HESI Practice Maternity V1
1. 1. A client has obtained Plan B (levonorgestrel 0.75 mg,
2 tablets) as emergency
contraception. After unprotected intercourse, the client calls
the clinic to ask questions
about taking the contraceptives. The nurse realizes the client
needs further explanation
when she makes which of the following responses?
1. "I can wait 3 to 4 days after intercourse to start taking
these to prevent pregnancy."
2. "My boyfriend can buy Plan B from the pharmacy if he is
over 18 years old."
3. "The birth control works by preventing ovulation or
fertilization of the egg."
4. "I may feel nauseated and have breast tenderness or a
headache after using the
contraceptive.": 1. Plan B is a series of contraceptive pills similar
in composition to birth control
pills that have been used for the past 30 years. Plan B is the brand
name for levonorgestrel 0.75 mg. Pills are most effective if taken
immediately after unpro- tected
intercourse and then again 12 hours later. Males can purchase this
contraceptive as long
as they are over 18 years of age. Common side effects include nausea,
breast tenderness, vertigo, and stomach pain.
,CN: Physiological adaptation; CL: Evaluate
2. 2. An antenatal G 2, T 1, P 0, Ab 0, L 1 client is discussing
her postpartum plans
for birth control with her health care provider. In analyzing
the available choices, which
of the following factors has the greatest impact on her birth
control options?
1. Satisfaction with prior methods.
2. Preference of sexual partner.
3. Breast- or bottle-feeding plan.
4. Desire for another child in 2 years.: :3. Birth control plans
are influenced primarily by whether the mother is breast- or
bottle-feeding her infant. The maternal milk supply must be well
established prior to the
initiation of most hormonal birth control methods. Low-dose oral
contraceptives would
be the exception. Use of estrogen-/progesterone-based pills and
proges-
,terone-only pills
are commonly initiated from 4 to 6 weeks postpartum because the
milk supply is well
established by this time. Prior experiences with birth control methods
have an impact on
the method chosen as do the preferences of the client's partner;
however, they are not the
most influential factors. Desire to have another child in two years
would make some methods, such as an IUD, less attractive but would
still be secondary to the choice to
breast-feed.
CN: Pharmacological and parenteral therapies; CL: Analyze
3. 3. After the nurse instructs a 20-year-old nulligravid
client on how to perform a
breast self-examination, which of the following client
statements indicates that the
teaching has been successful?
1. "I should perform breast self-examination on the day my
menstrual flow begins."
2. "It's important that I perform breast self-examination on the
same day each month."
3. "If I notice that one of my breasts is much smaller than the
other, I shouldn't worry."
4. "If there is discharge from my nipples, I should call my
health care provider.": : 4. The nurse determines that the client
, has understood the instructions when the
client says that she will notify her primary health care provider if
she notices discharge
or bleeding because this may be symptomatic of underlying disease.
Ideally, breast selfexamination
should be performed about 1 week after the onset of menses because
hormonal influences on breast tissue are at a low ebb at this time. The
client should perform breast self-examination on the same day each
month only if she has stopped
menstruating (as with menopause). The client's breasts should mirror
each other.
If one
breast is significantly larger than the other, or if there is "pitting" of
breast tissue, a tumor may be present.
CN: Reduction of risk potential; CL: Evaluate
1. 1. A client has obtained Plan B (levonorgestrel 0.75 mg,
2 tablets) as emergency
contraception. After unprotected intercourse, the client calls
the clinic to ask questions
about taking the contraceptives. The nurse realizes the client
needs further explanation
when she makes which of the following responses?
1. "I can wait 3 to 4 days after intercourse to start taking
these to prevent pregnancy."
2. "My boyfriend can buy Plan B from the pharmacy if he is
over 18 years old."
3. "The birth control works by preventing ovulation or
fertilization of the egg."
4. "I may feel nauseated and have breast tenderness or a
headache after using the
contraceptive.": 1. Plan B is a series of contraceptive pills similar
in composition to birth control
pills that have been used for the past 30 years. Plan B is the brand
name for levonorgestrel 0.75 mg. Pills are most effective if taken
immediately after unpro- tected
intercourse and then again 12 hours later. Males can purchase this
contraceptive as long
as they are over 18 years of age. Common side effects include nausea,
breast tenderness, vertigo, and stomach pain.
,CN: Physiological adaptation; CL: Evaluate
2. 2. An antenatal G 2, T 1, P 0, Ab 0, L 1 client is discussing
her postpartum plans
for birth control with her health care provider. In analyzing
the available choices, which
of the following factors has the greatest impact on her birth
control options?
1. Satisfaction with prior methods.
2. Preference of sexual partner.
3. Breast- or bottle-feeding plan.
4. Desire for another child in 2 years.: :3. Birth control plans
are influenced primarily by whether the mother is breast- or
bottle-feeding her infant. The maternal milk supply must be well
established prior to the
initiation of most hormonal birth control methods. Low-dose oral
contraceptives would
be the exception. Use of estrogen-/progesterone-based pills and
proges-
,terone-only pills
are commonly initiated from 4 to 6 weeks postpartum because the
milk supply is well
established by this time. Prior experiences with birth control methods
have an impact on
the method chosen as do the preferences of the client's partner;
however, they are not the
most influential factors. Desire to have another child in two years
would make some methods, such as an IUD, less attractive but would
still be secondary to the choice to
breast-feed.
CN: Pharmacological and parenteral therapies; CL: Analyze
3. 3. After the nurse instructs a 20-year-old nulligravid
client on how to perform a
breast self-examination, which of the following client
statements indicates that the
teaching has been successful?
1. "I should perform breast self-examination on the day my
menstrual flow begins."
2. "It's important that I perform breast self-examination on the
same day each month."
3. "If I notice that one of my breasts is much smaller than the
other, I shouldn't worry."
4. "If there is discharge from my nipples, I should call my
health care provider.": : 4. The nurse determines that the client
, has understood the instructions when the
client says that she will notify her primary health care provider if
she notices discharge
or bleeding because this may be symptomatic of underlying disease.
Ideally, breast selfexamination
should be performed about 1 week after the onset of menses because
hormonal influences on breast tissue are at a low ebb at this time. The
client should perform breast self-examination on the same day each
month only if she has stopped
menstruating (as with menopause). The client's breasts should mirror
each other.
If one
breast is significantly larger than the other, or if there is "pitting" of
breast tissue, a tumor may be present.
CN: Reduction of risk potential; CL: Evaluate
