HESI Exam: Toughest Questions On Maternity! Trivia Quiz

During the third trimester of pregnancy, a normal fetal heart rate (FHR) is typically around 120-160 beats per minute. Therefore, 150 beats per minute falls within the normal range and is considered a normal FHR for a client in the third trimester of pregnancy.

The appropriate range of fetal heart rate is 120-160 beats per minute.

Clients with DM are at greater risk of developing maternal and fetal complications during pregnancy.

During the third trimester of pregnancy, a normal fetal heart rate (FHR) ranges between 120 and 160 beats per minute. Therefore, a heart rate of 150 beats per minute is considered normal. FHR below 120 or above 160 may indicate fetal distress or other complications.

To determine the EDD when the date of the client’s LMP is known use Nagele rule. To the first day of the LMP, add 7 days, subtract 3 months, and add 1 year (if applicable) to arrive at the EDD as follows: 5 + 7 = 12 (July) minus 3 = 4 (April). Therefore, the client’s EDD is April 12.

Pressure and irritation of the bladder by the growing uterus during the first trimester is responsible for causing urinary frequency. Dysuria, incontinence, and burning are symptoms associated with urinary tract infections.

Positive signs of pregnancy are detected changes that provide objective, conclusive proof of pregnancy. 1. detection of fetal heartbeat 2. fetal movement palpated by a professional 3. visualization of the fetus by sonography The other choices are considered PROBABLE signs of pregnancy.

During the first trimester, common emotional reactions include ambivalence, fear, fantasies, or anxiety. The second trimester is a period of well- being accompanied by the increased need to learn about fetal growth and development. Common emotional reactions during this trimester include narcissism, passivity, or introversion. At times the woman may seem egocentric and self-centered. During the third trimester, the woman typically feels awkward, clumsy, and unattractive, often becoming more introverted or reflective of her own childhood.

Eating dry crackers before arising can assist in decreasing the common discomfort of nausea and vomiting. Avoiding strong food odors and eating a high-protein snack before bedtime can also help.

While administering vancomycin the LPN should know to monitor the client carefully for the development of Red Man Syndrome or anaphylactic shock. The common side effects of this medicine are pruritus, flushing and erythema to the head, neck, and upper body.

The Naegle's rule is a method used to estimate the expected date of delivery (EDC) for a pregnancy. According to this rule, you add 7 days to the first day of the last menstrual period (LMP), and then subtract 3 months from the result. In this case, adding 7 days to November 15, 2002, gives us November 22, 2002. Subtracting 3 months from that date gives us August 22, 2002. However, since the question asks for the EDC, which is the estimated date of delivery, we add 9 months to the LMP instead of subtracting 3 months. Therefore, the EDC is August 23, 2003.

The correct answer is G2P1. Gravida refers to the number of pregnancies the client has had, including the current one. Para refers to the number of pregnancies that have reached viability (20 weeks or more) regardless of the outcome (live birth or stillbirth). In this case, the client is pregnant with twins, so it counts as one pregnancy (G1). The client also has a 5-year-old child, which counts as one para (P1). Therefore, the correct documentation would be G2P1.

Castor oil can initiate premature uterine contractions in pregnant women. It also can produce other adverse effects, but it does not promote sodium retention. Castor oils is not known to increase absorption of fat-soluble vitamins, although laxatives, in general, may decrease absorption if intestinal motility is increased.

A pregnant woman usually can detect fetal movement (quickening) between 16 and 20 weeks’ gestation. Before 16 weeks, the fetus is not developed enough for the woman to detect movement. After 20 weeks, the fetus continues to gain weight steadily, the lungs start to produce surfactant, the brain is grossly formed, and myelination of the spinal cord begins.

Cervical softening (Goodell sign) and uterine soufflé are two probable signs of pregnancy.Probable signs are objective findings that strongly suggest pregnancy. Other probable signs include Hegar sign, which is softening of the lower uterine segment; Piskacek sign, which is enlargement and softening of the uterus; serum laboratory tests; changes in skin pigmentation; and ultrasonic evidence of a gestational sac. Presumptive signs are subjective signs and include amenorrhea; nausea and vomiting; urinary frequency; breast tenderness and changes; excessive fatigue; uterine enlargement; and quickening.

Chloasma, also called the mask of pregnancy, is an irregular hyperpigmented area found on the face. It is not seen on the breasts, areola, nipples, chest, neck, arms, legs, abdomen, or thighs.

The pressure of the growing uterus on blood vessels results in an increased risk for venous stasis in the lower extremities. Subsequently, edema and varicose vein formation may occur. Thrombophlebitis is an inflammation of the veins due to thrombus formation. Pregnancy-induced hypertension is not associated with these symptoms. Gravity plays only a minor role in these symptoms.

resumptive signs of pregnancy are subjective signs. Of the signs listed, only nausea and vomiting are presumptive signs. Hegar sign, skin pigmentation changes, and a positive serum pregnancy test are considered probably signs, which are strongly suggestive of pregnancy.

