2020 HESI OB – MATERNITY V2 EXAM
1. The nurse is caring for a client who had an emergency cesarean section, with her husband in attendance the day before. The baby’s Apgar was 9/9. The woman and her partner had attended childbirth education classes and had anticipated having a water birth with...
1 the nurse is caring for a client who had an emergency cesarean section
with her husband in attendance the day before the baby’s apgar was 99 the woman and her p
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2020 HESI OB – MATERNITY V2 EXAM
1. The nurse is caring for a client who had an emergency cesarean section, with her husband in attendance the day
before. The baby’s Apgar was 9/9. The woman and her partner had attended childbirth education classes and had
anticipated having a water birth with family present. Which of the following comments by the nurse is appropriate?
a) “Sometimes babies just don’t deliver the way we expect themto.”
b) “With all of your preparations, it must have been disappointingfor you to have had a cesarean.”
c) “I know you had to have surgery, but you are very lucky thatyour baby was born healthy.”
d) “At least your husband was able to be with you when the baby was born.”
2. A nurse has brought a 2-hour-old baby to a mother from the nursery.The nurse is going to assist the mother with the
first breastfeeding experience. Which of the following actions should the nurse perform first?
a) Compare mother’s and baby’s identification bracelets.
b) Help the mother into a comfortable position.
c) Teach the mother about a proper breast latch.
d) Tickle the baby’s lips with the mother’s nipple.
3. The obstetrician has ordered that a post-op cesarean section client’spatient-controlled analgesia (PCA) be
discontinued. Which of the following actions by the nurse is appropriate?
a) Discard the remaining medication in the presence of anothernurse.
b) Recommend waiting until her pain level is zero to discontinuethe medicine.
c) Discontinue the medication only after the analgesia iscompletely absorbed.
d) Return the unused portion of medication to the narcoticscabinet.
4. A client is receiving an epidural infusion of a narcotic for pain relief after a cesarean section. The nurse would report
to the anesthesiologistif which of the following were assessed?
a) Respiratory rate 8 rpm.
b) Complaint of thirst.
c) Urinary output of 250 cc/hr.
, d) Numbness of feet and ankles.
5. A client, 2 days postoperative from a cesarean section, complains to the nurse that she has yet to have a bowel
movement since the surgery.Which of the following responses by the nurse would be appropriate at this time?
a) “That is very concerning. I will request that your physicianorder an enema for you.”
b) “Two days is not that bad. Some patients go four days or longerwithout a movement.”
c) “You have been taking antibiotics through your intravenous.That is probably why you are constipated.”
d) “Fluids and exercise often help to combat constipation. Take astroll around the unit and drink lots of fluid.”
6. A post–cesarean section, breastfeeding client, whose subjective painlevel is 2/5, requests her as needed (prn)
narcotic analgesics every 3 hours. She states, “I have decided to make sure that I feel as little painfrom this experience
as possible.” Which of the following should the nurse conclude in relation to this woman’s behavior?
a) The woman needs a stronger narcotic order.
b) The woman is high risk for severe constipation.
c) The woman’s breast milk volume may drop while taking themedicine.
d) The woman’s newborn may become addicted to themedication.
7. A nurse is assessing a 1-day postpartum woman who had her baby by cesarean section. Which of the following
should the nurse report tothe surgeon?
a) Fundus at the umbilicus.
b) Nodular breasts.
c) Pulse rate 60 bpm.
d) Pad saturation every 30 minutes.
8. The nurse is assessing the midline episiotomy on a postpartum client. Which of the following findings should the
nurse expect to see?
a) Moderate serosanguinous drainage.
b) Well-approximated edges.
c) Ecchymotic area distal to the episiotomy.
d) An area of redness adjacent to the incision.
,9. A client, G1P1, who had an epidural, has just delivered a daughter, Apgar 9/9, over a mediolateral episiotomy. The
physician used low forceps. While recovering, the client states, “I’m a failure. I couldn’t stand the pain and couldn’t
even push my baby out by myself!” Whichof the following is the best response for the nurse to make?
a) “You’ll feel better later after you have had a chance to rest andto eat.”
b) “Don’t say that. There are many women who would be ecstaticto have that baby.”
c) “I am sure that you will have another baby. I bet that it will bea natural delivery.”
d) “To have things work out differently than you had planned isdisappointing.”
10. The nurse is developing a standard care plan for postpartum clients who have had midline episiotomies. Which of
the following interventions should be included in the plan?
a) Assist with stitch removal on third postpartum day.
b) Administer analgesics every four hours per doctor orders.
c) Teach client to contract her buttocks before sitting.
d) Irrigate incision twice daily with antibiotic solution.
11. A client, G1P1001, 1-hour postpartum from a spontaneous vaginaldelivery with local anesthesia, states that she
needs to urinate. Which of the following actions by the nurse is appropriate at this time?
a) Provide the woman with a bedpan.
b) Advise the woman that the feeling is likely related to thetrauma of delivery.
c) Remind the woman that she still has a catheter in place fromthe delivery.
d) Assist the woman to the bathroom.
12. A nurse is assessing the fundus of a client during the immediate postpartum period. Which of the following
actions indicates that thenurse is performing the skill correctly?
a) The nurse measures the fundal height using a paper centimetertape.
b) The nurse stabilizes the base of the uterus with his or herdependent hand.
c) The nurse palpates the fundus with the tips of his or herfingers.
d) The nurse precedes the assessment with a sterile vaginal exam.
, 13. A 1-day postpartum woman states, “I think I have a urinary tractinfection. I have to go to the bathroom all the
time.” Which of the following actions should the nurse take?
a) Assure the woman that frequent urination is normal afterdelivery.
b) Obtain an order for a urine culture.
c) Assess the urine for cloudiness.
d) Ask the woman if she is prone to urinary tract infections.
14. The nurse is assessing the laboratory report on a 2-day postpartum G1P1001. The woman had a normal
postpartum assessment this morning.Which of the following results should the nurse report to the primary
health care provider?
a. White blood cells—12,500 cells/mm3.
b. Red blood cells—4,500,000 cells/mm3.
c. Hematocrit—26%.
d. Hemoglobin—11 g/dL
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