NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022), Exams of Nursing

Download NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) and more Exams Nursing in PDF only on Docsity! NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10(75 Questions & Answers Updated 2022) 1.1. Question The nurse should visit which of the following clients first? o A. The client with diabetes with a blood glucose of95mg/dL o B. The client with hypertension being maintained onLisinopril o C. The client with chest pain and a history ofangina NCLEX-RN Exam Pack Set 10 (75 2022) consists of angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs), diuretics (usually thiazides), calcium channel blockers (CCBs), and beta-blockers (BBs), which are instituted taking into account age, race, and comorbidities such as presence of renal dysfunction, LV dysfunction, heart failure, and cerebrovascular disease. JNC-8, ACC, and ESC/ ESH have their separate recommendations for pharmacological management. o Option D: The client in answer D is in no distress. In Raynaud phenomenon, blood-flow restriction occurs during cold temperatures and emotional stress. Specifically, in Raynaud phenomenon, there is vasoconstriction of the NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 2. Question A client with cystic fibrosis is taking pancreatic enzymes. Thenurse should administer this medication: o A. Once per day in the morning o B. Three times per day with meals o C. Once per day at bedtime NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) Q N NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) Correct Answer: C. X-ray the leg. Following triage, an x-ray should be performed to rule out fracture. Review follow-up and serial X-rays. Provides visual evidence of proper alignment or beginning callus formation andhealing process to determine the level of activity and need for changes in or additional therapy. o Option A: Ice, not heat, should be applied to a recentsports injury. Apply cold or ice pack first 24–72 hr and as necessary. Reduces edema and hematoma formation, decreases pain sensation. Note: Length of application depends on degree of patient comfort andas long as the skin is carefully protected. o Option B: An elastic bandage may be applied. Maintain immobilization of affected part by means of bed rest, cast, splint, traction. Relieves pain and prevents bone displacement and extension of tissue injury. Elevate and support injured extremity. Promotesvenous return, decreases edema, and may reduce pain. o Option D: Pain medication can be given once fracture has been excluded. Medicate before care activities. Let the patient know it is NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) Bupivacaine is a potent local anesthetic with unique characteristics from the amide group of local anesthetics, first discovered in 1957. Local anesthetics are used in regional anesthesia, epidural anesthesia, spinal anesthesia, and local infiltration. Local anesthetics generally block the generation of an action potential in nerve cells by increasing the threshold for electrical excitation. o Option B: The eye doctor may dilate the pupils with a special medication called a mydriatic, so they can see the inside of the eye during a slit lamp test. Typically, mydriasis reverses within 4 to 8 hours. However, it may take 24 hours for the mydriatic effect to wear off in some individuals. Weaker strength may cause mydriasis with little cycloplegia. o Option D: Scopolamine ophthalmic is an anticholinergic agent that blocks constriction of sphincter muscle of iris and ciliary body muscle, which, in turn, results in mydriasis (dilation) and cycloplegia (paralysis of accommodation). Scopolamine competitively inhibits G-protein coupled post-ganglionic muscarinic receptors for acetylcholine and acts as a nonselective muscarinic antagonist, producing both peripheral antimuscarinic properties and central sedative, NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 5. Question A client with a severe corneal ulcer has an order for Gentamicingtt. q 4 hours and Neomycin 1 gtt q 4 hours. Which of the following schedules should be used when administering the drops? o A. Allow 5 minutes between the two NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) oC. The medications should be separated by a cycloplegicdrug. oD. The medications should not be used in the sameclient. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) medications. o B. The medications may be used together. