Here’s another nursing licensure practice
test for students who want a head start for their nursing review and for RN’s
who just can’t get enough quizzes to keep them sharp. Try to take this test in
24 minutes. Happy answering!
Situation: Nurse Lalaine manages her
own Reproductive and Children’s Nursing Clinic in Isabela and most of the time
she performs prenatal nursing assessment of the residents.
1.
Marichi, a 23 year-old pregnant client, asks how
much longer Nurse Lalaine will refer to the baby inside her as an embryo. Which
of the following would be Lalaine’s best response?
a.
After the 20th week of pregnancy, the baby is
called a zygote.
b.
From the
time of implantation until 8 weeks, the baby is an embryo.
c.
Her baby will be a fetus as soon as the placenta
forms.
d.
This term is used during the time before
fertilization.
2.
Marichi is worried that her baby will be born
with a congenital heart disease. What assessment is important to help determine
if the baby has the risk of having a congenital heart defect?
a.
Assessing
whether the umbilical cord has two arteries and one vein
b.
Assessing whether the Wharton’s jelly of the cord
has a pH higher than 7.2
c.
Determining that the color of the umbilical cord
if it’s not green
d.
Measuring the length of the cord to be certain
that it is longer than 3 feet
3.
Marichi asks Lalaine regarding risk factors that
affect the normal development of the fetus. Which of the following data about
Marichi would tell Lalaine that there’s a risk of developing congenital
anomalies of the fetus?
a.
Marichi been overly anxious about something.
b.
Marichi had a bacterial respiratory infection at
the early stage of her pregnancy.
c.
Marichi engaged in sexual activity during the second
trimester of her pregnancy.
d.
Marichi
smokes 20 cigarettes a day on average.
4.
Marichi is scheduled to have an ultrasound
examination. What instruction would be most appropriate to give before her
examination?
a.
Drink at
least 3 glasses of fluid before the procedure.
b.
Intravenous fluid should not be administered to
prevent hurting the fetus.
c.
Void immediately before the procedure.
d.
You can have medicine for pain for any
contractions caused by the test.
5.
Marichi is scheduled to have an amniocentesis to
test for fetal maturity. What instruction would you give her before this
procedure?
a.
No more amniotic fluid forms afterward, which is
why only a small amount is removed.
b.
The intravenous fluid infused to dilate your
uterus does not hurt the fetus.
c.
The X-ray used to reveal your fetus’ position
has no long term effects.
d.
Void
immediately before the procedure to reduce your bladder size.
Situation: Health instructions are
essentially given to pregnant mothers to help them cope with the overall
experience and prevent any risks.
6.
A public
health nurse would appropriately instruct a pregnant woman to notify the
physician immediately if which of the following symptoms occur during
pregnancy?
a.
Breast
tenderness
b.
Increased
vaginal discharge
c.
Presence
of dark color in the neck
d.
Swelling
of the face
7.
A woman
who is 9 weeks pregnant comes to the Health Center with moderate bright red vaginal
bleeding. On physical examination, the physician finds the client’s cervix 2 cm
dilated. Based on the given data, which term best describes the client’s
condition?
a.
Incomplete
abortion
b.
Inevitable
abortion
c.
Missed
abortion
d.
Threatened
abortion
8.
In a big
government hospital, Nurse Pattie is taking care of a woman with a diagnosis of
abruptio placentae. What complication of this condition is of most concern to
Nurse Pattie?
a.
Disseminated
intravascular coagulation
b.
Hypocalcemia
c.
Pulmonary
embolism
d.
Urinary
tract infection
9.
Which of
the following findings on a woman who has recently delivered would indicate she
is at risk for developing postpartum hemorrhage?
a.
Epidural
anesthesia
b.
Grand
multiparity
c.
Post-term
delivery
d.
Urinary
tract infection
10.
Mrs. Hally
Garcia, a 35 year-old postpartum client, is at risk of thrombophlebitis. Which
of the following nursing interventions would be the best intervention to
prevent postpartum thrombophlebitis?
a.
Administration
of anticoagulant postpartum
b.
Breastfeeding
the newborn
c.
Early
ambulation
d.
Immobilization
and elevation of the lower extremities
11.
The
nurse uses what equipment to check for fluid between the parietal and visceral
layers of the tunica vaginalis?
a.
3 cc
syringe
b.
