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NCLEX Questions Test Bank and Review 113th Edition
1. A nurse is providing dietary instructions to a pregnant client with a history of lactose intolerance. The nurse would instruct the client to consume which best food item to ensure an adequate source of calcium in the diet?
A. Dried fruits
B. Spinach
C. Orange juice
D. Cheese
Answer: A. Dried fruits
Rationale: Dairy products are the best source of calcium. Women with lactose intolerance need other sources of calcium because they are not able to consume dairy products. Calcium is present in dark green, leafy vegetables, broccoli, legumes, nuts, and dried fruits. Spinach contains calcium, but it also contains oxalates that decrease calcium availability. Orange juice does not contain significant amounts of calcium unless it is fortified with calcium. Option 4 is a dairy product and cannot be eaten when the client is lactose intolerant.
Test-Taking Strategy: Use the process of elimination and note that the client has a history of lactose intolerance. Option 4 can be eliminated first because it is a dairy product. Recalling that orange juice is not a good source of calcium unless fortified with calcium will assist in eliminating option C. Spinach contains calcium, but it also contains oxalates that decrease calcium absorption, so eliminate option B. This leaves option 1 as the correct answer. Review lactose intolerance and foods high in calcium if you had difficulty with this question.
Level of Cognitive Ability: Application
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Content Area: Maternity/Antepartum
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, pp. 314-315.
2. A nurse provides instructions to a pregnant client regarding the administration of iron. The nurse determines that the teaching has been effective if the client states that she will take the iron with which of the following food items?
A. Milk
B. Tea
C. Tomato juice
D. Water
Answer: C. Tomato juice
Rationale: Foods containing ascorbic acid (vitamin C), such as tomato juice, may increase the absorption of iron. Additionally, the absorption of iron is affected by many substances. Calcium and phosphorus in milk and tannin in tea decrease iron absorption. Water will not act to increase the absorption of the iron.
Test-Taking Strategy: Recall that vitamin C increases the absorption of iron. Next, use the process of elimination to direct you to option C. Review the teaching points related to the administration of iron if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Content Area: Pharmacology
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 61.
3. A client is seen in the health care clinic for complaints of vaginal bleeding and mild abdominal cramping. On further data collection, the nurse notes that the client’s last menstrual period was 10 weeks ago. The client reports that a home pregnancy test was performed and the results were positive. On physical examination, it is noted that the client has a dilated cervix. The nurse understands that the client is at risk for which type of abortion?
A. Inevitable
B. Incomplete
C. Threatened
D. Septic
Answer: A. Inevitable
Rationale: An inevitable abortion is a termination of pregnancy that cannot be prevented. Moderate to severe bleeding with mild cramping and cervical dilation is present. An incomplete abortion presents with heavy bleeding, severe cramping, cervical dilation, and passage of large clots. A threatened abortion presents with slight to moderate bleeding and intermittent cramping, but no dilation. A septic abortion presents with bleeding with odor, cervical dilation, and fever. Cramping may or may not be present.
Test-Taking Strategy: Use the process of elimination. Focus on the client’s symptoms and the physical assessment findings to help you answer the question. There are no supporting data in the question that suggest the occurrence of the types of abortions identified in options 2, 3, and D. Review the different types of abortion 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. (2005). Maternity nursing (9th ed.). Philadelphia: W.B. Saunders, p. 213.
4. A nurse is reviewing the health history of a pregnant client. Which of the following data if noted in the client’s health history would indicate a risk for spontaneous abortion?
A. Age of 45 years
B. Presence of syphilis
C. Inactive genital herpes
D. Diabetes mellitus
Answer: B. Presence of syphilis
Rationale: Maternal infections such as syphilis, toxoplasmosis, and rubella are causes of spontaneous abortion. There is inconclusive evidence that genital herpes is a causative agent in abortion. Maternal age over 40 years and diabetes mellitus are considered high risk factors in a pregnancy, increasing the risk of congenital malformations.
Test-Taking Strategy: Focus on the key words risk for spontaneous abortion. Eliminate options 1 and 4 first because these factors are high risk factors in pregnancy but are not directly related to high risk for abortion. From the remaining options, recall that genital herpes is not necessarily associated with spontaneous abortion. This will direct you to option B. Review the risk factors associated with spontaneous abortion if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Data Collection
Content Area: Maternity/Antepartum
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 617.
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