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HESI OB/MATERNITY V 2 QUESTIONS AND ANSWERS (GRADED A)

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HESI OB/MATERNITY V 2 QUESTIONS AND ANSWERS (GRADED A) HESI OB/MATERNITY V 2 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 them to.” b) “With all of your preparations, it must have been disappointing for you to have had a cesarean.” c) “I know you had to have surgery, but you are very lucky that your 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’s patient-controlled analgesia (PCA) be discontinued. Which of the following actions by the nurse is appropriate? a) Discard the remaining medication in the presence of another nurse. b) Recommend waiting until her pain level is zero to discontinue the medicine. c) Discontinue the medication only after the analgesia is completely absorbed. d) Return the unused portion of medication to the narcotics cabinet. 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 atthis 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 to the 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!” Which of 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 and to eat.” b) “Don’t say that. There are many women who would be ecstatic to have that baby.” c) “I am sure that you will have another baby. I bet that it will be a natural delivery.” d) “To have things work out differently than you had planned is disappointing.” 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 vaginal delivery 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 the trauma of delivery. c) Remind the woman that she still has a catheter in place from the 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 the nurse is performing the skill correctly? a) The nurse measures the fundal height using a paper centimeter tape. b) The nurse stabilizes the base of the uterus with his or her dependent hand. c) The nurse palpates the fundus with the tips of his or her fingers. d) The nurse precedes the assessment with a sterile vaginal exam. 13. A 1-day postpartum woman states, “I think I have a urinary tract infection. 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 after delivery. 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.

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b) Recommend waiting until her pain level is zero to discontinue
HESI OB/MATERNITY V 2 the medicine.
c) Discontinue the medication only after the analgesia is
QUESTIONS AND ANSWERS completely absorbed.
d) Return the unused portion of medication to the narcotics
(GRADED A) cabinet.


HESI OB/MATERNITY V 2
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 them
to.”
b) “With all of your preparations, it must have been disappointing
for you to have had a cesarean.”
c) “I know you had to have surgery, but you are very lucky that
your 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’s
patient-controlled analgesia (PCA) be discontinued. Which of the
following actions by the nurse is appropriate?
a) Discard the remaining medication in the presence of another
nurse.

,4. A client is receiving an epidural infusion of a narcotic for pain
relief after a cesarean section. The nurse would report to the
anesthesiologist if 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 atthis 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
the medicine.
d) The woman’s newborn may become addicted to
the medication.

, 7. A nurse is assessing a 1-day postpartum woman who had her baby d) Irrigate incision twice daily with antibiotic solution.
by cesarean section. Which of the following should the nurse report to
11. A client, G1P1001, 1-hour postpartum from a spontaneous vaginal
the surgeon?
delivery with local anesthesia, states that she needs to urinate. Which
a) Fundus at the umbilicus. of the following actions by the nurse is appropriate at this time?
b) Nodular breasts.
a) Provide the woman with a bedpan.
c) Pulse rate 60 bpm.
b) Advise the woman that the feeling is likely related to the
d) Pad saturation every 30 minutes.
trauma of delivery.
8. The nurse is assessing the midline episiotomy on a postpartum c) Remind the woman that she still has a catheter in place from
client. Which of the following findings should the nurse expect to see? the delivery.
a) Moderate serosanguinous drainage. d) Assist the woman to the bathroom.
b) Well-approximated edges.
12. A nurse is assessing the fundus of a client during the immediate
c) Ecchymotic area distal to the episiotomy.
postpartum period. Which of the following actions indicates that the
d) An area of redness adjacent to the incision.
nurse is performing the skill correctly?
9. A client, G1P1, who had an epidural, has just delivered a daughter,
a) The nurse measures the fundal height using a paper centimeter
Apgar 9/9, over a mediolateral episiotomy. The physician used low
tape.
forceps. While recovering, the client states, “I’m a failure. I couldn’t
b) The nurse stabilizes the base of the uterus with his or her
stand the pain and couldn’t even push my baby out by myself!” Which
dependent hand.
of the following is the best response for the nurse to make?
c) The nurse palpates the fundus with the tips of his or her
a) “You’ll feel better later after you have had a chance to rest and fingers.
to eat.” d) The nurse precedes the assessment with a sterile vaginal exam.
b) “Don’t say that. There are many women who would be ecstatic
to have that baby.”
c) “I am sure that you will have another baby. I bet that it will be 13. A 1-day postpartum woman states, “I think I have a urinary tract
a natural delivery.” infection. I have to go to the bathroom all the time.” Which of the
d) “To have things work out differently than you had planned is following actions should the nurse take?
disappointing.”
a) Assure the woman that frequent urination is normal after
10. The nurse is developing a standard care plan for postpartum clients delivery.
who have had midline episiotomies. Which of the following b) Obtain an order for a urine culture.
interventions should be included in the plan? c) Assess the urine for cloudiness.
d) Ask the woman if she is prone to urinary tract infections.
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.

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