MATERNITY HESI 1 TEST BANK EXAM
(QUESTIONS AND ANSWERS) WITH
RATIONALES EXPLAINED LATEST
UPDATE 2024 GRADE A+
Question 1.
,Twenty minutes after a continuous epidural anesthetic is
administered, a laboring client's blood pressure drops from
120/80 to 90/60. What action should the nurse take?
Ans: Place woman in a lateral position
The nurse should immediately turn the woman to a lateral
position, place a pillow or wedge under the right hip to deflect the
uterus, increase the rate of the main line IV infusion, and
administer oxygen by face mask at 10-12 L/min. If the blood
pressure remains low, especially if it further decreases, the
anesthesiologist/healthcare provider should be notified
immediately.
Question 2.
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: Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug,
stimulates
,beta-adrenergic receptors in the uterine muscle to stop
contractions. The beta-adrenergic agonist properties of the
drug may cause tachycardia, increased cardiac output,
restlessness, headache, and a feeling of "nervousness".
Question 3.
When do the anterior and posterior fontanels close?
Ans: anterior fontanel closes at 12 to 18 months and the
posterior by the end of the second month.
Question 4.
When assessing a client who is at 12-weeks gestation, the nurse
recommends that she and her husband consider attending
childbirth preparation classes. When is the best time for the
couple to attend these classes?
Ans: 30 weeks gestation
at 30 weeks gestation is closest (of the options) to the time
parents would be ready for such classes. Learning is facilitated
by an interested pupil! The couple is most interested in childbirth
toward the end of the pregnancy when they are psychologically
ready for the termination of the pregnancy, and the birth of their
child is an immediate concern
, Question 5.
The nurse should encourage the laboring client to
begin pushing when... Ans: the cervix is completely
dilated.
Pushing begins with the second stage of labor, i.e., when the
cervix is completely dilated at 10 cm (C). If pushing begins
before the cervix is completely dilated the cervix can become
edematous and may never completely dilate, necessitating an
operative delivery. Many primigravida’s begin active labor 100%
effaced and then proceed to dilate.
Question 6.
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: Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation
(blowing off too much carbon dioxide). Hyperventilation is
treated by retaining carbon dioxide. This can be facilitated by
breathing into a paper bag or cupped hands.
Question 7.
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
(QUESTIONS AND ANSWERS) WITH
RATIONALES EXPLAINED LATEST
UPDATE 2024 GRADE A+
Question 1.
,Twenty minutes after a continuous epidural anesthetic is
administered, a laboring client's blood pressure drops from
120/80 to 90/60. What action should the nurse take?
Ans: Place woman in a lateral position
The nurse should immediately turn the woman to a lateral
position, place a pillow or wedge under the right hip to deflect the
uterus, increase the rate of the main line IV infusion, and
administer oxygen by face mask at 10-12 L/min. If the blood
pressure remains low, especially if it further decreases, the
anesthesiologist/healthcare provider should be notified
immediately.
Question 2.
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: Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug,
stimulates
,beta-adrenergic receptors in the uterine muscle to stop
contractions. The beta-adrenergic agonist properties of the
drug may cause tachycardia, increased cardiac output,
restlessness, headache, and a feeling of "nervousness".
Question 3.
When do the anterior and posterior fontanels close?
Ans: anterior fontanel closes at 12 to 18 months and the
posterior by the end of the second month.
Question 4.
When assessing a client who is at 12-weeks gestation, the nurse
recommends that she and her husband consider attending
childbirth preparation classes. When is the best time for the
couple to attend these classes?
Ans: 30 weeks gestation
at 30 weeks gestation is closest (of the options) to the time
parents would be ready for such classes. Learning is facilitated
by an interested pupil! The couple is most interested in childbirth
toward the end of the pregnancy when they are psychologically
ready for the termination of the pregnancy, and the birth of their
child is an immediate concern
, Question 5.
The nurse should encourage the laboring client to
begin pushing when... Ans: the cervix is completely
dilated.
Pushing begins with the second stage of labor, i.e., when the
cervix is completely dilated at 10 cm (C). If pushing begins
before the cervix is completely dilated the cervix can become
edematous and may never completely dilate, necessitating an
operative delivery. Many primigravida’s begin active labor 100%
effaced and then proceed to dilate.
Question 6.
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: Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation
(blowing off too much carbon dioxide). Hyperventilation is
treated by retaining carbon dioxide. This can be facilitated by
breathing into a paper bag or cupped hands.
Question 7.
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
