NCLEX-PN
NCLEX Maternity Questions Questions
Extract:
Question 1 of 5
The nurse correctly sends a requisition and specimen for which laboratory test?
Correct Answer: C
Rationale: Human chorionic gonadotropin (hCG) is the hormone tested to confirm pregnancy, as it is produced by the placenta shortly after implantation.
Question 2 of 5
The primiparous client, who is bottle feeding her infant, asks the nurse when she can expect to start having her menstrual cycle again. Which response by the nurse is most accurate?
Correct Answer: A
Rationale: In nonlactating women, the average time to first ovulation is 45 days, and the return of menstruation usually happens within 6 to 10 weeks postbirth. Most women can expect to have lochial discharge for up to 24 days. However, the cessation of discharge is not related to the return of menstruation. The change in lochial color is not related to the return of menstruation. The return of ovulation and menstruation is associated with a rise in serum progesterone levels. Bottle feeding does not affect when this change occurs in the client’s body.
Question 3 of 5
According to the TPAL method, which of the following reflects the client's obstetric history?
Correct Answer: A
Rationale: TPAL: Term (3, one son and twin daughters), Preterm (0), Abortions (0), Living (3). The client has three term deliveries and three living children.
Question 4 of 5
The postpartum client, who had a forceps-assisted vaginal birth 4 hours ago, tells the nurse that she is having continuing perineal pain rated at 7 out of 10 and rectal pressure. An oral analgesic was given and ice applied to the perineum earlier. What should the nurse do now?
Correct Answer: B
Rationale: Reexamination of the perineum should be completed before calling the HCP to report the pain level. A forceps-assisted delivery can increase the risk of hematoma development. Rectal pressure and perineal pain can indicate a hematoma in the posterior vaginal wall. The nurse should closely examine the perineum and the vaginal introitus for ecchymosis and a bulging mass. Ambulation would not help the perineal pain. A stool softener would be appropriate to avoid constipation but would not help the immediate problem.
Question 5 of 5
Which action by the nurse best ensures that an accurate fetal heart rate is obtained?
Correct Answer: D
Rationale: Comparing maternal pulse with fetal heart rate ensures the nurse is not mistaking the maternal pulse for the fetal heartbeat.