HESI OBSTETRICS MATERNITY PRACTICE
ACTUAL TEST PAPER ALL QUESTIONS AND
SOLUTIONS COMPLETE SET ALREADY
GRADED A PLUS
⩥ 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 cervix is completely dilated
Pushing begins with the second stage of labor, i.e., when the cervix is
completely dilated (A, B, and D), the cervix can become edematous and
may never completely dilate, necessitating an operative delivery. Many
primigravidas begin active labor 100% effaced and then proceed to
dilate.
⩥ One hour after giving birth to an 8-pound infant, a client's lochia rubra
has increased from small to large and her fundus is boggy despite
massage. The client's pulse is 84 beats/minute and blood pressure is
156/96. The healthcare provider prescribes Methergine 0.2 mg IM x 1.
What action should the nurse take immediately?
a. Give the medication as prescribed and monitor for efficacy
,b. Encourage the client to breastfeed rather than bottle feed
c. Have the client empty her bladder and massage the fundus
d. Call the healthcare provider to question the prescription.
Answer: d. Call the healthcare provider to question the prescription
Methergine is contraindicated for clients with elevated blood pressure,
so the nurse should contact the healthcare provider and question the
prescription (D).
⩥ A newborn, whose mother is HIV positive, is scheduled for follow-up
assessments. The nurse knows that the most likely presenting symptom
for a pediatric client with AIDS is:
a. shortness of breath
b. joint pain
c. a persistent cold
d. organomegaly.
Answer: c. a persistent cold
Respiratory tract infections commonly occur in the pediatric population.
However, the child iwth AIDS has a decreased ability to defend the body
against these infections and often the presenting symptom of a child with
AIDS is a persistent cold (C).
,⩥ A healthcare provider informs the charge nurse of a labor and delivery
unit that a client is coming to the unit with suspected abruptio placentae.
What findings should the charge nurse expect the client to demonstrate?
(Select all that apply)
a. Dark, red vaginal bleeding
b. Lower back pain
c. Premature rupture of membranes
d. Increased uterine irritability
e. Bilateral pitting edema
f. A rigid abdomen.
Answer: a. Dark, red vaginal bleeding
d. Increased uterine irritability
f. A rigid abdomen
The symptoms of abruptio placentae include dark red vaginal bleeding
(A), increased uterine irritability (D), and a rigid abdomen (F).
⩥ The nurse assesses a client admitted to the labor and delivery unit and
obtains the following data: dark red vaginal bleeding, uterus slightly
tense between contractions, BP 110/68, FHR 110 beats/minute, cervix 1
cm dilated and uneffaced. Based on these assessment findings, what
intervention should the nurse implement?
a. Insert an internal fetal monitor
b. Assess for cervical changes q1h
, c. Monitor bleeding from IV sites
d. Perform Leopold's maneuvers.
Answer: c. Monitor bleeding from IV sites
Monitoring bleeding from peripheral sites (C) is the priority
intervention. This client is presenting with signs of placental abruption.
Disseminated intravascular coagulation (DIC) is a complication of
placental abruption, characterized by abnormal bleeding.
⩥ 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 it 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. It is difficult to consume 18 mg of additional iron by diet
alone
Consuming enough iron-containing foods to facilitate adequate fetal
storage of iron and to meet the demands of pregnancy is difficult (B) so
iron supplements are often recommended.
ACTUAL TEST PAPER ALL QUESTIONS AND
SOLUTIONS COMPLETE SET ALREADY
GRADED A PLUS
⩥ 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 cervix is completely dilated
Pushing begins with the second stage of labor, i.e., when the cervix is
completely dilated (A, B, and D), the cervix can become edematous and
may never completely dilate, necessitating an operative delivery. Many
primigravidas begin active labor 100% effaced and then proceed to
dilate.
⩥ One hour after giving birth to an 8-pound infant, a client's lochia rubra
has increased from small to large and her fundus is boggy despite
massage. The client's pulse is 84 beats/minute and blood pressure is
156/96. The healthcare provider prescribes Methergine 0.2 mg IM x 1.
What action should the nurse take immediately?
a. Give the medication as prescribed and monitor for efficacy
,b. Encourage the client to breastfeed rather than bottle feed
c. Have the client empty her bladder and massage the fundus
d. Call the healthcare provider to question the prescription.
Answer: d. Call the healthcare provider to question the prescription
Methergine is contraindicated for clients with elevated blood pressure,
so the nurse should contact the healthcare provider and question the
prescription (D).
⩥ A newborn, whose mother is HIV positive, is scheduled for follow-up
assessments. The nurse knows that the most likely presenting symptom
for a pediatric client with AIDS is:
a. shortness of breath
b. joint pain
c. a persistent cold
d. organomegaly.
Answer: c. a persistent cold
Respiratory tract infections commonly occur in the pediatric population.
However, the child iwth AIDS has a decreased ability to defend the body
against these infections and often the presenting symptom of a child with
AIDS is a persistent cold (C).
,⩥ A healthcare provider informs the charge nurse of a labor and delivery
unit that a client is coming to the unit with suspected abruptio placentae.
What findings should the charge nurse expect the client to demonstrate?
(Select all that apply)
a. Dark, red vaginal bleeding
b. Lower back pain
c. Premature rupture of membranes
d. Increased uterine irritability
e. Bilateral pitting edema
f. A rigid abdomen.
Answer: a. Dark, red vaginal bleeding
d. Increased uterine irritability
f. A rigid abdomen
The symptoms of abruptio placentae include dark red vaginal bleeding
(A), increased uterine irritability (D), and a rigid abdomen (F).
⩥ The nurse assesses a client admitted to the labor and delivery unit and
obtains the following data: dark red vaginal bleeding, uterus slightly
tense between contractions, BP 110/68, FHR 110 beats/minute, cervix 1
cm dilated and uneffaced. Based on these assessment findings, what
intervention should the nurse implement?
a. Insert an internal fetal monitor
b. Assess for cervical changes q1h
, c. Monitor bleeding from IV sites
d. Perform Leopold's maneuvers.
Answer: c. Monitor bleeding from IV sites
Monitoring bleeding from peripheral sites (C) is the priority
intervention. This client is presenting with signs of placental abruption.
Disseminated intravascular coagulation (DIC) is a complication of
placental abruption, characterized by abnormal bleeding.
⩥ 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 it 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. It is difficult to consume 18 mg of additional iron by diet
alone
Consuming enough iron-containing foods to facilitate adequate fetal
storage of iron and to meet the demands of pregnancy is difficult (B) so
iron supplements are often recommended.
