HESI PN MATERNITY EXAM-with latestsolutions-2023-2024HESI OB 2021 1) At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in the right lower quadrant of her abdomen. The LPN/LVN obtains a blood sample and initiates an IV. Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder pain. Assessment findings include diaphoresis, a heart rate of 120 beats/minute, and a blood pressure of 86/48. Which action should the nurse implement next?C. Increase the rate of IV fluids.2) During a prenatal visit, the LPN/LVN discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who haveD. a higher rate of congenital anomalies.3) Which action should the LPN/LVN implement when preparing to measure the fundal height of a pregnant client?A. Have the client empty her bladder.5) One hour after giving birth to an 8-pound infant, a client’s lochia rubra has increased from small to large and her fundus is boggy despite massage. Theclient’s pulse is 84 beats/minute and blood pressure is 156/96. The healthcare provider prescribes Methergine 0.2 mg IM <~ 1. What action should the LPN/LVN take immediately?D. Call the healthcare provider to question the prescription.7) A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea, fatigue, and a moist cough. Which question is most important for the LPN/LVN to ask this client?D. Do you have a history of rheumatic fever?12) Immediately after birth a newborn infant is suctioned, dried, and placed under a radiant warmer. The infant has spontaneous respirations and the nurse assesses an apical heart rate of 80 beats/minute and respirations of 20 breaths/ minute. What action should the LPN/LVN perform next?A. Initiate positive pressure ventilation
13) A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicates that she has delivered premature twins, one full- term baby, and has had no abortions. Which GTPAL should the LPN/LVN document in this client’s record?D. 3-1-1-0-3.16)The nurse is providing discharge teaching for a client who is 24 hours postpartum. The nurse explains to the client that her vaginal discharge will change from red to pink and then to white. The client asks, “What if I start having red bleeding after it changes?” Whatshould the nurse instruct the client to do?A. Reduce activity level and notify the healthcare provider.18) A pregnant client tells the LPN/LVN that the first day of her last menstrual period was August 2, 2006. Based on NBgele’s rule, what is the estimated date of delivery?B. May 9, 2007.20) The LPN/LVN is preparing a client with a term pregnancy who is in active labor for an amniotomy. What equipment should the nurse have available at the client’s bedside? (Select all that apply.)C. A sterile glove.D. An amniotic hook.F. A Doppler.21) The LPN/LVN should explain to a 30-year-old gravida client that alpha fetoprotein testing is recommended for which purpose?B. Screen for neural tube defects.25) A 38-week primigravida who works as a secretary and sits at a computer 8 hours eachday 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?C. Move about every hour.26) During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have:B. lower birth weight
29) A mother who is breastfeeding her baby receives instructions from the nurse. Whichinstruction is most effective to prevent nipple soreness?C. Correctly place the infant on the breast.30) A full term infant is transferred to the nursery from labor and delivery. Which information is most important for the LPN/LVN to receive when planning immediate care for the newborn?B. Infant’s condition at birth and treatment received.34) The LPN/LVN is counseling a couple who has sought information about conceiving. For teaching purposes, the nurse should know that ovulation usually occursA. two weeks before menstruation.37) A 28-year-old client in active labor complains of cramps in her leg. What intervention should the LPN/LVN implement?B. Extend the leg and dorsiflex the foot.39) Twenty-four hours after admission to the newborn nursery, a full-termmale infant develops localized edema on the right side of his head. The LPN/LVNknows that, in the newborn, an accumulation of blood between the periosteum andskull which does not cross the suture line is a newborn variation known asA. a cephalhematoma caused by forceps trauma and may last up to 8 weeks.41) 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 LPN/LVNis best?C. That is normal; the head will return to a round shape within 7-10 days.42) A new mother asks the LPN/LVN, “How do I know that my daughter is getting enoughbreast milk?” Which explanation should the nurse provide?B. Your milk is sufficient if the baby is voiding pale straw-colored urine 6 to 10 times a day.43) After each feeding, a 3-day-old newborn is spitting up large amounts of Enfamil® Newborn Formula, a nonfat cow’s milk formula. The pediatric healthcare provider changes the neonate’s formula to Similac® Soy Isomil® Formula, a soy protein isolate based infant formula. What information should the LPN/LVN provide to the mother about the newly prescribed formula?D. Similac® Soy Isomil® Formula is a soy-based formula that contains sucrose.
