2022/2023 NCLEX-PN Test Prep
Exam 3 (Three)
Questions and Answers with Explanations
1. A papular lesion is noted on the perineum of the laboring client. Which
initial action is most appropriate?
A. Document the finding
B. Report the finding to the doctor
C. Prepare the client for a C-section
D. Continue primary care as prescribed
Answer B: Any lesion should be reported to the doctor. This can indicate a
herpes lesion. Clients with open lesions related to herpes are delivered by
Cesarean section because there is a possibility of transmission of the infection
to the fetus with direct contact to lesions. It is not enough to document the
finding, so answer A is incorrect. The physician must make the decision to
perform a C-section, making answer C incorrect. It is not enough to continue
primary care, so answer D is incorrect.
2. A client with a diagnosis of human papillomavirus (HPV) is at risk for
which of the following?
A. Lymphoma
B. Cervical and vaginal cancer
C. Leukemia
D. Systemic lupus
Answer B: The client with HPV is at higher risk for cervical and vaginal
cancer related to this STI. She is not at higher risk for the other cancers
mentioned in answers A, C, and D, so those are incorrect.
3. The client seen in the family planning clinic tells the nurse that she has a
painful lesion on the perineum. The nurse is aware that the most likely source
of the lesion is:
,A. Syphilis
B. Herpes
C. Candidiasis
D. Condylomata
Answer B: A lesion that is painful is most likely a herpetic lesion. A chancre
lesion associated with syphilis is not painful, so answer A is incorrect. In
answer C, candidiasis is a yeast infection and does not present with a lesion,
but it is exhibited by a white, cheesy discharge. Condylomata lesions are
painless warts, so answer D is incorrect.
4. A client visiting a family planning clinic is suspected of having an STI.
The most diagnostic test for treponema pallidum is:
A. Venereal Disease Research Lab (VDRL)
B. Rapid plasma reagin (RPR)
C. Florescent treponemal antibody (FTA)
D. Thayer-Martin culture (TMC)
Answer C: FTA is the only answer choice for treponema pallidum. Answers
A and B are incorrect because VDRL and RPR are screening tests for syphilis
but are not conclusive of the disease; they only indicate exposure to the
disease. The Thayer-Martin culture is a test for gonorrhea, so answer D is
incorrect.
5. Which laboratory finding is associated with HELLP syndrome in the
obstetric client?
A. Elevated blood glucose
B. Elevated platelet count
C. Elevated creatinine clearance
D. Elevated hepatic enzymes
Answer D: The criteria for HELLP is hemolysis, elevated liver enzymes, and
low platelet count. In answer A, an elevated blood glucose level is not
associated with HELLP. Platelets are decreased in HELLP syndrome, not
,elevated, as stated in answer B. The creatinine levels are elevated in renal
disease and are not associated with HELLP syndrome, as stated in answer C.
6. The nurse is assessing the deep tendon reflexes of the client with
hypomagnesemia. Which method is used to elicit the biceps reflex?
A. The nurse places her thumb on the muscle inset in the antecubital space
and taps the thumb briskly with the reflex hammer.
B. The nurse loosely suspends the client’s arm in an open hand while tapping
the back of the client’s elbow.
C. The nurse instructs the client to dangle her legs as the nurse strikes the
area below the patella with the blunt side of the reflex hammer.
D. The nurse instructs the client to place her arms loosely at her side as the
nurse strikes the muscle insert just above the wrist.
Answer A: The answer can only be A because the other methods elicit
different reflexes. Answer B elicits the triceps reflex, answer C elicits the
patella reflex, and answer D elicits the radial nerve.
7. Which medication should be used with caution in the obstetric client with
diabetes?
A. Magnesium sulfate
B. Brethine
C. Stadol
D. Ancef
Answer B: Brethine is used cautiously because it raises the blood glucose
levels. Answers A, C, and D are all medications that are commonly used in
the diabetic client, so there is no need to question the order for these
medications.
8. A multigravida is scheduled for an amniocentesis at 32 weeks gestation to
determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1.
The nurse’s assessment of this data is:
A. The infant is at low risk for congenital anomalies.
, B. The infant is at high risk for intrauterine growth retardation.
C. The infant is at high risk for respiratory distress syndrome.
D. The infant is at high risk for birth trauma.
Answer C: When the L/S ratio reaches 2:1, the lungs are considered to be
mature. The infant will most likely be small for gestational age and will not
be at risk for birth trauma, so answer B is incorrect. The L/S ratio does not
indicate congenital anomalies, as stated in answer A, and the infant is not at
risk for intrauterine growth retardation, as stated in answer D.
9. Which observation in the newborn of a mother who is alcohol dependent
would require immediate nursing intervention?
A. Crying
B. Wakefulness
C. Jitteriness
D. Yawning
Answer C: Jitteriness is a sign of seizure in the neonate. Answers A, B, and
D are incorrect because crying, wakefulness, and yawning are expected in the
newborn.
10. The nurse caring for a client receiving magnesium sulfate must closely
observe for side effects associated with drug therapy. An expected side effect
of magnesium sulfate is:
A. Decreased urinary output
B. Hypersomnolence
C. Absence of knee jerk reflex
D. Decreased respiratory rate
Answer B: The client is expected to become sleepy, have hot flashes, and
experience lethargy. A decreasing urinary output, absence of the knee jerk
reflex, and decreased respirations are signs of toxicity and are not expected
side effects of magnesium sulfate. Therefore, answers A, C, and D are
incorrect.
