HESI Maternity

60 Questions  I  By Nursejbv21
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 HESI maternity
Welcome to Maternal and Child Health Nursing (HESI EXAMINATION) Prepared by: Jeffrey Viernes Maternity nursing is a form of intensive, informative and knowledgeable care provided by a maternity nurse. In most instances, the maternity nurse provides 2 related and integrated services. The first one is pre-birth care. The maternity nurse is there to help the mother and the family during their pregnancy and afterwards. In maternity nursing, the provider prepares the family for the entire birthing experience. The second responsibility of the maternity nurse is post birth. The nurse is also there after the birth. In this role, he or she advises mothers on such things as post natal care of themselves and their newborns.

  
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  • 1. 
    Mrs. Puente is visiting the clinic for a prenatal assessment. This is the client's fourth pregnancy. She lost one pregnancy during the ninth week of gestation. One pregnancy resulted in birth of a stillborn infant at full term, and she has one living child who was born the 35th week of gestation. Which of the following best describes the client?
    • A. 

      G5P2111

    • B. 

      G4P1111

    • C. 

      G4P1211

    • D. 

      G5P1112


  • 2. 
    Ativan 0.5 mg IM every 1 hour as needed is prescribed for a client experiencing delirium tremens. The medication vial reads 2mg/mL of solution. How many mL should the LPN draw into the syringe for single dose administration?

  • 3. 
    A 36 year-old male client loses all function from his waist down after sustaining a spinal cord injury after falling off the roof of his house. The nurse asks the client how this injury will affect the different aspects of his life. The client replie, "It won't." This reaction exemplifies that the client is in what stage of the grieving process?

  • 4. 
    A client is pregnant with her third child. Medical history of the client indicates a previous precipitate labor and birth. Which of the following interventions would NOT be expected during labor of the present pregnancy?
    • A. 

      Use of magnesium sulfate

    • B. 

      Close monitoring of the fetus for hypoxia

    • C. 

      The nurse stays at the bedside constantly or as much as possible

    • D. 

      Amnioinfusion will be performed


  • 5. 
    Fetal heart is carefully monitored throughout pregnancy and during labor to assess fetal well being. Which of the following represnts an appropriate fetal heart rate?
    • A. 

      108

    • B. 

      127

    • C. 

      170

    • D. 

      185


  • 6. 
    A client suspects that she is pregnant and visits the clinic. Of the following changes caused by pregnancy, which is the only positive sign that the client is pregnant?
    • A. 

      Enlarge abdomen

    • B. 

      Positive pregnancy test

    • C. 

      Detection of fetal heartbeat

    • D. 

      Uterine contraction


  • 7. 
    The physcician orders epinephrine 0.1 mg SQ x 1 now. The constitution of epinephrine according to the vial is 1;1000, or 1 g of epinephrine per 1,000 mL of solution. How much solution should be drawn into the syringe by the LPN?
    • A. 

      0.01 mL

    • B. 

      0.1 mL

    • C. 

      1.0 mL

    • D. 

      10 mL


  • 8. 
    The LPN is preparing to administer Solu-medrol 40 mg mixed in 150 mL of sodium chloride via intravenous piggyback. The medication is to be administered over 30 minutes. Using the tubing with a drop factor of 15 ggts/mL, what would the LPN calculate the rate to be in drops per minute?
    • A. 

      40

    • B. 

      50

    • C. 

      75

    • D. 

      150


  • 9. 
    The LPN has initiated the administration of vancomycin via IV piggyback . In which of the following situations should the nurse recognize that the client may be experiencing a fatal reaction to this medication?
    • A. 

      The client start coughing

    • B. 

      The client complains of pain at the intravenous catheter insertion site

    • C. 

      The nurse hears the client snoring from the hall

    • D. 

      The nurse notices the client's neck and chest is bright red


  • 10. 
    Pediazole is a suspension medication that contains 200 mg erythromycin and 600 mg sulfisoxazole per 5 mL. The physician orders Pediazole 4 mL PO every 12 hours. How many mg of sulfisoxazole is this client receiving in a 24-hour period?
    • A. 

      160 mg

    • B. 

      320 mg

    • C. 

      480 mg

    • D. 

      960 mg


  • 11. 
    During a lecture on reproduction,a student nurse asks the instructor what determines the sex of a fetus. Accurate information in response to this question would be:
    • A. 

      "The sex of the fetus is not determined until the eighth week of gestation."

