HESI Obstetrics and Maternity Assignment Practice Exam

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• A client delivers her first infant and asks the nurse if her skin changes from pregnancy are permanent. Which change should the nurse tell the client will remain after pregnancy?
• A multiparous patient is bleeding 2 hours after vaginal delivery. What action should the nurse implement next?
• Which labor stage is characterized by complete dilation (10 cm) and the onset of pushing?
• A neonate receiving an exchange transfusion develops respiratory distress, tachycardia, and a cutaneous rash. What nursing intervention should be implemented first?
• Which nonpharmacologic interventions are most effective for decreasing procedural pain in a neonate?
• What respiratory support method is used for a newborn with poor tone and apnea at birth during resuscitation guidelines?
• Which client finding should the nurse document as a positive sign of pregnancy?
• Which obstetric condition is defined by new-onset hypertension after 20 weeks gestation with proteinuria or end-organ dysfunction?
• Which prescription should the nurse administer to a newborn to reduce complications related to birth trauma?
• A client in active labor at 39-weeks gestation tells the nurse she feels a wet sensation on the perineum. The nurse notes pale, straw-colored fluid with small white particles. After reviewing the fetal monitor strip for fetal distress, what action should the nurse implement?
• A client in her second trimester asks if it is safe to have a drink with dinner. How should the nurse respond?
• Which of the following best describes Category II fetal tracing?
• Which medication is commonly used as a uterotonic to prevent postpartum hemorrhage after delivery?
• A client at 25-weeks gestation tells the nurse that she dropped a cooking utensil last week and her baby jumped in response to the noise. What information should the nurse provide?
• Which test is used to assess fetal well-being by measuring fetal heart rate accelerations in response to fetal movement?
• Which of the following statements would NOT support eligibility for VBAC?
• In the GTPAL designation 4-1-2-0-3, how many term births has the patient had?
• A 31-year-old woman uses an over-the-counter (OTC) pregnancy test that is positive one week after a missed period. She is taking phenytoin for epilepsy. How should the nurse explain the most likely cause for obtaining false-positive results?
• The father of a newborn tells the nurse, the baby just died. How should the nurse respond?
• A Rh-negative pregnant patient with partner of unknown Rh status would typically receive Rh immune globulin prophylaxis at which times if the newborn is Rh-positive?
• Which statement is true regarding prevention of neural tube defects through maternal nutrition?
• Which condition is a contraindication to the use of methylergonovine (Methergine) for postpartum hemorrhage?
• What is the appropriate approach to support bonding when a baby is stillborn?
• Which perineal care statement is not recommended for a client who is 24 hours postpartum?
• The nurse is preparing to gavage feed a preterm infant who is receiving IV antibiotics. The infant expels a bloody stool. What nursing action should the nurse implement?
• In the presence of suspected placental abruption with heavy bleeding, what is the immediate priority?
• A client in labor receives an epidural block. What intervention should the nurse implement first?
• During labor, which action is most appropriate when the umbilical cord is seen protruding from the vagina and the membranes have ruptured?
• Which finding on fetal monitoring would be considered nonreassuring and place tracing in Category III?
• In early pregnancy, which hormones are secreted by the placenta to support the pregnancy?
• What is the rationale for administering magnesium sulfate in preeclampsia/eclampsia management?
• Newborn screening for metabolic disorders is typically performed using which method?
• The nurse is teaching a primigravida at 10-weeks gestation about the need to increase her intake of folic acid. Which explanation should the nurse provide that supports preventative perinatal care?
• Which scar type is considered safer for VBAC eligibility?
• A client is receiving an oxytocin infusion for induction of labor. When the client begins active labor, the fetal heart rate slows at the onset of several contractions with subsequent return to baseline before each contraction ends. What action should the nurse implement?
• Which newborn condition is commonly treated with phototherapy?
• Two contraindications to breastfeeding in the postpartum period.
• Which vaccination is routinely recommended during pregnancy to protect the newborn from pertussis?
