Maternity/OB HESI Practice Part #1
Questions And Answers
1.rArprimiparousrwomanrhasrrecentlyrgivenrbirthrtorartermrinfant.rPriorityrteaching
forrtherclientrincludesrinformationron:
1.rSuddenrInfantrDeathrSyndromer(SIDS).
2.rBreast-feeding.
3.rInfantrbathing.
4.rInfantrsleep-wakercycles.r-rCORRECTrrANSWER-1.r2.rBreast-
fedrinfantsrshouldreatrwithinrtherfirstrhourrofrliferandrapproximately
everyr2rtor3rhours.rSuccessfulrbreast-feedingrwillrlikelyrrequirersustainedrsupport,
encouragement,randrinstructionrfromrthernurse.rInformationronrSIDS,rinfantrbathing,rand
sleep-wakercyclesrareralsorimportantrtopicsrforrthernewrparent,rbutrcanrberdoneratrany
timerpriorrtordischarge.
10.rAfterrthernurserexplainsrtorthermotherrofrarmalerneonaterscheduledrtorreceiveran
injectionrofrvitaminrKrsoonrafterrbirthraboutrtherrationalerforrthermedication,rwhichrof
therfollowingrstatementsrbyrthermotherrindicatesrsuccessfulrteaching?
1.r"Myrbabyrdoesn'trhaverthernormalrbacteriarinrhisrintestinesrtorproducerthis
vitamin."
2.r"Myrbabyrisratrarhighrriskrforrarproblemrinvolvingrhisrblood'srabilityrtorclot."
3.r"Therredrbloodrcellsrmyrbabyrformedrduringrpregnancyrarerdestroyingrthe
vitaminrK."
4.r"Myrbaby'srliverrisrnotrablertorproducerenoughrofrthisrvitaminrsorsoonrafter
birth."r-rCORRECTrrANSWER-
10.r1.rForrvitaminrKrsynthesisrinrtherintestinesrtorbegin,rfoodrandrnormalrintestinal
florararerneeded.rHowever,ratrbirth,rtherneonate'srintestinesrarersterile.rTherefore,
vitaminrKrisradministeredrviarinjectionrtorpreventrarvitaminrKrdeficiencyrthatrmayrresult
inrarbleedingrtendency.rWhenradministered,rvitaminrKrpromotesrformationrinrtherliver
ofrclottingrfactorsrII,rVII,rIX,randrX.rNeonatesrarernotrnormallyrsusceptiblertorclotting
disorders,runlessrtheyrarerdiagnosedrwithrhemophiliarorrdemonstraterardeficiencyrofror
arproblemrwithrclottingrfactors.rHemolysisrofrfetalrredrbloodrcellsrdoesrnotrdestroy
vitaminrK.rHemolysisrmayrbercausedrbyrRhrorrABOrincompatibility,rwhichrleadsrto
anemiarandrnecessitatesranrexchangertransfusion.rVitaminrKrsynthesisroccursrinrthe
intestines,rnotrtherliver.
11.rThernurserisrteachingrthermotherrofrarnewbornrtordeveloprherrbaby'srsensory
system.rTorfurtherrimprovertherinfant'srmostrdevelopedrsense,rthernursershouldrinstruct
thermotherrto:
1.rSpeakrinrarhigh-pitchedrvoicertorgetrthernewborn'srattention.
2.rPlacerthernewbornraboutr12rinchesrfromrmaternalrfacerforrbestrsight.
3.rStrokerthernewborn'srcheekrwithrherrnipplertordirectrtherbaby'srmouthrtornipple.
,4.rGiverinfantrformularwithrarsweetenedrtastertorstimulaterfeeding.r-rCORRECTrrANSWER-
11.r3.rCurrently,rtouchrisrbelievedrtorberthermostrhighlyrdevelopedrsenseratrbirth.rIt
isrprobablyrwhyrneonatesrrespondrwellrtortouch.rAuditoryrsensertypicallyrisrrelatively
immaturerinrtherneonate,rasrevidencedrbyrtherneonate'srselectiverresponsertortherhuman
voice.rByr4rmonths,rtherneonatershouldrturnrhisreyesrandrheadrtowardrarsoundrcoming
fromrbehind.rVisualrsensertendsrtorberrelativelyrimmature.rAtrbirth,rvisualracuityris
estimatedratr20/100rtor20/150,rbutritrimprovesrrapidlyrduringrinfancyrandrtoddlerhood.
