Hesi Maternity Practice Questions

Hesi Maternity Practice Questions Review for Maternity Hesi 1. The nurse is planning care for a client at 30-weeks gestation who is experiencing preterm labor. · Terbutaline (Brethine) 0.25 mg subcutaneously q15 minutes x 3 · Ampicillin 1 gram IV push q8h. · Betamethasone (Celestone) 12 mg deep IM · Butorphanol (Stadol) 1 mg IV push q2h PRN pain Note: page 495 and 496 Maternity book, en la opcion # 1 en el libro dice que se aplica cada 20 o 30 minutos, o sea que aqui no esta exacta aunque para mi es una Buena opcion porque es un tocolytic que se usa para disminuir las contracciones en los partos prematuros; aunque en el libro tambien hablan de comenzar el tratamiento para la maduracion pulmonar DEL FETO rapido y la opcion c si esta exacta como en el libro aunque en esta pregunta no hablan del feto, pero hay otra que si menciona para la maduracion del sistema respiratorio del feto entonces si seria la opcion c sin discusion…lo dejo a su eleccion. 2. A pregnant woman in the first trimester of pregnancy has hemoglobin of 8.6 mg/dl and a hematocrit of 25.1 %. What food should the nurse encourage this client to include in her diet? · Carrots · Chicken · Yogurt · Cheese Note: Page 274 Maternity book habla de la necesidad de acido folico en el primer trimester y la carne animal es el primer source, despues los productos lacteos, en la seccion de anemias solo especifica lo que ya sabemos que cuando no es patologica las mas frecuentes son por hierro o acido folico deficiency. 3. The nurse is preparing to administer methylergonovine maleate (Methergine) to a postpartum client. Based on what assessment finding should the nurse withhold the drug? · Respiratory rate of 22 breaths/min · A large amount of lochia rubra · Blood pressure 149/90 · Positive Homan’s sign Note: The only contraindication that has this medicine is HBP, page 581 Matern…book. 4. The nurse is planning care for a 16-year-old, who has juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscle. Which physical therapy regimen should the nurse encourage the adolescent to implement? · Begin a training program lifting weights and running · Splint affected joints during activity · Exercise in a swimming pool · Perform passive range of motion exercises twice daily Note: page 1710 MB (Maternity book) 5. A client receiving oxytocin (Pitocin) to augment early labor. Which assessment is most important for the nurse to obtain each time the infusion rate is increased? · Pain level · Blood pressure · Infusion site · Contraction pattern Note: Page 508 MB 6. One day after vaginal delivery of a full term baby, a postpartum client’s white blood cell count is 15.000/mm. What action should the nurse take first? · Check the differential, since the WBC is normal for this client · Assess the client’s temperature, pulse, and respirations q4h · Assess the client’s perineal area for signs of a perineal hematoma · Notify the healthcare provider, since this finding is indicative of infection Note: During the first 10 to 12 days after partum is between 20,000-25, 000 Page 530 7. A neonate who has congenital adrenal hypoplasia (CAH) presents with ambiguous genitalia. What is the primary nursing consideration when supporting the parents of a child with this anomaly? · Discuss the need for cortisol and aldosterone replacement therapy after discharge · Support the parents in their decision to assign sex of their child according to their preference · Offer information about ultrasonography and genotyping to determine sex assignment · Explain that corrective surgical procedures consistent with sex assignment can be delayed Note: page 776 MB 8. The nurse assessing a 9-year old boy who has been admitted to the hospital with possible acute postsreptococcal glomerulonephritis (APSGN). In obtaining his history, what information is most significant? · Back pain for a few days · A history of hypertension · A sore throats last week · Diuresis during the nights Note: Page 1538 MB 9. A loading dose of terbutaline (Brethine) 250 mcg IV is prescribed for a client in preterm labor. Brethine 20 mg is added to 1,000 ml D W. How many ml of the solution should the nurse administer? 