2023 NCLEX RN ACTUAL EXAM TEST BANK LATEST 800
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES/RN NCLEX TEST BANK
A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency
contraception. After unprotected intercourse , the client calls the clinic to ask
questions about taking the contraceptives. The nurse realizes the client needs
further explanation when she makes which of the following responses? - ANSWER:
1. I can wait 3 to 4 days after intercourse to start taking these to prevent
pregnancy.
Plan B is a series of contraceptive pills similar in composition to birth control pills
that have been used for the past 30 years. Plan B is the brand name for
levonorgestrel 0.75 mg. Pills are most effective if taken immediately after
unprotected intercourse and then again 12 hours later. Males can purchase this
contraceptive as long as they are over 18 years of age. Common side effects
include nausea, breast tenderness, vertigo, and stomach pain.
An antenatal G2, T1, P0, Ab0, L1 client is discussing her postpartum plans for birth
control with her health care provider. In analyzing the available choices, which of the
following factors has the greatest impact on her birth control options? - ANSWER: 3.
Breast - or bottle-feeding plan.
Birth control plans are influenced primarily by whether the mother is breast- or
bottle-feeding her infant. The maternal milk supply must be well established prior
to the initiation of most hormonal birth control methods. Low-dose oral
contraceptives would be the exception. Use of estrogen-/progesterone-based pills
and progesterone-only pills are commonly initiated from 4 to 6 weeks postpartum
because the milk supply is well established by this time. Prior experiences with
birth control methods have an impact on the method chosen as do to preferences
of the client's partner; however, they are not the most influential factors. Desire to
have another child in two years would make some methods, such as an IUD, less
attractive but would still be secondary to the choice to breast-feed.
After the nurse instructs a 20 year old nulligravid client on how to perform a breast
self-examination, which of the following client statements indicates that the
teaching has been successful? - ANSWER: 4. If there is discharge from my nipples, I
should call my health care provider.
The nurse determines that the client has understood the instructions when the
client says that she will notify her primary health care provider if she notices
discharge or bleeding because this may be symptomatic of underlying disease.
Ideally, breast self-examination should be performed about 1 week after the onset
of menses because hormonal influences on breast tissue are at a low ebb at this
time. The client should perform breast self-examination on the same day each
month only if she has stopped menstruating (as with menopause). The client's
breasts should mirror each other. If one breast is significantly larger than the
other, or if there is "pitting" of breast tissue, a tumor may be present.
Which of the following would be important to include in the teaching plan for the
client who wants more information on ovulation and fertility management? -
,ANSWER: 3. Ovulation usually occurs on day 14, plus or minus 2 days, before the
onset of the next menstrual cycle.
For a client with a typical menstrual cycle of 28 days, ovulation usually occurs on
day 14, plus or minus 2 days, before the onset of the next menstrual cycle. Stated
another way, the menstrual period begins about 2 weeks after ovulation has
occurred. Ovulation does not usually occur during the menses component of the
cycle when the uterine lining is being shed. In most women, the ovum survives for
about 12 to 24 hours after ovulation, during which time conception is possible. The
basal body temperature rises 0.5 F to 1.0 F (0.28 C to 0.56 C) when ovulation
occurs. Although some women experience some pelvic discomfort during ovulation
(mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus
is thin and copious.
Which of the following instructions about activities during menstruation would the
nurse include when counseling an adolescent who has just begun to menstruate? -
ANSWER: 1. Take a mild analgesic if needed for menstrual pain.
The nurse should instruct the client to take a mild analgesic, such as ibuprofen, if
menstrual pain or "cramps" are present. The client should also eat foods rich in
iron and should continue moderate exercise during menstruation, which increases
abdominal tone. Avoiding cold foods will not decrease dysmenorrhea. Sexual
intercourse is not prohibited during menstruation, but the male partner should
wear condom to prevent expose to blood.