• Which scenario would indicate that home birth with a midwife is not appropriate and hospital care is required?
• When assessing a 24-hour-old newborn, a pink papular rash with vesicles on the trunk is observed. What action is appropriate?
• A new mother avoids eye contact with her newborn. Which action should the nurse take?
• If late decelerations persist after initial actions, what is the recommended step?
• Which maternal complication requires monitoring after initiating an epidural analgesia?
• A client in the first stage of active labor is using a shallow pattern of rapid breaths that is twice the normal adult breathing rate. The client complains of feeling light-headed, dizzy, and states that her fingers are tingling. What action should the nurse implement?
• A client at 28-weeks gestation is concerned about her weight gain of 17 pounds. What information should the nurse provide this client?
• What screening test is commonly used for gestational diabetes between 24-28 weeks, and what follow-up test is used if positive?
• A client with asthma 8 hours post-delivery is experiencing postpartum hemorrhage. Which prescription should the nurse administer?
• What action should the nurse implement when caring for a newborn receiving phototherapy?
• Which statement about cephalohematoma is true?
• Which cardiovascular finding should the nurse assess further in a client who is at 20-weeks gestation?
• During labor with an oxytocin infusion, a slowing of the fetal heart rate occurs at the onset of contractions with return to baseline before the end of each contraction. Which action should be taken after monitoring this finding?
• A multiparous client who delivered an 8-lb 7-oz infant 4 hours ago has a completely saturated perineal pad within 15 minutes. What action should the nurse implement next?
• The nurse administers meperidine to a laboring client, who delivers 90 minutes later. What medication should the nurse anticipate administering to the infant?
• Which communication best demonstrates support for a patient experiencing perinatal loss?
• During labor, a patient experiences maternal hypotension after regional anesthesia. Which action is most appropriate to improve maternal status?
• Which device is used to monitor intrauterine pressure during labor?
• Which gastrointestinal finding at 28 weeks gestation should alert the nurse to a potential concern?
• Which statement correctly describes effacement in labor?
• A client in early labor is having uterine contractions every 3 to 4 minutes, lasting 55 to 60 seconds. An IUPC is inserted. The intrauterine pressure is 65 to 70 mm Hg at the peak of a contraction and the resting tone is 6 to 10 mm Hg. Based on this information, what action should the nurse implement?
• An infant with hyperbilirubinaemia is receiving phototherapy. What intervention should the nurse implement?
• Where are Mongolian spots most commonly located in newborns?
• In fetal monitoring, which statement correctly describes Category I tracing?
• The nurse notes a pattern of the fetal heart rate decreasing after each contraction. What action should the nurse implement?
• A client at 8-weeks gestation asks about the risk for a congenital heart defect (CHD) in her baby. Which response best explains when a CHD may occur?
• In a newborn assessment, which finding requires documentation rather than treatment?
• Which of the following best describes the initial assessment priorities after a cesarean delivery?
• Identify two priority nursing assessments for a patient undergoing a cesarean delivery.
• During early active labor, a patient demonstrates rapid shallow breathing and paresthesias. What should the nurse do?
• The nurse assesses a male newborn with axillary temperature 95.1 F, heart rate 136 bpm, and respiratory rate 48 breaths/min. Based on these findings, which action should the nurse take first?
• Which statement about the intrauterine pressure catheter readings is true given peak pressures of 65–70 mm Hg and resting tone of 6–10 mm Hg?
• While monitoring a client in active labor, the nurse observes a pattern of a 15-beat increases in the fetal heart rate that lasts 15 to 20 seconds and returns to baseline. Which information should the nurse report during shift change?
• If a fetal heart rate pattern shows decelerations after contractions, what is the initial intervention?
• If a mother refuses a newborn vitamin K injection, which response demonstrates patient-centered communication?
• Which statement best explains fetal hearing and maternal voice interactions in utero?
• A postpartum mother with a unilateral breast infection asks about continuing breastfeeding. What is the recommended plan?
• What fetal monitoring category indicates a normal antepartum fetal tracing with no signs of fetal distress?
