HESI Review Test-
Maternity, Evolve
Obstetrics/Maternity
Practice Exam, HESI
Maternity
The nurse observes a new mother avoiding eye contact with her newborn. Which action should the
nurse take? - correct answer Observe the mother for other attachment behaviors.
The nurse should explain to a 30-year-old gravid client that alpha fetoprotein testing is recommended
for which purpose? - correct answer Screen for neural tube defects.
What action should the nurse implement to decrease the client's risk for hemorrhage after a cesarean
section? - correct answer Check the firmness of the uterus every 15 minutes.
The nurse attempts to help an unmarried teenager deal with her feelings following a spontaneous
abortion at 8-weeks gestation. What type of emotional response should the nurse anticipate? - correct
answer Grief related to her perceptions about the loss of this child.
,The nurse is assessing a 3-day old infant with a cephalohematoma in the newborn nursery. Which
assessment finding should the nurse report to the healthcare provider? - correct answer Yellowish tinge
to the skin.
When assessing a client who is at 12-weeks gestation, the nurse recommends that she and her husband
consider attending childbirth preparation classes. When is the best time for the couple to attend these
classes? - correct answer At 30-weeks gestation is closest to the time parents would be ready for such
classes. Learning is facilitated by an interested pupil! The couple is most interested in childbirth toward
the end of the pregnancy when they are psychologically ready for the termination of the pregnancy, and
the birth of their child is an immediate concern.
A client at 32-weeks gestation is diagnosed with preeclampsia. Which assessment finding is most
indicative of an impending convulsion? - correct answer Epigastric pain (C) is indicative of an edematous
liver or pancreas which is an early warning sign of an impending convulsion (eclampsia) and requires
immediate attention.
A client is admitted with the diagnosis of total placenta previa. Which finding is most important for the
nurse to report to the healthcare provider immediately? - correct answer Onset of uterine contractions.
A client who is in the second trimester of pregnancy tells the nurse that she wants to use herbal therapy.
Which response is best for the nurse to provide? - correct answer It is important that you want to take
part in your care.
A couple, concerned because the woman has not been able to conceive, is referred to a healthcare
provider for a fertility workup and a hysterosalpingography is scheduled. Which postprocedure
complaint indicates that the fallopian tubes are patent? - correct answer If the tubes are patent (open),
pain is referred to the shoulder (C) from a subdiaphragmatic collection of peritoneal dye/gas.
A client who delivered an infant an hour ago tells the nurse that she feels wet underneath her buttock.
The nurse notes that both perineal pads are completely saturated and the client is lying in a 6-inch
diameter pool of blood. Which action should the nurse implement next? - correct answer Palpate the
firmness of the fundus.
One hour after giving birth to an 8-pound infant, a client's lochia rubra has increased from small to large
and her fundus is boggy despite massage. The client's pulse is 84 beats/minute and blood pressure is
156/96. The healthcare provider prescribes Methergine 0.2 mg IM × 1. What action should the nurse
,take immediately? - correct answer Methergine is contraindicated for clients with elevated blood
pressure, so the nurse should contact the healthcare provider and question the prescription (D).
A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea,
fatigue, and a moist cough. Which question is most important for the nurse to ask this client? - correct
answer Do you have a history of rheumatic fever? Clients with a history of rheumatic fever (D) may
develop mitral valve prolapse, which increases the risk for cardiac decompensation due to the increased
blood volume that occurs during pregnancy, so obtaining information about this client's health history is
a priority.
A primigravida at 40-weeks gestation is receiving oxytocin (Pitocin) to augment labor. Which adverse
effect should the nurse monitor for during the infusion of Pitocin? - correct answer Pitocin causes the
uterine myofibril to contract, so unless the infusion is closely monitored, the client is at risk for
hyperstimulation (B) which can lead to tetanic contractions, uterine rupture, and fetal distress or
demise.
A 35-year-old primigravida client with severe preeclampsia is receiving magnesium sulfate via
continuous IV infusion. Which assessment data indicates to the nurse that the client is experiencing
magnesium sulfate toxicity? - correct answer Urine output 90 ml/4 hours. Urine outputs of less than 100
ml/4 hours (D), absent DTRs, and a respiratory rate of less than 12 breaths/minute are cardinal signs of
magnesium sulfate toxicity.
The nurse is planning preconception care for a new female client. Which information should the nurse
provide the client? - correct answer Encourage healthy lifestyles for families desiring pregnancy.
Planning for pregnancy begins with healthy lifestyles in the family (D) which is an intervention in
preconception care that targets an overall goal for a client preparing for pregnancy.
A multigravida client at 41-weeks gestation presents in the labor and delivery unit after a non-stress test
indicated that the fetus is experiencing some difficulties in utero. Which diagnostic test should the nurse
prepare the client for additional information about fetal status? - correct answer Biophysical profile
(BPP). BPP (A) provides data regarding fetal risk surveillance by examining 5 areas: fetal breathing
movements, fetal movements, amniotic fluid volume, and fetal tone and heart rate.
A client with no prenatal care arrives at the labor unit screaming, "The baby is coming!" The nurse
performs a vaginal examination that reveals the cervix is 3 centimeters dilated and 75% effaced. What
additional information is most important for the nurse to obtain? - correct answer Date of last normal
menstrual period. Evaluating the gestation of the pregnancy (C) takes priority. If the fetus is preterm and
, the fetal heart pattern is reassuring, the healthcare provider may attempt to prolong the pregnancy and
administer corticosteroids to mature the lungs of the fetus.
A client at 28-weeks gestation calls the antepartal clinic and states that she is experiencing a small
amount of vaginal bleeding which she describes as bright red. She further states that she is not
experiencing any uterine contractions or abdominal pain. What instruction should the nurse provide? -
correct answer Come to the clinic today for an ultrasound. Third trimester painless bleeding is
characteristic of a placenta previa. Bright red bleeding may be intermittent, occur in gushes, or be
continuous. Rarely is the first incidence life-threatening, nor cause for hypovolemic shock. Diagnosis is
confirmed by transabdominal ultrasound (A).
A new mother is afraid to touch her baby's head for fear of hurting the "large soft spot." Which
explanation should the nurse give to this anxious client? - correct answer There's a strong, tough
membrane there to protect the baby so you need not be afraid to wash or comb his/her hair.
During labor, the nurse determines that a full-term client is demonstrating late decelerations. In which
sequence should the nurse implement these nursing actions? (Arrange in order.) - correct answer
Reposition the client.
Provide oxygen via face mask.
Increase IV fluid.
Call the healthcare provider.
An off-duty nurse finds a woman in a supermarket parking lot delivering an infant while her husband is
screaming for someone to help his wife. Which intervention has the highest priority? - correct answer
Put the newborn to breast. Putting the newborn to breast (D) will help contract the uterus and prevent a
postpartum hemorrhage--this intervention has the highest priority.
A 40-week gestation primigravida client is being induced with an oxytocin (Pitocin) secondary infusion
and complains of pain in her lower back. Which intervention should the nurse implement? - correct
answer Apply firm pressure to sacral area. The discomfort of back labor can be minimized by the
application of firm pressure to the sacral area
A multigravida client arrives at the labor and delivery unit and tells the nurse that her bag of water has
broken. The nurse identifies the presence of meconium fluid on the perineum and determines the fetal
heart rate is between 140 to 150 beats/minute. What action should the nurse implement next? - correct
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