Tasterisrwellrdeveloped,rwithrarpreferencertowardrglucose;rhowever,rtouchrisrmore
developedratrbirth.
12.rThernurserhasrcompletedrdischargerteachingrwithrnewrparentsrwhorhaverbeen
dischargedrhomerbottle-feedingrarnormalrtermrnewborn.rWhichrofrtherfollowing
responsesrindicatesrtherneedrforrfurtherrteaching?
1.r"Ourrbabyrwillrrequirerfeedingsrthroughrthernightrforrseveralrweeks/monthsrafter
birth."
2.r"Therbabyrshouldrburprduringrandrafterreachrfeedingrwithrnorprojective
vomiting."
3.r"Ourrbabyrshouldrhaver1rtor3rsoft,rformedrstoolsrarday."
4.r"Wershouldrweighrourrbabyrdailyrtormakersurerherisrgainingrweight."r-
rCORRECTrrANSWER-
12.r4.rHealthyrinfantsrarerweighedrduringrtheirrvisitsrtortheirrprimaryrcarerprovider,
soritrisrnotrnecessaryrtormonitorrweightsratrhome.rInfantsrmayrrequirer1rtor3rfeedings
duringrthernightrinitially.rByr3rmonths,r90%rofrbabiesrsleeprthroughrthernight.rProjective
vomitingrmayrindicaterpyloricrstenosisrandrshouldrnotrberseenrinrarnormalrnewborn.
Bottle-fedrinfantsrmayrstoolr1rtor3rtimesrdaily.
13.rThernurserknowsrthermotherrofrarneonaterhasrunderstoodrherrcarrseatrsafety
instructionsrwhenrshercomments:
1.r"Irdidrnotrrealizerthatrevenrchildrenrbetweenr1rtor2ryearsroldrarersaferrinrrearfacing
carrseats."
2.r"IrshouldrputrmyrcarrseatrinrtherfrontrsorIrcanrwatchrmyrbabyrwhenrIrdrive."
3.r"IrplanrtoruserthercarrseatrIrsavedrfromrmyrlastrbabyr10ryearsrago."
4.r"Therfront-facingrcarrseatsrdorarbetterrjobrsupportingrtherheadrandrneckrofrmy
baby."r-rCORRECTrrANSWER-13.r1.rTherheadrandrneckrarerbestrsupportedrinrarrear-
facingrseatrinrinfantsrand
toddlers,randrinfantsrshouldrremainrrearrfacingrforrasrlongrpossibleruntilrtheyroutgrow
theirrcarrseat.rInrtherUnitedrStates,rtherAmericanrAcademyrofrPediatricsrrecommendsra
rear-facingrcarrseatrforrchildrenryoungerrthanr2ryears.rThermiddlerofrtherbackrseatris
safestrforrarcarrseat.rBecauserplasticrcanrbecomerbrittleroverrtime,rcarrseatsrhaveran
expirationrdaterthatrmustrbercheckedrbeforeruse.rTenryearsrwouldrgenerallyrberoutside
ofrmostrcarrseats'rexpirationrdates.
14.rWhilermakingrarhomervisitrtorarprimiparousrclientrandrherr3-day-oldrson,rthe
nurserobservesrthermotherrchangingrtherbaby'srdisposablerdiaper.rBeforerputtingrthe
cleanrdiaperronrtherneonate,rthermotherrbeginsrtorapplyrbabyrpowderrtortherneonate's
buttocks.rWhichrofrtherfollowingrstatementsraboutrbabyrpowderrshouldrthernurserrelate
, torthermother?
1.rItrmayrcauserpneumoniartordevelop.
2.rItrhelpsrpreventrdiaperrrash.
3.rItrkeepsrtherdiaperrfromradheringrtortherskin.
