HESI MATERNITY EXAM PRACTICE QUESTIONS WITH FULLY
SOLVED ANSWERS.
1) A primiparous client is on a regular diet 24 hours postpartum. She is from Guatemala
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
and speaks only Spanish. The client's mother asks the nurse if she can bring her
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
daughter some "special foods from home." The nurse responds based on the
_ _ _ _ _ _ _ _ _ _ _ _
understanding about which of the following? _ _ _ _ _
1. Foods from home are generally discouraged on the postpartum unit.
_ _ _ _ _ _ _ _ _
2. The mother can bring the daughter any foods that she desires.
_ _ _ _ _ _ _ _ _ _
3. This is permissible as long as the foods are nutritious and high in iron.
_ _ _ _ _ _ _ _ _ _ _ _ _
4. The client's physician needs to give permission for the foods. -- Correct
_ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ 2. On most postpartum units, clients on regular diets are allowed
_ _ _ _ _ _ _ _ _ _ _ _ _
to eat whatever kinds of food they desire. Generally, foods from home are not
_ _ _ _ _ _ _ _ _ _ _ _ _
discouraged. The nurse does not need to obtain the physician's permission.
_ _ _ _ _ _ _ _ _ _ _ _
Although it is preferred, the foods do not necessarily have to be high in iron.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
In some cultures, there is a belief in the "hotcold" theory of disease; certain
_ _ _ _ _ _ _ _ _ _ _ _ _ _
foods (hot) are preferred during the postpartum period, and other foods
_ _ _ _ _ _ _ _ _ _ _
(cold) are avoided. Therefore, the nurse should allow the mother to bring her
_ _ _ _ _ _ _ _ _ _ _ _ _
daughter "special foods from home." Doing so demonstrates cultural
_ _ _ _ _ _ _ _ _
sensitivity and aids in developing a trusting relationship. _ _ _ _ _ _ _
2) A primiparous client, 48 hours after a vaginal birth, is to be discharged with a
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
prescription for vitamins with iron because she is anemic. To maximize absorption of
_ _ _ _ _ _ _ _ _ _ _ _ _
the iron, the nurse instructs the client to take the medication with which of the
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
following?
1. Orange juice. _
2. Herbal tea. _
3. Milk.
4. Grape juice. -- Correct Answer ✔✔ 1. Iron is best absorbed in an acid
_ _ _ _ _ _ _ _ _ _ _ _ _ _
environment or with vitamin C. For maximum iron absorption, the client _ _ _ _ _ _ _ _ _ _ _
should take the medication with orange juice or a vitamin C supplement.
_ _ _ _ _ _ _ _ _ _ _ _
Herbal tea has no effect on iron absorption. Milk decreases iron absorption.
_ _ _ _ _ _ _ _ _ _ _ _
, Grape juice is not acidic and therefore would have no effect on iron
_ _ _ _ _ _ _ _ _ _ _ _ _
absorption.
3) A 39-year-old multigravida client asks the nurse for information about female
_ _ _ _ _ _ _ _ _ _ _ _
sterilization with a tubal ligation. Which of the following client statements indicates
_ _ _ _ _ _ _ _ _ _ _ _
effective teaching? _
1. "My fallopian tubes will be tied off through a small abdominal incision."
_ _ _ _ _ _ _ _ _ _ _
2. "Reversal of a tubal ligation is easily done, with a pregnancy success rate of
_ _ _ _ _ _ _ _ _ _ _ _ _ _
80%."
3. "After this procedure, I must abstain from intercourse for at least 3 weeks."
_ _ _ _ _ _ _ _ _ _ _ _
4. "Both of my ovaries will be removed during the tubal ligation procedure." --
_ _ _ _ _ _ _ _ _ _ _ _ _
Correct Answer ✔✔ 1. Tubal ligation, a female sterilization procedure,
_ _ _ _ _ _ _ _ _ _
involves ligation (tying off) or cauterization of the fallopian tubes through a
_ _ _ _ _ _ _ _ _ _ _ _
small abdominal incision (laparotomy). Reversal of a tubal ligation is not easily
_ _ _ _ _ _ _ _ _ _ _ _
done, and the pregnancy success rate after reversal is about 30%. After a tubal
_ _ _ _ _ _ _ _ _ _ _ _ _ _
ligation, the client may engage in intercourse 2 to 3 days after the procedure.
