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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Document preview page 1

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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions)

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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 1 preview imageWhat nursing action should be implemented when intermittently gavage-feeding apreterm infant?Allow formula toflow by gravity.Avoid letting infant suck on tube.Insert feeding tube throughnares.Apply steady pressure tosyringe.RationaleGavage feeding is commonly used to feed preterm infants who are born at lessthan 32-weeks gestation, infants who weigh less than 1500 grams, or infants whoare unable to tolerate oral feedings. The feeding shouldflow by gravity (A) toavoid over-distention and a sudden sensation of fullness that may cause vomiting.Allowing the infant to suck on the tube, not (B), permits observation of the suckingresponse. The feeding tube should be inserted orally, since nasal insertion (C)impedes obligatory nose breathing and may irritate delicate nasal mucosa. (D) canresult in vomiting if the rate of administration is too fast.Aclient is receiving an oxytocin infusion for induction of labor. When the clientbegins active labor, the fetal heart rate (FHR) slows at the onset of severalcontractions with subsequent return to baseline before each contraction ends.What action should the nurse implement?Insert an internal monitordevice.Change the woman'sposition.Discontinue the oxytocin infusion.Document thefinding in the clientrecord.RationaleEarly FHR decelerations are a normalfinding during active labor that occurs due tofetal head compression, so thefinding should be documented in the client record(D). Although the client's status should be monitored continuously, this is areassuring FHR pattern, so (A, B, and C) are not indicated.The nurse is teaching a new mother about diet and breastfeeding. Whichinstruction is most important to include in the teaching plan?Avoid alcohol because it is excreted in breast milk.Avoid spicy foods to prevent infant colic.Increase caloric intake by approximately 500 calories/day.Double prenatal milk intake to improve Vitamin D transfer to the infant.RationaleAlcohol should be avoided while breastfeeding because, when consumed by themother, it is excreted in breast milk (A). It also adversely effects the milk ejectionHESI OB 2023/ 2024 EXAM QUESTIONS ANDANSWERS
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 2 preview image
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 3 preview imagereflex. While (B) may cause some gastric upset in some babies, it does not causecolic. (C) should also be included in diet teaching for a breastfeeding mother, butbecause it does not involve safety to the infant it does not have the same degreeof importance as (A). Recent research has shown that infants receive very littleVitamin D via the breastmilk and some sources recommend Vitamin Dsupplementation in exclusively breastfed babies to prevent rickets.
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 4 preview imageAn infant born at 37-weeks gestation, weighing 4.1 kg (9.02 pounds) is 2 hoursold and appears large for gestational age,flushed, and tremulous. Whatprocedure should the nurse follow to implement a glucose screening? (Arrangethe examination process fromfirst on top to last on the bottom.)Correct Answer:1.Wrap the infant's foot with a heel warmer for 5 minutes.2.Collect a spring-loaded automatic puncture device.3.Restrain the newborn's foot with your free hand.4.Cleanse puncture site on the lateral aspect of the heel.RationaleObtaining capillary blood for the glucose screening for a infant that is macrosomicand at risk for hypoglycemia should begin with wrapping the infant'sfoot with aheel warmer for 5 to 10 minutes to facilitate vasodilation to obtain an adequateblood sample volume. Next, a spring loaded automatic puncture device should beobtained to puncture the skin because it is less traumatic than a manual lancet.Then, the nurse's hand is used to restrain the foot as the puncture site on thelateral aspect of the heel is cleansed.The nurse observes a male newborn who is displaying a rigid posture with his eyestightly closed and grimacing as he is crying after an invasive procedure. Thebaby'sblood pressure is elevated on the Dinamap display. What action should the nurseimplement?Obtain a serum glucose level.Givetheinfantmedicationforpain.Feed the newborn 1 ounce off o r m u l a . R e q u e s tag e n e t i cconsultation.RationaleA cry face (or crying with the eyes squeezed or closed tightly), a rigid posture,and an increase in blood pressure are indicative of pain in the neonate, so
