NCLEX-PN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-PN

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Example Questions

Example Question #993 : 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?

Possible Answers:

Tachycardia

Recurrent acceleration

Acceleration

Deceleration

Prolonged acceleration

Correct answer:

Acceleration

Explanation:

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 #27 : Identifying Ob/Gyn Conditions

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?

Possible Answers:

Bradycardia

Recurrent

Sinusoidal

Variable

Intermittent

Correct answer:

Sinusoidal

Explanation:

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 #991 : Nclex

In a fetus positioned at left occiput anterior (LOA), where should the nurse assess the fetal heart rate (FHR)?

Possible Answers:

Below umbilicus on mother's left side

Above umbilicus on mother's left side

Below umbilicus on mother's right side

Above umbilicus on mother's right side

At level of umbilicus

Correct answer:

Below umbilicus on mother's left side

Explanation:

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 #992 : Nclex

What is the triad of presenting symptoms with endometriosis?

Possible Answers:

Dysmenorrhea, infertility, and dyspareunia

Hirsutism, infertility, and oligomenorrhea

Dysmenorrhea, metrorrhagia, and dysuria

Menorrhagia, infertility, and dyspraeunia

Correct answer:

Dysmenorrhea, infertility, and dyspareunia

Explanation:

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 #22 : Obstetrics And Gynecological Conditions

Which of the following increase the risk of endometriosis?

Possible Answers:

Presence of an intrauterine device (IUD)

Lack of exercise

Family history of endometriosis

All of these are correct

Correct answer:

All of these are correct

Explanation:

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). 

Example Question #31 : Obstetrics And Gynecological Conditions

Which of the following is a possible cause of vaginal bleeding in early pregnancy?

Possible Answers:

Trophoblastic disease

Cervical ectropion

All of these are correct

Spontaneous abortion/miscarriage

Correct answer:

All of these are correct

Explanation:

All of these could be possible reasons for bleeding in early pregnancy, including physiologic or implantation bleeding. Bleeding may indicate threatened miscarriage or other serious condition, or it may simply be due to the implantation of the embryo into the endometrium. 

Example Question #32 : Obstetrics And Gynecological Conditions

Which of the following terms denotes a menstrual cycle that is irregular, of shorter duration than normal, and of excessive volume or duration?

Possible Answers:

Menometrorrhagia

Amenorrhea

Oligomenorrhea

Metrorrhagia

Correct answer:

Menometrorrhagia

Explanation:

Menometrorrhagia is a term used to describe a menstrual cycle that is irregular, of shorter duration than normal, and of excessive volume or duration. Amenorrhea is the absence of a menstrual cycle. Metrorrhagia is a term for a menstrual cycle that is of normal flow duration and volume, but which is irregular and has a shorter-than normal cycle length. Oligomenorrhea describes a menstrual cycle that is longer than 35 days, often characterized by a prolonged follicular phase.

Example Question #33 : Obstetrics And Gynecological Conditions

Pregnant individuals with gestational hypertension, proteinuria, and signs of liver or kidney dysfunction should be evaluated for what potentially life-threatening condition?

Possible Answers:

Placenta previa

Gestational diabetes

Ectopic pregnancy

Preeclampsia

Correct answer:

Preeclampsia

Explanation:

Preeclampsia is a potentially life-threatening disorder that generally includes gestational hypertension, proteinuria, edema, red-blood cell dysfunction, and signs of liver or kidney dysfunction. It is more common in weeks 32-40 and develops in 2-8% of pregnancies worldwide.

Example Question #34 : Obstetrics And Gynecological Conditions

At what point does preeclampsia develop into eclampsia?

Possible Answers:

When blood pressure exceeds 160/95 mmHg

At the progression into seizures

At the initiation of kidney failure

When there is evidence of vascular dysregulation

Correct answer:

At the progression into seizures

Explanation:

Preeclampsia develops into eclampsia at the onset of seizures. Seizures are tonic-clonic and may appear during pregnancy, during labor, or postpartum. It is relatively rare, affecting only approximately 1.2-1.8% of pregnancies.

Example Question #35 : Obstetrics And Gynecological Conditions

What is the most common time for miscarriages to occur?

Possible Answers:

22-28 weeks

16-24 weeks

12-20 weeks

0-12 weeks

Correct answer:

0-12 weeks

Explanation:

The most common time for miscarriage to occur is during the first trimester, between 8 and 12 weeks. This may even occur before an individual is aware that they are pregnant. Chromosomal abnormalities are identified in approximately 50% of first trimester miscarriages, while later miscarriages may be more likely in individuals with uterine malformations or cervical incompetence.

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