4.rItrcanrresultrinrallergiesrlaterrinrlife.r-rCORRECTrrANSWER-
14.r1.rThernursershouldrinformrthermotherrthatrbabyrpowderrcanrenterrtherneonate's
lungsrandrresultrinrpneumoniarsecondaryrtoraspirationrofrtherparticles.rTherbest
preventionrforrdiaperrrashrisrfrequentrdiaperrchangingrandrkeepingrtherneonate'srskin
dry.rThernewrdisposablerdiapersrhavermoisture-collectingrmaterialsrandrgenerallyrdo
notradherertortherskinrunlessrtherdiaperrbecomesrsaturated.rTypically,rallergiesrarernot
associatedrwithrtheruserofrbabyrpowderrinrneonates.
15.rAfterrteachingrarnewrmotherraboutrthercarerofrherrneonaterafterrcircumcision
withrarGomcorclamp,rwhichrofrtherfollowingrstatementsrbyrthermotherrindicatesrtorthe
nurserthatrthermotherrneedsradditionalrinstructions?
1.r"Therpetroleumrgauzermayrfallroffrintortherdiaper."
2.r"Arfewrdropsrofrbloodroozingrfromrthersiterisrnormal."
3.r"I'llrleaverthergauzerinrplacerforr24rhours."
4.r"I'llrremoveranyryellowishrcrustingrgentlyrwithrwater."r-rCORRECTrrANSWER-
15.r4.rThermotherrneedsrfurtherrinstructionrwhenrshersaysrthatraryellowishrcrust
shouldrberremovedrwithrwater.rTheryellowishrcrustrisrnormalrandrindicatesrscar
formationratrthersite.rItrshouldrnotrberremoved,rbecausertordorsormightrcauserincreased
bleeding.rTherpetroleumrgauzerpreventsrtherdiaperrfromrstickingrtorthercircumcision
site,randritrmayrfallroffrinrtherdiaper.rIfrthisroccurs,rthermotherrshouldrnotrattemptrto
replaceritrbutrshouldrsimplyrapplyrplainrpetroleumrjellyrtorthersite.rThergauzershouldrbe
leftrinrplacerforr24rhours,randrthermotherrshouldrcontinuertorapplyrpetroleumrjellyrwith
eachrdiaperrchangerforr48rhoursrafterrtherprocedure.rArfewrdropsrofroozingrbloodris
normal,rbutrifrtheramountrisrgreaterrthanrarfewrdropsrthermotherrshouldrapplyrpressure
andrcontactrtherprimaryrhealthrcarerprovider.rAnyrbleedingrafterrtherfirstrdayrshouldrbe
reported.
16.rAfterrcompletingrdischargerinstructionsrforrarprimiparousrclientrwhorisrbottlefeeding
herrtermrneonate,rthernurserdeterminesrthatrthermotherrunderstandsrthe
instructionsrwhenrthermotherrsaysrthatrshershouldrcontactrtherprimaryrhealthrcare
providerrifrtherneonaterexhibitsrwhichrofrtherfollowing?
1.rAbilityrtorfallrasleepreasilyrafterreachrfeeding.
2.rSpittingruprofrartablespoonrofrformularafterrfeeding.
3.rPassagerofrarliquidrstoolrwithrarwateryrring.
4.rProductionrofronertortworlightrbrownrstoolsrdaily.r-rCORRECTrrANSWER-
16.r3.rThermotherrdemonstratesrunderstandingrofrtherdischargerinstructionsrwhenrshe
saysrthatrshershouldrcontactrtherprimaryrhealthrcarerproviderrifrtherbabyrhasrarliquid
stoolrwithrarwateryrring,rbecauserthisrindicatesrdiarrhea.rInfantsrcanrbecomerdehydrated
veryrquickly,randrfrequentrdiarrhearcanrresultrinrdehydration.rNormally,rbabiesrfall
asleepreasilyrafterrarfeedingrbecausertheyrarersatisfiedrandrcontent.rSpittingrupra
tablespoonrofrformularisrnormal.rHowever,rprojectilerorrforcefulrvomitingrinrlarger
amountsrshouldrberreported.rBottle-fedrinfantsrtypicallyrpassronertortworlightrbrown
Questions And Answers
1.rArprimiparousrwomanrhasrrecentlyrgivenrbirthrtorartermrinfant.rPriorityrteaching
forrtherclientrincludesrinformationron:
1.rSuddenrInfantrDeathrSyndromer(SIDS).
