Monroe College RN HESI Maternity | Nurselytic

Questions 55

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Monroe College RN HESI Maternity Questions

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Question 1 of 5

The nurse is about to administer phytonadione to a newborn. Which statement by the parents shows they understand why this medication is being given?

Correct Answer: C

Rationale: Phytonadione is given to newborns to prevent hemorrhagic disorders, specifically vitamin K deficiency bleeding (VKD
B). Newborns are at risk for VKDB because their gut does not yet have the bacteria necessary to produce vitamin K.

Question 2 of 5

A postpartum client who is formula-feeding her new baby inquires about when she should expect her menstruation to resume. What should the nurse inform the client?

Correct Answer: C

Rationale: For a postpartum client who is formula-feeding her new baby, menstruation typically resumes six to eight weeks after birth.

Question 3 of 5

What physical assessment data should the nurse consider a normal finding for a primigravida client who is 12 hours postpartum?

Correct Answer: C

Rationale: A pulse rate of 56 beats/minute can be a normal finding postpartum. Pregnancy increases blood volume and cardiac output, and these changes can persist for some time after delivery.

Question 4 of 5

The healthcare provider prescribes magnesium sulfate 4 grams intravenously (IV) to be infused over 20 minutes for a client with preeclampsia. The IV bag contains magnesium sulfate 20 grams in dextrose 5% in water 500 mL. How many mL/hour should the nurse program the infusion pump?

Correct Answer: 300 mL/hour

Rationale: Calculate the volume for 4 grams: 4 grams ÷ 20 grams × 500 mL = 100 mL. Infuse over 20 minutes: 100 mL ÷ 20 minutes × 60 minutes/hour = 300 mL/hour.

Question 5 of 5

An unlicensed assistive personnel (UAP) informs the charge nurse that a client who delivered a 7-pound (3,175 gram) infant 12 hours ago is experiencing a severe headache.The client's blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/minute, heart rate is 74 beats/minute, and temperature is 98.6° F (37° C). The client's fundus is firm and one fingerbreadth above the umbilicus.What should the charge nurse do first?

Correct Answer: C

Rationale: Determining if the client received anesthesia during delivery is the correct first action. A severe headache in the postpartum period can be a sign of a post-dural puncture headache, which can occur as a complication of spinal or epidural anesthesia.

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