NCLEX-RN Practice Test 20

Question 1

As the client reaches 8 cm dilation, the nurse notes late decelerations on the fetal monitor.
The FHR baseline is 165–175 bpm with variability of 0–2bpm.
What is the most likely explanation of this pattern?

Accepted Answer

There is uteroplacental insufficiency.

Answer

The baby is asleep.

Answer

The umbilical cord is compressed.

Answer

There is a vagal response.

Question 2

A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:

Accepted Answer

Luteinizing hormone is high.

Answer

Estrogen levels are low.

Answer

The endometrial lining is thin.

Answer

The progesterone level is low.

Question 3

A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:

Accepted Answer

The presence of fetal heart tones

Answer

Elevated human chorionic gonadotropin

Answer

Uterine enlargement

Answer

Breast enlargement and tenderness

Question 4

In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia, the nurse should expect:

Accepted Answer

Progressive cervical dilation

Answer

A painless delivery

Answer

Cervical effacement

Answer

Infrequent contractions

Question 5

The home health nurse is planning for the day’s visits. Which client should be seen first?

Accepted Answer

The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

Answer

The 78-year-old who had a gastrectomy 3 weeks ago and has a PEG tube

Answer

The 5-month-old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension

Answer

The 50-year-old with MRSA being treated with Vancomycin via a PICC line

Question 6

A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:

Accepted Answer

Regularity of the menses

Answer

Age of the client

Answer

Frequency of intercourse

Answer

Range of the client’s temperature

Question 7

The client with hyperemesis gravidarum is at risk for developing:

Accepted Answer

Metabolic acidosis with dehydration

Answer

Metabolic alkalosis with dehydration

Answer

Respiratory alkalosis without dehydration

Answer

Respiratory acidosis without dehydration

Question 8

A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:

Accepted Answer

Her contractions are 5 minutes apart.

Answer

Her contractions are 2 minutes apart.

Answer

She has back pain and a bloody discharge.

Answer

She experiences abdominal pain and frequent urination.

Question 9

The emergency room is flooded with clients injured in a tornado. Which clients can be assigned to share a room in the emergency department during the disaster?

Accepted Answer

The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm

Answer

A schizophrenic client having visual and auditory hallucinations and the client with ulcerative colitis

Answer

A child whose pupils are fixed and dilated and his parents, and a client with a frontal head injury

Answer

The client who arrives with a large puncture wound to the abdomen and the client with chest pain

Question 10

She decides to illustrate the organizational structure. Which of the following elements is NOT included?

Accepted Answer

Unity of direction

Answer

Level of authority

Answer

Lines of communication

Answer

Span of control