MATERNITY PRACTICE EXAM - 50
QUESTIONS., NURSING, EVOLVE
OBSTETRICS/MATERNITY,
OBSTETRICS/MATERNITY HESI PREP, HESI
REVIEW TEST-MATERNITY, HESI, OB HESI ,
HESI OB/PEDS 2 EXAM QUESTIONS WITH
COMPLETE ANSWERS
One hour following a normal vaginal delivery, a newborn infant boy's axillary
temperature is 96° F, his lower lip is shaking, and when the nurse assesses for a Moro
reflex, his hands shake. What intervention should the nurse implement first? - Answer-
Obtain a serum glucose level.
This infant is demonstrating signs of hypoglycemia, possibly secondary to a low body
temperature. The nurse should first determine the serum glucose level .
A client in active labor is becoming increasingly fearful because her contractions are
occurring more often than she expected. Her partner is also becoming anxious. The
nurse's response should focus on which content? - Answer-Asking the client and her
partner if they would like the nurse stay in the room.
Offering to remain with the client and her partner (C) offers support without providing
false reassurance. The length of labor is not always predictable, but (A and B) do not
offer the client the support that is needed at this time. (D) may be reassuring regarding
the fetal heart rate, but it does not provide the client the emotional support she needs at
this time during the labor process.
A breastfeeding postpartum client is diagnosed with mastitis and antibiotic therapy is
prescribed. What instruction should the nurse provide to this client? - Answer-
Breastfeed the infant, ensuring that both breasts are completely emptied.
Mastitis (caused by plugged milk ducts) is related to breast engorgement, and
breastfeeding during mastitis facilitates the complete emptying of engorged breasts ,
eliminating the pressure on the inflamed breast tissue.
Twenty minutes after a continuous epidural anesthetic is administered, a laboring
client's blood pressure drops from 120/80 to 90/60. What action should the nurse take
immediately? - Answer-Place the client in a lateral position. The nurse should
immediately turn the client to a lateral position or place a pillow or wedge under one hip
to deflect the uterus. Other immediate interventions include increasing the rate of the
main line IV infusion and administering oxygen by face mask at 10 to 12 L/min. If the
,blood pressure remains low after these interventions or decreases further, the
anesthesiologist/healthcare provider should be notified . immediately
In developing a teaching plan for expectant parents, the nurse decides to include
information about when the parents can expect the infant's fontanels to close. What
statement is accurate regarding the timing of closure of an infant's fontanels that should
be included in this teaching plan? - Answer-The anterior fontanel closes at 12 to 18
months and the posterior by the end of the second month.
In the normal infant, the anterior fontanel closes at 12 to 18 months of age and the
posterior fontanel by the end of the second month (D). These growth and development
milestones are frequently included in questions on the licensure exam.
A new mother who has just had her first baby says to the nurse, "I saw the baby in the
recovery room. She sure has a funny-looking head." Which response by the nurse is
best? - Answer-"That is normal. The head will return to a round shape within 7 to 10
days."
reassures the mother that this is normal in the newborn and provides correct information
regarding the return to a "normal" shape. NEVER say "Don't Worry".
A primipara presents to the perinatal unit describing rupture of the membranes (ROM),
which occurred 12 hours prior to coming to the hospital. A Pitocin infusion is begun, and
8 hours later the client's contractions are irregular and mild. What vital sign should the
nurse monitor with greater frequency than the typical unit protocol? - Answer-Maternal
temperature.Maternal temperature (A) should be monitored frequently as a primary
indicator of infection. This client's rupture of membranes (ROM) occurred at least 20
hours ago (12 hours before coming to the hospital in addition to 8 hours since hospital
admission). Delivery is not imminent and there is an increased risk of developing
infection 24 hours after ROM.
A 38-week primigravida who works as a secretary and sits at a computer 8 hours each
day tells the nurse that her feet have begun to swell. Which instruction will aid in the
prevention of pooling of blood in the lower extremities? - Answer-Move about (around)
every hour.
Pooling of blood in the lower extremities results from the enlarged uterus exerting
pressure on the pelvic veins. Moving about every hour will straighten out the pelvic
veins and increase venous return.
The nurse is counseling a client who wants to become pregnant. She tells the nurse that
she has a 36-day menstrual cycle and the first day of her last menstrual period was
January 8. When will the client's next fertile period occur? - Answer-January 29 to 30.
This client can expect her next period to begin 36 days from the first day of her last
menstrual period. Her next period would begin on February 12. Ovulation occurs 14
,days before the first day of the menstrual period. The client can expect ovulation to
occur January 29 to 30
A client comes to the OB clinic for her first prenatal visit, and complains of feeling
nauseated every morning. The client tells the nurse, "I'm having second thoughts about
wanting to have this baby." Which response is best for the nurse to make? -
Answer-"Tell me about these second thoughts you are having about this pregnancy."
