HESI STUDY GUIDE MATERNITY
PEDS Q & A
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) When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the
end of the second month.
,HESI STUDY GUIDE MATERNITY
PEDS Q & A
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?
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.
5) The nurse should encourage the laboring client to begin
pushing when... 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
,HESI STUDY GUIDE MATERNITY
PEDS Q & A
can become edematous and may never completely dilate, necessitating an
operative delivery. Many primigravida’s begin active labor 100%and
theneffacedproceed to dilate.
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?
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.
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 of blood between the
periosteum and skull which does not cross the suture line is a newborn
variation known as...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises within the
first 24 hours after delivery. Trauma from delivery causes capillary bleeding between
the periosteum and the skull.
8) When does the head return to its
normal shape? 7-10 days
9) What did Nurse theorist Reva Rubin describe?
, HESI STUDY GUIDE MATERNITY
PEDS Q & A
The initial postpartum period as the "taking-in phase," which is characterized
by maternal reliance on others to satisfy the needs for comfort, rest,
nourishment, and closeness to families and the newborn.
10) 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 post procedure complaint
indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub
diaphragmatic collection of peritoneal dye/gas.
11) Which nursing intervention is most helpful in relieving postpartum uterine
contractions or "afterpains?"
Lying prone with a pillow on the abdomen
2
PEDS Q & A
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) When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the
end of the second month.
,HESI STUDY GUIDE MATERNITY
PEDS Q & A
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?
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.
5) The nurse should encourage the laboring client to begin
pushing when... 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
,HESI STUDY GUIDE MATERNITY
PEDS Q & A
can become edematous and may never completely dilate, necessitating an
operative delivery. Many primigravida’s begin active labor 100%and
theneffacedproceed to dilate.
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?
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.
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 of blood between the
periosteum and skull which does not cross the suture line is a newborn
variation known as...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises within the
first 24 hours after delivery. Trauma from delivery causes capillary bleeding between
the periosteum and the skull.
8) When does the head return to its
normal shape? 7-10 days
9) What did Nurse theorist Reva Rubin describe?
, HESI STUDY GUIDE MATERNITY
PEDS Q & A
The initial postpartum period as the "taking-in phase," which is characterized
by maternal reliance on others to satisfy the needs for comfort, rest,
nourishment, and closeness to families and the newborn.
10) 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 post procedure complaint
indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub
diaphragmatic collection of peritoneal dye/gas.
11) Which nursing intervention is most helpful in relieving postpartum uterine
contractions or "afterpains?"
Lying prone with a pillow on the abdomen
2
