Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 133

1. Following TURP, which of the following instructions would be appropriate to prevent or alleviate anxiety concerning the client - s sexual functioning?

A) 'You may resume sexual intercourse in 2 weeks.'
B) 'Many men experience impotence following TURP.'
C) 'A transurethral resection does not usually cause impotence.'
D) 'Check with your doctor about resuming sexual activity.'

2. A client is having an amniocentesis. Prior to the procedure, an ultrasound is performed. In preparing the client, the nurse explains the reason for a sonogram in this situation to be:

A) Determination of multiple gestations
B) Determination of gross anomalies
C) Determination of placental location
D) Determination of fetal age

3. A client is resting comfortably after delivering her first child. When assessing her pulse rate, the nurse would recognize the following finding to be typical:

A) Thready pulse
B) Irregular pulse
C) Tachycardia
D) Bradycardia

4. A client is being admitted to the labor and delivery unit. She has had previous admissions for 'false labor.' Which clinical manifestation would be most indicative of true labor?

A) Increased bloody show
B) Progressive dilatation and effacement of the cervix
C) Uterine contractions
D) Decreased discomfort with ambulation

5. In evaluating the effectiveness of magnesium sulfate (MgSO4), which of the following might indicate that the client was developing MgSO4 toxicity?

A) A 31 patellar tendon reflex
B) Respirations of 12 breaths/min
C) Urine output of 40 mL/hr
D) A 21 proteinuria value

1. Right Answer: C
Explanation: (A) Sexual activity should be delayed until cleared by the clients physician. (B) Although many men experience retrograde ejaculation following prostate surgery, potency is seldom affected. (C) Although the client may experience retrograde ejaculation, it will not limit his ability to engage in sexual intercourse. (D) Although the client should obtain clearance from his physician before resuming sexual activity, this statement does not give the client any information or reassurance about future sexual activity or potency that could decrease his anxiety.

2. Right Answer: C
Explanation: (A) Sonography can be used to determine the presence of multiple gestation. In this question, the sonogram is used as a preparatory step for a specific invasive procedure. (B) Sonography can be used to determine the presence of gross anomalies. In this question, the sonogram is used as a preparatory step for a specific invasive procedure. (C) Prior to amniocentesis, the abdomen is scanned by ultrasound to locate the placenta, thus reducing the possibility of penetrating it with the spinal needle used to obtain amniotic fluid. (D) Sonography can be used to determine fetal age. In this question, the sonogram is used as a preparatory step for a specific invasive procedure.

3. Right Answer: D
Explanation: (A) A thready pulse is indicative of hypotension and excessive blood loss and is often rapid. (B) Pulse irregularities or dysrhythmias do not occur in the normal postpartal woman. (C) Tachycardia occurs less frequently than bradycardia and is related to increased blood loss or prolonged difficult labor and/or birth. (D)Puerperal bradycardia with rates of 5070 bpm commonly occurs during the first 610 days of the postpartal period. It may be related to decreased cardiac strain, decreased blood volume, contraction of the uterus, and increased stroke volume.

4. Right Answer: B
Explanation: (A) Bloody show is considered a sign of imminent labor, which usually begins in 2448 hours. An increase in bloody show is an indication that the cervix is changing. (B) Contractions of true labor produce progressive cervical effacement and dilatation. (C) Contractions of false labor may mimic those of true labor.However, the contractions of false labor do not produce progressive effacement and dilatation of the cervix. (D) In true labor, the discomfort is not relieved by ambulation; walking may intensify the discomfort.

5. Right Answer: B
Explanation: (A) Diminished (not accentuated) patellar tendon reflex is a sign of developing MgSO4 toxicity. A value of 21 is considered a normal tendon reflex; 3+ is considered brisker than normal. (B) MgSO4 is a central nervous system (CNS) depressant. It also relaxes smooth muscle. If the respiratory rate is <16 bpm magnesium toxicity may be developing. (C) Urine output of 40mL/hr is enough to allow elimination of toxic levels of magnesium. Urinary output of <100 mL in a 4- hour period may result in toxic levels of magnesium. (D) Presence of protein in the urine is a symptom of pregnancy-induced hypertension (PIH), a clinical syndrome for which magnesium sulfate is frequently used in medical management. Protein in the urine is not induced by magnesium sulfate intake.

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