While ambivalence is normal during the first trimester, (D) is the best nursing response
at this time. It is reflective and keeps the lines of communication open.
A client at 28 weeks of gestation calls the antepartal clinic and states that she just
experienced a small amount of vaginal bleeding, which she describes as bright red. The
bleeding has subsided. She further states that she is not experiencing any uterine
contractions or abdominal pain. What instruction should the nurse provide? -
Answer-"Come to the clinic today for an ultrasound." Third trimester painless bleeding is
characteristic of a placenta previa. Bright red bleeding may be intermittent, occur in
gushes, or be continuous. Rarely is the first incidence life threatening, nor cause for
hypovolemic shock. Diagnosis is confirmed by transabdominal ultrasound . Bleeding
that has a sudden onset and is accompanied by intense uterine pain indicates abruptio
placenta, which is life threatening to the mother and fetus.
The nurse calls a client who is 4 days postpartum to follow-up about her transition with
her newborn son at home. The woman tells the nurse, "I don't know what is wrong. I
love my son, but I feel so let down. I seem to cry for no reason!" Which adjustment
phase should the nurse determine the client is experiencing? - Answer-Postpartum
blues. During the postpartum period when serum hormone levels fall, women are
emotionally labile, often crying easily for no apparent reason. This phase is commonly
called postpartum blues , which peaks around the fifth postpartum day.
When assessing a client at 12 weeks of 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 of gestation. Learning is
facilitated by an interested pupil. The couple is most interested in childbirth toward the
end of the pregnancy when they are beginning to anticipate the onset of labor and the
birth of their child is an immediate 30 weeks is closest to the time parents would be
ready for such classes.
A nurse receives shift change report for a newborn who is 12 hours post vaginal
delivery. In developing a plan of care, the nurse should give the highest priority to which
finding? - Answer-Skin color that is slightly jaundiced. Jaundice, a yellow skin coloration,
is caused by elevated levels of bilirubin which should be further evaluated in a newborn
less than 24 hours old.
When reviewing the laboratory findings of a pregnant woman, the nurse determines that
the alpha-fetoprotein (AFP) level is elevated. What information is most important for the
, nurse to use when interpreting this finding? - Answer-Gestational age. Correct
interpretation of concentration of AFP requires precise knowledge of gestational age .
High levels after 15 weeks of gestation can indicate a neural tube defect, such as spina
bifida and anencephaly.
Just after delivery, a new mother tells the nurse, "I was unsuccessful breastfeeding my
first child, but I would like to try with this baby." Which intervention should the nurse
implement first? - Answer-Provide assistance to the mother to begin breastfeeding as
soon as possible after delivery. Infants respond to breastfeeding best when feeding is
initiated in the active phase soon after delivery .
A client who delivered a healthy infant 5 days ago calls the clinic nurse and reports that
her lochia is getting lighter in color and asks when the flow will stop. How should the
nurse respond? - Answer-When the placenta site has healed.
The placenta site in the uterus usually heals in 3 to 6 weeks, and the lochial flow should
cease at that time. Between 2 and 6 weeks after childbirth period, lochia alba occurs in
most women . The client is describing lochia serosa, a normal change in the lochial flow
between day 3 or 4 after childbirth and lasts to
about day 10.
The nurse is using the Silverman-Anderson index to assess an infant with respiratory
distress and determines that the infant is demonstrating marked nasal flaring, an
audible expiratory grunt, and just visible intercostal and xiphoid retractions. Which score
should the nurse assign using this scale? - Answer-5 (five) .
The Silverman-Anderson index is an assessment scale that scores a newborn's
respiratory status—grade 0, 1, or 2 for each component, which includes synchrony of
the chest and abdomen, retractions, nasal flaring, and expiratory grunt. No respiratory
distress is graded 0, a total of 10 indicates maximum respiratory distress. This infant is
demonstrating respiratory distress with maximal effort, so a grade 2 is assigned for
marked nasal flaring, grade 2 for an audible expiratory grunting, plus grade one for just
visible retractions, which is a total score of 5 .
A 25-year-old client has a positive pregnancy test. One year ago she had a
spontaneous abortion at 3 months of gestation. What is the correct description of this
client that should be documented in the medical record? - Answer-Gravida 2, para 0.
This is the client's second pregnancy or second "gravid" event, The spontaneous
abortion (miscarriage) occurred at 3 months of gestation (12 weeks), so she is a para 0.
Parity cannot be increased unless delivery occurs at 20 weeks of gestation or beyond.
On admission to the prenatal clinic, a client tells the nurse that her last menstrual period
began on February 15 and that previously her periods were regular (28-day cycle). Her
pregnancy test is positive. What is this client's expected date of birth (EDB)? - Answer-
November 22.
