NURS 220 HESI MATERNITY
PRACTICE QUESTIONS
,NURS 220 HESI Maternity
Practice Questions
1. The nurse is planning care for a client at 30 weeks gestation who is
experiencingpreterm labor. What maternal prescription is most
important in preventing this fetus from developing respiratory distress
syndrome?
a. terbutaline (Brethine) 0.25 mg SubQ Q15 mins x 3
b. Betamethasone (Celestone) 12 mg deep IM
c. Butorphanol 1 mg IV push q2h PRN pain
d. Ampicillin 1-gram IV push q8h
2. A primigravida client confides in the nurse that her sister told her that she
shouldeliminate all salt once she is at 26 weeks’ gestation because it will
eliminate fluid retention and swelling. How should the nurse respond?
a. Salt foods lightly during cooking but add no additional salt at the table.
b. eliminate all added salt from the diet to improve kidney function during pregnancy
c. limit grain, meat and milk products which are significant sources of sodium
d. use canned food products to obtain salt because it is easier to monitor salt intake
3. A one-day-old neonate develops a cephalohematoma. The nurse should
closelyassess this neonate for which common complication?
a. jaundice*
b. brain damage
c. poor appetite
d. hypoglycemia
4. The mother of a breastfeeding 24 hr old infant is very concerned about the
techniques involved in breastfeeding. She calls the nurse with each feeding
to seek reassurance that she is “doing it right.” She tells the nurse, “I just
, know mydaughter is not getting enough to eat.” What response would be
best for the nurse to make?
a. feed your baby hourly until you feel confident that your child is receiving enough milk
b. don’t worry, soon your milk will come in, and you will feel how full your breasts are
c. since you are so concerned, you should probably supplement breastfeeding with
formula
d. if your baby’s urine is straw-colored, she is getting enough milk*
5. A client at 30 weeks gestation reports that she has not felt the baby move
in thelast 24 hours. Concerned, she arrives in a panic at the obstetric
clinic where sheis immediately sent to the hospital. Which assessment
finding warrants immediate intervention by the nurse?
a. the onset of uterine contractions
b. leaking amniotic fluid
c. fetal heart rate 60 beats/min*
, d. ruptured amniotic membrane
6. A client at 40-weeks’ gestation presents to the obstetrical floor and
indicates thatthe amniotic membranes ruptured spontaneously at home.
She is in active labor and feels the need to bear down and push. What
information is most important for the nurse to obtain first?
a. the estimated amount of fluid
b. time the membranes ruptured
c. color and consistency of the fluid
d. any odor noted when membranes ruptured.
7. A 32-week gestation client has deep tendon reflexes (DTRs) are 4+. What
actionshould the nurse take first?
a. assess the urine for proteinuria
b. record the finding on a flowsheet
c. obtain blood pressure reading
d. notify the healthcare provider
8. The nurse is preparing to draw blood from a newborn to obtain
hemoglobin andhematocrit levels. What is the best method to obtain this
blood sample?
a. use a butterfly, small gauge needle to do a venous puncture on the hand
b. draw blood from the infant's antecubital vein using a small gauge needle
c. use a small gauge needle to puncture the vastus lateralis
d. use a lancet to puncture the outer lateral aspect of the heel *
9. A 25-year-old client who had a severe postpartum hemorrhage following
the vaginal birth of twins is transferred to the postpartum unit. The nurse
knows thatassessment for what complication has the highest priority for
this client?
PRACTICE QUESTIONS
,NURS 220 HESI Maternity
Practice Questions
1. The nurse is planning care for a client at 30 weeks gestation who is
experiencingpreterm labor. What maternal prescription is most
important in preventing this fetus from developing respiratory distress
syndrome?
a. terbutaline (Brethine) 0.25 mg SubQ Q15 mins x 3
b. Betamethasone (Celestone) 12 mg deep IM
c. Butorphanol 1 mg IV push q2h PRN pain
d. Ampicillin 1-gram IV push q8h
2. A primigravida client confides in the nurse that her sister told her that she
shouldeliminate all salt once she is at 26 weeks’ gestation because it will
eliminate fluid retention and swelling. How should the nurse respond?
a. Salt foods lightly during cooking but add no additional salt at the table.
b. eliminate all added salt from the diet to improve kidney function during pregnancy
c. limit grain, meat and milk products which are significant sources of sodium
d. use canned food products to obtain salt because it is easier to monitor salt intake
3. A one-day-old neonate develops a cephalohematoma. The nurse should
closelyassess this neonate for which common complication?
a. jaundice*
b. brain damage
c. poor appetite
d. hypoglycemia
4. The mother of a breastfeeding 24 hr old infant is very concerned about the
techniques involved in breastfeeding. She calls the nurse with each feeding
to seek reassurance that she is “doing it right.” She tells the nurse, “I just
, know mydaughter is not getting enough to eat.” What response would be
best for the nurse to make?
a. feed your baby hourly until you feel confident that your child is receiving enough milk
b. don’t worry, soon your milk will come in, and you will feel how full your breasts are
c. since you are so concerned, you should probably supplement breastfeeding with
formula
d. if your baby’s urine is straw-colored, she is getting enough milk*
5. A client at 30 weeks gestation reports that she has not felt the baby move
in thelast 24 hours. Concerned, she arrives in a panic at the obstetric
clinic where sheis immediately sent to the hospital. Which assessment
finding warrants immediate intervention by the nurse?
a. the onset of uterine contractions
b. leaking amniotic fluid
c. fetal heart rate 60 beats/min*
, d. ruptured amniotic membrane
6. A client at 40-weeks’ gestation presents to the obstetrical floor and
indicates thatthe amniotic membranes ruptured spontaneously at home.
She is in active labor and feels the need to bear down and push. What
information is most important for the nurse to obtain first?
a. the estimated amount of fluid
b. time the membranes ruptured
c. color and consistency of the fluid
d. any odor noted when membranes ruptured.
7. A 32-week gestation client has deep tendon reflexes (DTRs) are 4+. What
actionshould the nurse take first?
a. assess the urine for proteinuria
b. record the finding on a flowsheet
c. obtain blood pressure reading
d. notify the healthcare provider
8. The nurse is preparing to draw blood from a newborn to obtain
hemoglobin andhematocrit levels. What is the best method to obtain this
blood sample?
a. use a butterfly, small gauge needle to do a venous puncture on the hand
b. draw blood from the infant's antecubital vein using a small gauge needle
c. use a small gauge needle to puncture the vastus lateralis
d. use a lancet to puncture the outer lateral aspect of the heel *
9. A 25-year-old client who had a severe postpartum hemorrhage following
the vaginal birth of twins is transferred to the postpartum unit. The nurse
knows thatassessment for what complication has the highest priority for
this client?
