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Example Questions
Example Question #991 : Nclex
Sally arrives at the clinical office for a routine prenatal appointment. She becomes red in the face as she states that lately she has been craving and ingesting dirt. Which of the following is the most appropriate response from the nurse?
"You must stop immediately."
"Why would you eat dirt?"
"You must be admitted to the hospital."
"Where have you been obtaining the dirt that you're ingesting?"
"Do you have a history of psychiatric illness?"
"Where have you been obtaining the dirt that you're ingesting?"
During pregnancy, many women crave and eat substances that adults do not generally ingest. This condition is normal and is called pica. Often, the substances do not have high nutritional value. Examples are dirt, chalk, rocks, toothpaste, toilet paper, etc. It is important to determine the risks involved with ingesting these materials. For example, the nurse must determine that a woman who is eating dirt does not ingest potting soil mixed with fertilizer and other potentially toxic chemicals.
Example Question #991 : Nclex
Your patient is under 24-hour fetal monitoring and observation. The fetal monitoring strip begins to show decelerations, starting after the peak of contractions and recovering late. Which of the following interventions does the nurse anticipate doing?
Removing oxygen supplementation
Increasing rate of oxytocin
Fluid bolus with normal saline (NS)
Reposition mother
Administering medication
Reposition mother
Late decelerations are caused by uteroplacental insufficiency. The nurse should anticipate many interventions to promote uteroplacental blood flow. Initially, the nurse should implement oxygen supplementation, stop the oxytocin infusion, reposition the mother to the left side, and introduce a fluid bolus of lactated Ringer's solution (LR).
Example Question #993 : Nclex
The nurse is reviewing a fetal monitoring strip. Decelerations are onset with the beginning of each contraction and recover at the end of each contraction. Which type of deceleration is this, and why does it occur?
Variable decelerations; head compression
Early decelerations; head compression
Late decelerations; uteroplacental insufficiency
Variable decelerations; umbilical cord compression
Early decelerations; uteroplacental insufficiency
Early decelerations; head compression
A fetal heart rate (FHR) deceleration occurs when the FHR drops 15 bpm below baseline for a period of 15 seconds when the gestation is more than 32 weeks and 10 bpm below baseline for 10 seconds when gestation is less than 32 weeks. When the onset of the deceleration occurs at the onset of a new contraction and recovers with the end of the same contraction, the strip is demonstrating early decelerations, and the fetus is exhibiting head compression. Late decelerations occur when the deceleration begins after the start of a contraction and does not resolve until after the contraction has finished; late decelerations are the result of uteroplacental insufficiency. A variable deceleration is caused by cord compression, and appears as a brief drop in FHR from baseline that resolves quickly, creating a "V" shape on the strip.
Example Question #991 : Nclex
Which of the following describes a category II fetal heart rate (FHR) tracing?
Baseline FHR145 bpm; moderate variability; two accelerations; zero decelerations
Baseline 100bpm; absent variability; one acceleration; prolonged decelerations
Baseline FHR 100bpm; minimal variability; zero accelerations; variable decelerations
Baseline FHR170 bpm; moderate variability; two accelerations; zero decelerations
Baseline FHR 90bpm; marked variability; zero accelerations; late decelerations
Baseline FHR 100bpm; minimal variability; zero accelerations; variable decelerations
A category II fetal heart rate tracing include all FHR tracings that are not category I or category III. Category I FHR tracings are as follows: baseline 110-160bpm, moderate variability, absent late or variable decelerations, present or absent early decelerations, and present or absent accelerations. Category III FHR tracings are as follows: absent baseline FHR variability, recurrent late decelerations, recurrent variable decelerations, bradycardia, and sinusoidal patterns.
Example Question #992 : Nclex
Which of the following is not a risk factor for gestational diabetes?
Family history of diabetes
Obesity
Previous stillbirth
Previous macrosomic infant
Poor diet
Poor diet
Risk factors for gestational diabetes include: obesity, family history of diabetes, history of gestational diabetes, hypertension, pre-eclampsia/eclampsia, recurrent urinary tract infections, vaginitis, polyhydramnios, previous large infants (9lbs or greater than 4000g), glycosuria or proteinuria on two or more occasions. While poor diet may contribute to diabetic concerns, it is not directly associated with a higher risk of gestation diabetes as the other risk factors are. During the prenatal period, nurses are responsible for educating their patients on all of these risk factors as well as a proper prenatal diet.
Example Question #996 : Nclex
The nurse is observing the fetal monitoring strip of a 37-week-old fetus. He observes a visually apparent and abrupt increase in fetal heart rate (FHR) from a baseline of 140 to a peak of 159. The FHR returns to baseline after 20 seconds. What type of fetal heart rate characteristic has occurred?
