NCLEX-PN
Free NCLEX Maternity Questions Questions
Extract:
Question 1 of 5
The 38-year-old pregnant client at 22 weeks’ gestation has just been told she has hydramnios after undergoing a sonogram for size greater than dates. The nurse should further assess for which conditions associated with hydramnios? Select all that apply.
Correct Answer: A,B,D
Rationale: In cases of anencephaly, the fetus is thought to urinate excessively because of overstimulation of the cerebrospinal centers, resulting in hydramnios. The nurse should further assess for gestational diabetes. Hydramnios is thought to occur from excessive fetal urination due to fetal hyperglycemia. Infants with mothers infected with toxoplasmosis, rubella, CMV, or herpes simplex virus infections (TORCH) are more likely to have hydramnios due to the inflammatory response and fluid accumulation. Chronic hypertension is not associated with excess amniotic fluid. Preeclampsia is not associated with excess amniotic fluid.
Question 2 of 5
When up to the bathroom for the first time after a vaginal delivery, the client states, “A friend told me that I’m going to have trouble with urinary incontinence now that I have had a baby.” Which is the best response by the nurse?
Correct Answer: B
Rationale: Women of any life stage can experience urinary incontinence. Kegel exercises strengthen muscles surrounding the vagina and urinary meatus, preventing urinary incontinence for many women.
To perform Kegel exercise, contract the muscles around the vagina and hold for 10 seconds, then rest for 10 seconds. This should be repeated 30 or more times each day. The nurse should educate the client about ways in which to prevent urinary incontinence, not just offer information about how to manage the condition if it should occur. Surgical repair only occurs in the most extreme circumstances, after less invasive interventions have been unsuccessful.
Question 3 of 5
Using Naegele's Rule, the nurse can assume the client's expected delivery date to be approximately which date?
Correct Answer: C
Rationale: Naegele's Rule: Subtract 3 months from the first day of the last menstrual period (March 13) and add 7 days, resulting in December 3.
Question 4 of 5
The nurse is counseling the pregnant client who has painful hemorrhoids. Which initial recommendation should be made by the nurse?
Correct Answer: B
Rationale: An initial recommendation should be a high-fiber diet because high-fiber foods increase intestinal bulk and make passage of stool easier. Steroid-based creams are frequently used for hemorrhoids, although evidence does not support their effectiveness. Surgical intervention to remove hemorrhoids is not recommended in pregnancy because hemorrhoids frequently resolve after pregnancy. Flavonoids aid in symptom relief, although they are not recommended as the first line of treatment.
Question 5 of 5
The client on the labor unit has been experiencing frequent, painful contractions for the last 6 hours. The contractions are of poor quality, and there has been no cervical change. Which interventions should the nurse implement? Select all that apply.
Correct Answer: A,B,C,E
Rationale: This client is experiencing a hypertonic labor pattern in which her contractions are frequent and painful, but no cervical change has occurred. This client should be encouraged to rest often. A sedative should be given to assist the client to rest. Because the contractions are painful, an analgesic should be administered to help the client relax and cope more effectively. If the hypertonic labor pattern continues, augmentation should be initiated with either an oxytocin infusion or amniotomy. A cesarean birth is not a treatment for a hypertonic labor pattern unless a nonreassuring FHR pattern is present.