HESI Maternity Case Study Practice Test

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• A pregnant client with a history of ectopic pregnancy asks about the risk of tubal pregnancy again. What is the best nurse response?
• Which nursing diagnosis is most appropriate as a priority for a pregnant patient with reduced fluid intake and signs of dehydration?
• In response to the order for Stadol (butorphanol tartrate) for Susan, which action is indicated?
• Using Naegele's rule, what is the estimated due date if the last menstrual period began on July 20?
• What action is most important to implement immediately when a postpartum patient is disoriented and found lying in a pool of vaginal blood?
• In breech presentation, where is the fetal heart rate best heard?
• A laboring client is 3 centimeters dilated and 75% effaced. Which information is most important to obtain next to assess labor status?
• In total placenta previa, which finding requires immediate reporting to the healthcare provider?
• Which physical finding is most consistent with a postmature newborn?
• Normal full-term AGA newborn weight range?
• A nurse detects a fetal heart rate of 175 beats per minute with decreased variability and late decelerations. What action should be taken first?
• Which symptom is typically associated with hyperemesis gravidarum during assessment?
• A client in active labor presents with dark red vaginal bleeding and a uterus tense between contractions. The nurse should prioritize which intervention?
• What is a normal bilirubin range for a newborn?
• In a woman with heart disease in the second stage of labor, which assessment findings are of greatest concern?
• In response to a late deceleration during labor, which action should be carried out FIRST?
• Which statement about enhancing iron absorption is correct?
• Which finding would indicate magnesium sulfate toxicity?
• In the late active phase of labor, a multigravida requests opioids; which nurse response is best?
• Magnesium sulfate is used to prevent seizures in pregnancy-induced hypertension.
• Which feature most strongly suggests true labor contractions rather than Braxton Hicks?
• Fetal bradycardia defined as baseline FHR for more than 10 minutes?
• How long does a newborn typically feed on each breast?
• Physiologic anemia of pregnancy occurs because of which change in blood volume?
• The frontal-occipital circumference (FOC) of a full-term newborn is typically within which range?
• Which length would be within the normal full-term AGA range?
• Where is the tocodynamometer placed to monitor contractions externally?
• In latent labor, sedatives may be prescribed to help the patient rest. Which statement best describes this practice?
• Ovulation occurs how many days before the first day of the menstrual period?
• Which action is recommended to help manage morning sickness?
• What is the purpose of administering vitamin K to newborns?
• Vitamin K prophylaxis in newborns is given to prevent bleeding problems in the early neonatal period. Which statement best reflects this purpose?
• What does variability indirectly indicate?
• A 40-week gestation primigravida is being induced with Pitocin and reports lower back pain. Which intervention should the nurse implement?
• You apply erythromycin ophthalmic ointment to the newborn's eyes to:
• At 28 weeks' gestation, for constipation, what action is recommended?
• Which statement about managing heartburn (pyrosis) in pregnancy indicates a need for additional teaching?
• How many arteries and veins are in the umbilical cord?
• Which sign is most consistent with abruptio placentae?
• Zero station is achieved when the presenting part is at which anatomical landmark?
• A client is receiving epidural anesthesia and develops nausea and becomes pale and clammy. The nurse should take which action first?
• In the immediate postpartum period, an IV infusion rate of 125 mL/hour may contribute to which physiologic change?
• Which intervention is recommended in the management of hyperemesis gravidarum?
• Prostaglandin levels increase late in pregnancy secondary to elevated which hormone?
• In the first 12 hours postpartum, the fundus should be located how relative to the umbilicus?
• Which hormone's release by the pituitary is associated with the onset of labor?
• A pregnant client with severe preeclampsia is started on IV magnesium sulfate and has a serum magnesium level of 15 mEq/L. Which manifestation is expected?
• Which statement describes the purpose of providing eye prophylaxis to all newborns?
• What is the normal range for serum sodium during pregnancy?
• Effacement refers to which cervical change?
• Which statement regarding phototherapy is correct for discharge planning?
• A laboring client with preeclampsia: which assessment finding is most significant for planning care?
• Total placenta previa is defined as the placenta covering which anatomical area?
• Which statement about placental abruption bleeding is true?
• Bleeding in placental abruption may be concealed despite heavy internal bleeding.
• Which symptom is listed as a danger sign requiring immediate attention during pregnancy in the second trimester?
• A client in latent labor for about 12 hours requests rest; which medication is most likely prescribed to help her rest?
• Which fetal heart rate pattern is most concerning during labor?
• A newborn has a reddish papular rash across his face. Which statement best describes this rash to the client?
• To manage venous issues in pregnancy, stockings should have which labeling?
• Which condition may require continued treatment during pregnancy?
