NCLEX : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #201 : Conditions And Treatments

Which of the following is a risk for preeclampsia?

Possible Answers:

Primigravida

All of these

History of hypertension

Diabetes

Correct answer:

All of these

Explanation:

There are several risk factors for preeclampsia. These include history of hypertension, diabetes, older maternal age, first-time pregnancies (primigravida), and pregnancies with twins or multiples.

Example Question #201 : Conditions And Treatments

A labor and delivery nurse is assessing a newborn infant and notes that the infant appears to be jaundiced. What is a possible cause for this condition?

Possible Answers:

The mother had gestational diabetes causing jaundice of the infant. 

The mother's blood is Rh negative and gave birth to her second Rh positive child without receiving Rhogam during the pregnancy.

The infant is experiencing fetal alcohol syndrome, as the mother admitted to utilizing drugs and alcohol throughout the pregnancy.

The mother has exposed the infant to an active genital herpes outbreak.

The baby has been born HIV positive, as the mother was unable to afford HIV medications.

Correct answer:

The mother's blood is Rh negative and gave birth to her second Rh positive child without receiving Rhogam during the pregnancy.

Explanation:

Jaundice of a newborn may be either pathologic or physiologic. Pathologic jaundice is usually the result of Rh incompatability between the mother and the fetus. It occurs during a subsequent birth after the mother's blood has been exposed to the infant's blood during the first birth. Rhogam is given to the mother to prevent her immune system from attacking the second fetus, causing erythroblastosis fetalis and subsequent pathological jaundice. 

Example Question #202 : Conditions And Treatments

A labor and delivery nurse is monitoring a client in active labor after receiving epidural anesthetic. Upon assessing the client she notes that the patient's blood pressure has fallen to 95/75.

The nurse's first action should be?

Possible Answers:

Obtain an ECG

Increase IV fluids

Place in semi fowler's position

Give 1 mg Epinephrine

Contact the physician immediately

Correct answer:

Increase IV fluids

Explanation:

The first action should be to increase fluids, place on their left side and give oxygen. It is not necessary to contact the physician until all nursing interventions have failed. Epinephrine, a vasopressor should be reserved for emergent situations only. 

Example Question #203 : Conditions And Treatments

A 26 year old female primigravida presents to the clinic to discuss her estimated date of birth (EDB). The nurse records the client's first day of her last menstrual period as February 28th 2015. What would be her (EDB)?

Possible Answers:

November 28, 2015

December 7, 2015

November 5, 2015

December 6, 2015

December 5, 2015

Correct answer:

December 5, 2015

Explanation:

The calculation of an estimated date of birth requires applying Naegele's rule, where once determining the first day of the client's last menstral period, subtract 3 months and add 7 days and one year. 

Example Question #204 : Conditions And Treatments

A labor and delivery nurse is caring for a pregnant client that is experiencing contractions and has been on an external tocodynamometer to measure fetal heart tones as well as uterine contractions. The nurse notes that there are decreases in the fetal heart rate at different times of a contraction.

The nurse is aware that this type of finding is consistent with variable decelerations, which are indicative of which of the following?

Possible Answers:

The third stage of labor

Fetal head compression during contraction

An utero-placental insufficency

A prolapsed umbilical cord or nuchal cord

The effects of decreased pitosin infusion

Correct answer:

A prolapsed umbilical cord or nuchal cord

Explanation:

Variable decelerations can occur at any time during a contraction, or without a contraction. They are caused by the umbilical cord that is prolapsed or wrapped around the fetal neck also known as a "nuchal cord." The compression of the cord can ultimately lead to fetal hypoxia and therefore an intervention will be required to alleviate the compression. 

Example Question #41 : Obstetrics And Gynecological Conditions

A 24 year old primigravida client has just given birth to a Rh positive child and she herself is Rh negative. The nurse recognizes this situation can lead to future problems in terms of future pregnancies due to this blood type mismatch. 

All of the following are associated with Rh factor incompatibility except __________.

Possible Answers:

Kernicterus is a potentially serious effect due to pathological jaundice that can have long lasting neurological effects on the child if not prevented. 

