OB HESI EXAM PREP STUDY GUIDE
PRACTICE QUESTIONS AND ACCURATE
SOLUTIONS
●● The nurse is preparing a laboring client for an amniotomy.
Immediately after the procedure is completed, it is most important for
the nurse to obtain which information?
A.Maternal blood pressure
B.Maternal temperature
C.Fetal heart rate (FHR)
D.White blood cell count (WBC).
Answer: C. Fetal heart rate (FHR)
Rationale:
The FHR should be assessed before and after the procedure to detect
changes that may indicate the presence of cord compression or prolapse.
An amniotomy (artificial rupture of membranes [AROM]) is used to
stimulate labor when the condition of the cervix is favorable. The fluid
should be assessed for color, odor, and consistency. Option A should be
,assessed every 15 to 20 minutes during labor but is not specific for
AROM. Option B is monitored hourly after the membranes are ruptured
to detect the development of amnionitis. Option D should be determined
for all clients in labor.
●● A nurse receives a shift change report for a newborn who is 12 hours
post-vaginal delivery. In developing a plan of care, the nurse should give
the highest priority to which finding?
A.Cyanosis of the hands and feet
B.Skin color that is slightly jaundiced
C.Tiny white papules on the nose or chin
D.Red patches on the cheeks and trunk.
Answer: B. Skin color that is slightly jaundiced
Rationale: Jaundice, a yellow skin coloration, is caused by elevated
levels of bilirubin, which should be further evaluated in a newborn <24
hours old. Acrocyanosis (blue color of the hands and feet) is a common
finding in newborns; it occurs because the capillary system is immature.
Milia are small white papules present on the nose and chin that are
caused by sebaceous gland blockage and disappear in a few weeks.
,Small red patches on the cheeks and trunk are called erythema toxicum
neonatorum, a common finding in newborns.
●● A breastfeeding postpartum client is diagnosed with mastitis, and
antibiotic therapy is prescribed. Which instruction should the nurse
provide to this client?
A.Breastfeed the infant, ensuring that both breasts are completely
emptied.
B.Feed expressed breast milk to avoid the pain of the infant latching
onto the infected breast.
C.Breastfeed on the unaffected breast only until the mastitis subsides.
D.Dilute expressed breast milk with sterile water to reduce the
antibiotic effect on the infant..
Answer: A.Breastfeed the infant, ensuring that both breasts are
completely emptied.
Rationale:Mastitis, caused by plugged milk ducts, is related to breast
engorgement, and breastfeeding during mastitis facilitates the complete
emptying of engorged breasts, eliminating the pressure on the inflamed
breast tissue. Option B is less painful but does not facilitate complete
emptying of the breast tissue. Option C will not relieve the engorgement
, on the affected side. Option D will not decrease antibiotic effects on the
infant.
●● A 38-week primigravida who works as a secretary and sits at a
computer 8 hours each day tells the nurse that her feet have begun to
swell. Which instruction will aid in the prevention of pooling of blood in
the lower extremities?
A.Wear support stockings.
B.Reduce salt in the diet.
C.Move about every hour.
D.Avoid constrictive clothing..
Answer: C.Move about every hour.
Rationale:
Pooling of blood in the lower extremities results from the enlarged
uterus exerting pressure on the pelvic veins. Moving about every hour
will relieve pressure on the pelvic veins and increase venous return.
Option A would increase venous return from varicose veins in the lower
extremities but would be of little help with swelling. Option B might be
helpful with generalized edema but is not specific for edematous lower
PRACTICE QUESTIONS AND ACCURATE
SOLUTIONS
●● The nurse is preparing a laboring client for an amniotomy.
Immediately after the procedure is completed, it is most important for
the nurse to obtain which information?
A.Maternal blood pressure
B.Maternal temperature
C.Fetal heart rate (FHR)
D.White blood cell count (WBC).
Answer: C. Fetal heart rate (FHR)
Rationale:
The FHR should be assessed before and after the procedure to detect
changes that may indicate the presence of cord compression or prolapse.
An amniotomy (artificial rupture of membranes [AROM]) is used to
stimulate labor when the condition of the cervix is favorable. The fluid
should be assessed for color, odor, and consistency. Option A should be
,assessed every 15 to 20 minutes during labor but is not specific for
AROM. Option B is monitored hourly after the membranes are ruptured
to detect the development of amnionitis. Option D should be determined
for all clients in labor.
●● A nurse receives a shift change report for a newborn who is 12 hours
post-vaginal delivery. In developing a plan of care, the nurse should give
the highest priority to which finding?
A.Cyanosis of the hands and feet
B.Skin color that is slightly jaundiced
C.Tiny white papules on the nose or chin
D.Red patches on the cheeks and trunk.
Answer: B. Skin color that is slightly jaundiced
Rationale: Jaundice, a yellow skin coloration, is caused by elevated
levels of bilirubin, which should be further evaluated in a newborn <24
hours old. Acrocyanosis (blue color of the hands and feet) is a common
finding in newborns; it occurs because the capillary system is immature.
Milia are small white papules present on the nose and chin that are
caused by sebaceous gland blockage and disappear in a few weeks.
,Small red patches on the cheeks and trunk are called erythema toxicum
neonatorum, a common finding in newborns.
●● A breastfeeding postpartum client is diagnosed with mastitis, and
antibiotic therapy is prescribed. Which instruction should the nurse
provide to this client?
A.Breastfeed the infant, ensuring that both breasts are completely
emptied.
B.Feed expressed breast milk to avoid the pain of the infant latching
onto the infected breast.
C.Breastfeed on the unaffected breast only until the mastitis subsides.
D.Dilute expressed breast milk with sterile water to reduce the
antibiotic effect on the infant..
Answer: A.Breastfeed the infant, ensuring that both breasts are
completely emptied.
Rationale:Mastitis, caused by plugged milk ducts, is related to breast
engorgement, and breastfeeding during mastitis facilitates the complete
emptying of engorged breasts, eliminating the pressure on the inflamed
breast tissue. Option B is less painful but does not facilitate complete
emptying of the breast tissue. Option C will not relieve the engorgement
, on the affected side. Option D will not decrease antibiotic effects on the
infant.
●● A 38-week primigravida who works as a secretary and sits at a
computer 8 hours each day tells the nurse that her feet have begun to
swell. Which instruction will aid in the prevention of pooling of blood in
the lower extremities?
A.Wear support stockings.
B.Reduce salt in the diet.
C.Move about every hour.
D.Avoid constrictive clothing..
Answer: C.Move about every hour.
Rationale:
Pooling of blood in the lower extremities results from the enlarged
uterus exerting pressure on the pelvic veins. Moving about every hour
will relieve pressure on the pelvic veins and increase venous return.
Option A would increase venous return from varicose veins in the lower
extremities but would be of little help with swelling. Option B might be
helpful with generalized edema but is not specific for edematous lower
