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POP Quiz NCLEX Question

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4000+ Free NCLEX QUESTIONS. Go to QBankProAcademy.com FREE Qbank questions for NCLEX RN, PN, HESI Exit, Med Surg, AANP, ANCC, and HesiA2. Practice questions, quizzes, and listen to the Free Podcast. In this video, we review a question on AUTONOMIC DYSREFLEXIA Nursing Care. At QbankproAcademy.com our mission is to provide free QBanks, videos, and the most up to date test prep information for nurses. If you find our website helpful, please tell other aspiring nurses, nursing students, and professors. Please link to our site from your blogs, videos, and college websites, or share us on your favorite social media sites. Thank you for your support! Free nursing NCLEX 60-DAY CHALLENGE https://qbankpro.thinkific.com/courses/qbankpro-academy nclex Nurses Nursing aanp qbank ancc hesi medsurg qbank

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prenatal disorders

Question 1: A nurse is caring for a client who is 24 hours postpartum. The client reports difficulty urinating. Which of the following interventions should the nurse prioritize?

A) Initiate a bladder training program.
B) Provide privacy and run water to promote voiding.
C) Immediately insert a urinary catheter.
D) Increase caffeine intake to stimulate diuresis.
E) Recommend complete bed rest until voiding occurs.

Correct Answer: B) Provide privacy and run water to promote voiding.

Rationale: Postpartum clients may experience difficulty urinating due to perineal swelling, decreased bladder tone, or fear of pain during urination. Providing privacy and running water can help relax the client and stimulate the micturition reflex, promoting voiding. Initiating a bladder training program is premature at 24 hours postpartum. Immediate catheterization should be considered only if other measures fail and the bladder is distended, to prevent injury. Increasing caffeine intake is not recommended due to its diuretic effect, which can dehydrate rather than promote healthy voiding. Recommending complete bed rest does not directly address the issue of difficulty urinating and may delay the recovery process.

Question 2: A pregnant client at 35 weeks gestation is diagnosed with mild preeclampsia. Which of the following dietary modifications should the nurse recommend?

A) High sodium diet
B) Increased fluid intake
C) High protein diet
D) Restricted calorie intake
E) Eliminate carbohydrate intake

Correct Answer: C) High protein diet

Rationale: In cases of mild preeclampsia, a high protein diet can be beneficial as proteinuria is a common symptom, indicating the loss of protein through the kidneys. Increasing protein intake helps replenish lost protein and supports overall nutritional status. A high sodium diet is contraindicated in preeclampsia due to the risk of exacerbating hypertension. Increased fluid intake is generally recommended during pregnancy, but specific advice should be tailored to the individual’s condition and healthcare provider’s recommendations. Restricted calorie intake is not advisable during pregnancy unless under specific medical guidance. Similarly, eliminating carbohydrates is not recommended as they are a necessary component of a balanced diet, especially during pregnancy.

Question 3: A nurse is educating a pregnant client about the signs of labor. Which of the following should the nurse include as a possible early sign of labor?

A) Decreased fetal movement
B) The expulsion of the mucus plug
C) A sudden burst of energy
D) Abdominal cramping unrelated to contractions
E) Decrease in vaginal discharge

Correct Answer: B) The expulsion of the mucus plug

Rationale: The expulsion of the mucus plug, also known as the “bloody show,” is a common early sign of labor that occurs when the cervix begins to dilate and efface, dislodging the plug that has sealed the cervical canal during pregnancy. Decreased fetal movement is a sign that warrants immediate medical evaluation rather than indicating labor. A sudden burst of energy, or “nesting instinct,” can occur before labor but is not a reliable sign of labor onset. Abdominal cramping may be part of normal labor if it progresses into regular contractions, but on its own, without the context of contractions, it’s not a specific sign of labor. A decrease in vaginal discharge is not typically associated with the onset of labor; in fact, an increase may occur due to the expulsion of the mucus plug or rupture of membranes.

Question 4: During a routine prenatal visit, a nurse notices that a client at 30 weeks gestation has swollen ankles and a blood pressure of 140/90 mm Hg. Which of the following actions should the nurse take first?

A) Recommend immediate bed rest.
B) Measure the blood pressure again after 5 minutes of rest.
C) Initiate emergency delivery protocols.
D) Prescribe a diuretic to reduce swelling.
E) Schedule an immediate ultrasound.

Correct Answer: B) Measure the blood pressure again after 5 minutes of rest.

Rationale: When a nurse encounters elevated blood pressure in a pregnant client, the initial step should be to recheck the blood pressure after a period of rest to confirm the reading, as transient factors such as stress or activity can temporarily elevate blood pressure. Immediate bed rest is a potential management strategy for confirmed hypertension but should not be the first action without confirming persistent high blood pressure. Initiating emergency delivery protocols is premature without further evaluation and confirmation of a condition like severe preeclampsia or eclampsia. Prescribing medication, such as a diuretic, is beyond the nurse’s scope of practice and would not be the first step without a confirmed diagnosis and physician order. Scheduling an immediate ultrasound would be useful for assessing fetal well-being but is not the first step in response to a single elevated blood pressure reading.