Fluid
meter
c.
Manometer
d.
Transilluminator
12.
The
nurse knows that the occurrence of shoulder dystocia during labor is most
associated with which of the following conditions?
a.
Macrosomia
b.
Late age
pregnancy
c.
Polyhydramnios
d.
Preterm
birth
13.
The
nurse correctly instructs the mother that overstimulated infants tend to:
a.
Breathe
at a faster rate
b.
Look
away to reduce the intensity of the interaction
c.
Respond
with coordinated, synchronous body movement
d.
Show
increased alertness and eye contact
14.
The
nurse instructs a couple on the proper use of contraceptives. Which statement
by the nurse is correct regarding the use of the cervical cap?
a.
“It does
not need to be fitted by the physician.”
b.
“It does
not require the use of spermicide.”
c.
“It may
affect Pap smear results.”
d.
“It must
be removed within 24 hours.”
15.
The
endometrium thickens during which phase of the menstrual cycle?
a.
Ischemic
phase
b.
Menstrual
phase
c.
Proliferative
phase
d.
Secretory
phase
16.
A client
is 7 months pregnant and has just been diagnosed as having a partial placenta
previa. She is stable and has minimal spotting and is being sent home. Which of
these instructions to the client may indicate a need for further teaching?
a.
Avoid
intercourse for three days.
b.
Call if
contractions occur.
c.
Maintain
bed rest with bathroom privileges
d.
Stay on
left side as much as possible when lying down.
17.
The
painful phenomenon known as “back labor” occurs in a client whose fetus in what
position?
a.
Breech
position
b.
Brow
position
c.
Left
Occipito-Posterior position
d.
Right
Occipito-Anterior position
18.
When a
person is discussing the strong influence of childrearing methods on the development
of the child, this person is most probably referring to which of the following theories?
a.
Naturalistic
b.
Nature
c.
Neoclassic
d.
Nurture
19.
A client
says she heard from a friend that people stop having periods once they are on
the “pill”. The most appropriate response of the nurse would be:
a.
“If your
friend has missed her period, she should stop taking the pills and get a pregnancy
test as soon as possible.”
b.
“Missed
period can be very dangerous and may lead to the formation of precancerous cells.”
c.
“The
pill prevents the uterus from making such endometrial lining, and that is why periods
may often be scant or skipped occasionally.”
d.
“The
pill should cause a normal menstrual period every month. It sounds like your
friend has not been taking the pills properly.”
20.
The
nurse is teaching a group of expectant mothers about the prevention of diaper
dermatitis. The nurse explains that one of the preventive measures is the use
of:
a.
Absorbent
disposable diapers
b.
Baby
powder or cornstarch
c.
Cloth
diaper
d.
Plastic
panties over diapers
Here are the answers:
1.
Answer:
B
Rationale: In human
development, the fertilized multicellular diploid eukaryote is called an embryo
from the time of fertilization to 8 weeks; afterwards it is called a fetus. The
zygote is the earliest developmental stage of the embryo. It is the week of
gestation, not the time of placental formation, which marks developmental
stages.
2.
Answer:
A
Rationale: According
to Pillitteri, the umbilical cord should be routinely assessed for the number
of arteries and veins because 15-20% of newborns with a single umbilical artery
are associated with congenital anomalies of the heart.
3.
Answer:
D
Rationale: Cigarette
smoke, drugs, alcohol and other teratogenic chemicals are major risk factors
for congenital abnormalities.
4.
Answer:
A
Rationale: 3 glasses
of fluid intake (approximately 24-32 oz) optimizes the procedure, since a full
bladder will push the intestines out of the way, so that the uterus and other
reproductive organs can be readily seen. The administration of IV fluids is not
contraindicated, and pain medications are not indicated for uterine
contractions.
5.
Answer:
D
Rationale: Amniocentesis
is a medical procedure involving the insertion of a needle on the abdominal
wall to draw amniotic fluid, and it is particularly important to instruct the
client to empty the bladder to avoid puncturing it.
6.
Answer:
D
Rationale: Breast
tenderness and skin darkening are normal, subtle signs of pregnancy, while
increased discharge (leukorrhea) is normally experienced due to increased
estrogen production and blood flow into the vaginal area. While slight swelling
can be expected, the client should nevertheless have it assessed by the doctor
as uncontrolled edema might lead to serious complications.
