NURS 4125 HESI RN Maternity & Peds V1 –Study Notes and Questions with Answers Graded A+

2021 HESI RN Maternity & Peds V1 – Notes and Questions Maternity and Peds • The nurse is planning care for a client at 30-weeks gestation who is experiencing preterm labor. • Terbutaline (Brethine) 0.25 mg subcutaneously q15 minutes x 3 • Ampicillin 1 gram IV push q8h. • Betamethasone (Celestone) 12 mg deep IM • Butorphanol (Stadol) 1 mg IV push q2h PRN pain 2. A pregnant woman in the first trimester of pregnancy has hemoglobin of 8.6 mg/dl and a hematocrit of 25.1 %. What food should the nurse encourage this client to include in her diet? • Carrots • Chicken • Yogurt • Cheese 3. The nurse is preparing to administer methylergonovine maleate (Methergine) to a postpartum client. Based on what assessment finding should the nurse withhold the drug? • Respiratory rate of 22 breaths/min • A large amount of lochia rubra • Blood pressure 149/90 • Positive Homan’s sign 4. The nurse is planning care for a 16-year-old, who has juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscle. Which physical therapy regimen should the nurse encourage the adolescent to implement? • Begin a training program lifting weights and running • Splint affected joints during activity • Exercise in a swimming pool • Perform passive range of motion exercises twice daily 5. A client receiving oxytocin (Pitocin) to augment early labor. Which assessment is most important for the nurse to obtain each time the infusion rate is increased? • Pain level • Blood pressure • Infusion site • Contraction pattern 6. One day after vaginal delivery of a full term baby, a postpartum client’s white blood cell count is 15.000/mm. What action should the nurse take first? • Check the differential, since the WBC is normal for this client • Assess the client’s temperature, pulse, and respirations q4h • Assess the client’s perineal area for signs of a perineal hematoma • Notify the healthcare provider, since this finding is indicative of infection 7. A neonate who has congenital adrenal hypoplasia (CAH) presents with ambiguous genitalia. What is the primary nursing consideration when supporting the parents of a child with this anomaly? • Discuss the need for cortisol and aldosterone replacement therapy after discharge • Support the parents in their decision to assign sex of their child according to their preference • Offer information about ultrasonography and genotyping to determine sex assignment • Explain that corrective surgical procedures consistent with sex assignment can be delayed 8. The nurse assessing a 9-year old boy who has been admitted to the hospital with possible acute postsreptococcal glomerulonephritis (APSGN). In obtaining his history, what information is most significant? • Back pain for a few days • A history of hypertension • A sore throats last week • Diuresis during the nights Note: Page 1538 MB 9. A loading dose of terbutaline (Brethine) 250 mcg IV is prescribed for a client in preterm labor. Brethine 20 mg is added to 1,000 ml D W. How many ml of the solution should the nurse administer? 13 10. A 36-week primigravida is admitted to labor and delivery with severe abdominal pain and bright red vaginal bleeding. Her abdomen is rigid and tender to touch. The fetal heart rate FHR) is 90 beats/minute, and the maternal heart rate is 120 beats/minute. What action should the nurse implement first? • Alert the neonatal team and prepare for neonatal resuscitation • Notify the healthcare provider from the client’s bedside • Obtain written consent for an emergency cesarean section • Draw a blood sample for stat hemoglobin and hematocrit 11. A laboring client’s membranes rupture spontaneously. The nurse notices that the amniotic fluid is greenish-brown. What intervention should the nurse implement first? • Turn the client to her left side • Contact the healthcare provider • Assess the fetal heart rate • Check the cervical dilation 12. A 5-year-old child is admitted to the pediatric unit with fever and pain secondary to a sickle cell crisis. Which intervention should the nurse implement first? A. Obtain a culture of any sputum or wound drainage. • Obtain a culture of any sputum or wound drainage • Initiate normal saline IV at 50 ml/hr • Administer a loading dose of penicillin IM • Administer the initial dose of folic acid PO 13. A child has been vomiting for 3 days is admitted for correction of fluid and electrolyte imbalances. What acid base imbalance is this child likely to exhibit? • Respiratory alkalosis • Respiratory acidosis • Metabolic alkalosis • Metabolic acidosis 14. A child admitted with diabetic ketoacidosis is demonstrating Kussmaul respiration. The nurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration? • Respiratory alkalosis • Respiratory acidosis • Metabolic acidosis • Metabolic alkalosis 15. The nurse is caring for a 5-year-old child with Reye’s syndrome. Which goal of treatment most clearly relates to caring for this child? • Reduce cerebral edema and lower intracranial pressure • Avert hypotension and septic shock • Prevent cardiac arrhythmias and heart failure • Promote kidney perfusion and normal blood pressure. 16. A client whose labor is being augmented with an oxytocin(Pitocin) infusion requests an epidural for pain control. Findings of the last vaginal exam, performed 1 hour ago, were 3 cm cervical dilation, 60% effacement, and a 2-station. What action should the nurse implement first? • Decrease the oxytocin infusion rate • Determine current cervical dilation • Request placement of the epidural • Give a bolus of intravenous fluids 17. A child who received multiple blood transfusions after correction of a congenital heart defects is demonstrating muscular irritability and is oozing blood from the surgical incision. Which serum value is most important for the nurse before reporting to the healthcare provider? • CO combining power • Calcium • Sodium • Chloride 18. A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chronic (sudden aimless movements of the arms and legs). Which information should the nurse to the parents? • Muscle tension is decreased with fine motor skill projects, so these activities should be encouraged • The chorea or movements are temporary and will eventually disappear • Permanent life-style changes need to be made to promote safety in the home • Consistent discipline is needed to help the child control the movements 19. The nurse is measuring the frontal occipital circumference (FOC) of a 3-month-old infant, notes that the FOC has increased 5 inches since birth and the child’s head appears large in relation to body size. Which action is most important for the nurse to take next? • Measure the infant’s head to heel length • Observe the infant for sunset eyes • Palpate the anterior fontanel for tension and bulging • Plot the measurement on the infant’s growth chart 20. A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in this client’s nursing care plan? • Keep airway equipment at the bedside. • Allow liberal family visitation • Monitor blood pressure, pulse, and respirations q4h • Assess temperature q1h 21. During a well-child visit for their child, one of the parent who has an autosomal dominant disorder tells the nurse, “We don’t plan on having any more children, since the next child is likely to inherit this disorder”. How should the nurse respond? • Explain that the risk of inhering the disorder decrease by 50% with each child the couple has • Acknowledge that the next that the next child will inherit the disorder since the first child did not • Encourage the couple to reconsider their decision since the inheritance pattern may be sex-linked • Confirm that there is a 50% chance of their future children inheriting the disorder 22. The nurse is caring for a one-year-old child following surgical correction of hypospadias. The nursing action has the highest priority? • Monitor urinary output • Auscultate bowel sounds • Observe appearance of stool • Record percent of diet eaten 23. Patient with Duchenne Disease. The nurse has to explain to the mother that: This condition is inherited in an X-linked recessive chromosome pattern 24. Primipara patient. What is the pet to share time a, home that is not recommended? CAT