_ _ _ _ _ _ _ _ _ _ _ _ _ _
The ovaries are not generally removed during a tubal ligation. An
_ _ _ _ _ _ _ _ _ _ _
oophorectomy involves removal of one or both ovaries. _ _ _ _ _ _ _
CN: Health promotion and maintenance; CL: Evaluate
_ _ _ _ _ _
4) The nurse is caring for a multiparous client after vaginal birth of a set of male twins 2
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
hours ago. The nurse should encourage the mother and husband to:
_ _ _ _ _ _ _ _ _ _
1. Bottle-feed the twins to prevent exhaustion and fatigue. _ _ _ _ _ _ _
2. Plan for each parent to spend equal amounts of time with each twin.
_ _ _ _ _ _ _ _ _ _ _ _
3. Avoid assistance from other family members until attachment occurs.
_ _ _ _ _ _ _ _
4. Relate to each twin individually to enhance the attachment process. -- Correct
_ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ . 4. It is believed that the process of attachment is structured so
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
that the parents become attached to only one infant at a time. Therefore, the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
nurse should encourage the parents to relate to each twin individually, rather
_ _ _ _ _ _ _ _ _ _ _ _
than as a unit, to enhance the attachment process. Mothers of twins are
_ _ _ _ _ _ _ _ _ _ _ _ _
usually able to breast-feed successfully because the milk supply increases on
_ _ _ _ _ _ _ _ _ _ _
demand. However, possible fatigue and exhaustion require that the mother
_ _ _ _ _ _ _ _ _ _
rest whenever possible. It would be highly unlikely and unrealistic that each
_ _ _ _ _ _ _ _ _ _ _ _
parent would be able to spend equal amounts of time with both twins. Other
_ _ _ _ _ _ _ _ _ _ _ _ _ _
responsibilities, such as employment, may prevent this. The parents should try _ _ _ _ _ _ _ _ _ _ _
, to engage assistance from family and friends, because caring for twins or other
_ _ _ _ _ _ _ _ _ _ _ _ _
multiple births (e.g., triplets) can be exhausting for the family.
_ _ _ _ _ _ _ _ _
5) Twelve hours after a vaginal birth with epidural anesthesia, the nurse palpates the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
fundus of a primiparous client and finds it to be firm, above the umbilicus, and
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
deviated to the right. Which of the following would the nurse do next?
_ _ _ _ _ _ _ _ _ _ _ _
1. Document this as a normal finding in the client's record. _ _ _ _ _ _ _ _ _
2. Contact the physician for a prescription for oxytocin. _ _ _ _ _ _ _
3. Encourage the client to ambulate to the bathroom and void. _ _ _ _ _ _ _ _ _
4. Gently massage the fundus to expel the clots. -- Correct Answer ✔✔ 3. At 12
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
hours postpartum, the fundus normally should be in the midline and at the
_ _ _ _ _ _ _ _ _ _ _ _ _
level of the umbilicus. When the fundus is firm yet above the umbilicus, and
_ _ _ _ _ _ _ _ _ _ _ _ _ _
deviated to the right rather than in the midline, the client's bladder is most
_ _ _ _ _ _ _ _ _ _ _ _ _ _
likely distended. The client should be encouraged to ambulate to the
_ _ _ _ _ _ _ _ _ _ _
bathroom and attempt to void, because a full bladder can prevent normal _ _ _ _ _ _ _ _ _ _ _ _
involution. A firm but deviated fundus above the level of the umbilicus is not a
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
normal finding and if voiding does not return it to midline, it should be
_ _ _ _ _ _ _ _ _ _ _ _ _ _
reported to the physician. Oxytocin is used to treat uterine atony. This client's
_ _ _ _ _ _ _ _ _ _ _ _
fundus is firm, not boggy or soft, which would suggest atony. Gentle massage
_ _ _ _ _ _ _ _ _ _ _ _ _ _
is not necessary because there is no evidence of atony or clots.
_ _ _ _ _ _ _ _ _ _ _
6) A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency
_ _ _ _ _ _ _ _ _ _ _ _ _
contraception. After unprotected intercourse, the client calls the clinic to ask
_ _ _ _ _ _ _ _ _ _ _
questions about taking the contraceptives. The nurse realizes the client needs further
_ _ _ _ _ _ _ _ _ _ _ _
explanation when she makes which of the following responses?
_ _ _ _ _ _ _ _
1. "I can wait 3 to 4 days after intercourse to start taking these to prevent
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
pregnancy."
2. "My boyfriend can buy Plan B from the pharmacy if he is over 18 years old."
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3. "The birth control works by preventing ovulation or fertilization of the egg."
_ _ _ _ _ _ _ _ _ _ _
4. "I may feel nauseated and have breast tenderness or a headache after using the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
contraceptive." -- Correct Answer ✔✔ 1. Plan B is a series of contraceptive _ _ _ _ _ _ _ _ _ _ _ _ _
pills similar in composition to birth control pills that have been used for the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
past 30 years. Plan B is the brand name for levonorgestrel 0.75 mg. Pills are
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
most effective if taken immediately after unprotected intercourse and then
_ _ _ _ _ _ _ _ _ _
again 12 hours later. Males can purchase this contraceptive as long as they are
_ _ _ _ _ _ _ _ _ _ _ _ _ _
SOLVED ANSWERS.
