MATERNITY HESI PREPARED BY ME
FROM EVOLVE EXAM QUESTIONS
WITH COMPLETE ANSWERS
The nurse educates the pregnant client about a new diagnosis of gestational
diabetes. Which statement made by the client indicates the need for further
education?
a. "I should watch for signs of infection and report them to my doctor."
b. "My doctor will prescribe oral medication to help keep my blood sugars normal."
c. "I should continue to exercise because it will help keep my blood glucose levels
down."
d. "If I cannot control my blood sugar with diet alone, my provider may prescribe
insulin." - ANSWER-b. "My doctor will prescribe oral medication to help keep my
blood sugars normal."
Rationale:
Oral hypoglycemics are not prescribed during pregnancy.
The practical nurse (PN) is teaching a couple about ovulation and conception. The
nurse realizes the teaching is effective if the couple states which time is most likely
for conception to occur?
a. 2 weeks before menstruation
b. Immediately after menstruation
c. Immediately before menstruation
d. 3 weeks before menstruation - ANSWER-a. 2 weeks before menstruation
Rationale:
Ovulation occurs 14 days before the first day of the menstrual period.
The practical nurse is teaching a primigravida about breastfeeding. Which finding
requires follow-up?
a. The client wears push-up bras because of small breasts.
b. The client plans to enroll in an exercise class to regain her figure.
c. The client drinks one or two beers each evening to relax.
d. The client uses warm water, but no soap, to wash her nipples. - ANSWER-c. The
client drinks one or two beers each evening to relax.
Rationale:
Alcohol of all kinds should be avoided while breastfeeding, because it can be
transferred through the breast milk to the infant and can cause CNS depression in
the infant.
The practical nurse (PN) caring for a laboring client encourages her to void at least
every 2 hours and records each time the client empties her bladder. What is the
rationale for implementing this nursing intervention?
a. Emptying the bladder during delivery is difficult because of the position of the
presenting fetal part
b. An overdistended bladder could be traumatized during labor and could prolong the
progress of labor.
,c. Urine specimens for glucose and protein must be obtained at certain intervals
throughout labor.
d. Frequent voiding minimizes the need for catheterization, which increases the
chance of bladder infection. - ANSWER-b. An overdistended bladder could be
traumatized during labor and could prolong the progress of labor.
Rationale:
A full bladder can impair the efficiency of the uterine contractions and impede
descent of the fetus during labor. Also, because of the close proximity of the bladder
to the uterus, the bladder can be traumatized by the descent of the fetus.
A nurse receives shift change report for a newborn who was delivered vaginally 12
hours ago. The nurse recognizes which report should be given the highest priority to
evaluate further?
a. Cyanosis of the hands and feet
b. Skin color that is slightly jaundicedCorrect Answer
c. Hair located on the back of the shoulders
d. Red patches on the cheeks and the trunk - ANSWER-b. Skin color that is slightly
jaundiced
Rationale:
Jaundice, a yellow skin discoloration, should be evaluated further because it
occurred in a newborn less than 24 hours old. An Rh blood incompatibility can also
cause jaundice in a newborn. Acrocyanosis (bluish color of the hands and feet) is a
common finding in newborns. Hair on the back of the shoulders and red patches on
the cheeks and trunk are common findings on the skin of newborns.
Following a vaginal delivery, a postpartum client complains of severe cramping after
breastfeeding her newborn. Which explanation describes the most likely reason for
the client's pain?
a. A retained placenta
b. Problems with the process of involution
c. The release of oxytocin hormone
d. A possible ileusIncorrect Answer - ANSWER-Correct Answer:
c. The release of oxytocin hormone
Rationale:
During breastfeeding, oxytocin is released and will cause uterine contractions and
cramping.
As part of the preoperative plan of care for a client who is scheduled for a repeat
cesarean section, the practical nurse (PN) plans to administer the nonparticulate
antacid sodium citrate by mouth. What is the purpose of administering this drug
preoperatively?
a. Prevent postoperative nausea and vomiting.
b. Raise the gastric pH to above 2.5.
c. Improve gastric motility.
d. Decrease the risk of aspiration. - ANSWER-Correct Answer:
b. Raise the gastric pH to above 2.5.
Rationale:
Sodium citrate is prescribed to increase the pH of gastric secretions and make them
more alkaline so that if the client should vomit and aspirate, the chance of
pneumonitis occurring is decreased.
, The nurse is reinforcing instructions regarding nutritional needs during pregnancy.
