1. During labor, the nurse 1. Reposition the client
determines that a 2. Increase IV fluids
full-term client is demon- 3. Provide oxygen via face mask
strating late decelera- 4. Call the healthcare provider
tions. In which sequence To stabilize the fetus, intrauterine resuscitation
should the nurse imple- is the first priority, and to enhance fetal blood
ment these nursing ac- supply, the laboring client should be repositioned
tions? (Arrange in order.) (1) to displace the gravid uterus and improve
fetal perfusion. Secondly, to optimize oxygenation
of the circulatory blood volume, oxygen via face
mask (2) should be applied to the mother. Next,
the IV fluids should be increased (3) to expand
the maternal circulating blood volume. Then, the
primary healthcare provider should be notified
(4) for additional interventions to resolve the fetal
stress.
2. A client with NO prena- Date of last normal menstrual period:
tal care arrives at the la- Evaluating the gestation of the pregnancy takes
bor unit screaming, "The priority. If the fetus is preterm and the fetal heart
baby is coming!" The pattern is reassuring, the healthcare provider may
nurse performs a vaginal attempt to prolong the pregnancy and administer
examination that reveals corticosteroids to mature the lungs of the fetus.
the cervix is 3 centime-
ters dilated and 75% ef-
faced. What additional in-
formation is most impor-
tant for the nurse to ob-
tain?
3. A 38-week primigravida Move about every hour:
who works as a secre- Pooling of blood in the lower extremities results
tary and sits at a comput- from the enlarged uterus exerting
er for 8 hours each day pressure on the pelvic veins. Moving about every
tells the nurse that her hour will straighten out the pelvic
feet have begun to swell. veins and increase venous return.
Which instruction would
be most effective in pre-
, 2024 HESI MATERNITY OB EXAM VERSION 4
venting pooling of blood
in the lower extremities?
4. 2. A 26-year-old, gravi- Tachycardia and a feeling of nervousness:
da 2, para 1 client is Terbutaline sulfate (Brethine), a beta-sympath-
admitted to the hospi- omimetic drug, stimulates beta-adrenergic recep-
tal at 28-weeks gestation tors in the uterine muscle to stop contractions.
in preterm labor. She is The beta-adrenergic agonist properties of the
given 3 doses of terbu- drug may cause tachycardia, increased cardiac
taline sulfate (Brethine) output, restlessness, headache, and a feeling of
0.25 mg subcutaneously "nervousness"
to stop her labor contrac-
tions. The nurse plans to
monitor for which prima-
ry side effect of terbu-
taline sulfate?
5. When do the anterior anterior fontanel closes at 12 to 18 months and
and posterior fontanels the posterior by the end of the second month.
close?
6. When assessing a client 30 weeks gestation:
who is at 12-weeks ges- at 30 weeks gestation is closest (of the options)
tation, the nurse rec- to the time parents would be ready for
ommends that she and such classes. Learning is facilitated by an inter-
her husband consider at- ested pupil! The couple is most
tending childbirth prepa- interested in childbirth toward the end of the preg-
ration classes. When is nancy when they are psychologically
the best time for the cou- ready for the termination of the pregnancy, and
ple to attend these class- the birth of their child is an immediate
es? concern
7. The nurse should en- the cervix is completely dilated:
courage the laboring Pushing begins with the second stage of labor,
client to begin pushing i.e., when the cervix is completely
when... dilated at 10 cm (C). If pushing begins before the
cervix is completely dilated the cervix
can become edematous and may never com-
pletely dilate, necessitating an operative delivery.
, 2024 HESI MATERNITY OB EXAM VERSION 4
Many primigravida's begin active labor 100% ef-
faced and then proceed to dilate.
8. The nurse instructs a Have the client breathe into her cupped hands:
laboring client to use Tingling fingers and dizziness are signs of hyper-
accelerated-blow breath- ventilation (blowing off too much carbon dioxide).
ing. The client begins to Hyperventilation is treated by retaining carbon
complain of tingling fin- dioxide. This can be facilitated by breathing into
gers and dizziness. What a paper bag or cupped hands
action should the nurse
take?
9. Twenty-four hours after a cephalohematoma, caused by forceps trauma
admission to the new- and may last up to 8 weeks:
born nursery, a full-term Cephalohematoma, a slight abnormal variation
male infant develops lo- of the newborn, usually arises within the first 24
calized edema on the hours after delivery. Trauma from delivery causes
right side of his head. capillary bleeding between the periosteum and
The nurse knows that, in the skull.
the newborn, an accumu-
lation of blood between
the periosteum and skull
which does not cross the
suture line is a newborn
variation known as...
10. When does the head re- 7-10 days
turn to its normal shape?
11. What did Nurse theorist The initial postpartum period as the "taking-in
Reva Rubin describe? phase," which is characterized by maternal re-
liance on others to satisfy the needs for comfort,
rest, nourishment, and closeness to families and
the newborn.
12. A couple, concerned be- Shoulder pain:
cause the woman has not If the tubes are patent (open), pain is referred to
been able to conceive, is the shoulder from a sub diaphragmatic
referred to a healthcare collection of peritoneal dye/gas.
provider for a fertility
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