HESI MATERNITY OBSTETRICS 2000
CERTIFICATION EVALUATION COMPLETE
QUESTIONS WITH VERIFIED SOLUTIONS
◉ The nurse should explain to a 30-year-old gravid client that alpha
fetoprotein testing is recommended for which purpose?
Answer: Screen for neural tube defects.
◉ What action should the nurse implement to decrease the client's
risk for hemorrhage after a cesarean section?
Answer: Check the firmness of the uterus every 15 minutes.
◉ The nurse attempts to help an unmarried teenager deal with her
feelings following a spontaneous abortion at 8-weeks gestation.
What type of emotional response should the nurse anticipate?
Answer: Grief related to her perceptions about the loss of this child.
◉ The nurse is assessing a 3-day old infant with a cephalohematoma
in the newborn nursery. Which assessment finding should the nurse
report to the healthcare provider?
Answer: Yellowish tinge to the skin.
,◉ When assessing a client who is at 12-weeks gestation, the nurse
recommends that she and her husband consider attending childbirth
preparation classes. When is the best time for the couple to attend
these classes?
Answer: At 30-weeks gestation is closest to the time parents would
be ready for such classes. Learning is facilitated by an interested
pupil! The couple is most interested in childbirth toward the end of
the pregnancy when they are psychologically ready for the
termination of the pregnancy, and the birth of their child is an
immediate concern.
◉ A client at 32-weeks gestation is diagnosed with preeclampsia.
Which assessment finding is most indicative of an impending
convulsion?
Answer: Epigastric pain (C) is indicative of an edematous liver or
pancreas which is an early warning sign of an impending convulsion
(eclampsia) and requires immediate attention.
◉ 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?
Answer: Onset of uterine contractions.
◉ A client who is in the second trimester of pregnancy tells the
nurse that she wants to use herbal therapy. Which response is best
for the nurse to provide?
,Answer: It is important that you want to take part in your care.
◉ A couple, concerned because the woman has not been able to
conceive, is referred to a healthcare provider for a fertility workup
and a hysterosalpingography is scheduled. Which postprocedure
complaint indicates that the fallopian tubes are patent?
Answer: If the tubes are patent (open), pain is referred to the
shoulder (C) from a subdiaphragmatic collection of peritoneal
dye/gas.
◉ A client who delivered an infant an hour ago tells the nurse that
she feels wet underneath her buttock. The nurse notes that both
perineal pads are completely saturated and the client is lying in a 6-
inch diameter pool of blood. Which action should the nurse
implement next?
Answer: Palpate the firmness of the fundus.
◉ 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 × 1. What action should the nurse take immediately?
Answer: Methergine is contraindicated for clients with elevated
blood pressure, so the nurse should contact the healthcare provider
and question the prescription (D).
, ◉ A client at 32-weeks gestation comes to the prenatal clinic with
complaints of pedal edema, dyspnea, fatigue, and a moist cough.
Which question is most important for the nurse to ask this client?
Answer: Do you have a history of rheumatic fever? Clients with a
history of rheumatic fever (D) may develop mitral valve prolapse,
which increases the risk for cardiac decompensation due to the
increased blood volume that occurs during pregnancy, so obtaining
information about this client's health history is a priority.
◉ 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?
Answer: Pitocin causes the uterine myofibril to contract, so unless
the infusion is closely monitored, the client is at risk for
hyperstimulation (B) which can lead to tetanic contractions, uterine
rupture, and fetal distress or demise.
◉ A 35-year-old primigravida client with severe preeclampsia is
receiving magnesium sulfate via continuous IV infusion. Which
assessment data indicates to the nurse that the client is experiencing
magnesium sulfate toxicity?
Answer: Urine output 90 ml/4 hours. Urine outputs of less than 100
ml/4 hours (D), absent DTRs, and a respiratory rate of less than 12
breaths/minute are cardinal signs of magnesium sulfate toxicity.