44) A client who gave birth to a healthy 8 pound infant 3 hours ago is admitted to thepostpartum unit. Which nursing plan is best in assisting this mother to bond withher newborn infant?D. Meet the mother’s physical needs and demonstrate warmth toward the infant.45) Which nursing intervention is most helpful in relieving postpartum uterine contractions or “afterpains?”A. Lying prone with a pillow on the abdomen.46) Which maternal behavior is the LPN/LVN most likely to see when a new mother receives her infant for the first time?B. Her arms and hands receive the infant and she then traces the infant’s profile with her fingertips.48) The LPN/LVN is counseling a woman who wants to become pregnant. The woman tells the nurse that she has a 36-day menstrual cycle and the first day of her last menstrual period was January 8. The nurse ly calculates that the woman’s next fertile period isC. January 30-31.50 Twenty minutes after a continuous epidural anesthetic is administered, a laboring client’s blood pressure drops from 120/80 to 90/60. What action should the LPN/LVN take?C. Place the woman in a lateral position.51) A client at 28-weeks gestation calls the antepartal 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 uterinecontractions or abdominal pain. What instruction should the LPN/LVN provide?A. Come to the clinic today for an ultrasound.53) A pregnant client with mitral stenosis Class III is prescribed complete bedrest. The client asks the nurse, “Why must I stay in bed all the time?” Which response is best for theLPN/LVN to provide this client?A. Complete bedrest decreases oxygen needs and demands on the heart muscle tissue.55) Just after delivery, a new mother tells the nurse, “I was unsuccessful breastfeeding my first child, but I would like to try with this baby.” Which intervention is best for the LPN/LVN to implement first?D. Provide assistance to the mother to begin breastfeeding as soon as possible after delivery.
1) A client is admitted to the labor and delivery unit with contractions that are 3-5 minutesapart, lasting 60-70 seconds. She reports that she is leaking fluid. A vaginal exam reveals that her cervix is 80 percent effaced and 4 cm dilated and a -1 station. The LPN/LVN knows that the client is in which phase and stage of labor?B) Active Phase of First Stage5) The factors that affect the process of labor and birth, known commonly as the five Ps, include all EXCEPT:D) Pressure.6) While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. The LPN/LVN first priority is to:C) Change the woman’s position19) What is an advantage of external electronic fetal monitoring?C) The external EFM does not require rupture of membranes or introduction of scalp electrode or IUPC which may introduce risk of infection or fetal scarring.23) A woman in active labor receives an analgesic, an opioid agonist. Which medication relieves severe, persistent, or recurrent pain; creates a sense of well-being; overcomes inhibitory factors; and may even relax the cervix but should be used cautiously in women with cardiac disease?A) Meperidine (Demerol)24) A laboring woman received meperidine (Demerol) intravenously 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate?C) Naloxone (Narcan)25) A woman in labor has just received an epidural block. The most important nursingintervention is to:C) Monitor the maternal blood pressure for possible hypotension.26) A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure would be to use:A) Counterpressure against the sacrum
27) A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced.The baby is in a vertex position and is engaged. The LPN/LVN increases the woman’s intravenous fluid for a pre-procedural bolus. She reviews her laboratory values and notes that the woman’s hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for the woman?C) She has thrombocytopenia29) With regard to systemic analgesics administered during labor, LPN/LVN should be aware that:B) Effects on the fetus and newborn can include decreased alertness and delayed sucking.32) Nursing care measures are commonly offered to women in labor. Which nursing measure reflects application of the gate-control theory?A) Massaging the woman’s back33) A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The LPN/LVN should:D) Help her breathe into a paper bag42) Through vaginal examination the nurse determines that a woman is 4 cm dilated, and the external fetal monitor shows uterine contractions every 3.5 to 4 minutes. The LPN/LVN would report this as:B) First stage, active phase46) For women who have a history of sexual abuse, a number of traumatic memories may be triggered during labor. The woman may fight the labor process and react with pain or anger. Alternately she may become a passive player and emotionally absent herself from the process. The nurse is in a unique position of being able to assist the client to associate the sensations of labor with the process of childbirth and not the past abuse. The nurse canimplement a number of care measures to help her client view the childbirth experience in apositive manner. Which intervention would be key for the LPN/LVN to use while providing care?B) Limiting the number of procedures that invade her body
