Maternity HESI Test Bank

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A 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light and asks for her nurse right away, stating 'I'm bleeding a lot.' What is the most likely cause of postpartum hemorrhage in this client?

  • A. Retained placental fragments.
  • B. Unrepaired vaginal lacerations.
  • C. Uterine atony.
  • D. Puerperal infection.
Correct Answer: C

Rationale: Uterine atony is the most likely cause of bleeding 4 hours after delivery, especially after delivering a macrosomic infant and augmenting labor with oxytocin. Uterine atony is characterized by the inability of the uterine muscles to contract effectively after childbirth, leading to excessive bleeding. The other options, such as retained placental fragments (A), unrepaired vaginal lacerations (B), and puerperal infection (D), are less likely causes of postpartum hemorrhage in this scenario. Retained placental fragments can cause bleeding, but this typically presents earlier than 4 hours postpartum. Unrepaired vaginal lacerations would likely be evident sooner and not typically result in significant bleeding. Puerperal infection is not a common cause of immediate postpartum hemorrhage unless there are other signs of infection present.

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After mitosis, the genetic code is identical in new cells unless _________ occur through radiation or other environmental influences.

  • A. reductions
  • B. expulsions
  • C. conceptions
  • D. mutations
Correct Answer: D

Rationale: After mitosis, the genetic code is typically preserved and remains identical in the new cells. However, mutations can occur due to radiation or environmental influences, leading to changes in the DNA sequence and potentially altering the genetic code. Therefore, the correct answer is 'mutations.' Choices A, B, and C are incorrect because reductions, expulsions, and conceptions do not accurately describe the changes in the genetic code that can result from external factors. Mutations are the only option that reflects the alteration in the genetic code caused by external influences, making it the correct choice in this context.

What additional assessment is required for the postoperative care of a pregnant woman who undergoes abdominal surgery for appendicitis?

  • A. Intake and output (I&O) and intravenous (IV) site.
  • B. Signs and symptoms of infection.
  • C. Vital signs and incision.
  • D. Fetal heart rate (FHR) and uterine activity.
Correct Answer: D

Rationale: The correct additional assessment for postoperative care of a pregnant woman requiring abdominal surgery for appendicitis is monitoring the fetal heart rate (FHR) and uterine activity. This is crucial due to the presence of the fetus. Continuous fetal and uterine monitoring should be prioritized to ensure the well-being of both the mother and the baby. While assessing I&O levels and the IV site are common postoperative care procedures, they are not specific to the unique needs of a pregnant woman. Evaluating for signs and symptoms of infection is important for any postoperative patient but is not the additional assessment required specifically for a pregnant woman in this scenario. Routine vital signs and incision evaluation are standard components of postoperative care but do not address the specific needs related to the fetus and the uterus in this case.

A client at 37 weeks gestation presents to labor and delivery with contractions every two minutes. The nurse observes several shallow small vesicles on her pubis, labia, and perineum. The nurse should recognize the client is exhibiting symptoms of which condition?

  • A. Genital Warts
  • B. Syphilis
  • C. Herpes Simplex Virus
  • D. German Measles
Correct Answer: C

Rationale: The correct answer is C: Herpes Simplex Virus (HSV). HSV can present with small vesicles on the genital area, and it is a concern during labor due to the risk of transmission to the newborn. Genital warts (Choice A) are caused by the human papillomavirus (HPV) and typically present as flesh-colored growths, not vesicles. Syphilis (Choice B) manifests as painless sores and can have systemic effects but does not typically present with vesicles. German measles (Choice D), also known as Rubella, is a viral illness characterized by a red rash, fever, and lymphadenopathy, not vesicles.

An individual's phenotype reflects both genetic and environmental influences.

  • A. phenotype
  • B. chromosome
  • C. allele
  • D. genotype
Correct Answer: A

Rationale: The correct answer is A: phenotype. A phenotype is the observable characteristics of an individual, which result from the interaction of their genotype with the environment. This interaction between genetics and the environment determines how genes are expressed and how traits are manifested in an individual. Choices B, C, and D are incorrect because chromosomes, alleles, and genotypes are components of an individual's genetic makeup, but they do not directly reflect the observable traits influenced by both genetics and the environment.

When should the low-risk patient, who is 16 weeks pregnant, be advised to return to the prenatal clinic?

  • A. 1 week.
  • B. 2 weeks.
  • C. 3 weeks.
  • D. 4 weeks.
Correct Answer: D

Rationale: The correct answer is D: 4 weeks. Low-risk pregnant patients typically have prenatal visits every 4 weeks until 28 weeks of gestation. This frequency allows for adequate monitoring of the pregnancy without being overly burdensome on the patient. Choices A, B, and C are incorrect as they do not align with the standard prenatal care schedule for low-risk pregnancies. Visits that are too frequent may cause unnecessary anxiety for the patient, while visits that are too infrequent may miss important opportunities for monitoring and intervention.

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