Rapid Prep Worksheets 3

GTPAL Practice Worksheet 1. 42 year old female in her second trimester. She has 4 previous pregnancies. Her first two children were born at 39 and 37 weeks. Her third child was born at 35 weeks. Her fourth child miscarried at 22 weeks and did not survive. a. G______ T_______ P ______ A ______ L______ 2. A 29 year old patient with a history of 2 miscarriages at 8 and 18 weeks, twins born at 34 weeks that are still living, and is currently in her 3rd trimester with a singleton pregnancy. a. G______ T_______ P ______ A ______ L______ 3. A 19 year old patient in her first pregnancy. a. G______ T_______ P ______ A ______ L______ 4. A 32 year old patient currently 15 weeks pregnant. She has had two other pregnancies. She delivered a boy at 39 weeks gestation, and a girl at 38 weeks gestation. a. G______ T_______ P ______ A ______ L______ 5. A 41 year old patient who presents in her second trimester. She has a history of a healthy delivery at 38 weeks, and an emergency c-section at 29 weeks. a. G______ T_______ P ______ A ______ L______ 1 6. A 22 year old patient presents for her first prenatal appointment. She is estimated to be 8 weeks pregnant. Her OB history includes a twin pregnancy that was aborted at 12 weeks, and a singleton pregnancy ending in a c-section at 32 weeks where the infant did not survive. a. G______ T_______ P ______ A ______ L______ 7. A 35 year old patient arrives at the oce for her 36 week check up. In her history you note the following: one delivery at 39 weeks, one abortion at 12 weeks, one miscarriage at 22 weeks, and a twin delivery at 38 weeks. a. G______ T_______ P ______ A ______ L______ 8. A 29 year old patient currently in her first trimester has the following history: one spontaneous abortion at 12 weeks, one elective termination at 8 weeks, a twin pregnancy ending in an emergency c-section at 19 weeks where the infants did not survive, and a singleton pregnancy delivered at 32 weeks where the infant did survive. a. G______ T_______ P ______ A ______ L______ 9. A 16 year old patient presents to the ED actively miscarrying a pregnancy. She reports that she has never been pregnant before and did not know she was pregnant. What is her GTPAL after miscarrying this pregnancy? a. G______ T_______ P ______ A ______ L______ 10. A 26 year old patient is admitted to the L&D unit for delivery of a 38 week singleton pregnancy. She has a history of a twin pregnancy delivered at 36 weeks, and one miscarriage at 16 weeks. What is her GTPAL after delivery of this pregnancy? a. G______ T_______ P ______ A ______ L______ 2 GTPAL Practice Worksheet - Answers 1. 42 year old female in her second trimester. She has 4 previous pregnancies. Her first two children were born at 39 and 37 weeks. Her third child was born at 35 weeks. Her fourth child miscarried at 22 weeks and did not survive. a. G5 T2 P2 A0 L3 *Make sure to include the current pregnancy under G! 2. A 29 year old patient with a history of 2 miscarriages at 8 and 18 weeks, twins born at 34 weeks that are still living, and is currently in her 3rd trimester with a singleton pregnancy. a. G4 T0 P1 A2 L2 *Twins only count for ONE gestation, but TWO living children (if they’re living!) 3. A 19 year old patient in her first pregnancy. a. G1 T0 P0 A0 L0 4. A 32 year old patient currently 15 weeks pregnant. She has had two other pregnancies. She delivered a boy at 39 weeks gestation, and a girl at 38 weeks gestation. a. G3 T2 P0 A0 L2 5. A 41 year old patient who presents in her second trimester. She has a history of a healthy delivery at 38 weeks, and an emergency c-section at 29 weeks. a. G3 T1 P1 A0 L2 *If the delivery was between 20 and 37 weeks, count it under P! 3 6. A 22 year old patient presents for her first prenatal appointment. She is estimated to be 8 weeks pregnant. Her OB history includes a twin pregnancy that was aborted at 12 weeks, and a singleton pregnancy ending in a c-section at 32 weeks where the infant did not survive. a. G3 T0 P1 A1 L0 *Unless explicitly told in the question (like we see here), assume children are living. 