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Maternal/Pediatric HESI practice Exam
Questions with Verified Answers
Client teaching is an important part of the maternity nurse's role. Which factor has the greatest influence on successful teaching of the gravid client? a. the client's readiness to learn b. the client's educational background c. the order in which the information is presented d. the extent to which the pregnancy is planned - Answer -A A 38-week primigravida who works as a secretary and sits at a computer 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? a. wearing support stockings b. reduce salt in her diet c. move about every hour d. avoid constrictive clothing - Answer -C During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have a. lower apgar scores
b. lower birth weights c. respiratory distress d. a higher rate of congenital anomalies - Answer -B 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? a. drowsiness and bradycardia b. depressed reflexes and increased respirations c. tachycardia and a feeling of nervousness. d. a flushed, warm feeling and a dry mouth - Answer -C A mother who is breastfeeding her baby receives instructions from the nurse. Which instructions is most effective to prevent nipple soreness? a. wear a cotton bra b. increase nursing time gradually c. correctly place the infant on the breast d. manually express a small amount of milk before nursing - Answer -C A full term infant is transferred to the nursery from labor and delivery. Which information is most
a. at 16-week gestation b. at 20-weeks gestation c. at 24-weeks gestation d. at 30-weeks gestation - Answer -D The nurse should encourage the laboring client to begin pushing when a. there is only an anterior or posterior lip of cervix left. b. the client describes the need to have a bowel movement c. the cervix is completely dilated d. the cervix is completely effaced - Answer -C The nurse is counseling a couple who has sought information about conceiving. For teaching purposes, the nurse should know that ovulation usually occurs a. two weeks before menstruation b. immediately after menstruation c. immediately before mensturation d. three weeks before menstruation - Answer -A 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? a. administer oxygen by face mask.
b. notify the healthcare provider of the client's symptoms. c. have the client breathe into her cupped hands d. check the client's blood pressure and fetal heart rate - Answer -C When preparing a class on newborn care for expectant parents, what content should the nurse teach concerning the newborn infant born at term gestation? a. milia are red marks made by forceps and will disappear within 7 to 10 days b. meconium is the first stool and is usually yellow gold in color c. vernix is a white, cheesy substance, predominantly located in the skin folds. d. pseudostrabismus found in newborns is treated by minor surgery - Answer -C 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. a cephalhematoma, caused by forceps trauma and may last up to 8 weeks.
She sure has a funny looking head." Which response by the nurse is best? a. "this is not an unusual shaped head, especially for a first baby." b. "it may look funny to you, but newborn babies are often born with heads like your baby's" c. "that is normal; the head will return to a round shape within 7 to 10 days." d. "your pelvis was too small, so the baby's head had to adjust to the birth canal." - Answer -C A new mother asks the nurse, "how do I know that my daughter is getting enough breast milk?" Which explanation will the nurse provide? a. "weight the baby daily, and if she is gaining weight, she is eating enough." b. "your milk is sufficient if the baby is voiding pale straw-colored urine 6 to 10 times a day." c. "Offer the baby extra bottle milk after her feeding, and see if she is still hungry." d. "If you're concerned, you might consider bottle feeding so that you can monitor her intake." - Answer -B A client who gave birth to a healthy 8 pound infant 3 hours ago is admitted to the postpartum unit. Which nursing plan is best in assisting this mother to bond with her newborn infant?
a. encourage the mother to provide total care for her infant b. provide privacy so the mother can develop a relationship with the infant. c. encourage the father to provide most of the infant's care during hospitalization. d. meet the mother's physical needs and demonstrate warmth toward the infant. - Answer -D A couple, concerned because the woman has not been able to conceive, is referred to a healthcare provider for a fertility workup and a hysterosalpingogrphy is scheduled. Which complaint would indicate to the nurse that the woman's fallopian tubes are patent? a. back pain b. abdominal pain c. shoulder pain d. leg cramps - Answer -C Which nursing intervention would be most helpful in relieving postpartum uterine contractions or "afterpains"? a. lying prone with a pillow on the abdomen b. using a breast pump c. massaging the abdomen d. giving oxytocic medications - Answer -A
a. January 14- b. January 22- c. January 30- d. February 6-7 - Answer -C A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms. Which assessment findings would indicate that therapeutic drug level has been achieved? a. 4+ reflexes b. urinary output of 50 mL per hour c. a decrease in respiratory rate from 24 to 16 d. a decreased body temperature - Answer -C Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action will the nurse take? a. notify the healthcare provider or anesthesiologist immediately b. continue to assess the blood pressure q 5 minutes c. place the woman in a lateral position d. turn off the continuous epidural - Answer -C
A client at 28-weeks gestation calls the antepartal clinic and states that she is experiencing a small amount of vaginal bleeding which she describes as bright red. She further states that she is not experiencing any uterine contractions or abdominal pain. What instruction should the nurse provide? a. come to the clinic today for an ultrasound b. go immediately to the emergency room c. lie on your left side for about one hour and see if the bleeding stops. d. bring a urine specimen to the lab tomorrow to determine if you have a urinary tract infection - Answer -A An off-duty nurse finds a woman in a supermarket parking lot delivering an infant while her husband is screaming for someone to help her wife. Which intervention has the highest priority? a. use a thread to tie off the umbilical cord b. provide as much privacy as possible for the woman. c. reassure the husband and try to keep him calm d. put the newborn to breast - Answer -D A pregnant client with mitral stenosis Class III is prescribed complete bedrest. The client asks the nurse, "why must I stay in bed all the time?" Which response is best for the nurse to provide this client?