• What is a normal approximate newborn respiratory rate range that a nurse should expect at birth?
• Name two common causes of nonreassuring fetal status during labor.
• For a pregnant patient with diabetes, what is a common target fasting blood glucose during pregnancy to reduce fetal risk?
• A pregnant client asks about delivering at home with a midwife. Which statement reflects an appropriate eligibility criterion for home birth?
• Which of the following best describes Category III fetal tracing features?
• What action should the nurse implement to prevent conductive heat loss in a newborn?
• While inspecting a newborn's head, the nurse identifies a swelling of the scalp that does not cross the suture line. Which finding should the nurse document?
• During labor augmentation with oxytocin, which finding indicates the infusion should be discontinued?
• Which statement accurately describes dilation and effacement in labor?
• Which action is appropriate during phototherapy to protect the newborn's eyes?
• Which action should the nurse implement when caring for a newborn immediately after birth?
• In the postpartum period, what assessment finding indicates uterine atony requiring intervention?
• A client comes in to the clinic for her six week postpartum check up and complains that her left breast is eythematous and painful. The client asks, "Can I still breastfeed my baby?" What is the best response for the nurse to provide?
• A macrosomic infant (4550 g) is stable after a difficult forceps delivery. What is the priority nursing action?
• Which statement best reflects the most important instruction to include in breastfeeding diet teaching?
• The postpartum period is defined as the first six weeks after birth.
• Which antibiotic is commonly used intrapartum for GBS prophylaxis in most cases?
• Which postpartum skin change is permanent after pregnancy?
• In a newborn who appears to be in pain after an invasive procedure, what is the most appropriate nursing action?
• Postpartum assessment should recognize that a full bladder most directly contributes to which uterine finding?
• Which tracing category indicates a normal fetal tracing with no distress?
• A preterm infant with an apnea monitor experiences an apneic episode. Which action should the nurse implement first?
• If electronic fetal monitoring shows recurrent late decelerations and reduced variability, what is the immediate priority?
• Which diagnostic study is most informative for evaluating fetal anatomy and placental function in a gestation around 29 weeks?
• Which statement best explains the rationale for folic acid supplementation in early pregnancy?
• What is the Apgar score used for, and at which two time points is it typically measured?
• The nurse is teaching a new mother about diet and breastfeeding. Which instruction is most important to include in the teaching plan?
• The apnea monitor alarm sounds for the third time during one shift for a neonate who was delivered at 37-weeks gestation. What nursing action should be implemented first?
• In the GTPAL designation 4-1-2-0-3, how many living children does the patient have?
• 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?
• A 37-week newborn weighing 4.1 kg (9.02 lb) is 2 hours old and appears large for gestational age, flushed, and tremulous. What procedure should the nurse follow to implement a glucose screening? Arrange the steps from first on top to last on the bottom.
• Using the GTPAL system, which designation is the most accurate summary of this client's obstetrical history (4 pregnancies; 1 term birth; 2 preterm births; 0 abortions; 3 living children)?
• Which analgesic is associated with potential neonatal respiratory depression and is used cautiously in labor?
• A multigravida client at 35-weeks gestation is diagnosed with pregnancy-induced hypertension (PIH). Which symptom should the nurse instruct the client to report immediately?
• Which test is used to evaluate fetal well-being by observing fetal heart rate in response to fetal movement over a period without contractions?
• Which action is most important for the nurse to implement for a client at 36-weeks gestation who is admitted with vaginal bleeding?
• Why are oral contraceptives recommended for 12 months after suction curettage for hydatidiform mole?
• A woman, whose pregnancy is confirmed, asks the nurse what the function of the placenta is in early pregnancy. What information supports the explanation that the placenta secretes hormones in early pregnancy?
• A laboring client with back labor complains of intense pain in the lower lumbar-sacral area. What action should the nurse implement?
• Which scalp swelling crosses the suture lines?
• Which sign is typically associated with the onset of labor?
• Which finding indicates to the nurse that a 4-day-old infant is receiving adequate breast milk?