7. A 35 year old patient arrives at the oce for her 36 week check up. In her history you note the following: one delivery at 39 weeks, one abortion at 12 weeks, one miscarriage at 22 weeks, and a twin delivery at 38 weeks. a. G5 T2 P1 A1 L3 *Miscarriages between 20 and 37 weeks still count under P. 8. A 29 year old patient currently in her first trimester has the following history: one spontaneous abortion at 12 weeks, one elective termination at 8 weeks, a twin pregnancy ending in an emergency c-section at 19 weeks where the infants did not survive, and a singleton pregnancy delivered at 32 weeks where the infant did survive. a. G5 T0 P1 A3 L1 *Spontaneous abortion, elective termination, and miscarriage will all fall under ‘A’, IF they occur before 20 weeks. 9. A 16 year old patient presents to the ED actively miscarrying a pregnancy, presumed to be 8 weeks or less. She reports that she has never been pregnant before and did not know she was pregnant. What is her GTPAL after miscarrying this pregnancy? a. G1 T0 P0 A1 L0 *Make sure you know if the question is asking you the GTPAL status before or after the current pregnancy. 10. A 26 year old patient is admitted to the L&D unit for delivery of a 38 week singleton pregnancy. She has a history of a twin pregnancy delivered at 36 weeks, and one miscarriage at 16 weeks. What is her GTPAL after delivery of this pregnancy? a. G3 T1 P1 A1 L3 *Don’t forget to add one under ‘L’ after this delivery! 4 Cumulative NCLEX Practice Test 1. A client has been admitted to the hospital with findings of urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement and has returned to normal hydration status if the blood urea nitrogen level is: a. 5 mg/dL b. 15 mg/dL c. 27 mg/dL d. 34 mg/dL 2. A client newly diagnosed with diabetes mellitus has a glycosylated hemoglobin A1c level of 10%. The nurse ensures that client teaching includes which of the following: a. Avoiding infection b. Taking in adequate fluids c. Preventing and recognizing hypoglycemia d. Preventing and recognizing hyperglycemia 3. A client in septic shock in the intensive care unit is receiving a Dopamine infusion. Upon assessment, the nurse notices that the client’s; blood pressure is 195/120 mm Hg. Which initial nursing action would the nurse implement? a. Discontinue dopamine. b. Notify the physician c. Administer Furosemide. d. Assess the clients’ GCS 4. The client is admitted for having unstable angina. The nurse caring for the client understands that nitroglycerin should not be given to the client if he manifests which sign or symptom? a. Atrial fibrillation b. A blood pressure of 78/59 mm Hg. c. Headache d. A warm flushed feeling 5. The nurse is caring for a client in the Intensive Care Unit in acute respiratory failure. The nurse should expect which ABG results? a. pH: 7.29; PCO2: 56; PaO2: 83; HCO3: 22 b. pH: 7.38; PCO2: 40; PaO2: 92; HCO3: 25 c. pH: 7.49; PCO2: 34; PaO2: 96; HCO3: 28 d. pH: 7.40; PCO2: 65; PaO2: 85; HCO3: 16 6. A client in his early 60s is brought to the ER complaining of shortness of breath. Initial assessment findings include crackles, finger clubbing, and dry cough. The client states that he has previously worked in construction for 15 years. The ER physician suspects asbestosis. Which nursing problem should the nurse prioritize in the client? a. Impaired gas exchange b. Imbalanced nutrition: Less than body requirements c. Fatigue d. Ineffective airway clearance 7. A nurse is reviewing the arterial blood gas results of a client and notes the following: pH 7.45, PCO2 of 30 mm Hg, and HCO3-of 22 mEq/L. Which of the following conditions do these results indicate? a. Metabolic acidosis, compensated b. Respiratory alkalosis, compensated c. Metabolic alkalosis, uncompensated d. Respiratory acidosis, uncompensated 8. A middle-aged African American is being treated in the emergency room for a sickle cell crisis. Which position should the nurse place the patient in? a. Side-lying with flexed knees b. Fetal position c. Semi-Fowler’s position with knees and hips bent d. Semi-Fowler’s with legs extended on the bed 9. The nurse is talking to a client that is being evaluated for possible acute leukemia. Which question by the nurse is most relevant? a. How has your sleep been recently? b. Did you have a respiratory infection recently? c. Did you lose weight the last couple of months? d. Have you noticed any changes in your bowels lately?” 