HESI Obstetrics/Maternity Assignment Exam

What is the priority nursing intervention for a mother who wants to breastfeed after previous unsuccessful attempts?

Provide assistance to begin breastfeeding as soon as possible after delivery.

What is the most effective way to prevent nipple soreness during breastfeeding?

Correctly place the infant on the breast to ensure proper latch.

What is the most common cause of nipple soreness in breastfeeding mothers?

Incorrect positioning of the infant, such as grasping too little of the areola or only the nipple.

What equipment is required for an amniotomy procedure? (Select all that apply)

A sterile glove, an amniotic hook, and a Doppler.

How is the estimated date of delivery calculated using Naegele’s rule?

Subtract 3 months and add 7 days from the first day of the last menstrual period.

What is the correct EDD for LMP August 2, 2022?

May 9, 2023.

How should the nurse manage back labor pain in a client receiving oxytocin?

Apply firm pressure to the sacral area.

Why is Methergine contraindicated in a postpartum client with high blood pressure?

It can worsen hypertension and increase risk of complications.

What is the priority intervention when a postpartum client has a boggy fundus and heavy bleeding?

Have the client empty her bladder and massage the fundus.

Why must a client empty her bladder before fundal height measurement?

A full bladder can elevate the uterus and cause inaccurate measurement.

Why is bedrest prescribed for a pregnant client with mitral stenosis Class III?

It decreases oxygen demand and workload on the heart.

What is the inheritance risk of an autosomal dominant disorder?

Each pregnancy carries a 50% chance of inheritance.

Why is soy-based formula prescribed for newborns with feeding intolerance?

It is lactose-free and tolerated by infants with lactose intolerance.

What is the priority teaching to reduce infant mortality risk?

Stress the importance of keeping prenatal care appointments.

What are the “3 Cs” of esophageal atresia?

Choking, coughing, and cyanosis.

What is the first action for a postpartum client with excessive bleeding?

Palpate the firmness of the fundus.

When does ovulation typically occur in the menstrual cycle?

About 14 days before menstruation.

What should a client do if lochia returns to bright red after turning pink/white?

Reduce activity and notify the healthcare provider.

What does painless bright red bleeding in the third trimester indicate?

Placenta previa.

What complication is a newborn with cephalohematoma at risk for?

Jaundice due to breakdown of red blood cells.

Which client is at highest risk for postpartum hemorrhage (PPH)?

A client receiving magnesium sulfate during labor.

What is the primary goal of preconception care?

Encourage healthy lifestyle changes to promote a healthy pregnancy.

What is the best response to a pregnant client interested in herbal therapy?

Support her involvement and acknowledge her desire to participate in care.

What newborn finding requires immediate reporting?

Central cyanosis when crying.

What infection is prevented by erythromycin eye ointment in newborns?

Gonorrhea (ophthalmia neonatorum).

What lab value contraindicates epidural anesthesia?

Platelet count of 67,000/mm³.

What is the priority action after rupture of membranes with meconium present?

Perform a sterile vaginal exam to assess for cord prolapse.

What is the first intervention for preterm contractions with uterine irritability?

Obtain a urine specimen to rule out UTI.

What is the priority assessment when administering terbutaline?

Monitor maternal and fetal heart rates.

What is the appropriate action for erythema toxicum in a newborn?

Document as a normal finding.

What indicates therapeutic magnesium sulfate effect in PIH?

Decreased respiratory rate (but not below 12).

What is the next step for a newborn with HR 80 and RR 20?

Initiate positive pressure ventilation.

What is the most important information for newborn care planning?

Infant’s condition at birth and treatment received.

What platelet-related complication can occur with epidurals?

Increased bleeding risk due to thrombocytopenia.

What is the correct position for newborn sleep safety?

Supine (not prone).

What is the EDD for LMP February 15?

November 22.

How is postpartum hemorrhage prevented after cesarean section?

Check uterine firmness every 15 minutes.

What is the first action for hypotension after epidural anesthesia?

Place the client in a lateral position.

What is a Silverman-Anderson score of 4 indicative of?

Moderate respiratory distress.

What is the most important supplement after a recent miscarriage and new pregnancy?

Multivitamins and minerals.

What is the normal structure of the umbilical cord?

Three vessels: two arteries and one vein.

When should oxytocin be discontinued?

When contractions are too frequent with inadequate resting time.

