OB HESI Practice – Flashcards with Answers
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At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in the right lower quadrant of her abdomen. The nurse obtains a blood sample and initiates an IV. Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder pain. Assessment findings include diaphoresis, a heart rate of 120 beats/minute, and a blood pressure of 86/48. Which action should the nurse implement next? a. Check the hematocrit results. b. Administer pain medication. c. Increase the rate of IV fluids. d. Monitor client for contractions.
answer
c. increase the rate of IV fluids
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A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask wen she could use a home pregnancy test to diagnose pregnancy. Which response is best? a. a home pregnancy test can be used right after your first missed period b. these tests are most accurate after you have missed your second period c. home pregnancy tests often give false positives and should not be trusted d. the test can provide accurate information when used right after ovulation
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a. a home pregnancy test can be used right after your first missed period
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A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse knows that the most likely presenting symptom for a pediatric client with AIDS is: a. shortness of breath b. joint pain c. a persistent cold d. organmegaly
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c. a persistent cold
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Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action should the nurse take? a. notify the healthcare provider or anesthesiologist b. continue to assess the blood pressure q5min c. place the woman in a lateral position d. turn off continuous epidural
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c. place the woman in a lateral position
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In developing a teaching plan for expectant parents, the nurse plans to include information about when the parents can expect the infant's fontanels to close. The nurse bases the explanation on knowledge that for the normal newborn, the a. anterior fontanel closes at 2 to 4 months and the posterior by the end of the first week b. anterior fontanel closes at 5 to 7 months and the posterior by the end of the week c. anterior fontanel closes at 8 to 11 months and the posterior by the end of the second week d. anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month
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d. anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month
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A client in active labor is admitted with preeclampsia. Which assessment finding is most significant in planning this client's care? a. patellar reflex 4+ b. blood pressure 158/80 c. four hour urine output 240 ml d. respiration 12/minute
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a. patellar reflex 4+
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A 4 week old premature infant has been receiving epoetin alfa for the last three weeks. Which assessment finding indicates to the nurse that the drug is effective? a. slowly increasing urine output over the last week b. respiratory rate changes from the 40s to the 60s c. changes in apical heart rate from the 180 to the 140s d. change in indirect bilirubin from 12 mg/dl to 8 mg/dl
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c. changes in apical rate from the 180s to the 140s
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A pregnant client tells the nurse that the first day of her last menstrual period was August 2, 2006. Based on Nagele's rule, what is the estimated date of delivery? a. April 25, 2007 b. May 9, 2007 c. May 29, 2007 d. June 2, 2007
answer
b. May 9, 2007
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The nurse is performing a AGA on a full-term newborn during the first hour of transition using the Dubowitz scale. Based on this assessment, the nurse determines that the neonate has a maturity rating of 40 weeks. Which findings should the nurse identify to determine if the neonate is SGA? (Select all that apply.) a. admission weight of 4 lbs 15 oz b. head to heel length of 17 in c. frontal occipital circumference of 12.5 in d. skin smooth with visible veins and abundant vernix e. anterior plantar crease and smooth heel surfaces f. full flexion of all extremities in resting supine position
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a, b, c
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The nurse assess a client admitted to the labor and delivery unit and obtains the following data: BP 110/68, FHR 110 bpm, cervix 1 cm dilated and uneffaced. Based on these assessment findings, what intervention should the nurse implement? a. insert a fetal monitor b. assess for cervical changes q1H c. monitor bleeding from IV sites d. perform Leopold's maneuvers
answer
c. monitor for bleeding from IV sites
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Immediately after birth a newborn infant is suctioned, dried, and placed under a radiant warmer. The infant has spontaneous respirations and the nurse assess an apical heart rate of 80 bpm and respirations 20. What action should the nurse perform next? a. initiate positive pressure ventilation b. intervene after one minute APGAR is assessed c. initiate CPR on the infant d. assess the infant's blood glucose level
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a. initiate positive pressure ventilation
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A client with no prenatal care arrives at the labor unit screaming, "The baby is coming!" The nurse performs a vaginal examination that reveals the cervix is 3 cm dilated and 75% effaced. What additional information is most important for the nurse to obtain? a. gravidity and parity b. time and amount of last oral intake c. date of last normal menstrual period d. frequency and intensity of contractions
