HESI RN Maternity V1 – Notes and Questions

Maternity and Peds • The nurse is planning care for a client at 30-weeks gestation who is experiencing preterm labor. • Terbutaline (Brethine) 0.25 mg subcutaneously q15 minutes x 3 • Ampicillin 1 gram IV push q8h. • Betamethasone (Celestone) 12 mg deep IM • Butorphanol (Stadol) 1 mg IV push q2h PRN pain 2. A pregnant woman in the first trimester of pregnancy has hemoglobin of 8.6 mg/dl and a hematocrit of 25.1 %. What food should the nurse encourage this client to include in her diet? • Carrots • Chicken • Yogurt • Cheese 3. The nurse is preparing to administer methylergonovine maleate (Methergine) to a postpartum client. Based on what assessment finding should the nurse withhold the drug? • Respiratory rate of 22 breaths/min • A large amount of lochia rubra • Blood pressure 149/90 • Positive Homan’s sign 4. The nurse is planning care for a 16-year-old, who has juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscle. Which physical therapy regimen should the nurse encourage the adolescent to implement? • Begin a training program lifting weights and running • Splint affected joints during activity • Exercise in a swimming pool • Perform passive range of motion exercises twice daily 5. A client receiving oxytocin (Pitocin) to augment early labor. Which assessment is most important for the nurse to obtain each time the infusion rate is increased? • Pain level • Blood pressure • Infusion site • Contraction pattern 6. One day after vaginal delivery of a full term baby, a postpartum client’s white blood cell count is 15.000/mm. What action should the nurse take first? • Check the differential, since the WBC is normal for this client • Assess the client’s temperature, pulse, and respirations q4h • Assess the client’s perineal area for signs of a perineal hematoma • Notify the healthcare provider, since this finding is indicative of infection 7. A neonate who has congenital adrenal hypoplasia (CAH) presents with ambiguous genitalia. What is the primary nursing consideration when supporting the parents of a child with this anomaly? • Discuss the need for cortisol and aldosterone replacement therapy after discharge • Support the parents in their decision to assign sex of their child according to their preference • Offer information about ultrasonography and genotyping to determine sex assignment • Explain that corrective surgical procedures consistent with sex assignment can be delayed 8. The nurse assessing a 9-year old boy who has been admitted to the hospital with possible acute postsreptococcal glomerulonephritis (APSGN). In obtaining his history, what information is most significant? • Back pain for a few days • A history of hypertension • A sore throats last week • Diuresis during the nights Note: Page 1538 MB 9. A loading dose of terbutaline (Brethine) 250 mcg IV is prescribed for a client in preterm labor. Brethine 20 mg is added to 1,000 ml D W. How many ml of the solution should the nurse administer? 13 10. A 36-week primigravida is admitted to labor and delivery with severe abdominal pain and bright red vaginal bleeding. Her abdomen is rigid and tender to touch. The fetal heart rate FHR) is 90 beats/minute, and the maternal heart rate is 120 beats/minute. What action should the nurse implement first? • Alert the neonatal team and prepare for neonatal resuscitation • Notify the healthcare provider from the client’s bedside • Obtain written consent for an emergency cesarean section • Draw a blood sample for stat hemoglobin and hematocrit 11. A laboring client’s membranes rupture spontaneously. The nurse notices that the amniotic fluid is greenish-brown. What intervention should the nurse implement first? • Turn the client to her left side • Contact the healthcare provider • Assess the fetal heart rate • Check the cervical dilation 12. A 5-year-old child is admitted to the pediatric unit with fever and pain secondary to a sickle cell crisis. Which intervention should the nurse implement first? A. Obtain a culture of any sputum or wound drainage. • Obtain a culture of any sputum or wound drainage • Initiate normal saline IV at 50 ml/hr • Administer a loading dose of penicillin IM • Administer the initial dose of folic acid P