HESI SAUNDERS MATERNITY NURSING
REPRODUCTIVE SYSTEM - ANS REPRODUCTIVE SYSTEM
The nurse is preparing to teach a prenatal class about fetal circulation. Which statements
should be included in the teaching plan? (SELECT ALL THAT APPLY.)
1. "The ductus arteriosus allows blood to bypass the fetal lungs."
2. "One vein carries oxygenated blood from the placenta to the fetus."
3. "The normal fetal heart tone range is 140 to 160 beats per minute in early pregnancy."
4. "Two arteries carry deoxygenated blood and waste products away from the fetus to the
placenta."
5. "Two veins carry blood that is high in carbon dioxide and other waste products away from the
fetus to the placenta." - ANS 1, 2, 4
The ductus arteriosus is a unique fetal circulation structure that allows the nonfunctioning lungs
to receive only a minimal amount of oxygenated blood for tissue maintenance. Oxygenated
blood is transported to the fetus by one umbilical vein. The normal fetal heart tone range is
considered to be 110 to 160 beats per minute. Arteries carry deoxygenated blood and waste
products from the fetus, and the umbilical vein carries oxygenated blood and provides oxygen
and nutrients to the fetus. Blood pumped by the embryo's heart leaves the embryo through two
umbilical arteries.
The nursing instructor asks the student to describe fetal circulation, specifically the ductus
venosus. Which statement by the student indicates an understanding of the ductus venosus?
1. "It connects the pulmonary artery to the aorta."
2. "It is an opening between the right and left atria."
3. "It connects the umbilical vein to the inferior vena cava."
4. "It connects the umbilical artery to the inferior vena cava." - ANS 3
The ductus venosus connects the umbilical vein to the inferior vena cava. The foramen ovale is
a temporary opening between the right and left atria. The ductus arteriosus joins the aorta and
the pulmonary artery.
A pregnant client tells the clinic nurse that she wants to know the sex of her baby as soon as it
can be determined. The nurse informs the client that she should be able to find out the sex at 12
weeks' gestation because of which factor?
1. The appearance of the fetal external genitalia
2. The beginning of differentiation in the fetal groin
3. The fetal testes are descended into the scrotal sac
,4. The internal differences in males and females become apparent - ANS 1
By the end of the twelfth week, the external genitalia of the fetus have developed to such a
degree that the sex of the fetus can be determined visually. Differentiation of the external
genitalia occurs at the end of the ninth week. Testes descend into the scrotal sac at the end of
the thirty-eighth week. Internal differences in the male and female occur at the end of the
seventh week.
The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that
the fetal heart rate (FHR) is 174 beats/minute. On the basis of this finding, what is the priority
nursing action?
1. Document the finding.
2. Check the mother's heart rate.
3. Notify the health care provider (HCP).
4. Tell the client that the fetal heart rate is normal. - ANS 3
The FHR depends on gestational age and ranges from 160 to 170 beats/minute in the first
trimester, but slows with fetal growth to 110 to 160 beats/minute near or at term. At or near term,
if the FHR is less than 110 beats/minute or more than 160 beats/minute with the uterus at rest,
the fetus may be in distress. Because the FHR is increased from the reference range, the nurse
should notify the HCP. Options 2 and 4 are inappropriate actions based on the information in the
question. Although the nurse documents the findings, based on the information in the question,
the HCP needs to be notified.
The nurse is conducting a prenatal class on the female reproductive system. When a client in
the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's
best response?
1. "It promotes the fertilized ovum's chances of survival."
2. "It promotes the fertilized ovum's exposure to estrogen and progesterone."
3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus."
4. "It promotes the fertilized ovum's exposure to luteinizing hormone and follicle-stimulating
hormone." - ANS 3
The tubal isthmus remains contracted until 3 days after conception to allow the fertilized ovum
to develop within the tube. This initial growth of the fertilized ovum promotes its normal
implantation in the fundal portion of the uterine corpus. Estrogen is a hormone produced by the
ovarian follicles, corpus luteum, adrenal cortex, and placenta during pregnancy. Progesterone is
a hormone secreted by the corpus luteum of the ovary, adrenal glands, and placenta during
pregnancy. Luteinizing hormone and follicle-stimulating hormone are excreted by the anterior
pituitary gland. The survival of the fertilized ovum does not depend on it staying in the fallopian
tube for 3 days.