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c. date of last normal menstrual period
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A mutigravida client at 41 weeks gestation present in the labor and delivery unit after a non-stress test indicated that the fetus is experiencing some difficulties in utero. Which diagnostic test should the nurse prepare the client for additional information about fetal status? a. biophysical profile b. ultrasound for fetal abnormalities c. maternal serum alpha-fetoprotein screening d. percutaneous umbilical blood sampling
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a. biophysical profile
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A client receiving epidural anesthesia begins to experience nausea and becomes pale and clammy. What intervention should the nurse implement first? a. raise the foot of the bed b. assess for vaginal bleeding c. evaluate the fetal heart rate d. take the client's blood pressure
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a. raise the foot of the bed
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A client at 28 weeks gestation calls the antepartal clinic and states that she is experiencing a small amount of vaginal bleeding which she describes as bright red. She further states that she is not experiencing any uterine contractions or abdominal pain. What instruction should the nurse provide? a. come to the clinic today for an ultrasound b. go immediately to the emergency room c. lie on your left side for about one hour and see if the bleeding stops d. bring a urine specimen to the lab tomorrow to determine if you have a UTI
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a. come to the clinic today for an ultrasound
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Which nursing intervention is helpful in relieving "afterpains"? a. using relaxation breathing techniques b. using a breast pump c. massaging the abdomen d. giving oxytocic medications
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a. using relaxation breathing techniques
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The nurse is counseling a couple who has sought information about conceiving. For teaching purposes, the nurses should know that ovulation usually occurs a. two weeks before menstruation b. immediately after menstruation c. immediately before menstruation d. three weeks before menstruation
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a. two weeks before menstruation
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A client who has an autosomal dominant inherited disorder is exploring family planning options and the risk of transmission of the disorder to an infant. The nurses's response should be based on what information? a. males inherit the disorder with a greater frequency than females b. each pregnancy carries a 50% chance of inheriting the disorder c. the disorder occurs in 25% of pregnancies d. all children will be carriers of the disorder
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b. each pregnancy carries 50% chance of inheriting the disorder
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The nurse is assessing a 3 day old infant with a cephalohematoma in the newborn nursery. Which assessment finding should the nurse report to the healthcare provider? a. yellowish tinge to the skin b. Babinski reflex present bilaterally c. pink papular rash on the face d. Moro reflex noted after a loud noise
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a. yellowish tinge to the skin
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A woman who had a miscarriage 6 months ago becomes pregnant. Which instruction is most important for the nurse to provide this client? a. elevate lower legs while resting b. increase caloric intake by 200 to 300 calories per day c. increase water intake to 8 full glasses per day d. take prescribed multivitamin and mineral supplements
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d. take prescribed multivitamin and mineral supplements
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Which assessment finding should the nursery nurse report to the pediatric healthcare provider? a. blood glucose level of 45 b. blood pressure of 82/45 c. non-bulging anterior fontanel d. central cyanosis when crying
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d. central cyanosis when crying
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A 28 year old client in active labor complains of cramps in her leg. What intervention should the nurse implement? a. massage the calf and foot b. extend the leg and dorsiflex the foot c. lower the leg off the side of the bed d. elevate the leg above the heart
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b. extend the leg and dorsiflex the foot
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A new mother asks the nurse "How do I know that my daughter is getting enough breast milk?" Which explanation should the nurse provide? a. weigh the baby daily and if she is gaining weight she is eating enough b. your milk is sufficient if the baby is voiding pale straw-colored urine 6 to 10 times a day c. offer the baby extra bottle milk after her feeding and see if she is still hungry d. if you're concerned you might consider bottle feeding so that you can monitor her intake
answer
b. your milk is sufficient if the bay is voiding pale straw-colored urine 6 to 10 times a day
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On admission to the prenatal clinic, a 23 year old woman tells the nurse that her last menstrual period began on February 15 that previously her periods were regular. Her pregnancy test is positive. This client's expected date of delivery a. November 22 b. November 8 c. December 22 d. October 22