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 5 preview imageanalgesia should be given for pain (B). The symptoms of hypoglycemia (A) arejitteriness and mottling. The signs of hunger include rooting, tongue extrusion
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 6 preview imageand possibly crying (C). A high-pitched shrill cry is associated with neurologic andgenetic anomalies (D).The nurse assesses a high-risk neonate under a radiant warmer who has anumbilical catheter and identifies that the neonate's feet are blanched. Whatnursing action should be implemented?Place socks on infant.Elevate feet 15 degrees.Wrap feet loosely in prewarmed blanket.Reportfindings to the healthcare provider.RationaleVasoconstriction of peripheral vessels, which can seriously impair circulation, istriggered by arterial vasospasm caused by the presence of the catheter, theinfusion offluids, or the injection of medication. Blanching of the buttocks,genitalia, or the legs or feet is an indication of vasospasm and should be reportedimmediately to the healthcare provider (D). (A, B, and C) do not provide effectiveresolution of this potentially serious complications.Agravid client develops maternal hypotension following regional anesthesia.What intervention(s) should the nurse implement? (Select all that apply.)Select all that applySome correct answers were not selectedAdminister oxygen.Increase IVfluids.Perform a vaginal examination.Assist client to a sittingposition.Place the client in a lateral position.Monitor fetal status.RationaleCorrect selections are (A, B, E, and F). Oxygen (A),fluids (B), lateral position (E),and evaluating fetal response (F) effectively manage maternal hypotensionfollowing regional anesthesia. Placing the client in a sitting position (D) does notfacilitate venous return to the heart and limits perfusion of the fetus. A sterilevaginal examination (C) does not increase bloodflow and oxygenation to theplacenta and fetus.A newborn infant who is 24-hours-old is on a 4-hour feeding schedule of formula.To meet daily caloric needs, how many ounces are recommended at each feeding?2 ounces.4 ounces.1.5ounces.3.5
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 7 preview imageo u n c e s .RationaleA newborn requires approximately 19 to 21 ounces of formula each day (sixfeedings per 24-hour period x 3.5 = 21). One-and-a-half to two ounces (A and C)
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 8 preview imagemay be insufficient to meet the newborn's calorie needs. (B) may cause the infantto spit-up due to over-feeding.Aclient at 28-weeks gestation arrives at the labor and delivery unit with a complaintof bright red, painless vaginal bleeding. For which diagnostic procedure should thenurse prepare the client?Contraction stress test.Internal fetal monitoring.Abdominal ultrasound.Lecithin-sphingomyelinratio.RationaleBright red, painless vaginal bleeding occuring after 20-weeks gestation can be anindicator of placenta previa, which is confirmed by abdominal ultrasound (C). (A, Band D) are invasive procedures that increase the risk for premature onset of labor,and are not indicated at this client's gestation.Aprimigravida at 12-weeks gestation who just moved to the United States indicatesshe has not received any immunizations. Which immunization(s) shouldthe nurseadminister at this time? (Select all that apply.)Select all that applySome correct answers were not selectedTetanus.Rubella.Diphtheria.Chickenpox.HepatitisB.RationaleCorrect selections are (A, C, and E). Vaccines composed of killed viruses may beadministered during pregnancy. Rubella (B) and chickenpox (D) consist of live orattenuated live viruses which would be contraindicated during pregnancy due topotential teratogenicity.Aclient in labor receives an epidural block. What intervention should the nurseimplementfirst?Encourage oral fluids.Assess contractions.Monitor bloodpressure.Obtain a radialpulse.RationaleThe risk for maternal hypotension is commonly increased by an epidural, so bloodpressure should be monitored immediately after thefirst epidural dose (C) and for15 minutes thereafter. Oralfluids should be encouraged to help keep the clienthydrated (A), but thefirst action is to evaluate the client for side effects of theepidural block. Although (B and D) should be continuously monitored after an
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 9 preview imageepidural, thefirst objective sign of epidural precipitated vasodilation ishypotension.