Which client instructions should be included?
a. Your protein intake should increase by 40 g/day.
b. Your calories should increase by 300 calories/day.
c. You should drink 10 to 12 glasses of fluid per day.
d. You should lose weight if you weigh over 200 pounds (88kg) - ANSWER-b. Your
calories should increase by 300 calories/day.
Rationale:
Calorie intake is increased by 300 calories/day. Protein intake should increase by 30
g/day. The pregnant client should drink 8 to 10 glasses of fluid daily. Weight loss
should not be undertaken during pregnancy.
A pregnant client is scheduled for an amniocentesis. The client asks the practical
nurse (PN) what to expect during the procedure. How should the PN respond?
(Select all that apply.)
a. The nurse will be checking your vital signs every 15 minutes.
b. You should expect to have a low-grade fever after the procedure.
c. Amniocentesis is noninvasive, and it is used to look for fetal anomalies.
d. You will be positioned on your back during the procedure and on your left side
following the procedure.
e. Uterine contractions or cramping following the procedure are not normal and
should be reported to your health care provider. - ANSWER-a. The nurse will be
checking your vital signs every 15 minutes.
d. You will be positioned on your back during the procedure and on your left side
following the procedure.
e. Uterine contractions or cramping following the procedure are not normal and
should be reported to your health care provider.
Rationale:
During the procedure and recovery, the client's vital signs should be monitored every
15 minutes. The client should expect to be positioned supine during the procedure
and on the left side following the procedure. Uterine contractions or cramping may
be a sign of premature labor and should be reported to the health care provider
immediately.
The nurse is assisting the health care provider who will be performing an
amniocentesis on a client who is 37 weeks pregnant. Which is the priority action for
the nurse to take prior to the procedure?
a. Give the client at least 2000 mL fluid orally before the procedure.
b. Turn the client to the left lateral position before the procedure.
c. Inform the client to expect contractions after the procedure.
d. Instruct the client to empty her bladder prior to the procedure. - ANSWER-d.
Instruct the client to empty her bladder prior to the procedure.
Rationale:
The client who is in late pregnancy should empty her bladder before the procedure to
prevent injury to the bladder. It is not necessary to give the client fluids prior to the
procedure, or to turn the client to the left lateral position. It is not normal to
experience contractions after this procedure, if these happen, the health care
provider should be notified.
FROM EVOLVE EXAM QUESTIONS
WITH COMPLETE ANSWERS
The nurse educates the pregnant client about a new diagnosis of gestational
diabetes. Which statement made by the client indicates the need for further
education?
a. "I should watch for signs of infection and report them to my doctor."
b. "My doctor will prescribe oral medication to help keep my blood sugars normal."
c. "I should continue to exercise because it will help keep my blood glucose levels
down."
d. "If I cannot control my blood sugar with diet alone, my provider may prescribe
insulin." - ANSWER-b. "My doctor will prescribe oral medication to help keep my
blood sugars normal."
Rationale:
Oral hypoglycemics are not prescribed during pregnancy.
The practical nurse (PN) is teaching a couple about ovulation and conception. The
nurse realizes the teaching is effective if the couple states which time is most likely
for conception to occur?
a. 2 weeks before menstruation
b. Immediately after menstruation
c. Immediately before menstruation
d. 3 weeks before menstruation - ANSWER-a. 2 weeks before menstruation
Rationale:
Ovulation occurs 14 days before the first day of the menstrual period.
The practical nurse is teaching a primigravida about breastfeeding. Which finding
requires follow-up?
a. The client wears push-up bras because of small breasts.
b. The client plans to enroll in an exercise class to regain her figure.
c. The client drinks one or two beers each evening to relax.
d. The client uses warm water, but no soap, to wash her nipples. - ANSWER-c. The
client drinks one or two beers each evening to relax.
Rationale:
Alcohol of all kinds should be avoided while breastfeeding, because it can be
transferred through the breast milk to the infant and can cause CNS depression in
the infant.
The practical nurse (PN) caring for a laboring client encourages her to void at least
every 2 hours and records each time the client empties her bladder. What is the
rationale for implementing this nursing intervention?
a. Emptying the bladder during delivery is difficult because of the position of the
presenting fetal part
b. An overdistended bladder could be traumatized during labor and could prolong the
progress of labor.
,c. Urine specimens for glucose and protein must be obtained at certain intervals
throughout labor.
d. Frequent voiding minimizes the need for catheterization, which increases the
chance of bladder infection. - ANSWER-b. An overdistended bladder could be
traumatized during labor and could prolong the progress of labor.
