2024lTESTlBANKlFORlNCLEXlRNl(NEXTlGENERATIONlF
ORMAT)lLATESTlUPDATEDlWITHlOVERl1600lCORRECT
LYlANSWEREDlQUESTIONSl&lDETAILEDlANSWERSlWI
THlRATIONALESl|VERIFIEDl&lGRADEDlA+|GUARANTE
EDlPASS|
Question:l1
Onlthelthirdlpostpartumlday,lthelnurselwouldlexpectlthellochialtolbe:
A. Rubra
B. Serosa
C. Alba
D. Scant
Answer:lA
Explanation:
(A)
Thisldischargeloccurslfromldeliverylthroughlthel3rdlday.lTherelisldarklredlblood,lplacentall
debris,landlclots.Thisldischargeloccurslfromldaysl4-
10.lThellochialislbrownish,lserous,landlthin.l(C)lThisldischargeloccurslfromldayl10lthroughlthel6th
week.lThellochialislyellowishlwhite.l(D)lThislislnotlalclassificationlofllochialbutlrelatesltolthelamo
untlofldischarge.
Question:l2
Alpregnantlclientlislhavinglalnonstressltestl(NST).lItlislnotedlthatlthelfetallheartlbeatlrisesl20lbpm,llastingl2
0lseconds,leveryltimelthelfetuslmoves.lThelnurselexplainslthat:
A. Theltestlislinconclusivelandlshouldlbelrepeated
B. Furtherltestinglislneeded
C. Theltestlislnormallandlthelfetuslislreactinglappropriately
D. Thelfetuslisldistressed
,Explanation:
(A)lTheltestlresultslwerelnormal,lsoltherelwouldlbelnolneedltolrepeatltoldeterminelresults.l(B)lTherelar
elnoldataltolindicatelfurtherltestslarelneeded,lbecauselthelresultloflthelNSTlwaslnormal.l(C)lAnlNSTlislre
portedlaslreactivelifltherelareltwoltolthreelincreaseslinlthelfetallheartlratelofl15lbpm,llastinglatlleastl15l
secondslduringlal15-minutelperiod.l(D)lThelNSTlresultslwerelnormal,lsoltherelwaslnolfetalldistress.
Question:l3
Whichlstagelofllaborllastslfromldeliveryloflthelbabyltoldeliveryloflthelplacenta?
A. Second
B. Third
C. Fourth
D. Fifth
Answer:lB
Explanation:
(A)lThislstagelislfromlcompleteldilatationloflthelcervixltoldeliveryloflthelfetus.l(B)lThislislthelcorrectlstag
elforltheldefinition.l(C)lThislstagellastslforlaboutl2lhourslafterltheldeliveryloflthelplacenta.l(D)lTherelislno
lfifthlstagelofllabor.
Question:l4
Alclientldevelopslcomplicationslfollowinglalhysterectomy.lBloodlcultureslreveallPseudomonaslaeruginos
a.lThelnurselexpectslthatlthelphysicianlwouldlorderlanlappropriatelantibioticltoltreatlP.laeruginosalsuchlas
:
A. Cefoperazonel(Cefobid)
B. Clindamycinl(Cleocin)
C. Dicloxacillinl(Dycill)
D. Erythromycinl(Erythrocin)
Answer:lA
Explanation:
,(A) CefoperazonelislindicatedlinltheltreatmentloflinfectionlwithPseudomonaslaeruginosa.(B)lClindamy
cinlislnotlindicatedlinltheltreatmentloflinfectionlwithP.laeruginosa.(C)lDicloxacillinlislnotlindicatedli
nltheltreatmentloflinfectionlwithP.laeruginosa.(D)lErythromycinlislnotlindicatedlinltheltreatmentlo
flinfectionlwithP.laeruginosa.l
Question:l5
Alcouplelislexperiencingldifficultieslconceivinglalbaby.lThelnurselexplainslbasallbodyltemperaturel(BBT)lbyl
instructinglthelfemalelclientltoltakelherltemperature:
A. Orallylinlthelmorninglandlatlbedtime
B. Onlyloneltimelduringltheldaylasllonglaslitlislalwayslatlthelsameltimeloflday
C. Rectallylatlbedtime
D. Aslsoonlaslshelawakens,lpriorltolanylactivity
Answer:lD
Explanation:
(A)lMonitoringltemperatureltwicelaldaylpredictslthelbiphasiclpatternloflovulation.l(B)lPredictionloflovu
lationlrelieslonlconsistencylinltakingltemperature.l(C)Nightlylrectalltemperatureslarelmorelaccuratelinl
predictinglovulation.l(D)lActivitylchangeslthelaccuracyloflbasallbodyltemperaturelandlabilityltoldetectlth
elluteinizinglhormonelsurge.