• Before initiating terbutaline (Brethine) for preterm labor, the nurse should assess for which condition?
• Which statement best defines abortion in pregnancy?
• Why would Stadol (butorphanol tartrate) not be given if Susan is within one hour of delivery?
• A BMI of 23 in pregnancy is considered what weight category?
• In the second and third trimesters, a pregnant client with a healthy BMI is advised to increase daily calorie intake by how many calories above pre-pregnancy intake?
• Which fontanel is located at the back of the newborn skull and closes by 8 - 12 weeks?
• During epidural anesthesia in labor, what is a priority nursing intervention?
• Which factor best explains why the supine position should be avoided during labor?
• Which statement about iron supplementation is correct?
• Normal full-term AGA newborn length range?
• What is the most important aspect of fetal heart rate monitoring?
• For suspected peripheral venous thrombosis in pregnancy, which intervention is typically prescribed?
• After the fundus is massaged and help has been summoned, which assessment is most important to perform immediately?
• Which activity is believed to help alleviate venous pooling and varicose veins in pregnancy?
• Which sign would most clearly indicate magnesium sulfate toxicity in a laboring patient?
• Which fetal heart rate pattern is most concerning and signals fetal compromise?
• On the tenth day postpartum, lochia color is typically observed as which color?
• What is the typical heart rate range for a newborn infant?
• In preeclampsia, a 4+ patellar reflex indicates risk of which complication?
• What is the normal range for the blood urea nitrogen (BUN) level in most adults?
• During labor, late decelerations are noted. Arrange the following actions in the correct order (first to last).
• Which finding may indicate postmaturity in a newborn?
• Which condition is most concerning given persistent nausea and vomiting with weight loss and signs of dehydration in a pregnant client at 18 weeks?
• What is the cardinal rule regarding medications and herbal remedies during pregnancy?
• Occurrence of which event makes maternal breathing easier?
• Tachycardia in a fetus can be an early sign of which condition?
• Which statement about fetal heart rate variability is true?
• A 28-week pregnant patient with bright red vaginal bleeding and no uterine contractions should be instructed to which of the following?
• How often should a woman in the early second trimester return for a follow-up visit?
• In the context of the five Ps of labor, what does 'psych' refer to?
• Which statement describes Braxton Hicks contractions?
• By the 32nd week of gestation, approximately how much does the maternal blood volume increase?
• Which statement is true regarding caput succedaneum and cephalohematoma in newborns?
• Which sign requires immediate attention in the second trimester of pregnancy?
• Alpha fetoprotein testing in pregnancy is used to screen for which condition?
• You perform a sterile vaginal exam and determine Susan is 5-6 cm dilated, 100% effaced, and the fetus is at zero station. You determine that Susan is now in which phase of stage one labor?
• A soft swelling of the scalp that extends across the suture lines in a newborn is called what?
• Which factor is listed as a contributor to the onset of labor?
• When is the vitamin K shot given to newborns?
• What is the purpose of the maternal blood volume increase during pregnancy?
• Which statement indicates correct information about breaking suction during breastfeeding?
• In pregnancy for a client with a low BMI, what is the safe weight gain?
• A gravida 2 para 1 at 26 weeks with preterm labor is treated with terbutaline. Which assessment is highest priority to monitor during administration?
• Fetal station is measured relative to which pelvic landmark?
• Which hormone stimulates milk production?
• Which sign would prompt immediate evaluation for placental abruption?
• What is the first cardinal movement of labor?
• Which term describes the dilution of blood due to increased plasma volume during pregnancy?
• Estrogen rise in late pregnancy promotes production of what substances to prepare for labor?
• Hyperemesis gravidarum is best defined as?
• A fetal position notation LSA indicates which part presenting?
• During the first assessment on the postpartum unit, where would the nurse palpate the fundus?
• A rubella titer result is less than 1:8 at an initial prenatal visit. Which statement best describes what this means?
• During labor, which temperature change is expected?
• What action should be taken if contractions exceed 6 times per hour and last longer than 30 seconds?
• Which diagnostic test should be used to evaluate fetal status when a 41-week gestation NST shows potential difficulties?
• Which procedure would not be anticipated as part of genetic studies in a high-risk pregnancy?
• What is the normal fetal heart rate range for a healthy fetus around term?
• A rubella titer showing a greatly increased level over a previous reading indicates what?
• Which factor should alert the nurse to assess for the risk of jaundice?
• For an amniotomy during active labor, which item should be available at the bedside to perform the procedure safely?
• Erythema toxicum in newborns typically resolves by which day?
• Promethazine is effective when the patient demonstrates which finding?
• During the active stage of labor, the cervix is typically dilating between which values?
• Which of the following is NOT a typical contributor to fetal tachycardia?