The LPN would calculate the rate to be 75 drops per minute by using the formula: (Volume in mL x Drop factor) / Time in minutes. In this case, the volume is 150 mL, the drop factor is 15 gtt/mL, and the time is 30 minutes. So, (150 mL x 15 gtt/mL) / 30 minutes = 75 gtt/minute.

When the LMP is unknown, the gestational age of the fetus is estimated by uterine size or position (fundal height). The presence of the uterus in the pelvis indicates less than 12 weeks’ gestation. At approximately 12 to 14 weeks, the fundus is out of the pelvis above the symphysis pubis. The fundus is at the level of the umbilicus at approximately 20 weeks’ gestation and reaches the xiphoid at term or 40 weeks.

First-trimester classes commonly focus on such issues as early physiologic changes, fetal development, sexuality during pregnancy, and nutrition. Some early classes may include pregnant couples. Second and third-trimester classes may focus on preparation for birth, parenting, and newborn care.

It suggests that the instruction might need to be reinforced on preventing stomach distention.

Gravida represents the total number of pregnancies that the client has had. Para describes the results of the pregnancies. Para is made up of four parts: the number of infants born at term or after 37 weeks; the number of infants born preterm or after 20 weeks but before 37 weeks; the number of spontaneous or therapeutic abortions or pregnancies that ended up prior to 20 weeks; and the number of living children. Mrs. Puente has had 4 pregnancies, meaning she is a gravid four. She gave birth to a stillborn infant at term, gave birth to a preterm infant who is also her living child, lost one pregnancy during the ninth week of gestation. Mrs. Puente is G4P1111, the answer is B.

Follicle stimulating hormone (FSH) is responsible for the development of the ovum during the menstrual cycle. FSH stimulates the growth and maturation of follicles in the ovaries, which contain the eggs. As the follicles develop, they produce estrogen, which further supports the growth of the ovum. Once the ovum is fully developed, it is released from the ovary in a process called ovulation, which is triggered by a surge in luteinizing hormone (LH). Progesterone plays a role in preparing the uterus for potential pregnancy after ovulation. However, FSH is specifically responsible for the development of the ovum.

The average amount of weight gained during pregnancy is 25 to 35 lb. This weight gain consists of the following: fetus – 7.5 lb; placenta and membrane – 1.5 lb; amniotic fluid – 2 lb; uterus – 2.5 lb; breasts – 3 lb; and increased blood volume – 2 to 4 lb; extravascular fluid and fat – 4 to 9 lb. A gain of 12 to 22 lb is insufficient, whereas a weight gain of 15 to 25 lb is marginal. A weight gain of 25 to 40 lb is considered excessive.

Fluid Volume deficit  due to the potential blood loss is a potential problem but the pain is imminent.

Based on the partner’s statement, the couple is verbalizing feelings of inadequacy and negative feelings about themselves and their capabilities. Thus, the nursing diagnosis of self-esteem disturbance is most appropriate. Fear, pain, and ineffective family coping also may be present but as secondary nursing diagnoses.

A rubella titer should be 1:8 or greater. Thurs, a finding of a titer less than 1:8 is significant, indicating that the client may not possess immunity to rubella. A hematocrit of 33.5% a white blood cell count of 8,000/mm3, and a 1 hour glucose challenge test of 110 g/dl are with normal parameters.

A false-positive reaction can occur if the pregnancy test is performed less than 10 days after an abortion. Performing the tests too early or too late in the pregnancy, storing the urine sample too long at room temperature, or having a spontaneous or missed abortion impending can all produce false-negative results.

Amnioinfusion is the instillation of fluid into the amniotic sac within the uterus to treat oligohydramnios. This is not done to prevent precipitate labor and birth.

1000mg/1000mL = 0.1mg/x mL 1000x=100 x= 100/1000 x=0.1 mL

The three classic signs of preeclampsia are hypertension, generalized Edna, and proteinuria.

The correct answer is to dorsiflex the foot while extending the knee when the cramps occur. Dorsiflexion of the foot involves pulling the foot upwards towards the shin, while plantar flexion involves pointing the foot downwards. Extending the knee means straightening the leg, while flexing the knee means bending the leg. By dorsiflexing the foot and extending the knee, it helps to stretch the muscles in the leg and relieve the cramps.

Before amniocentesis, routine ultrasound is valuable in locating the placenta, locating a pool of amniotic fluid, and showing the physician where to insert the needle. Color Doppler imaging ultrasonography identifies blood flow through the umbilical cord. A routine ultrasound does not accomplish this.

The FHR can be auscultated with a fetoscope at about 20 weeks gestation. FHR usually is auscultated at the midline suprapubic region with Doppler ultrasound transducer at 10 to 12 weeks gestation. FHR, cannot be heard any earlier than 10 weeks’ gestation.

The secretory phase of the menstrual cycle is the ideal time for implantation of a fertilized egg to occur. This phase occurs after ovulation and is characterized by the thickening of the uterine lining in preparation for pregnancy. During this phase, the endometrium becomes highly vascularized and glandular, providing an optimal environment for the fertilized egg to implant and develop. If implantation does not occur, the endometrium will shed during the subsequent menstrual phase.

