HESI OB QUESTIONS BANK (Orange Book)
184. The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply.
1. “The ductus arteriosus allows blood to bypass the fetal lungs.”
2. “One vein carries oxyge...
184 the nurse is preparing to teach a prenatal class about fetal circulation which statements should be included in the teaching plan select all that apply 1
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HESI OB QUESTIONS BANK (Orange Book)
184. The nurse is preparing to teach a prenatal class about fetal circulation. Which
statementsshould be included in the teaching plan? Select all that apply.
1. “The ductus arteriosus allows blood to bypass the fetal lungs.”
2. “One vein carries oxygenated blood from the placenta to the fetus.”
3. “The normal fetal heart beat range is 160 to 180 beats per minute in pregnancy.”
4. “Two arteries carry deoxygenated blood and waste products away from the
fetus to theplacenta.”
5. “Two veins carry blood that is high in carbon dioxide and other waste products
away from thefetus to the placenta.”
Rationale: The ductus arteriosus is a unique fetal circulation structure that allows blood
to bypass the nonfunctioning fetal lungs. Oxygenated blood is transported to the fetus
by one umbilical vein. The normal fetal heart beat range is considered to be 110 to 160
beats per minute.Two arteries carry deoxygenated blood and waste products from the
fetus, and one umbilical veincarries oxygenated blood and provides oxygen and
nutrients to the fetus. Blood pumped by the embryo’s heart leaves the embryo through
two umbilical arteries.
185. The nursing instructor asks the student to describe fetal circulation, specifically
the ductusvenosus. Which statement by the student indicates an understanding of the
ductus venosus?
1. “It connects the pulmonary artery to the
aorta.” 2. “It is an opening between the right
and left atria.”
3. “It connects the umbilical vein to the inferior vena
cava.” 4. “It connects the umbilical artery to the inferior
vena cava.”
Rationale: The ductus venosus connects the umbilical vein to the inferior vena cava.
The foramen ovale is a temporary opening between the right and left atria. The ductus
arteriosus joinsthe aorta and the pulmonary artery.
186. A pregnant client tells the clinic nurse that she wants to know the sex of her baby
as soon as it can be determined. The nurse informs the client that she should be able to
find out the sex at 16weeks’ gestation because of which factor?
1. The appearance of the fetal external genitalia
,2. The beginning of differentiation in the fetal
groin3. The fetal testes are descended into the
scrotal sac
4. The internal differences in males and females become apparent
187. The nurse is performing an assessment on a client who is at 38 weeks’ gestation
and notesthat the fetal heart rate (FHR) is 174 beats per minute. On the basis of this
finding, what is the priority nursing action?
1. Document the finding.
2. Check the mother’s heart rate.
3. Notify the obstetrician (OB).
4. Tell the client that the fetal heart rate is normal.
Rationale: The FHR depends on gestational age and ranges from 160 to 170 beats per
minute inthe first trimester but slows with fetal growth to 110 to 160 beats per minute.
If the FHR is less than 110 beats per minute or more than 160 beats per minute with the
uterus at rest, the fetus may be in distress. Because the FHR is increased from the
reference range, the nurse should notify the OB. Options 2 and 4 are inappropriate
actions based on the information in the question. Although the nurse documents the
findings, based on the information in the question, the OB needs to be notified.
188. The nurse is conducting a prenatal class on the female reproductive system. When
a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days,
what is the nurse’sbest response?
1. “It promotes the fertilized ovum’s chances of survival.”
2. “It promotes the fertilized ovum’s exposure to estrogen and progesterone.”
3. “It promotes the fertilized ovum’s normal implantation in the top portion of the
uterus.”
4. “It promotes the fertilized ovum’s exposure to luteinizing hormone and follicle-
stimulatinghormone.”
189. The nursing instructor asks a nursing student to explain the characteristics of the
amnioticfluid. The student responds correctly by explaining which as characteristics
of amniotic fluid? Select all that apply.
