HESI RN Maternity Nursing Q & A

1. A primigravida mother who is one day post delivery tells the nurse that she is not producing enough milk for her new baby, and she wants to begin breastfeeding at home when her milk comes in. What info should the nurse obtain before responding to the client? AͲwhen the lactation consultant is scheduled to visit the client in her home BͲthe womans understanding of how her body produces breast milk. CͲif the woman is feeling pressured by her family to breast feed her infant. DͲwhy the woman thinks her infant is not receiving enough milk CorrectͲD Sometimes new mothers do not understand that colostrums provided adequate nutrition the first three days following delivery. So the clients thinking regarding this issue should be assessed (D). Waiting for a visit from a lactation consultant (A) to address this issue is likely to inhibit lactation if the mother delays suckling the infant. Although assessing the mother’s understanding of milk production (B) may provide a teaching opportunity, it does not elicit information about the clients concern regarding the delay of breast feeding/ Assessing the mothers feelings about her family’s desire for her to breastfreed (C) doesn’t address the issue athand. 2. A client with endometritis is preparing for discharge on her third postpartum day, Which statement by he client indicates that the discharge teaching was effective? AͲI should limit my visitors until this infection clears BͲI will resume breastfeeding when the infection is gone CͲI should sit an upright position as much as possible DͲI will stop taking antibiotics when my fever disappears CorrectͲC A client with endo metris should sit in an upright position© to facilitate drainage of lochia and prevent infected fluids from enetering the peritoneal cavity. (A,B and D) indicate a needs for additional instruction. Endometritis is an infection of the endometrial lining and is not contagious, so visitors do not need to be restricted or limited(A). there is no indication to stop or withholding breastfeeding (b) if a client develops endometritis. All antibiotics should be completed regardless of fever abatement. 3. A multipara postpartum client complains about intenst cramping while breastfeeding. What instructions should the nurse provide to this client? AͲ TAKE A PRESCRIBED ANALGESIC AN HOUR PRIOR TO BREASTFEEDING BͲ change then infants position during the next feeding CͲ drink two glasses of Water 30 minutes prior to breastfeeding DͲ void and completely empty bladder before each feeding CorrectͲa The client is experiencing atterpains which typically affect multigravidas due to relaxation of the uterine muscles and release of oxytocin during breastfeeding. The client should take a prescribed analgesic one hour before breastfeeding (A) to relieve this discomfort. Infant positioning during B is effective in relieving sore nipples. C and D are not effectivemeasures for relieving uttering cramping. 4. A client at 28 weeks gestation is admitted to the obstetrical unit following her involvement in a motor vehicle collossion. After stabilizing the client, the nurse obtains a fetal monitor reading. What action should the nurse take if fetal tachycardia is assessed on the monitor? AͲSuspect that the monitor is malfunctioning and recount the heart rate manually BͲExplain to the client that a rapid heart right is normal for a preterm fetus. CͲPerform a vaginal Examination to see if the accident initiated preterm labor DͲAdminister oxygen to the client and contact the healthcare provider immediately. CorrectͲD Administering oxygen and contacting the healthcare provider (D) are the priority interventions for fetal oxygen deprivation secondary to placental abruption, which is known complication of trauma to the mother. AͲwastes time and increased the chance of errors in the assessment. BͲprovides the client with dales information. CͲincreased the risk of hemorrhage, further compromising fetal oxygenation, and is not a recommended intervention at this time. Vaginal bleeding should be assessed without palpation. 5.The nurse is assessing a 24 hour postpartum client. Which finding would be most indicative of a postpartum infection. 6. in caring for a newborn infant who starts gagging and becomes cyanotic, what action should the nurse implement first? aͲgive three back blows to clear the airway bͲcall for assistance and start CPR cͲsuction mouth nose with bulb

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Category HESI
Release date 2021-09-09
Pages 19
Language English
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