Question:l6
Alclientlislhavinglepisodesloflhyperventilationlrelatedltolherlsurgerylthatlislscheduledltomorrow.lAppropriat
elnursinglactionsltolhelplcontrollhyperventilatinglinclude:
A. Administeringldiazepaml(Valium)l1015lmglpolq4hlandlq1hlprnlforlhyperventilatinglepisode
B. Keepingltheltemperaturelinlthelclient’slroomlatlalhighllevelltolreducelrespiratorylstimulation
C. Havinglthelclientlholdlherlbreathlorlbreathelintolalpaperlbaglwhenlhyperventilationlepisodeslo
ccur
D. Usingldistractionltolhelplcontrollthelclient’slhyperventilationlepisodes
Answer:lC
Explanation:
, (A)lAnladultldiazepamldosagelforltreatmentloflanxietylisl210lmglPOl24ltimesldaily.lThelorderlaslwrittenl
wouldlplacelalclientlatlrisklforloverdose.l(B)lAlhighlroomltemperaturelcouldlincreaselhyperventilatingl
episodeslbylstimulatinglthelrespiratorylsystem.l(C)lBreathlholdinglandlbreathinglintolalpaperlbaglmayl
belusefullinlcontrollinglhyperventilation.lBothlmeasureslincreaselCO2lretention.l(D)lDistractionlwilllno
tlpreventlorlcontrollhyperventilationlcausedlbylanxietylorlfear.
Question:l7
Alclientldeliveredlalstillbornlmalelatlterm.lAnlappropriatelactionloflthelnurselwouldlbelto:
A. State,l"Youlhavelanlangellinlheaven."
B. Discouragelthelparentslfromlseeinglthelbaby.
C. Providelanlopportunitylforlthelparentsltolseelandlholdlthelbabylforlanlundeterminedlamountloflti
me.
D. Reassurelthelparentslthatltheylcanlhavelotherlchildren.
Answer:lC
Explanation:
(A)lThislislnotlalsupportivelstatement.lTherelarelalsolnoldataltolindicatelthelfamily’slreligiouslbeliefs.l(B
)lSeeingltheirlbabylassistslthelparentslinlthelgrievinglprocess.lThislgiveslthemlthelopportunityltolsayl"go
od-
bye."l(C)lParentslneedltimeltolgetltolknowltheirlbaby.l(D)lThislislnotlalcomfortinglstatementlwhenlalba
bylhasldied.lThere
arelalsolnolguaranteeslthatlthelcouplelwilllbelableltolhavelanotherlchild.lQuestion:l8
Al29-year-
oldlclientlisladmittedlforlalhysterectomy.lShelhaslrepeatedlyltoldlthelnurseslthatlshelislworriedlaboutlhav
inglthislsurgery,lhaslnotlsleptlwellllately,landlislafraidlthatlherlhusbandlwilllnotlfindlherldesirablelafterlthe
lsurgery.lShortlylintolthelpreoperativelteaching,lshelcomplainsloflaltightnesslinlherlchest,lalfeelingloflsuff
ocation,llightheadedness,landltinglinglinlherlhands.lHerlrespirationslarelrapidlandldeep.lAssessmentlreve
alslthatlthelclientlis:
A. Havinglalheartlattack
B. Wantinglattentionlfromlthelnurses
C. Sufferinglfromlcompletelupperlairwaylobstruction
D. Hyperventilating
ORMAT)lLATESTlUPDATEDlWITHlOVERl1600lCORRECT
LYlANSWEREDlQUESTIONSl&lDETAILEDlANSWERSlWI
THlRATIONALESl|VERIFIEDl&lGRADEDlA+|GUARANTE
EDlPASS|
Question:l1
Onlthelthirdlpostpartumlday,lthelnurselwouldlexpectlthellochialtolbe:
A. Rubra
B. Serosa
C. Alba
D. Scant
Answer:lA
Explanation:
(A)
Thisldischargeloccurslfromldeliverylthroughlthel3rdlday.lTherelisldarklredlblood,lplacentall
debris,landlclots.Thisldischargeloccurslfromldaysl4-
10.lThellochialislbrownish,lserous,landlthin.l(C)lThisldischargeloccurslfromldayl10lthroughlthel6th
week.lThellochialislyellowishlwhite.l(D)lThislislnotlalclassificationlofllochialbutlrelatesltolthelamo
untlofldischarge.
