HESI RN
HESI Maternity Test Bank
1. A young girl with a fractured radius has a cast applied. As the cast is drying, it is elevated above the level of her heart. Which assessment finding should the healthcare provider be reported to immediately?
- A. Itching sensation under the cast.
- B. Swelling of fingers with brisk capillary refill.
- C. Numbness and inability to move fingers.
- D. Visible bruising above the cast.
Correct answer: C
Rationale: Numbness and inability to move fingers are concerning findings that suggest potential nerve damage or compartment syndrome due to increased pressure within the cast. This requires immediate notification of the healthcare provider to prevent further complications or permanent damage.
2. During a woman's first prenatal visit, the nurse reviews her health care record, noting a history of chickenpox as a child and syphilis as a teenager. Which action is most important for the nurse to take?
- A. Obtain blood and urine for prenatal screens.
- B. Schedule prenatal visits to occur monthly.
- C. Explain common complications of pregnancy.
- D. Obtain baseline blood pressure and weight.
Correct answer: A
Rationale: Obtaining blood and urine for prenatal screens is crucial in identifying any potential infections or conditions that may require monitoring throughout the pregnancy. Screening for infections such as syphilis is essential to ensure appropriate management and prevent adverse outcomes. This action helps in early detection and timely intervention, promoting the health and well-being of both the mother and the developing fetus. The other options, while important during prenatal care, are not as critical as obtaining prenatal screens to assess for any existing infections that could impact the pregnancy.
3. What should the nurse recommend to a woman with mastitis?
- A. Apply heat to the affected area.
- B. Apply cold compresses to the affected area.
- C. Use a breast pump to express milk.
- D. Continue breastfeeding as usual.
Correct answer: A
Rationale: The nurse should recommend applying heat to the affected area for a woman with mastitis. Heat can help reduce pain and inflammation associated with mastitis by improving blood flow to the area and promoting healing.
4. A 4-year-old boy presents with a rash and is diagnosed with varicella (chickenpox). What is the most appropriate intervention to manage this condition?
- A. Administer oral acyclovir.
- B. Apply calamine lotion to soothe itching.
- C. Encourage scratching to relieve itching.
- D. Encourage bed rest to avoid spreading the rash.
Correct answer: B
Rationale: The most appropriate intervention for managing varicella (chickenpox) in a 4-year-old child is to apply calamine lotion to soothe itching. Calamine lotion helps alleviate the itching associated with the chickenpox rash, providing relief to the child. It is important to discourage scratching to prevent complications such as scarring or secondary bacterial infections. Encouraging bed rest can be beneficial for comfort but is not the primary intervention to manage chickenpox.
5. A 6-month-old child who had a cleft-lip repair has elbow restraints in place. What nursing intervention should the nurse plan to implement?
- A. Obtain the healthcare provider’s advice as to when the restraints should be removed.
- B. Remove restraints one at a time to provide range of motion exercises.
- C. Record observation of the restraints q2h and ensure that they are in place at all times.
- D. Remove restraints q4h for 30 minutes and place gloves on the child’s hands.
Correct answer: B
Rationale: Removing restraints one at a time for range of motion exercises prevents muscle stiffness and allows assessment of the skin.
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