,The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid.
The student responds correctly by explaining which as characteristics of amniotic fluid?
(SELECT ALL THAT APPLY.)
1. Allows for fetal movement
2. Surrounds, cushions, and protects the fetus
3. Maintains the body temperature of the fetus
4. Can be used to measure fetal kidney function
5. Prevents large particles such as bacteria from passing to the fetus
6. Provides an exchange of nutrients and waste products between the mother and the fetus -
ANS 1, 2, 3, 4
The amniotic fluid surrounds, cushions, and protects the fetus. It allows the fetus to move freely
and maintains the body temperature of the fetus. In addition, the amniotic fluid contains urine
from the fetus and can be used to assess fetal kidney function. The placenta 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.
A couple comes to the family planning clinic and asks about sterilization procedures. Which
question by the nurse should determine whether this method of family planning would be most
appropriate?
1. "Did you ever had surgery?"
2. "Do you plan to have any other children?"
3. "Do either of you have diabetes mellitus?"
4. "Do either of you have problems with high blood pressure?" - ANS 2
Sterilization is a method of contraception for couples who have completed their families. It
should be considered a permanent end to fertility because reversal surgery is not always
successful. The nurse would ask the couple about their plans for having children in the future.
Options 1, 3, and 4 are unrelated to this procedure.
The nurse should make which statement to a pregnant client found to have a gynecoid pelvis?
1. "Your type of pelvis has a narrow pubic arch."
2. "Your type of pelvis is the most favorable for labor and birth."
3. "Your type of pelvis is a wide pelvis, but it has a short diameter."
4. "You will need a cesarean section because this type of pelvis is not favorable for a vaginal
delivery." - ANS 2
A gynecoid pelvis is a normal female pelvis and is the most favorable for successful labor and
birth. An android pelvis (resembling a male pelvis) would be unfavorable for labor because of
the narrow pelvic planes. An anthropoid pelvis has an outlet that is adequate, with a normal or
, moderately narrow pubic arch. A platypelloid pelvis (flat pelvis) has a wide transverse diameter,
but the anteroposterior diameter is short, making the outlet inadequate.
Which purposes of placental functioning should the nurse include in a prenatal class? (SELECT
ALL THAT APPLY.)
1. It cushions and protects the baby.
2. It maintains the temperature of the baby.
3. It is the way the baby gets food and oxygen.
4. It prevents all antibodies and viruses from passing to the baby.
5. It provides an exchange of nutrients and waste products between the mother and developing
fetus. - ANS 3, 5
The placenta provides an exchange of oxygen, nutrients, and waste products between the
mother and the fetus. The amniotic fluid surrounds, cushions, and protects the fetus and
maintains the body temperature of the fetus. Nutrients, medications, antibodies, and viruses can
pass through the placenta.
A 55-year-old male client confides in the nurse that he is concerned about his sexual function.
What is the nurse's best response?
1. "How often do you have sexual relations?"
2. "Please share with me more about your concerns."
3. "You are still young and have nothing to be concerned about."
4. "You should not have a decline in testosterone until you are in your 80s." - ANS 2
The nurse needs to establish trust when discussing sexual relationships with men. The nurse
should open the conversation with broad statements to determine the true nature of the client's
concerns. The frequency of intercourse is not a relevant first question to establish trust.
Testosterone declines with the aging process.
PRENATAL PERIOD - ANS PRENATAL PERIOD
The nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis.
What instruction should the nurse provide?
1. Strict bed rest is required after the procedure.
2. Hospitalization is necessary for 24 hours after the procedure.
3. An informed consent needs to be signed before the procedure.
4. A fever is expected after the procedure because of the trauma to the abdomen. - ANS 3
Because amniocentesis is an invasive procedure, informed consent needs to be obtained
before the procedure. After the procedure, the client is instructed to rest, but may resume light
activity after the cramping subsides. The client is instructed to keep the puncture site clean and
REPRODUCTIVE SYSTEM - ANS REPRODUCTIVE SYSTEM
The nurse is preparing to teach a prenatal class about fetal circulation. Which statements
should be included in the teaching plan? (SELECT ALL THAT APPLY.)
