HESI Obstetrics/Maternity Practice Exam

HESI Obstetrics/Maternity Practice Exam Client teaching is an important part of the maternity nurse's role. Which factor has the greatest influence on successful teaching of the gravid client? Ans- A. The client's readiness to learn A 38-week primagravida who works as a secretary and sits at a computer 8 hours a day tells the nurse that her feet have begun to swell. Which instruction would be most effective in preventing pooling of blood in the lower extremities? Ans- C. Move about every hour During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have Ans- B. lower birth weights A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation in preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25 mg subcutaneously to stop her labor contractions. The nurse plans to monitor for which primary side effect of terbutaline sulfate? Ans- C. Tachycardia and a feeling of nervousness A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective to prevent nipple soreness? Ans- C. correctly place the infant on the breast A full term infant is transferred to the nursery from L & D. Which information is most important for the nurse to receive when planning immediate care for the newborn? Ans- B. Infant's condition at birth and treatment received. In developing a teaching plan for expectant parents, the nurse plans to include information about when the parents can expect the infant's fontanels to close. The nurse bases the explanation on knowledge that for the normal newborn, the Ans- D. anterior fontanel closes at 12-18 mos and the posterior fontanel by the end of the second month. When assessing a client who is 12-weeks gestation, the nurse recommends the she and her husband consider attending childbirth preparation classes. What is the best time for the couple to attend these classes? Ans- D. At 30 weeks gestation. The nurse should encourage the laboring client to begin pushing when Ans- C. the cervix is completely dilated The nurse is counseling a couple who has sought information about conceiving. For teaching purposes, the nurse should know that ovulation usually occurs Ans- A. two weeks before menstruation. The nurse instructs a laboring client to use accelerated-blow breathing. The client begins to complain of tingling fingers and dizziness. What action should the nurse take? Ans- C. have the client breath into her cupped hands When preparing a newborn care for expectant parents, what content should the nurse teach concerning the newborn infant born at term gestation? Ans- C. Vernix is a white, cheesy substance, predominately located in the skin folds. Twenty-four hours after admission to the newborn nursery, a full-term male infant develops localized edema on the right side of his head. The nurse knows that, in the newborn, an accumulation of blood between the periosteum and skull which does not cross the suture line is a newborn variation known as Ans- A. a cephalhematoma, caused by forceps trauma and may last up to 8 weeks. An expectant father tells the nurse he fears that his wife "is losing her mind". He states she is constantly rubbing her abdomen and talking to the baby and that she actually reprimands the baby when it moves too much. What recommendation should the nurse make to the expectant father? Ans- D. Let him know that these behaviors are part of normal maternal/fetal bonding which occurs once the mother feels fetal movement. A new mother asks the nurse, "How do I know my daughter is getting enough breast milk? Which explanation will the nurse provide? Ans- B. "your milk is sufficient if the baby is voiding pale strawcolored urine 6-10 times a day. A new mother who has just had her first baby says to the nurse, "I saw the baby in the recovery room. She has a funny looking head". Which response by the nurse is the best? Ans- C. That is normal, the head will return to a round shape within 7-10 days. A client who gave birth to a healthy 8 pound infant 3 hours ago is admitted to the postpartum unit. Which nursing plan is best in assisting the mother to bond with her newborn infant? Ans- D. Meet the mother's physical needs and demonstrate warmth toward the infant. 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 complaint would indicate to the nurse that the woman's fallopian tubes are patent? Ans- C. shoulder pain Which nursing intervention is most helpful in relieving postpartum uterine contractions or "afterpains?" Ans- A. Lying prone with a pillow on the abdomen Which maternal behavior is the nurse most likely to see when a new mother receives her infant for the first time? Ans- B. Her arms and hands receive the infant and she ten traces the infant's profile with her fingertips. On admission to the prenatal clinic, a 23-year-old woman tells the nurse that her last menstrual period began on February 15, and that previously her periods were regular. Her pregnancy test is positive. This client's expected date of delivery (EDD) is Ans- A. November 22 The nurse is counseling a woman who wants to become pregnant. The woman tells the nurse she has a 36-day menstrual cycle and the first day of her last menstrual period was January 8. The nurse correctly calculates the woman's next fertile period will be Ans- C. January 30-31 A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms. Which assessment finding would indicate that therapeutic drug level has been achieved? Ans- C. a decrease in RR from 24 to 16. Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action will the nurse take? Ans- C. place the woman in a lateral position. 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? Ans- A. Come to the clinic today for an ultrasound. 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? Ans- D. Put the newborn to breast. A pregnant client with mitral stenosis Class III is prescribed complete bedrest. The client asks the nurse. "Why must I stay in bed all the time?" Which response is the best for the nurse to provide this client? Ans- A. Complete bedrest decreases oxygen needs and demands on the heart muscle tissue. The nurse is teaching care of the newborn to a group of prospective parents and describes the need for administering antibiotic ointment into the eyes of the newborn. Which infectious organism will this treatment prevent from harming the infant? Ans- C. Gonorrhea A newborn infant is brought to the nursery from the birthing suite. The nurse notices that the infant is breathing satifactorily but appears dusky. What action should the nurse take first? Ans- C. Check the infant's oxygen saturation rate. Just after delivery, a new mother tells the nurse, "I was unsuccessful breastfeeding my first child, but I would like to try with this baby." Which intervention is best for the nurse to implement first? Ans- D. Provide assistance to the mother to begin breastfeeding as soon as possible after delivery. The nurse is teaching a woman how to use her basal body temp pattern as a tool to assist her in conceiving a child. Which temperature pattern indicates the occurrence of ovulation, and therefore, the best time for intercourse to ensure conception? Ans- A. Between the time the temp falls and rises. A woman who had a miscarriage 6 mos ago becomes pregnant. Which instruction is most important for the nurse to provide this client? Ans- D. Take prescribed multivitamin and mineral supplements. A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse knows that the most likely presenting symptom for a pediatric client with AIDS is Ans- C. a persistent cold The nurse is caring for a woman with a previously diagnosed heart disease who is in the second stage of labor. Which assessment findings are of greatest concern? Ans- A. Edema, basilar ral