Maternity HESI Test Bank o o o o
EXAMoQUESTIONSoANDoANSWERSo100%oCORRECToLATESToo
oo
1. Ao38-
weekoprimigravidaowhooworksoasoaosecretaryoandositsoatoaocomputeroforo8ohoursoeachod
ayotellsotheonurseothatoherofeetohaveobegunotooswell.oWhichoinstructiono wouldobeomostoe
ffectiveoinopreventingopoolingoofobloodoinotheoloweroextremities?
Moveoaboutoeveryohour
Poolingoofobloodoinotheoloweroextremitiesoresultsofromotheoenlargedouterusoexertingop
ressureo ono theo pelvico veins.o Movingo abouto everyo houro willo straighteno outo theope
lvicoveinsoandoincreaseovenousoreturn.
2. Ao26-year-old,ogravidao2,oparao1oclientoisoadmittedotootheohospitaloato28-
weeksogestationoinopretermolabor.oSheoisogiveno3odosesoofoterbutalineosulfateo(Brethine)o0
.25omgosubcutaneouslyotoostopoherolaborocontractions.oTheonurseoplansotoomonitoroforow
hichoprimaryosideoeffectoofoterbutalineosulfate?
Tachycardiaoandoaofeelingoofonervousness
Terbutalineosulfateo(Brethine),oaobeta-sympathomimeticodrug,ostimulatesobeta-
adrenergicoreceptorsoinotheouterineomuscleotoostopocontractions.oTheobeta-
adrenergicoagonistopropertiesoofotheodrugomayocauseotachycardia,oincreasedocardiacooutp
ut,orestlessness,oheadache,oandoaofeelingoofo"nervousness".
,3. Whato doeso ao diaphragmatico herniao lookolike
?oScaphoidoabdomenoandoanorexia
4. Aonewomotheroisoafraidotootouchoherobaby'soheadoforofearoofohurtingotheo"largeosoftospot."o
Whichoexplanationoshouldotheonurseogiveotoothisoanxiousoclient?
There'so ao strong,o tougho membraneo thereo too protecto theo babyo soo youo needo noto beoafra
idotoowashoorocombohis/herohair.
5. Aoclientowhooisoattendingoantepartumoclassesoasksotheonurseowhyoherohealthcareop
roviderohasoprescribedoironotablets.oTheonurse'soresponseoisobasedoonowhatoknow
ledge?
Itoisodifficultotooconsumeo18omgoofoadditionaloironobyodietoalone.
Consumingoenoughoiron-
containingofoodsotoofacilitateoadequateofetalostorageoofoironoandotoomeetotheodemandsoof
pregnancyoisodifficultosooironosupplementsoareooftenorecommended.
o
6. Whato iso megaloblastico anemiao causedoby
?ofolicoacidodeficiency
7. Aowomanowhoothinksosheocouldobeopregnantocallsoheroneighbor,oaonurse,otooaskowhenos
heocouldouseoaohomeopregnancyotestotoodiagnoseopregnancy.oWhichoresponseoisobest?
Aohomeopregnancyotestocanobeousedorightoafteroyourofirstomissedoperiod.
Homeourineotestsoareobasedoonotheochemicalodetectionoofohumanochorionicogonado
trophin,o whicho beginso too increaseo 6o too 8o dayso aftero conceptiono ando isobestodete
ctedoato2oweeks’gestationooroimmediatelyoafterotheofirstomissedoperiod.
8. Ao28-year-
oldoclientoinoactiveolaborocomplainsoofocrampsoinoheroleg.oWhatointerventionoshouldotheo
nurseoimplement?
, Extendotheolegoandodorsiflexotheofoot
Dorsiflexingotheofootobyopushingotheosoleoofotheofootoforwardoorobyostandingo(ifotheoclientoiso
capable)oandoputtingotheoheeloofotheofootoonotheoflooroisotheobestomeansooforelievingolegocr
amps.
9. Aoclientoato30-
weeks’gestation,ocomplainingoofopressureooverotheopubicoarea,oisoadmittedoforoobservatio
n.oSheoisocontractingoirregularlyoandodemonstratesounderlyingouterineoirritability.oVaginaloe
xaminationorevealsothatoherocervixoisoclosed,othick,oandohigh.oBasedoonotheseodata,owhichoi
nterventionoshouldotheonurseoimplementofirst?
Obtainingoaourineoanalysisoshouldobeodoneofirstobecauseopretermoclientso withouterineo
irritabilityoandocontractionsoareooftenosufferingofromoaourinaryotractoinfection,oandothiso
shouldobeoruledooutofirst.
10. Aoclientoinoactiveolaboroisoadmittedowithopreeclampsia.oWhichoassessmentofindingoisomostos
ignificantoinoplanningothisoclient'socare?
Ao4+oreflexoinoaoclientowithopregnancy-
inducedohypertensiono indicatesohyperreflexia,owhichoisoanoindicationoofoanoimpendin
goseizure.
11. WhatoisoEpogenofor?
Changesoanoapicaloheartorateofromotheo180sotootheo140s.
