Maternal Hesi Study Questions
The nurse is caring for a client in active labor with a history of T5 spinal cord injury. Which of the following findings indicates to the nurse that the client is experiencing a complication of the labor process?
Increased blood pressure
A client with severe preeclampsia develops eclampsia. After the seizure, the client has a temperature of 102° F (38.9° C). What does the nurse suspect as the cause of the elevated temperature?
Irregularity in the cerebral thermal center
The nurse teaches a client who is about to undergo an amniocentesis that ultrasonography will be performed just before the procedure to determine what?
Position of the fetus and the placenta
A multiparous client presents to the labor and delivery area in active labor. The initial vaginal examination reveals that the cervix is dilated 4 cm and 100% effaced. Two hours later the client experiences rectal pressure, followed by delivery 5 minutes later. How is this delivery best documented?
Precipitous vaginal delivery
Immediately after a client has completed the third stage of labor, the nurse adds the prescribed 10 units of oxytocin to the intravenous line. What is the desired response to this medication?
Prevention of the occurrence of profuse bleeding after placental separation
A client at 32 weeks' gestation visits the prenatal clinic because she is experiencing uterine contractions. She is to be treated at home with restricted activity and long periods of bed rest. Which instructions should the teaching plan include when the client is advised to remain in bed?
"Assume a side position, with the head raised on a small pillow."
A client with a history of endometriosis gives birth to a healthy infant. She expresses concern that the problems associated with endometriosis will return now that her pregnancy is over. What is the best response by the nurse?
"Breast-feeding will delay the return of the endometriosis."
A pregnant client tells the nurse that she thinks she has developed an allergy because her nose is often very congested and she has difficulty breathing. How should the nurse reply?
"That is an expected occurrence; the increased hormones are responsible for the congestion."
Which gestational period is appropriate for the administration of corticosteroids during preterm labor?
24-34 weeks
A mental health nurse is admitting a client with anorexia nervosa. When obtaining the history and physical assessment, the nurse expects the client's condition to reveal which symptom?
Amenorrhea
A pregnant woman who is in the third trimester arrives in the emergency department with vaginal bleeding. She states that she snorted cocaine approximately 2 hours ago. Which complication does the nurse suspect as the cause of the bleeding?
Abruptio placenta
A 16-year-old primigravida who appears to be at or close to term arrives at the emergency department stating that she is in labor and complaining of pain continuing between contractions. The nurse palpates the abdomen, which is firm and shows no sign of relaxation. What problem does the nurse conclude that the client is experiencing?
Abruptio placentae
A pregnant client was exposed to a teratogen in her tenth week of gestation. Which nursing intervention should be provided?
Assure the client that the risk of malformation is minimal
Which statement is true for attachment in the newborn?
Attachment is the interaction between parent and child.
A primigravida is admitted to the birthing unit in early labor. A pelvic examination reveals that her cervix is 100% effaced and dilated 3 cm. The fetal head is at +1 station. In which area of the client's pelvis is the fetal occiput?
Below the ischial spine
The cervix of a client in labor is dilated to 8 cm. She tells the nurse that she has a desire to push and is becoming increasingly uncomfortable. The client requests pain medication. How should the nurse respond at this time?
Help her take panting breaths
A nurse is caring for a pregnant client with thrombophlebitis. Which anticoagulant medication may be prescribed?
Heparin and Enoxaprin
A client tells the nurse that the first day of her last menstrual period was July 22. What is the estimated date of birth (EDB)?
Her EDB is April 29. The Nägele rule is an indirect, noninvasive method for estimating the date of birth: EDB = last menstrual period + 1 year - 3 months + 7 days. May 7 is beyond the expected date of birth. April 22 and March 6 are both before the EDB.
A female client is undergoing treatment for infertility. After therapy with clomiphene the client comes for follow-up visits and no results are seen. What further treatment does the nurse anticipate administering?
Human chorionic gonadotropin
The nurse is caring for a client in the transition phase of labor. Which breathing pattern should the nurse instruct the client to use when there is an urge to push at 9 cm of dilation?
Panting-blowing pattern
The nurse is providing discharge instructions to the parents of a child who has undergone surgical correction of hypospadias. What is the priority information for the nurse to include?
Teaching parents how to care for the catheterization system
What issues are associated with the difficulty in identification of teratogens?
Teratogenic effects may be delayed. Prolonged drug exposure may be required. Animal test results may not be applicable to humans.
A client at 31 weeks' gestation is admitted in preterm labor. What class of drugs might the nurse anticipate being prescribed?
beta-adrenergic
Oral contraceptives are prescribed for a client who smokes heavily. What side effect should the nurse warn the client might occur?
blood clots
In the eighth month of pregnancy a client tells the nurse that she is experiencing dyspareunia. Which information would be most helpful for the nurse to teach the client?
try other positions
A client is receiving an oxytocin infusion for induction of labor. The uterine graph on the electronic monitor indicates no rest period between contractions, and this is confirmed on palpation. What should the nurse do first?
turn oxytocin infusion off
What complication should a nurse be alert for in a client receiving an oxytocin infusion to induce labor?
uterine tetany
At 38 weeks' gestation a client is admitted to the birthing unit in active labor, and an external fetal monitor is applied. Late fetal heart rate decelerations begin to appear when her cervix is dilated 6 cm, and her contractions are occurring every 4 minutes and lasting 45 seconds. What is the likely cause of these late decelerations?
uteroplacental insufficiency
A pregnant client is prescribed heparin to prevent the risk of thromboembolism. Which adverse effects should the nurse anticipate with this medication?