Deceleration
Recurrent acceleration
Acceleration
Prolonged acceleration
Tachycardia
Acceleration
An acceleration in fetal heart rate is defined as a visually apparent and abrupt increase in FHR, where the FHR increases from the onset of the acceleration to the peak in less than 30 seconds. At less than 32 weeks, the acceleration must peak at least 10 bpm above baseline and last at least 10 seconds. At more than 32 weeks, the acceleration must peak at least 15 bpm above baseline and last at least 15 seconds. A prolonged acceleration follows the same guidelines as an acceleration, but lasts more than 2 minutes and is not longer than 10 minutes in duration; after 10 minutes, it is a change in baseline FHR. A deceleration is a visually apparent decrease in FHR from the baseline, gradual or abrupt, that returns to the original baseline. Recurrent accelerations occur with more than 50% of contracts in any 20 minute window. Tachycardia is a baseline FHR of more than 160 bpm.
Example Question #997 : Nclex
The nurse observes an electronic fetal monitoring strip. Upon review, the fetal heart rate (FHR) undulates from 140bpm to 160bpm and back down to 140bpm in a consistent cycle over a period of 35 minutes. What type of fetal heart rate characteristic is occurring on this electronic fetal monitoring strip?
Sinusoidal
Bradycardia
Variable
Recurrent
Intermittent
Sinusoidal
A sinusoidal pattern is a visually apparent, smooth, sine wave-like undulating pattern in fetal heart rate baseline with a cycle frequency of at least that persists for more than 20 minutes. Variable describes an abrupt deceleration of visually apparent decrease and return in fetal heart rate (FHR) from baseline lasting less than 30 seconds. Bradycardia occurs when the baseline FHR is less than 110 bpm. Intermittent describes an acceleration or deceleration occurring with less than 50% of contractions in any 20 minute window. Recurrent describes an acceleration or deceleration occurring with more than 50% of contractions in any 20 minute window.
Example Question #998 : Nclex
In a fetus positioned at left occiput anterior (LOA), where should the nurse assess the fetal heart rate (FHR)?
Above umbilicus on mother's right side
Above umbilicus on mother's left side
Below umbilicus on mother's right side
At level of umbilicus
Below umbilicus on mother's left side
Below umbilicus on mother's left side
When considering where to hear fetal heart rate best, the nurse must consider the location of the fetal back. Weeks gestation or size may also effect the location of the best place to assess fetal heart rate. LOA, or left occiput anterior, is the most common fetal lie. A fetus in LOA is in vertex presentation with the fetal occiput on the mother's left side toward the front of her pelvis. In LOA, the FHR is best heard below the umbilicus on the mother's left side.
In LOP (left occiput posterior), the FHR is best heard on the mother's left side at the level of the umbilicus. In ROA (right occiput anterior): the mother's right side below the umbilicus. In ROP (right occiput posterior): the mother's right side at the level of the umbilicus. In LSA (left sacrum anterior): the mother's left side above the umbilicus. In RSA (right sacrum anterior): the mother's right side above the umbilicus.
Example Question #999 : Nclex
What is the triad of presenting symptoms with endometriosis?
Menorrhagia, infertility, and dyspraeunia
Hirsutism, infertility, and oligomenorrhea
Dysmenorrhea, infertility, and dyspareunia
Dysmenorrhea, metrorrhagia, and dysuria
Dysmenorrhea, infertility, and dyspareunia
The triad of presenting symptoms for endometriosis is dysmenorrhea (painful menses), infertility, and dyspareunia (pain on sexual intercourse). The most common presenting symptom is extreme, intense uterine cramps which may radiate to the back or down the thighs. Endometriosis is also a common cause of infertility due to a local paracrine effect. Pain on intercourse may be due to the implantation of endometrial cells in the vagina or the area around the cervix. Endometriosis will not necessarily result in menorrhagia, or excessively heavy bleeding. Hirsutism, infertility, and oligomenorrhea are symptoms commonly seen in polycystic ovarian syndrome (PCOS), rather than endometriosis.
Example Question #191 : Conditions And Treatments
Which of the following increase the risk of endometriosis?
Family history of endometriosis
Lack of exercise
Presence of an intrauterine device (IUD)
All of these are correct
All of these are correct
The incidence of endometriosis increases significantly in individuals with a family history of the condition. Other contributing factors are sedentary lifestyle (lack of exercise), presence of an intrauterine device, a diet high in fat, the presence of estrogen dominance, and liver dysfunction (due to decreased estrogen metabolism).
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