• Which symptom is most characteristic of abruptio placentae?
• Which phase of stage one labor is associated with cervix dilation of 8 to 10 cm?
• What is the diagonal conjugate in obstetrics?
• What is the normal duration for closure of the posterior fontanel in a newborn?
• Which hormone is responsible for milk ejection (let-down)?
• At the next assessment, Susan's uterus is midline. The fundus feels boggy at one fingerbreadth below the umbilicus. What should you do first?
• Methergine is contraindicated in patients with which condition?
• In a cephalic presentation, where is the fetal heart rate best heard?
• Which action is the sixth cardinal movement in labor?
• Which statement about breastfeeding advantages is accurate?
• A client at 32 weeks gestation with severe PIH is treated with magnesium sulfate. Which assessment finding indicates a therapeutic drug level has been achieved?
• For an amniotomy, which item is not required at the bedside?
• After the placenta has been expelled, Pitocin (oxytocin) is started at a concentration of 10 units in 1000 mL Lactated Ringer's. You know this is given at this time to:
• During pregnancy, the change in hematocrit is due to which of the following?
• Which description best characterizes true contractions?
• Braxton Hicks contractions bring about oxytocin sensitivity.
• At 18 weeks' gestation, which finding is typically documented during a routine prenatal visit?
• Which parameter is most useful for assessing fetal oxygenation during labor?
• Which of the following weights would be considered within the normal full-term AGA range?
• In assessment of a fetus with occiput presentation, where should the ultrasound transducer be placed on the abdomen?
• The end of stage one occurs when the cervix is fully dilated. Which option represents this?
• Which imaging modality confirms placenta previa?
• Which maternal behavior is most consistent with early bonding when a newborn is presented to the mother?
• Which statement about smoking cessation during pregnancy best communicates the benefits?
• Which finding is most consistent with placental abruption?
• Which finding would indicate magnesium sulfate toxicity rather than a therapeutic effect?
• Which newborn finding is consistent with a postmature infant?
• You perform a vaginal exam to check for shortening and thinning of the cervix. This is called _______________
• Engagement in labor refers to which description?
• A primigravida at term is receiving oxytocin (Pitocin) to augment labor. Which adverse effect is the nurse most concerned about?
• Gestational diabetes is associated with elevated blood glucose levels. Which option best reflects this?
• From 37 weeks of gestation to birth, how often are follow-up visits typically scheduled?
• For an autosomal dominant inherited disorder, what is the risk to each pregnancy?
• What term describes the gradual reduction in size of the uterus after delivery as it contracts to return to its normal size?
• Which maternal physiologic change is NOT expected during labor?
• During magnesium sulfate therapy, which finding indicates possible toxicity?
• If a newborn's temperature is below 97.7°F, what action is appropriate?
• Which laboratory finding would be considered normal in labor?
• Which statement about nipple care during breastfeeding is correct?
• During growth spurts, which nursing pattern is typically observed?
• Which vaccine is contraindicated in pregnancy due to its live-virus composition?
• A postpartum patient is prescribed Methergine 0.2 mg IM for uterine atony, but her blood pressure is 156/96. What action should the nurse take?
• Braxton Hicks contractions move the cervix from which position to which position?
• Lubricants can affect fertility. Which statement is accurate?
• Placental previa bleeding is typically described as which of the following?
• What does variability indicate?
• Which is the most likely cause of hemorrhage in a postpartum patient with a boggy uterus?
• A normal hematocrit range during pregnancy is which of the following?
• Which of the following is a sign that labor may be starting?
• Which statement best describes postpartum blues?
• Terbutaline increases maternal glucose levels; which statement best describes this effect?
• During late pregnancy (29-36 weeks), how often are routine follow-up visits scheduled?
• What is the normal temperature range for a newborn?
• A laboring patient is at -1 station. This indicates the fetus is:
• Which statement best describes the Biophysical Profile (BPP) in fetal assessment?
• In the context of hyperemesis gravidarum, a weight loss of 3 pounds in two days typically indicates dehydration and necessitates what initial action?
• A pregnant woman with pica who ingests lead paint may put the fetus at risk for what outcome?
• Which FOC range is typical for a normal full-term newborn?
• Which fetal heart rate reading is within a normal range for a term fetus?
• Which definition corresponds to fetal tachycardia?
• If contractions become hyperstimulation during Pitocin augmentation and fetal tracing worsens, what should the nurse do?
• Which statement about a distended bladder during labor is NOT true?
• Zero station means that:
• Terbutaline tocolytic to treat preterm labor acts by stimulating which receptor to cause uterine relaxation?
• Which term is NOT part of the five Ps of labor?
• What is the third cardinal movement in labor?
• Which of the following lists represents the five Ps of labor?