After conducting a class for female adolescents about human reproduction, which of
the following statements indicates that the school nurse's teaching has been
effective? - ANSWER: 1. Under ideal conditions, sperm can reach the ovum in 15 to
30 minutes, resulting in pregnancy.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes. This is an
important point to make with adolescents who may be sexually active. Many
people believe that the time interval is much longer and that they can wait until
after intercourse to take steps to prevent conception. Without protection,
pregnancy and sexually transmitted diseases can occur. When using the abstinence
or calendar method, the couple should abstain from intercourse on the days of
menstrual cycle when the woman is most likely to conceive. Using a 28-day cycle as
an example, a couple should abstain from coitus 3 to 4 days before ovulation (days
10 through 14) and 3 to 4 days after after ovulation (days 15 through 18). Sperm
from a healthy male can remain viable for 24 to 72 hours in the female
reproductive tract. If the female client ovu
A 20-year-old nulligravid client expresses a desire to learn more about the
symptothermal method of family planning. Which of the following would the nurse
include in the teaching plan? - ANSWER: 3. Cervical mucus is carefully monitored for
changes.
The symptothermal method is a natural method of fertility management that
depends on knowing when ovulation has occurred. Because regular menstrual
cycles can vary by 1 or 2 days in either direction, the symptothermal method
requires daily basal body temperature assessments plus close monitoring of
cervical mucus changes. The method relies on abstinence during the period of
ovulation, which occurs approximately 14 days before the beginning of the next
cycle. Abstinence from coitus for 5 days after menses is unnecessary because it is
, unlikely that ovulation will occur during this time period (days 1 through 10).
Typically, the failure rate for this method is between 10% and 20 %. Although a
condom may increase the effectiveness of this method, most clients who choose
natural methods are not interested in chemical or barrier types of family planning.
Before advising a 24-year-old client desiring oral contraceptives for family planning,
the nurse would assess the client for signs and symptoms of which of the following? -
ANSWER: 2. Hypertension.
Before advising a client about oral contraceptives, the nurse needs to assess the
client for signs and symptoms of hypertension. Clients who have hypertension,
thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident
are poor candidates for oral contraceptives. In addition, women who smoke, are
older than 40 years of age, or have a history of pulmonary disease should be advised
to use a different method. Iron-deficiency, anemia, dysmenorrhea, and acne are not
contraindications for the use of oral contraceptives. Iron-deficiency anemia is a
common disorder in young women. Oral contraceptives decrease the amount of iron
lost through menses, thereby providing a beneficial effect when used by clients with
anemia.Low-dose oral contraceptives to prevent ovulation may be effective in
decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is
thought to be ca
After instructing a 20-year-old nulligravid client about adverse effects of oral
contraceptives, the nurse determines that further instruction is needed when the
client states which of the following as an adverse effect? - ANSWER: 4. Ovarian
cancer.
The nurse determines that the client needs further instruction when the client says
that one of the adverse effects of oral contraceptive use is ovarian cancer. Some
studies suggest that ovarian and endometrial cancers are reduced in women using
oral contraceptives. Other adverse effects of oral contraceptives include weight gain,
nausea, headache, breakthrough bleeding, and monilial infections. The most serious
adverse effect is thrombophlebitis.
A 22-year-old nulligravid client tells the nurse that she and her husband have been
considering using condoms for family planning. Which of the following instructions
should the nurse include about the use of condoms as a method for family planning?
- ANSWER: 1. Using a spermicide with the condom offers added protection against
pregnancy.
The typical failure rate of a condom is approximately 12% to 14%. Adding a
spermicide can decrease this potential failure rate because it offers additional
protection against pregnancy. Natural skin condoms do not offer the same
protection against sexually transmitted diseases caused by viruses as latex condoms
do. Unlike latex condoms, natural skin (membrane) condoms do not prevent the
passage of viruses. Most condom users report decreased penile gland sensibility.
However, some users do report an increased sensitivity or allergic reaction (such as a
rash) to latex, necessitating the use of another method of family planning or a switch
to a natural skin condom.
Which of the following would the nurse include in the teaching plan for a 32-year-old
female client requesting information about using a diaphragm for family planning? -
ANSWER: 2. Diaphragms should not be used if the client develops acute cervicitis.