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) uestions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Q Correct Answer: A. Allow 5 minutes between the two medications. When using eye drops, allow 5 minutes between the two medications. Antibiotic eye drops are prescribed by a doctor totreat bacterial eye infections. They work by killing the bacteria(microscopic organism) that entered the eye and caused the infection. o Option B: Allow 5 minutes interval before administering the next eyedrops. Take the full course, don’t stop early/without consulting your doctor, even ifthings seem better. Antibiotic eye drops usually help symptoms get better after three days. Call your doctorif your symptoms don’t go away. o Option C: It is not necessary to use a cycloplegic withthese medications. Eye infections cause redness, tearing and drainage (yellow-green pus or watery), and can be highly contagious. A certain type of eye infection—a bacterial eye infection—may need treatment with a medicine called an antibiotic eye drop. o Option D: These medications can be used by the same client. Don’t use anyone else’s NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) Correct Answer: B. Violet Clients with color blindness will most likely have problems distinguishing violets, blues, and green. The most common formsare protanopia and deuteranopia, conditions arising from loss of function of one of the cones, leading to dichromic vision. Protanopia is the loss of L cones (red) resulting in green- blue vision only. Deuteranopia is the loss of M cones (green) resultingin red-blue vision only. o Option A: Color vision results from the combination ofsignals from three visual pigment types within cones: that of red, green, and blue, which correspond to conetypes L, M, and S (RGB-LMS). Those colors correspond to the wavelengths of peak light absorption 000 of the modified chromophores. L cones have peak absorptions at 555 nm to 565 nm, M cones at 0 nm to 537 nm, and S cones at 415 nm to 430 nm. o Option C: Similar to above, but not as severe in its symptoms, is the condition anomalous trichromatic vision (tritanomaly), where all three cones are presentbut the color vision is aberrant. The two common forms, protanomaly, NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) and deuteranomaly result in L or M cones, respectively, being replaced with a cone of intermediate spectral tuning. Both are X-linked and occur in 7% of males. o Option D: In addition to disorders of proper color recognition, many diseases in vision display phototransduction defects affecting many portions of the signal pathway and its regulation. Here, not only iscolor vision function lessened but scotopic (low-light, rod-associated) vision as well. • 7. Question The client with a pacemaker should be taught to: o A. Report ankle edema o B. Check his blood pressure daily o C. Refrain from using a microwave oven o D. Monitor his pulse rate NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) tamponade, pneumothorax, coronary sinus dissection, or perforation. Some old pacemakers are not MRI safe. o Option B: Checking the blood pressure daily is not necessary for these clients. Patients who eventually require permanent pacemaker implantation often present with symptoms of dizziness, lightheadedness,fatigue, syncope, or lack of exercise tolerance. Frequently, these symptoms arise from bradyarrhythmias and patients will have sinus node dysfunction or atrioventricular (AV) conduction defects. o Option C: The client with a pacemaker can use a microwave oven, but he should stand about 5 feet from the oven while it is operating. There are some areas where the indications for a pacemaker are clear,but there are few areas where clinical judgment and expertise plays a greater role. Although the guidelinesattempt to define practices that meet the needs of most patients, the ultimate decision for the patient should be based on the particular patient presenting NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o Option B: It is important to go to the toilet at regular intervals so that your bladder gets used to a certain frequency. A voiding (bathroom visit) schedule can be helpful here. Bladder training programs often recommend that, once you have emptied your bladderfirst thing in the morning and perhaps again after breakfast, you try to keep the intervals between bathroom visits as regular as possible. o Option C: Even if you have a very strong urge to go to the bathroom, it usually only lasts a few minutes and then dies down again. You can practice not emptying your bladder as soon as you feel the need togo. Going to the bathroom calmly and at a slow pace rather than rushing to get there can help too. o Option D: You can try to wait longer between trips to the bathroom, but do so at a slow pace and without any stress. A voiding schedule can be helpful here too.You can use it to remember, for example, that you NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) want to try to wait 5 minutes before emptying your bladder in the first few days, and then keep this up for about half a week. You can then lengthen that “waiting period” to 10, 15 and NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 9. Question Which of the following diet instructions should be given to theclient with recurring urinary tract infections? o A. Increase intake of meats. o B. Avoid citrus fruits. o C. Perform peri care with hydrogen peroxide. o D. Drink a glass of cranberry juice every day. Correct Answer: D. Drink a glass of cranberry juice everyday. Cranberry juice is more alkaline and, when metabolized by the body, is excreted with acidic urine. Bacteria do not grow freely inacidic urine. A 2003 study that included 324 women found that frequently drinking freshly squeezed, 100% juice — especially berry juice, as well as consuming fermented dairy products like yogurt, was associated with NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) douching, although strong evidence to support these claims is lacking. