Hesi Maternity practice test 2022|2023 Questions and Answers

Hesi Maternity practice test 2022|2023 Questions and Answers A full term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms are this newborn likely to exhibit? A. Choking, coughing, and cyanosis. B. Projectile vomiting and cyanosis. C. Apneic spells and grunting. D. Scaphoid abdomen and anorexia. A. Choking, coughing, and cyanosis. Rationale The "3 Cs" of esophageal atresia are coughing, chocking and cyanosis. They are caused by the overflow of secretions into the trachea. Which action should the nurse implement when preparing to measure the fundal height of a pregnant client? A. Have the client empty her bladder. B. Request the client lie on her left side. C. Perform Leopold's maneuvers first. D. Give the client some cold juice to drink. A. Have the client empty her bladder. Rationale To avoid an elevation of the uterus, the client must empty the bladder prior to obtaining an accurate fundal height measurement. A 30-year-old multiparous woman who has a 3-year-old boy and a newborn girl tells the nurse, "My son is so jealous of my daughter, I don’t know how I’ll ever manage both children when I get home." How should the nurse respond? A. "Tell the older child that he is a big boy now and should love his new sister." B. "Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him." C. "Let the older child stay with his grandparents for the first six weeks to allow him to adjust to the newborn." D. "Regression in behaviors in the older child is a typical reaction so he needs attention at this time." D. "Regression in behaviors in the older child is a typical reaction so he needs attention at this time." Rationale Preschool-aged children frequently regress in habits or behaviors, such as toileting and sleep habits, as a method of seeking attention, so the parents should distribute their attention between the children and include the preschooler during infant care. A client who is attending antepartum classes asks the nurse why her healthcare provider has prescribed iron tablets. The nurse's response is based on what knowledge? A. Supplementary iron is more efficiently utilized during pregnancy. B. It is difficult to consume 18 mg of additional iron by diet alone. C. Iron absorption is decreased in the GI tract during pregnancy. D. Iron is needed to prevent megaloblastic anemia in the last trimester. B. It is difficult to consume 18 mg of additional iron by diet alone. Rationale Consuming enough iron-containing foods to facilitate adequate fetal storage of iron and to meet the demands of pregnancy is difficult so iron supplements are often recommended. A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective to prevent nipple soreness? A. Wear a cotton bra. B. Increase nursing time gradually. C. Correctly place the infant on the breast. D. Manually express a small amount of milk before nursing. C. Correctly place the infant on the breast. Rationale The most common cause of nipple soreness is incorrect positioning of the infant on the breast, e. g., grasping too little of the areola or grasping only the nipple. The nurse is teaching care of the newborn to a group of prospective parents and describes the need for administering antibiotic ointment into the eyes of the newborn. Which infectious organism will this treatment prevent from harming the infant? A. Herpes. B. Staphylococcus. C. Gonorrhea. D. Syphilis. C. Gonorrhea. Rationale 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, and inclusion conjunctivitis, an infection caused by chlamydia On admission to the prenatal clinic, a 23-year-old woman tells the nurse that her last menstrual period began on February 15, and that previously her periods were regular. Her pregnancy test is positive. This client's expected date of delivery (EDD) would be A. November 22. B. November 8. C. December 22. D. October 22. A. November 22. Rationale November 22 is the answer. The RN correctly applied N gele’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). The total bilirubin level of a 36-hour, breastfeeding newborn is 14 mg/dl. Based on this finding, which intervention should the nurse implement? A. Provide phototherapy for 30 minutes q8h. B. Feed the newborn sterile water hourly. C. Encourage the mother to breastfeed frequently. D. Assess the newborn's blood glucose level C. Encourage the mother to breastfeed frequently. Rationale The normal total bilirubin level is 6 to 12 mg/dl after Day 1 of life. This infant's bilirubin is beginning to climb and the infant should be monitored to prevent further complications. Breast milk provides calories and enhances GI motility, which will assist the bowel in eliminating bilirubin. The nurse instructs a laboring client to use accelerated-blow breathing. The client begins to complain of tingling fingers and dizziness. What action should the nurse take? A. Administer oxygen by face mask. B. Notify the healthcare provider of the client's symptoms. C. Have the client breathe into