NCLEX-RN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #5 : Obstetrics And Gynecological Conditions

The nurse is assessing fetal heart rate in a pregnant patient. The nurse records a pulse of 82 beats per minute. The nurse should __________.

Possible Answers:

add lubricant to the doppler's surface

call the physician immediately

move the doppler device

ask the mother to lay on her right side

try another doppler device

Correct answer:

move the doppler device

Explanation:

An 82 beat per minute reading could be the mother's heart rate, indicating that the nurse does not have the doppler in the correct position. A normal fetal heart rate is between 120 and 160 beats per minute. The nurse must always remember to take the mother's pulse before assessing the fetal heart rate. Before calling the physician, it is important to determine that the data is accurate. To increase oxygen perfusion to the fetus, ask the mother to lay on her left side.

Example Question #3 : Obstetrics And Gynecological Conditions

Brittany is 40 weeks pregnant and calls because she is seeing pink-tinged discharge for the first time. The nurse should tell Brittany to __________.

Possible Answers:

eat a bland diet and continue regular exercise

call an ambulance

lie on her back and place her feet in the air until help arrives

continue to monitor

drive to the hospital immediately

Correct answer:

continue to monitor

Explanation:

This is most likely the normal "bloody show" at the beginning of labor. There is no need to immediately arrive at the hospital, change position, or eat a bland diet. The patient should continue to monitor and call back or seek care when she experiences regular contractions that are becoming more intense and frequent.

Example Question #4 : Obstetrics And Gynecological Conditions

Sarah is a seventeen-year-old female who has not gotten her first period and is visiting her doctor for an exam. She has displayed the normal growth and development of several secondary sex characteristics. The nurse would describe to the doctor that Sarah is showing signs of __________.

Possible Answers:

primary amenorrhea

primary dysmenorrhea

secondary dysmenorrhea

oligomenorrhea 

secondary amenorrhea

Correct answer:

primary amenorrhea

Explanation:

Primary amenorrhea occurs when a female is fourteen years old and has not gotten her first period and has not developed secondary sex characteristics. Primary amenorrhea also occurs when a female sixteen or older has not gotten her first period but has developed secondary sex characteristics. Primary dysmenorrhea refers to painful menstruation not linked to a physiological disorder. Secondary dysmenorrhea refers to painful menstruation due to an underlying cause such as endometriosis. Oligomenorrhea refers to the absence of a period, typically for at least 35 days. 

Example Question #2 : Obstetrics And Gynecological Conditions

Amber is a 39-year-old woman who is experiencing secondary dysmenorrhea. The nurse knows that Amber could be suffering from which of the following?

Possible Answers:

Amenorrhea

High levels of prostaglandin

Endometriosis

Low levels of aldosterone

Turner syndrome

Correct answer:

Endometriosis

Explanation:

Secondary dysmenorrhea refers to painful menstruation due to an underlying condition. Endometriosis, an example of a condition that frequently causes secondary dysmenorrhea, refers to the growth of uterine tissue in inappropriate places such as the ovary or rectum. High levels of prostaglandin are frequently found in women with primary dysmenorrhea which is painful menstruation without an underlying condition. Low levels of aldosterone would not likely cause painful menstruation. Turner syndrome is a chromosomal disorder that can frequently cause amenorrhea, or absence of a period.

Example Question #5 : Obstetrics And Gynecological Conditions

A nurse is assessing an 18-year-old woman who has come into the emergency department for bilateral abdominal pain. Which of the following should the nurse not consider a risk factor for ectopic pregnancy?

Possible Answers:

Neisseria gonorrhoeae

Yeast infection

Chlamydia trachomatis

Uterine fibroids

Endometriosis

Correct answer:

Yeast infection

Explanation:

Uterine conditions such as endometriosis and uterine fibroids increase the risk of ectopic pregnancy. Endometriosis is the inappropriate growth of uterine tissue outside the uterus. Uterine fibroids are benign tumors within the uterus. Sexually transmitted infections can cause a condition called pelvic inflammatory disease which can result in scarring. Scarring of the reproductive system greatly increases the risk of ectopic pregnancy and infertility. Yeast infections are common after antibiotic therapy and are treated with an over-the-counter medication. They generally do not cause permanent damage to the body.