Osteoporosis Compression fractures of the spine
A pregnant woman reports night sweats, sleep disturbances, and weight gain. Upon diagnosis, the woman has low levels of estrogen and is treated with hormonal therapy. Which teratogenic effect is likely to occur in the newborn?
Congenital defects of the female reproductive system
When assessing a newly admitted primigravida in labor, a nurse determines that the fetal heartbeat is loudest in the upper left quadrant. What fetal position does the nurse identify?
Left Sacral anterior
A client expresses a desire to postpone her first pregnancy for at least 5 years. She smokes 1.5 packs of cigarettes a day, has never been pregnant, and does not want to use a barrier method. Which method does the nurse anticipate the primary healthcare provider will recommend?
Medroxyprogesterone long-acting progestin-only contraceptive that is less likely to cause cardiovascular problems in women who smoke than contraceptives containing estrogen might. Vaginal rings, combined oral contraceptive pills, and the birth control patch all contain estrogen and are not recommended for women who smoke.
A client had a cesarean birth 3 days ago. Where should the nurse, while palpating the client's fundus, expect to locate the fundus if each line represents 1 cm?
Three days after birth, the fundus should be located 3 cm below the umbilicus; 12 hours after birth it should be located about 1 cm above the umbilicus; each following day it drops 1 to 2 cm. Location a is too high; the fundal height is 1 cm below the umbilicus on day 1. Location b is too high; the fundal height is 2 cm below the umbilicus on day 2. Location d is too low; the fundal height is 4 cm below the umbilicus on day 4.
While a client is being given intravenous magnesium sulfate therapy for preeclampsia, it is essential for the nurse to monitor the client's deep tendon reflexes. What reason does the nurse give to the client to explain why this is done?
Reveals the potential for respiratory depression
While auscultating the lungs of a client admitted with severe preeclampsia, the nurse identifies crackles. What inference does the nurse make when considering the presence of crackles in the lungs?
pulmonary edema
A client's labor has progressed to the point where she is 6 cm dilated; however, the fetal head is not engaged. An amniotomy is performed. After this procedure, the nurse checks the fetal heart rate. What other nursing action should be performed at this time?
Inspect the perinuem
An expectant couple asks the nurse about the cause of low back pain in labor. The nurse replies that this pain occurs most often when the fetus is in what position?
Occiput posterior
Which drug may cause gynecologic malignancies in females?
Diethylstilbestrol
An ultrasound scan of a 7-month-pregnant woman indicates fetal death. Which drug should be given to the client to evacuate the contents of the uterus?
Dinoprostone
Which medication is indicated for evacuation in case of a miscarriage?
Dinoprostone
Which drug is used to induce abortion?
Mifepristone
A pregnant client's history reveals opioid abuse. What is the nurse's initial plan for providing pain relief measures during labor?
Scheduling pain medication at regular intervals
A nurse on the high-risk unit is caring for a client with severe preeclampsia. Which intervention is the most effective in preventing a seizure?
controlling external stimuli
A client at 43 weeks' gestation has just given birth to an infant with typical postmaturity characteristics. Which signs of postmaturity does the nurse identify?
A client at 43 weeks' gestation has just given birth to an infant with typical postmaturity characteristics. Which postmature signs does the nurse identify? (Select all that apply.)
A woman is being seen in the prenatal clinic at 36 weeks' gestation. The nurse is reviewing signs and symptoms that should be reported to the primary healthcare provider with the mother. Which signs and symptoms require further evaluation by the primary healthcare provider?
Decreased urine output Blurred vision with spots Contractions that are regular and 5 minutes apart
The nurse is providing care to a client with preeclampsia who is receiving magnesium sulfate 2 g/hr. The nurse receives a call from the laboratory technician indicating that the client has a magnesium level of 6.4 mEq/L (0.30 mmol/L). What is the next nursing action?
Documenting the level in the client's electronic medical record
Which tocolytic agent can be used safely without combining with other agents to inhibit labor and maintain a pregnancy?
Nifedipine
A nurse in the prenatal clinic is caring for a client with heart disease who is in her second trimester. Which hemodynamic change of pregnancy is likely to affect the client at this time?
heart rate acceleration in the last half of pregnancy
A pregnant couple is attending childbirth preparation classes. Which exercise should the nurse teach the mother to increase the tone of the muscles of the pelvic floor?
kegels
A client is admitted in active labor at 39 weeks' gestation. During the initial examination the nurse identifies multiple red blisterlike lesions on the edges of the client's vaginal orifice. Once the nurse has spoken to the primary healthcare provider and received prescriptions, what is the priority nursing action?
preparing for a ceserean
During a childbirth preparation class, the nurse teacher discusses the importance of the "spurt" of energy that occurs before labor. Why is it important to conserve this energy?
Fatigue may influence pain medication requirements.
A primigravida at 8 weeks' gestation is visiting the prenatal clinic for the first time. Which finding would an assessment reveal at this time?
Goodell's sign
During a routine prenatal office visit at 26 weeks' gestation, a client states that she is getting fat all over and that she even needed to buy bigger shoes. What is the next nursing action?
Obtaining the client's weight and blood pressure
Which criteria may prove that a drug is a teratogen?
The drug may cause fetal malformations. The drug acts in the gestation period. The drug-related malformations increase with an increase in the dose and exposure.
The postpartum nurse is providing care to four maternal/infant couplets who have all delivered within the past 24 hours. After receiving the handoff report from the off-going nurse, which client is a priority for the nurse to see first?
The term infant with a transcutaneous bilirubin reading of 8.6 mg/dL 12 hours after birth