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 10. Question The physician has prescribed NPH insulin for a client with diabetes mellitus. Which statement indicates that the clientknows when the peak action of the insulin occurs? o A. "I will make sure I eat breakfast within 2 hours oftaking my insulin." o B. "I will need to carry candy or some form of sugar withme all the time." o C. "I will eat a snack around three o'clock eachafternoon." NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o Option B: NPH insulin is time-released and does not usually cause sudden hypoglycemia. NPH insulin is an isophane suspension of human insulin and categorized as an intermediate- acting insulin. It helps increase the cellular intake of glucose in the liver, adipose tissue, and skeletal muscles. It acts as basal insulin and stimulates the liver to promote hepatic glycogen synthesis, fatty acid metabolism for lipoprotein synthesis. o Option D: The client should eat a bedtime snack. NPH cannot classify as ideal basal insulin. It shows much variability in its absorption and action after subcutaneous injection. This situation leads to fluctuations in blood glucose control and causes hypoglycemic episodes. For this reason, it requires meticulous monitoring, including fasting blood glucose, NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 11. Question The nurse is caring for a 30-year-old male admitted with a stab wound. While in the emergency room, a chest tube is inserted. Which of the following explains the primary rationale for insertionof chest tubes? o A. The tube will allow for equalization of the lungexpansion. o B. Chest tubes serve as a method of draining blood and serous fluid and assist in re inflating thelungs. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) oD. Chest tubes assist with cardiac function by stabilizinglung expansion. Correct Answer: B. Chest tubes serve as a method of draining blood and serous fluid and assist in re inflating the lungs. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o C. Chest tubes relieve pain associated with a collapsedlung. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) majority are fenestrated along the sides of the insertion end, and the tubes have a radiopaque stripe. After placement, the distal end of the tube is connected to a pleur-evacsystem. There are three chambers of a pleur- evac: suction chamber, water seal chamber, and the collection chamber. The water seal chamber acts as a one- way valve allowing air to escape from gravity, butnot to re-enter the thoracic cavity. • 12. Question A client who delivered this morning tells the nurse that she plansto breastfeed her baby. The nurse is aware that successful breastfeeding is most dependent on the: o A. Mother’s educational level o B. Infant’s birth weight o C. Size of the mother’s breast NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o D. Mother’s desire to breastfeed Correct Answer: D. Mother’s desire to breastfeed Success with breastfeeding depends on many factors, but the most dependable reason for success is desire and willingness tocontinue breastfeeding until the infant and mother have time toadapt. Breastfeeding is an important part of a newborn’s life. Breastfeeding or lactation provides total nutritional and emotionaldependency of the baby on the mother. The strong emotional bonding between the mother-child dyad is needed for successfully prolong breastfeeding. o Option A: Baby and maternal factors can influence this bonding. Skin-to- skin contact in the first 2 hours after birth is essential for successful initiation of lactation. The breast crawl, soon after birth, while thebaby is alert will initiate the bonding, and it will be an assurance by giving comfort and calm to the mother. The breast crawl is when the baby is placed on the mother’s abdomen after birth; the baby finds its way to the breast to suckle. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o C. The presence of green-tinged amniotic fluid o D. Moderate uterine contractions Correct Answer: C. The presence of green- tinged amnioticfluid Green-tinged amniotic fluid is indicative of meconium staining. This finding indicates fetal distress. Amniotic fluid should be clear,or straw tinged with small vernix particles in the fluid. Brown or green staining of the fluid indicates the passage of meconium. Because the fetus swallows amniotic fluid in utero, meconium canbe present in the infant’s oropharynx at delivery. During delivery, if meconium-stained amniotic fluid is noted, a neonatal resuscitation team should be promptly involved o Option A: In the third trimester, bleeding is concerning for placental abruption, placenta previa, orlabor. Each of these pathologies has its entry discussing its presentation and pathophysiology. Although bleeding in pregnancy is not considered “normal,” it is common, affecting about one in three pregnancies. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o Option B: An increased urge to urinate can be a resultof the baby’s head dropping into the pelvis. The low position of the baby’s head puts even more pressure on the urinary bladder, so many women approaching labor might feel a frequent need to urinate. o Option D: Although precisely determining when laborstarts may be inexact, labor is generally defined as beginning when contractions become strong and regularly spaced at approximately 3 to 5 minutes apart. Throughout pregnancy, women may experiencepainful contractions that do not lead to cervical dilation or effacement, referred to as false labor. • 14. Question The nurse is measuring the duration of the client’s contractions.Which statement is true regarding the measurement of the duration of contractions? Questi NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) timedfrom the start of one contraction to the start of the next. It includes the contraction as well as the rest period until the next contraction begins. Option B: We do not measure from the end of one contraction to the beginning of the next contraction. Contractions are considered regular when the durationand frequency are stable over a period of time. An example is contractions lasting 60 seconds and coming five minutes apart for an hour. o Option D: Duration is not measured from the peak of the contraction to the end, as stated in D. Contractionsthat are lasting longer and getting closer together are considered to be progressing. Over the course of labor,contractions get longer, stronger, and closer together. • 15. Question The physician has ordered an intravenous infusion of Pitocin forthe induction of labor. When caring for the obstetric client receiving intravenous Pitocin, the nurse should monitor for: NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) or even slowly during 24 hours, the medication can exhibit an antidiuretic effect resulting in extreme water intoxication. This excessive dosing can result incoma, seizures, and even death in the mother. o Option D: When oxytocin is given to women who arein the first or second stages of labor, or to women to cause induction of labor, uterine rupture, as well as maternal subarachnoid hemorrhages, maternal death,and even fetal death, can result. • 16. Question A client with diabetes visits the prenatal clinic at 28 weeks gestation. Which statement is true regarding insulin needs duringpregnancy? o A. Insulin requirements moderate as the pregnancyprogresses. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o B. A decreased need for insulin occurs during the secondtrimester. o C. Elevations in human chorionic gonadotropin decreasethe need for insulin. o D. Fetal development depends on adequateinsulin regulation. Correct Answer: D. Fetal development depends on adequate insulin regulation. Fetal development depends on adequate nutrition and insulin regulation. Significant alterations in maternal metabolism duringpregnancy ensure a continuous supply of nutrients to the fetus. Glucose is the primary energy source for the fetus. In early pregnancy, increases in maternal insulin sensitivity enable the storage of energy and nutrients. o Option A: Insulin requirements do not moderate as the pregnancy progresses. To counteract insulin resistance and achieve adequate metabolic control inlate pregnancy, the dose of insulin may need to be increased. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) -RN Exam Pack Set 10 (75 ons & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) A client in the prenatal clinic is assessed to have a blood pressureof 180/96. The nurse should give priority to: o A. Providing a calm environment o B. Obtaining a diet history o C. Administering an analgesic o D. Assessing fetal heart tones Correct Answer: A. Providing a calm environment A calm environment is needed to prevent seizure activity. Any stimulation can precipitate seizures. Establish measures to lessenlikelihood of seizures; i.e., keep the room quiet and dimly lit, limitvisitors, plan and coordinate care, and promote rest. Lessens environmental factors that may stimulate irritable cerebrum and cause a convulsive state. NCLEX Questi o Option B: Obtainin g a diet history should be done later. Determi ne patient’ s nutrition