HESI OB/MATERNITY V 2 Quiz

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Questions and Answers

What is the most appropriate comment by the nurse for the client who had an emergency cesarean section?

With all of your preparations, it must have been disappointing for you to have had a cesarean.

At least your husband was able to be with you when the baby was born.

I know you had to have surgery, but you are very lucky that your baby was born healthy. (correct)

Sometimes babies just don’t deliver the way we expect them to.

What should the nurse do first when assisting a mother with the first breastfeeding experience for her 2-hour-old baby?

Teach the mother about a proper breast latch.

Compare mother’s and baby’s identification bracelets.

Help the mother into a comfortable position. (correct)

Tickle the baby’s lips with the mother’s nipple.

What is the optimal Apgar score range for a newborn to be considered in good health?

9/9 (correct)

10/10

5/5

7/7

Why is it important for healthcare providers to pay attention to childbirth education classes attended by clients?

To tailor care based on clients' preferences and preparations. Signup and view all the answers

What is a common misconception about childbirth education classes?

They guarantee a specific mode of delivery. Signup and view all the answers

Why is it important for a nurse to assist a mother with breastfeeding shortly after birth?

To improve maternal-infant bonding and establish breastfeeding early. Signup and view all the answers

What is the primary route of administration for Ibuprofen?

Oral Signup and view all the answers

Which effect does Ibuprofen have on prostaglandins?

Prostaglandin inhibition Signup and view all the answers

What is the recommended way to take an iron supplement according to the nurse?

Orange juice Signup and view all the answers

What hemoglobin and hematocrit values would be expected 2 days after a normal spontaneous vaginal delivery in a healthy client?

Hgb 12.5 gm/dL; Hct 37% Signup and view all the answers

What would be an appropriate response from the nurse regarding a laboring client's meal schedule?

"A heavy meal is discouraged. I can get clear fluids for you whenever you would like them, though." Signup and view all the answers

Which teaching point would be appropriate for a woman with postpartum hemorrhoids?

"Use hot baths to relieve discomfort." Signup and view all the answers

What action should the nurse prioritize when caring for a postpartum client in the 'taking in' phase?

Assist the client with activities of daily living Signup and view all the answers

Which finding is considered normal in a laboratory report of a 34-week gestation client?

Polycythemia Signup and view all the answers

What maternal sign/symptom would be concerning if observed in a 36-week gestation gravid lying flat on her back?

Hypertension Signup and view all the answers

Which question would be culturally insensitive for a nurse to ask a Muslim woman in her 38th week of gestation?

"How do you feel about having an episiotomy?" Signup and view all the answers

During a prenatal visit for a woman at 36-weeks’ gestation, which test is typically NOT performed?

Karyotype analysis Signup and view all the answers

What should the nurse ask the primipara who will be discharged 4 days after a cesarean delivery?

Have you experienced any unusual symptoms post-delivery? Signup and view all the answers

What is an appropriate nursing intervention for mastitis in a breastfeeding mother?

Apply warm compresses to the affected breast. Signup and view all the answers

How should the nurse respond to a breastfeeding mother who had breast augmentation surgery?

Inform the woman she may have difficulties breastfeeding. Signup and view all the answers

What is an appropriate nursing action after a woman experiences a fetal demise at 26 weeks' gestation?

Offer grief counseling and emotional support. Signup and view all the answers

What should the nurse consider concerning anesthesia when assessing a primipara in the labor suite?

Anesthesia may increase the risk of postpartum hemorrhage. Signup and view all the answers

What should the nurse do when a breastfeeding mother calls with mastitis diagnosis?

Recommend bed rest and minimal physical activity. Signup and view all the answers

What should the nurse advise the client to do regarding her physician appointment?

Keep the appointment for the RhoGAM injection Signup and view all the answers

Which observation indicates that the nurse's intervention for expressing breast milk has been successful?

The mother's nipples are soft to the touch Signup and view all the answers

What should the nurse do immediately after the delivery of a dead baby with visible defects?

Discourage the parents from naming the baby Signup and view all the answers

Why is it important for the client to bottlefeed for the next twenty-four hours?

To prevent breast engorgement Signup and view all the answers

What should the nurse inform the client's physician before discharge?

The RhoGAM injection could not be given on time Signup and view all the answers

When should lanolin ointment be applied to the areas during breastfeeding?

