HESI: Maternity & Women's Health Exam
Questions & Answers Scored A+ 2024
A couple arrives at the newborn nursery asking to take their newborn grandson to his
mother's room. What is the best response by the nurse? - ANSWER-1
"I'll get your grandchild. You must be very excited."
Correct2
"Please go on to see your daughter. I'll bring the baby to her room."
3
"Show me your identification. I need to see it before I can give you the baby."
4
"Only the mother can ask for the baby. Have her call us to bring the baby to her."
Telling the couple that the baby will be brought to the client's room maintains the nurse's
legal responsibility of providing for the infant's safety while still promoting a positive
interaction with the client's family. Giving the infant to another person without the
mother's knowledge or consent is illegal. Legally the nurse may not give the infant to the
grandparents. Although insisting that only the mother can ask for the infant may follow
legal policy, it is an abrupt nontherapeutic response to the grandparents.
The nurse is caring for a 1-hour-old newborn. Which assessment characteristics
represent a preterm gestational age? - ANSWER-Correct1
Skin: thin, veins visible; breasts: flat areolae, no buds; plantar creases: absent; lanugo:
abundant
2
Skin: parchment/wrinkled; breasts: flat areolae, no buds; plantar creases: cover entire
sole; lanugo: absent
3
,Skin: thin, veins visible; breasts: flat areolae, no buds; plantar creases: covering the
entire sole; lanugo: abundant
4
Skin: cracking/few veins; breasts: raised areolae (3- to 4-mm buds); plantar creases:
covering the anterior two thirds of the sole; lanugo: thinning
The characteristics of preterm, term, and postterm gestational age are based on
assessments of physical maturity such as the Ballard or Dubowitz assessment. A
preterm infant's skin is translucent, with many visible veins. A term infant has some
cracking of the skin and some visible veins, depending on gestational age. Term is any
gestation after 38 weeks; veins are less visible at 40 weeks' gestation. The postterm
infant typically has dry, leathery, parchmentlike skin with numerous deep wrinkles. The
areolae of a preterm infant are flat, without buds, and they become more raised during
development, averaging 3 to 4 mm at term and 5 to 10 mm in the postterm infant. The
plantar creases develop on the foot during gestation, beginning smooth, then covering
two thirds at term, and finally covering the entire sole after term. Lanugo is the fine
downy hair that diminishes as the infant develops gestationally.
A newborn is found to have a diaphragmatic hernia. What is the immediate intervention
after the neonate is admitted to the neonatal intensive care unit? - ANSWER-Hydrating
the infant with isotonic enemas
2
Limiting formula feedings to small amounts
3
Placing the infant in the Trendelenburg position
Correct4
Providing gastric decompression via nasogastric tube
When a diaphragmatic hernia is present, intra-abdominal pressure must be minimized;
this is accomplished with the use of gastric decompression. Hydrating the infant with
isotonic enemas is not beneficial. These infants are not fed orally; intravenous fluids are
given with careful measurement of electrolytes and intake and output to guide
,replacement therapy. The Trendelenburg position is contraindicated; the abdominal
organs will increase pressure on the diaphragm.
A client gives birth to a full-term male with an 8/9 Apgar score. What should the
immediate nursing care of this newborn include? - ANSWER-Correct1
Assessing respirations, keeping him warm, and identifying him
2
Applying an antibiotic to the eyes, administering vitamin K, and bathing him
3
Aspirating the oropharynx, rushing him to the nursery, and stimulating him often
4
Weighing him, placing him in a crib, and waiting until the mother is ready to hold him
Establishing a patent airway, diminishing cold stress, and identifying the newborn are
the priorities. Application of eye prophylaxis and administration of vitamin K are often
delayed to allow the parents to bond with the infant; a bath at this time will increase the
risk of cold stress. Aspirating the oropharynx, rushing him to the nursery, and
stimulating him frequently are measures appropriate for a compromised newborn; an
8/9 Apgar score is indicative of a healthy newborn. Weighing him, placing him in a crib,
and waiting until the mother is ready to hold him are not the priority care for a newborn.
A new mother asks the nurse why her baby seems to have a bowel movement after
every feeding. While preparing a response to explain why this is an expected
occurrence, the nurse remembers that this regularity indicates that what function is
adequate? - ANSWER-1
Fluid intake
2
Cardiac sphincter
3
, Pancreatic amylase level
Correct4
Gastrocolic reflex response
The gastrocolic reflex is stimulated when the newborn's stomach begins to fill with fluid;
this causes an increase in peristalsis, resulting in the passage of stool during or after a
feeding. Six to 10 voidings a day of pale straw-colored urine are indicative of adequate
fluid intake, not the frequency of bowel movements. The cardiac sphincter is unrelated
to bowel movements; the cardiac sphincter, located between the esophagus and the
stomach, is immature in the newborn and is the reason for the newborn's tendency to
regurgitate some of the feedings. Although pancreatic amylase is a digestive enzyme, it
does not stimulate bowel movements after feedings.
An infant in the newborn nursery has cyanosis of the hands and feet and circumoral
pallor when crying. In light of these assessment findings, which actions should the nurse
consider taking next? - ANSWER-1
Taking no specific action, because both signs are expected in a newborn until 2 weeks
of age
Correct2
Notifying the health care provider, because circumoral pallor may signal a cardiac
problem
3
Taking no specific action, because circumoral pallor is a common finding for the first 72
to 96 hours
4
Notifying the health care provider, because cyanosis usually accompanies increased
intracranial pressure
Cardiac pathology can be detected at an early age, and circumoral pallor may be a sign.
Circumoral pallor is not expected in a healthy newborn, or in a person of any age.
Cyanosis does not indicate increased intracranial pressure.