al status, conditio nof hair and nails, and height and pregravi d weight. Establis hes guidelin es for situation as stated in answer D. Assess for signs of impending eclampsia: hyperactivity of deep tendon reflexes (3+ to 4+), ankle clonus, decreased pulse and respirations, epigastric pain, and oliguria (less than 50 ml/hr). NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 18. Question A primigravida, age 42, is 6 weeks pregnant. Based on theclient’s age, her infant is at risk for: o A. Down syndrome o B. Respiratory distress syndrome o C. Turner’s syndrome o D. Pathological jaundice Correct Answer: A. Down syndrome The client who is age 42 is at risk for fetal anomalies such as Down syndrome and other chromosomal aberrations. The risk ofchromosome abnormalities is higher. Babies born to older mothers have a higher risk of certain chromosome problems, such as Down syndrome. -RN Exam Pack Set 10 (75 ons & Answers Updated 2022) NCLEX Questi NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o Option B: Risk factors for respiratory distress syndrome include prematurity, maternal diabetes, cesarean delivery, and asphyxia. The mother will morelikely have a low birth weight baby and a premature birth. Premature babies, especially those born earliest,often have complicated medical problems. o Option C: Turner’s syndrome is a genetic disorder. Turner syndrome results from a deletion or the non- functioning of one X chromosome in females. About half of the population with Turner syndrome have monosomy X (45,XO). The other 50% of the populationhas a mosaic chromosomal component (45,X with mosaicism). Option D: Premature infants are at most risk for pathological jaundice because they develop higher levels of bilirubin. The risk of pregnancy loss — by miscarriage and stillbirth — increases as you get older, NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) Correct Answer: C. Dinoprostone (Prostin E.) The client with a missed abortion will have induction of labor. Prostin E. is a form of prostaglandin used to soften the cervix. Prostaglandin E2 (PGE2), also known by the name dinoprostone, is a naturally occurring compound that is involved in promoting labor, though it is also present in the inflammatory pathway. Prostaglandin E2 is FDA approved for cervical ripening for the induction of labor in patients for which there is a medical indication for induction. o Option A: Magnesium sulfate is used for preterm labor and preeclampsia. Magnesium sulfate is a naturally occurring mineral used to control low blood levels of magnesium. Magnesium injection is also used for pediatric acute nephritis and to prevent seizures in severe pre-eclampsia, eclampsia, or toxemia of pregnancy. o Option B: Calcium gluconate is the antidote for magnesium sulfate. Calcium gluconate is typically administered intravenously (IV) or orally in the treatment of hypocalcemia, cardiac arrest, or o D. Bromocriptine (Parlodel) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) cardiotoxicity due to hyperkalemia or hypermagnesemia. Calcium gluconate has also been used off-label in the management of ?- blocker toxicity, calcium-channel blocker (CCB) toxicity, magnesium toxicity, and hydrofluoric acid burns. o Option D: Pardel is a dopamine receptor stimulant used to treat Parkinson’s disease. Bromocriptine is also used as an early treatment for PD to delay the onset of the use of levodopa, ultimately delaying the likely dyskinesia and motor fluctuations that occur NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 20. Question A client with preeclampsia has been receiving an infusion containing magnesium sulfate for a blood pressure that is 160/80;deep tendon reflexes are 1 plus, and the urinary output for the past hour is 100mL. The nurse should: o A. Continue the infusion of magnesium sulfatewhile monitoring the client’s blood pressure o B. Stop the infusion of magnesium sulfate and contactthe physician o C. Slow the infusion rate and turn the client on her leftside NCLEX-RN Exam Pack Set 10 (75 magnesium sulfate can be given parenterally to replete low serum concentrations with recommended follow up laboratory testing. o Option C: There is no need to stop the infusion at this time or slow the rate. If patients exhibit signs and symptoms of hypermagnesemia, the recommendation is to discontinue magnesium sulfate products immediately. If the patient consumed magnesium sulfate orally, then the use of magnesium-free enemas or cathartics can be useful in removing excess magnesium from the GI tract. o Option D: Calcium gluconate is the antidote for magnesium sulfate, but there is no data to indicate toxicity. Patients should receive parenteral doses of calcium gluconate to help alleviate symptoms, but continued doses may be necessary as the calcium provides NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 21. Question A mother complains to the clinic nurse that her 2 ½-year- old son is not yet toilet trained. She is particularly concerned that, although he reliably uses the potty seat for bowel movements, heisn’t able to hold his urine for long periods. Which of the followingstatements by the nurse is correct? o A. The child should have been trained by age 2 and mayhave a psychological problem that is NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) bowel control, and the child should be required to sit on the pottyseat until he passes urine. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) responsible for his "accidents." o B. Bladder control is usually achieved before NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) and is much more commonly related to individual developmental maturity. Timing is important. Toilet training should not be started when the child is feelingill or when the child is experiencing any major life changes such as moving, new siblings, new school, or new child- care situation. o Option B: Bowel control is first achieved before bladder control. Start a routine with regular remindersbeginning with one time a day—after breakfast or maybe at bath time when the child is already undressed. Watch for behavior, grimaces, or poses that may signal the need for a bowel movement, and ask the child if he or she needs to go. o Option D: Reprimanding the child will not speed the process and may be confusing. Accidents are commonand should be expected in the training process. Praise the child whenever he or she tells you that he/she needs to go and when the child tells you without beingreminded. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o 50% chance that the child would be a carrier, and 25% chance that they would be homozygous dominant andunaffected. • 22. Question A pregnant client, age 32, asks the nurse why her doctor hasrecommended a serum alpha fetoprotein. The nurse shouldexplain that the doctor has recommended the test: o A. Because it is a state law o B. To detect cardiovascular defects o C. Because of her age o D. To detect neurological defects NCLEX-RN Exam Pack Set 10 (75 NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) usually interpreted for age, race, weight, and gestational age. The elevated levels imply a significant risk of having birth defects, hence, further evaluation may be required to assess the level of risk. o Option C: The mother’s age has no bearing on the need for the test, so answer C is . A significant numberof patients with elevated maternal AFP do not develop birth defects, but there may be an increased risk of obstetric complications like premature rupture of membrane, placenta accreta, increta, and packet. • 23. Question A client with hypothyroidism asks the nurse if she will still need totake thyroid medication during the pregnancy. The nurse’s response is based on the knowledge that: o A. There is no need to take thyroid medication because the fetus’s thyroid produces a thyroid- stimulating hormone. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) o B. Regulation of thyroid medication is more difficult because the thyroid gland increases in sizeduring pregnancy. o C. It is more difficult to maintain thyroid regulationduring pregnancy due to a slowing of metabolism. o D. Fetal growth is arrested if thyroid medication iscontinued during pregnancy. Correct Answer: B. Regulation of thyroid medication is more difficult because the thyroid gland increases in sizeduring pregnancy. During pregnancy, the thyroid gland triples in size. This makes itmore difficult to regulate thyroid medication. During pregnancy, there are increased metabolic needs of the maternal body resulting in changes in thyroid physiology. These changes in thyroid physiology reflect in altered thyroid function tests. o Option A: There could be a need for thyroid medication during pregnancy. The serum TSH concentration is the as well as an increase in renal iodine clearance. Along with the NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) -RN Exam Pack Set 10 (75 ons & Answers Updated 2022) above two factors, there is also a fetal iodine requirement; therefore, dietary iodine requirements are higher during pregnancy. NCLEX-RN Exam Pack Set 10 (75 Questions & Answers Updated 2022) • 24. Question The nurse is responsible for performing a neonatal assessment ona full-term infant. At 1 minute, the nurse would expect to find: o A. An apical pulse of 100 o B. An absence of tonus o C. Cyanosis of the feet and hands o D. Jaundice of the skin and sclera Correct Answer: C. Cyanosis of the feet and hands Cyanosis of the feet and hands is acrocyanosis. This is a normal finding 1 minute after birth. Acrocyanosis is bluish discoloration around the mouth and extremities, with the remaining area pink. It is a benign finding often seen in healthy newborns and is common in the initial days of life due to initial peripheral vasoconstriction. This is managed by routine newborn care. The routine newborn care NCLEX Questi