NCLEX-RN
NCLEX-RN Exam Practice Questions
Extract:
Question 1 of 5
A client is admitted to the postpartal unit with a large amount of lochia rubra, uterine enlargement, and excessive clots. Which medication will likely be ordered for the client?
Correct Answer: D
Rationale: Hemabate, a prostaglandin, is used to treat postpartum hemorrhage by promoting uterine contractions to control bleeding. Fentanyl and Stadol are analgesics, and Prepidil is for labor induction, not hemorrhage.
Question 2 of 5
A client is pregnant for the fourth time and has had three normal vaginal deliveries. She is in active labor and fully dilated. Suddenly she calls, 'Nurse, the baby is coming.' As the nurse responds to her call, which one of the following observations should the nurse make first?
Correct Answer: A
Rationale: The nurse must assess the labor status to determine if birth is imminent. The nurse may note perineal bulging, crowning, or birth of the head to ascertain labor status. Assessing uterine contractions is one intervention to ascertain labor status. Based on the client's cry, it is not the intervention of choice. If delivery of the infant is imminent, preparing a clean or sterile area for delivery is appropriate, but labor status must be established, whether delivery is imminent, by perineal assessment. Assessing FHR is one intervention to ascertain fetal well-being. Based on the client's cry, this is not the intervention of choice.
Question 3 of 5
The primary reason that an increase in heart rate (100 bpm) detrimental to the client with a myocardial infarction (MI) is that:
Correct Answer: D
Rationale: Decreased stroke volume and blood pressure will occur secondary to decreased diastolic filling. Tachycardia primarily decreases diastole; systolic time changes very little. Contractility decreases owing to the decreased filling time and decreased time for fiber lengthening. Decreased O2 supply due to decreased time for filling of the coronary arteries increases ischemia and infarct size. Tachycardia primarily robs the heart of diastolic time, which is the primary time for coronary artery filling.
Question 4 of 5
A client's behavior is annoying other clients on the unit. He is meddling with their belongings and dominating the group. The best approach by the nurse is to:
Correct Answer: B
Rationale: Consistent limit setting will help the client to know what is acceptable behavior, addressing the disruptive actions effectively.
Question 5 of 5
The nurse is discussing breastfeeding with a postpartum client. Breastfeeding is contraindicated in the postpartum client with:
Correct Answer: B
Rationale: HIV is a contraindication for breastfeeding due to the risk of viral transmission to the infant. Diabetes hypertension and thyroid disease are not absolute contraindications though they require management.