QUESTIONS., NURSING, EVOLVE
OBSTETRICS/MATERNITY,
OBSTETRICS/MATERNITY HESI PREP, HESI
REVIEW TEST-MATERNITY, HESI, OB HESI ,
HESI OB/PEDS 2 EXAM QUESTIONS WITH
COMPLETE ANSWERS
One hour following a normal vaginal delivery, a newborn infant boy's axillary
temperature is 96° F, his lower lip is shaking, and when the nurse assesses for a Moro
reflex, his hands shake. What intervention should the nurse implement first? - Answer-
Obtain a serum glucose level.
This infant is demonstrating signs of hypoglycemia, possibly secondary to a low body
temperature. The nurse should first determine the serum glucose level .
A client in active labor is becoming increasingly fearful because her contractions are
occurring more often than she expected. Her partner is also becoming anxious. The
nurse's response should focus on which content? - Answer-Asking the client and her
partner if they would like the nurse stay in the room.
Offering to remain with the client and her partner (C) offers support without providing
false reassurance. The length of labor is not always predictable, but (A and B) do not
offer the client the support that is needed at this time. (D) may be reassuring regarding
the fetal heart rate, but it does not provide the client the emotional support she needs at
this time during the labor process.
A breastfeeding postpartum client is diagnosed with mastitis and antibiotic therapy is
prescribed. What instruction should the nurse provide to this client? - Answer-
Breastfeed the infant, ensuring that both breasts are completely emptied.
Mastitis (caused by plugged milk ducts) is related to breast engorgement, and
breastfeeding during mastitis facilitates the complete emptying of engorged breasts ,
eliminating the pressure on the inflamed breast tissue.
Twenty minutes after a continuous epidural anesthetic is administered, a laboring
client's blood pressure drops from 120/80 to 90/60. What action should the nurse take
immediately? - Answer-Place the client in a lateral position. The nurse should
immediately turn the client to a lateral position or place a pillow or wedge under one hip
to deflect the uterus. Other immediate interventions include increasing the rate of the
main line IV infusion and administering oxygen by face mask at 10 to 12 L/min. If the
,blood pressure remains low after these interventions or decreases further, the
anesthesiologist/healthcare provider should be notified . immediately
In developing a teaching plan for expectant parents, the nurse decides to include
information about when the parents can expect the infant's fontanels to close. What
statement is accurate regarding the timing of closure of an infant's fontanels that should
be included in this teaching plan? - Answer-The anterior fontanel closes at 12 to 18
months and the posterior by the end of the second month.
In the normal infant, the anterior fontanel closes at 12 to 18 months of age and the
posterior fontanel by the end of the second month (D). These growth and development
milestones are frequently included in questions on the licensure exam.
A new mother who has just had her first baby says to the nurse, "I saw the baby in the
recovery room. She sure has a funny-looking head." Which response by the nurse is
best? - Answer-"That is normal. The head will return to a round shape within 7 to 10
days."
reassures the mother that this is normal in the newborn and provides correct information
regarding the return to a "normal" shape. NEVER say "Don't Worry".
A primipara presents to the perinatal unit describing rupture of the membranes (ROM),
which occurred 12 hours prior to coming to the hospital. A Pitocin infusion is begun, and
8 hours later the client's contractions are irregular and mild. What vital sign should the
nurse monitor with greater frequency than the typical unit protocol? - Answer-Maternal
temperature.Maternal temperature (A) should be monitored frequently as a primary
indicator of infection. This client's rupture of membranes (ROM) occurred at least 20
hours ago (12 hours before coming to the hospital in addition to 8 hours since hospital
admission). Delivery is not imminent and there is an increased risk of developing
infection 24 hours after ROM.
A 38-week primigravida who works as a secretary and sits at a computer 8 hours each
day tells the nurse that her feet have begun to swell. Which instruction will aid in the
prevention of pooling of blood in the lower extremities? - Answer-Move about (around)
every hour.
Pooling of blood in the lower extremities results from the enlarged uterus exerting
pressure on the pelvic veins. Moving about every hour will straighten out the pelvic
veins and increase venous return.
The nurse is counseling a client who wants to become pregnant. She tells the nurse that
she has a 36-day menstrual cycle and the first day of her last menstrual period was
January 8. When will the client's next fertile period occur? - Answer-January 29 to 30.
This client can expect her next period to begin 36 days from the first day of her last
menstrual period. Her next period would begin on February 12. Ovulation occurs 14
,days before the first day of the menstrual period. The client can expect ovulation to
occur January 29 to 30
A client comes to the OB clinic for her first prenatal visit, and complains of feeling
nauseated every morning. The client tells the nurse, "I'm having second thoughts about
wanting to have this baby." Which response is best for the nurse to make? -
Answer-"Tell me about these second thoughts you are having about this pregnancy."