After each and every breastfeeding session Signup and view all the answers

What is the most appropriate counseling needed for the woman based on the nurse's conclusion?

Marriage counseling for the couple Signup and view all the answers

Which procedure would provide the couple with the highest probability of conceiving a healthy child?

Pre-implantation genetic diagnosis Signup and view all the answers

What would be the nurse's best response regarding cord blood banking?

It is a valuable option for future medical needs. Signup and view all the answers

What is the most appropriate response by the nurse to the woman at 34-week gestation with repeated nosebleeds?

Recommend immediate evaluation by a healthcare provider. Signup and view all the answers

What is a potential emotional challenge for the client who underwent an emergency cesarean section despite attending childbirth education classes and planning for a water birth?

Disappointment in not having a water birth as anticipated Signup and view all the answers

What potential concern might arise if the nurse tickles the baby's lips with the mother's nipple during the first breastfeeding experience?

Risk of aspiration for the baby Signup and view all the answers

Why is it crucial for the nurse to compare the mother's and baby's identification bracelets before assisting with breastfeeding?

To prevent accidental feeding of another woman's baby Signup and view all the answers

What might be a concern for a 2-hour-old baby during the first breastfeeding experience if the mother is not helped into a comfortable position?

Inability to achieve a successful latch due to poor positioning Signup and view all the answers

Which action by the nurse might lead to psychological distress for the mother who just had an emergency cesarean section?

Discussing alternative birthing methods for future pregnancies Signup and view all the answers

What aspect of breastfeeding education should the nurse prioritize when assisting a mother with her first breastfeeding experience?

Ensuring immediate and proper latch-on technique Signup and view all the answers

'Why is it important not to delay first breastfeeding?' Which answer best addresses this question?

'To establish bonding and secure attachment between mother and baby' Signup and view all the answers

'What potential misconception might arise from a nurse stating, 'Sometimes babies just don’t deliver the way we expect them to?'' Which option best reflects this misconception?

'Natural births always proceed as planned.' Signup and view all the answers

What advice should the nurse give to a client who is concerned about distinguishing between labor contractions and normal pregnancy aches and pains?

The contractions will feel different from your pregnancy aches and pains. Signup and view all the answers

Which statement by the nurse is appropriate when counseling a pregnant couple who are carriers for phenylketonuria (PKU)?

There is a 2 out of 4 chance that your child will have PKU. Signup and view all the answers

What procedure would the nurse perform to obtain the obstetric conjugate measurement?

Calculating the distance from the sacral promontory to the upper margin of the pubic symphysis. Signup and view all the answers

How should the nurse respond to an anxious client questioning her ability to differentiate between labor contractions and regular pregnancy discomfort?

Labor contractions are usually accompanied by other symptoms like backache. Signup and view all the answers

In what way would human placental lactogen affect pregnancy?

It maintains the function of the corpus luteum during early pregnancy. Signup and view all the answers

What physiologic changes are primarily attributed to progesterone during pregnancy?

Promoting hyperpigmentation and vascular skin changes. Signup and view all the answers

How does estrogen primarily impact the respiratory system during pregnancy?

Causing relaxation of smooth muscles in the airways. Signup and view all the answers

Bonus Question: Which hormone is responsible for initiating and maintaining lactation postpartum?

Prolactin Signup and view all the answers

What is a priority nursing diagnosis for a woman with postpartum hemorrhage after a spontaneous vaginal delivery?

Fluid volume deficit related to blood loss Signup and view all the answers

After a 12-hour labor resulting in a macrosomic baby, what complication should a woman be carefully monitored for?

Uterine atony Signup and view all the answers

What should a nurse conclude if a 1 day-postpartum client, who had a vaginal delivery with an intact perineum, complains of perineal pain despite taking ibuprofen?

She may have a hidden laceration Signup and view all the answers

To prevent drug/food interactions, what should a client advised to refrain from consuming when taking Paxil (paroxetine) for postpartum depression?

Grapefruit Signup and view all the answers

In the context of postpartum care, what could a firm fundus at the umbilicus indicate in a 1 day-postpartum client?

Uterine atony Signup and view all the answers

After postpartum hemorrhage, what is the appropriate nursing intervention to address the risk for sleep deprivation?