    • B. 

      "The fertilization of the zygote is the point at which sex is determined."

    • C. 

      "Males have one less pair of chromosomes than females."

    • D. 

      "Sex is determined by the chromosomes contributed by the ovum."


  • 12. 
    The nurse identifies substance abuse behaviors exhibited by a pregnant client during an initial prenatal screening. While promoting a therapeutic and accepting environment,the care managment by the nurse would be MOST appropriate if focused on which of the following?
    • A. 

      Discouraging substance use during pregnancy

    • B. 

      Termination of the pregnancy at an early stage

    • C. 

      Eliminating substance use during pregnancy

    • D. 

      Setting boundaries with the client in regards to substance use


  • 13. 
    A 25-year-old client with diabetes type I visits the clinic to discuss her and her husband'sdesire to start a family. This diabetic client 
    • A. 

      Should be discouraged from becoming pregnant

    • B. 

      Has a greater risk of complications during pregnancy

    • C. 

      Should be informed about treatment for infertility

    • D. 

      Will be able to carry out a completely normal pregnancy


  • 14. 
    During the prenatal visit,the client states that she has been experiencing heartburn frequently. The LPN provides instruction on the cause and prevention of heartburn. When she ask to verbalize understanding of the information,which of the following statements by the client indicates further instruction may be necessary?
    • A. 

      "The sphincter that normally prevents stomach contents from going back up into the esophagus is relaxed."

    • B. 

      "I should try to avoid drinking fluids while I'm eating."

    • C. 

      "Eating six or seven small meals a day may help my symptoms."

    • D. 

      "I'll eat enough to ensure that I am full at every meal."


  • 15. 
    A nurse is collecting data from a client who suspects that she is pregnant. The nurse is checking the client for probable signs of pregnancy. Select all that apply.
    • A. 

      Ballottement

    • B. 

      Chadwick 's sign

    • C. 

      Uterine enlargement

    • D. 

      Braxton Hicks contractions

    • E. 

      Outline of fetus via radiography or ultrasound

    • F. 

      Fetal heart rate detected by a non electronic device

    • G. 

      Hegar' s sign

    • H. 

      Goodle's sign


  • 16. 
    A nurse is monitoring a pregnant client with gestational hypertension who is at risk for preeclampsia. The nurse checks the client for which classic signs of preeclampsia? Select all that apply.
    • A. 

      Proteinuria

    • B. 

      Hypertension

    • C. 

      Low grade fever

    • D. 

      Generalized edema

    • E. 

      Increase pulse rate

    • F. 

      Increase respiratory rate


  • 17. 
    A nurse is monitoring for the Physiological Maternal Changes relating to pregnancy for a primigravida patient. What are the normal changes that happens during pregnancy? Select all that apply.
    • A. 

      Circulating blood volume increases

    • B. 

      Sodium and water retention may occur, which can lead to weight gain

    • C. 

      Shortness of breath may be experienced

    • D. 

      Breast size atrophies

    • E. 

      There is a decrease in vaginal secretions

    • F. 

      Frequency of urination occurs during second trimester

    • G. 

      Chloasma occurs


  • 18. 
    The nurse knows that there are psychological maternal changes that occurs during pregnancy in a primigravida patient. Select all  the normal psychological maternal changes that happens throughout pregnancy.  
    • A. 

      Ambivalence

    • B. 

      Breast tenderness

    • C. 

      Emotional lability

    • D. 

      Body image changes

    • E. 

      Bonding or relationship with the fetus

    • F. 

      Nausea and vomiting

    • G. 

      Syncope

    • H. 

      Urinary frequency


  • 19. 
     A primigravida patient who is 12 weeks pregnant visits a helath promotion program in the community pertaining to the pregnancy care. A group of nursing student is educating the public about measures to prevent discomfort of pregnancy. The primigravida patient asks one of the student about measures on how to prevent heartburn she is experiencing throughout the day. Select all the necessary measures to prevent the primigravia patient's complaint.
    • A. 

      Eating small, frequent meals and avoiding fatty and spicy food

    • B. 

      Eating high fiber foods and increase drinking fluids

    • C. 

      Drinking milk between milk

    • D. 

      Arranging frequent rest periods throughout the day

    • E. 

      Sitting upright for 30 minutes after a meal

    • F. 

