Free Quizzes for Nurses - Free NCLEX Exam Practice

 

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1. A nurse in the prenatal clinic is caring for a client with heart disease who is in the second trimester. What hemodynamic of pregnancy may affect the client at this time?

• Decrease in the number of RBCs
• Gradually increasing size of the uterus
• Heart rate acceleration in the last half of pregnancy
• Increase in cardiac output during the third trimester

2. A nurse is monitoring a client with severe preeclampsia for the onset of eclampsia. What clinical finding indicate an impending seizure?

• Persistent headache with blurred vision
• Epigastric pain with nausea and vomiting
• Spots with flashes of light before the eyes
• Rolling of the eyes to one side with a fixed stare

3. The nurse is counseling a pregnant client with type 1 diabe tes about medication changes as pregnancy progresses. Which medication will be needed in increased dosages during the second half of her pregnancy?

• Insulin
• Antihypertensives
• Pancreatic enzymes
• Estrogenic hormones

4. A nurse in the birthing suite has just admitted four clients. Which client should the nurse anticipate will need to be prepared for a cesarean birth?

• Multipara with a shoulder presentation
• Multipara with a documented station of “floating”
• Primigravida with a fetus presenting in the occiput posterior position
• Primigravida with a twin gestation with the lowermost in the vertex presentation

5. A newborn has small, whitish, pinpoint spots over the nose that are caused by retained sebaceous secretions. When documenting this observation, a nurse identifies them as:

• milia.
• lanugo.
• whiteheads.
• mongolian spots.

6. At the beginning of the first formula feeding a newborn begins to cough and choke, and the lips become cyanotic. What is the immediate nursing action?

• Stimulate crying.
• Suction and then oxygenate.
• Substitute the formula with sterile water.
• Stop the feeding momentarily and then restart.

7. In a noisy room a sleeping newborn initially startles and has rapid movements but soon goes back to sleep. What is the most appropriate nursing action in response to this behavior?

• Accept the infant’s behavior
• Assess the infant’s vital signs
• Test the infant’s ability to hear.
• Stimulate the infant’s respirations

8. A client with class I heart disease is admitted to the birthing suite in active labor. In what position should the nurse place the client?

• High Fowler
• Semi Fowler
• Left lateral with head elevated
• Right lateral with head elevated

9. A nurse who is assessing a newborn 3 minutes after birth takes into consideration that the heart rate of a healthy, alert neonate may range between:

• 120 and 180 beats/min.
• 130 and 170 beats/min.
• 110 and 160 beats/min.
• 100 and 130 beats/min.

10. A client in the prenatal clinic is diagnosed with preeclampsia. What clinical findings support this diagnosis?

• Elevated blood pressure of 150/100 mm Hg
• Elevated blood pressure that is accompanied by a headache
• Blood pressure above the baseline while fluctuating at each reading
• Blood pressure more than 140 mm Hg systolic accompanied by proteinuria

11. How should a nurse screen a newborn of a diabetic mother for hypoglycemia?

• Test for glucose tolerance.
• Draw blood for a serum glucose level.
• Arrange for a fasting blood glucose level.
• Test heel blood with a glucose-oxidase strip.

12. An infant is born with a bilateral cleft palate. Plans are made to begin reconstruction immediately. What nursing intervention should be included to promote parent-infant attachment?

• Demonstrating a positive acceptance of the infant
• Placing the infant in a nursery away from view of the general public
• Explaining to the parents that the infant will look normal after the surgery
• Encouraging the parents to limit contact with the infant until after the surgery

13. When caring for a family on a postpartum unit, a nurse must consider that parenting includes all the tasks, responsibilities, and attitudes that make up child care and that either parent can exhibit these qualities. Which factor is the most important influence on parenting ability?

• Inborn instincts
• Marriage with flexible roles
• Childhood roles and concepts
• Education about growth and development

14. A nurse is assessing a newborn’s respirations. What clinical findings indicate that the respirations are within the expected range?

• Regular, thoracic, 40 to 60/min
• Irregular, thoracic, 30 to 60/min
• Regular, abdominal, 40 to 50/min
• Irregular, abdominal, 30 to 60/min

15. A client is rooming-in with her newborn. A nurse observes the infant lying quietly in the bassinet with eyes opened wide. What action should the nurse take in response to the infants behavior?

• Brighten the lights in the room.
• Wrap and then turn the infant to the side.
• Encourage the mother to talk to her baby.
• Begin the physical and behavioral assessments.

16. A client who has six living children has just given birth. After the expulsion of the placenta, an infusion of lactated Ringer solution with 10 units of oxytocin (Pitocin) is prescribed. What should the nurse explain to the client when asked why this infusion is needed?

• “You had a precipitous birth.”
• “This is required for an extramural birth.”
• “It will help expel the retained placental fragments.”
• “Your uterus may have a relaxed tone after multiple pregnancies.”