Question 5: A client in her third trimester reports experiencing frequent heartburn. Which of the following suggestions should the nurse offer to alleviate her discomfort?

A) Lie down immediately after meals.
B) Increase intake of high-fat foods.
C) Drink carbonated beverages with meals.
D) Eat smaller, more frequent meals.
E) Take over-the-counter antacids without consulting a healthcare provider.

Correct Answer: D) Eat smaller, more frequent meals.

Rationale: Eating smaller, more frequent meals can help reduce heartburn during pregnancy by preventing the stomach from becoming too full, which can push stomach contents back into the esophagus, causing discomfort. Lying down immediately after meals can exacerbate heartburn by facilitating the backflow of acid into the esophagus. High-fat foods can slow stomach emptying and exacerbate heartburn symptoms. Carbonated beverages can introduce gas into the stomach, increasing pressure and exacerbating heartburn. While antacids can be helpful in managing heartburn, pregnant clients should always consult with a healthcare provider before taking any over-the-counter medications to ensure they are safe during pregnancy.

Question 6: A client at 32 weeks gestation comes to the labor and delivery unit with complaints of sudden onset of severe abdominal pain, vaginal bleeding, and a rigid abdomen. The nurse suspects a placental abruption. Which of the following actions should the nurse prioritize?

A) Encourage the client to lie flat on her back.
B) Prepare the client for an immediate ultrasound.
C) Administer oral pain medications as ordered.
D) Encourage ambulation to assess mobility and pain.
E) Monitor fetal heart rate and maternal vital signs.

Correct Answer: E) Monitor fetal heart rate and maternal vital signs.

Rationale: Monitoring fetal heart rate and maternal vital signs is crucial in suspected cases of placental abruption due to the risk of fetal distress and maternal hemorrhage. This action helps in assessing the immediate condition of both the mother and the fetus, guiding further interventions. Lying flat on the back can worsen the situation by increasing vena cava compression, leading to decreased venous return and hypotension. Immediate ultrasound is important but not before assessing and stabilizing the vital signs and fetal heart rate, while administering oral pain medications and encouraging ambulation are not immediate priorities given the potential for rapid deterioration in both maternal and fetal conditions.

Question 7: A pregnant client at 28 weeks gestation is diagnosed with gestational diabetes. Which of the following instructions by the nurse is most appropriate regarding nutritional management?

A) Increase intake of simple carbohydrates.
B) Eliminate all sources of dietary fat.
C) Monitor blood glucose levels regularly.
D) Consume a high-protein, low-carbohydrate diet.
E) Avoid all forms of physical activity.

Correct Answer: C) Monitor blood glucose levels regularly.

Rationale: Monitoring blood glucose levels regularly is essential for managing gestational diabetes, as it helps in adjusting dietary intake and medication to maintain glucose levels within the target range. Increasing intake of simple carbohydrates can elevate blood sugar levels rapidly, which is not advisable. Eliminating all dietary fats is unnecessary, as healthy fats are an important part of a balanced diet. A high-protein, low-carbohydrate diet may be beneficial, but it is essential to balance carbohydrates intake rather than eliminate them, and physical activity is generally encouraged unless contraindicated, to help control blood glucose levels.

Question 8: A postpartum client is being educated on methods to prevent mastitis while breastfeeding. Which of the following pieces of advice should the nurse include?

A) Limit breastfeeding to no more than 5 minutes per session.
B) Wear a tight-fitting bra at all times.
C) Ensure proper latching technique during breastfeeding.
D) Only breastfeed from one side to increase milk supply.
E) Avoid expressing milk between feedings.

Correct Answer: C) Ensure proper latching technique during breastfeeding.

Rationale: Ensuring proper latching technique is crucial in preventing mastitis, as it helps to prevent nipple trauma and incomplete emptying of the breast, both of which are risk factors for infection. Limiting breastfeeding time and wearing a tight-fitting bra can actually contribute to mastitis by leading to incomplete emptying of the breast and restricted milk flow, respectively. Breastfeeding from only one side does not increase milk supply effectively and can lead to engorgement and increased risk of infection in the unused breast. Expressing milk between feedings can help to relieve engorgement and reduce the risk of mastitis, contrary to the advice to avoid it.

Question 9: During a prenatal visit, a client at 35 weeks gestation complains of frequent nocturnal leg cramps. Which of the following recommendations should the nurse make?

A) Decrease daily physical activity.
B) Increase intake of caffeinated beverages.
C) Take a warm bath before bedtime.
D) Restrict fluid intake in the evening.
E) Engage in regular, moderate exercise.

Correct Answer: E) Engage in regular, moderate exercise.