      Engaging in regular exercise


  • 20. 
    A 36 weeks gestation pregnant woman is complaining of urinary urgency and frequency. The nurse explained that the enlarging fetus is pressing the bladder which causes frequent urination. This is normally occuring during the first and third trimesters of pregnancy. The nurse advices the patient to do the following measures to prevent urinary frequency. Select all the necessary measures that the nurse can provide to the patient. 
    • A. 

      Drink 2 quarts of fluid during the day

    • B. 

      Engaging in a regular exercise

    • C. 

      Performing Kegel exercises

    • D. 

      Soaking in a warm sitz bath

    • E. 

      Limiting fluid intake during the evening


  • 21. 

    Reddish purple strech marks that usually occur on the abdomen, breasts, thighs, and upper arm. As a nurse, you would document this correctly in the client's chart by using what medical terminology?

  • 22. 
    The OB/GYN physician required the LPN to perform different laboratory tests for the primigravida woman who is on her 20 weeks' gestation. As a nurse you would expect that the physician will order what types of laboratory testing for the pregnant woman?
    • A. 

      Blood type and Rh factor

    • B. 

      Pap's smear

    • C. 

      Rubella titer

    • D. 

      Urinalysis

    • E. 

      Hemoglobin and hematocrit levels

    • F. 

      Hepatitis B surface antigen


  • 23. 
    The nurse is educating a primigravida patient who is 12 weeks pregnant about the danger signs of pregnancy. The information provided is clearly understood by the expectant mother if the client states the following danger signs of pregnancy: Slect all that apply.
    • A. 

      Gush of vaginal discharge

    • B. 

      Vaginal bleeding

    • C. 

      Persistent vomiting

    • D. 

      Constipation

    • E. 

      Urinary frequency

    • F. 

      Epigastric or abdominal pain

    • G. 

      Fetal heart rate of 120


  • 24. 
    What is the recommended drug for the prevention of maternal-fetal HIV transmission;itis usually administered orally beginning after 14 weeks'gestation,intravenously during labor,and in the form of syrup to the neonate after birth for 6 weeks?

  • 25. 
    A nurse is collecting data during the admission asessment of a client who is pregnant with twins. The client also has 5 year old child. The nurse would document which gravida and para status on this client?
    • A. 

      G1P1

    • B. 

      G2P1

    • C. 

      G2P2

    • D. 

      G3P2


  • 26. 

    This is a dark streak down the midline of the abdomen that may appear as the uterus is enlarging. The LPN correctly describes this to the pregnant woman as?

  • 27. 
    A nursing instructor asks a nursing student to list the functions of the amniotic fluid. The student responds correctly by stating that which of the following are functions of amniotic fluid? Select all that apply.
    • A. 

      Allows for fetal movement

    • B. 

      Is a measure of kidney function

    • C. 

      Surrounds, cushions, and protects the fetus

    • D. 

      Maintains the body temperature of the fetus

    • E. 

      Prevents large particles such as bacteria from passing to the fetus

    • F. 

      Provides an exchange of nutrients and waste products between the mother and the fetus


  • 28. 
    During a prenatal visit, the nurse checks the fetal heart rate of a client in the third trimester of pregnancy. The nurse determines that the FHR is normal if which of the following heart rates is noted?
    • A. 

      80 beats per minute

    • B. 

      100 beats per minute

    • C. 

      150 beats per minute

    • D. 

      180 beats per minute


  • 29. 
    During a prenatal visit, the nurse checks the fetal heart rate of a client in the third trimester of pregnancy. The nurse determines that the FHR is normal if which of the following heart rates is noted?
    • A. 

      80 beats per minute

    • B. 

      100 beats per minute

    • C. 

      150 beats per minute

    • D. 

      180 beats per minute


  • 30. 
    A client at 36 weeks’ gestation is schedule for a routine ultrasound prior to an amniocentesis. After teaching the client about the purpose for the ultrasound, which of the following client statements would indicate to the nurse in charge that the client needs further instruction?
    • A. 

      The ultrasound will help to locate the placenta

    • B. 

      The ultrasound identifies blood flow through the umbilical cord

    • C. 

      The test will determine where to insert the needle

    • D. 

      The ultrasound locates a pool of amniotic fluid


  • 31. 
    While the postpartum client is receiving herapin for thrombophlebitis, which of the following drugs would the nurse Mica expect to administer if the client develops complications related to heparin therapy?
    • A. 

      Calcium gluconate

    • B. 

      Protamine sulfate

    • C. 

