functions
D. Determine55the55extent55of55congenital55malformations
Correct55Answer:5
5C55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55Apgar55scores55are55not55related55to55the55infant's55care,55but55to55the55infant's55physical55condition.55(B)55Apgar55scores55assess55the55current55physical
55condition55of55the55infant55and55are55not55related55to55future55environmental55adaptation.55(C)55The55purpose55of55the55Apgar55system55is55to55evaluate55
the55physical55condition55of55the55newborn55at55birth55and55to55determine55if55there55is55an55immediate55need55for55resuscitation.55(D)55Congenital55malfor
mations55are55not55one55of55the55areas55assessed55with55Apgar55scores.
QUESTION558
A55pregnant55woman55at553655weeks'55gestation55is55followed55for55PIH55and55develops55proteinuria.55To55increase55protein55in55her55diet,55which55of55the55follo
wing55foods55will55provide55the55greatest55amount55of55protein55when55added55to55her55intake55of5510055mL55of55milk?
A. Fifty55milliliters55light55cream55and55255tbsp55corn55syrup
B. Thirty55grams55powdered55skim55milk55and55155egg
QUESTION551
A5525-year-
old55client55believes55she55may55be55pregnant55with55her55first55child.55She55schedules55an55obstetric55examination55with55the55nurse55practitioner55to55determi
ne55the55status55of55her55possible55pregnancy.55Her55last55menstrual55period55began55May5520,55and55her55estimated55date55of55confinement55using55Näge
le's55rule
is:
A. March5527
B. February551
C. February5527
D. January553
Correct55Answer:5
5C55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)March552755is55a55miscalculation.55(B)55February55155is55a55miscalculation.55(C)55February552755is55the55correct55answer.55To55calculate55the55estimated55dat
e55of55confinement55using55Nagele's55rule,55subtract55355months55from55the55date55that55the55last55menstrual55cycle55began55and55then55add55755days55to55th
e55result.55(D)55January55355is55a55miscalculation.
QUESTION552
The55nurse55practitioner55determines55that55a55client55is55approximately55955weeks'55gestation.55During55the55visit,55the55practitioner55informs55the55client55about5
5symptoms55of55physical55changes55that55she55will55experience55during55her55first55trimester,55such55as:
A. Nausea55and55vomiting
B. Quickening
C. A556855lb55weight55gain
D. Abdominal55enlargement
Correct55Answer:5
5A55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55Nausea55and55vomiting55are55experienced55by55almost55half55of55all55pregnant55women55during55the55first55355months55of55pregnancy55as55a55result55of
55elevated55human55chorionic55gonadotropin55levels55and55changed55carbohydrate55metabolism.55(B)55Quickening55is55the55mother's55perception55of55fetal55mov
ement55and55generally55does55not55occur55until551820
,weeks55after55the55last55menstrual55period55in55primigravidas,55but55it55may55occur55as55early55as551655weeks55in55multigravidas.55(C)55During55the55first55t
rimester55there55should55be55only55a55modest55weight55gain55of552455lb.55It55is55not55uncommon55for55women55to55lose55weight55during55the55first55trimeste
r55owing55to55nausea55and/or55vomiting.55(D)55Physical55changes55are55not55apparent55until55the55second55trimester,55when55the55uterus55rises55out55of55t
he55pelvis.
QUESTION553
A5538-year-
old55pregnant55woman55visits55her55nurse55practitioner55for55her55regular55prenatal55checkup.55She55is553055weeks'55gestation.55The55nurse55should55be55alert
55to55which55condition55related55to55her55age?
A. Iron-deficiency55anemia
B. Sexually55transmitted55disease55(STD)
C. Intrauterine55growth55retardation
D. Pregnancy-induced55hypertension55(PIH)
Correct55Answer:5
5D55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55Iron-
deficiency55anemia55can55occur55throughout55pregnancy55and55is55not55age55related.55(B)55STDs55can55occur55prior55to55or55during55pregnancy55and55are55n
ot55age55related.55(C)55Intrauterine55growth55retardation55is55an55abnormal55process55where55fetal55development55and55maturation55are55delayed.55It55is55not55a
ge55related.55(D)55Physical55risks55for55the55pregnant55client55older55than553555include55increased55risk55for55PIH,55cesarean55delivery,55fetal55and55neonatal55
mortality,55and55trisomy.
QUESTION554
A55client55returns55for55her556-
month55prenatal55checkup55and55has55gained551055lb55in55255months.55The55results55of55her55physical55examination55are55normal.55How55does55the55nurse55i
nterpret55the55effectiveness55of55the55instruction55about55diet55and55weight55control?