Just after delivery, a new mother tells the nurse, "I was unsuccessful breastfeeding my first child, but I would like to try with this baby." Which intervention is best for the nurse to implement first? a. assess the husband's feelings about his wife's decision to breastfeed their baby b. ask the client to describe why she was unsuccessful with breastfeeding her last child c. encourage the clients to develop a positive attitude about breastfeeding to help ensure success d. provide assistance to the mother to begin breastfeeding as soon as possible after delivery. - Answer -D The nurse is teaching a woman how to use her basal body temperature pattern as a tool to assist her in conceiving a child. Which temperature pattern indicates the occurrence of ovulation, and therefore, the best time for intercourse to ensure conception? a. between the time the temperature falls and rises b. between 36 and 48 hours after the temperature rises c. when the temperature fails and remains low for 36 hours. d. within 72 hours before the temperature falls - Answer -A
A woman who had a miscarriage 6 months ago becomes pregnant. Which instruction is most important for the nurse to provide this client? a. elevate lower legs while resting b. increase caloric intake by 200 to 300 calories per day c. increase water intake to 8 full glasses per day d. take prescribed multivitamin and mineral supplements - Answer -D A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse knows that the most likely presenting symptoms for a pediatric client with AIDS is a. shortness of breath b. joint pain c. a persistent cold d. organomegaly - Answer -C The nurse is caring for a woman with a previously diagnosed heart disease who is in the second stage of labor. Which assessment finding are of greatest concern? a. edema, basilar rales, and an irregular pulse b. increased urinary output and tachycardia c. shortness of breath, bradycardia, and hypertension d. regular heart rate and hypertension - Answer -A
d. assess the newborn's blood glucose level - Answer -C A 35-year-old primigravida client with severe preeclampsia is receiving magnesium sulfate via continuous IV infusion. Which assessment data would indicate to the nurse that the client is experiencing magnesium sulfate toxicity? a. deep tendon reflexes 2+ b. blood pressure 140/ c. respiratory rate 18/minute d. urine output 90 mL/4 hours - Answer -D A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26-weeks gestation in preterm labor. She is started on an IV solution of terbutaline (Brethine). Which assessment is the highest priority for the nurse to monitor during the administration of this drug? a. maternal blood pressure and respirations b. maternal and fetal heart rates c. hourly urinary output d. deep tendon reflexes - Answer -B A full term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms are this newborn likely to exhibit?
a. choking, coughing, and cyanosis b. projectile vomiting and cyanosis c. apneic spells and grunting d. scaphoid abdomen and anorexia - Answer -A The nurse attempts to help an unmarried teenager deal with her feelings following a spontaneous abortion at 8-weeks gestation. What type of emotional response should the nurse anticipate? a. grief related to her perceptions about the loss of this child. b. relief of ambivalent feelings experienced with this pregnancy. c. shock because she may not have realized that she was pregnant. d. guilt because she had not followed her healthcare provider's instructions - Answer -A The nurse is teaching breastfeeding to prospective parents in a childbirth education class. Which instruction should the nurse include as content in the class? a. begin as soon as your baby is born to establish a four-hour feeding schedule. b. resting helps with milk production. Ask that your baby be fed at night in the nursery. c. feed your baby every 2 to 3 hours or on demand, whichever comes first.
The nurse caring for a laboring client encourages her to void at least q2h, and records each time the client empties her bladder. What is the primary reason for implementing this nursing intervention? a. emptying the bladder during delivery is difficult because of the position of the presenting fetal part. b. an over-distended bladder could be traumatized during labor, as well as 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 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? a. supplementary iron is more efficiently utilized during pregnancy. b. it is difficult to consume 18 mg of additional iron by diet alone c. iron absorption is decreased in the GI tract during pregnancy d. iron is needed to prevent megaloblastic anemia in the last trimester - Answer -B
A woman who things 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 appropriate? a. "A home pregnancy test can be used right after your first missed period" b. "These tests are most accurate after you have missed your second period" c. "home pregnancy tests often give false positives and should not be trusted." d. "the test can provide accurate information when used right after ovulation." - Answer -A A full-term infant is transferred to the nursery from labor and delivery. Which information is most important for the nurse to receive when planning immediate care for the newborn? a. the length of labor and method of delivery b. the infant's condition at birth and treatment received c. the feeding method chosen by the parents d. the history of drugs given to the mother during labor - Answer -B A client in active labor complains of cramps in her leg. What intervention should the nurse implement? a. ask if she takes a daily calcium tablet b. extend the leg and dorsiflex the foot