17. After an 8 hour, uneventful labor, a client gives birth. After an airway is ensured and the neonate is dried and wrapped in a blanket, the nurse places the newborn in the mothers arms. The mother asks, “Is my baby normal?” What is the nurse’s best response?

• “Most babies are normal; of course your baby is.”
• “Your baby must be all right; listen to that strong cry.”
• “Yes, because your entire pregnancy has been so normal.”
• “We will unwrap your baby; now you can see for yourself.”

18. A client arrives at the hospital at 38 weeks’ gestation with profuse vaginal bleeding. She states that it occurred suddenly without any contractions. Which condition may the client be experiencing that requires immediate notification of the health care provider?

• Placenta previa
• Placenta accreta
• Ruptured uterus
• Concealed abruptio

19. A nurse is reviewing a clients history. What two predispos ing causes of puerperal (postpartum) infection should alert the nurse to monitor this client?

• Malnutrition and anemia
• Hemorrhage and trauma during labor
• Preeclampsia and retention of placental fragments
• Organisms in the birth canal and trauma during labor

20. Which behavior should a nurse identify as the Moro reflex response?

• Extension and adduction of the arms
• Abduction and then adduction of the arms
• Adduction of the arms and fanning of the toes
• Extension of the arms and curling of the fingers

21. Which client should the nurse identify is at risk for developing a hypertensive disorder of pregnancy?

• Primigravida who is obese
• Multipara who is 31 years old
• Multipara who had more than six previous pregnancies
• Primigravida who took oral contraceptives within 3 months of conception

22. When does a nurse caring for a client with eclampsia determine that the risk for another seizure has subsided?

• After birth occurs
• After labor begins
• 48 hours postpartum
• 24 hours postpartum

23. What nursing intervention is specific for clients with cardiac problems who are in active labor?

• Encouraging frequent voiding
• Monitoring the blood pressure hourly
• Auscultating the lungs for crackles every 30 minutes
• Helping to turn from side to side at 15-minute intervals

24. What is the safest position for a woman in labor when a nurse observes a prolapsed cord?

• Prone
• Fowler
• Lithotomy
• Trendelenburg

25. A nurse is reviewing the obstetric history of a client who had an abruptio placentae. What prenatal condition does the nurse expect the client to have had?

• Cardiac disease
• Hyperthyroidism
• Gestational hypertension
• Cephalopelvic disproportion

26. A client pregnant with twins is told by the health care provider that she is at risk for postpartum hemorrhage. Later, the client asks the nurse why she is at risk for hemorrhage. What should the nurse consider is the cause of the postpartum hemorrhage before responding in language the client will understand?

• Uterine atony
• Mediolateral episiotomy
• Lacerations of the cervix
• Retained placental fragments

27. What nursing intervention should be included when caring for a client with placenta previa?

• Vital signs at least once per shift
• Tap water enema before the birth
• Documentation of the amount of bleeding
• Limited ambulation until the bleeding stops

28. During the second postpartum hour after a long labor and birth, a nurse identifies that the client has heavy vaginal bleeding that does not diminish after fundal massage. The client states, “I am so thirsty. Can I have some ginger ale?” How should the nurse reply?

• “It is good to regain your fluids. I will bring some for you right now.”
• “I can imagine how thirsty you are. However, I must get an order before giving you any fluid.”
• “Your fluid level should return to normal as quickly as possible. The blood loss can begin to balance if you drink enough fluids.”
• “As difficult as it is, it is best for you to wait for the bleeding to subside. I can give you a moisturizer for your lips to relieve the dryness.”

29. Which behavior indicates to a nurse that a new mother is in the taking-hold phase?

• Calling the baby by name
• Talking about the labor and birth
• Touching the baby with her fingertips
• Being involved with her need to eat and sleep

30. A pilot program is being developed to assist new mothers who are at risk for mother-infant relationship problems. Which mother’s situation would make her a candidate for the program?

• The pregnancy was not planned.
• There are negative feelings about the birth experience.
• The pregnancy elicited ambivalent feelings during the first trimester.
• There was a preference for one sex, but she gave birth to a baby of the other sex.

31. At 10 hours of age a neonate’s oral cavity is filled with mucus and cyanosis develops. What should the nurse do first?

• Suction.
• Administer oxygen.
• Record the incident.
• Insert a nasogastric tube.

32. What should supportive nursing care in the beginning mother-infant relationship include?

• Suggesting the mother choose breastfeeding instead of formula feeding
• Encouraging the mother to assist with simple aspects of her newborns care
• Advising the mother to participate in rooming-in with the newborn at the bedside
• Observing the mother/infant interaction unobtrusively to evaluate the relationship

33. During the postpartum period it is expected for women to have an increased cardiac output with tachycardia. This knowledge should motivate a nurse who is caring for a client with cardiac problems to monitor for:

• an irregular pulse.
• respiratory distress.
• hypovolemic shock.
• an increase in vaginal bleeding.

