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OB HESI FINAL EXAM QUESTIONS WITH COMPLETE SOLUTIONS
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OB HESI FINAL EXAM QUESTIONS WITH COMPLETE SOLUTIONS
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OB HESI FINAL EXAM QUESTIONS WITHCOMPLETE SOLUTIONS
A client who delivered an infant an hour ago tells the nurse the she feels wet
underneath her buttock. The nurse notes that the perineal pad is saturated and the
client is lying in a 6-inch diameter pool of blood. Which action should the nurse
implement first?
A. Cleanse the perineum
B. Obtain a blood pressure
C. Palpate the firmness of the fundus
D. Inspect the perineum for lacerations - Answer-Correct Answer: C
A firm uterus is needed to control bleeding from the placental site of attachment on the
uterine wall. The nurse should FIRST assess for firmness and massage the fundus as
indicated.
A woman who thinks she could be pregnant calls her neighbor, who is a nurse, to ask
when she should use a home pregnancy test. Which response is appropriate?
A. "A home pregnancy test can be used right after your first missed period."
B. "These tests are most accurate after you 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." -
Answer-Correct Answer: A
Home urine test are based on the chemical detection of human chorionic
gonadotrophin, which begins to increase 6-8 days after conception. Best detected at 2
weeks gestation or immediately after first missed period.
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. Mood swings
B. Panic attacks
C. Tearfulness
D. Decreased need for sleep
E. Disinterest in the infant - Answer-Correct Answers: A,C
"Postpartum blues" is a common emotional response related to the rapid decrease in
placental hormones after delivery and include mood swings, teaefulness, feeling low,
emotional, and fatigued.
B,D, and E indicate "Postpartum Depression"
,One hour after giving birth to an 8-pound infant, a client's lochia rubra has increased
from small to large and her fundus is boggy despite massage. HR is 84 bpm, BP
156/96. The M.D. prescribe Methergine 0.2 mg IM x 1. Which action should the nurse
take immediately?
A. Give the medication as prescribed and monitor for efficacy
B. Encourage the client to breastfeed rather than bottle feed
C. Have the client empty her bladder and massage her fundus
D. Call the HP to question the prescription - Answer-Correct Answer: D
Methergine is contraindicated for clients with elevated BP, so the nurse should contact
the HP and question the prescription.
The nurse should encourage the laboring patient to begin pushing when
A. there is only an anterior or posterior lip of cervix left
B. the client describes the need to have a BM
C. the cervix is completely dilated
C. the cervix is completely effaced - Answer-Correct Answer: C
Pushing begins with the second stage of labor (i.e. when the cervix is completely dilated
at 10 cm). Pushing before this point could case the cervix to become edematous =
operative delivery.
A client at 32-weeks gestation is hospitalized with severe pregnancy-induced
hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms.
Which assessment finding indicates the therapeutic drug level has been achieved?
A. 4+ reflexes
B. Urinary output of 50 ml/hr
C. A decrease in RR from 24 to 16
D. A decreased body temp - Answer-Correct Answer: C
Magnesium sulfate, a CNS depressant, helps prevent seizures.** RR <12 indicate
toxicity, Urine output should be at least 30 ml/hr
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized edema on the right side of his head. The nurse knows that, in the
newborn, an accumulation of blood between the periosteum and skull which does not
cross the suture line is a newborn variation known as
A. a cephalhematoma, caused by forceps trauma and may last up to 8 weeks
B. a subarachnoid hematoma, which requires immediate drainage to prevent
complications
C. molding, caused by pressure during labor and will disappear within 2 to 3 days
,D. a subdural hematoma which can result in lifelong damage - Answer-Correct Answer:
A
A slight abnormal variation of the newborn, usually arises within first 24 hours after
delivery. Trauma from delivery causes capillary bleeding between the periosteum and
the skull
(B) a cranial distortion lasting 5-7 days, caused by pressure on the cranium
(C&D) involves cranial bleeding; cannot be detected on physical exam alone
A couple has been trying to conceive for nine months without success. Which
information obtained from the clients is most likely to have an impact on the couple's
ability to conceive a child?
A. Exercise regimen of both partners includes running four miles each morning
B. History of having sexual intercourse 2-3 times per week
C. The woman's menstrual period occurs every 35 days
D. They use lubricants with each sexual encounter to decrease friction - Answer-Correct
Answer: D
The use of lubricants has the potential to affect fertility because some lubricants
interfere with sperm motility
Which action should the nurse implement when preparing to measure the fundal height
of a pregnant client?
A. Have the client empty the bladder
B. Request the client lie on her left side
C. Perform Leopold's maneuvers first
D. Give the client some juice - Answer-Correct Answer: A
The bladder must be completely empty to accurately measure the fundal height.
An off-duty nurse 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. Use a thread to tie off the umbilical cord
B. Provide as much privacy as possible
C. Reassure the husband and try to keep him calm
D. Put the newborn to breast - Answer-Correct Answer: D
Putting the newborn to breast will help contract the uterus and prevent a postpartum
hemorrhage. Preventing hemorrhage is the highest priority.
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.
Which 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 sample to the lab tomorrow to determine if you have a UTI - Answer-
Correct Answer: A
Third trimester painless bleeding is characteristic of a placental previa. Bright red
bleeding may be intermittent, occur in gushes, or be continuous
**Bleeding that is sudden and accompanied by intense uterine pain indicates placental
abruption, which IS life threatening
An expectant father tells the nurse he fears that his wife "is losing her mind." He states
she is constantly rubbing her abdomen and talking to the baby, and that she actually
reprimands the baby when it moves too much. What recommendation should the nurse
make to this expectant father?
A. Reassure him that these are normal reactions to pregnancy and suggest that he
discuss his concerns with the childbirth education nurse
B. Help him to understand that his wife is experiencing normal symptoms of
ambivalence about the pregnancy and no action is needed
C. Ask him to observe his wife's behavior carefully for the next few weeks and report
any similar behavior to the nurse
D. Let him know that these are normal maternal/fetal bonding behaviors which occur
once the mother feels fetal movement - Answer-Correct Answer: D
These behaviors are positive maternal/fetal bonding
The nurse assesses a client admitted to the labor and delivery unit and obtains the
following data: dark red vaginal bleeding, uterus slightly tense between contractions, BP
110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced. Based on these
assessment findings, what intervention should the nurse implement?
A. Insert an internal fetal monitor
B. Assess for cervical changes q1h
C. Monitor bleeding from IV sites
D. Perform Leopold's maneuvers - Answer-Correct Answer: D
The client is presenting with signs of placental abruption so monitoring bleeding from
peripheral IV sites is priority.
WHY? Disseminated intravascular coagulation (DIC) is a complication of PA
characterized by abnormal bleeding
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