HESI OB MATERNITY EXAM ACTUAL TEST BANK EXAM
QUESTIONS WITH DETAILED VERIFIED ANSWERS/A+ GRADE
ASSURED
• A 38-week primigravida who works as a secretary and sits at a
computer for 8 hours each day tells the nurse that her feet have begun
to swell. Which instruction would be most effective in preventing
pooling of blood in the lower extremities?
Move about 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.
• A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-
weeks gestationin preterm labor. She is given 3 doses of terbutaline
sulfate (Brethine) 0.25 mg subcutaneously to stop her labor contractions.
The nurse plans to monitor for which primary side effect of terbutaline
sulfate?
Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug,
stimulates beta-adrenergicreceptors in the uterine muscle to stop
contractions. The beta-adrenergic agonist properties of the drug
may cause tachycardia, increased cardiac output, restlessness,
headache, and a feeling of "nervousness".
• When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the
end of thesecond month.
• When assessing a client who is at 12-weeks 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?
30 weeks gestation
, at 30 weeks gestation is closest (of the options) to the time
parents would be ready for such classes. Learning is facilitated
by an interested pupil! The couple is most interested in childbirth
toward the end of the pregnancy when they are psychologically
ready for the termination of the pregnancy, and the birth of their
childis an immediate concern.
• The nurse should encourage the laboring client to begin
pushing when...the cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix
is completely dilatedat 10 cm (C). If pushing begins before the
cervix is completely dilated the cervix
1
can become edematous and may never completely dilate,
necessitating an operativedelivery. Many primigravida’s begin
active labor 100%and theneffacedproceed todilate.
• 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?
Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation
(blowing off too much carbon dioxide). Hyperventilation is
treated by retaining carbon dioxide. This can befacilitated by
breathing into a paper bag or cupped hands.
• Twenty-four hours after admission to the newborn nursery, a full-term
male infant develops localized edema on the right side of his head.
The nurse knows that, in thenewborn, an accumulation of blood
between the periosteum and skull which does not cross the suture line
is a newborn variation known as...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn,
usually arises within the first 24 hours after delivery. Trauma from
delivery causes capillary bleeding between the periosteum and the
skull.
,• When does the head return
to its normalshape? 7-10 days
• What did Nurse theorist Reva Rubin describe?
The initial postpartum period as the "taking-in phase," which is
characterized by maternal reliance on others to satisfy the needs for
comfort, rest, nourishment, andcloseness to families and the newborn.
• A couple, concerned because the woman has not been able to conceive,
is referred toa healthcare provider for a fertility workup and a
hysterosalpingography is scheduled. Which post procedure complaint
indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from
a sub diaphragmatic collection of peritoneal dye/gas.
• Which nursing intervention is most helpful in relieving postpartum
uterine contractionsor "afterpains?"
Lying prone with a pillow on the abdomen
2
Lying prone keeps the fundus contracted and is especially useful
with multiparas, who commonly experience afterpains due to
lack of uterine tone.
• Which maternal behavior is the nurse most likely to see when a new
motherreceives her infant for the first time?
Her arms and hands receive the infant and she then traces the infant's
profile withher fingertips.
Attachment/bonding theory indicates that most mothers will
demonstrate behaviorsdescribed in during the first visit with the
newborn, which may be at delivery or later.
• A client at 32-weeks gestation is hospitalized with severe
pregnancy-induced hypertension (PIH), and magnesium sulfate is
, prescribed to control the symptoms.Which assessment finding
indicates the therapeutic drug level has been achieved?
A decreased in respiratory rate from 24 to 16
Magnesium sulfate, a CNS depressant, helps prevent seizures. A
decreased respiratory rate indicates that the drug is effective.
(Respiratory rate below 12 indicatestoxic effects.)
• Urinary output must be monitored when administering magnesium
sulfate and should be at least 30 ml per hour. (The therapeutic level of
magnesium sulfate for a PIH clientis 4.8 to 9.6 mg/dl.) What is the
therapeutic level of magnesium sulfate?
The therapeutic level of magnesium sulfate for a PIH client is
4.8 to 9.6mg/dl. What does it help prevent? helps prevent
seizures
What indicates toxic levels? 3
Respiratory rate below 12
indicates toxic effects.Urine
output of less than 100 ml/4
hours
Absent DTRs
• Twenty minutes after a continuous epidural anesthetic is administered, a
laboring client'sblood pressure drops from 120/80 to 90/60. What action
should the nurse take?
Place woman in a lateral position
The nurse should immediately turn the woman to a lateral
position, place a pillow orwedge 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.
• A client at 28-weeks gestation calls the antepartum clinic and states
that she is experiencing a small amount of vaginal bleeding which she
describes as bright red. She further states that she is not experiencing
any uterine contractions or abdominalpain. What instruction should
the nurse provide?
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