Encourage napping during the day Signup and view all the answers

What is a potential complication for a woman with grand multiparity experiencing postpartum hemorrhage?

Vaginal hematoma Signup and view all the answers

What should be the primary focus of care for a postpartum client presenting with fluid volume deficit due to extensive blood loss?

Ensuring adequate nutrition intake Signup and view all the answers

What is the most appropriate action for the nurse when assessing a 1-day postpartum woman complaining of urinary frequency?

Obtain an order for a urine culture Signup and view all the answers

Which finding in the laboratory report of a 2-day postpartum woman should the nurse report to the primary health care provider?

Hematocrit—26% Signup and view all the answers

What should the nurse do when a bottle-feeding woman, 11⁄2 weeks postpartum, reports saturating 2 pads in 1 hour?

Advise her to visit the emergency room immediately Signup and view all the answers

Which action by the nurse would indicate correct fundal height measurement technique?

Stabilizing the base of the uterus with a dependent hand Signup and view all the answers

What should the nurse advise a 1-day postpartum woman who thinks she has a urinary tract infection?

See your healthcare provider for an evaluation Signup and view all the answers

What could be a concerning symptom for a 1-day postpartum woman with suspected urinary tract infection?

Painful urination Signup and view all the answers

Why is it important for the nurse to assess the laboratory report of a 2-day postpartum woman?

To assess for signs of infection or abnormal blood values Signup and view all the answers

Which response by the nurse is appropriate for a 1-day postpartum woman who has frequent urination concerns?

'Frequent urination is expected after delivery, but I will monitor it.' Signup and view all the answers

Study Notes

Pharmacological Interventions

Ibuprofen is taken every two hours and has an antiprostaglandin effect.
Ibuprofen should be administered in high doses.

Nutrition and Hydration

In the postpartum period, a heavy meal is discouraged, but clear fluids can be taken whenever desired.
Iron supplements are recommended to be taken with orange juice or ginger ale to enhance absorption.

Maternal and Fetal Health

A woman's hemoglobin (Hgb) and hematocrit (Hct) levels may decrease after a normal spontaneous vaginal delivery.
Anemia, thrombocytopenia, polycythemia, and hyperbilirubinemia are potential findings in a 34-week gestation client.
Hypertension, dizziness, and varicose veins are potential maternal signs/symptoms observed in a 36-week gestation gravid lying flat on her back.
Chloasma may be observed in a 36-week gestation client.

Labor and Delivery

During a postpartum assessment, a cluster of hemorrhoids may be noted in a woman who delivered vaginally over an intact perineum.
A nurse should advise the client to keep her physician appointment at the end of the week to receive her RhoGAM injection.

Breastfeeding

Manual expression of breast milk can help relieve engorgement and facilitate breastfeeding.
The mother's nipples should be soft to the touch after manual expression.
Breast implants do not contaminate milk with toxins, but the glandular tissue may be deficient.
Mastitis can be diagnosed by inspecting the breast and may be treated by breastfeeding frequently.

Postpartum Care

A woman who has had a cesarean section may be discharged home 4 days after delivery.
A nurse should ask the client about anesthesia experience and provide a nutritious meal, encourage rest, and assist with activities of daily living.
A woman who has had a fetal demise may be dressed in a tee shirt and swaddled in a receiving blanket.

Family Planning and Genetics

Pre-implantation genetic diagnosis provides the highest probability of conceiving a healthy child for a couple with a family history of an autosomal dominant disease.
Chorionic villus sampling and amniocentesis are also options for genetic diagnosis.
A couple who are both carriers for phenylketonuria (PKU), an autosomal recessive disease, have a 2 in 4 chance of having a child who is a carrier like both of them.
A woman who has inherited the gene for familial adenomatous polyposis (FAP) should consider pre-implantation genetic diagnosis.

Complications

Postpartum hemorrhage, endometrial ischemia, and prolapsed uterus are potential complications.
A woman who has had a macrosomic baby should be monitored for complications.
A woman who is experiencing perineal pain after delivery may need to be assessed by her doctor or have a sitz bath.

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Description

Test your knowledge on obstetrics and maternity nursing with this quiz based on a scenario involving a client who had an emergency cesarean section. Questions include topics on Apgar scores, childbirth education, and post-operative care.