Example Question #11 : Obstetrics And Gynecological Conditions

A woman who is 20 weeks pregnant calls the clinic because she is experiencing pink-tinged discharge for the first time. The nurse should advise the patient to __________.

Possible Answers:

make an appointment to be seen tomorrow

decrease her activity level

call back if the symptoms have not subsided in 24 hours

seek medical attention immediately

call back if she experiences an increase in pelvic pressure

Correct answer:

seek medical attention immediately

Explanation:

This woman could be experiencing pre-term labor. A 20 week pregnancy is not considered viable. She should be seen immediately to determine if there is a cause such as cervical insufficiency (premature dilation of the cervix). 

Example Question #12 : Obstetrics And Gynecological Conditions

Hanna is a 21-year-old woman who is presenting at the emergency room for severe vaginal bleeding. She is 32 weeks pregnant. Upon further examination, she is found to be suffering from abruptio placentae. Which of the following assessment findings would be of least concern to the nurse? 

Possible Answers:

Small red dots on the skin

Bleeding from oral mucosa

Decreasing blood pressure

A tender uterus

Shortness of breath

Correct answer:

A tender uterus

Explanation:

Abruptio placentae is a serious condition where the placenta inappropriately and prematurely detaches from the uterus. Women with obstetric complications such as abruptio placentae can quickly develop disseminated intravascular coagulation (DIC). DIC is a clotting disorder in which the blood inappropriately clots. Severe bleeding can also occur as clotting proteins become scarce. Symptoms of DIC include blood clots, and bleeding into the tissues such as the skin and oral mucosa. A decreasing blood pressure is concerning due to the severe bleeding caused by the combination of DIC and abruptio placentae. Shortness of breath could indicate a the presence of a blood clot. Although uterine tenderness is of concern, it is common with abruptio placentae and does not indicate an immediately life-threatening condition.

Example Question #13 : Obstetrics And Gynecological Conditions

The nurse completes a cervical exam on her laboring patient. She determines that her patient's cervix is 1cm in length. How would the nurse describe this length?

Possible Answers:

 effaced

 effaced

 effaced

 effaced

 effaced

Correct answer:

 effaced

Explanation:

The normal cervical canal is 2cm in length. Effacement is the thinning of the cervix as the body prepares for delivery. Thus, a 2cm cervix is 0% effaced and a 0cm cervix is 100% effaced.

Example Question #14 : Obstetrics And Gynecological Conditions

The nurse helps the healthcare team to deliver a healthy baby girl. Upon delivery of the placenta, the nurse notices that it is not 100% intact. What is the nurse's first concern?

Possible Answers:

Pulmonary embolism

Deep vein thrombosis

Tissue perfusion

Hemorrhage

Infection

Correct answer:

Hemorrhage

Explanation:

If the placenta is not whole upon delivery, a piece may still be present in the uterus. This inhibits the ability of the uterus to shrink in size and may cause hemorrhage. The missing piece needs to be located immediately.

Example Question #15 : Obstetrics And Gynecological Conditions

While monitoring a laboring patient, the nurse notices that the fetal heart rate at baseline varies from 110-145 beats per minute. The nurse's first action would be which of the following?

Possible Answers:

No action is required

Decrease IV fluids

Administer oxygen at  via nasal cannula

Have the mother bear down

Turn the mother on her left side

Correct answer:

Turn the mother on her left side

Explanation:

Marked fetal heart rate baseline variability of 25 beats per minute or more may be cause for concern. Similar findings may indicate that there is poor oxygenation of the fetus. Turn the mother to her left side (to increase perfusion) and notify the physician. Note that this is still in the normal range for fetal heart rate for a laboring patient (about 130 beats per minute), and that the low end of this spectrum is of slightly more concern.

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