Maternity HESI Test Bank

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A client at 26 weeks gestation was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks what she should do next. What information should the nurse provide?

  • A. Reassure the client that the AFP results are likely to be a false reading.
  • B. Explain that a sonogram should be scheduled for definitive results.
  • C. Inform her that a repeat alpha-fetoprotein (AFP) test should be evaluated.
  • D. Discuss options for intrauterine surgical correction of congenital defects.
Correct Answer: B

Rationale: An elevated AFP level during pregnancy can indicate potential fetal anomalies. Further evaluation is necessary to confirm the findings and assess the need for additional interventions. Scheduling a sonogram is the appropriate next step as it can provide more definitive results and help identify any underlying issues. Choice A is incorrect because dismissing the elevated AFP level as a false reading without further investigation can lead to missing important information about the baby's health. Choice C is not the best immediate action, as scheduling a sonogram would provide more detailed information than just repeating the AFP test. Choice D is incorrect as discussing intrauterine surgical correction is premature at this stage and not typically indicated based solely on an elevated AFP level.

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A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for an induction of labor with misoprostol?

  • A. A client who has active genital herpes
  • B. A client who has gestational diabetes mellitus
  • C. A client who has a previous uterine incision
  • D. A client who has placenta previa
Correct Answer: B

Rationale: Misoprostol can be used for induction in clients with gestational diabetes mellitus. Choice A, a client with active genital herpes, is not a candidate for misoprostol induction due to the risk of viral shedding and transmission. Choice C, a client with a previous uterine incision, may be at risk for uterine rupture with misoprostol use. Choice D, a client with placenta previa, is not an appropriate candidate for misoprostol induction due to the risk of increased bleeding associated with the condition.

What is the central layer of the embryo from which the bones and muscles develop?

  • A. neural tube
  • B. mesoderm
  • C. ectoderm
  • D. umbilical cord
Correct Answer: B

Rationale: The correct answer is mesoderm. The mesoderm is the middle layer of the embryo that gives rise to the bones, muscles, and other connective tissues. The neural tube (choice A) develops into the nervous system, not bones and muscles. The ectoderm (choice C) forms the skin and nervous system, not bones and muscles. The umbilical cord (choice D) is a structure that connects the developing fetus to the placenta; it is not a layer of the embryo that gives rise to bones and muscles.

A 38-week primigravida is admitted to labor and delivery after a non-reactive result on a non-stress test (NST). The nurse begins a contraction stress test (CST) with an oxytocin infusion. Which finding is most important for the nurse to report to the healthcare provider?

  • A. A pattern of fetal late decelerations.
  • B. Fetal heart rate accelerations with fetal movement.
  • C. Absence of uterine contractions within 20 minutes.
  • D. Spontaneous rupture of membranes.
Correct Answer: A

Rationale: The correct answer is A: A pattern of fetal late decelerations. Late decelerations during a contraction stress test are concerning as they indicate uteroplacental insufficiency, which can pose a risk to fetal well-being. Reporting this finding to the healthcare provider is crucial for prompt intervention. Choice B, fetal heart rate accelerations with fetal movement, is a reassuring sign of fetal well-being and does not raise immediate concerns. Choice C, absence of uterine contractions within 20 minutes, may require further assessment but is not as critical as late decelerations. Choice D, spontaneous rupture of membranes, is important but not the most immediate concern during a contraction stress test.

Which of the following pairs of bases is present in the rungs of the ladder-like structure of deoxyribonucleic acid (DNA)?

  • A. Cytosine with guanine.
  • B. Rhodamine with biotin.
  • C. Diaminopurine with ribozyme.
  • D. Serine with tyrosine.
Correct Answer: A

Rationale: The correct answer is A: Cytosine with guanine. In the DNA double helix, cytosine always pairs with guanine forming a base pair, and adenine pairs with thymine. These complementary base pairs form the rungs of the ladder-like structure of DNA. Choice B, Rhodamine with biotin, is incorrect as they are not base pairs found in DNA. Choice D, Serine with tyrosine, is incorrect as they are amino acids, not DNA bases. Choice C, Diaminopurine with ribozyme, is also incorrect as ribozyme is an enzyme, not a base, and diaminopurine is not one of the standard bases found in DNA.

A healthcare provider is assessing a preterm newborn who is at 32 weeks of gestation. Which of the following finding should the healthcare provider expect?

  • A. Minimal arm recoil
  • B. Popliteal angle of less than 90°
  • C. Creases over the entire sole
  • D. Sparse lanugo
Correct Answer: A

Rationale: When assessing a preterm newborn at 32 weeks of gestation, healthcare providers should expect minimal arm recoil. This finding is common in preterm infants due to lower muscle tone. Choice B, a popliteal angle of less than 90°, is incorrect for this age group. Creases over the entire sole (Choice C) typically develop at term age, not at 32 weeks of gestation. Sparse lanugo (Choice D) is a normal finding in preterm infants but is not specific to those at 32 weeks of gestation.

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