10. During handoff, the nurse was informed that a patient’s serum potassium is 2.8 mEq/L. During rounds, the first thing that the nurse should assess in this client should be: a. Ability to balance while walking b. Quality of peripheral pulses c. Respiratory status looking out for shallow respirations d. Frequency of bowel movement 11. The infant just finished surgery for the repair of a malfunctioning ventriculoperitoneal shunt. Which symptom would indicate to the nurse that a problem could be arising? a. Increased urine output b. Depressed fontanels c. A decreased heart rate d. Irritability 12. A nurse is calling the physician regarding a new medication order because the dosage prescribed is higher than the usual recommended dosage. The nurse, however, is unable to locate the physician, and the medication is due to be administered. Which action should the nurse implement first? a. Contact the unit’s nursing supervisor b. Administer the dose as prescribed since the nurse is protected by a written order c. Hold the medication until the physician can be contacted and the order is clarified d. Administer what the nurse knows as the recommended dose until the physician can be located 13. A nurse employed in an emergency department is doing triage on the evening shift. Which of the following clients should be assigned the highest priority? a. A client complaining of muscle aches, a headache, and malaise that has been on for 5 hours b. A client who twisted her ankle when she fell while skateboarding c. A client with a minor laceration on the index finger sustained while slicing vegetables d. A client with chest pain whom claims that he just ate a very spicy pizza 2 hours ago 14. A client has just been transferred back to his room following a below-knee amputation of the right leg. The nurse is closely monitoring the client. Which sign would prompt the nurse to assess further as it could indicate a developing complication? a. The client is growing increasingly restless b. The client has a blood pressure of 127/78 mmHg c. The client has a pulse rate of 89 bpm d. Hypoactive bowel sounds were found upon auscultation of 4 quadrants 15. A nurse is conducting client teaching on a client receiving a monoamine oxidase inhibitor (MAOI) about his drug therapy. The client has demonstrated understanding by stating, I should avoid tyramine-containing foods, or I may go into hypertensive crisis. When asked to list down specific tyramine-containing foods, the client would be correct by including which of the following food? a. Cream cheese b. Swiss cheese c. Milk d. Ice cream 16. A client with thrombocytopenia is currently having epistaxis. The most appropriate nursing intervention should be: a. Instruct the client to lie flat with his neck suspended b. Ask the client to sit upright, leaning slightly forward c. Ask the client to blow his nose, then put lateral pressure on his nose d. Ask the client to hold his nose while bending forward from the waist 17. A 16-year-old adolescent is brought to the ER following an accident at a skating rink. The adolescent’s left knee is bruised and swollen. Upon interview, the nurse finds out that the adolescent has Hemophilia A. Which medication would be most appropriate for the client? a. Oxycodone a. Aspirin b. Ibuprofen c. Oxycodone terephthalate/acetylsalicylate 18. The client in a psychiatric clinic tells the nurse, I want to kill my wife. The moment I see I am going to kill her. What should be the nurse’s next action? a. Respect the client’s right to privacy and confidentiality. b. Document the client’s statements c. Notify the client’s psychiatrist of the comments. d. Explore the client’s feelings about his wife 19. A nurse is assigned to care for a 2-year-old who is newly diagnosed with acute lymphocytic leukemia. Which action should be included in the client’s plan of care that is directed to facilitate growth and development in the acutely ill toddler? a. Focus on educating parents to minimize anxiety over the parenting of the child b. Make sure that the toddler is informed in advance of what is to take place in a procedure c. Isolate the child from parents, especially if there are temper tantrums. d. Encourage regression to a previous developmental level for familiarity and comfort. 20. A nurse is taking care of a male client who has just been diagnosed with hepatitis C. Which statement about this condition is accurate? a. The potential for chronic liver disease is unlikely b. Symptoms set in abruptly c. The incubation period for hepatitis C is usually 2-26 weeks d. Vaccinations are available for hepatitis C Cumulative NCLEX Practice Test - Answer Key 1. A client has been admitted to the hospital with findings of urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement and has returned to normal hydration status if the blood urea nitrogen level is a. 5 mg/dL b. 15 mg/dL c. 27 mg/dL d. 34 mg/dL Correct answer: B Rationale: The average blood urea nitrogen level is 8 to 25 mg/dL. Values such as those in options C and D indicate continued dehydration. Option A reflects a lower than average cost, which may occur with fluid volume overload, among other conditions. 