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48) When planning care for a laboring woman whose membranes have ruptured, the LPN/LVN recognizes that the woman’s risk for has increased.A) Intrauterine infection50) When assessing a multiparous woman who has just given birth to an 8-pound boy,the nurse notes that the woman’s fundus is firm and has become globular in shape. Agush of dark red blood comes from her vagina. The LPN/LVN concludes that:A) The placenta has separated.51) LPN can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate?B) Active: Moderate, regular contractions; 4- to 7-cm dilation; duration of 3 to 6 hours53) Which of the following is true about placenta previa?D) Once placenta previa is diagnosed by a 20 week ultrasound, it is very likely the placentaprevia will resolve in the third trimester.54) What assessment is least likely to be associated with a breech presentation?C) Postterm gestation55) During labor, the patient at 4 cm suddenly becomes dyspneic, cyanotic, and hypotensive. The nurse must prepare immediately for: (Select all that apply.)B) Cesarean deliveryC) CPRA client who is attending antepartum classes asks the nurse why her healthcare providerhas prescribed iron tablets. The nurse’s response is based on what knowledge?b. It difficult to consume 18 mg of additional iron by diet aloneThe 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?c. GonorrheaThe nurse is calculating the estimated date of confinement (EDC) using Nagele’s rule for a client whose last menstrual period started on December 1. Which date is most accurate?d. September 8
The total bilirubin level of a 36-hour, breastfeeding newborns is 14 mg/dl. Based on this finding, which intervention should the nurse implement?c. Encourage the mother to breastfeed frequentlyA client is admitted with the diagnosis of total placenta previa. Which finding is mostimportant for the nurse to report to the healthcare provider immediately?c. Onset of uterine contractions2. A new mother who is a lacto-ovo vegetarian, plans to breastfeed her infant. Which information should the nurse provide prior to discharge?B. Continue prenatal vitamins with B12 while breast feeding.5. A multiparous client at 38-weeks’ gestation is admitted to labor and delivery with a complaint of contractions 5 minutes apart. While the client is in the bathroom changinginto a hospital gown, the nurse hears a baby crying. Which action should the nurse take first?D. Push the call light for help6. The nurse is providing care for a newborn who was delivered vaginally assisted by forceps. The nurse observes red marks on the head with swelling that does not cross the suture lines. Which condition should the nurse document in the medical record?D. Cephalhematoma7. A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began one hour ago. The nurse’s assessment reveals approximately 30 ml of bright red vaginal bleeding, Fetal Heart Rate of 130 to 140 beats/min, no contractions, and no complaints of pain. What is the most likely cause of this client’s bleeding?C. Placenta previa8. A newborn’s head circumference is 12 inches, and his chest measurement is 13 inches. The nurse notes that this infant has no molding and was a breech presentation delivered by Caesarean section. What action should the nurse take based on these data?C. Record the findings on the chart. They are within normal limits