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a. November 22
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An off-duty finds a woman in a supermarket parking lot delivering an infant while her husband is screaming for someone to help his wife. Which intervention has the highest priority? a. provide as much privacy as possible for the woman b. use a thread to tie off the umbilical cord c. put the newborn to breast d. reassure the husband and try to keep him calm
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c. put the newborn to breast
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During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have a. a higher rate of congenital abnormalities b. respiratory distres c. lower birth weights d. lower APGAR scores
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c. lower birth weights
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A new mother who has just had her first baby says to the nurse, "I saw the baby in the recovery room. She sure has a funny looking head." Which response by the nurse is best? a. this is not an unusual shaped head especially for a first baby b. that is normal the head will return to a round shape within 7 to 10 days c. it may look funny to you but newborn babies are often born with heads like your baby's d. your pelvis was too small so the baby's head had to adjust to the birth canal
answer
b. that is normal the head will return to a round shape within 7 to 10 days
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After each feeding, a 3 day old newborn is spitting up large amounts of newborn formula, a nonfat cow's milk formula. The pediatric healthcare provider changes the neonates's formula to Similac. What information should the nurse provide to the mother about the newly prescribed formula? a. Enfamil formula is demineralized whey formula that is needed with diarrhea b. The new formula is a coconut milk formula used with babies with impaired fat absorption c. the new formula is a casein protein source that is low in phenylalanine d. similac is a soy based formula that contains sucrose
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d. similac is a soy based formula that contains sucrose
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A client who is attending antepartum classes asks the nurse why her healthcare provider has prescribed iron tablets. The nurse's response is based on what knowledge? a. iron absorption is decreased in the GI tract during pregnancy b. it is difficult to consume 18 mg of additional iron by diet alone c. iron is needed to prevent megaloblastic anemia in the last trimester d. supplementary iron is more efficiently utilized during pregnancy
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b. it is difficult to consume 18 mg of additional iron by diet alone
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When explaining postpartum blues to a client who is 1 day postpartum, which symptoms should the nurse include in the teaching plan? (select all that apply) a. panic attacks b. tearfulness c. decreased need for sleep d. mood swings e. disinterest in the infant
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b, d
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The nurse observes a new mother avoiding eye contact with her newborn. Which action should the nurse take? a. recognize this is a common reaction in new mothers b. ask the mother why she won't look at the infant c. observe the mother for other attachment behaviors d. examine the newborn's eyes for the ability to focus
answer
c. observe the mother for other attachment behaviors
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A couple concerned because the woman has not been able to conceive is referred to a HCP for a fertility workup and a hysterosalpingography is scheduled. Which postprocedure complaint indicates that the fallopian tubes are patent? a. shoulder pain b. leg cramps c. back pain d. abdominal pain
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a. shoulder pain
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A client who delivered an infant an hour ago tells the nurse that she feels wet underneath her buttock. The nurse notes that both perineal pads are completely saturated and the cline is lying in a 6 in diameter pool of blood. Which action should the nurse implement next? a. obtain a blood pressure b. inspect the perineum for lacerations c. cleanse the perineum d. palpate the firmness of the fundus
answer
d. palpate the firmness of the fundus
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A 38 week primigravida who works as a secretary and sits at a computer 8 hrs each day tells the nurse that her feet have begun to swell. Which instruction would be most effective in preventing pooling blood in the lower extremities? a. avoid constrictive clothing b. move every hour c. wear support stockings d. reduce salt in her diet
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b. move every hour
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The total bilirubin level of a 36 hour breastfeeding newborn is 14 mg/dl. Based on this finding which intervention should the nurse implement? a. feed the newborn sterile water hourly b. assess the newborn's blood glucose level c. provide phototherapy for 30 mins q8h d. encourage the mother to breastfeed frequently
answer
c. encourage the mother to breastfeed frequently
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A newborn infant is brought to the nursery from the birthing suite. The nurse notices that the infant is breathing satisfactorily but appears dusky. What action should the nurse take first? a. notify the pediatrician immediately b. position the infant on the right side c. suction the infant's nares then the oral cavity d. check the infant's oxygen saturation rate
answer
d. check the infant's oxygen saturation rate
