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NCLEX-RN - National Council Licensure Examination(NCLEX-RN) - BrainDump Information

Vendor Name : NCLEX
Exam Code : NCLEX-RN
Exam Name : National Council Licensure Examination(NCLEX-RN)
Questions and Answers : 845 Q & A
Updated On : April 23, 2018
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Question: 837


A pregnant woman at 36 weeks’ gestation is followed for PIH and develops proteinuria. To increase protein in her diet, which of the following foods will provide the greatest amount of protein when added to her intake of 100 mL of milk?

  1. Fifty milliliters light cream and 2 tbsp corn syrup

  2. Thirty grams powdered skim milk and 1 egg

  3. One small scoop (90 g) vanilla ice cream and 1 tbsp chocolate syrup

  4. One package vitamin-fortified gelatin drink


Answer: B


Explanation:

(A) This choice would provide more unwanted fat and sugar than protein. (B) Skim milk would add protein. Eggs are good sources of protein while low in fat and calories. (C) The benefit of protein from ice cream would be outweighed by the fat content. Chocolate syrup has caffeine, which is contraindicated or limited in pregnancy. (D) Although most animal proteins are higher in protein than plant proteins, gelatin is not. It loses protein during the processing for food consumption.


Question: 838


The physician recommends immediate hospital admission for a client with PIH. She says to the nurse, "It’s not so easy for me to just go right to the hospital like that." After acknowledging her feelings, which of these approaches by the nurse would probably be best?

  1. Stress to the client that her husband would want her to do what is best for her health.

  2. Explore with the client her perceptions of why she is unable to go to the hospital.

  3. Repeat the physician’s reasons for advising immediate hospitalization.

  4. Explain to the client that she is ultimately responsible for her own welfare and that of her baby.


Answer: B


Explanation:

(A) This answer does not hold the client accountable for her own health. (B) The nurse should explore potential reasons for the client’s anxiety: are there small children at home, is the husband out of town? The nurse should aid the client in seeking support or interventions to decrease the anxiety of hospitalization. (C) Repeating the physician’s reason for recommending hospitalization may not aid the client in dealing with her reasons for anxiety.

(D) The concern for self and welfare of baby may be secondary to a woman who is in a crisis situation. The nurse should explore the client’s potential reasons for anxiety. For example, is there another child in the home who is ill, or is there a husband who is overseas and not able to return on short notice?


Question: 839


What is the most effective method to identify early breast cancer lumps?

  1. Mammograms every 3 years

  2. Yearly checkups performed by physician

  3. Ultrasounds every 3 years

  4. Monthly breast self-examination


Answer: D

Explanation:

(A) Mammograms are less effective than breast self-examination for the diagnosis of abnormalities in younger women, who have denser breast tissue. They are more effective forwomen older than 40. (B) Up to 15% of early- stage breast cancers are detected by physical examination; however, 95% are detected by women doing breast self-examination. (C) Ultrasound is used primarily to determine the location of cysts and to distinguish cysts from solid masses. (D) Monthly breast self-examination has been shown to be the most effective method for early detection of breast cancer. Approximately 95% of lumps are detected by women themselves.


Question: 840


Which of the following risk factors associated with breast cancer would a nurse consider most significant in a client’s history?

  1. Menarche after age 13

  2. Nulliparity

  3. Maternal family history of breast cancer

  4. Early menopause


Answer: C


Explanation:

(A) Women who begin menarche late (after 13 years old) have a lower risk of developing breast cancer than women who have begun earlier. Average age for menarche is 12.5 years. (B) Women who have never been pregnant have an increased risk for breast cancer, but a positive family history poses an even greater risk. (C) A positive family history puts a woman at an increased risk of developing breast cancer. It is recommended that mammography screening begin 5 years before the age at which an immediate female relative was diagnosed with breast cancer. (D) Early menopause decreases the risk of developing breast cancer.


