Hesi RN Maternal Newborn

Hesi RN Maternal Newborn Related

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History and Physical:
Nurses' Notes
Flow Sheet
The client is a 26-year-old female gravida 2, para 1, term 1, living 1. She was admitted to the labor and delivery unit with cervical dilation of 4 cm, 70% effacement, and -1 station. Her pregnancy has been uncomplicated, and she has no significant medical history.
A nurse is caring for a 26-year-old female client in the labor and delivery unit. The client is gravida 2, para 1, term 1, living 1, and is admitted with cervical dilation of 4 cm, 70% effacement, and -1 station. The pregnancy has been uncomplicated.

The nurse reviews the client data. Drag the word choices to complete the sentence. Abnormal FHR patterns can result in [Dropdown Group 1], [Dropdown Group 2], and [Dropdown Group 3].

  • A. Acidemia.
  • B. Hypoxemia.
  • C. Hypoxia.
  • D. Meconium stool.
  • E. Maternal hypotension.
  • F. Hypoglycemia.
Correct Answer: A,B,C

Rationale: Abnormal FHR patterns indicate acidemia (low pH), hypoxemia (low blood oxygen), and hypoxia (tissue oxygen deficiency), directly affecting fetal oxygenation.

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One day after vaginal delivery of a full-term baby, a postpartum client's white blood cell (WBC) count is 15,000/mm³ (15 x 10⁹/L). Which action should the nurse take first?

  • A. Check the differential, since the WBC is normal for this client.
  • B. Assess the client's perineal area for signs of a perineal hematoma.
  • C. Assess the client's temperature, heart rate, and respirations every 4 hours.
  • D. Notify the healthcare provider (HCP), since this finding is indicative of infection.
Correct Answer: A

Rationale: A WBC count of 15,000/mm³ is normal postpartum due to physiological stress; checking the differential confirms this, avoiding unnecessary interventions.

The nurse is preparing to administer phytonadione to a newborn. Which statement made by the parents indicates understanding why the nurse is administering this medication?

  • A. Improve insufficient dietary intake.
  • B. Stimulate the immune system.
  • C. Prevent hemorrhagic disorders.
  • D. Help an immature liver.
Correct Answer: C

Rationale: Phytonadione (vitamin K) prevents hemorrhagic disorders in newborns by supporting clotting factor synthesis, addressing low vitamin K levels at birth.

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

  • A. Heart rate of 56 beats/minute.
  • B. Saturating two perineal pads per hour.
  • C. Soft, spongy fundus.
  • D. Unilateral lower leg pain.
Correct Answer: A

Rationale: Bradycardia (56 beats/minute) is normal postpartum due to increased stroke volume, unlike excessive bleeding, uterine atony, or DVT signs.

A client at 9 weeks gestation tells the nurse that while she has cut down, she still has at least one alcoholic drink every evening before bedtime. Which intervention should the nurse implement?

  • A. Notify child protective services of the client's illicit drug use and probable child endangerment.
  • B. Praise the client for her actions and offer to discuss ways to decrease consumption even more.
  • C. Refer the client to an outpatient alcohol abuse program for disulfiram therapy.
  • D. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit.
Correct Answer: B

Rationale: Praising reduced alcohol intake encourages further reduction, while offering support fosters a collaborative approach to minimize fetal alcohol exposure.

A client in active labor receives a prescription for oxytocin 6 milliunits/minute intravenously (IV). The IV bag contains oxytocin 10 units in lactated Ringer's 1,000 mL. How many mL/hour should the nurse program the infusion pump to deliver? (Enter numerical value only.)

Correct Answer: 36

Rationale: Calculated as: (6 milliunits/min ÷ 10,000 milliunits) × 1,000 mL = 0.6 mL/min; 0.6 mL/min × 60 min/hour = 36 mL/hour.

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