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 10 preview imageA client at 8-weeks gestation ask the nurse about the risk for a congenital heartdefect (CHD) in her baby. Which response best explains when a CHD may occur?It depends on what the causative factors are for aCHD.We don't really know what or when CHDs occur.They usually occur in the first trimester of pregnancy.The heart develops in the third tofifth weeks after conception.RationaleThe cardiovascular system is thefirst organ system to develop and function in theembryo. The blood vessel and blood formation begin in the third week, and theheart is developmentally complete in thefifth week (D). Regardless of theetiological factor, the heart is vulnerable during its period of development -- thethird tofifth weeks. (A, B, and C) are inaccurate.Aprimigravida at 12-weeks gestation tells the nurse that she does not like diaryproducts. Which food should the nurse recommend to increase the client's calciumintake?Canned clams.Fresh apricots.Canned sardines.Spaghetti with meatsauce.RationaleA 3 ounce can of sardines (with bones) provides about the same amount ofcalciumas 1 cup of milk (C). (A, B, and D) are not good sources for dietary calcium.When discussing birth in a home setting with a group of pregnant women, whichsituation should the nurse include about the safety of a home birth?Onlythewomanandhermidwifeshouldbepresentduringthedelivery. The woman should live no more than 15 minutes from thehospital.The woman's extended family should be allowed to attend the homebirth.Medicalbackupshouldbeavailablequicklyincaseofcomplications.RationaleAccess to quick emergency care should be available in the event that anunforeseen complication arises (D) during a home birth. Although the nurse-midwife should be a competent healthcare provider during a home birth (A),access to emergency, surgical, and resuscitation assistance should be readilyavailable. A 15-minute drive to the hospital is ideal, but (B) does not ensure thesafest situation. The presence and support of family during the home birth (C)does not necessarily ensure a safe home birth.
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 11 preview imageWhich statement by a client who is pregnant indicates to the nurse anunderstandingof the role of protein during pregnancy?
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 12 preview image"Protein helps the fetus grow while I ampregnant.""Gestational diabetes is prevented byeating protein." "Anemia is averted by consumingenough protein." "My baby will develop strong teethafter he is born." RationaleAdequate protein intake is essential to meet increasing demands of rapid growthof the fetus (A) and maternal changes during pregnancy, such as enlargement ofthe uterus, mammary glands, and placenta, increase in the maternal blood volume,and formation of amnioticfluid. Protein is essential for anabolism, but itsconsumption does not prevent gestational diabetes (B). Iron found in high proteinfoods, such as meat, helps prevent anemia (C), but the basic need for protein is theanabolic growth processes of the fetus. Although calcium is needed for fetal boneand teeth development (D), it is not found in all protein food sources.The nurse is assessing a full-term newborn’s breathing pattern. Whichfindingsshould the nurse assess further? (Select all that apply.)Select all that applyShallow with an irregular rhythm.Chest breathing with nasalflaring.Diaphragmatic with chest retraction.Abdominal with synchronous chestmovements.Heart rate of 158 beats perminute.Grunting heard with a stethoscope.RationaleBreathing with nasalflaring, diaphragmatic breathing with chest retraction, andgrunting are signs of respiratory distress in the infant.Aclient is experiencing "back" labor and complains of intense pain in the lowerlumbar-sacral area. What action should the nurse implement?Perform effleurage on the abdomen.Encourage pant-blow breathing techniques.Apply counter pressure against the sacrum.Assist the client in guided imagery.RationaleCounter pressure against the sacrum (C) during contractions often providessignificant relief for "back labor," which results from occipital posterior position.Effleurage (A) is a helpful distraction strategy many clients use during contractionsbut does not assist with lower back pain. Back labor can occur throughout labor ifthe fetus does not rotate, and helpful distractions, such as (B),used duringtransition, and (D), used during phase one of labor, are not effective for back labor.A client at 28-weeks gestation experiences blunt abdominal trauma. Whichparameter should the nurse assessfirst for signs of internal hemorrhage?Vaginal bleeding.Complaints of abdominal pain.Changes in fetal heart rate
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 13 preview imagepatterns.Alteration in maternal bloodpressure. Rationale