Question:l2
Alpregnantlclientlislhavinglalnonstressltestl(NST).lItlislnotedlthatlthelfetallheartlbeatlrisesl20lbpm,llastingl2
0lseconds,leveryltimelthelfetuslmoves.lThelnurselexplainslthat:
A. Theltestlislinconclusivelandlshouldlbelrepeated
B. Furtherltestinglislneeded
C. Theltestlislnormallandlthelfetuslislreactinglappropriately
D. Thelfetuslisldistressed
,Explanation:
(A)lTheltestlresultslwerelnormal,lsoltherelwouldlbelnolneedltolrepeatltoldeterminelresults.l(B)lTherelar
elnoldataltolindicatelfurtherltestslarelneeded,lbecauselthelresultloflthelNSTlwaslnormal.l(C)lAnlNSTlislre
portedlaslreactivelifltherelareltwoltolthreelincreaseslinlthelfetallheartlratelofl15lbpm,llastinglatlleastl15l
secondslduringlal15-minutelperiod.l(D)lThelNSTlresultslwerelnormal,lsoltherelwaslnolfetalldistress.
Question:l3
Whichlstagelofllaborllastslfromldeliveryloflthelbabyltoldeliveryloflthelplacenta?
A. Second
B. Third
C. Fourth
D. Fifth
Answer:lB
Explanation:
(A)lThislstagelislfromlcompleteldilatationloflthelcervixltoldeliveryloflthelfetus.l(B)lThislislthelcorrectlstag
elforltheldefinition.l(C)lThislstagellastslforlaboutl2lhourslafterltheldeliveryloflthelplacenta.l(D)lTherelislno
lfifthlstagelofllabor.
Question:l4
Alclientldevelopslcomplicationslfollowinglalhysterectomy.lBloodlcultureslreveallPseudomonaslaeruginos
a.lThelnurselexpectslthatlthelphysicianlwouldlorderlanlappropriatelantibioticltoltreatlP.laeruginosalsuchlas
:
A. Cefoperazonel(Cefobid)
B. Clindamycinl(Cleocin)
C. Dicloxacillinl(Dycill)
D. Erythromycinl(Erythrocin)
Answer:lA
Explanation:
,(A) CefoperazonelislindicatedlinltheltreatmentloflinfectionlwithPseudomonaslaeruginosa.(B)lClindamy
cinlislnotlindicatedlinltheltreatmentloflinfectionlwithP.laeruginosa.(C)lDicloxacillinlislnotlindicatedli
nltheltreatmentloflinfectionlwithP.laeruginosa.(D)lErythromycinlislnotlindicatedlinltheltreatmentlo
flinfectionlwithP.laeruginosa.l
Question:l5
Alcouplelislexperiencingldifficultieslconceivinglalbaby.lThelnurselexplainslbasallbodyltemperaturel(BBT)lbyl
instructinglthelfemalelclientltoltakelherltemperature:
A. Orallylinlthelmorninglandlatlbedtime
B. Onlyloneltimelduringltheldaylasllonglaslitlislalwayslatlthelsameltimeloflday
C. Rectallylatlbedtime
D. Aslsoonlaslshelawakens,lpriorltolanylactivity
Answer:lD
Explanation:
(A)lMonitoringltemperatureltwicelaldaylpredictslthelbiphasiclpatternloflovulation.l(B)lPredictionloflovu
lationlrelieslonlconsistencylinltakingltemperature.l(C)Nightlylrectalltemperatureslarelmorelaccuratelinl
predictinglovulation.l(D)lActivitylchangeslthelaccuracyloflbasallbodyltemperaturelandlabilityltoldetectlth
elluteinizinglhormonelsurge.
