RN HESI MATERNITY FINAL EXAM WITH
REAL QUESTIONS AND WELL VERIFIED
ANSWERS | ALREADY GRADED A+|
GUARANTEED PASS | LATEST UPDATE!!!
A postpartal client complains that she has the urge to urinate every hour but is
only able to void a small amount. What interventions provides the nurse with
the most useful information? A. Initiate a perineal pad count
B. Catheterize for residual urine after next voiding
C. Assess for perineal hematoma
D. Determine the clients usual voiding pattern - ANSWER-B. Catheterize for
residual urine after next voiding
A new mother asks the nurse about an area of swelling on her baby's head near
the posterior fontanel that lies across the suture line. How should the nurse
respond?
A. "This is called caput succedaneum. It will absorb and cause no problems."
B. "This is called caput succedaneum. It will have to be drained."
C. "This is called a cephalhematoma. It will cause no problems."
D. "This is called cephalhematome. It can cause jaundice as it is absorbed." -
ANSWER-A. "This is called caput succedaneum. It will absorb and cause no
problems."
The parents of a male newborn have signed an informed consent for
circumcision. What priority intervention should the nurse implement upon
completion of the circumcision?
A. Offer a pacifier dipped in glucose water.
,B. Give PRN dose of liquid acetaminophen.
C. Place petrolatum gauze dressing on the site.
D. Wrap the infant in warm receiving blankets. - ANSWER-C. Place petrolatum
gauze dressing on the site.
The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14
ounces, has a head circumference of 13 inches, and a chest circumference of 10
inches. Based on these physical findings, assessment for which condition has
the highest priority? A. Hyperthermia
B. Hyperbilirubinemia
C. Polycythemia
D. Hypoglycemia - ANSWER-D. Hypoglycemia
A primipara at 20-weeks gestation is scheduled for an ultrasound. In preparing
the client for the procedure, the nurse should explain that the primary reason for
conducting this diagnostic study is to obtain which information? A. Sex and size
of the infant.
B. Fetal growth and gestational age.
C. Chromosomal abnormalities.
D. Lecithin-sphingomyelin ration. - ANSWER-B. Fetal growth and gestational
age.
A 38-week primigravida is admitted to labor and delivery after a non-reactive
stress test (NST). The nurse begins a contraction stress test (CST) with an
oxytocin (Pitocin) infusion. Which finding is most important for the nurse to
report to the healthcare provider?
A. Spontaneous rupture of membranes.
B. Fetal heart rate accelerations with fetal movement.
C. Absences of uterine contraction of 20 minutes.
D. A pattern of fetal late decelerations. - ANSWER-D. A pattern of fetal late
decelerations.
,A full term infant is admitted to the newborn nursery 2 hours after delivery. The
delivery record reports that the mother is positive for HIV and received AZT
intravenously during labor. What action should the nurse implement first?
A. Ensure that AZT is given within 6 hours after birth
B. Collect venous specimen for serum glucose level
C. Asses for the presence of the Moro reflex
Obtain consent for the Hep B vaccine - ANSWER-A. Ensure that AZT is given
within 6 hours after birth
Following a precipitous labour, a postpartum client has a continuous trickling of
bright red blood from her vagina. Her uterus is firm and her vital signs are
within normal limits. The nurse determines that this sign may indicate which
condition?
A. Early postpartum haemorrhage.
B. Laceration on the cervix
C. Expected course in the fourth stage of labour.
D. A full urinary bladder. - ANSWER-B. Laceration on the cervix
When planning care for a labouring client, the nurse identifies the need to
withhold solid foods while the client is in labour. What is the most important
reason for this nursing intervention?
A. Gastric emptying time decreases during labour
B. Nausea occurs from analgesic used during labour
C. An increased risk for aspiration can occur if general analgesic is needed
D. Autonomic nervous system stimulation during labour decreases peristalsis -
ANSWER-C. An increased risk for aspiration can occur if general analgesic
is needed
A new mother who is breastfeeding her 4 week old infant has type 1 diabetes ,
reports that her insulin needs have decreased after the birth of her child. What
action should the nurse implement?
A. Schedule an appointment with diabetic nurse educator
, B. Advise the client to breastfeed more frequently
C. Counsel her to increase calorie intake
D. Inform her that a decreased need for insulin occurs while breastfeeding -
ANSWER-D. Inform her that a decreased need for insulin occurs while
breastfeeding
A multiparous women at 38 weeks gestation with a history of rapid progression
of labour is admitted for induction due to signs and symptoms of pregnancy
induced hypertension (PIH). One hour after the oxytocin infusion is initiated she
complains of a headache. Her contractions are occurring every 1-2 mins , lasting
60-75 seconds and a vaginal exam reveals that her cervix is 90% and dilated 6
cm. What intervention is most important for the nurse to implement?
A. Prepare for immediate delivery
B. Measure deep tendon reflexes
C. Discontinue the Pitocin infusion
D. Turn the client to her left side - ANSWER-C. Discontinue the Pitocin
infusion
An infant born to a heroin addict mother is admitted to the neonatal care unit. .
What behaviours can the baby exhibit?
A. Lethargy and a poor suck
B. Facial abnormalities and microcephaly
C. Irritability and high pitched cry
D. Low birth weight and intrauterine growth retardation - ANSWER-C.
Irritability and high pitched cry
A multigravida full term , labouring client complains of back labour. Vaginal
examine reveals that the client is 3cm with 50% effacement, and the fetal head
is at -1 station. What action should the nurse implement first?