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES/RN NCLEX TEST BANK
A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency
contraception. After unprotected intercourse , the client calls the clinic to ask
questions about taking the contraceptives. The nurse realizes the client needs
further explanation when she makes which of the following responses? - ANSWER:
1. I can wait 3 to 4 days after intercourse to start taking these to prevent
pregnancy.
Plan B is a series of contraceptive pills similar in composition to birth control pills
that have been used for the past 30 years. Plan B is the brand name for
levonorgestrel 0.75 mg. Pills are most effective if taken immediately after
unprotected intercourse and then again 12 hours later. Males can purchase this
contraceptive as long as they are over 18 years of age. Common side effects
include nausea, breast tenderness, vertigo, and stomach pain.
An antenatal G2, T1, P0, Ab0, L1 client is discussing her postpartum plans for birth
control with her health care provider. In analyzing the available choices, which of the
following factors has the greatest impact on her birth control options? - ANSWER: 3.
Breast - or bottle-feeding plan.
Birth control plans are influenced primarily by whether the mother is breast- or
bottle-feeding her infant. The maternal milk supply must be well established prior
to the initiation of most hormonal birth control methods. Low-dose oral
contraceptives would be the exception. Use of estrogen-/progesterone-based pills
and progesterone-only pills are commonly initiated from 4 to 6 weeks postpartum
because the milk supply is well established by this time. Prior experiences with
birth control methods have an impact on the method chosen as do to preferences
of the client's partner; however, they are not the most influential factors. Desire to
have another child in two years would make some methods, such as an IUD, less
attractive but would still be secondary to the choice to breast-feed.
After the nurse instructs a 20 year old nulligravid client on how to perform a breast
self-examination, which of the following client statements indicates that the
teaching has been successful? - ANSWER: 4. If there is discharge from my nipples, I
should call my health care provider.
The nurse determines that the client has understood the instructions when the
client says that she will notify her primary health care provider if she notices
discharge or bleeding because this may be symptomatic of underlying disease.
Ideally, breast self-examination should be performed about 1 week after the onset
of menses because hormonal influences on breast tissue are at a low ebb at this
time. The client should perform breast self-examination on the same day each
month only if she has stopped menstruating (as with menopause). The client's
breasts should mirror each other. If one breast is significantly larger than the
other, or if there is "pitting" of breast tissue, a tumor may be present.
Which of the following would be important to include in the teaching plan for the
client who wants more information on ovulation and fertility management? -
,ANSWER: 3. Ovulation usually occurs on day 14, plus or minus 2 days, before the
onset of the next menstrual cycle.
For a client with a typical menstrual cycle of 28 days, ovulation usually occurs on
day 14, plus or minus 2 days, before the onset of the next menstrual cycle. Stated
another way, the menstrual period begins about 2 weeks after ovulation has
occurred. Ovulation does not usually occur during the menses component of the
cycle when the uterine lining is being shed. In most women, the ovum survives for
about 12 to 24 hours after ovulation, during which time conception is possible. The
basal body temperature rises 0.5 F to 1.0 F (0.28 C to 0.56 C) when ovulation
occurs. Although some women experience some pelvic discomfort during ovulation
(mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus
is thin and copious.
Which of the following instructions about activities during menstruation would the
nurse include when counseling an adolescent who has just begun to menstruate? -
ANSWER: 1. Take a mild analgesic if needed for menstrual pain.
The nurse should instruct the client to take a mild analgesic, such as ibuprofen, if
menstrual pain or "cramps" are present. The client should also eat foods rich in
iron and should continue moderate exercise during menstruation, which increases
abdominal tone. Avoiding cold foods will not decrease dysmenorrhea. Sexual
intercourse is not prohibited during menstruation, but the male partner should
wear condom to prevent expose to blood.
