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  1. Home
  2. NCLEX Certification
  3. NCLEX-PN Exam
  4. NCLEX.NCLEX-PN.v2023-10-03.q213 Dumps
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Question 201

A woman is in the active phase of labor. An external monitor has been applied, and a fetal heart deceleration of uniform shape is observed, beginning just as the contraction is under way and returning to the baseline at the end of the contraction. Which of the following
nursing actions is most appropriate?

Correct Answer: D
It is an early deceleration as a result of head compression, and at this time no action is necessary. Close observation of the mother and baby is needed.Physiological Adaptation
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Question 202

During surgery, it is found that a client with adenocarcinoma of the rectum has positive peritoneal lymph nodes. What is the next most likely site of metastasis?

Correct Answer: C
Colon tumors tend to spread through the lymphatics and portal vein to the liver. Although metastasis to the other sites listed is possible, the liver is most likely the first to be affected.
Physiological Adaptation
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Question 203

Vaccines provide what type of immunity?

Correct Answer: A
Explanation/Reference:
Explanation:
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. Health Promotion and Maintenance
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Question 204

A client comes to the clinic for assessment of his physical status and guidelines for starting a weight- reduction diet. The client's weight is 216 pounds and his height is 66 inches. The nurse identifies the BMI (body mass index) as:

Correct Answer: C
Explanation/Reference:
Explanation:
Obesity is defined by a BMI of 30 or more with no co-morbid conditions. It is calculated by utilizing a chart or nomogram that plots height and weight. This client's BMI is 35, indicating obesity. Goals of diet therapy are aimed at decreasing weight and increasing activity to healthy levels based on a client's BMI, activity status, and energy requirements. Physiological Adaptation
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Question 205

An LPN learns her newly admitted female patient is of the Muslim faith.
Which of these actions would not be appropriate to take before meeting the patient?

Correct Answer: B
Section: Psychosocial Integrity
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