A. Apply counter - pressure to the sacral area
B. Turn the client lateral position
REAL QUESTIONS AND WELL VERIFIED
ANSWERS | ALREADY GRADED A+|
GUARANTEED PASS | LATEST UPDATE!!!
A postpartal client complains that she has the urge to urinate every hour but is
only able to void a small amount. What interventions provides the nurse with
the most useful information? A. Initiate a perineal pad count
B. Catheterize for residual urine after next voiding
C. Assess for perineal hematoma
D. Determine the clients usual voiding pattern - ANSWER-B. Catheterize for
residual urine after next voiding
A new mother asks the nurse about an area of swelling on her baby's head near
the posterior fontanel that lies across the suture line. How should the nurse
respond?
A. "This is called caput succedaneum. It will absorb and cause no problems."
B. "This is called caput succedaneum. It will have to be drained."
C. "This is called a cephalhematoma. It will cause no problems."
D. "This is called cephalhematome. It can cause jaundice as it is absorbed." -
ANSWER-A. "This is called caput succedaneum. It will absorb and cause no
problems."
The parents of a male newborn have signed an informed consent for
circumcision. What priority intervention should the nurse implement upon
completion of the circumcision?
A. Offer a pacifier dipped in glucose water.
,B. Give PRN dose of liquid acetaminophen.
C. Place petrolatum gauze dressing on the site.
D. Wrap the infant in warm receiving blankets. - ANSWER-C. Place petrolatum
gauze dressing on the site.
The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14
ounces, has a head circumference of 13 inches, and a chest circumference of 10
inches. Based on these physical findings, assessment for which condition has
the highest priority? A. Hyperthermia
B. Hyperbilirubinemia
C. Polycythemia
D. Hypoglycemia - ANSWER-D. Hypoglycemia
A primipara at 20-weeks gestation is scheduled for an ultrasound. In preparing
the client for the procedure, the nurse should explain that the primary reason for
conducting this diagnostic study is to obtain which information? A. Sex and size
of the infant.
B. Fetal growth and gestational age.
C. Chromosomal abnormalities.
D. Lecithin-sphingomyelin ration. - ANSWER-B. Fetal growth and gestational
age.
A 38-week primigravida is admitted to labor and delivery after a non-reactive
stress test (NST). The nurse begins a contraction stress test (CST) with an
oxytocin (Pitocin) infusion. Which finding is most important for the nurse to
report to the healthcare provider?
A. Spontaneous rupture of membranes.
B. Fetal heart rate accelerations with fetal movement.
C. Absences of uterine contraction of 20 minutes.
D. A pattern of fetal late decelerations. - ANSWER-D. A pattern of fetal late
decelerations.
,A full term infant is admitted to the newborn nursery 2 hours after delivery. The
delivery record reports that the mother is positive for HIV and received AZT
intravenously during labor. What action should the nurse implement first?
A. Ensure that AZT is given within 6 hours after birth
B. Collect venous specimen for serum glucose level
C. Asses for the presence of the Moro reflex
Obtain consent for the Hep B vaccine - ANSWER-A. Ensure that AZT is given
within 6 hours after birth
Following a precipitous labour, a postpartum client has a continuous trickling of
bright red blood from her vagina. Her uterus is firm and her vital signs are
within normal limits. The nurse determines that this sign may indicate which
condition?
A. Early postpartum haemorrhage.
B. Laceration on the cervix
C. Expected course in the fourth stage of labour.
D. A full urinary bladder. - ANSWER-B. Laceration on the cervix
When planning care for a labouring client, the nurse identifies the need to
withhold solid foods while the client is in labour. What is the most important
reason for this nursing intervention?
A. Gastric emptying time decreases during labour
B. Nausea occurs from analgesic used during labour
C. An increased risk for aspiration can occur if general analgesic is needed
D. Autonomic nervous system stimulation during labour decreases peristalsis -
ANSWER-C. An increased risk for aspiration can occur if general analgesic
is needed
A new mother who is breastfeeding her 4 week old infant has type 1 diabetes ,
reports that her insulin needs have decreased after the birth of her child. What
action should the nurse implement?
A. Schedule an appointment with diabetic nurse educator
, B. Advise the client to breastfeed more frequently
C. Counsel her to increase calorie intake
D. Inform her that a decreased need for insulin occurs while breastfeeding -
ANSWER-D. Inform her that a decreased need for insulin occurs while
breastfeeding
A multiparous women at 38 weeks gestation with a history of rapid progression
of labour is admitted for induction due to signs and symptoms of pregnancy
induced hypertension (PIH). One hour after the oxytocin infusion is initiated she
complains of a headache. Her contractions are occurring every 1-2 mins , lasting
60-75 seconds and a vaginal exam reveals that her cervix is 90% and dilated 6
cm. What intervention is most important for the nurse to implement?
A. Prepare for immediate delivery
B. Measure deep tendon reflexes
C. Discontinue the Pitocin infusion
D. Turn the client to her left side - ANSWER-C. Discontinue the Pitocin
infusion
An infant born to a heroin addict mother is admitted to the neonatal care unit. .
What behaviours can the baby exhibit?
A. Lethargy and a poor suck
B. Facial abnormalities and microcephaly
C. Irritability and high pitched cry
D. Low birth weight and intrauterine growth retardation - ANSWER-C.
Irritability and high pitched cry
A multigravida full term , labouring client complains of back labour. Vaginal
examine reveals that the client is 3cm with 50% effacement, and the fetal head
is at -1 station. What action should the nurse implement first?
A. Apply counter - pressure to the sacral area
B. Turn the client lateral position
