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Maternity HESI Test Bank
1. What maternal factor should the nurse identify as having the greatest impact on the development of spina bifida occulta in a newborn?
- A. Short interval between pregnancies
- B. Folic acid deficiency
- C. Preeclampsia
- D. Tobacco use
Correct answer: B
Rationale: Folic acid deficiency during pregnancy is a well-known risk factor for neural tube defects, including spina bifida occulta, making supplementation critical in prenatal care. Folic acid plays a crucial role in neural tube formation during early pregnancy. Short intervals between pregnancies do not directly impact the development of spina bifida occulta. Preeclampsia is a hypertensive disorder of pregnancy and is not directly linked to spina bifida occulta. While tobacco use during pregnancy has various adverse effects, it is not the primary factor influencing the development of spina bifida occulta in newborns.
2. During a prenatal visit, for which of the following clients should the nurse auscultate the fetal heart rate?
- A. A client who has an ultrasound confirming a molar pregnancy
- B. A client who has a crown-rump length corresponding to 7 weeks gestation
- C. A client who has a positive urine pregnancy test 1 week after missed menses
- D. A client who has felt quickening for the first time
Correct answer: D
Rationale: The correct answer is D because feeling quickening typically occurs around 18-20 weeks of gestation, indicating fetal movement. This is an appropriate time to auscultate the fetal heart rate. Choice A is incorrect because a molar pregnancy is not a viable pregnancy, and auscultating the fetal heart rate in this case is not applicable. Choice B is incorrect because a crown-rump length of 7 weeks gestation is too early for fetal heart rate auscultation. Choice C is incorrect because a positive urine pregnancy test alone does not indicate the appropriate timing for fetal heart rate auscultation.
3. 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.
4. Genotypes are solely based on genetic information.
- A. TRUE
- B. FALSE
- C. Sometimes
- D. Never
Correct answer: B
Rationale: The correct answer is B - FALSE. Genotypes are solely based on genetic information and do not reflect environmental influences. Phenotypes, on the other hand, result from the interaction of genetic and environmental factors. Choices A, C, and D are incorrect because genotypes are not influenced by environmental factors, and they are determined by an individual's genetic makeup.
5. Does a blastocyst gain mass only when it receives nourishment from outside?
- A. TRUE
- B. FALSE
- C. Sometimes
- D. Always
Correct answer: A
Rationale: A blastocyst does indeed require external nourishment from the mother's body to continue developing and gaining mass. Without this external nourishment, the blastocyst would not be able to grow and develop properly. Therefore, the statement that a blastocyst gains mass only when it receives nourishment from outside is true. Choices B, C, and D are incorrect because they do not accurately reflect the dependency of a blastocyst on external nourishment for its development and growth.
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