HESI Maternity 55 Questions Quizlet

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Twenty-four hours after admission to the newborn nursery, a full-term male infant develops localized edema on the right side of his head. The LPN/LVN knows that, in the newborn, an accumulation of blood between the periosteum and skull which does not cross the suture line is a newborn variation known as

  • A. a cephalhematoma, caused by birth trauma and may last up to 8 weeks.
  • B. a subarachnoid hematoma, which requires immediate drainage to prevent further complications.
  • C. molding, caused by pressure during labor and will disappear within 2 to 3 days.
  • D. a subdural hematoma, which can result in lifelong damage.
Correct Answer: A

Rationale: Cephalhematoma is the accumulation of blood between the periosteum and skull, often due to birth trauma, and typically resolves within weeks. It is a common finding in newborns and is not usually a cause for concern as it gradually resolves without specific treatment. Subarachnoid hematoma and subdural hematoma are different conditions that present with distinct characteristics and require different management strategies. Therefore, the correct answer is A. Subarachnoid hematoma is typically found in the subarachnoid space and requires immediate intervention, not just observation like cephalhematoma. Molding refers to the shaping of the fetal head during passage through the birth canal and is a temporary change, not a collection of blood like in cephalhematoma. Subdural hematoma is located beneath the dura mater and is associated with significant complications, unlike the self-limiting nature of cephalhematoma.

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After a full-term vaginal delivery, a postpartum client's white blood cell count is 15,000/mm3. What action should the nurse take first?

  • A. Check the differential, as the WBC count can be normal for this client.
  • B. Assess the client's temperature, pulse, and respirations every 4 hours.
  • C. Notify the healthcare provider, as this finding may indicate infection.
  • D. Assess the client's perineal area for signs of a perineal hematoma.
Correct Answer: A

Rationale: In postpartum clients, a white blood cell count of 15,000/mm3 can be within normal limits due to physiological changes that occur after childbirth. Checking the differential count would provide a more detailed analysis of the specific types of white blood cells present, helping to differentiate between normal postpartum changes and potential infection. This action allows the nurse to gather more information before escalating the situation to the healthcare provider or initiating other assessments. Assessing vital signs and the perineal area are important aspects of postpartum care but may not be the priority in this scenario where the white blood cell count can be influenced by normal physiological changes.

A full-term infant is transferred to the nursery from labor and delivery. Which information is most important for the LPN/LVN to receive when planning immediate care for the newborn?

  • A. Length of labor and method of delivery.
  • B. Infant's condition at birth and treatment received.
  • C. Feeding method chosen by the parents.
  • D. History of drugs given to the mother during labor.
Correct Answer: B

Rationale: When a full-term infant is transferred to the nursery, the most crucial information for the LPN/LVN to receive for immediate care planning is the infant's condition at birth and any treatments received. This data helps in determining the initial care needs and monitoring requirements for the newborn. Choices A, C, and D are not as critical as the infant's condition at birth and treatment received. The length of labor and method of delivery may provide background information but may not be as essential for immediate care planning. The feeding method chosen by the parents and the history of drugs given to the mother during labor are important but do not take precedence over knowing the infant's condition and treatment received.

The nurse is caring for a client who experienced fetal demise at 32 weeks' gestation. After the fetus is delivered vaginally, the nurse implements fetal demise protocol and identification procedures. Which action is most important for the nurse to take?

  • A. Create a memory box with the baby's footprint and photographs.
  • B. Determine if the mother desires a visit from her clergy.
  • C. Encourage the mother to hold and spend time with her baby.
  • D. Explain the reasons for obtaining consent for an infant autopsy.
Correct Answer: C

Rationale: Encouraging the mother to hold and spend time with her baby is crucial after a fetal demise at 32 weeks' gestation. This action can support the mother in the grieving process, facilitate bonding, and provide closure, helping her cope with the loss of the baby. Creating a memory box with the baby's footprint and photographs could be emotionally comforting but not as immediate and impactful as encouraging direct physical contact. While offering a visit from her clergy may provide spiritual support, the immediate need is to address the physical and emotional aspects of the situation. Explaining the reasons for obtaining consent for an infant autopsy is important, but it is secondary to the immediate emotional support needed by the mother.

Using N¤gele's rule, what is the estimated date of delivery for a pregnant client who reports that the first day of her last menstrual period was August 2, 2006?

  • A. April 25, 2007.
  • B. May 9, 2007.
  • C. May 29, 2007.
  • D. June 2, 2007.
Correct Answer: B

Rationale: N¤gele's rule is used to estimate the date of delivery. It involves adding 7 days to the first day of the last menstrual period (August 2), which gives August 9. Then, subtracting 3 months from August 9, we arrive at May 9 of the following year as the estimated date of delivery. This makes choice B, 'May 9, 2007,' the correct answer. Choices A, C, and D are incorrect as they do not follow the correct calculation based on N¤gele's rule.

The LPN/LVN caring for a laboring client encourages her to void at least q2h, and records each time the client empties her bladder. What is the primary reason for implementing this nursing intervention?

  • A. Emptying the bladder during delivery is difficult because of the position of the presenting fetal part.
  • B. An over-distended bladder could be traumatized during labor as well as prolong the progress of labor.
  • C. Urine specimens for glucose and protein must be obtained at certain intervals throughout labor.
  • D. Frequent voiding minimizes the need for catheterization, which increases the chance of bladder infection.
Correct Answer: B

Rationale: The primary reason for encouraging the laboring client to void regularly is to prevent an over-distended bladder, which could impede the descent of the fetus, prolong labor, and be at risk for trauma during delivery. Choice A is incorrect because the difficulty in emptying the bladder during delivery is not the main reason for this nursing intervention. Choice C is incorrect as it pertains to obtaining urine specimens for glucose and protein, not the primary reason for encouraging voiding. Choice D is incorrect because although frequent voiding can indeed minimize the need for catheterization, the primary reason is to prevent an over-distended bladder and potential complications.

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