Assessment of High Risk Pregnancy NCLEX Questions

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A gravida 1 patient at 32 weeks of gestation reports that she has severe lower back pain. What should the nurse's assessment include?

  • A. Palpation of the lumbar spine
  • B. Exercise pattern and duration
  • C. Observation of posture and body mechanics
  • D. Ability to sleep for at least 6 hours uninterrupted
Correct Answer: C

Rationale: The correct answer is C. Observation of posture and body mechanics is essential in assessing lower back pain in a pregnant patient to identify any potential causes related to the growing uterus and changes in body mechanics. Palpation of the lumbar spine (Choice A) may provide some information but does not address the underlying issue. Exercise pattern and duration (Choice B) are important but not the priority in this scenario. Ability to sleep for at least 6 hours uninterrupted (Choice D) is not directly related to assessing lower back pain.

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Using the graph below, of the following weights, how many grams would a 34-week neonate need to weigh to be labeled appropriate-for-gestational age?

  • A. 500 grams.
  • B. 1,700 grams.
  • C. 2,900 grams.
  • D. 4,100 grams.
Correct Answer: C

Rationale: A 34-week neonate weighing 2,900 grams would be considered appropriate-for-gestational age based on standard growth charts.

What point in the pregnancy is the most accurate time to determine gestational age through ultrasound?

  • A. First trimester
  • B. Second trimester
  • C. Third trimester
  • D. No difference in accuracy among the trimesters
Correct Answer: A

Rationale: The correct answer is A: First trimester. During the first trimester, gestational age can be accurately determined through ultrasound by measuring the crown-rump length of the fetus. This measurement is most accurate during this time as the fetus is small and growth is consistent. In the second and third trimesters, other factors such as fetal growth variations and positioning can affect the accuracy of gestational age determination. Therefore, the first trimester is the most accurate time for determining gestational age through ultrasound. Other choices are incorrect because the precision of ultrasound measurements decreases as pregnancy progresses, making the first trimester the optimal window for accurate gestational age assessment.

A baby is exhibiting signs of neonatal abstinence syndrome. Which action would be appropriate for the nursery nurse to make?

  • A. Cover the baby with at least two blankets.
  • B. Stimulate the baby with rattles.
  • C. Play soft classical music in the nursery.
  • D. Attach a mobile to the crib.
Correct Answer: A

Rationale: Neonatal abstinence syndrome babies are sensitive to stimuli, so minimizing environmental stimulation, such as by swaddling, is important.

When providing contraceptive counseling to a woman, which of the following factors should the nurse consider? Select all that apply.

  • A. Age.
  • B. Obstetric history.
  • C. Religious beliefs.
  • D. Employment.
Correct Answer: A

Rationale: Age, obstetric history, and religious beliefs are important factors to consider when providing contraceptive counseling. Employment is less relevant to contraceptive choice.

A neonate in the nursery, whose mother had no prenatal care, has been diagnosed with macrosomia. For which of the following signs/symptoms should the nurse carefully monitor this baby?

  • A. Jaundice.
  • B. Jitters.
  • C. Blepharitis.
  • D. Strabismus.
Correct Answer: B

Rationale: Macrosomic babies are at risk for hypoglycemia, which can present as jitteriness.

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