A major effect of Rh incompatibility is an increased risk of blood clotting and thrombosis in the fetus during subsequent pregnancies

The mother will form IgG and IgM antibodies in response to being exposed to a fetus' incompatible blood type. 

May lead to fetal anemia and lead to an acceleration of red blood cell production if the mother is not given Rho-D immune globulin to prevent antibodies from destroying fetal blood cells.

The mixing of fetal blood with maternal blood may occur during an amniocentesis or early seperation of the placenta during birth. 

Correct answer:

A major effect of Rh incompatibility is an increased risk of blood clotting and thrombosis in the fetus during subsequent pregnancies

Explanation:

Blood clots are not a common effect in the fetus due to Rh incompatibility. A disorder known as erythroblastosis fetalis is a type of hemolytic disease that occurs in the fetus due to an immune reaction of the Rh negative mother and an Rh positive fetus. All other choices are associated with this type of incompatibility.

Example Question #41 : Obstetrics And Gynecological Conditions

Which type of abortion is associated with sepsis, cramping, abdominal tenderness and an open cervical os?

Possible Answers:

Inevitable abortion

Threatened abortion

Complete abortion

Spontaneous abortion

Missed abortion

Correct answer:

Missed abortion

Explanation:

A missed abortion is marked by the death of the fetus in utero but is not expelled from the uterus. If left untreated can lead to infection in the womb, it is marked by foul odor and bleeding as well as an elevated temperture and sepsis. 

Example Question #43 : Obstetrics And Gynecological Conditions

Which of the following statements is true about a hydatidiform molar pregnancy?

Possible Answers:

A hydatidiform molar pregnancy is reported to cause malignancy in approximately 60% of cases. 

A molar pregnancy can proceed without incident once Rho-D immune globulin is administered to the mother. 

The cause of a molar pregnancy is due multiple ovum becoming fertized and coalescing to form a cluster of atypical cells containing a haploid number of chromosomes. 

An ultraound usually reveals a mass resembling a "cluster of grapes", and a blood test will reveal a positive pregnancy result due to elevated HCG (human chorionic gonadotropin) hormone.

A molar pregnancy is a type of ectopic pregnancy in need of dilation and curratage to prevent internal hemorrhaging or possible hysterectomy.

Correct answer:

An ultraound usually reveals a mass resembling a "cluster of grapes", and a blood test will reveal a positive pregnancy result due to elevated HCG (human chorionic gonadotropin) hormone.

Explanation:

A hydatidiform molar pregnancy is mostly a benign process that may occur due to an abnormal ovum becoming fertilized and growing into collection of cells in a cluster like formation. They are benign over 80% of the time. Rho-D immune globulin is a medication administered to an Rh negative mother that will give birth to a second Rh positive child to prevent an immune reaction that may harm the child. 

Example Question #1 : Causes And Treatments Of Ob/Gyn Conditions

A woman is hospitalized for preeclampsia. Which medication may the nurse administer to prevent the occurrence of seizures?

Possible Answers:

Nubain

Calcium gluconate

Magnesium sulfate

Pitocin

Zolpidem

Correct answer:

Magnesium sulfate

Explanation:

Magnesium sulfate is used to prevent seizures in women with severe preeclampsia. Calcium gluconate is the antidote if magnesium toxicity is assessed. It should be readily available when a woman is receiving magnesium sulfate. Pitocin is used to stimulate the uterus, often to induce labor. Nubain is an opioid that can be given to women during labor to treat pain. Zolpidem (Ambien) is a sleep aid. 

Example Question #42 : Obstetrics And Gynecological Conditions

Jean is a 33-year-old woman who has previously had regular periods but has not gotten her period for six months. Which of the following would the nurse rule out as the cause? 

Possible Answers:

Kidney disease

Cross country running five times per week

Poor eating habits

Yoga once per week

Antidepressant use

Correct answer:

Yoga once per week

Explanation:

Yoga once per week (light exercise) is the least likely of the above to cause a change in regular menstruation. Cross country or long distance running (vigorous exercise) is more likely to cause changes to a woman's cycle. Poor lifestyle choices such as eating habits and health issues such as kidney disease can also cause irregular menstruation. Likewise, pharmaceuticals can have the same effect.

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