1. "The ductus arteriosus allows blood to bypass the fetal lungs."
2. "One vein carries oxygenated blood from the placenta to the fetus."
3. "The normal fetal heart tone range is 140 to 160 beats per minute in early pregnancy."
4. "Two arteries carry deoxygenated blood and waste products away from the fetus to the
placenta."
5. "Two veins carry blood that is high in carbon dioxide and other waste products away from the
fetus to the placenta." - ANS 1, 2, 4
The ductus arteriosus is a unique fetal circulation structure that allows the nonfunctioning lungs
to receive only a minimal amount of oxygenated blood for tissue maintenance. Oxygenated
blood is transported to the fetus by one umbilical vein. The normal fetal heart tone range is
considered to be 110 to 160 beats per minute. Arteries carry deoxygenated blood and waste
products from the fetus, and the umbilical vein carries oxygenated blood and provides oxygen
and nutrients to the fetus. Blood pumped by the embryo's heart leaves the embryo through two
umbilical arteries.
The nursing instructor asks the student to describe fetal circulation, specifically the ductus
venosus. Which statement by the student indicates an understanding of the ductus venosus?
1. "It connects the pulmonary artery to the aorta."
2. "It is an opening between the right and left atria."
3. "It connects the umbilical vein to the inferior vena cava."
4. "It connects the umbilical artery to the inferior vena cava." - ANS 3
The ductus venosus connects the umbilical vein to the inferior vena cava. The foramen ovale is
a temporary opening between the right and left atria. The ductus arteriosus joins the aorta and
the pulmonary artery.
A pregnant client tells the clinic nurse that she wants to know the sex of her baby as soon as it
can be determined. The nurse informs the client that she should be able to find out the sex at 12
weeks' gestation because of which factor?
1. The appearance of the fetal external genitalia
2. The beginning of differentiation in the fetal groin
3. The fetal testes are descended into the scrotal sac
,4. The internal differences in males and females become apparent - ANS 1
By the end of the twelfth week, the external genitalia of the fetus have developed to such a
degree that the sex of the fetus can be determined visually. Differentiation of the external
genitalia occurs at the end of the ninth week. Testes descend into the scrotal sac at the end of
the thirty-eighth week. Internal differences in the male and female occur at the end of the
seventh week.
The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that
the fetal heart rate (FHR) is 174 beats/minute. On the basis of this finding, what is the priority
nursing action?
1. Document the finding.
2. Check the mother's heart rate.
3. Notify the health care provider (HCP).
4. Tell the client that the fetal heart rate is normal. - ANS 3
The FHR depends on gestational age and ranges from 160 to 170 beats/minute in the first
trimester, but slows with fetal growth to 110 to 160 beats/minute near or at term. At or near term,
if the FHR is less than 110 beats/minute or more than 160 beats/minute with the uterus at rest,
the fetus may be in distress. Because the FHR is increased from the reference range, the nurse
should notify the HCP. Options 2 and 4 are inappropriate actions based on the information in the
question. Although the nurse documents the findings, based on the information in the question,
the HCP needs to be notified.
The nurse is conducting a prenatal class on the female reproductive system. When a client in
the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's
best response?
1. "It promotes the fertilized ovum's chances of survival."
2. "It promotes the fertilized ovum's exposure to estrogen and progesterone."
3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus."
4. "It promotes the fertilized ovum's exposure to luteinizing hormone and follicle-stimulating
hormone." - ANS 3
The tubal isthmus remains contracted until 3 days after conception to allow the fertilized ovum
to develop within the tube. This initial growth of the fertilized ovum promotes its normal
implantation in the fundal portion of the uterine corpus. Estrogen is a hormone produced by the
ovarian follicles, corpus luteum, adrenal cortex, and placenta during pregnancy. Progesterone is
a hormone secreted by the corpus luteum of the ovary, adrenal glands, and placenta during
pregnancy. Luteinizing hormone and follicle-stimulating hormone are excreted by the anterior
pituitary gland. The survival of the fertilized ovum does not depend on it staying in the fallopian
tube for 3 days.