After conducting a class for female adolescents about human reproduction, which of
the following statements indicates that the school nurse's teaching has been
effective? - ANSWER: 1. Under ideal conditions, sperm can reach the ovum in 15 to
30 minutes, resulting in pregnancy.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes. This is an
important point to make with adolescents who may be sexually active. Many
people believe that the time interval is much longer and that they can wait until
after intercourse to take steps to prevent conception. Without protection,
pregnancy and sexually transmitted diseases can occur. When using the abstinence
or calendar method, the couple should abstain from intercourse on the days of
menstrual cycle when the woman is most likely to conceive. Using a 28-day cycle as
an example, a couple should abstain from coitus 3 to 4 days before ovulation (days
10 through 14) and 3 to 4 days after after ovulation (days 15 through 18). Sperm
from a healthy male can remain viable for 24 to 72 hours in the female
reproductive tract. If the female client ovu
A 20-year-old nulligravid client expresses a desire to learn more about the
symptothermal method of family planning. Which of the following would the nurse
include in the teaching plan? - ANSWER: 3. Cervical mucus is carefully monitored for
changes.
The symptothermal method is a natural method of fertility management that
depends on knowing when ovulation has occurred. Because regular menstrual
cycles can vary by 1 or 2 days in either direction, the symptothermal method
requires daily basal body temperature assessments plus close monitoring of
cervical mucus changes. The method relies on abstinence during the period of
ovulation, which occurs approximately 14 days before the beginning of the next
cycle. Abstinence from coitus for 5 days after menses is unnecessary because it is
, unlikely that ovulation will occur during this time period (days 1 through 10).
Typically, the failure rate for this method is between 10% and 20 %. Although a
condom may increase the effectiveness of this method, most clients who choose
natural methods are not interested in chemical or barrier types of family planning.
Before advising a 24-year-old client desiring oral contraceptives for family planning,
the nurse would assess the client for signs and symptoms of which of the following? -
ANSWER: 2. Hypertension.
Before advising a client about oral contraceptives, the nurse needs to assess the
client for signs and symptoms of hypertension. Clients who have hypertension,
thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident
are poor candidates for oral contraceptives. In addition, women who smoke, are
older than 40 years of age, or have a history of pulmonary disease should be advised
to use a different method. Iron-deficiency, anemia, dysmenorrhea, and acne are not
contraindications for the use of oral contraceptives. Iron-deficiency anemia is a
common disorder in young women. Oral contraceptives decrease the amount of iron
lost through menses, thereby providing a beneficial effect when used by clients with
anemia.Low-dose oral contraceptives to prevent ovulation may be effective in
decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is
thought to be ca
After instructing a 20-year-old nulligravid client about adverse effects of oral
contraceptives, the nurse determines that further instruction is needed when the
client states which of the following as an adverse effect? - ANSWER: 4. Ovarian
cancer.
The nurse determines that the client needs further instruction when the client says
that one of the adverse effects of oral contraceptive use is ovarian cancer. Some
studies suggest that ovarian and endometrial cancers are reduced in women using
oral contraceptives. Other adverse effects of oral contraceptives include weight gain,
nausea, headache, breakthrough bleeding, and monilial infections. The most serious
adverse effect is thrombophlebitis.
A 22-year-old nulligravid client tells the nurse that she and her husband have been
considering using condoms for family planning. Which of the following instructions
should the nurse include about the use of condoms as a method for family planning?
- ANSWER: 1. Using a spermicide with the condom offers added protection against
pregnancy.
The typical failure rate of a condom is approximately 12% to 14%. Adding a
spermicide can decrease this potential failure rate because it offers additional
protection against pregnancy. Natural skin condoms do not offer the same
protection against sexually transmitted diseases caused by viruses as latex condoms
do. Unlike latex condoms, natural skin (membrane) condoms do not prevent the
passage of viruses. Most condom users report decreased penile gland sensibility.
However, some users do report an increased sensitivity or allergic reaction (such as a
rash) to latex, necessitating the use of another method of family planning or a switch
to a natural skin condom.
Which of the following would the nurse include in the teaching plan for a 32-year-old
female client requesting information about using a diaphragm for family planning? -
ANSWER: 2. Diaphragms should not be used if the client develops acute cervicitis.
