BEST ANSWERS HESI Peds &
Maternity Exam HESI Test Bank
2023 100%CORRECT ANSWERS
1. A 38-week primigravida who works as a secretary and sits at a computer for 8 hours
each 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?
Move about every hour
Pooling of blood in the lower extremities results from the enlarged uterus exerting
pressure on the pelvic veins. Moving about every hour will straighten out the
pelvic veins and increase venous return.
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?
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".
,3. What does a diaphragmatic hernia look
like? Scaphoid abdomen and anorexia
4. A new mother is afraid to touch her baby's head for fear of hurting the "large soft
spot." Which explanation should the nurse give to this anxious client?
There's a strong, tough membrane there to protect the baby so you need not be
afraid to wash or comb his/her hair.
5. A client who is attending antepartum classes asks the nurse why her
healthcare provider has prescribed iron tablets. The nurse's response is based
on what knowledge?
It is difficult to consume 18 mg of additional iron by diet alone.
Consuming enough iron-containing foods to facilitate adequate fetal storage of iron
and to meet the demands of pregnancy is difficult so iron supplements are often
recommended.
6. What is megaloblastic anemia caused
by? folic acid deficiency
7. A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when
she could use a home pregnancy test to diagnose pregnancy. Which response is
best?
A home pregnancy test can be used right after your first missed period.
Home urine tests are based on the chemical detection of human chorionic
gonadotrophin, which begins to increase 6 to 8 days after conception and is
best detected at 2 weeks’gestation or immediately after the first missed period.
8. A 28-year-old client in active labor complains of cramps in her leg. What
intervention should the nurse implement?
, Extend the leg and dorsiflex the foot
Dorsiflexing the foot by pushing the sole of the foot forward or by standing (if the client
is capable) and putting the heel of the foot on the floor is the best means of relieving
leg cramps.
9. A client at 30-weeks’gestation, complaining of pressure over the pubic area, is
admitted for observation. She is contracting irregularly and demonstrates underlying
uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high.
Based on these data, which intervention should the nurse implement first?
Obtaining a urine analysis should be done first because preterm clients with
uterine irritability and contractions are often suffering from a urinary tract infection,
and this should be ruled out first.
10. A client in active labor is admitted with preeclampsia. Which assessment finding is
most significant in planning this client's care?
A 4+ reflex in a client with pregnancy-induced hypertension indicates
hyperreflexia, which is an indication of an impending seizure.
11. What is Epogen for?
Changes an apical heart rate from the 180s to the 140s.
Epogen, given to prevent or treat anemia, stimulates erythropoietin production,
resulting in an increase in RBCs. Since the body has not had to compensate for
anemia with an increased heart rate, changes in heart rate from high to normal is one
indicator that Epogen is effective
12. The healthcare provider prescribes terbutaline (Brethine) for a client in preterm labor.
Before initiating this prescription, it is most important for the nurse to assess the
3
, client for which condition?
Gestational diabetes.
The nurse should evaluate the client for gestational diabetes because
terbutaline (Brethine) increases blood glucose levels.
13. A client with NO prenatal care arrives at the labor unit screaming, "The baby is
coming!" The nurse performs a vaginal examination that reveals the cervix is 3
centimeters dilated and 75% effaced. What additional information is most important for
the nurse to obtain?
Date of last normal menstrual period.
Evaluating the gestation of the pregnancy takes priority. If the fetus is preterm and the
fetal heart pattern is reassuring, the healthcare provider may attempt to prolong
the pregnancy and administer corticosteroids to mature the lungs of the fetus.
14. The nurse assesses a client admitted to the labor and delivery unit and obtains the
following data: dark red vaginal bleeding, uterus slightly tense between contractions,
BP 110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced. Based on
these assessment findings, what intervention should the nurse implement?
Monitoring bleeding from IV sites
Monitoring bleeding from peripheral sites is the priority intervention. This client is
presenting with signs of placental abruption. Disseminated intravascular coagulation
(DIC) is a complication of placental abruptio, characterized by abnormal bleeding.