27 mg/dL indicates a normal BUN, showing that the client has received adequate volume replacement and has returned to normal hydration status. 2. A client newly diagnosed with diabetes mellitus has a glycosylated hemoglobin A1c level of 10%. The nurse ensures that client teaching includes which of the following: a. Avoiding infection b. Taking in adequate fluids c. Preventing and recognizing hypoglycemia d. Preventing and recognizing hyperglycemia Correct answer: D Rationale: Glycosylated Hemoglobin is tested to monitor long-term control for diabetes mellitus. It measures the amount of glucose that has become permanently bound to the red blood cells from circulating glucose. If the blood glucose level rises, the amount of glycosylation is also elevated. This indicates that the client has had periods of undetected hyperglycemia. For glycosylated hemoglobin A1c, 7% or less indicates reasonable control, 7% to 8% indicates good power, and 8% or higher indicates poor control. The test result helps the nurse identify the continued need for teaching related to the prevention of hyperglycemic episodes. Options A, B, and C are therefore incorrect, while option D is the correct answer. 3. A client in septic shock in the intensive care unit is receiving a Dopamine infusion. Upon assessment, the nurse notices that the client’s; blood pressure is 195/120 mm Hg. Which initial nursing action would the nurse implement? a. Discontinue dopamine. b. Notify the physician c. Administer Furosemide. d. Assess the clients’ GCS Correct answer: A A is correct. The initial action for the nurse is to discontinue Dopamine, which is a vasoconstrictor, the medication that causes the client’s high blood pressure. B is incorrect. The nurse needs to notify the physician in order to arrange an adjustment of the medication dosage. However, this should not be the initial action of the nurse. C is incorrect. The nurse can give Furosemide to decrease the patient's blood pressure. But the nurse should terminate the exact cause of hypertension which is Dopamine. D is incorrect. The nurse can assess the client's GCS, but the nurse should decrease the client's blood pressure. 4. The client is admitted for having unstable angina. The nurse caring for the client understands that nitroglycerin should not be given to the client if he manifests which sign or symptom? a. Atrial fibrillation b. A blood pressure of 78/59 mm Hg. c. Headache d. A warm flushed feeling Correct answer: B A is incorrect. Nitroglycerin is not contraindicated in atrial fibrillation. Therefore, it is safe to administer the drug even if there is atrial fibrillation. B is correct. Nitroglycerin is a vasodilator that causes a decrease in blood pressure. The nurse should not administer any drug that causes the blood pressure to drop when the client’s systolic blood pressure is below 90 mm Hg. C is incorrect. Headaches are a common side effect of nitroglycerin and should not be a reason to withhold the drug. D is incorrect. A warm flushed feeling is also a side effect of Nitroglycerin, which is caused by its vasodilatory effects. 5. The nurse is caring for a client in the Intensive Care Unit in acute respiratory failure. The nurse should expect which ABG results? a. pH: 7.29; PCO2: 56; PaO2: 83; HCO3: 22 b. pH: 7.38; PCO2: 40; PaO2: 92; HCO3: 25 c. pH: 7.49; PCO2: 34; PaO2: 96; HCO3: 28 d. pH: 7.40; PCO2: 65; PaO2: 85; HCO3: 16 Correct answer: A A is correct. A client in respiratory distress should be expected to exhibit acidosis, hypoxemia, and hypercapnia (respiratory acidosis) in his ABGs. Option A indicates respiratory acidosis. B is incorrect. This is indicative of a normal Arterial blood gas result. C is incorrect. This is an arterial blood gas result showing respiratory alkalosis. Respiratory alkalosis commonly occurs in hyperventilation wherein more carbon dioxide is eliminated. D is incorrect. This is an example of a compensated respiratory acidosis. 6. A client in his early 60s is brought to the ER complaining of shortness of breath. Initial assessment findings include crackles, finger clubbing, and dry cough. The client states that he has previously worked in construction for 15 years. The ER