2024 HESI MATERNITY OB EXAM VERSION 4 WITH CORRECT ANSWERS |A+ GRADES

2024 HESI MATERNITY OB EXAM VERSION 4 WITH CORRECT ANSWERS |A+ GRADES During labor, the nurse determines that a full-term client is demonstrating late decelerations. In which sequence should the nurse implement these nursing actions? (Arrange in order.) - ANSWER-1. Reposition the client 2. Increase IV fluids 3. Provide oxygen via face mask 4. Call the healthcare provider To stabilize the fetus, intrauterine resuscitation is the first priority, and to enhance fetal blood supply, the laboring client should be repositioned (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. Copyright ©KATELYNWHITMAN 2025. ALL RIGHTS RESERVED Page 2/25 A client with NO prenatal care arrives at the labor unit screaming, "The baby is coming!" The nurse performs a vaginal examination that reveals the cervix is 3 centimeters dilated and 75% effaced. What additional information is most important for the nurse to obtain? - ANSWER-Date of last normal menstrual period: Evaluating the gestation of the pregnancy takes priority. If the fetus is preterm and the fetal heart pattern is reassuring, the healthcare provider may attempt to prolong the pregnancy and administer corticosteroids to mature the lungs of the fetus. 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? - ANSWER- 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. 2. A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation in 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? - ANSWER-Tachycardia and a feeling of nervousness: Copyright ©KATELYNWHITMAN 2025. ALL RIGHTS RESERVED Page 3/25 Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta- adrenergic receptors 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? - ANSWER-anterior fontanel closes at 12 to 18 months and the posterior by the end of the second 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? - ANSWER-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 child is an immediate concern The nurse should encourage the laboring client to begin pushing when... - ANSWER-the cervix is completely dilated: Pushing begins with the second stage of labor, i.e., when the cervix is completely dilated at 10 cm (C). If pushing begins before the cervix is completely dilated the cervix Copyright ©KATELYNWHITMAN 2025. ALL RIGHTS RESERVED Page 4/25 can become edematous and may never completely dilate, necessitating an operative delivery. Many primigravida's begin active labor 100% effaced and then proceed to dilate. 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? - ANSWER-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 be facilitated 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 the newborn, an accumulation of blood between the periosteum and skull which does not cross the suture line is a newborn variation known as... - ANSWER-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 c