Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 103

1. A female client presents to the obstetric-gynecology clinic for a pregnancy test, the result which turns out to be positive. Her last menstrual period beganDecember 10, 1993. Using Ngeles rule, the nurse estimates her date of delivery to be:

A) September 17, 1994
B) September 10, 1994
C) September 3, 1994
D) August 17, 1994

2. A female client comes for her second prenatal visit. The nurse-midwife tells her, 'Your blood tests reveal that you do not show immunity to the German measles.'Which notation will the nurse include in her plan of care for the client? 'Will need . . .

A) Rh-immune globulin at the next visit'
B) Rh-immune globulin within 3 days of delivery'
C) Rubella vaccine at the next visit'
D) Rubella vaccine after delivery on the day of discharge'

3. A female client at 37 weeks gestation has just undergone a nonstress test. The results were two fetal movements with a corresponding increase in fetal heart rate(FHR) of 15 bpm lasting 15 seconds within a 20-minute period. Her results would be classified as:

A) Reactive; needs follow-up contraction stress test
B) Reactive; no contraction stress test required
C) Non-reactive; needs follow-up contraction stress test
D) Non-reactive; no contraction stress test required

4. A female client at 36 weeks gestation has been treated successfully for premature labor for 4 weeks. She has begun having uterine contractions today and has been admitted to the labor and delivery suite. Her amniocentesis results reveal a lecithin/sphingomyelin (L/S) ratio of 2 and positive phosphatidylglycerol (PG).These lab values indicate:

A) Placental maturity
B) Suspected chronic asphyxia
C) Cord compression
D) Fetal lung maturity

5. A primigravida with a blood type A negative is at 28 weeks gestation. Today her physician has ordered a RhoGAM injection. Which statement by the client demonstrates that more teaching is needed related to this therapy?

A) 'I - m getting this shot so that my baby won - t develop antibodies against my blood, right?'
B) 'I understand that if my baby is Rh positive I - ll be getting another one of these injections.'
C) 'This shot should help to protect me in future pregnancies if this baby is Rh positive, like my husband.'
D) 'This shot will prevent me from becoming sensitized to Rh-positive blood.'

1. Right Answer: A
Explanation: (A) According to Ngeles rule, the estimated date of delivery is calculated by adding 7 days to the date of the first day of the normal menstrual period (December10 + 7 days = December 17), and then by counting back 3 months (December 17 -3 mo = September 17). (B, C, D) These answers are incorrect.

2. Right Answer: D
Explanation: (A) Rh immune globulin is given to Rh-negative mothers to prevent the maternal Rh immune response. (B) Rh immune globulin is given to Rh-negative mothers to prevent the maternal Rh immune response. (C) The rubella vaccine is not given during pregnancy because of its teratogenicity. (D) Nonimmune mothers are vaccinated early in the postpartum period to prevent future infection with the rubella virus.

3. Right Answer: B
Explanation: (A) A contraction stress test is unnecessary following a reactive (normal) nonstress test. (B) The results are considered reactive, indicating that the fetus is not showing distress. Therefore, a contraction stress test, which is a more in-depth test for fetal distress, is unnecessary. (C) A nonreactive test would show fewer than two fetal movements or a failure of the FHR to increase at least 15 bpm with the movements in a 20-minute period. (D) A contraction stress test should follow a nonreactive nonstress test to validate fetal distress.

4. Right Answer: D
Explanation: (A) Placental maturity is assessed by a biophysical profile. (B) L/S ratio and presence of phosphatidylglycerol are not used to determine fetal asphyxia. A biophysical profile score of6 may indicate this condition. (C) Cord compression is not reflected by the L/S ratio or presence of phosphatidylglycerol. Variable decelerations observed through electronic fetal monitoring could reflect umbilical cord compression. (D) An L/S ratio>2 and the presence of phosphatidylglycerol in amniotic fluid indicate fetal lung maturity.

5. Right Answer: A
Explanation: (A) RhoGAM is given to Rh-negative mothers to prevent the maternal Rh immune response to fetal Rh-positive antigens. (B) If the infant is Rh positive, the mother will receive another dose postdelivery to prevent maternal sensitization. (C) Prevention of maternal sensitization will protect future pregnancies because the mothers blood will be free of antibodies against her fetus. (D) RhoGAM prevents maternal sensitization to Rh-positive blood.

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