      Methylegonovine

    • D. 

      Nitrofurantoin


  • 32. 
    The nurse is caring for a primigravida at about 2 months and 1 week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says:
    • A. 

      “Nausea and vomiting can be decreased if I eat a few crackers before arising”

    • B. 

      “If I start to leak colostrum, I should cleanse my nipples with soap and water”

    • C. 

      “If I have a vaginal discharge, I should wear nylon underwear”

    • D. 

      “Leg cramps can be alleviated if I put an ice pack on the area”


  • 33. 
     A primigravida client at 25 weeks’ gestation visits the clinic and tells the nurse that her lower back aches when she arrives home from work. The nurse should suggest that the client perform:
    • A. 

      Tailor sitting

    • B. 

      Leg lifting

    • C. 

      Shoulder circling

    • D. 

      Squatting exercises


  • 34. 
    A pregnant patient asks the nurse Kate if she can take castor oil for her constipation. How should the nurse respond?
    • A. 

      “Yes, it produces no adverse effect.”

    • B. 

      “No, it can initiate premature uterine contractions.”

    • C. 

      “No, it can promote sodium retention.”

    • D. 

      “No, it can lead to increased absorption of fat-soluble vitamins.”


  • 35. 
    A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several cloth. What is the primary nursing diagnosis for this patient
    • A. 

      Knowledge deficit

    • B. 

      Fluid volume deficit

    • C. 

      Anticipatory grieving

    • D. 

      Pain


  • 36. 
    After administering bethanechol to a patient with urine retention, the nurse in charge monitors the patient for adverse effects. Which is most likely to occur?
    • A. 

      Decreased peristalsis

    • B. 

      Increase heart rate

    • C. 

      Dry mucous membranes

    • D. 

      Nausea and Vomiting


  • 37. 
    The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The LPN should tell the patient that she can expect to feel the fetus move at which time?
    • A. 

      Between 10 and 12 weeks’ gestation

    • B. 

      Between 16 and 20 weeks’ gestation

    • C. 

      Between 21 and 23 weeks’ gestation

    • D. 

      Between 24 and 26 weeks’ gestation


  • 38. 
    When assessing the adequacy of sperm for conception to occur, which of the following is the most useful criterion? 
    • A. 

      Sperm count

    • B. 

      Sperm motility

    • C. 

      Sperm maturity

    • D. 

      Sperm volume


  • 39. 
    A couple who wants to conceive but has been unsuccessful during the last 2 years has undergone many diagnostic procedures. When discussing the situation with the nurse, one partner states, “We know several friends in our age group and all of them have their own child already, Why can’t we have one?”. Which of the following would be the most pertinent nursing diagnosis for this couple?
    • A. 

      Fear related to the unknown

    • B. 

      Pain related to numerous procedures.

    • C. 

      Ineffective family coping related to infertility.

    • D. 

      Self-esteem disturbance related to infertility.


  • 40. 
    Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester?
    • A. 

      Dysuria

    • B. 

      Frequency

    • C. 

      Incontinence

    • D. 

      Burning urination


  • 41. 
    Heartburn and flatulence, common in the second trimester, are most likely the result of which of the following?
    • A. 

      Increased plasma HCG levels

    • B. 

      Decreased intestinal motility

    • C. 

      Decrease gastric acidity

    • D. 

      Elevated estrogen levels


  • 42. 
    On which of the following areas would the nurse expect to observe chloasma?
    • A. 

      Breast, areola, and nipples

    • B. 

      Chest, neck, arms, and legs

    • C. 

      Abdomen, breast, and thighs

    • D. 

      Cheeks, forehead, and nose


  • 43. 
    A pregnant client states that she “waddles” when she walks. The nurse’s explanation is based on which of the following as the cause?
    • A. 

      The large size of the newborn

    • B. 

      Pressure on the pelvic brim

    • C. 

      Relaxation of the pelvic joints

    • D. 

      Excessive weight gain


  • 44. 
    Which of the following represents the average amount of weight gained during pregnancy?
    • A. 

      12 to 2 lbs

    • B. 

      15 to 25 lbs

    • C. 

      25 to 35 lbs

    • D. 

      25 to 40 lbs


  • 45. 
    When talking with a pregnant client who is experiencing aching swollen, leg veins, the nurse would explain that this is most probably the result of which of the following?
    • A. 

      Thrombophlebitis

    • B. 

