HESI RN
Maternity HESI Quizlet Questions
Question 1 of 5
A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in this client's nursing care plan?
Correct Answer: A
Rationale: In the case of a 16-year-old gravida 1, para 0 client with eclampsia, the correct intervention is to keep airway equipment at the bedside (Option A). This is crucial because eclampsia is a serious condition characterized by seizures, and having airway equipment readily available ensures immediate intervention in case of convulsions to maintain the client's airway patency and prevent complications like hypoxia. Option B, allowing liberal family visitation, is incorrect as it does not address the immediate safety needs of the client. In a critical condition like eclampsia, ensuring the client's safety and health takes precedence over family visitation. Option C, monitoring blood pressure, pulse, and respirations q4h, is not the most appropriate intervention for a client with eclampsia. Continuous monitoring is essential in such cases to detect any deterioration promptly and initiate appropriate interventions. Option D, assessing temperature q1h, is not a priority intervention for a client with eclampsia. While monitoring temperature is essential in general care, in the case of eclampsia, managing and preventing seizures to ensure the client's safety and well-being are the primary concerns. Educationally, understanding the priority interventions in managing eclampsia is vital for nurses caring for pregnant women. Prompt recognition and appropriate interventions can help prevent complications and ensure the best possible outcomes for both the mother and the baby.
Question 2 of 5
A child with leukemia is admitted for chemotherapy, and the nursing diagnosis 'altered nutrition, less than body requirements related to anorexia, nausea, and vomiting' is identified. Which intervention should the nurse include in this child's plan of care?
Correct Answer: B
Rationale: In children with leukemia undergoing chemotherapy, anorexia, nausea, and vomiting are common issues leading to altered nutrition. Providing small, frequent meals that are high in protein and calories is essential to address these symptoms and meet the child's nutritional needs effectively. This approach helps in managing the side effects of treatment and supporting the child's nutritional requirements during this challenging time.
Question 3 of 5
What should the nurse recommend to a woman with mastitis?
Correct Answer: A
Rationale: In the context of mastitis, which is inflammation of the breast tissue often caused by blocked milk ducts or bacterial infection, the correct recommendation for a woman experiencing this condition is to apply heat to the affected area. Heat helps to promote circulation, reduce pain, and facilitate milk flow, which can alleviate the symptoms of mastitis and aid in recovery. Option B, applying cold compresses, is not the recommended intervention for mastitis because cold may constrict blood vessels and hinder milk flow, exacerbating the issue. Option C, using a breast pump to express milk, can be beneficial in ensuring complete emptying of the breast, but it may not address the inflammation and infection present in mastitis. Option D, continuing breastfeeding as usual, is generally encouraged in cases of mastitis because frequent nursing helps to clear the blockage and maintain milk supply; however, this option does not directly address the inflammation and discomfort associated with mastitis. Educationally, it is important for nurses and healthcare providers to understand the appropriate management strategies for mastitis to provide effective care and support to breastfeeding women. By recommending heat application, nurses can help alleviate symptoms, promote healing, and support the woman in continuing to breastfeed her baby.
Question 4 of 5
A child with glomerulonephritis is asking for strawberries. What should the nurse do?
Correct Answer: B
Rationale: In glomerulonephritis, it is crucial to restrict the child's diet, particularly avoiding foods high in potassium like strawberries. Potassium restriction is essential because impaired kidney function in glomerulonephritis can lead to potassium retention, potentially causing hyperkalemia. Therefore, the nurse should restrict the child's diet to manage their condition effectively.
Question 5 of 5
At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in the right lower quadrant of her abdomen. The LPN/LVN obtains a blood sample and initiates an IV. Thirty minutes after admission, the client reports feeling a sharp abdominal pain and shoulder pain. Assessment findings include diaphoresis, a heart rate of 120 beats/minute, and a blood pressure of 86/48. Which action should the nurse implement next?
Correct Answer: C
Rationale: The client's symptoms suggest hypovolemic shock, possibly due to an ectopic pregnancy. Increasing IV fluids is crucial to stabilize the client by improving blood pressure and perfusion. This intervention helps address the underlying issue of hypovolemia and supports the client's hemodynamic status, which takes priority in this emergent situation.