1) A primiparous client is on a regular diet 24 hours postpartum. She is from Guatemala
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
and speaks only Spanish. The client's mother asks the nurse if she can bring her
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
daughter some "special foods from home." The nurse responds based on the
_ _ _ _ _ _ _ _ _ _ _ _
understanding about which of the following? _ _ _ _ _
1. Foods from home are generally discouraged on the postpartum unit.
_ _ _ _ _ _ _ _ _
2. The mother can bring the daughter any foods that she desires.
_ _ _ _ _ _ _ _ _ _
3. This is permissible as long as the foods are nutritious and high in iron.
_ _ _ _ _ _ _ _ _ _ _ _ _
4. The client's physician needs to give permission for the foods. -- Correct
_ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ 2. On most postpartum units, clients on regular diets are allowed
_ _ _ _ _ _ _ _ _ _ _ _ _
to eat whatever kinds of food they desire. Generally, foods from home are not
_ _ _ _ _ _ _ _ _ _ _ _ _
discouraged. The nurse does not need to obtain the physician's permission.
_ _ _ _ _ _ _ _ _ _ _ _
Although it is preferred, the foods do not necessarily have to be high in iron.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
In some cultures, there is a belief in the "hotcold" theory of disease; certain
_ _ _ _ _ _ _ _ _ _ _ _ _ _
foods (hot) are preferred during the postpartum period, and other foods
_ _ _ _ _ _ _ _ _ _ _
(cold) are avoided. Therefore, the nurse should allow the mother to bring her
_ _ _ _ _ _ _ _ _ _ _ _ _
daughter "special foods from home." Doing so demonstrates cultural
_ _ _ _ _ _ _ _ _
sensitivity and aids in developing a trusting relationship. _ _ _ _ _ _ _
2) A primiparous client, 48 hours after a vaginal birth, is to be discharged with a
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
prescription for vitamins with iron because she is anemic. To maximize absorption of
_ _ _ _ _ _ _ _ _ _ _ _ _
the iron, the nurse instructs the client to take the medication with which of the
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
following?
1. Orange juice. _
2. Herbal tea. _
3. Milk.
4. Grape juice. -- Correct Answer ✔✔ 1. Iron is best absorbed in an acid
_ _ _ _ _ _ _ _ _ _ _ _ _ _
environment or with vitamin C. For maximum iron absorption, the client _ _ _ _ _ _ _ _ _ _ _
should take the medication with orange juice or a vitamin C supplement.
_ _ _ _ _ _ _ _ _ _ _ _
Herbal tea has no effect on iron absorption. Milk decreases iron absorption.
_ _ _ _ _ _ _ _ _ _ _ _
, Grape juice is not acidic and therefore would have no effect on iron
_ _ _ _ _ _ _ _ _ _ _ _ _
absorption.
3) A 39-year-old multigravida client asks the nurse for information about female
_ _ _ _ _ _ _ _ _ _ _ _
sterilization with a tubal ligation. Which of the following client statements indicates
_ _ _ _ _ _ _ _ _ _ _ _
effective teaching? _
1. "My fallopian tubes will be tied off through a small abdominal incision."
_ _ _ _ _ _ _ _ _ _ _
2. "Reversal of a tubal ligation is easily done, with a pregnancy success rate of
_ _ _ _ _ _ _ _ _ _ _ _ _ _
80%."
3. "After this procedure, I must abstain from intercourse for at least 3 weeks."
_ _ _ _ _ _ _ _ _ _ _ _
4. "Both of my ovaries will be removed during the tubal ligation procedure." --
_ _ _ _ _ _ _ _ _ _ _ _ _
Correct Answer ✔✔ 1. Tubal ligation, a female sterilization procedure,
_ _ _ _ _ _ _ _ _ _
involves ligation (tying off) or cauterization of the fallopian tubes through a
_ _ _ _ _ _ _ _ _ _ _ _
small abdominal incision (laparotomy). Reversal of a tubal ligation is not easily
_ _ _ _ _ _ _ _ _ _ _ _
done, and the pregnancy success rate after reversal is about 30%. After a tubal
_ _ _ _ _ _ _ _ _ _ _ _ _ _
ligation, the client may engage in intercourse 2 to 3 days after the procedure.