      Pregnancy induced hypertension

    • C. 

      Pressure on blood vessels from the enlarging uterus

    • D. 

      The force of gravity pulling down on the uterus


  • 46. 
    Cervical softening and uterine souffle are classified as which of the following?
    • A. 

      Diagnostic signs

    • B. 

      Presumptive signs

    • C. 

      Probable signs

    • D. 

      Positive signs


  • 47. 
    Which of the following would the nurse identify as a presumptive sign of pregnancy?
    • A. 

      Hegar sign

    • B. 

      Nausea and vomiting

    • C. 

      Skin pigmentation changes

    • D. 

      Positive serum pregnancy test


  • 48. 
    Which of the following common emotional reactions to pregnancy would the nurse expect to occur during the first trimester?
    • A. 

      Introversion, egocentrism, narcissism

    • B. 

      Awkwardness, clumsiness, and unattractiveness

    • C. 

      Anxiety, passivity, extroversion

    • D. 

      Ambivalence, fear, fantasies


  • 49. 
    During which of the following would the focus of classes be mainly on physiologic changes, fetal development, sexuality, during pregnancy, and nutrition?
    • A. 

      Post partum phase

    • B. 

      First trimester

    • C. 

      Second trimester

    • D. 

      Third trimester


  • 50. 
    Which of the following would cause a false-positive result on a pregnancy test?
    • A. 

      The test was performed less than 10 days after an abortion

    • B. 

      The test was performed too early or too late in the pregnancy

    • C. 

      The urine sample was stored too long at room temperature

    • D. 

      A spontaneous abortion or a missed abortion is impending


  • 51. 
     FHR can be auscultated with a fetoscope as early as which of the following?
    • A. 

      5 weeks gestation

    • B. 

      10 weeks gestation

    • C. 

      13 weeks gestation

    • D. 

      20 weeks gestation


  • 52. 
    A client LMP began July 5. Her EDD should be which of the following?
    • A. 

      January 2

    • B. 

      March 28

    • C. 

      April 12

    • D. 

      October 12


  • 53. 
    Which of the following fundal heights indicates less than 12 weeks’ gestation when the date of the LMP is unknown?
    • A. 

      Uterus in the pelvis

    • B. 

      Uterus at the xiphoid process

    • C. 

      Uterus in the abdomen

    • D. 

      Uterus in the umbilicus


  • 54. 
    Which of the following prenatal laboratory test values would the nurse consider as significant?
    • A. 

      Hematocrit 33.5%

    • B. 

      Rubella titer less than 1:8

    • C. 

      White blood cells 8,000/mm3

    • D. 

      One hour glucose challenge test 110 g/dL


  • 55. 
    The hormone responsible for the development of the ovum during the menstrual cycle is?    
    • A. 

      Estrogen

    • B. 

      Progesterone

    • C. 

      Follicle stimulating hormone

    • D. 

      Leutenizing hormone


  • 56. 
    Family centered nursing care for women and newborn focuses on which of the following?    
    • A. 

      Assisting individuals and families achieve their optimal health

    • B. 

      Diagnosing and treating problems promptly

    • C. 

      Preventing further complications from developing

    • D. 

      Conducting nursing research to evaluate clinical skills


  • 57. 
    During which of the following phase of the menstrual cycle is it ideal for implantation of a fertilized egg to occur? 
    • A. 

      Ischemic phase

    • B. 

      Mentrual phase

    • C. 

      Proliferative phase

    • D. 

      Secretory phase


  • 58. 
    Variation on the length of menstrual cycle is due to variations in the number of days in which of the following phase? 
    • A. 

      Proliferative phase

    • B. 

      Mentrual phase

    • C. 

      Proliferative phase

    • D. 

      Secretory phase


  • 59. 
    According to Diane, her LMP is November 15, 2002, using the Naegle’s rule what is her EDC? 
    • A. 

      August 23, 2003

    • B. 

      August 18, 2003

    • C. 

      July 22, 2003

    • D. 

      February 22, 2003


  • 60. 
    She complained of leg cramps, which usually occurs at night. To provide relief, the nurse tells Diane to: 
    • A. 

      Dorsiflex the foot while extending the knee when the cramps occur

    • B. 

      Dorsiflex the foot while flexing the knee when the cramps occurs

    • C. 

      Plantar flex the foot while flexing the knee when the cramps occur

    • D. 

      Plantar flex the foot while extending the knee when the cramp occur


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