NCLEX-PN
Best NCLEX Next Gen Prep
1. When a client who is 25 years of age asks the nurse when she should seek fertility counseling, the best response by the nurse is:
- A. "Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse."?
- B. "Fertility counseling should be sought when you have not been able to conceive after 6-9 months of unprotected intercourse."?
- C. "The average time it takes someone your age to conceive is 5.3 months, so if you haven't conceived by then, we can refer you."?
- D. "We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn't happen within a year."?
Correct answer: D
Rationale: The best response in this scenario is to offer immediate guidance while also indicating when fertility counseling should be sought. While Choice A is technically correct as guidelines recommend seeking fertility counseling after 1 year of unprotected intercourse, it lacks providing immediate guidance. Choice B suggests seeking counseling after 6-9 months, which is earlier than the standard recommendation of 1 year. Choice C mentions the average time to conceive for someone of the client's age without addressing the client's current concern. Therefore, Choice D is the most appropriate response as it offers immediate guidance along with a plan for referral if needed.
2. When should rehabilitation services begin?
- A. when the client enters the health care system.
- B. after the client requests rehabilitation services.
- C. after the client's physical condition stabilizes.
- D. when the client is discharged from the hospital.
Correct answer: A
Rationale: Rehabilitation services should begin when the client enters the health care system to ensure early intervention and optimal outcomes. Initiating rehabilitation early can prevent complications, maximize recovery potential, and improve overall health outcomes. Choice B is incorrect because delaying rehabilitation until the client requests it may result in missed opportunities for timely intervention. Choice C is incorrect as waiting for the client's physical condition to stabilize can lead to unnecessary delays in starting the rehabilitation process, potentially slowing down recovery progress. Choice D is incorrect because starting rehabilitation only after discharge can hinder the recovery process by missing out on crucial early stages of intervention and support.
3. A pregnant client is being educated by a nurse on nutrition and foods rich in folic acid. Which food item does the nurse inform the client contains the highest amount of folic acid?
- A. Pinto beans
- B. Lettuce
- C. Oranges
- D. Broccoli
Correct answer: A
Rationale: Pinto beans contain the highest amount of folic acid among the options provided, with 294 mcg per 1-cup serving. Oranges contain 44 mcg per 1-cup serving, lettuce contains 60 mcg per 1-cup serving, and broccoli contains 78 mcg per 1-cup serving. Therefore, pinto beans are the best choice for increasing folic acid intake during pregnancy. Choosing oranges, lettuce, or broccoli would not provide as much folic acid compared to pinto beans, making them less optimal choices for meeting folic acid requirements during pregnancy.
4. A nurse is determining the fetal heart rate (FHR) and places the fetoscope on the mother's abdomen to count the FHR. The nurse simultaneously palpates the mother's radial pulse and notes that it is synchronized with the sounds heard through the fetoscope. Which action should the nurse take?
- A. Count the FHR for 60 seconds, ensuring that it is synchronized consistently with the mother's radial pulse.
- B. Move the fetoscope to another area on the mother's abdomen to locate the fetal heart.
- C. Ask the mother to lie still while both the FHR and the radial pulse rate are counted.
- D. Count the FHR for 30 seconds and then count the radial pulse rate of the mother for 30 seconds.
Correct answer: B
Rationale: When auscultating the fetal heart rate, the nurse would place the fetoscope on the maternal abdomen, over the fetal back. The nurse would then palpate the mother's radial pulse. If her pulse is synchronized with the sounds from the fetoscope, the nurse would move the fetoscope to another area on the mother's abdomen to locate the FHR. The nurse needs to be sure that the FHR is what is actually being heard. Other sounds that may be heard are the funic sound (blood flowing through the umbilical cord) and the uterine sound (blood flowing through the uterine vessels). The funic sound is synchronized with the FHR; the uterine sound is synchronized with the mother's pulse. Therefore, moving the fetoscope to a different area will help in accurately locating and counting the fetal heart rate. Choice A is incorrect because counting for 60 seconds without changing the position may not address the issue of accurately locating the FHR. Choice C is incorrect as it does not address the need to reposition the fetoscope to locate the fetal heart. Choice D is incorrect because counting the FHR and the radial pulse rate separately may not help in differentiating the two sounds.
5. People who live in poverty are most likely to obtain health care from:
- A. their primary care physician (family doctor)
- B. a neighborhood clinic
- C. specialists
- D. Emergency Departments or urgent care centers
Correct answer: D
Rationale: Individuals living in poverty often face barriers to accessing regular healthcare services, leading them to utilize Emergency Departments or urgent care centers as their primary source of healthcare. These facilities provide immediate care without the need for appointments or insurance, making them more accessible to those in poverty. While primary care physicians and neighborhood clinics are essential for preventive care, individuals in poverty may have difficulty accessing these services due to financial constraints or lack of insurance. Specialists typically require referrals and may not be easily accessible to individuals without stable healthcare coverage. Therefore, Emergency Departments or urgent care centers are the most likely healthcare option for people living in poverty.
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