Rationale:
A full bladder can impair the efficiency of the uterine contractions and impede
descent of the fetus during labor. Also, because of the close proximity of the bladder
to the uterus, the bladder can be traumatized by the descent of the fetus.
A nurse receives shift change report for a newborn who was delivered vaginally 12
hours ago. The nurse recognizes which report should be given the highest priority to
evaluate further?
a. Cyanosis of the hands and feet
b. Skin color that is slightly jaundicedCorrect Answer
c. Hair located on the back of the shoulders
d. Red patches on the cheeks and the trunk - ANSWER-b. Skin color that is slightly
jaundiced
Rationale:
Jaundice, a yellow skin discoloration, should be evaluated further because it
occurred in a newborn less than 24 hours old. An Rh blood incompatibility can also
cause jaundice in a newborn. Acrocyanosis (bluish color of the hands and feet) is a
common finding in newborns. Hair on the back of the shoulders and red patches on
the cheeks and trunk are common findings on the skin of newborns.
Following a vaginal delivery, a postpartum client complains of severe cramping after
breastfeeding her newborn. Which explanation describes the most likely reason for
the client's pain?
a. A retained placenta
b. Problems with the process of involution
c. The release of oxytocin hormone
d. A possible ileusIncorrect Answer - ANSWER-Correct Answer:
c. The release of oxytocin hormone
Rationale:
During breastfeeding, oxytocin is released and will cause uterine contractions and
cramping.
As part of the preoperative plan of care for a client who is scheduled for a repeat
cesarean section, the practical nurse (PN) plans to administer the nonparticulate
antacid sodium citrate by mouth. What is the purpose of administering this drug
preoperatively?
a. Prevent postoperative nausea and vomiting.
b. Raise the gastric pH to above 2.5.
c. Improve gastric motility.
d. Decrease the risk of aspiration. - ANSWER-Correct Answer:
b. Raise the gastric pH to above 2.5.
Rationale:
Sodium citrate is prescribed to increase the pH of gastric secretions and make them
more alkaline so that if the client should vomit and aspirate, the chance of
pneumonitis occurring is decreased.
, The nurse is reinforcing instructions regarding nutritional needs during pregnancy.
Which client instructions should be included?
a. Your protein intake should increase by 40 g/day.
b. Your calories should increase by 300 calories/day.
c. You should drink 10 to 12 glasses of fluid per day.
d. You should lose weight if you weigh over 200 pounds (88kg) - ANSWER-b. Your
calories should increase by 300 calories/day.
Rationale:
Calorie intake is increased by 300 calories/day. Protein intake should increase by 30
g/day. The pregnant client should drink 8 to 10 glasses of fluid daily. Weight loss
should not be undertaken during pregnancy.
A pregnant client is scheduled for an amniocentesis. The client asks the practical
nurse (PN) what to expect during the procedure. How should the PN respond?
(Select all that apply.)
a. The nurse will be checking your vital signs every 15 minutes.
b. You should expect to have a low-grade fever after the procedure.
c. Amniocentesis is noninvasive, and it is used to look for fetal anomalies.
d. You will be positioned on your back during the procedure and on your left side
following the procedure.
e. Uterine contractions or cramping following the procedure are not normal and
should be reported to your health care provider. - ANSWER-a. The nurse will be
checking your vital signs every 15 minutes.
d. You will be positioned on your back during the procedure and on your left side
following the procedure.
e. Uterine contractions or cramping following the procedure are not normal and
should be reported to your health care provider.
Rationale:
During the procedure and recovery, the client's vital signs should be monitored every
15 minutes. The client should expect to be positioned supine during the procedure
and on the left side following the procedure. Uterine contractions or cramping may
be a sign of premature labor and should be reported to the health care provider
immediately.
The nurse is assisting the health care provider who will be performing an
amniocentesis on a client who is 37 weeks pregnant. Which is the priority action for
the nurse to take prior to the procedure?
a. Give the client at least 2000 mL fluid orally before the procedure.
b. Turn the client to the left lateral position before the procedure.
c. Inform the client to expect contractions after the procedure.
d. Instruct the client to empty her bladder prior to the procedure. - ANSWER-d.
Instruct the client to empty her bladder prior to the procedure.
Rationale:
The client who is in late pregnancy should empty her bladder before the procedure to
prevent injury to the bladder. It is not necessary to give the client fluids prior to the
procedure, or to turn the client to the left lateral position. It is not normal to
experience contractions after this procedure, if these happen, the health care
provider should be notified.
