Hesi Obstetrics & Maternity Proctored Exam
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Hesi Obstetrics & Maternity Proctored Exam
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Question: 1 of 42Hesi Obstetrics & Maternity Proctored Exam
A 34-week gestation multigravida comes to the clinic for her bimonthly appointment. Which assessment finding should the nurse report to the healthcare provider?
Explanation
Choice A rationale Weight gain of two pounds during a two week period at thirty four weeks gestation is considered a normal finding. Typically, a woman is expected to gain about one pound per week during the third trimester. Because this weight gain aligns with standard prenatal growth curves, it does not indicate a pathological process like preeclampsia or gestational diabetes. Therefore, the nurse would document this finding as normal and continue routine monitoring of the pregnancy. Choice B rationale Dependent edema of 1+ in the lower extremities is a common physiological occurrence during the third trimester of pregnancy. It results from the gravid uterus compressing the inferior vena cava, which increases hydrostatic pressure in the lower limbs. While generalized edema involving the face or hands can be a warning sign of pregnancy induced hypertension, mild pedal edema is expected. This finding does not require immediate notification of the healthcare provider unless accompanied by high blood pressure. Choice C rationale A fetal heart rate of 110 beats per minute is within the normal baseline range of 110 to 160 beats per minute. Fetal heart rate is a primary indicator of fetal well being and oxygenation. Since 110 represents the lower limit of normal, the nurse should continue to monitor the fetal heart rate for variability and accelerations. However, because it remains within the established safe parameters, it is not an urgent finding that necessitates reporting to the physician. Choice D rationale Fundal height should generally correspond to the number of weeks of gestation plus or minus two centimeters after twenty weeks. At thirty four weeks, a fundal height of 30 cm is significantly lower than the expected range of 32 to 36 cm. This discrepancy could indicate intrauterine growth restriction or oligohydramnios, which are serious conditions. Therefore, the nurse must report this lag in fundal growth to the healthcare provider to initiate further diagnostic ultrasound evaluation of the fetus.
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