HESI RN
HESI Maternity 55 Questions Quizlet
1. A postpartum client who is Rh-negative refuses to receive RhoGAM after the delivery of an infant who is Rh-positive. Which information should the nurse provide this client?
- A. RhoGAM prevents maternal antibody formation for future Rh-positive babies.
- B. RhoGAM is not necessary unless all of her pregnancies are Rh-positive.
- C. The Rh-positive factor from the fetus threatens her blood cells.
- D. The mother should receive RhoGAM when the baby is Rh-negative.
Correct answer: A
Rationale: The correct answer is A. RhoGAM is administered to Rh-negative individuals after exposure to Rh-positive blood to prevent the development of antibodies that could harm future Rh-positive babies during subsequent pregnancies. By refusing RhoGAM after the delivery of an Rh-positive infant, the mother risks developing these antibodies, which could lead to hemolytic disease in future pregnancies with Rh-positive babies. Therefore, it is crucial for the nurse to explain to the client that receiving RhoGAM prevents the formation of maternal antibodies against Rh-positive blood, safeguarding the health of future babies. Choices B, C, and D are incorrect. Choice B is incorrect because RhoGAM is necessary after exposure to Rh-positive blood, regardless of the Rh status of future pregnancies. Choice C is incorrect as it does not accurately convey the purpose of RhoGAM administration. Choice D is incorrect because RhoGAM is specifically given after exposure to Rh-positive blood, not when the baby is Rh-negative.
2. When counseling a couple seeking information about conceiving, the LPN/LVN should know that ovulation usually occurs
- A. two weeks before menstruation.
- B. immediately after menstruation.
- C. immediately before menstruation.
- D. three weeks before menstruation.
Correct answer: A
Rationale: Ovulation typically occurs about 14 days before the start of the next menstrual period. This timing allows for the released egg to travel down the fallopian tube where it may be fertilized by sperm, leading to conception. Understanding the timing of ovulation is crucial for couples trying to conceive to increase their chances of success.
3. A client whose labor is being augmented with an oxytocin (Pitocin) infusion requests an epidural for pain control. Findings of the last vaginal exam, performed 1 hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station. What action should the nurse implement first?
- A. Decrease the oxytocin infusion rate
- B. Determine current cervical dilation
- C. Request placement of the epidural
- D. Give a bolus of intravenous fluids
Correct answer: D
Rationale: In a client receiving an oxytocin infusion who requests an epidural, it is crucial to give a bolus of intravenous fluids first. This action helps prevent hypotension, a common side effect of epidural anesthesia, before the placement of the epidural. Maintaining adequate hydration is essential to support maternal blood pressure stability during the procedure.
4. The client delivered hours ago and has a boggy uterus displaced above and to the right of the umbilicus. What action should the nurse take?
- A. Inspect the perineal pad.
- B. Encourage voiding.
- C. Monitor vital signs.
- D. Notify the healthcare provider.
Correct answer: B
Rationale: A boggy uterus that is displaced above and to the right of the umbilicus may indicate a full bladder, which can impede uterine contraction and lead to hemorrhage. Encouraging the client to void helps relieve pressure on the uterus, promoting better contraction and preventing postpartum hemorrhage.
5. An expectant father tells the LPN/LVN he fears that his wife 'is losing her mind.' He states she is constantly rubbing her abdomen and talking to the baby, and that she actually reprimands the baby when it moves too much. What recommendation should the nurse make to this expectant father?
- A. Reassure him that these are normal reactions to pregnancy and suggest that he discuss his concerns with the childbirth education nurse.
- B. Help him understand that his wife is experiencing normal maternal behaviors and bonding with the baby, and reassure him that these actions are positive.
- C. Ask him to observe his wife's behavior carefully for the next few weeks and report any similar behavior to the nurse at the next prenatal visit.
- D. Let him know that these behaviors are part of normal maternal-fetal bonding which occur once the mother feels fetal movement.
Correct answer: D
Rationale: The father's concerns about his wife's behaviors can be addressed by explaining that behaviors like talking to the baby and responding to fetal movements are part of normal maternal-fetal bonding. These actions indicate that the mother is connecting with the baby and are positive signs of a healthy pregnancy. The nurse should reassure the father that these behaviors are common and beneficial for the mother-baby relationship during pregnancy.
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