2023 - 2024 HESI OB MATERNITY VERSION 1 AND 2 EXIT EXAM
WITH VERIFIED SOLUTIONS AND RATIONALE/A+ GRADE
1. A 38-week primigravida who works as a secretar... [Show More] y and sits at a computer for 8 hours
each day tells the nurse that her feet have begun to swell. Which instruction wouldbe
most effective in preventing pooling of blood in the lower extremities?
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 gestationin
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?
Tachycardia and a feeling of nervousness
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".
3. When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the end of the
second month.
4. When assessing a client who is at 12-weeks gestation, the nurse recommends thatshe
and her husband consider attending childbirth preparation classes. When is thebest
time for the couple to attend these classes?
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 childis an immediate concern.
5. The nurse should encourage the laboring client to begin pushing when...the
cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is completely dilatedat 10
cm (C). If pushing begins before the cervix is completely dilated the cervix
1
can become edematous and may never completely dilate, necessitating an operativedelivery.
Many primigravida’s begin active labor 100%and theneffacedproceed todilate.
6. 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?
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 befacilitated by
breathing into a paper bag or cupped hands.
7. 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...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises within thefirst
24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and the skull.
8. When does the head return to its normal
shape? 7-10 days
9. What did Nurse theorist Reva Rubin describe?
The initial postpartum period as the "taking-in phase," which is characterized by maternal
reliance on others to satisfy the needs for comfort, rest, nourishment, andcloseness to
families and the newborn.
10. A couple, concerned because the woman has not been able to conceive, is referred toa
healthcare provider for a fertility workup and a hysterosalpingography is scheduled.
Which post procedure complaint indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub diaphragmatic
collection of peritoneal dye/gas.
11. Which nursing intervention is most helpful in relieving postpartum uterine contractions
or "afterpains [Show Less]