Epogen,ogivenotoopreventoorotreatoanemia,ostimulatesoerythropoietinoproduction,oresulting
inoanoincreaseoinoRBCs.oSinceotheobodyohasonotohadotoocompensateoforoanemiaowithoanoi
o
ncreasedoheartorate,ochangesoinoheartorateofromohighotoonormaloisooneoindicatorothatoEpog
enoisoeffective
3
, 12. Theohealthcareoprovideroprescribesoterbutalineo(Brethine)oforoaoclientoinopretermolabor.oB
eforeo initiatingo thiso prescription,o ito iso mosto importanto foro theo nurseo too assesso theocli
entoforowhichocondition?
Gestationalodiabetes.
Theo nurseo shouldo evaluateo theo cliento foro gestationalo diabeteso becauseoterbutalineo
(Brethine)oincreasesobloodoglucoseolevels.
13. AoclientowithoNOoprenatalocareoarrivesoatotheolaborounitoscreaming,o"Theobabyoisocoming!"oT
heonurseoperformsoaovaginaloexaminationothatorevealsotheocervixoiso3ocentimetersodilatedo
ando75%oeffaced.oWhatoadditionaloinformationoisomostoimportantoforotheonurseotooobtain?
Dateoofolastonormalomenstrualoperiod.
Evaluatingotheogestationoofotheopregnancyotakesopriority.oIfotheofetusoisopretermoandothe
fetaloheartopatternoisoreassuring,otheohealthcareoprovideromayoattemptotooprolongothe
pregnancyoandoadministerocorticosteroidsotoomatureotheolungsoofotheofetus.
o
14. Theonurseoassessesoaoclientoadmittedotootheolaboroandodeliveryounitoandoobtainsotheofollo
wingodata:odarkoredovaginalobleeding,outerusoslightlyotenseobetweenocontractions,oBPo11
0/68,oFHRo110obeats/minute,ocervixo1ocmodilatedoandouneffaced.oBasedoonotheseoassess
mentofindings,owhatointerventionoshouldotheonurseoimplement?
MonitoringobleedingofromoIVosites
Monitoringobleedingofromoperipheralositesoisotheopriorityointervention.oThisoclientoisopres
entingowithosignsoofoplacentaloabruption.oDisseminatedointravascularocoagulationo(DIC)oi
soaocomplicationoofoplacentaloabruptio,ocharacterizedobyoabnormalobleeding.
15. Immediatelyoafterobirthoaonewbornoinfantoisosuctioned,odried,oandoplacedounderoaoradianto
4
EXAMoQUESTIONSoANDoANSWERSo100%oCORRECToLATESToo
oo
1. Ao38-
weekoprimigravidaowhooworksoasoaosecretaryoandositsoatoaocomputeroforo8ohoursoeachod
ayotellsotheonurseothatoherofeetohaveobegunotooswell.oWhichoinstructiono wouldobeomostoe
ffectiveoinopreventingopoolingoofobloodoinotheoloweroextremities?
Moveoaboutoeveryohour
Poolingoofobloodoinotheoloweroextremitiesoresultsofromotheoenlargedouterusoexertingop
ressureo ono theo pelvico veins.o Movingo abouto everyo houro willo straighteno outo theope
lvicoveinsoandoincreaseovenousoreturn.
2. Ao26-year-old,ogravidao2,oparao1oclientoisoadmittedotootheohospitaloato28-
weeksogestationoinopretermolabor.oSheoisogiveno3odosesoofoterbutalineosulfateo(Brethine)o0
.25omgosubcutaneouslyotoostopoherolaborocontractions.oTheonurseoplansotoomonitoroforow
hichoprimaryosideoeffectoofoterbutalineosulfate?
Tachycardiaoandoaofeelingoofonervousness
Terbutalineosulfateo(Brethine),oaobeta-sympathomimeticodrug,ostimulatesobeta-
adrenergicoreceptorsoinotheouterineomuscleotoostopocontractions.oTheobeta-
adrenergicoagonistopropertiesoofotheodrugomayocauseotachycardia,oincreasedocardiacooutp
ut,orestlessness,oheadache,oandoaofeelingoofo"nervousness".
,3. Whato doeso ao diaphragmatico herniao lookolike
?oScaphoidoabdomenoandoanorexia
4. Aonewomotheroisoafraidotootouchoherobaby'soheadoforofearoofohurtingotheo"largeosoftospot."o
Whichoexplanationoshouldotheonurseogiveotoothisoanxiousoclient?
There'so ao strong,o tougho membraneo thereo too protecto theo babyo soo youo needo noto beoafra
idotoowashoorocombohis/herohair.
5. Aoclientowhooisoattendingoantepartumoclassesoasksotheonurseowhyoherohealthcareop
roviderohasoprescribedoironotablets.oTheonurse'soresponseoisobasedoonowhatoknow
ledge?
Itoisodifficultotooconsumeo18omgoofoadditionaloironobyodietoalone.
