HESI Practice Test Questions & Answers with Explanations 2023

1. The nurse instructs a laboring client to use accelerated-blow breathing. The client begins to complain of tingling fingers and dizziness. What action should the nurse take? a) Administer oxygen by face mask. b) Notify the healthcare provider of the client's symptoms. c) Have the client breathe into her cupped hands. d) Check the client's blood pressure and fetal heart rate. Tingling fingers and dizziness are signs of hyperventilation (blowing off too much carbon dioxide). Hyperventilation is treated by retaining carbon dioxide. This can be facilitated by breathing into a paper bag or cupped hand. 2. When explaining "postpartum blues" to a client who is 1 day postpartum, which symptoms should the nurse include in the teaching plan? (Select all that apply.) Select all that apply a) Mood swings. b) Panic attacks. c) Tearfulness. d) Decreased need for sleep. e) Disinterest in the infant. "Postpartum blues" is a common emotional response related to the rapid decrease in placental hormones after delivery and include mood swings, tearfulness, feeling low, emotional, and fatigued. 3. A client is admitted with the diagnosis of total placenta previa. Which finding is most important for the nurse to report to the healthcare provider immediately? a) Heart rate of 100 beats/minute. b) Variable fetal heart rate. c) Onset of uterine contractions. d) Burning on urination. Total (complete) placenta previa involves the placenta covering the entire cervical os (opening). The onset of uterine contractions places the client at risk for dilation and placental separation, which causes painless hemorrhaging. The risk of hemorrhage is the priority. 4. 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. Methergine is used to treat postpartum hemorrhage, but is contraindicated for clients with elevated blood pressure, so the nurse should contact the healthcare provider and question the prescription because the client's elevated blood pressure. 5. The nurse observes a new mother is rooming-in and caring for her newborn infant. Which observation indicates the need for further teaching? a) Cuddles the baby close to her. b) Rocks and soothes the infant in her arms. c) Places the infant prone in the bassinet. d) Wraps the baby in a warm blanket after bathing. The mother should be instructed to avoid placing the infant prone which is associated with an increased incidence of sudden infant death syndrome (SIDS). 6. On admission to the prenatal clinic, a 23-year-old woman tells the nurse that her last menstrual period began on February 15, and that previously her periods were regular. Her pregnancy test is positive. This client's expected date of delivery (EDD) would be a) November 22. b) November 8. c) December 22. d) October 22. 7. A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26-weeks gestation in preterm labor. She is started on an IV solution of terbutaline (Brethine). Which assessment is the highest priority for the nurse to monitor during the administration of this drug? a) Maternal blood pressure and respirations. b) Maternal and fetal heart rates. c) Hourly urinary output. d) Deep tendon reflexes. Terbutaline has effects on receptors. It acts as a sympathomimetic agent stimulating beta 1 receptors which cause tachycardia as a side effect and that is a reason why monitoring maternal and fetal heart rates is most important when terbutaline is being administered. It also affects beta 2 receptors which relaxes the uterus and that is the reason for its administration. 8. A pregnant client tells the nurse that the first day of her last menstrual period was August 2, 2016. Based on Naegele's rule, what is the estimated date of delivery? a) April 25, 2017. b) May 9, 2017. c) May 29, 2017. d) June 2, 2017. 9. Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action will the nurse take? a) Notify the healthcare provider or anesthesiologist immediately. b) Continue to assess the blood pressure q5 minutes. c) Place the woman in a lateral position. d) Turn off the continuous epidural. The nurse should immediately turn the woman to a lateral position, place a pillow or wedge under the right hip to deflect the uterus, increase the rate of the main line IV infusion, and administer oxygen by face mask at 10-12 L/min. If the blood pressure remains low, especially if it further decreases, the anesthesiologist/healthcare provider should be notified immediately. 10. A primigravida at 40-weeks gestation is receiving oxytocin (Pitocin) to augment labor. Which adverse effect should the nurse monitor for during the infusion of Pitocin? a) Dehydration. b) Hyperstimulation. c) Galactorrhea. d) Fetal tachycardia. Pitocin causes the uterine myofibril to contract, so unless the infusion is closely monitored, the client is at risk for hyperstimulation which can lead to tetanic contractions, uterine rupture, and fetal distress or demise.