Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions - Part 26

1. A client is pregnant with her second child. Her last menstrual period began on January 15. Her expected date of delivery would be:

A) October 8
B) October 15
C) October 22
D) October 29

2. The nurse instructs a pregnant client (G2P1) to rest in a side-lying position and avoid lying flat on her back. The nurse explains that this is to avoid 'vena caval syndrome,' a condition which:

A) Occurs when blood pressure increases sharply with changes in position
B) Results when blood flow from the extremities is blocked or slowed
C) Is seen mainly in first pregnancies
D) May require medication if positioning does not help

3. A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the GTPAL system to record her obstetrical history, the nurse should record:

A) 3-2-0-0-2
B) 2-2-0-2-2
C) 3-1-1-0-2
D) 2-1-1-0-2

4. A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the gravida and para system to record the clients obstetrical history, the nurse should record:

A) Gravida 3 para 1
B) Gravida 3 para 2
C) Gravida 2 para 1
D) Gravida 2 para 2

5. A gravida 2 para 1 client is hospitalized with severe preeclampsia. While she receives magnesium sulfate(MgSO4) therapy, the nurse knows it is safe to repeat the dosage if:

A) Deep tendon reflexes are absent
B) Urine output is 20 mL/hr
C) MgSO4serum levels are>15 mg/dL
D) Respirations are>16 breaths/min

1. Right Answer: C
Explanation: (A) Incorrect application of Ngeles rule: correctly subtracted 3 months but subtracted 7 days rather than added. (B) Incorrect application of Ngeles rule: correctly subtracted 3 months but did not add 7 days. (C) Correct application of Ngeles rule: correctly subtracted 3 months and added 7 days. (D) Incorrect application of Ngeles rule: correctly subtracted 3 months but added 14 days instead of 7 days.

2. Right Answer: B
Explanation: (A) Blood pressure changes are predominantly due to pressure of the gravid uterus. (B) Pressure of the gravid uterus on the inferior vena cava decreases blood return from lower extremities. (C) Inferior vena cava syndrome is experienced in the latter months of pregnancy regardless of parity. (D) There are no medications useful in the treatment of interior vena cava syndrome; alleviating pressure by position changes is effective.

3. Right Answer: C
Explanation: (A) This answer is an incorrect application of the GTPAL method.One prior pregnancy was a preterm birth at 36 weeks (T =1, P= 1; not T = 2). (B) This answer is an incorrect application of the GTPAL method. The client is currently pregnant for the third time (G = 3, not 2), one prior pregnancy was preterm (T= 1, P= 1; not T= 2), and she has had no prior abortions (A =0). (C) This answer is the correct application of GTPAL method. The client is currently pregnant for the third time (G =3), her first pregnancy ended at term (>37 weeks) (T =1), her second pregnancy ended preterm 2033 weeks) (P = 1), she has no history of abortion (A=0), and she has two living children (L = 2). (D) This answer is an incorrect application of the GTPAL method. The client is currently pregnant for the third time (G =3, not 2).

4. Right Answer: B
Explanation: (A) This answer is an incorrect application of gravida and para. The client has had two prior deliveries of more than 20 weeks gestation; therefore, para equals 2, not 1. (B) This answer is the correct application of gravida and para. The client is currently pregnant for the third time (G = 3), regardless of the length of the pregnancy, and has had two prior pregnancies with birth after the 20th week (P = 2), whether infant was alive or dead. (C) This answer is an incorrect application of gravida and para. The client is currently pregnant for the third time (G = 3, not 2); prior pregnancies lasted longer than 20 weeks (therefore, P = 2, not 1). (D)This is an incorrect application of gravida and para. Client is currently pregnant for third time (G = 3, not 2).

5. Right Answer: D
Explanation: (A) MgSO4is a central nervous system depressant. Loss of reflexes is often the first sign of developing toxicity. (B) Urinary output at <25 mL/hr or 100 mL in 4 hours may result in the accumulation of toxic levels of magnesium. (C) The therapeutic serum range for MgSO4is 68 mg/dL. Higher levels indicate toxicity. (D)Respirations of>16 breaths/min indicate that toxic levels of magnesium have not been reached. Medication administration would be safe.

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