2.rBreast-feeding.
3.rInfantrbathing.
4.rInfantrsleep-wakercycles.r-rCORRECTrrANSWER-1.r2.rBreast-
fedrinfantsrshouldreatrwithinrtherfirstrhourrofrliferandrapproximately
everyr2rtor3rhours.rSuccessfulrbreast-feedingrwillrlikelyrrequirersustainedrsupport,
encouragement,randrinstructionrfromrthernurse.rInformationronrSIDS,rinfantrbathing,rand
sleep-wakercyclesrareralsorimportantrtopicsrforrthernewrparent,rbutrcanrberdoneratrany
timerpriorrtordischarge.
10.rAfterrthernurserexplainsrtorthermotherrofrarmalerneonaterscheduledrtorreceiveran
injectionrofrvitaminrKrsoonrafterrbirthraboutrtherrationalerforrthermedication,rwhichrof
therfollowingrstatementsrbyrthermotherrindicatesrsuccessfulrteaching?
1.r"Myrbabyrdoesn'trhaverthernormalrbacteriarinrhisrintestinesrtorproducerthis
vitamin."
2.r"Myrbabyrisratrarhighrriskrforrarproblemrinvolvingrhisrblood'srabilityrtorclot."
3.r"Therredrbloodrcellsrmyrbabyrformedrduringrpregnancyrarerdestroyingrthe
vitaminrK."
4.r"Myrbaby'srliverrisrnotrablertorproducerenoughrofrthisrvitaminrsorsoonrafter
birth."r-rCORRECTrrANSWER-
10.r1.rForrvitaminrKrsynthesisrinrtherintestinesrtorbegin,rfoodrandrnormalrintestinal
florararerneeded.rHowever,ratrbirth,rtherneonate'srintestinesrarersterile.rTherefore,
vitaminrKrisradministeredrviarinjectionrtorpreventrarvitaminrKrdeficiencyrthatrmayrresult
inrarbleedingrtendency.rWhenradministered,rvitaminrKrpromotesrformationrinrtherliver
ofrclottingrfactorsrII,rVII,rIX,randrX.rNeonatesrarernotrnormallyrsusceptiblertorclotting
disorders,runlessrtheyrarerdiagnosedrwithrhemophiliarorrdemonstraterardeficiencyrofror
arproblemrwithrclottingrfactors.rHemolysisrofrfetalrredrbloodrcellsrdoesrnotrdestroy
vitaminrK.rHemolysisrmayrbercausedrbyrRhrorrABOrincompatibility,rwhichrleadsrto
anemiarandrnecessitatesranrexchangertransfusion.rVitaminrKrsynthesisroccursrinrthe
intestines,rnotrtherliver.
11.rThernurserisrteachingrthermotherrofrarnewbornrtordeveloprherrbaby'srsensory
system.rTorfurtherrimprovertherinfant'srmostrdevelopedrsense,rthernursershouldrinstruct
thermotherrto:
1.rSpeakrinrarhigh-pitchedrvoicertorgetrthernewborn'srattention.
2.rPlacerthernewbornraboutr12rinchesrfromrmaternalrfacerforrbestrsight.
3.rStrokerthernewborn'srcheekrwithrherrnipplertordirectrtherbaby'srmouthrtornipple.
,4.rGiverinfantrformularwithrarsweetenedrtastertorstimulaterfeeding.r-rCORRECTrrANSWER-
11.r3.rCurrently,rtouchrisrbelievedrtorberthermostrhighlyrdevelopedrsenseratrbirth.rIt
isrprobablyrwhyrneonatesrrespondrwellrtortouch.rAuditoryrsensertypicallyrisrrelatively
immaturerinrtherneonate,rasrevidencedrbyrtherneonate'srselectiverresponsertortherhuman
voice.rByr4rmonths,rtherneonatershouldrturnrhisreyesrandrheadrtowardrarsoundrcoming
fromrbehind.rVisualrsensertendsrtorberrelativelyrimmature.rAtrbirth,rvisualracuityris
estimatedratr20/100rtor20/150,rbutritrimprovesrrapidlyrduringrinfancyrandrtoddlerhood.