13 10. A 36-week primigravida is admitted to labor and delivery with severe abdominal pain and bright red vaginal bleeding. Her abdomen is rigid and tender to touch. The fetal heart rate FHR) is 90 beats/minute, and the maternal heart rate is 120 beats/minute. What action should the nurse implement first? · Alert the neonatal team and prepare for neonatal resuscitation · Notify the healthcare provider from the client’s bedside · Obtain written consent for an emergency cesarean section · Draw a blood sample for stat hemoglobin and hematocrit Note: S&S of Abruption Placentae …page 366 collaborative cares MB 11. A laboring client’s membranes rupture spontaneously. The nurse notices that the amniotic fluid is greenish-brown. What intervention should the nurse implement first? · Turn the client to her left side · Contact the healthcare provider · Assess the fetal heart rate · Check the cervical dilation Note: page 202 meconium and intrapartal period MB 12. A 5-year-old child is admitted to the pediatric unit with fever and pain secondary to a sickle cell crisis. Which intervention should the nurse implement first? A. Obtain a culture of any sputum or wound drainage. · Obtain a culture of any sputum or wound drainage · Initiate normal saline IV at 50 ml/hr · Administer a loading dose of penicillin IM · Administer the initial dose of folic acid PO Note: Therapeutic management page 1497 MB. 13. A child has been vomiting for 3 days is admitted for correction of fluid and electrolyte imbalances. What acid base imbalance is this child likely to exhibit? · Respiratory alkalosis · Respiratory acidosis · Metabolic alkalosis · Metabolic acidosis Note: In the book under Vomiting topic I did not find any but I know that when the people has frequent vomits it’s at risk for developing metabolic alkalosis related to the loss of hydrochloric acid. 14. A child admitted with diabetic ketoacidosis is demonstrating Kussmaul respiration. The nurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration? · Respiratory alkalosis · Respiratory acidosis · Metabolic acidosis · Metabolic alkalosis Note: page 1617 MB under ketoacidosis. 15. The nurse is caring for a 5-year-old child with Reye’s syndrome. Which goal of treatment most clearly relates to caring for this child? · Reduce cerebral edema and lower intracranial pressure · Avert hypotension and septic shock · Prevent cardiac arrhythmias and heart failure · Promote kidney perfusion and normal blood pressure. Note: Page 1581 MB under therapeutic and nursing care management. 16. A client whose labor is being augmented with an oxytocin(Pitocin) infusion requests an epidural for pain control. Findings of the last vaginal exam, performed 1 hour ago, were 3 cm cervical dilation, 60% effacement, and a 2-station. What action should the nurse implement first? · Decrease the oxytocin infusion rate · Determine current cervical dilation · Request placement of the epidural · Give a bolus of intravenous fluids Note: page 413 MB 17. A child who received multiple blood transfusions after correction of a congenital heart defects is demonstrating muscular irritability and is oozing blood from the surgical incision. Which serum value is most important for the nurse before reporting to the healthcare provider? · CO combining power · Calcium · Sodium · Chloride Note: Transfusions are in the page , del unico electrolyte imbalance que habla es del K porque lo mas frecuente en las tranfusiones Es hyperkalemia, pero en esta pregunta los s&s no concuerdan con la hyperkalemia y ademas tampoco es una de las opciones de respuesta, por otra parte nos dan el key word de que son varias tranfusiones en donde existe el riesgo que producto del anticoagulante citrate que contienen las tranfusiones y que se encarga de binde o combinarse con el Ca free, entonces este, el calcio este disminuido en sangre y produce estos sintomas. 18. A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chronic (sudden aimless movements of the arms and legs). Which information should the nurse to the parents? · Muscle tension is decreased with fine motor skill projects, so these activities should be encouraged · The chorea or movements are temporary and will eventually disappear · Permanent life-style changes need to be made to promote safety in the home · Consistent discipline is needed to help the child control the movements Note: page 1474 ....................................................