34. A nurse is counseling a client who is experiencing preterm contractions in the 35 th week of gestation and whose cervix is dilated 2 cm. What should the nurse teach this client about sexual intercourse at this time?

• Should be limited to once a week
• Is prohibited because it may stimulate labor
• Should be restricted to the side-lying position
• Is permitted as long as penile penetration is shallow

35. A pregnant client with class II heart disease is concerned that her pregnancy will be an added burden on her already compromised heart. A nurse explains that during pregnancy the cardiac system is most compromised during the:

• first trimester.
• third trimester.
• transitional phase of labor.
• first two days after the birth.

36. A nurse is assessing the apical and radial pulses of a postpartum client 3 hours after the birth of her second child. Which clinical finding does the nurse expect?

• Thready pulse
• Slow heartbeat
• Bounding pulse
• Irregular heartbeat

37. A client with the diagnosis of severe preeclampsia is admit ted to the hospital from the emergency department. What precaution should the nurse initiate?

• Pad the side rails on the bed.
• Place the call button next to the client.
• Have oxygen with face mask available.
• Assign a nursing assistant to stay with the client.

38. A nurse anticipates that newborns of mothers who have diabetes often have tremors, periods of apnea, cyanosis, and poor sucking ability. With what complication are these signs associated?

• Hypoglycemia
• Hypercalcemia
• Central nervous system edema
• Congenital depression of the islets of Langerhans

39. During the first hour after a cesarean birth, a nurse observes that the client’s lochia has saturated one perineal pad. Based on the knowledge of expected lochial flow, what should the nurse conclude that this indicates?

• Scant lochial flow
• Postpartum hemorrhage
• Retained placental fragments
• Lochial flow within expected limits

40. What is a nurse’s primary critical observation when performing an assessment for determining an Apgar score?

• Heart rate
• Respiratory rate
• Presence of meconium
• Evaluation of Moro reflex

41. A client who had a severe abruptio placentae asks the nurse why there was so much bleeding. What should the nurse consider is the cause of the heavy bleeding before responding in language the client will understand?

• Polycythemia
• Thrombocytopenia
• Hyperglobulinemia
• Hypofibrinogenemia

42. During an emergency birth the fetal head is crowning on the perineum. How should a nurse support the head as it is being born?

• Apply suprapubic pressure
• Place a hand firmly against the perineum
• Distribute the fingers evenly around the head
• Maintain pressure against the anterior fontanel

43. A pregnant woman who is in the third trimester arrives in the emergency department with vaginal bleeding. She states that she snorted cocaine approximately 2 hours ago. Which complication does the nurse suspect is the cause of the bleeding?

• Placenta previa
• Tubal pregnancy
• Abruptio placentae
• Spontaneous abortion

44. What is the most important factor for a nurse to consider when selecting nursing measures to help parent-child relationships during the immediate postpartum period?

• Physical status of the infant
• Duration and difficulty of the labor
• Anesthesia during the labor process
• Health and emotional status during the pregnancy

45. A client in labor at 39 weeks’ gestation is told by the health care provider that she will need a cesarean birth. The nurse reviews the client’s prenatal history. What preexisting condition is the most likely reason for the cesarean birth?

• Gonorrhea
• Chlamydia
• Chronic hepatitis
• Active genital herpes

46. A mother is concerned that her newborn may be exposed to communicable diseases when she goes home. When teaching the mother ways to decrease the risk of infection, what type of immunity should the nurse explain was transferred to her baby through the placenta?

• Active natural
• Passive natural
• Active artificial
• Passive artificial

47. A nurse notifies the health care provider that a client has been admitted to the high-risk unit in her 36th week of gestation. She is bleeding, has severe abdominal pain and a rigid fundus, and is demonstrating signs of shock. For what intervention should the nurse prepare?

• A high-forceps birth
• An immediate cesarean birth
• The insertion of an internal fetal monitor
• The administration of an oxytocin infusion

48. A nurse observes a healthy newborn lying in the supine position with the head turned to the side and legs and arms extended on the same side and flexed on the opposite side. Which reflex does the nurse identify?

• Moro
• Babinski
• Tonic neck
• Palmar grasp

49. What does a nurse anticipate will be provided for a newborn of a mother with a history of long-standing diabetes?

• Fast-acting insulin
• Special high-risk care
• Routine newborn care
• Limited glucose intake

50. What should a nurse anticipate about the insulin requirements of a client with diabetes on her first postpartum day?

• A rapid increase
• Will remain unchanged
• A sharp and sudden decrease
• Will decrease slowly and steadily