CERTIFICATION EVALUATION COMPLETE
QUESTIONS WITH VERIFIED SOLUTIONS
◉ The nurse should explain to a 30-year-old gravid client that alpha
fetoprotein testing is recommended for which purpose?
Answer: Screen for neural tube defects.
◉ What action should the nurse implement to decrease the client's
risk for hemorrhage after a cesarean section?
Answer: Check the firmness of the uterus every 15 minutes.
◉ The nurse attempts to help an unmarried teenager deal with her
feelings following a spontaneous abortion at 8-weeks gestation.
What type of emotional response should the nurse anticipate?
Answer: Grief related to her perceptions about the loss of this child.
◉ The nurse is assessing a 3-day old infant with a cephalohematoma
in the newborn nursery. Which assessment finding should the nurse
report to the healthcare provider?
Answer: Yellowish tinge to the skin.
,◉ When assessing a client who is at 12-weeks gestation, the nurse
recommends that she and her husband consider attending childbirth
preparation classes. When is the best time for the couple to attend
these classes?
Answer: At 30-weeks gestation is closest to the time parents would
be ready for such classes. Learning is facilitated by an interested
pupil! The couple is most interested in childbirth toward the end of
the pregnancy when they are psychologically ready for the
termination of the pregnancy, and the birth of their child is an
immediate concern.
◉ A client at 32-weeks gestation is diagnosed with preeclampsia.
Which assessment finding is most indicative of an impending
convulsion?
Answer: Epigastric pain (C) is indicative of an edematous liver or
pancreas which is an early warning sign of an impending convulsion
(eclampsia) and requires immediate attention.
◉ 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?
Answer: Onset of uterine contractions.
◉ A client who is in the second trimester of pregnancy tells the
nurse that she wants to use herbal therapy. Which response is best
for the nurse to provide?
,Answer: It is important that you want to take part in your care.
◉ A couple, concerned because the woman has not been able to
conceive, is referred to a healthcare provider for a fertility workup
and a hysterosalpingography is scheduled. Which postprocedure
complaint indicates that the fallopian tubes are patent?
Answer: If the tubes are patent (open), pain is referred to the
shoulder (C) from a subdiaphragmatic collection of peritoneal
dye/gas.
◉ A client who delivered an infant an hour ago tells the nurse that
she feels wet underneath her buttock. The nurse notes that both
perineal pads are completely saturated and the client is lying in a 6-
inch diameter pool of blood. Which action should the nurse
implement next?
Answer: Palpate the firmness of the fundus.
◉ 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 × 1. What action should the nurse take immediately?
Answer: Methergine is contraindicated for clients with elevated
blood pressure, so the nurse should contact the healthcare provider
and question the prescription (D).
, ◉ A client at 32-weeks gestation comes to the prenatal clinic with
complaints of pedal edema, dyspnea, fatigue, and a moist cough.
Which question is most important for the nurse to ask this client?
Answer: Do you have a history of rheumatic fever? Clients with a
history of rheumatic fever (D) may develop mitral valve prolapse,
which increases the risk for cardiac decompensation due to the
increased blood volume that occurs during pregnancy, so obtaining
information about this client's health history is a priority.
◉ 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?
Answer: Pitocin causes the uterine myofibril to contract, so unless
the infusion is closely monitored, the client is at risk for
hyperstimulation (B) which can lead to tetanic contractions, uterine
rupture, and fetal distress or demise.
◉ A 35-year-old primigravida client with severe preeclampsia is
receiving magnesium sulfate via continuous IV infusion. Which
assessment data indicates to the nurse that the client is experiencing
magnesium sulfate toxicity?
Answer: Urine output 90 ml/4 hours. Urine outputs of less than 100
ml/4 hours (D), absent DTRs, and a respiratory rate of less than 12
breaths/minute are cardinal signs of magnesium sulfate toxicity.