Rationale: Engaging in regular, moderate exercise can help alleviate nocturnal leg cramps by improving circulation and muscle tone. Decreasing daily physical activity can actually contribute to the cramps by decreasing circulation. Increasing intake of caffeinated beverages may worsen cramps, as caffeine can contribute to dehydration. Taking a warm bath before bedtime may provide temporary relief but does not address the underlying cause. Restricting fluid intake in the evening can lead to dehydration, which can exacerbate leg cramps.

Question 10: A nurse is caring for a client in the first stage of labor. The client’s partner asks about the best way to support her during contractions. Which of the following suggestions should the nurse make?

A) Leave the room to give her privacy.
B) Encourage her to hold her breath during contractions.
C) Offer ice chips only after contractions.
D) Apply counterpressure to her lower back.
E) Discourage walking around the room.

Correct Answer: D) Apply counterpressure to her lower back.

Rationale: Applying counterpressure to the lower back can provide significant pain relief during contractions, especially if the baby is in a posterior position, which can cause back labor. Leaving the room does not provide the support or presence that many laboring women find comforting. Encouraging her to hold her breath during contractions is not advisable, as focused breathing helps manage pain and ensures adequate oxygenation for both mother and fetus. Offering ice chips is helpful for hydration but does not directly support her during contractions. Encouraging mobility, such as walking around, can actually facilitate labor progression and provide comfort, contrary to discouraging it.

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Answers to NCLEX-style Questions

NCLEX Musculoskeletal Questions

1. C
Measuring fundal height is used to evaluate fetal growth and estimate gestational age. It is measured from the pubic symphysis to the top of the mother’s uterus. At 36 weeks, the fundus of the uterus is at the mother’s xiphoid process. (C) represents the fundal height at 20 weeks.
2. A
During the first 3 months of pregnancy, it is acceptable to gain between 2-4 pounds per week and about 1 pound per week later during the pregnancy. This may vary somewhat depending on the mother’s pre-pregnancy weight. Mothers who are having twins will typically gain more.
3. B, C
Tobacco use and smoking tobacco should be avoided during pregnancy. Tobacco smoking can result in low birth rate and increased rates of birth defects. Other substances that should be avoided include alcohol and drugs. Medications may be taken but should be prescribed by the health care provider or a health care provider should be consulted before use.
4. C
The benefits of supplemental folic acid in pregnancy are well-documented. Folic acid during pregnancy is important and adequate intake helps prevent neural tube defects and cleft deformities. Many health care providers recommend 0.4 milligrams of folic acid daily, starting before conception.
5. B, C, D
To measure the fundal height, you can use a simple flexible tape measure. Place one end at the pubic symphysis (palpable) and the other end at the top of the uterus or fundus. Measure the height in centimeters. This is a way to assess fetal growth and gestational age.
6. D
In vena cava syndrome the large vein returning blood to the heart is compressed by the large uterus late in pregnancy. The mother may experience symptoms that include dizziness, nausea, tachycardia and shortness of breath. Avoiding supine position later in pregnancy is a way to avoid superior vena cava syndrome.
7. B, C, D
The Naegele’s rule is used to calculate the due date. Using a mathematical formula, we can estimate the delivery date. It should be considered a guideline and not a definite due date.
8. B
This question test whether the student understands the terminology. Primigravida refers to a woman  who has been pregnant once. It is distinguished from the term primipara that refers to a woman who has carried a pregnancy to 20 weeks.
9. A, B
A nonstress may be done during pregnancy to evaluate the condition of the fetus. It is referred to as nonstress test because it doesn’t place any stress on the fetus. During a nonstress test that takes about 20 minutes, the healthcare provider may assess the baby’s heartbeat and mother’s contractions. You would expect the baby’s heart rate to increase when moving or waking.
10. C, D
GPATL is an acronym that stands for gravida, preterm births, abortions, term births, and living children. It allows a straightforward way to record the obstetric history of a woman.
11. D
The most common symptoms of morning sickness are nausea and vomiting. Odors and higher environmental temperature may trigger these symptoms, or they may occur spontaneously without a trigger. It is most common during the 1^st trimester. Rarely, in some women, it may last throughout pregnancy.
12. D
Braxton Hicks uterine contractions are normal during pregnancy. They are normally felt in the 2^nd and 3^rd trimester. Unlike labor contractions, Braxton Hicks contractions are usually not painful, and they do not get stronger over time. They may stop when the patient changes activities or positions.
13. C
During a nonstress test that takes about 20 minutes, the healthcare provider may assess the baby’s heartbeat and mother’s contractions. You may expect the baby’s heartrate to increase when moving or when waking up or becoming more active.
14. B, D
Chadwick’s sign is a bluish-purple discoloration of the cervix caused by venous congestion. Hegar’s sign is evident when there is compressibility and softening of the lower segment of the uterus. Both B and D are signs of pregnancy.
15. B
(B) Is the correct answer and can by calculated using Naegele’s Rule. The Naegele’s rule is used to calculate the due date. Using a mathematical formula, we can estimate the delivery date. It should be considered a guideline and not a definite due date.