The laboring client is requesting IV pain medication instead of epidur

NCLEX Maternity Questions

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Question 1 of 5.

The laboring client is requesting IV pain medication instead of epidural anesthesia. The nurse determines that which factor would most definitely contraindicate the administration of nalbuphine hydrochloride?

A. Completely dilated and 100 percent effaced

B. Fetal heart rate (FHR) of 120 beats per minute

C. Reassuring FHR variability and accelerations

D. Variable decelerations with reassuring FHR

Explanation: Systemic medications, such as nalbuphine hydrochloride (Nubain), should not be administered when advanced dilation is present (transition stage of labor) because its use can lead to respiratory depression if given too close to the time of delivery. An FHR of 120 bpm is within normal parameters of 120 to 160 bpm. Reassuring FHR variability and accelerations are interpreted as adequate placental oxygenation and do not contraindicate administration of nalbuphine hydrochloride. If mild variable decelerations are present but the FHR pattern remains reassuring, nalbuphine hydrochloride can still be administered.

Question 2 of 5.

When the client asks the nurse about the viability of the ovum after ovulation, the nurse correctly explains that after ovulation, the ovum remains alive for how many hours?

A. 2 hours

B. 24 hours

C. 48 hours

D. 72 hours

Explanation: The ovum remains viable for approximately 24 hours after ovulation, during which it can be fertilized by sperm.

Question 3 of 5.

The nurse correctly sends a requisition and specimen for which laboratory test?

A. Alpha-fetoprotein (AFP)

B. Corticotropin-releasing hormone (CRH)

C. Human chorionic gonadotropin (hCG)

D. Follicle-stimulating hormone (FSH)

Explanation: Human chorionic gonadotropin (hCG) is the hormone tested to confirm pregnancy, as it is produced by the placenta shortly after implantation.

Question 4 of 5.

According to the TPAL method, which of the following reflects the client's obstetric history?

A. T-III, P-0, A-0, L-III

B. T-III, P-II, A-0, L-0

C. T-III, P-II, A-0, L-II

D. T-III, P-0, A-0, L-III

Explanation: TPAL: Term (3, one son and twin daughters), Preterm (0), Abortions (0), Living (3). The client has three term deliveries and three living children.

Question 5 of 5.

Which action by the nurse best ensures that an accurate fetal heart rate is obtained?

A. Assess the fetal heart rate when the client is lying on her right side.

B. Assess the fetal heart rate when the client reports fetal movement.

C. Assess the fetal heart rate between Braxton Hicks contractions.

D. Assess the maternal pulse and fetal heart rate, and compare the two.

Explanation: Comparing maternal pulse with fetal heart rate ensures the nurse is not mistaking the maternal pulse for the fetal heartbeat.