Question: 841


The nurse practitioner determines that a client is approximately 9 weeks’ gestation. During the visit, the practitioner informs the client about symptoms of physical changes that she will experience during her first trimester, such as:

  1. Nausea and vomiting

  2. Quickening

  3. A 68 lb weight gain

  4. Abdominal enlargement


Answer: A


Explanation:

(A) Nausea and vomiting are experienced by almost half of all pregnant women during the first 3 months of pregnancy as a result of elevated human chorionic gonadotropin levels and changed carbohydrate metabolism. (B) Quickening is the mother’s perception of fetal movement and generally does not occur until 1820 weeks after the last menstrual period in primigravidas, but it may occur as early as 16 weeks in multigravidas. (C) During the first trimester there should be only a modest weight gain of 24 lb. It is not uncommon for women to lose weight during the first trimester owing to nausea and/or vomiting. (D) Physical changes are not apparent until the second trimester, when the uterus rises out of the pelvis.


Question: 842


A client is 6 weeks pregnant. During her first prenatal visit, she asks, "How much alcohol is safe to drink during pregnancy?" The nurse’s response is:

  1. Up to 1 oz daily

  2. Up to 2 oz daily

  3. Up to 4 oz weekly

  4. No alcohol

Answer: D


Explanation:

(A, B, C) No amount of alcohol has been determined safe for pregnant women. Alcohol should be avoided owing to the risk of fetal alcohol syndrome. (D) The recommended safe dosage of alcohol consumption during pregnancy is none.


Question: 843


A 38-year-old pregnant woman visits her nurse practitioner for her regular prenatal checkup. She is 30 weeks’ gestation. The nurse should be alert to which condition related to her age?

  1. Iron-deficiency anemia

  2. Sexually transmitted disease (STD)

  3. Intrauterine growth retardation

  4. Pregnancy-induced hypertension (PIH)


Answer: D


Explanation:

(A) Iron-deficiency anemia can occur throughout pregnancy and is not age related. (B) STDs can occur prior to or during pregnancy and are not age related. (C) Intrauterine growth retardation is an abnormal process where fetal development and maturation are delayed. It is not age related. (D) Physical risks for the pregnant client older than 35 include increased risk for PIH, cesarean delivery, fetal and neonatal mortality, and trisomy.


Question: 844


A client returns for her 6-month prenatal checkup and has gained 10 lb in 2 months. The results of her physical examination are normal. How does the nurse interpret the effectiveness of the instruction about diet and weight control?

  1. She is compliant with her diet as previously taught.

  2. She needs further instruction and reinforcement.

  3. She needs to increase her caloric intake.

  4. She needs to be placed on a restrictive diet immediately.


Answer: B


Explanation:

(A) She is probably not compliant with her diet and exercise program. Recommended weight gain during second and third trimesters is approximately 12 lb. (B) Because of her excessive weight gain of 10 lb in 2 months, she needs re-evaluation of her eating habits and reinforcement of proper dietary habits for pregnancy. A 2200-calorie diet is recommended for most pregnant women with a weight gain of 2730 lb over the 9-month period. With rapid and excessive weightgain, PIH should also be suspected. (C) She does not need to increase her caloric intake, but she does need to re-evaluate dietary habits. Ten pounds in 2 months is excessive weight gain during pregnancy, and health teaching is warranted. (D) Restrictive dieting is not recommended during pregnancy.


Question: 845


Diabetes during pregnancy requires tight metabolic control of glucose levels to prevent perinatal mortality. When evaluating the pregnant client, the nurse knows the recommended serum glucose range during pregnancy is:

  1. 70 mg/dL and 120 mg/dL

  2. 100 mg/dL and 200 mg/dL

  3. 40 mg/dL and 130 mg/dL

  4. 90 mg/dL and 200 mg/dL

Answer: A


Explanation:

(A) The recommended range is 70120 mg/dL to reduce the risk of perinatal mortality. (B, C, D) These levels are not recommended. The higher the blood glucose, the worse the prognosis for the fetus. Hypoglycemia can also have detrimental effects on the fetus.

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