NCLEX-RN Practice Exam Part 5

We are now halfway through with our NCLEX-RN practice exam series. This is part 5 and I have provided the links below for parts 1 to 4 together with it’s corresponding answers and rationales page.

If you want to have more NCLEX practice exam questions like this, we strongly suggest to get a copy of NCLEX-RN Exam Cram and NCLEX-RN Exam Practice Questions Exam Cramfrom

1.      A gravida III para 0 is admitted to the labor and delivery unit. The doctor performs an amniotomy. Which observation would the nurse be expected to make after the amniotomy?

a.       Fetal heart tones 160bpm

b.      A moderate amount of straw-colored fluid

c.       A small amount of greenish fluid

d.      A small segment of the umbilical cord

2.      The client is admitted to the unit. A vaginal exam reveals that she is 2cm dilated. Which of the following statements would the nurse expect her to make?

a.       "We have a name picked out for the baby."

b.      "I need to push when I have a contraction."

c.       "I can’t concentrate if anyone is touching me."

d.      "When can I get my epidural?"

3.      The client is having fetal heart rates of 90–110bpm during the contractions. The first action the nurse should take is:

a.       Reposition the monitor

b.      Turn the client to her left side

c.       Ask the client to ambulate

d.      Prepare the client for delivery

4.      In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia, the nurse should expect:

a.       A painless delivery

b.      Cervical effacement

c.       Infrequent contractions

d.      Progressive cervical dilation

5.      A vaginal exam reveals a footling breech presentation. The nurse should take which of the following actions at this time?

a.       Anticipate the need for a Caesarean section

b.      Apply the fetal heart monitor

c.       Place the client in Genu Pectoral position

d.      Perform an ultrasound exam

6.      A vaginal exam reveals that the cervix is 4cm dilated, with intact membranes and a fetal heart tone rate of 160–170bpm. The nurse decides to apply an external fetal monitor. The rationale for this implementation is:

a.       The cervix is closed.

b.      The membranes are still intact.

c.       The fetal heart tones are within normal limits.

d.      The contractions are intense enough for insertion of an internal monitor.

7.      The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labor. Which one would be most appropriate for the primagravida as she completes the early phase of labor?

a.       Impaired gas exchange related to hyperventilation

b.      Alteration in placental perfusion related to maternal position

c.       Impaired physical mobility related to fetal-monitoring equipment

d.      Potential fluid volume deficit related to decreased fluid intake

8.      As the client reaches 8cm dilation, the nurse notes late decelerations on the fetal monitor. The FHR baseline is 165–175bpm with variability of 0–2bpm. What is the most likely explanation of this pattern?

a.       The baby is asleep.

b.      The umbilical cord is compressed.

c.       There is a vagal response.

d.      There is uteroplacental insufficiency.

9.      The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:

a.       Notify her doctor

b.      Start an IV

c.       Reposition the client

d.      Readjust the monitor

10.  Which of the following is a characteristic of a reassuring fetal heart rate pattern?

a.       A fetal heart rate of 170–180bpm

b.      A baseline variability of 25–35bpm

c.       Ominous periodic changes

d.      Acceleration of FHR with fetal movements

11.  The rationale for inserting a French catheter every hour for the client with epidural anesthesia is:

a.       The bladder fills more rapidly because of the medication used for the epidural.

b.      Her level of consciousness is such that she is in a trancelike state.

c.       The sensation of the bladder filling is diminished or lost.

d.      She is embarrassed to ask for the bedpan that frequently.

12.  A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:

a.       Estrogen levels are low.

b.      Lutenizing hormone is high.

c.       The endometrial lining is thin.

d.      The progesterone level is low.

13.  A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:

a.       Age of the client

b.      Frequency of intercourse

c.       Regularity of the menses

d.      Range of the client’s temperature

14.  A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?

a.       Intrauterine device

b.      Oral contraceptives

c.       Diaphragm

d.      Contraceptive sponge

15.  The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of ectopic pregnancy?

a.       Painless vaginal bleeding

b.      Abdominal cramping

c.       Throbbing pain in the upper quadrant

d.      Sudden, stabbing pain in the lower quadrant

16.  The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?

a.       Hamburger pattie, green beans, French fries, and iced tea

b.      Roast beef sandwich, potato chips, baked beans, and cola

c.       Baked chicken, fruit cup, potato salad, coleslaw, yogurt, and iced tea

d.      Fish sandwich, gelatin with fruit, and coffee

17.  The client with hyperemesis gravidarum is at risk for developing:

a.       Respiratory alkalosis without dehydration

b.      Metabolic acidosis with dehydration

c.       Respiratory acidosis without dehydration

d.      Metabolic alkalosis with dehydration

18.  A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:

a.       Elevated human chorionic gonadatropin

b.      The presence of fetal heart tones

c.       Uterine enlargement

d.      Breast enlargement and tenderness

19.  The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be:

a.       Hypoglycemic, small for gestational age

b.      Hyperglycemic, large for gestational age

c.       Hypoglycemic, large for gestational age

d.      Hyperglycemic, small for gestational age

20.  Which of the following instructions should be included in the nurse’s teaching regarding oral contraceptives?

a.       Weight gain should be reported to the physician.

b.      An alternate method of birth control is needed when taking antibiotics.

c.       If the client misses one or more pills, two pills should be taken per day for 1 week.

d.      Changes in the menstrual flow should be reported to the physician.

21.  The nurse is discussing breastfeeding with a postpartum client. Breastfeeding is contraindicated in the postpartum client with:

a.       Diabetes

b.      Positive HIV

c.       Hypertension

d.      Thyroid disease

22.  A client is admitted to the labor and delivery unit complaining of vaginal bleeding with very little discomfort. The nurse’s first action should be to:

a.       Assess the fetal heart tones

b.      Check for cervical dilation

c.       Check for firmness of the uterus

d.      Obtain a detailed history

23.  A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:

a.       Her contractions are 2 minutes apart.

b.      She has back pain and a bloody discharge.

c.       She experiences abdominal pain and frequent urination.

d.      Her contractions are 5 minutes apart.

24.  The nurse is teaching a group of prenatal clients about the effects of cigarette smoke on fetal development. Which characteristic is associated with babies born to mothers who smoked during pregnancy?

a.       Low birth weight

b.      Large for gestational age

c.       Preterm birth, but appropriate size for gestation

d.      Growth retardation in weight and length

25.  The physician has ordered an injection of RhoGam for the postpartum client whose blood type is A negative but whose baby is O positive. To provide postpartum prophylaxis, RhoGam should be administered:

a.       Within 72 hours of delivery

b.      Within 1 week of delivery

c.       Within 2 weeks of delivery

d.      Within 1 month of delivery


Latest Comments
  1. axa

    i have learned alot..and it is immensely useful

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