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 14 preview imageHypoperfusion of the fetus may be present before the onset of clinical signs ofmaternal compromise or shock in a pregnant woman, so the external fetal monitortracings should be assessedfirst to determine signs of fetal hypoxia due tointernal bleeding in the mother. (A, B, and D) are not thefirstfindings of internalhemorrhage in the pregnant client.Which prescription should the nurse administer to a newborn to reducecomplications related to birth trauma?Silver nitrate.Erythromycin (Ilotycinointment).Ceftriaxone(Rocephin).Vitamin K (AquaMEPHYTON).RationaleThe normal neonate is vitamin K deficient, so to rapidly elevate prothrombin levelsand reduce the risk of neonatal bleeding, newborns receive a single injection ofvitamin K (AquaMEPHYTON) (D). (A and B) are prophylactic ophthalmic agentsused to prevent neonatal ophthalmia. (C) is an antibiotic used to treat neonatalinfections.Amultiparous client has been in labor for 8 hours when her membranes rupture.What action should the nurse implementfirst?Prepare the client for imminent birth.Assess the fetal heart rate andpattern.Document the characteristics ofthe fluid.Notify the client's primary healthcareprovider.RationaleThe fetal heart rate and pattern should be assessed (B) to determine compromiseof fetal well-being caused by compression or prolapse of the umbilical cord. Theintensity and frequency of the uterine contractions often trigger spontaneousrupture of the membranes (SROM), which does not indicate that birth is imminent(A). The healthcare provider should be notified of the client and fetal well-beingafter evaluation of SROM. Although the characteristics of the amnioticfluid shouldbe documented (C), assessment of fetal response to the SROM is the priority.The nurse is teaching a primigravida at 10-weeks gestation about the need toincrease her intake of folic acid. Which explanation should the nurse provide thatsupports preventative perinatal care?The risk for neonatal cerebral palsy increases with folic acid deficiencies duringpregnancy.Folic acid can significantly reduce the incidence of mental retardation.Adequate folic acid during embryogenesis reduces the incidence of neural tubedefects.The incidence of congenital heart defects is related to folic acid intake deficiencies.
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 15 preview imageRationaleFolic acid can significantly reduce neural tube defects (C) if taken during earlypregnancy. (A, B, or D) are not valid explanations.
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2023-2024 HESI Maternity OB Practice Exam With Answers (108 Solved Questions) - Page 16 preview imageThe nurse is preparing to gavage feed a preterm infant who is receiving IVantibiotics. The infant expels a bloody stool. What nursing action should thenurseimplement?Institute contact precautions.Obtain a rectal temperature.Assess for abdominal distention.Decrease the amount of thefeeding.RationaleEtiological factors playing an important role in the development of necrotizingenterocolitis (NEC), a complication common in premature infants, include intestinalischemia, colonization by pathogenic bacteria, and substrate (formula feeding) inthe intestinal lumen. Bloody stools, abdominal distention, diarrhea, and biliousvomitus are signs of NEC. Nursing responsibilities include measuringthe abdomen(C) and listening for bowel sounds. Contact precautions (A) are necessary if acontagious gastrointestinal infection is suspected. Rectal temperatures arecontraindicated (B) because of the risk for perforation of the bowel. Oral orgavage feeding is stopped, not (D), until necrotizing enterocolitis isruled out.Aclient in active labor at 39-weeks gestation tells the nurse she feels a wet sensationon the perineum. The nurse notices pale, straw-coloredfluid with smallwhiteparticles. After reviewing the fetal monitor strip for fetal distress, what actionshould the nurse implement?Escort the client to thebathroom.Offer the client a bedpan.Perform a nitrazinetest.Clean the perinealarea. RationaleThe normal characteristic of amnioticfluid is pale, straw-coloredfluid, which maycontain whiteflecks of vernix, with an alkaline pH, so (C) should be done toconfirm the pH of thefluid. (A or B) may be indicated if thefluid is urine. (D)should be done after determining the type offluid expelled.The nurse is providing discharge teaching for a gravid client who is being releasedfrom the hospital after placement of cerclage. Which instruction is the mostimportant for the client to understand?Plan for a possible cesarean birth.Arrange for home uterinemonitoring. Make arrangements forcare at home.Report uterine cramping or low backache.RationaleUterine cramping and low back pain (D) are symptoms of preterm labor and
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