,The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid.
The student responds correctly by explaining which as characteristics of amniotic fluid?
(SELECT ALL THAT APPLY.)
1. Allows for fetal movement
2. Surrounds, cushions, and protects the fetus
3. Maintains the body temperature of the fetus
4. Can be used to measure fetal kidney function
5. Prevents large particles such as bacteria from passing to the fetus
6. Provides an exchange of nutrients and waste products between the mother and the fetus -
ANS 1, 2, 3, 4
The amniotic fluid surrounds, cushions, and protects the fetus. It allows the fetus to move freely
and maintains the body temperature of the fetus. In addition, the amniotic fluid contains urine
from the fetus and can be used to assess fetal kidney function. The placenta 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.
A couple comes to the family planning clinic and asks about sterilization procedures. Which
question by the nurse should determine whether this method of family planning would be most
appropriate?
1. "Did you ever had surgery?"
2. "Do you plan to have any other children?"
3. "Do either of you have diabetes mellitus?"
4. "Do either of you have problems with high blood pressure?" - ANS 2
Sterilization is a method of contraception for couples who have completed their families. It
should be considered a permanent end to fertility because reversal surgery is not always
successful. The nurse would ask the couple about their plans for having children in the future.
Options 1, 3, and 4 are unrelated to this procedure.
The nurse should make which statement to a pregnant client found to have a gynecoid pelvis?
1. "Your type of pelvis has a narrow pubic arch."
2. "Your type of pelvis is the most favorable for labor and birth."
3. "Your type of pelvis is a wide pelvis, but it has a short diameter."
4. "You will need a cesarean section because this type of pelvis is not favorable for a vaginal
delivery." - ANS 2
A gynecoid pelvis is a normal female pelvis and is the most favorable for successful labor and
birth. An android pelvis (resembling a male pelvis) would be unfavorable for labor because of
the narrow pelvic planes. An anthropoid pelvis has an outlet that is adequate, with a normal or
, moderately narrow pubic arch. A platypelloid pelvis (flat pelvis) has a wide transverse diameter,
but the anteroposterior diameter is short, making the outlet inadequate.
Which purposes of placental functioning should the nurse include in a prenatal class? (SELECT
ALL THAT APPLY.)
1. It cushions and protects the baby.
2. It maintains the temperature of the baby.
3. It is the way the baby gets food and oxygen.
4. It prevents all antibodies and viruses from passing to the baby.
5. It provides an exchange of nutrients and waste products between the mother and developing
fetus. - ANS 3, 5
The placenta provides an exchange of oxygen, nutrients, and waste products between the
mother and the fetus. The amniotic fluid surrounds, cushions, and protects the fetus and
maintains the body temperature of the fetus. Nutrients, medications, antibodies, and viruses can
pass through the placenta.
A 55-year-old male client confides in the nurse that he is concerned about his sexual function.
What is the nurse's best response?
1. "How often do you have sexual relations?"
2. "Please share with me more about your concerns."
3. "You are still young and have nothing to be concerned about."
4. "You should not have a decline in testosterone until you are in your 80s." - ANS 2
The nurse needs to establish trust when discussing sexual relationships with men. The nurse
should open the conversation with broad statements to determine the true nature of the client's
concerns. The frequency of intercourse is not a relevant first question to establish trust.
Testosterone declines with the aging process.
PRENATAL PERIOD - ANS PRENATAL PERIOD
The nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis.
What instruction should the nurse provide?
1. Strict bed rest is required after the procedure.
2. Hospitalization is necessary for 24 hours after the procedure.
3. An informed consent needs to be signed before the procedure.
4. A fever is expected after the procedure because of the trauma to the abdomen. - ANS 3
Because amniocentesis is an invasive procedure, informed consent needs to be obtained
before the procedure. After the procedure, the client is instructed to rest, but may resume light
activity after the cramping subsides. The client is instructed to keep the puncture site clean and
