Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 105

1. A female client at 36 weeks gestation is experiencing preterm labor. Her physician has prescribed two doses of betamethasone 12 mg IM q24h. The nurse explains that she is receiving this drug to:

A) Treat fetal respiratory distress syndrome
B) Prevent uterine infection
C) Promote fetal lung maturation
D) Increase uteroplacental circulation

2. A female client at 30 weeks gestation is brought into the emergency department after falling down a flight of stairs. On examination, the physician notes a rigid, boardlike abdomen; FHR in the 160s; and stable vital signs. Considering possible abdominal trauma, which obstetric emergency must be anticipated?

A) Abruptio placentae
B) Ectopic pregnancy
C) Massive uterine rupture
D) Placenta previa

3. A 4 days postpartum client who is gravida 3, para 3, isexamined by the home health nurse during her first postpartum home visit. The nurse notes that she has a pink vaginal discharge with a serosanguineous consistency. The nurse would most accurately chart the clients lochia as:

A) Rubra
B) Rosa
C) Serosa
D) Alba

4. A primipara is assessed on arrival to the postpartum unit. The nurse finds her uterus to be boggy. The nurse - s first action should be to:

A) Call the physician
B) Assess her vital signs
C) Give the prescribed oxytocic drug
D) Massage her fundus

5. A female client plans to bottle-feed her newborn. Her physician has ordered bromocriptine (Parlodel) to suppress lactation. Which of the following instructions about bromocriptine should be given by the nurse?

A) Bromocriptine stimulates the production of prolactin.
B) Hypertension is a primary side effect.
C) Bromocriptine is generally taken for 5 days.
D) Her blood pressure must be stable before starting bromocriptine.

1. Right Answer: C
Explanation: (A) Respiratory distress syndrome occurs in the newborn, not the fetus. It may be treated postnatally with surfactant therapy. (B) Betamethasone is a corticosteroid, not an anti-infective drug; therefore, its use would not prevent uterine infection. (C) Betamethasone binds with glucocorticoid receptors in alveolar cells to increase production of surfactant, thus increasing lung maturity in the preterm fetus. (D) Betamethasone does not affect uteroplacental circulatory exchange.

2. Right Answer: A
Explanation: (A) Abruptio placentae, the complete or partial separation of the placenta from the uterine wall, can be caused by external trauma. When hemorrhage is concealed, one sign is a rapid increase in uterine size with rigidity. (B) Ectopic pregnancy occurs when the embryo implants itself outside the uterine cavity. (C)Massive uterine rupture occurs during labor when the uterine contents are extruded through the uterine wall. It is usually due to weakness from a pre-existing uterine scar and trauma from instruments or an obstetrical intervention. (D) Placenta previa is the condition in which the placenta is implanted in the lower uterine segment and either completely or partially covers the cervical os.

3. Right Answer: C
Explanation: (A) Lochia rubra is bloody with clots and occurs 13 days postpartum. (B) There is no such term as lochia rosa. (C) Lochia serosa is a pink-brown discharge with a serosanguineous consistency that occurs 49 days postpartum. (D) Lochia alba is yellow to white in color and occurs approximately 10 days postpartum.

4. Right Answer: D
Explanation: (A) The nurse should first implement independent and dependent measures to achieve uterine tone before calling the physician. (B) Assessment of vital signs will not help to restore uterine atony, which is the priority need. (C) Giving a prescribed oxytocic drug would be necessary ifthe uterus did not maintain tone with massage. (D) Fundal massage generally restores uterine tone within a few moments and should be attempted first.

5. Right Answer: D
Explanation: (A) Bromocriptine inhibits the secretion of prolactin. (B) Hypotension is a side effect of this drug; hypertension is not. (C) Bromocriptine is generally taken for 14 days. (D) The administration of bromocriptine is delayed at least 4 hours postpartum and given only when the clients blood pressure is stable, because it can cause hypotension and syncope.

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