15. Immediately after birth a newborn infant is suctioned, dried, and placed under a
radiant warmer. The infant has spontaneous respirations and the nurse assesses an
4
Maternity Exam HESI Test Bank
2023 100%CORRECT ANSWERS
1. A 38-week primigravida who works as a secretary and sits at a computer for 8 hours
each 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?
Move about every hour
Pooling of blood in the lower extremities results from the enlarged uterus exerting
pressure on the pelvic veins. Moving about every hour will straighten out the
pelvic veins and increase venous return.
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?
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".
,3. What does a diaphragmatic hernia look
like? Scaphoid abdomen and anorexia
4. A new mother is afraid to touch her baby's head for fear of hurting the "large soft
spot." Which explanation should the nurse give to this anxious client?
There's a strong, tough membrane there to protect the baby so you need not be
afraid to wash or comb his/her hair.
5. A client who is attending antepartum classes asks the nurse why her
healthcare provider has prescribed iron tablets. The nurse's response is based
on what knowledge?
It is difficult to consume 18 mg of additional iron by diet alone.
Consuming enough iron-containing foods to facilitate adequate fetal storage of iron
and to meet the demands of pregnancy is difficult so iron supplements are often
recommended.
6. What is megaloblastic anemia caused
by? folic acid deficiency
7. A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when
she could use a home pregnancy test to diagnose pregnancy. Which response is
best?
A home pregnancy test can be used right after your first missed period.
Home urine tests are based on the chemical detection of human chorionic
gonadotrophin, which begins to increase 6 to 8 days after conception and is
best detected at 2 weeks’gestation or immediately after the first missed period.
8. A 28-year-old client in active labor complains of cramps in her leg. What
intervention should the nurse implement?
, Extend the leg and dorsiflex the foot
Dorsiflexing the foot by pushing the sole of the foot forward or by standing (if the client
is capable) and putting the heel of the foot on the floor is the best means of relieving
leg cramps.
9. A client at 30-weeks’gestation, complaining of pressure over the pubic area, is
admitted for observation. She is contracting irregularly and demonstrates underlying
uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high.
Based on these data, which intervention should the nurse implement first?
Obtaining a urine analysis should be done first because preterm clients with
uterine irritability and contractions are often suffering from a urinary tract infection,
and this should be ruled out first.
10. A client in active labor is admitted with preeclampsia. Which assessment finding is
most significant in planning this client's care?
A 4+ reflex in a client with pregnancy-induced hypertension indicates
hyperreflexia, which is an indication of an impending seizure.
11. What is Epogen for?
Changes an apical heart rate from the 180s to the 140s.
Epogen, given to prevent or treat anemia, stimulates erythropoietin production,
resulting in an increase in RBCs. Since the body has not had to compensate for
anemia with an increased heart rate, changes in heart rate from high to normal is one
indicator that Epogen is effective
12. The healthcare provider prescribes terbutaline (Brethine) for a client in preterm labor.
Before initiating this prescription, it is most important for the nurse to assess the
3
, client for which condition?
Gestational diabetes.
The nurse should evaluate the client for gestational diabetes because
terbutaline (Brethine) increases blood glucose levels.
13. A client with NO prenatal care arrives at the labor unit screaming, "The baby is
coming!" The nurse performs a vaginal examination that reveals the cervix is 3
centimeters dilated and 75% effaced. What additional information is most important for
the nurse to obtain?
Date of last normal menstrual period.
Evaluating the gestation of the pregnancy takes priority. If the fetus is preterm and the
fetal heart pattern is reassuring, the healthcare provider may attempt to prolong
the pregnancy and administer corticosteroids to mature the lungs of the fetus.
14. The nurse assesses a client admitted to the labor and delivery unit and obtains the
following data: dark red vaginal bleeding, uterus slightly tense between contractions,
BP 110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced. Based on
these assessment findings, what intervention should the nurse implement?
Monitoring bleeding from IV sites
Monitoring bleeding from peripheral sites is the priority intervention. This client is
presenting with signs of placental abruption. Disseminated intravascular coagulation
(DIC) is a complication of placental abruptio, characterized by abnormal bleeding.
15. Immediately after birth a newborn infant is suctioned, dried, and placed under a
radiant warmer. The infant has spontaneous respirations and the nurse assesses an
4
