Evolve HESI Maternity

A 29-week-pregnant woman is found to have uterine contractions. Which medication does the primary healthcare provider prescribe? 1 Oxytocin 2 Dinoprostone 3 Indomethacin 4 Methylergonovine

3 Substantial uterine contractions that occur prior to the 37th week of pregnancy should be stopped because a premature birth increases the risk of neonatal death. Therefore indomethacin should be given for the management of preterm labor. Oxytocin is used to induce labor. Dinoprostone is also a uterine stimulant administered via the vaginal route; it is not appropriate in this condition. Methylergonovine is indicated for postpartum uterine atony and hemorrhage.

What is the first line drug used to manage intrauterine fetal death? 1 Dinoprostone 2 Misoprostol 3 Mifepristone 4 Methylergonovine

1 Dinoprostone (Cervidil) is a synthetic derivative of the hormone prostaglandin E2, which is used to induce labor after establishing intrauterine fetal demise of up to 28 weeks of gestational age. Misoprostol (Cytotec) is a synthetic prostaglandin E1 analog typically used as an antiulcer agent that also has an off-label use for cervical ripening (softening), and it is used in combination with mifepristone (RU486) to induce abortion. Methylergonovine maleate (Methergine) is an ergot derivative that functions as an oxytocic and is prescribed to reduce postpartum hemorrhage when uterine massage does not improve uterine tone to decrease bleeding.

Which interventions are included in the care plan of a postpartum client with a fourth-degree laceration? Select all that apply. 1 Pain management with oral analgesics 2 Continuous application of a warm pack 3 Assessment of the site every 15 minutes 4 Gentle cleansing with antibacterial cleanser 5 Application of an ice pack for 20-minute intervals 6 Instructing the client in how to promote normal bowel function

1, 3, 5 Providing pain management will prevent the client's pain from reaching an unmanageable level. Assessment of the site will identify any abnormal changes. Application of ice will decrease pain and edema. Warmth applied to newly traumatized tissue will increase pain and edema. Antibacterial cleanser would be caustic and painful to the laceration. Teaching regarding bowel function would be more appropriately presented after the client has completed the fourth stage and resumed normal intake.

Which of these statements about the transition from intrauterine to extrauterine life is true? 1 Hyperthermia is observed in the newborn. 2 Newborns are susceptible to heat loss and cold stress. 3 Apgar assessments are conducted 5 and 10 minutes after birth. 4 Physiological changes in the newborn occur during the first 12 hours of life

2 During the transition from intrauterine to extrauterine life, newborns are susceptible to heat loss and cold stress. Newborns are susceptible to hypothermia, not hyperthermia. Apgar assessments are generally conducted between 1 and 5 minutes after birth. Physiological changes in the newborn are seen during the first 24 hours of life.

A client is prescribed uterine stimulants to augment labor. Which condition should be assessed in the client before initiating therapy? 1 Liver disease 2 Pituitary tumors 3 Pelvic inflammatory disease 4 Presence of an intrauterine device

3 Labor-inducing drugs are contraindicated in women who have pelvic inflammatory disease. Ovarian stimulants are contraindicated in women who have liver disease and pituitary tumors. Abortifacient drugs are contraindicated in women who have intrauterine devices.