• A multiparous client is postpartum after rapid labor and birth. The fundus is boggy, lochia is heavy, and vital signs are unchanged. After voiding and uterine massage, the fundus remains difficult to locate and lochia remains heavy. What action should the nurse implement next?
• Which of the following best describes factors that influence eligibility for TOLAC and VBAC?
• Which practice best supports immediate initiation of breastfeeding after birth?
• Name two signs of magnesium sulfate toxicity to monitor for in the mother.
• Which behavior should the nurse anticipate for a new mother with an uncomplicated vaginal birth on the third postpartum day?
• Which client should be flagged for risk of postpartum hemorrhage?
• Which statement about phototherapy is correct?
• Which medication is commonly used as a first-line uterotonic in the postpartum period to treat hemorrhage?
• Which of the following prophylaxis is routinely administered to a newborn after birth to prevent hemorrhagic disease of the newborn?
• A primigravida at 12-weeks gestation tells the nurse that she does not like diary products. Which food should the nurse recommend to increase the client's calcium intake?
• What is the term for the first six weeks after birth, during which major physiologic changes occur?
• What screening is used after birth to detect inborn errors of metabolism?
• A client delivers twins, one stillborn; the other is recovering in the NICU. The client softly cries, “I wish my baby could have lived.” Which nursing response is the most supportive?
• Which newborn vital signs are considered normal immediately after birth, and which ranges would indicate distress for heart rate and respiratory rate?
• During insertion of a pulmonary artery catheter in a client at 32 weeks with severe preeclampsia and pulmonary edema, what is the priority nursing assessment when the catheter enters the right ventricle?
• When should Rh immune globulin be given to an Rh-negative mother after delivery of an Rh-positive infant?
• Which medication is typically first-line for severe hypertension in pregnancy?
• 72 hours after delivery, a bottle-feeding mother reports both breasts are swollen, warm, and tender. Which instruction should the nurse give?
• The nurse observes a male newborn who is displaying a rigid posture with his eyes tightly closed and grimacing as he is crying after an invasive procedure. The baby's blood pressure is elevated on the Dinamap display. What action should the nurse implement?
• Which statement by a client who is pregnant indicates to the nurse an understanding of the role of protein during pregnancy?
• Which statement best describes the timing of intrapartum antibiotic prophylaxis for GBS?
• Which statement best differentiates caput succedaneum from cephalohematoma?
• A preterm infant on gavage feeds with a bloody stool presents for assessment. Which action is appropriate?
• Which finding in a newborn's scalp is described as diffuse edema crossing the suture lines?
• Which analgesia is commonly used for labor and has potential maternal hypotension and fetal heart rate changes requiring monitoring?
• A newborn infant is jaundiced due to Rh incompatibility. Which finding is most important for the nurse to report to the healthcare provider?
• What is the most important technique when assessing a newborn's heart rate?
• A primigravida at 37-weeks gestation tells the nurse that her "bag-of-water" has broken. While inspecting the client's perineum, the nurse notes the umbilical cord protruding from the vagina. What action should the nurse implement first?
• A client at 35-weeks gestation visits the clinic for a prenatal check-up. Which complaint by the client warrants further assessment by the nurse?
• Which information should the nurse include about perineal self-care for a client who is 24-hours post delivery?
• Name two risk factors for placental insufficiency or fetal growth restriction in the context of hypertensive disorders.
• A macrosomic newborn is at risk for which immediate complication requiring frequent monitoring after birth?
• What nursing action is essential after birth to promote infant respiration if apneic?
• A pregnant patient on anticonvulsant therapy presents a positive home pregnancy test; which factor is most likely responsible for this false-positive result?
• Which factor contributes to a newborn's greater risk of heat loss after birth?
• Following chorionic villus sampling, which finding requires immediate intervention?
• The nurse tells a client in her first trimester to increase her daily intake of calcium to 1,200 mg during pregnancy. The client dislikes milk. Which dietary adjustment should be recommended?