Consumingoenoughoiron-
containingofoodsotoofacilitateoadequateofetalostorageoofoironoandotoomeetotheodemandsoof
pregnancyoisodifficultosooironosupplementsoareooftenorecommended.
o
6. Whato iso megaloblastico anemiao causedoby
?ofolicoacidodeficiency
7. Aowomanowhoothinksosheocouldobeopregnantocallsoheroneighbor,oaonurse,otooaskowhenos
heocouldouseoaohomeopregnancyotestotoodiagnoseopregnancy.oWhichoresponseoisobest?
Aohomeopregnancyotestocanobeousedorightoafteroyourofirstomissedoperiod.
Homeourineotestsoareobasedoonotheochemicalodetectionoofohumanochorionicogonado
trophin,o whicho beginso too increaseo 6o too 8o dayso aftero conceptiono ando isobestodete
ctedoato2oweeks’gestationooroimmediatelyoafterotheofirstomissedoperiod.
8. Ao28-year-
oldoclientoinoactiveolaborocomplainsoofocrampsoinoheroleg.oWhatointerventionoshouldotheo
nurseoimplement?
, Extendotheolegoandodorsiflexotheofoot
Dorsiflexingotheofootobyopushingotheosoleoofotheofootoforwardoorobyostandingo(ifotheoclientoiso
capable)oandoputtingotheoheeloofotheofootoonotheoflooroisotheobestomeansooforelievingolegocr
amps.
9. Aoclientoato30-
weeks’gestation,ocomplainingoofopressureooverotheopubicoarea,oisoadmittedoforoobservatio
n.oSheoisocontractingoirregularlyoandodemonstratesounderlyingouterineoirritability.oVaginaloe
xaminationorevealsothatoherocervixoisoclosed,othick,oandohigh.oBasedoonotheseodata,owhichoi
nterventionoshouldotheonurseoimplementofirst?
Obtainingoaourineoanalysisoshouldobeodoneofirstobecauseopretermoclientso withouterineo
irritabilityoandocontractionsoareooftenosufferingofromoaourinaryotractoinfection,oandothiso
shouldobeoruledooutofirst.
10. Aoclientoinoactiveolaboroisoadmittedowithopreeclampsia.oWhichoassessmentofindingoisomostos
ignificantoinoplanningothisoclient'socare?
Ao4+oreflexoinoaoclientowithopregnancy-
inducedohypertensiono indicatesohyperreflexia,owhichoisoanoindicationoofoanoimpendin
goseizure.
11. WhatoisoEpogenofor?
Changesoanoapicaloheartorateofromotheo180sotootheo140s.
Epogen,ogivenotoopreventoorotreatoanemia,ostimulatesoerythropoietinoproduction,oresulting
inoanoincreaseoinoRBCs.oSinceotheobodyohasonotohadotoocompensateoforoanemiaowithoanoi
o
ncreasedoheartorate,ochangesoinoheartorateofromohighotoonormaloisooneoindicatorothatoEpog
enoisoeffective
3
, 12. Theohealthcareoprovideroprescribesoterbutalineo(Brethine)oforoaoclientoinopretermolabor.oB
eforeo initiatingo thiso prescription,o ito iso mosto importanto foro theo nurseo too assesso theocli
entoforowhichocondition?
Gestationalodiabetes.
Theo nurseo shouldo evaluateo theo cliento foro gestationalo diabeteso becauseoterbutalineo
(Brethine)oincreasesobloodoglucoseolevels.
13. AoclientowithoNOoprenatalocareoarrivesoatotheolaborounitoscreaming,o"Theobabyoisocoming!"oT
heonurseoperformsoaovaginaloexaminationothatorevealsotheocervixoiso3ocentimetersodilatedo
ando75%oeffaced.oWhatoadditionaloinformationoisomostoimportantoforotheonurseotooobtain?
Dateoofolastonormalomenstrualoperiod.
Evaluatingotheogestationoofotheopregnancyotakesopriority.oIfotheofetusoisopretermoandothe
fetaloheartopatternoisoreassuring,otheohealthcareoprovideromayoattemptotooprolongothe
pregnancyoandoadministerocorticosteroidsotoomatureotheolungsoofotheofetus.
o
14. Theonurseoassessesoaoclientoadmittedotootheolaboroandodeliveryounitoandoobtainsotheofollo
wingodata:odarkoredovaginalobleeding,outerusoslightlyotenseobetweenocontractions,oBPo11
0/68,oFHRo110obeats/minute,ocervixo1ocmodilatedoandouneffaced.oBasedoonotheseoassess
mentofindings,owhatointerventionoshouldotheonurseoimplement?
MonitoringobleedingofromoIVosites
Monitoringobleedingofromoperipheralositesoisotheopriorityointervention.oThisoclientoisopres
entingowithosignsoofoplacentaloabruption.oDisseminatedointravascularocoagulationo(DIC)oi
soaocomplicationoofoplacentaloabruptio,ocharacterizedobyoabnormalobleeding.
15. Immediatelyoafterobirthoaonewbornoinfantoisosuctioned,odried,oandoplacedounderoaoradianto
4