A. She55is55compliant55with55her55diet55as55previously55taught.
B. She55needs55further55instruction55and55reinforcement.
C. She55needs55to55increase55her55caloric55intake.
,D. She55needs55to55be55placed55on55a55restrictive55diet55immediately.
Correct55Answer:5
5B55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55She55is55probably55not55compliant55with55her55diet55and55exercise55program.55Recommended55weight55gain55during55second55and55third55trimesters55i
s55approximately551255lb.55(B)55Because55of55her55excessive55weight55gain55of551055lb55in55255months,55she55needs55re-
evaluation55of55her55eating55habits55and55reinforcement55of55proper55dietary55habits55for55pregnancy.55A552200-
calorie55diet55is55recommended55for55most55pregnant55women55with55a55weight55gain55of55273055lb55over55the559-
month55period.55With55rapid55and55excessive55weightgain,55PIH55should55also55be55suspected.55(C)55She55does55not55need55to55increase55her55caloric55int
ake,55but55she55does55need55to55re-
evaluate55dietary55habits.55Ten55pounds55in55255months55is55excessive55weight55gain55during55pregnancy,55and55health55teaching55is55warranted.55(D)55Res
trictive55dieting55is55not55recommended55during55pregnancy.
QUESTION555
Diabetes55during55pregnancy55requires55tight55metabolic55control55of55glucose55levels55to55prevent55perinatal55mortality.55When55evaluating55the55pregnant55cl
ient,55the55nurse55knows55the55recommended55serum55glucose55range55during55pregnancy55is:
A. 7055mg/dL55and5512055mg/dL
B. 10055mg/dL55and5520055mg/dL
C. 4055mg/dL55and5513055mg/dL
D. 9055mg/dL55and5520055mg/dL
Correct55Answer:5
5A55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55The55recommended55range55is557012055mg/dL55to55reduce55the55risk55of55perinatal55mortality.55(B,55C,55D)55These55levels55are55not55recommended.55T
he55higher55the55blood55glucose,55the55worse55the55prognosis55for55the55fetus.55Hypoglycemia55can55also55have55detrimental55effects55on55the55fetus.
QUESTION556
When55assessing55fetal55heart55rate55status55during55labor,55the55monitor55displays55late55decelerations55with55tachycardia55and55decreasing55variability.55Wh
at55action55should55the55nurse55take?
A. Continue55monitoring55because55this55is55a55normal55occurrence.
B. Turn55client55on55right55side.
, C. Decrease55IV55fluids.
D. Report55to55physician55or55midwife.
Correct55Answer:5
5D55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55This55is55not55a55normal55occurrence.55Late55decelerations55need55prompt55intervention55for55immediate55infant55recovery.55(B)55To55increase55O255perf
usion55to55the55unborn55infant,55the55mother55should55be55placed55on55her55left55side.55(C)55IV55fluids55should55be55increased,55not55decreased.55(D)55Imm
ediate55action55is55warranted,55such55as55reporting55findings,55turning55mother55on55left55side,55administering55O2,55discontinuing55oxytocin55(Pitocin),55ass
essing55maternal55blood55pressure55and55the55labor55process,55preparing55for55immediate55cesarean55delivery,55and55explaining55plan55of55action55to55clien
t.
QUESTION557
The55predominant55purpose55of55the55first55Apgar55scoring55of55a55newborn55is55to:
A. Determine55gross55abnormal55motor55function
B. Obtain55a55baseline55for55comparison55with55the55infant's55future55adaptation55to55the55environment
C. Evaluate55the55infant's55vital55functions
D. Determine55the55extent55of55congenital55malformations
Correct55Answer:5
5C55Section:55(no
ne)55Explanation
Explanation/Reference:
Explanation:
(A)55Apgar55scores55are55not55related55to55the55infant's55care,55but55to55the55infant's55physical55condition.55(B)55Apgar55scores55assess55the55current55physical
55condition55of55the55infant55and55are55not55related55to55future55environmental55adaptation.55(C)55The55purpose55of55the55Apgar55system55is55to55evaluate55
the55physical55condition55of55the55newborn55at55birth55and55to55determine55if55there55is55an55immediate55need55for55resuscitation.55(D)55Congenital55malfor
mations55are55not55one55of55the55areas55assessed55with55Apgar55scores.
QUESTION558
A55pregnant55woman55at553655weeks'55gestation55is55followed55for55PIH55and55develops55proteinuria.55To55increase55protein55in55her55diet,55which55of55the55follo
wing55foods55will55provide55the55greatest55amount55of55protein55when55added55to55her55intake55of5510055mL55of55milk?
A. Fifty55milliliters55light55cream55and55255tbsp55corn55syrup
B. Thirty55grams55powdered55skim55milk55and55155egg
