a client who is 32 weeks gestation comes to the womens health clinic and reports nausea and vomiting on examination the nurse notes that the client ha

HESI RN

Maternity HESI 2023 Quizlet

1. A client who is 32 weeks' gestation comes to the women's health clinic and reports nausea and vomiting. On examination, the nurse notes that the client has an elevated blood pressure. Which action should the nurse implement next?

A. Inspect the client's face for edema.
B. Ascertain the frequency of headaches.
C. Evaluate for a history of cluster headaches.
D. Observe and time the client's contractions.

Correct answer: A

Rationale: Inspecting the client's face for edema is crucial to assess for preeclampsia, a serious condition characterized by high blood pressure during pregnancy. Edema, particularly facial edema, can be a significant indicator of preeclampsia, prompting the need for further evaluation and management to ensure the well-being of both the client and the unborn child.

2. After a client delivered vaginally 2 days ago, what information should you share with her if she wants to resume using her diaphragm for birth control?

A. The diaphragm is the most effective form of contraception.
B. The diaphragm must be refitted after childbirth.
C. Vaseline lubricant should be used when inserting the diaphragm.
D. The diaphragm should be inserted 2 to 4 hours before intercourse.

Correct answer: B

Rationale: After childbirth, the diaphragm must be refitted to ensure a proper fit and effectiveness. Changes in the body post-delivery can affect the fit of the diaphragm, making it necessary to get refitted. Choice A is incorrect because while the diaphragm can be effective, it is not the most effective form of contraception. Choice C is incorrect because oil-based lubricants like Vaseline can damage latex diaphragms. Choice D is incorrect because the diaphragm should be inserted no more than 2 hours before intercourse, not 2 to 4 hours.

3. What should the nurse recommend to a woman with mastitis?

A. Apply heat to the affected area.
B. Apply cold compresses to the affected area.
C. Use a breast pump to express milk.
D. Continue breastfeeding as usual.

Correct answer: A

Rationale: The nurse should recommend applying heat to the affected area for a woman with mastitis. Heat can help reduce pain and inflammation associated with mastitis by improving blood flow to the area and promoting healing.

4. After each feeding, a 3-day-old newborn is spitting up large amounts of Enfamil® Newborn Formula, a nonfat cow's milk formula. The pediatric healthcare provider changes the neonate's formula to Similac® Soy Isomil® Formula, a soy protein isolate-based infant formula. What information should the LPN/LVN provide to the mother about the newly prescribed formula?

A. The new formula is a coconut milk formula used with babies with impaired fat absorption.
B. Enfamil® Formula is a demineralized whey formula that is needed with diarrhea.
C. The new formula is a casein protein source that is low in phenylalanine.
D. Similac® Soy Isomil® Formula is a soy-based formula that contains sucrose.

Correct answer: D

Rationale: The LPN/LVN should inform the mother that Similac® Soy Isomil® Formula is a soy-based formula containing sucrose. This formula is suitable for infants with cow's milk protein allergy or intolerance, which may be the reason for the newborn spitting up large amounts of the previous cow's milk formula.

5. What maternal behavior is typically observed when a new mother first receives her infant?

A. She eagerly reaches for the infant, undresses the infant, and examines the infant completely.
B. Her arms and hands receive the infant and she then traces the infant's profile with her fingertips.
C. Her arms and hands receive the infant and she then cuddles the infant to her own body.
D. She eagerly reaches for the infant and then holds the infant close to her own body.

Correct answer: B

Rationale: When a new mother first receives her infant, a typical maternal behavior is to use her arms and hands to receive the infant and then trace the infant's profile with her fingertips. This action is a gentle way of bonding with the newborn and aids in recognizing the infant's features. Choices A, C, and D are incorrect as they do not accurately describe the common behavior of tracing the infant's profile, which is a significant part of the initial interaction between a mother and her newborn.