7.
Answer:
B
Rationale: By
definition, this case falls under inevitable abortion which occurs when
cervical dilation is present. An incomplete abortion happens when part of the
conceptus (usually the fetus) is expelled, while a threatened abortion occurs
when there is no cervical dilation despite the bright red bleeding. A missed
abortion occurs when the fetus dies in utero but is not expelled, and this can
happen without prior vaginal bleeding and cervical dilation.
8.
Answer:
A
Rationale: Abruptio
placentae involves the premature separation of the placenta from the uterine
wall, and this separation may result to massive bleeding that can further
complicate to disseminated intravascular coagulation (DIC).
9.
Answer:
B
Rationale: The risk
factors of postpartal hemorrhage include multiple gestations, deep anesthesia,
placenta previa and premature rupture of membranes. Urinary tract infection and
post-term delivery are not usually associated with this complication.
10.
Answer:
C
Rationale: Early
ambulation is the intervention that would prevent clot formation in the blood
vessels of the lower extremities. Anticoagulants are not routinely administered
with postpartum clients, although they can be prescribed by the physician in
special cases. Breastfeeding the newborn might help, since the mother would be
moving about while doing it. Immobilization would worsen the condition because
it will lead to venous stasis.
11.
Answer:
D
Rationale: Fluid from
this tissue can be assessed using a transilluminator, where is light is shone
on the affected part. Fluid detection is not usually done with aspiration or
fluid meters, while a manometer is an instrument that measures pressure.
12.
Answer:
A
Rationale: Shoulder
dystocia is a specific type of labor pain resulting from a difficult delivery
of the newborn’s head and shoulders. This usually occurs with cephalopelvic
disproportion, and a common cause of this is a macrosomic infant.
13.
Answer:
B
Rationale: The
infant’s nervous system has not yet fully developed, and they can only take so
many stimuli at this stage of life. Three things usually occur when an infant
is overstimulated: (1) they could fall asleep, (2) they could zone you out and
stop paying attention to you, and (3) they get irritable and cranky.
14.
Answer:
C
Rationale: A cervical
cap can be readily inserted by the client, and a spermicide is not required for
it to be effective in contraception. It’s not required to be removed within 24
hours, and it can be left in place for 48 hours. However, it might affect Pap
smear results since it blocks the area to be sampled.
15.
Answer:
D
Rationale: The
endometrium thickens during the secretory phase. Recall of the menstrual cycle
is needed to properly answer this question.
16.
Answer:
A
Rationale: A client
with placental previa must maintain a side-lying position to maximize oxygen
delivery to both her and the fetus, and the physician must be notified if
contractions occur. The client should be advised to rest and must be assisted
when moving. Sexual intercourse should be withheld during the course of signs
and symptoms.
17.
Answer:
C
Rationale: A frequent
cause of back labor is the position of the baby, and the occipito-posterior
position is commonly associated with it. This fetal position causes pressure on
the mother’s sacrum.
18.
Answer:
D
Nature and Nurture are
two contrasting assumptions that explore the factors that influence child
development. Nature emphasizes that individual traits are innate and external
factors have minimal influence on it, while Nurture asserts the significant
influence of experiences over the person’s development.
19.
Answer:
C
Rationale: When women
talk about the “pill”, they talk about the contraceptive pill, and it is
expected that women taking them would have missed periods, as these oral contraceptive
pills supports the endometrium to
prevent breakthrough bleeding mid-cycle and makes it inhospitable for a
fertilized egg. However, the nurse should keep in mind that OCPs have numerous
adverse effects, thus clients must be thoroughly assessed before administering
them.
20.
Answer:
B
Rationale: Regardless
of the diaper used, dermatitis will occur if the diapers are not changed
frequently. Baby powder or cornstarch is an additional preventive measure
because it will keep the area dry. The key is to prevent the skin from
prolonged contact with urine, which turns into ammonia and causes skin
irritation and breakdown.
Hope you did pretty good in this test. If you
got 12-15 questions right, then you have a good working knowledge on these
topics. However, keep in mind that a single test is not enough to test your
ability.
For people who got below 12, it only means
that you have to read more and answer more practice questions.
Remember: the key to any nursing licensure
preparation is repetitive mental exercise. Read and practice. Don’t overdo it
though, and don’t forget to have fun!
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