While ambivalence is normal during the first trimester, (D) is the best nursing response
at this time. It is reflective and keeps the lines of communication open.
A client at 28 weeks of gestation calls the antepartal clinic and states that she just
experienced a small amount of vaginal bleeding, which she describes as bright red. The
bleeding has subsided. She further states that she is not experiencing any uterine
contractions or abdominal pain. What instruction should the nurse provide? -
Answer-"Come to the clinic today for an ultrasound." Third trimester painless bleeding is
characteristic of a placenta previa. Bright red bleeding may be intermittent, occur in
gushes, or be continuous. Rarely is the first incidence life threatening, nor cause for
hypovolemic shock. Diagnosis is confirmed by transabdominal ultrasound . Bleeding
that has a sudden onset and is accompanied by intense uterine pain indicates abruptio
placenta, which is life threatening to the mother and fetus.
The nurse calls a client who is 4 days postpartum to follow-up about her transition with
her newborn son at home. The woman tells the nurse, "I don't know what is wrong. I
love my son, but I feel so let down. I seem to cry for no reason!" Which adjustment
phase should the nurse determine the client is experiencing? - Answer-Postpartum
blues. During the postpartum period when serum hormone levels fall, women are
emotionally labile, often crying easily for no apparent reason. This phase is commonly
called postpartum blues , which peaks around the fifth postpartum day.
When assessing a client at 12 weeks of 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 of gestation. Learning is
facilitated by an interested pupil. The couple is most interested in childbirth toward the
end of the pregnancy when they are beginning to anticipate the onset of labor and the
birth of their child is an immediate 30 weeks is closest to the time parents would be
ready for such classes.
A nurse receives shift change report for a newborn who is 12 hours post vaginal
delivery. In developing a plan of care, the nurse should give the highest priority to which
finding? - Answer-Skin color that is slightly jaundiced. Jaundice, a yellow skin coloration,
is caused by elevated levels of bilirubin which should be further evaluated in a newborn
less than 24 hours old.
When reviewing the laboratory findings of a pregnant woman, the nurse determines that
the alpha-fetoprotein (AFP) level is elevated. What information is most important for the
, nurse to use when interpreting this finding? - Answer-Gestational age. Correct
interpretation of concentration of AFP requires precise knowledge of gestational age .
High levels after 15 weeks of gestation can indicate a neural tube defect, such as spina
bifida and anencephaly.
Just after delivery, a new mother tells the nurse, "I was unsuccessful breastfeeding my
first child, but I would like to try with this baby." Which intervention should the nurse
implement first? - Answer-Provide assistance to the mother to begin breastfeeding as
soon as possible after delivery. Infants respond to breastfeeding best when feeding is
initiated in the active phase soon after delivery .
A client who delivered a healthy infant 5 days ago calls the clinic nurse and reports that
her lochia is getting lighter in color and asks when the flow will stop. How should the
nurse respond? - Answer-When the placenta site has healed.
The placenta site in the uterus usually heals in 3 to 6 weeks, and the lochial flow should
cease at that time. Between 2 and 6 weeks after childbirth period, lochia alba occurs in
most women . The client is describing lochia serosa, a normal change in the lochial flow
between day 3 or 4 after childbirth and lasts to
about day 10.
The nurse is using the Silverman-Anderson index to assess an infant with respiratory
distress and determines that the infant is demonstrating marked nasal flaring, an
audible expiratory grunt, and just visible intercostal and xiphoid retractions. Which score
should the nurse assign using this scale? - Answer-5 (five) .
The Silverman-Anderson index is an assessment scale that scores a newborn's
respiratory status—grade 0, 1, or 2 for each component, which includes synchrony of
the chest and abdomen, retractions, nasal flaring, and expiratory grunt. No respiratory
distress is graded 0, a total of 10 indicates maximum respiratory distress. This infant is
demonstrating respiratory distress with maximal effort, so a grade 2 is assigned for
marked nasal flaring, grade 2 for an audible expiratory grunting, plus grade one for just
visible retractions, which is a total score of 5 .
A 25-year-old client has a positive pregnancy test. One year ago she had a
spontaneous abortion at 3 months of gestation. What is the correct description of this
client that should be documented in the medical record? - Answer-Gravida 2, para 0.
This is the client's second pregnancy or second "gravid" event, The spontaneous
abortion (miscarriage) occurred at 3 months of gestation (12 weeks), so she is a para 0.
Parity cannot be increased unless delivery occurs at 20 weeks of gestation or beyond.
On admission to the prenatal clinic, a client tells the nurse that her last menstrual period
began on February 15 and that previously her periods were regular (28-day cycle). Her
pregnancy test is positive. What is this client's expected date of birth (EDB)? - Answer-
November 22.