Exam 3 (Three)
Questions and Answers with Explanations
1. A papular lesion is noted on the perineum of the laboring client. Which
initial action is most appropriate?
A. Document the finding
B. Report the finding to the doctor
C. Prepare the client for a C-section
D. Continue primary care as prescribed
Answer B: Any lesion should be reported to the doctor. This can indicate a
herpes lesion. Clients with open lesions related to herpes are delivered by
Cesarean section because there is a possibility of transmission of the infection
to the fetus with direct contact to lesions. It is not enough to document the
finding, so answer A is incorrect. The physician must make the decision to
perform a C-section, making answer C incorrect. It is not enough to continue
primary care, so answer D is incorrect.
2. A client with a diagnosis of human papillomavirus (HPV) is at risk for
which of the following?
A. Lymphoma
B. Cervical and vaginal cancer
C. Leukemia
D. Systemic lupus
Answer B: The client with HPV is at higher risk for cervical and vaginal
cancer related to this STI. She is not at higher risk for the other cancers
mentioned in answers A, C, and D, so those are incorrect.
3. The client seen in the family planning clinic tells the nurse that she has a
painful lesion on the perineum. The nurse is aware that the most likely source
of the lesion is:
,A. Syphilis
B. Herpes
C. Candidiasis
D. Condylomata
Answer B: A lesion that is painful is most likely a herpetic lesion. A chancre
lesion associated with syphilis is not painful, so answer A is incorrect. In
answer C, candidiasis is a yeast infection and does not present with a lesion,
but it is exhibited by a white, cheesy discharge. Condylomata lesions are
painless warts, so answer D is incorrect.
4. A client visiting a family planning clinic is suspected of having an STI.
The most diagnostic test for treponema pallidum is:
A. Venereal Disease Research Lab (VDRL)
B. Rapid plasma reagin (RPR)
C. Florescent treponemal antibody (FTA)
D. Thayer-Martin culture (TMC)
Answer C: FTA is the only answer choice for treponema pallidum. Answers
A and B are incorrect because VDRL and RPR are screening tests for syphilis
but are not conclusive of the disease; they only indicate exposure to the
disease. The Thayer-Martin culture is a test for gonorrhea, so answer D is
incorrect.
5. Which laboratory finding is associated with HELLP syndrome in the
obstetric client?
A. Elevated blood glucose
B. Elevated platelet count
C. Elevated creatinine clearance
D. Elevated hepatic enzymes
Answer D: The criteria for HELLP is hemolysis, elevated liver enzymes, and
low platelet count. In answer A, an elevated blood glucose level is not
associated with HELLP. Platelets are decreased in HELLP syndrome, not
,elevated, as stated in answer B. The creatinine levels are elevated in renal
disease and are not associated with HELLP syndrome, as stated in answer C.
6. The nurse is assessing the deep tendon reflexes of the client with
hypomagnesemia. Which method is used to elicit the biceps reflex?
A. The nurse places her thumb on the muscle inset in the antecubital space
and taps the thumb briskly with the reflex hammer.
B. The nurse loosely suspends the client’s arm in an open hand while tapping
the back of the client’s elbow.
C. The nurse instructs the client to dangle her legs as the nurse strikes the
area below the patella with the blunt side of the reflex hammer.
D. The nurse instructs the client to place her arms loosely at her side as the
nurse strikes the muscle insert just above the wrist.
Answer A: The answer can only be A because the other methods elicit
different reflexes. Answer B elicits the triceps reflex, answer C elicits the
patella reflex, and answer D elicits the radial nerve.
7. Which medication should be used with caution in the obstetric client with
diabetes?
A. Magnesium sulfate
B. Brethine
C. Stadol
D. Ancef
Answer B: Brethine is used cautiously because it raises the blood glucose
levels. Answers A, C, and D are all medications that are commonly used in
the diabetic client, so there is no need to question the order for these
medications.
8. A multigravida is scheduled for an amniocentesis at 32 weeks gestation to
determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1.
The nurse’s assessment of this data is:
A. The infant is at low risk for congenital anomalies.
, B. The infant is at high risk for intrauterine growth retardation.
C. The infant is at high risk for respiratory distress syndrome.
D. The infant is at high risk for birth trauma.
Answer C: When the L/S ratio reaches 2:1, the lungs are considered to be
mature. The infant will most likely be small for gestational age and will not
be at risk for birth trauma, so answer B is incorrect. The L/S ratio does not
indicate congenital anomalies, as stated in answer A, and the infant is not at
risk for intrauterine growth retardation, as stated in answer D.
9. Which observation in the newborn of a mother who is alcohol dependent
would require immediate nursing intervention?
A. Crying
B. Wakefulness
C. Jitteriness
D. Yawning
Answer C: Jitteriness is a sign of seizure in the neonate. Answers A, B, and
D are incorrect because crying, wakefulness, and yawning are expected in the
newborn.
10. The nurse caring for a client receiving magnesium sulfate must closely
observe for side effects associated with drug therapy. An expected side effect
of magnesium sulfate is:
A. Decreased urinary output
B. Hypersomnolence
C. Absence of knee jerk reflex
D. Decreased respiratory rate
Answer B: The client is expected to become sleepy, have hot flashes, and
experience lethargy. A decreasing urinary output, absence of the knee jerk
reflex, and decreased respirations are signs of toxicity and are not expected
side effects of magnesium sulfate. Therefore, answers A, C, and D are
incorrect.
