NCLEX-PN Test #6 2

Question 1

A client at 34 weeks gestation presents with painless, bright red vaginal bleeding. Which condition does the nurse suspect?

Accepted Answer

Placenta previa

Answer

Painless, bright red vaginal bleeding in the third trimester is the hallmark of placenta previa (abnormal placental implantation over the cervical os). Abruptio placentae typically presents with painful, dark red bleeding and a rigid uterus. A vaginal examination is contraindicated until placenta previa is ruled out by ultrasound.

Question 2

A client with preeclampsia is receiving IV magnesium sulfate. Which finding indicates magnesium toxicity?

Accepted Answer

Respiratory rate of 10 breaths per minute

Answer

Respiratory depression (rate < 12/min) is a sign of magnesium toxicity. Loss of deep tendon reflexes (areflexia) is the earliest sign of toxicity. Normal therapeutic monitoring includes DTRs every hour, urine output ≥25 mL/hr, and respirations ≥12/min. The antidote is calcium gluconate.

Question 3

An APGAR score of 6 is assigned to a newborn at 1 minute. What is the priority nursing intervention?

Accepted Answer

Provide stimulation, dry the infant, and administer supplemental oxygen

Answer

APGAR 4–6 indicates moderate newborn depression requiring intervention. The initial actions are stimulation (rubbing back, flicking feet), drying, warming, and supplemental oxygen. Scores 0–3 require immediate resuscitation. Naloxone is only given for known opioid exposure causing respiratory depression.

Question 4

The nurse is caring for a client with HELLP syndrome. Which laboratory findings are consistent with this diagnosis?

Accepted Answer

Hemolysis (low Hgb), elevated liver enzymes, low platelet count

Answer

HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. It is a severe variant of preeclampsia with potentially fatal complications including DIC, liver rupture, and placental abruption. Prompt delivery is the definitive treatment.

Question 5

The PN is assessing a newborn at 24 hours of life and notes jaundice involving the face and upper chest. Which type of jaundice is this most likely?

Accepted Answer

Physiological jaundice — expected normal finding

Answer

Physiological jaundice appears after 24 hours of age and progresses in a head-to-toe pattern as bilirubin levels rise. It is caused by the breakdown of fetal hemoglobin and immature liver conjugation. Jaundice appearing within the first 24 hours of life is pathological and requires urgent evaluation.

NCLEX Practice Test

NCLEX Practice Test

NCLEX-PN Test #6 2