• In labor, when is intrapartum antibiotics recommended for GBS during labor?
• Why is it important to keep a newborn warm in the immediate period after birth?
• A newborn is at risk for opioid exposure due to maternal analgesia during labor. Which medication should the nurse anticipate administering to the newborn?
• The nurse assesses a high-risk neonate under a radiant warmer who has an umbilical catheter and identifies that the neonate's feet are blanched. What nursing action should be implemented?
• A multigravida client at 40+ weeks gestation is induced with oxytocin. An intrauterine pressure catheter (IUPC) is in place when the membranes rupture after 5 hours of active labor. Which finding should require the nurse to implement further action?
• A client at 29-weeks gestation with possible placental insufficiency is being prepared for prenatal testing. Which diagnostic study should the nurse provide information about?
• Intrapartum antibiotic prophylaxis for GBS is given in which scenario?
• Rh immune globulin (RhIg) prophylaxis is given at 28 weeks and postpartum if the newborn is Rh-positive. Which option reflects this timing?
• Apgar scoring is used to assess newborn adaptation. Which option describes this purpose?
• What condition involves placental detachment from the uterus before birth and is a medical emergency?
• Which statement about protein in pregnancy is correct?
• Which of the following is a sign that would prompt immediate resuscitation with ventilation for a newborn?
• During active labor, a nurse observes V-shaped decelerations in the fetal heart rate that align with the peak of contractions. What action should be taken?
• A multiparous client has been in labor for 8 hours when her membranes rupture. What action should the nurse implement first?
• A client states, I have to go to the bathroom every five minutes during pregnancy. Which explanation should the nurse provide?
• Which statement about home birth safety should be included in a discussion with pregnant women?
• The nurse is planning for the care of a 30-year-old primigravida with pre-gestational diabetes. What is the most important factor affecting this client's pregnancy outcome?
• After suction curettage for hydatidiform mole, which diagnostic test is used to monitor for persistent gestational trophoblastic disease?
• During mid-pregnancy, which cardiovascular change is typically observed in the mother?
• Name two common postpartum mood disorders and a warning sign for each.
• Which statement best defines tocolysis?
• Which scenario is a contraindication to breastfeeding in many settings?
• Which of the following statements best describes Category I fetal tracing?
• The nurse is providing discharge teaching for a gravid client who is being released from the hospital after placement of cerclage. Which instruction is the most important for the client to understand?
• Which postpartum complication is characterized by heavy vaginal bleeding with a soft uterus and fundus that is not well contracted?
• Which statement best reflects safe home birth planning?
• What nursing action should be implemented when intermittently gavage-feeding a preterm infant?
• In intrauterine pressure catheter readings, which value represents the peak intrauterine pressure during a contraction?
• A client who is breastfeeding develops engorged breasts on the third postpartum day. Which action should the nurse recommend to relieve breast engorgement?
• In the first 24 hours, what is a healthy feeding pattern for a term newborn?
• A client who is stable has family members present when the nurse enters the birthing suite to assess the mother and newborn. What action should the nurse implement at this time?
• Which of the following is NOT listed as a common risk factor for postpartum infection?
• Which description best matches a bluish hue noted on a newborn's sacral area?
• Define 'tocolysis' and name two indications for tocolysis in obstetric care.
• A newborn at 37 weeks weighing 4.1 kg at 2 hours old is at risk for neonatal hypoglycemia. Which screening should be performed?
• What is the purpose of postpartum fundal assessment and what indicates normal involution?
• What is the recommended technique to promote effective breastfeeding latch?
• What action should the nurse implement with the family when an infant is born with anencephaly?
• At 10-weeks gestation, a high-risk multiparous client with a family history of Down syndrome is admitted for observation following a chorionic villi sampling (CVS) procedure. What assessment finding requires immediate intervention?
• A nulliparous client telephones the labor and delivery unit to report that she is in labor. What action should the nurse implement?
• Name a common tocolytic drug used in the management of preterm labor.
