HESI RN
HESI RN Maternal Newborn I Questions
Extract:
Question 1 of 5
The nurse is providing preconception counseling. Which supplement should the nurse recommend to help prevent the occurrence of anencephaly?
Correct Answer: A
Rationale: Folic acid (400-800 mcg daily) prevents neural tube defects like anencephaly by supporting neural tube closure.
Extract:
History and Physical
Nurses' Notes
Flow Sheet
Laboratory Results
38-year-old primiparous client is seen in the outpatient obstetric office 2 weeks postpartum after a spontaneous vaginal birth of a full-term infant after rupture of membranes for 16 hours. The client was discharged on day 2, exclusively breastfeeding.
Question 2 of 5
Select the findings that will help the nurse determine what is causing the client's symptoms.
| Rupture of membranes for 16 hours |
| Normal spontaneous vaginal birth |
| Breastfeeding 7 to 8 times a day for 10 minutes |
| Discharge hemoglobin of 9.2 g/dL (92 g/L) |
| Current vital signs |
| Shopping yesterday for 5 hours |
| Foul-smelling lochia rubra |
Correct Answer: A,D,E,F,G
Rationale: Prolonged rupture of membranes, low hemoglobin, fever, tachycardia, prolonged shopping, and foul-smelling lochia suggest postpartum infection risks like endometritis or mastitis. These findings indicate systemic inflammation, anemia, and potential milk stasis.
Extract:
History and Physical
Nurses' Notes
Orders
The client is a 4-month-old female with a history of gastroesophageal reflux (GERD). Client had fundoplication surgery and will be hospitalized for several days of recovery.
Question 3 of 5
Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate.
| Options | Appropriate | Not appropriate |
|---|---|---|
| Ask the healthcare provider to prescribe a nonsteroidal anti-inflammatory drug (NSAID) | ||
| Have one of the parents hold the baby | ||
| Perform guided imagery | ||
| Consult a child life specialist | ||
| Encourage the baby's mother to breastfeed the baby | ||
| Wait 1 hour, reassess, and give medication if the FLACC score remains elevated | ||
| Request a prescription for an opioid |
Correct Answer: B,D,G
Rationale: NSAIDs, parental holding, child life consultation, and opioids (if severe) are appropriate. Guided imagery is too advanced, breastfeeding is contraindicated (NPO), and delaying treatment is inappropriate.
Extract:
Question 4 of 5
A 34-week gestation multigravida comes to the clinic for her bimonthly appointment. Which assessment finding should the nurse report to the healthcare provider (HCP)?
Correct Answer: B
Rationale: Fundal height of 30 cm is below the expected range (32-36 cm) for 34 weeks gestation, suggesting possible intrauterine growth restriction (IUGR) or oligohydramnios, which requires further evaluation. Mild edema is common, weight gain is normal, and a fetal heart rate of 110 bpm is within the acceptable range.
Question 5 of 5
Following a vaginal delivery, the nurse places the neonate under the radiant warmer, provides naso-oropharyngeal suction, and dries the neonate's skin to elicit spontaneous respirations. The newborn heart rate is 100 beats/minute and remains apneic when the nurse flicks the soles of the feet. Which action should the nurse implement next?
Correct Answer: D
Rationale: Positive pressure ventilation is critical for an apneic newborn to establish breathing and ensure oxygenation, per neonatal resuscitation guidelines.