Question:l6
Alclientlislhavinglepisodesloflhyperventilationlrelatedltolherlsurgerylthatlislscheduledltomorrow.lAppropriat
elnursinglactionsltolhelplcontrollhyperventilatinglinclude:
A. Administeringldiazepaml(Valium)l1015lmglpolq4hlandlq1hlprnlforlhyperventilatinglepisode
B. Keepingltheltemperaturelinlthelclient’slroomlatlalhighllevelltolreducelrespiratorylstimulation
C. Havinglthelclientlholdlherlbreathlorlbreathelintolalpaperlbaglwhenlhyperventilationlepisodeslo
ccur
D. Usingldistractionltolhelplcontrollthelclient’slhyperventilationlepisodes
Answer:lC
Explanation:
, (A)lAnladultldiazepamldosagelforltreatmentloflanxietylisl210lmglPOl24ltimesldaily.lThelorderlaslwrittenl
wouldlplacelalclientlatlrisklforloverdose.l(B)lAlhighlroomltemperaturelcouldlincreaselhyperventilatingl
episodeslbylstimulatinglthelrespiratorylsystem.l(C)lBreathlholdinglandlbreathinglintolalpaperlbaglmayl
belusefullinlcontrollinglhyperventilation.lBothlmeasureslincreaselCO2lretention.l(D)lDistractionlwilllno
tlpreventlorlcontrollhyperventilationlcausedlbylanxietylorlfear.
Question:l7
Alclientldeliveredlalstillbornlmalelatlterm.lAnlappropriatelactionloflthelnurselwouldlbelto:
A. State,l"Youlhavelanlangellinlheaven."
B. Discouragelthelparentslfromlseeinglthelbaby.
C. Providelanlopportunitylforlthelparentsltolseelandlholdlthelbabylforlanlundeterminedlamountloflti
me.
D. Reassurelthelparentslthatltheylcanlhavelotherlchildren.
Answer:lC
Explanation:
(A)lThislislnotlalsupportivelstatement.lTherelarelalsolnoldataltolindicatelthelfamily’slreligiouslbeliefs.l(B
)lSeeingltheirlbabylassistslthelparentslinlthelgrievinglprocess.lThislgiveslthemlthelopportunityltolsayl"go
od-
bye."l(C)lParentslneedltimeltolgetltolknowltheirlbaby.l(D)lThislislnotlalcomfortinglstatementlwhenlalba
bylhasldied.lThere
arelalsolnolguaranteeslthatlthelcouplelwilllbelableltolhavelanotherlchild.lQuestion:l8
Al29-year-
oldlclientlisladmittedlforlalhysterectomy.lShelhaslrepeatedlyltoldlthelnurseslthatlshelislworriedlaboutlhav
inglthislsurgery,lhaslnotlsleptlwellllately,landlislafraidlthatlherlhusbandlwilllnotlfindlherldesirablelafterlthe
lsurgery.lShortlylintolthelpreoperativelteaching,lshelcomplainsloflaltightnesslinlherlchest,lalfeelingloflsuff
ocation,llightheadedness,landltinglinglinlherlhands.lHerlrespirationslarelrapidlandldeep.lAssessmentlreve
alslthatlthelclientlis:
A. Havinglalheartlattack
B. Wantinglattentionlfromlthelnurses
C. Sufferinglfromlcompletelupperlairwaylobstruction
D. Hyperventilating