_ _ _ _ _ _ _ _ _ _ _ _ _ _
The ovaries are not generally removed during a tubal ligation. An
_ _ _ _ _ _ _ _ _ _ _
oophorectomy involves removal of one or both ovaries. _ _ _ _ _ _ _
CN: Health promotion and maintenance; CL: Evaluate
_ _ _ _ _ _
4) The nurse is caring for a multiparous client after vaginal birth of a set of male twins 2
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
hours ago. The nurse should encourage the mother and husband to:
_ _ _ _ _ _ _ _ _ _
1. Bottle-feed the twins to prevent exhaustion and fatigue. _ _ _ _ _ _ _
2. Plan for each parent to spend equal amounts of time with each twin.
_ _ _ _ _ _ _ _ _ _ _ _
3. Avoid assistance from other family members until attachment occurs.
_ _ _ _ _ _ _ _
4. Relate to each twin individually to enhance the attachment process. -- Correct
_ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ . 4. It is believed that the process of attachment is structured so
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
that the parents become attached to only one infant at a time. Therefore, the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
nurse should encourage the parents to relate to each twin individually, rather
_ _ _ _ _ _ _ _ _ _ _ _
than as a unit, to enhance the attachment process. Mothers of twins are
_ _ _ _ _ _ _ _ _ _ _ _ _
usually able to breast-feed successfully because the milk supply increases on
_ _ _ _ _ _ _ _ _ _ _
demand. However, possible fatigue and exhaustion require that the mother
_ _ _ _ _ _ _ _ _ _
rest whenever possible. It would be highly unlikely and unrealistic that each
_ _ _ _ _ _ _ _ _ _ _ _
parent would be able to spend equal amounts of time with both twins. Other
_ _ _ _ _ _ _ _ _ _ _ _ _ _
responsibilities, such as employment, may prevent this. The parents should try _ _ _ _ _ _ _ _ _ _ _
, to engage assistance from family and friends, because caring for twins or other
_ _ _ _ _ _ _ _ _ _ _ _ _
multiple births (e.g., triplets) can be exhausting for the family.
_ _ _ _ _ _ _ _ _
5) Twelve hours after a vaginal birth with epidural anesthesia, the nurse palpates the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
fundus of a primiparous client and finds it to be firm, above the umbilicus, and
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
deviated to the right. Which of the following would the nurse do next?
_ _ _ _ _ _ _ _ _ _ _ _
1. Document this as a normal finding in the client's record. _ _ _ _ _ _ _ _ _
2. Contact the physician for a prescription for oxytocin. _ _ _ _ _ _ _
3. Encourage the client to ambulate to the bathroom and void. _ _ _ _ _ _ _ _ _
4. Gently massage the fundus to expel the clots. -- Correct Answer ✔✔ 3. At 12
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
hours postpartum, the fundus normally should be in the midline and at the
_ _ _ _ _ _ _ _ _ _ _ _ _
level of the umbilicus. When the fundus is firm yet above the umbilicus, and
_ _ _ _ _ _ _ _ _ _ _ _ _ _
deviated to the right rather than in the midline, the client's bladder is most
_ _ _ _ _ _ _ _ _ _ _ _ _ _
likely distended. The client should be encouraged to ambulate to the
_ _ _ _ _ _ _ _ _ _ _
bathroom and attempt to void, because a full bladder can prevent normal _ _ _ _ _ _ _ _ _ _ _ _
involution. A firm but deviated fundus above the level of the umbilicus is not a
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
normal finding and if voiding does not return it to midline, it should be
_ _ _ _ _ _ _ _ _ _ _ _ _ _
reported to the physician. Oxytocin is used to treat uterine atony. This client's
_ _ _ _ _ _ _ _ _ _ _ _
fundus is firm, not boggy or soft, which would suggest atony. Gentle massage
_ _ _ _ _ _ _ _ _ _ _ _ _ _
is not necessary because there is no evidence of atony or clots.
_ _ _ _ _ _ _ _ _ _ _
6) A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency
_ _ _ _ _ _ _ _ _ _ _ _ _
contraception. After unprotected intercourse, the client calls the clinic to ask
_ _ _ _ _ _ _ _ _ _ _
questions about taking the contraceptives. The nurse realizes the client needs further
_ _ _ _ _ _ _ _ _ _ _ _
explanation when she makes which of the following responses?
_ _ _ _ _ _ _ _
1. "I can wait 3 to 4 days after intercourse to start taking these to prevent
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
pregnancy."
2. "My boyfriend can buy Plan B from the pharmacy if he is over 18 years old."
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3. "The birth control works by preventing ovulation or fertilization of the egg."
_ _ _ _ _ _ _ _ _ _ _
4. "I may feel nauseated and have breast tenderness or a headache after using the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
contraceptive." -- Correct Answer ✔✔ 1. Plan B is a series of contraceptive _ _ _ _ _ _ _ _ _ _ _ _ _
pills similar in composition to birth control pills that have been used for the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
past 30 years. Plan B is the brand name for levonorgestrel 0.75 mg. Pills are
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
most effective if taken immediately after unprotected intercourse and then
_ _ _ _ _ _ _ _ _ _
again 12 hours later. Males can purchase this contraceptive as long as they are
_ _ _ _ _ _ _ _ _ _ _ _ _ _