The nursing student correctly describes the dark streak down the midline of the abdomen as "linea nigra." This is a common occurrence during pregnancy as the uterus enlarges. The term "linea nigra" refers to the dark line that appears on the abdomen, running from the pubic bone to the belly button or even higher. This is caused by an increase in hormones during pregnancy, which stimulates the production of melanin in the skin. The nursing student is providing accurate information to the pregnant woman about this common phenomenon.

During pregnancy, hormonal changes cause relaxation of the pelvic joints, resulting in the typical “waddling” gait. Changes in posture are related to the growing fetus. Pressure on the surrounding muscles causing discomfort is due to the growing uterus. Weight gain has no effect on gait.

The sex of the fetus is determined at the point that the sperm fertilizes the ovum to form the zygote. Sex is ultimately determined by the chromosome contributed by the sperm.

The use of substances during pregnancy can lead to severe fetal or neonatal abnormalities, complications, and death. The primary goal of nursing care should be prevention or elimination of substance use during pregnancy.

During the second trimester, the reduction in gastric acidity in conjunction with pressure from the growing uterus and smooth muscle relaxation can cause heartburn and flatulence. HCG levels increase in the first, not the second, trimester. Decrease intestinal motility would most likely be the cause of constipation and bloating. Estrogen levels decrease in the second trimester.

The client demonstrates understanding of the danger signs of pregnancy by stating the following symptoms: gush of vaginal discharge, vaginal bleeding, persistent vomiting, and epigastric or abdominal pain. These symptoms can indicate potential complications such as infection, placental problems, or preeclampsia. Constipation and urinary frequency are not typically considered danger signs of pregnancy. Fetal heart rate of 120 is within the normal range and not a danger sign.

Zidovudine is the recommended drug for the prevention of maternal-fetal HIV transmission. It is usually administered orally beginning after 14 weeks' gestation to the pregnant mother, intravenously during labor, and in the form of syrup to the neonate after birth for 6 weeks. Zidovudine, also known as AZT, is an antiretroviral medication that helps reduce the risk of HIV transmission from mother to child. By taking zidovudine during pregnancy, labor, and postpartum, the viral load in the mother's blood is suppressed, reducing the chances of transmission to the fetus or newborn.

The functions of amniotic fluid include allowing for fetal movement, surrounding, cushioning, and protecting the fetus, maintaining the body temperature of the fetus, and serving as a measure of kidney function. It also prevents large particles such as bacteria from passing to the fetus and provides an exchange of nutrients and waste products between the mother and the fetus.

During pregnancy, there are several normal physiological changes that occur in a woman's body. These include an increase in circulating blood volume, which is necessary to support the growing fetus. Sodium and water retention may also occur, leading to weight gain. Shortness of breath is a common symptom due to the growing uterus putting pressure on the diaphragm. Chloasma, also known as the "mask of pregnancy," is a condition where dark patches appear on the face. These changes are considered normal and expected during pregnancy.

Ballottement or rebound of the fetus against the examiner's fingers on palpation; Chadwick's sign or the bluish coloration of the mucous membrane of the cervix, Uterine enlargement, Goodle's sign or the softening of the cervix; Braxton Hicks contraction, and Hegar's sign the softening and thinning of the lower uterine segment are ALL PROBABLE SIGNS OF PREGNANCY.

During pregnancy, the enlarging fetus can press on the bladder, causing urinary urgency and frequency. This is particularly common during the first and third trimesters. To prevent urinary frequency, the nurse can advise the patient to drink 2 quarts of fluid during the day to stay hydrated, perform Kegel exercises to strengthen the pelvic floor muscles and control bladder function, and limit fluid intake during the evening to reduce nighttime urination. These measures can help manage the symptoms and improve the patient's comfort during pregnancy.

The correct medical terminology to document reddish purple stretch marks that occur on the abdomen, breasts, thighs, and upper arm is "striate gravidarum." This term specifically refers to stretch marks that develop during pregnancy. By using this medical terminology, the nurse accurately describes the condition in the client's chart.

The OB/GYN physician will order blood type and Rh factor testing to determine the woman's blood type and Rh factor. This information is important for determining if the woman is at risk for developing Rh incompatibility with her baby. Pap's smear testing is done to screen for cervical cancer. HIV/AIDS testing is important to identify any potential infections that could affect the woman and her baby. Urinalysis is done to check for any urinary tract infections or other abnormalities. Hemoglobin and hematocrit levels are measured to assess the woman's iron levels and overall blood health. Sickle Cell testing is done to determine if the woman carries the sickle cell trait, which could be passed on to her baby.

During pregnancy, it is normal for a primigravida patient to experience psychological maternal changes such as ambivalence, emotional lability, body image changes, and bonding or relationship with the fetus. Ambivalence refers to having mixed feelings about the pregnancy, while emotional lability refers to experiencing mood swings. Body image changes occur as the body undergoes physical changes during pregnancy, and bonding or relationship with the fetus refers to the emotional connection a mother develops with her unborn baby.