Tasterisrwellrdeveloped,rwithrarpreferencertowardrglucose;rhowever,rtouchrisrmore
developedratrbirth.
12.rThernurserhasrcompletedrdischargerteachingrwithrnewrparentsrwhorhaverbeen
dischargedrhomerbottle-feedingrarnormalrtermrnewborn.rWhichrofrtherfollowing
responsesrindicatesrtherneedrforrfurtherrteaching?
1.r"Ourrbabyrwillrrequirerfeedingsrthroughrthernightrforrseveralrweeks/monthsrafter
birth."
2.r"Therbabyrshouldrburprduringrandrafterreachrfeedingrwithrnorprojective
vomiting."
3.r"Ourrbabyrshouldrhaver1rtor3rsoft,rformedrstoolsrarday."
4.r"Wershouldrweighrourrbabyrdailyrtormakersurerherisrgainingrweight."r-
rCORRECTrrANSWER-
12.r4.rHealthyrinfantsrarerweighedrduringrtheirrvisitsrtortheirrprimaryrcarerprovider,
soritrisrnotrnecessaryrtormonitorrweightsratrhome.rInfantsrmayrrequirer1rtor3rfeedings
duringrthernightrinitially.rByr3rmonths,r90%rofrbabiesrsleeprthroughrthernight.rProjective
vomitingrmayrindicaterpyloricrstenosisrandrshouldrnotrberseenrinrarnormalrnewborn.
Bottle-fedrinfantsrmayrstoolr1rtor3rtimesrdaily.
13.rThernurserknowsrthermotherrofrarneonaterhasrunderstoodrherrcarrseatrsafety
instructionsrwhenrshercomments:
1.r"Irdidrnotrrealizerthatrevenrchildrenrbetweenr1rtor2ryearsroldrarersaferrinrrearfacing
carrseats."
2.r"IrshouldrputrmyrcarrseatrinrtherfrontrsorIrcanrwatchrmyrbabyrwhenrIrdrive."
3.r"IrplanrtoruserthercarrseatrIrsavedrfromrmyrlastrbabyr10ryearsrago."
4.r"Therfront-facingrcarrseatsrdorarbetterrjobrsupportingrtherheadrandrneckrofrmy
baby."r-rCORRECTrrANSWER-13.r1.rTherheadrandrneckrarerbestrsupportedrinrarrear-
facingrseatrinrinfantsrand
toddlers,randrinfantsrshouldrremainrrearrfacingrforrasrlongrpossibleruntilrtheyroutgrow
theirrcarrseat.rInrtherUnitedrStates,rtherAmericanrAcademyrofrPediatricsrrecommendsra
rear-facingrcarrseatrforrchildrenryoungerrthanr2ryears.rThermiddlerofrtherbackrseatris
safestrforrarcarrseat.rBecauserplasticrcanrbecomerbrittleroverrtime,rcarrseatsrhaveran
expirationrdaterthatrmustrbercheckedrbeforeruse.rTenryearsrwouldrgenerallyrberoutside
ofrmostrcarrseats'rexpirationrdates.
14.rWhilermakingrarhomervisitrtorarprimiparousrclientrandrherr3-day-oldrson,rthe
nurserobservesrthermotherrchangingrtherbaby'srdisposablerdiaper.rBeforerputtingrthe
cleanrdiaperronrtherneonate,rthermotherrbeginsrtorapplyrbabyrpowderrtortherneonate's
buttocks.rWhichrofrtherfollowingrstatementsraboutrbabyrpowderrshouldrthernurserrelate
, torthermother?
1.rItrmayrcauserpneumoniartordevelop.
2.rItrhelpsrpreventrdiaperrrash.
3.rItrkeepsrtherdiaperrfromradheringrtortherskin.
