NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 981:

  An Rh-negative woman with previous sensitization has delivered an Rh-positive fetus.

  Which of the following nursing actions should be included in the client's care plan?

  A. emotional support to help the family deal with feelings of guilt about the infant's condition

  B. administration of MICRhoGam to the woman within 72 hours of delivery

  C. administration of Rh-immune globulin to the newborn within 1 hour of delivery

  D. lab analysis of maternal Direct Coombs' test

  Correct Answer: A

  If a woman is sensitized to the Rh factor, it poses a threat to any Rh-positive fetus she delivers. The nurse needs to provide emotional support to help the family deal with the infant's condition, which might involve a host of conditions that could lead to death or marked neurological damage. RhoGam is never given to a woman already sensitized. If not previously sensitized, MICRhoGam (a smaller dose of Rh immune globulin) is given after an abortion or ectopic pregnancy to prevent sensitization. If not sensitized, RhoGam is given to the woman within 72 hours of delivery. Rh-immune globulin is never given to the newborn. To determine if sensitization has occurred, an Indirect Coombs' is drawn on the mother to measure the number of Rh-positive antibodies.

• Question 982:

  A client, age 28, is 81/2 months pregnant.

  She is most likely to display which normal skin-color variation?

  A. vitiligo

  B. erythema

  C. cyanosis

  D. chloasma

  Correct Answer: D

  Chloasma, also known as the mask of pregnancy, is described as tan-to-brown patches on the face. This hyperpigmentation results from hormonal changes.

• Question 983:

  Which is the best way to position a client's neck for palpation of the thyroid?

  A. flexed toward the side being examined

  B. hyperextended directly backward

  C. flexed away from the side being examined

  D. flexed directly forward

  Correct Answer: A

  Flexed toward the side being examined.

• Question 984:

  An assessment of the skull of a normal 10-monthold baby should identify which of the following?

  A. Closure of the posterior fontanel.

  B. Closure of the anterior fontanel.

  C. Overlap of cranial bones.

  D. Ossification of the sutures.

  Correct Answer: A

  The posterior fontanel should close by the age of 2 months.

• Question 985:

  The nurse teaching an obese client about nutritional needs and weight loss should include all of the following except __________.

  A. knowledge of food and food products

  B. development of a positive mental attitude

  C. adequate exercise

  D. starting a fast weight-loss diet

  Correct Answer: D

  Start a fast weight-loss diet.

• Question 986:

  A concern regarding maternal and infant mortality and morbidity is that __________.

  A. a segment of the population is not receiving prenatal care

  B. families appear unconcerned about quality health care

  C. the personnel shortage in the maternity field will increase

  D. maternal-child health workers are not adequately prepared

  Correct Answer: A

  There is a concern that a segment of the population is not accessing prenatal care, affecting infant and maternal mortality and morbidity.

• Question 987:

  A 2-year-old child diagnosed with HIV comes to a clinic for immunizations.

  Which of the following vaccines should the nurse expect to administer in addition to the scheduled vaccines?

  A. pneumococcal vaccine

  B. hepatitis A vaccine

  C. Lyme disease vaccine

  D. typhoid vaccine

  Correct Answer: A

  Pneumococcal vaccine should be administered as a supplemental vaccine.

  Hepatitis A vaccine is for travelers and individuals with chronic liver disease.

  The Lyme disease vaccine is for people between the ages of 15 and 70 who are at risk for Lyme disease

  (transmitted by ticks primarily).

  The typhoid vaccine is for workers in microbiology laboratories who frequently work with Salmonella typhi.

• Question 988:

  Vaccines provide what type of immunity?

  A. active

  B. passive

  C. transplacental

  D. active and passive

  Correct Answer: A

  Vaccines provide active immunity.

  Passive immunity comes from antibodies produced in another human or host.

  Transplacental immunity comes from passive immunity transferred from mother to infant.

• Question 989:

  As part of a routine health screening, the nurse notes the play of a 2-year-old child.

  Which of the following is an example of age-appropriate play at this age?

  A. builds towers with several blocks

  B. tries to color within the lines

  C. says "Mine!" when playing with toys

  D. tries to jump rope

  Correct Answer: C

  Toddlers are possessive and struggle for independence.

  The other play activities are too advanced for a 2-year-old child.

• Question 990:

  In conducting a health screening for 12-month-old children, the nurse expects them to have been immunized against which of the following diseases?

  A. measles, polio, pertussis, hepatitis B

  B. diptheria, pertussis, polio, tetanus

  C. rubella, polio, pertussis, hepatitis A

  D. measles, mumps, rubella, polio

  Correct Answer: B

  By 12 months of age, the child should have had DtaP and polio. MMR is not administered until a child is 12 months of age.