Free NCLEX Questions With Rationale 62th Edition

Free NCLEX Questions With Rationale 62th Edition

1. A pregnant client tells the nurse that she has been craving “unusual foods.” On further data collection, the nurse discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Which of the following laboratory results indicates a physiological consequence of a result of this practice?

A. Hematocrit 37%
B. Hemoglobin 9.1 g/dl
C. Glucose 86 mg/dl
D. White blood cell count 12,400/mm3

Answer: B. Hemoglobin 9.1 g/dl

Rationale: Pica cravings often lead to iron deficiency anemia, resulting in a lowered hemoglobin level. The other three laboratory values are within normal limits for the pregnant woman.

Test-Taking Strategy: Knowledge of normal laboratory values and the physiological effects of pica will assist you in selecting the correct option. Review pica and normal laboratory values if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Antepartum
Reference: Leifer, G. (2005). Maternity nursing (9th ed.). Philadelphia: W.B. Saunders, p. 64.

2. During the first trimester of pregnancy, a client complains of frequent nausea followed by vomiting. On data collection, which finding would indicate a more serious nutritional disorder of pregnancy?

A. Ketone bodies in urine are negative
B. Weight compared to last visit is a loss of 2.3 pounds
C. Patellar reflex is 2+
D. Chadwick’s sign is positive

Answer: B. Weight compared to last visit is a loss of 2.3 pounds

Rationale: Weight loss along with the symptoms described in the question could indicate hyperemesis gravidarum. Ketone bodies, if present, would indicate protein wasting. Patellar reflexes would be checked during magnesium sulfate administration. Chadwick’s sign may be an indicator of pregnancy.

Test-Taking Strategy: Focus on the issue—a more serious nutritional disorder. Use the process of elimination, noting that option 2 is the option that is abnormal. Review normal and abnormal findings in pregnancy if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Antepartum
Reference: Leifer, G. (2005). Maternity nursing (9th ed.). Philadelphia: W.B. Saunders, p. 226.

3. A nonstress test is performed on a client, and the results are documented in the chart. The results are documented as a reactive nonstress test. The nurse interprets these findings as indicating:

A. A negative test
B. A positive test
C. A suspicious test
D. An unsatisfactory test

Answer: A. A negative test

Rationale: A reactive nonstress test (normal/negative) indicates a healthy fetus. A nonreactive nonstress test is an abnormal test. A suspicious test result requires further follow-up. An unsatisfactory test cannot be interpreted because of the poor quality of the fetal heart rate findings.

Test-Taking Strategy: Knowledge regarding the nonstress test is required to answer the question. Remembering that a reactive nonstress test is a normal or negative test will direct you to the correct option. If you had difficulty answering this question, review the nonstress test.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Maternity/Antepartum
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 332.

4. A nurse is collecting data from a client who is pregnant with twins. The nurse understands that which of the following complications is most likely associated with a twin pregnancy?

A. Maternal anemia
B. Postterm labor
C. Oligohydramnios
D. Gestational diabetes

Answer: A. Maternal anemia

Rationale: Maternal anemia occurs in a client pregnant with twins because the maternal system is nurturing more than one fetus. Preterm labor, rather than postterm labor, is likely to occur. Hydramnios may be associated with a twin pregnancy because of increased renal perfusion from cross-vessel anastomosis with monozygotic twins. Option 4 is not a complication of a twin pregnancy.

Test-Taking Strategy: Use knowledge regarding the complications associated with a twin pregnancy and the process of elimination to answer the question. Remember, maternal anemia occurs in a client pregnant with twins because the maternal system is nurturing more than one fetus. Review complications of multiple gestation if you had difficulty with this question.

Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Antepartum
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, pp. 44-45.

Source : NCLEX example quiz and answer

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