4.rItrcanrresultrinrallergiesrlaterrinrlife.r-rCORRECTrrANSWER-
14.r1.rThernursershouldrinformrthermotherrthatrbabyrpowderrcanrenterrtherneonate's
lungsrandrresultrinrpneumoniarsecondaryrtoraspirationrofrtherparticles.rTherbest
preventionrforrdiaperrrashrisrfrequentrdiaperrchangingrandrkeepingrtherneonate'srskin
dry.rThernewrdisposablerdiapersrhavermoisture-collectingrmaterialsrandrgenerallyrdo
notradherertortherskinrunlessrtherdiaperrbecomesrsaturated.rTypically,rallergiesrarernot
associatedrwithrtheruserofrbabyrpowderrinrneonates.
15.rAfterrteachingrarnewrmotherraboutrthercarerofrherrneonaterafterrcircumcision
withrarGomcorclamp,rwhichrofrtherfollowingrstatementsrbyrthermotherrindicatesrtorthe
nurserthatrthermotherrneedsradditionalrinstructions?
1.r"Therpetroleumrgauzermayrfallroffrintortherdiaper."
2.r"Arfewrdropsrofrbloodroozingrfromrthersiterisrnormal."
3.r"I'llrleaverthergauzerinrplacerforr24rhours."
4.r"I'llrremoveranyryellowishrcrustingrgentlyrwithrwater."r-rCORRECTrrANSWER-
15.r4.rThermotherrneedsrfurtherrinstructionrwhenrshersaysrthatraryellowishrcrust
shouldrberremovedrwithrwater.rTheryellowishrcrustrisrnormalrandrindicatesrscar
formationratrthersite.rItrshouldrnotrberremoved,rbecausertordorsormightrcauserincreased
bleeding.rTherpetroleumrgauzerpreventsrtherdiaperrfromrstickingrtorthercircumcision
site,randritrmayrfallroffrinrtherdiaper.rIfrthisroccurs,rthermotherrshouldrnotrattemptrto
replaceritrbutrshouldrsimplyrapplyrplainrpetroleumrjellyrtorthersite.rThergauzershouldrbe
leftrinrplacerforr24rhours,randrthermotherrshouldrcontinuertorapplyrpetroleumrjellyrwith
eachrdiaperrchangerforr48rhoursrafterrtherprocedure.rArfewrdropsrofroozingrbloodris
normal,rbutrifrtheramountrisrgreaterrthanrarfewrdropsrthermotherrshouldrapplyrpressure
andrcontactrtherprimaryrhealthrcarerprovider.rAnyrbleedingrafterrtherfirstrdayrshouldrbe
reported.
16.rAfterrcompletingrdischargerinstructionsrforrarprimiparousrclientrwhorisrbottlefeeding
herrtermrneonate,rthernurserdeterminesrthatrthermotherrunderstandsrthe
instructionsrwhenrthermotherrsaysrthatrshershouldrcontactrtherprimaryrhealthrcare
providerrifrtherneonaterexhibitsrwhichrofrtherfollowing?
1.rAbilityrtorfallrasleepreasilyrafterreachrfeeding.
2.rSpittingruprofrartablespoonrofrformularafterrfeeding.
3.rPassagerofrarliquidrstoolrwithrarwateryrring.
4.rProductionrofronertortworlightrbrownrstoolsrdaily.r-rCORRECTrrANSWER-
16.r3.rThermotherrdemonstratesrunderstandingrofrtherdischargerinstructionsrwhenrshe
saysrthatrshershouldrcontactrtherprimaryrhealthrcarerproviderrifrtherbabyrhasrarliquid
stoolrwithrarwateryrring,rbecauserthisrindicatesrdiarrhea.rInfantsrcanrbecomerdehydrated
veryrquickly,randrfrequentrdiarrhearcanrresultrinrdehydration.rNormally,rbabiesrfall
asleepreasilyrafterrarfeedingrbecausertheyrarersatisfiedrandrcontent.rSpittingrupra
tablespoonrofrformularisrnormal.rHowever,rprojectilerorrforcefulrvomitingrinrlarger
amountsrshouldrberreported.rBottle-fedrinfantsrtypicallyrpassronertortworlightrbrown