• A client at 28-weeks gestation arrives at the labor and delivery unit with a complaint of bright red, painless vaginal bleeding. For which diagnostic procedure should the nurse prepare the client?
• A multiparous client delivered a 7 lb 10 oz infant 5 hours ago. The uterus is boggy and displaced above and to the right of the umbilicus. What action should the nurse implement next?
• The nurse is discussing the stages of labor with a group of women in the last month of pregnancy and provides examples of different positional techniques used during the second stage of labor. Which position should the nurse address that provides the best advantage of gravity during delivery?
• Which nursing intervention most effectively prevents neonatal hypothermia?
• A client at 28 weeks gestation experiences blunt abdominal trauma. Which parameter should the nurse assess first for signs of internal hemorrhage?
• Which client should the nurse report to the healthcare provider as needing a prescription for Rh Immune Globulin (RhoGAM)?
• Which procedure evaluates the effect of fetal movement on fetal heart activity?
• Which of the following is a postpartum psychosis warning sign?
• What is the normal fetal heart rate range for a healthy term fetus during intrapartum monitoring?
• What is the initial postpartum management for a boggy uterus with heavy lochia?
• What assessment finding should the nurse report to the healthcare provider that is consistent with concealed hemorrhage in an abruptio placenta?
• When discussing CHD risk with a patient at 8 weeks gestation, which development timeline is accurate?
• Which nursing action should be included in the plan of care for a newborn experiencing symptoms of drug withdrawal?
• A 36-week gestation client with pregnancy-induced hypertension (PIH) is receiving an IV infusion of magnesium sulfate. Which assessment finding should the nurse report to the healthcare provider?
• Which neonatal feature is commonly used to identify fetal alcohol syndrome?
• Which finding in a postpartum patient’s history would lead the nurse to withhold Methergine (methylergonovine maleate)?
• To prevent conductive heat loss in a newborn, which action is not recommended?
• A primigravida at 12-weeks gestation who just moved to the United States indicates she has not received any immunizations. Which immunization(s) should the nurse administer at this time?
• The nurse is assessing a full-term newborn's breathing pattern. Which finding should the nurse assess further?
• Which finding in a laboring client at 41 weeks gestation requires additional assessment?
• In the GTPAL designation 4-1-2-0-3, how many pregnancies has the patient had?
• Which nursing intervention is the priority during the fourth stage of labor?
• What is the purpose of group B streptococcus (GBS) screening at 35-37 weeks, and how is positive status managed during labor?
• Which factor is a key criterion for home birth suitability according to the provided material?
• Which statement best describes the timing of fetal response to sound during gestation?
• The nurse is assessing a 12-hour-old infant with a maternal history of frequent alcohol consumption during pregnancy. Which finding should the nurse report that is most suggestive of fetal alcohol syndrome (FAS)?
• Which observation should alert the nurse to a possible battering situation for a client at 24 weeks gestation?
• An infant who weighs 3.8 kg is delivered vaginally at 39-weeks gestation with a nuchal cord after a 30-minute second stage. The nurse identifies petechiae over the face and upper back of the newborn. What information should the nurse provide the parents about this finding?
• Which test is used to confirm rupture of membranes in labor?
• What is the primary goal of neonatal resuscitation at birth?
• A gravida client develops maternal hypotension following regional anesthesia. Which action should the nurse implement as the best initial step?
• Which test is used to assess fetal lung maturity by measuring the ratio of phospholipids?
• Which nutrient is essential to promote fetal neural development during preconception planning?
• What does tachysystole refer to, and why is it clinically significant during labor?
• When supporting a family with a fetus diagnosed with anencephaly, what is the most appropriate initial nursing action?
• Which ultrasound finding would suggest placenta previa?
• Which swelling crosses suture lines in a newborn?
• In preconception counseling for women planning pregnancy in 3 to 6 months, which information should the nurse provide?
• A multiparous client is bearing down with contractions and crying out, The baby is coming! Which immediate action should the nurse implement?
• Which pharmacologic agent is commonly used to induce or augment labor by stimulating uterine contractions?