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
The nurse is counselling 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.
correctly applies Nägele's rule for estimating the due date by counting back 3 months
from the first day of the last menstrual period (January, December, November) and
adding 7 days (15 + 7 = 22).
A 41-week multigravida is receiving oxytocin (Pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal heart
rate increases with each contraction and returns to the baseline after the contraction.
What action should the nurse implement? - Answer-Increase the rate of the Pitocin
infusion. The goal of labor augmentation is to produce firm contractions that occur every
2 to 3 minutes, with a duration of 60 to 70 seconds, and without evidence of fetal stress.
Fetal heart rate accelerations are a normal response to contractions, so the Pitocin
infusion should be increased per protocol to stimulate the frequency and intensity of
contractions.
A newborn infant, diagnosed with congenital hip dysplasia, is being prepared for
discharge. Which nursing intervention should be included in this infant's discharge
teaching plan? - Answer-Observe the parents apply a Pavlik harness. It is important that
the hips of infants with hip dysplasia are maintained in an abducted position, which can
be accomplished by using the Pavlik harness , which keeps the hips and knees flexed,
the hips abducted, and the femoral head in the acetabulum. Early treatment often
negates the need for surgery.
During a prenatal visit, the nurse discusses with a client the effects that smoking has on
the fetus. Which statement is most characteristic of an infant whose mother smoked
during pregnancy compared to the infant of a nonsmoking mother? - Answer-Lower
, initial weight documented at birth. Smoking is associated with low-birth-weight infants .
Therefore, mothers are encouraged not to smoke during pregnancy.
The nurse is teaching care of the newborn to a childbirth preparation class and
describes the need for administering antibiotic ointment into the eyes of the newborn.
An expectant father asks, "What type of disease causes infections in babies that can be
prevented by using this ointment?" Which response by the nurse is accurate? - Answer-
Gonorrhea. Erythromycin ointment is instilled into the lower conjunctiva of each eye
within 2 hours after birth to prevent ophthalmica neonatorum, an infection caused by
gonorrhea (C), and inclusion conjunctivitis, an infection caused by chlamydia. The infant
may be exposed to these bacteria when passing through the birth canal.
An expectant father tells the nurse he fears that his wife "is losing her mind." He states
she is constantly rubbing her abdomen and talking to the baby, and that she actually
reprimands the baby when it moves too much. What recommendation should the nurse
make to this expectant father? - Answer-Reassure him that normal maternal/fetal
bonding is occurring.These behaviors are positive signs of maternal/fetal bonding and
do not reflect ambivalence .
A client who is 3 days postpartum and breastfeeding asks the nurse how to reduce
breast engorgement. Which instruction should the nurse provide? - Answer-Breastfeed
the infant every 2 hours. The mother should be instructed to attempt feeding her infant
every 2 hours while massaging the breasts as the infant is feeding. If the infant does not
feed adequately and empty the breast, using a breast pump helps to extract the milk
and relieve some of the discomfort.
Which maternal behavior is the nurse most likely to see when a new mother receives
her infant for the first time? - Answer-Her arms and hands receive the infant and she
then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors
described in during the first visit with the newborn, which may be at delivery or later.
After the first visit, the mother may exhibit different touching behaviors such as eagerly
reaching for the infant and cuddling the infant close to her
A mother who is HIV-positive delivers a full-term newborn and asks the nurse if her
baby will become HIV infected. Which explanation should the nurse provide? - Answer-
HIV infection is determined at 18 months of age when maternal HIV antibodies are no
longer present.
All newborns of HIV-positive mothers receive passive HIV antibodies from the mother,
so the evaluation of an infant for the HIV virus is determined at 18 months of age when
all the maternal antibodies are no longer in the infant's blood. Passive HIV antibodies
disappear in the infant within 18 months of age .
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
The nurse is counselling 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.
correctly applies Nägele's rule for estimating the due date by counting back 3 months
from the first day of the last menstrual period (January, December, November) and
adding 7 days (15 + 7 = 22).
A 41-week multigravida is receiving oxytocin (Pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal heart
rate increases with each contraction and returns to the baseline after the contraction.
What action should the nurse implement? - Answer-Increase the rate of the Pitocin
infusion. The goal of labor augmentation is to produce firm contractions that occur every
2 to 3 minutes, with a duration of 60 to 70 seconds, and without evidence of fetal stress.
Fetal heart rate accelerations are a normal response to contractions, so the Pitocin
infusion should be increased per protocol to stimulate the frequency and intensity of
contractions.
A newborn infant, diagnosed with congenital hip dysplasia, is being prepared for
discharge. Which nursing intervention should be included in this infant's discharge
teaching plan? - Answer-Observe the parents apply a Pavlik harness. It is important that
the hips of infants with hip dysplasia are maintained in an abducted position, which can
be accomplished by using the Pavlik harness , which keeps the hips and knees flexed,
the hips abducted, and the femoral head in the acetabulum. Early treatment often
negates the need for surgery.
During a prenatal visit, the nurse discusses with a client the effects that smoking has on
the fetus. Which statement is most characteristic of an infant whose mother smoked
during pregnancy compared to the infant of a nonsmoking mother? - Answer-Lower
, initial weight documented at birth. Smoking is associated with low-birth-weight infants .
Therefore, mothers are encouraged not to smoke during pregnancy.
The nurse is teaching care of the newborn to a childbirth preparation class and
describes the need for administering antibiotic ointment into the eyes of the newborn.
An expectant father asks, "What type of disease causes infections in babies that can be
prevented by using this ointment?" Which response by the nurse is accurate? - Answer-
Gonorrhea. Erythromycin ointment is instilled into the lower conjunctiva of each eye
within 2 hours after birth to prevent ophthalmica neonatorum, an infection caused by
gonorrhea (C), and inclusion conjunctivitis, an infection caused by chlamydia. The infant
may be exposed to these bacteria when passing through the birth canal.
An expectant father tells the nurse he fears that his wife "is losing her mind." He states
she is constantly rubbing her abdomen and talking to the baby, and that she actually
reprimands the baby when it moves too much. What recommendation should the nurse
make to this expectant father? - Answer-Reassure him that normal maternal/fetal
bonding is occurring.These behaviors are positive signs of maternal/fetal bonding and
do not reflect ambivalence .
A client who is 3 days postpartum and breastfeeding asks the nurse how to reduce
breast engorgement. Which instruction should the nurse provide? - Answer-Breastfeed
the infant every 2 hours. The mother should be instructed to attempt feeding her infant
every 2 hours while massaging the breasts as the infant is feeding. If the infant does not
feed adequately and empty the breast, using a breast pump helps to extract the milk
and relieve some of the discomfort.
Which maternal behavior is the nurse most likely to see when a new mother receives
her infant for the first time? - Answer-Her arms and hands receive the infant and she
then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors
described in during the first visit with the newborn, which may be at delivery or later.
After the first visit, the mother may exhibit different touching behaviors such as eagerly
reaching for the infant and cuddling the infant close to her
A mother who is HIV-positive delivers a full-term newborn and asks the nurse if her
baby will become HIV infected. Which explanation should the nurse provide? - Answer-
HIV infection is determined at 18 months of age when maternal HIV antibodies are no
longer present.
All newborns of HIV-positive mothers receive passive HIV antibodies from the mother,
so the evaluation of an infant for the HIV virus is determined at 18 months of age when
all the maternal antibodies are no longer in the infant's blood. Passive HIV antibodies
disappear in the infant within 18 months of age .