her cupped hands. D. Check the client's blood pressure and fetal heart rate. C. Have the client breathe into her cupped hands. Rationale Tingling fingers and dizziness are signs of hyperventilation (blowing off too much carbon dioxide). Hyperventilation is treated by retaining carbon dioxide. This can be facilitated by breathing into a paper bag or cupped hand. A new mother is afraid to touch her baby's head for fear of hurting the "large soft spot." Which explanation should the nurse give to this anxious client? A. "Some care is required when touching the large soft area on top of your baby's head until the bones fuse together." B. "That's just an 'old wives' tale' so don't worry, you can't harm your baby's head by touching the soft spot." C. "The soft spot will disappear within 6 weeks and is very unlikely to cause any problems for your baby." D. "There's a strong, tough membrane there to protect the baby so you need not be afraid to wash or comb his/her hair." Rationale The anterior fontanel or "large soft spot" has a strong epidermal membrane present, which can be touched. The posterior fontanel closes at 8-12 weeks. Providing this information to the client will alleviate her anxiety related to knowledge deficit D. "There's a strong, tough membrane there to protect the baby so you need not be afraid to wash or comb his/her hair." Rationale The anterior fontanel or "large soft spot" has a strong epidermal membrane present, which can be touched. The posterior fontanel closes at 8-12 weeks. Providing this information to the client will alleviate her anxiety related to knowledge deficit The nurse is calculating the estimated date of confinement (EDC) using Ngele’s rule for a client whose last menstrual period started on December 1. Which date is most accurate? A. August 1. B. August 10. C. September 3. D. September 8. Rationale Calculation of a client's EDC provides baseline data to monitor fetal gestation.N gele’s rule uses the formula: subtract 3 months and add 7 days to the first day of the last normal menstrual period, so December 1 minus 3 months + 7 days is September 8. D. September 8. Rationale Calculation of a client's EDC provides baseline data to monitor fetal gestation.N gele’s rule uses the formula: subtract 3 months and add 7 days to the first day of the last normal menstrual period, so December 1 minus 3 months + 7 days is September 8. A pregnant client tells the nurse that the first day of her last menstrual period was August 2, 2016. Based on Naegele’s rule, what is the estimated date of delivery? A. April 25, 2017. B. May 9, 2017. C. May 29, 2017. D. June 2, 2017. B. May 9, 2017. Rationale Since this client's first day of her last normal menstrual period occurred on August 2, 2017, the estimated date of delivery is May 9, 2018. Naegele’s rule is used to calculate the expected date of delivery and is obtained by subtracting 3 months and adding 7 days beginning from the first day of the last normal menstrual period. 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? A. "This is not an unusual shaped head, especially for a first baby." B. "It may look funny to you, but newborn babies are often born with heads like your baby's." C. "That is normal; the head will return to a round shape within 7 to 10 days." D. "Your pelvis was too small, so the baby's head had to adjust to the birth canal." Rationale Reassuring the mother that this is normal for a newborn head to have that appearance and provide correct information regarding the return to a "normal" shape is the best response. C. "That is normal; the head will return to a round shape within 7 to 10 days." Rationale Reassuring the mother that this is normal for a newborn head to have that appearance and provide correct information regarding the return to a "normal" shape is the best response. Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action will the nurse take? A. Notify the healthcare provider or anesthesiologist immediately. B. Continue to assess the blood pressure q5 minutes. C. Place the woman in a lateral position. D. Turn off the continuous epidural. C. Place the woman in a lateral position. Rationale The nurse should immediately turn the woman to a lateral position, place a pillow or wedge under the right hip to deflect the uterus, increase the rate of the main line IV infusion, and administer oxygen by face mask at 10-12 L/min. If the blood pressure remains low, especially if it further decreases, the anesthesiologist/healthcare provider should be notified immediately. 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? A. Yellowish tinge to the skin. B. Babinski reflex present bilaterally. C. Pink papular rash on the face. D. Moro reflex noted after a loud noise A. Yellowish tinge to the skin. Rationale Cephalohematomas are characterized by bleeding between the bone and its covering, the periosteum. Due to the breakdown of the red blood cells within a hematoma, the infant is at a greater risk for jaundice thus it should be reported.