1. Allows for fetal movement
2. Surrounds, cushions, and protects the fetus
3. Maintains the body temperature of the fetus
4. Can be used to measure fetal kidney function
,5. Prevents large particles such as bacteria from passing to the fetus - PLACENTA
6. Provides an exchange of nutrients and waste products between the mother and
the fetus -PLACENTA
190. A couple comes to the family planning clinic and asks about sterilization
procedures. Whichquestion by the nurse should determine whether this method of
family planning would be most appropriate?
1. “Have you ever had surgery?”
2. “Do you plan to have any other
children?”3. “Do either of you have
diabetes mellitus?”
4. “Do either of you have problems with high blood pressure?”
191. The nurse should make which statement to a pregnant client found to have a
gynecoidpelvis?
1. “Your type of pelvis has a narrow pubic arch.”
2. “Your type of pelvis is the most favorable for labor and
birth.” 3. “Your type of pelvis is a wide pelvis, but it has a
short diameter.”
4. “You will need a cesarean section because this type of pelvis is not favorable for a
vaginaldelivery.”
Rationale: A gynecoid pelvis is a normal female pelvis and is the most favorable for
successful labor and birth. An android pelvis (resembling a male pelvis) would be
unfavorable for labor because of the narrow pelvic planes. An anthropoid pelvis has an
outlet that is adequate, with a normal or moderately narrow pubic arch. A platypelloid
pelvis (flat pelvis) has a wide transversediameter, but the anteroposterior diameter is
short, making the outlet inadequate.
192. Which purposes of placental functioning should the nurse include in a prenatal
class? Selectall that apply.
1. It cushions and protects the baby.
2. It maintains the temperature of the baby.
3. It is the way the baby gets food and oxygen.
4. It prevents all antibodies and viruses from passing to the baby.
5. It provides an exchange of nutrients and waste products between the mother and
developingfetus.
, Rationale: The placenta provides an exchange of oxygen, nutrients, and waste
products betweenthe mother and the fetus. The amniotic fluid surrounds, cushions,
and protects the fetus and maintains the body temperature of the fetus. Nutrients,
medications, antibodies, and viruses can pass through the placenta.
193. A 55-year-old male client confides in the nurse that he is concerned about his
sexualfunction. What is the nurse’s best response?
1. “How often do you have sexual relations?”
2. “Please share with me more about your concerns.”
3. “You are still young and have nothing to be concerned about.”
4. “You should not have a decline in testosterone until you are in your 80s.”
Prenatal Period
194. The nurse is providing instructions to a pregnant client who is scheduled for an
amniocentesis. What instruction should the nurse provide?
1. Strict bed rest is required after the procedure.
2. Hospitalization is necessary for 24 hours after the procedure.
3. An informed consent needs to be signed before the procedure.
4. A fever is expected after the procedure because of the trauma to the abdomen.
Rationale: Because amniocentesis is an invasive procedure, informed consent needs to
be obtained before the procedure. After the procedure, the client is instructed to rest,
but may resume light activity after the cramping subsides. The client is instructed to
keep the puncture site clean and to report any complications, such as chills, fever,
bleeding, leakage of fluid at theneedle insertion site, decreased fetal movement, uterine
contractions, or cramping.
Amniocentesis is an outpatient procedure and may be done in the obstetrician’s office
or in aspecial prenatal testing unit. Hospitalization is not necessary after the
procedure.
195. A pregnant client in the first trimester calls the nurse at a health care clinic and
reports that she has noticed a thin, colorless vaginal drainage. The nurse should make
which statement to theclient?
1. “Come to the clinic immediately.”
2. “The vaginal discharge may be bothersome, but is a normal
occurrence.” 3. “Report to the emergency department at the maternity
center immediately.”
4. “Use tampons if the discharge is bothersome, but be sure to change the tampons
every 2hours.”
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