What is the correct order of interventions for late decelerations?

Reposition → oxygen → increase IV fluids → notify provider.

What are symptoms of abruptio placentae?

Dark red bleeding, uterine irritability, rigid abdomen.

What behavior indicates maternal-fetal bonding?

Talking to and interacting with the fetus.

What is the major adverse effect of oxytocin?

Uterine tachysystole.

What are early side effects of terbutaline?

Tachycardia and nervousness.

When should childbirth classes be taken?

Around 30 weeks gestation.

What is vernix?

White, cheesy substance in skin folds of newborn.

How is epoetin alfa effectiveness assessed?

Decrease in heart rate due to improved RBC count.

When can a home pregnancy test be used?

After the first missed period.

What is a cephalohematoma?

Blood collection between periosteum and skull that does not cross sutures.

What fertility factor can decrease conception chances?

Use of lubricants that impair sperm motility.

Why are iron supplements needed in pregnancy?

Diet alone often cannot meet increased iron demands.

What behavior indicates early maternal bonding?

Tracing infant’s features with fingertips.

What is the most important factor for effective teaching?

Client’s readiness to learn.

How is GTPAL calculated for this client?

3-1-1-0-3.

What helps relieve postpartum uterine cramps?

Lying prone with a pillow on the abdomen.

What is the antidote for magnesium sulfate toxicity?

Calcium gluconate.

What symptom indicates patent fallopian tubes during hysterosalpingography?

Shoulder pain.

What test evaluates fetal well-being at 41 weeks?

Biophysical profile (BPP).

What indicates impending seizure in preeclampsia?

4+ reflexes.

What is the first action for a dusky newborn?

Check oxygen saturation.

What is priority concern in placenta previa?

Onset of contractions causing hemorrhage.

What indicates magnesium toxicity?

Low urine output (<100 mL in 4 hours).

What is the EDD for LMP December 1?

September 8.

What does alpha-fetoprotein screen for?

Neural tube defects.

What are postpartum blues symptoms?

Mood swings, tearfulness, panic attacks.

What is priority intervention for suspected ectopic pregnancy?

Increase IV fluids.

What condition must be assessed before giving terbutaline?

Gestational diabetes.

What is key diabetes teaching in pregnancy?

Maintain blood glucose within normal range.

What is the most common effect of smoking in pregnancy?

Low birth weight.

What should be done for a nonreactive NST?

Ask about fetal movement.

What is first intervention for epidural hypotension symptoms?

Raise foot of bed.

When do fontanels close?

Anterior: 12–18 months, Posterior: by 2 months.

When is ovulation for a 36-day cycle?

Around day 22 (Jan 30–31 in this case).

What complication must be monitored in placental abruption?

DIC (bleeding from IV sites).

What phase describes maternal dependency postpartum?

Taking-in phase.

What is caput succedaneum?

Scalp edema that resolves in a few days.

What indicates impending eclampsia?

Epigastric pain.

What is priority care for newborn of HIV-positive mother?

Bathe infant immediately.

What is highest priority in emergency delivery?

Put newborn to breast (stimulates uterine contraction + warmth).

How should newborn head molding be explained?

Normal and resolves in 3–4 days.

How are leg cramps relieved in labor?

Dorsiflex the foot.

What is normal sibling reaction to new baby?

Regression due to need for attention.

Why must laboring clients void every 2 hours?

Prevent bladder distention that impedes labor.

What is treatment for elevated newborn bilirubin?

Encourage frequent breastfeeding.

When is vaginal exam risky?

When presenting part is not engaged (risk of cord prolapse).

What reassures a mother about fontanels?

Strong membrane protects brain.

How do you know a breastfed baby is getting enough milk?

6–10 wet diapers/day with pale urine.

What indicates cardiac decompensation in labor?

Edema, rales, irregular pulse.

What is priority assessment for unknown gestation?

Date of last menstrual period.

What emotional response is expected after miscarriage?

Grief.

What is priority intervention for Type 2 diabetic pregnancy?

Diet management.

How is breast engorgement treated?

Cold compresses.

How often should newborns breastfeed?

Every 2–3 hours or on demand.

When is best time for conception using BBT?

Between temperature drop and rise.

What indicates SGA newborn?

Low weight, length, and head circumference.

How is hyperventilation during labor treated?

Breathe into cupped hands.

When should pushing begin in labor?

When cervix is fully dilated (10 cm).