- A primigravida arrives at the observation unit of the maternity unit because she thinks she is in labor. The nurse applies the external fetal heart monitor and determines that the fetal heart rate is 140 beats/minute, and the contractions are occurring irregularly every 10to 15 minutes. What assessment finding confirms to the nurse that the client is not in labor at this time?D. Contractions decrease with walking.13. The health care provider prescribes a maintenance dose of magnesium sulfate 2 grams per hour intravenously (IV) for client with preeclampsia. The IV bag contains magnesium sulfate 20 grams in dextrose 5% in water 500 mL. How many mL/hr should the nurse program the infusion pump? 5014. An UAP reports to the charge nurse that a client who delivered a 7-pound infant 12 hours ago is reporting a severe headache. The clients’ blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/minute, heart rate is 74 bpm, and temperature is 98.6 F. The client’s fundus is firm and one fingerbreadth above the umbilicus. Which action should the charge nurse implement first?A. Assign a practical nurse to reassess the client’s vital signs15. A new mother who is breastfeeding her 4-week-old infant and has type 1 diabetes,reports that her insulin needs have decreased since the birth of her child. Whataction should the nurse implement?D. Inform her that a decreased need for insulin occurs while breastfeeding20. The healthcare provider prescribes 10 units/L of oxytocin via IV drip to augment a client’s labor because she is experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin?C. Contraction duration of 100 seconds22. A client tells the nurse that she thinks she is pregnant. Which sign or symptom providesthe best indication that the client is pregnant?A. Amenorrhea24. The nurse notes on the fetal monitor that a laboring client has a variable deceleration. Which action should the nurse implement first?D. Change the client’s position
- The nurse is receiving report for a laboring client who arrived in the emergency center with ruptured membranes that the client did not recognize. Which is the priority nursing action to implement when the client is admitted to the labor and delivery suite?C. Prepare to start an IV27. A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with adiagnosis of eclampsia. She is not presently convulsing. Which intervention shouldthe nurse plan to include in this client’s nursing care plan?B. Keep an airway at the bedside.28. The nurse is scheduling a client with gestational diabetes for an amniocentesis because the fetus has an estimated weight of 8 pounds at 36- weeks’ gestation. This amniocentesis isbeing performed to obtain which information?D. Fetal lung maturity29. A client arrives to the clinic reporting she is unable to conceive for the last year. The obstetrical history includes: a live birth at 28 weeks and one at 22 weeks who lived to 2 days, and 3 miscarriages in the first trimester. Which GTPAL should the nurse document?B. G5 P023130. A 17-year-old client gave birth 12 hours ago. She states that she doesn’t know how tocare for her baby. To promote parent- infant attachment behaviors, which intervention should the nurse implement?A. Encourage rooming-in while in the hospital35. The nurse is planning care for a client at 30-weeks’ gestation who is experiencing preterm labor. What maternal prescription is most important in preventing this fetus fromdeveloping respiratory distress syndrome?C. Betamethasone (Celestone) 12 mg deep IM.38. A multigravida client in labor is receiving oxytocin 4 mu/minute to help promote aneffective contraction pattern. The available solution is Lactated Ringer’s 1000 ml with oxytocin 20 units. The nurse should program the pump to deliver how many ml/hr? 1243. A client at 37-weeks’ gestation presents to labor and delivery with contractions every 2 minutes. The nurse observes several shallow, small vesicles on her pubis, labia, and perineum. The nurse should recognize the client is exhibiting symptoms of which condition?C. Herpes simplex virus
- The nurse is planning discharge teaching for 4 mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?C. A primiparous woman who has recently immigrated to the U.S. with her spouse50. a client in the first trimester of pregnancy calls the prenatal clinic to report she is nauseated, and her stools are black and thick since she started taking iron supplements last week. how should the nurse respond? (Select all that apply)B. Take the iron supplement at bedtimeC. Changes in color and consistency of stool are normal54. The mother of a breastfeeding 24-hour-old infant is very concerned about the techniques involved in breastfeeding. She calls the nurse with each feeding to seek reassurance that she is “doing it right.” She tells the nurse, “I just know my daughter is not getting enough to eat.” What response would be best for the nurse to make?C. If your baby’s urine is straw-colored, she is getting enough milk55. A client at 18-weeks’ gestation was informed this morning that she has an elevated alpha fetoprotein level. After the healthcare provider leaves the room, the client asks what she should do next. What information should the nurse provide?D. Explain that a sonogram should be scheduled for definitive results