OB HESI: ULTIMATE QUESTION PACK
3 day old baby. Feeds every 2 hours. Nurse notes white curd patches on oral mucus membranes. Action
to implement? ans: needs medicine
3 day postpartum patient. Husband calls states wife is crying, irritable. Inform the husband? ans: contact
the clinic in 2 weeks if symptoms become worse
Baby blues are normal, he needs to bring her in if it gets severe or persists for two weeks
Review this bc the answer choices are tricky!!Not just be there with her.. WATCH her and symptoms
3 months pregnant, thin watery secretions ans: normal lochia
4 postpartum clients. Who is a priority for psychosocial distress? ans: Immigrant that just moved with
her husband, first baby, new country**
24 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 an accumulation of blood between the periosteum and
skull that does not cross suture lines is known as ans: Cephalohematoma
(Caused by forceps trauma, may last up to 8 weeks)
28 weeks gestation with twins. Fundal height 27 cm. fundal height measured 28 cm 3 weeks ago. What
does the nurse conclude from this? ans: may indicate IUGR
30 minutes postpartum, continuing to bleed. Boggy uterus. Intervention? ans: Uterine massage
30 year old primigravida delivers 9 pound vaginally after 30 hour labor. Priority nursing action? ans:
observe for signs of hemorrhage
32 weeks gestations with possible UTI. Action to implement? ans: Collect urine for culture**
35 weeks gestation. Breech baby. Contractions 3-5 minutes apart and mom states "I think my water just
broke". Inspection reveals umbilical cord protruding. Intervention to implement? ans: Place patient in
the knee-chest position
38 weeks gestation with a history of PIH. Pitocin started. 1 hour after Pitocin, patients gets a headache.
Contractions are 1-2 minutes apart lasting 60-75 seconds. Intervention most important? ans:
discontinue the Pitocin
38 weeks gestation, tachycardia, tremulous, hypertensive. Assessment action most important? ans:
obtain a drug screen
40 weeks gestation and spontaneous rupture of membranes that is meconium stained. What additional
finding should the nurse report? ans: - FHR 100-110
,A 3-day postpartum client, who is not immune to rubella, is to receive the vaccine at discharge. Which of
the following must the nurse include in her discharge teaching regarding the vaccine?
A) The woman should not become pregnant for at least 4 weeks.
B) The woman should pump and dump her breast milk for 1 week.
C) The mother must wear a surgical mask when she cares for the baby.
D) Passive antibodies transported across the placenta will protect the baby. ans: A) The woman should
not become pregnant for at least 4 weeks.
A 3-day-postpartum client questions why she is to receive the rubella vaccine before leaving the
hospital. Which of the following rationales should guide the nurse's response?
A) The client's obstetric status is optimal for receiving the vaccine.
B)The client's immune system is highly responsive during the postpartum period.
C) The client's baby will be high risk for acquiring rubella if the woman does not receive the vaccine.
D) The client's insurance company will pay for the shot if it is given during the immediate postpartum
period. ans: A) The client's obstetric status is optimal for receiving the vaccine.
A 4-day postpartum client calls the clinic and reports that her nipples are so sore that she does not know
if she can continue to breastfeed her infant. What instruction is best for the nurse to provide? ans: ---
A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of
eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in this
client's nursing care plan? ans: Monitor Blood pressure, pulse, and respirations q4h.
A 26-year old, G2 P1 client is admitted to the hospital at 28-weeks gestation in preterm labor. She is
given 3 doses of terbutaline sulfate (Brethine) 0.25 mg SQ to stop her labor contractions. The nurse
plans to monitor which primary side effect of terbutaline sulfate? ans: Tachycardia & feeling of
nervousness
A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26 weeks gestation in preterm labor.
Given dose of terbutaline sulfate (Berthine) 0.25 mg SQ. Which assessment is the highest priority for the
nurse to monitor during administration of this drug? ans: Monitoring fetal & maternal heart rates!!!
A 34-week primigravida with pregnancy induced hypertension (PIH) is receiving Ringer's Lactate 500 ml
with magnesium sulfate 20 grams at the rate of 3 grams/hour. How many ml/hour should the nurse
program the infusion pump? (Enter numeric value only) ans: 75
A 36-week primigravida is admitted to labor and delivery with severe abdominal pain and bright red
vaginal bleeding. Her abdomen is rigid and tender to touch. The fetal heart rate (FHR) is 90
beats/minute, and the maternal heart rate is 120 beats/minute. What action should the nurse
implement first? ans: obtain written consent for an emergency cesarean section.
A 36-year-old woman comes to the emergency department complaining of severe abdominal cramping
and heavy bleeding. She informs the nurse that she is 10 weeks pregnant. Cervical examination reveals
heavy bleeding; the cervical os is open and tissue is present. Which type of miscarriage is the client
experiencing?
,A) Missed
B) Complete
C) Inevitable
D) Threatened ans: C) Inevitable
Miscarriage is inevitable because the cervical os has opened, heavy bleeding is occurring, and tissue is
present with the bleeding. In a missed miscarriage, the fetus has died but the products of conception are
retained in utero for as long as several weeks. There may be no bleeding or cramping, and the os is
closed. In a complete miscarriage all fetal tissue has already passed and the cervix is closed; there may
be slight bleeding. Symptoms of a threatened miscarriage include spotting and a closed cervical os.
There may be mild cramping.
A 38 week primigravida is admitted to L&D after a non-reactive result on a non-stress test (NST). The
nurse begins contraction stress test (CST) with oxytocin (Pitocin) infusion, Which finding is most
important to report to the HCP?
A) Spontaneous rupture of membranes
B) FHR accelerations with fetal movement
C) Absence of uterine contractions within 20 minutes
D) A pattern of late fetal decelerations ans: D) A pattern of late fetal decelerations
A 38-week primigravida who works as a secretary & sits at a computer for 8 hours each day tells the
nurse that her feet have begun to swell. Which instruction would be most effective in preventing pooling
of blood in lower extremities? ans: Move about every hour
A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine
(T4) and high levels of thyroid stimulating hormone (TSH). What is the best explanation for this finding?
ans: The TSH is high because of the low production of T4 by the thyroid.
A client arrives at the clinic in preterm labor, and terbutaline (Brethine) is prescribed. For what
therapeutic effect should the nurse monitor the client?
A) increased blood pressure and pulse
B) Reduction of pain in the perineal area
C) Gradual cervical dilation as labor progresses
D) Decreased frequency and duration of contractions ans: D) Decreased frequency and duration of
contractions
Terbutaline sulfate (Brethine) is a β-mimetic that acts on the smooth muscles of the uterus to reduce
contractility, which in turn inhibits dilation and the frequency and duration of contractions. Although
terbutaline may increase blood pressure and pulse, this is a side, not a therapeutic, effect requiring
frequent assessments. Terbutaline is not an analgesic. It should stop cervical dilation rather than
increase it.
A client at 28 weeks gestation admitted to unit following involvement in a motor vehicle collision. While
stabilizing the patient, the nurse obtains fetal monitor reading. Which action should the nurse take if the
fetus is tachycardic on the monitor? ans: Contact the healthcare provider after initiating oxygen per face
mask
, A client at 28-weeks gestation calls the antepartum 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 contractions or abdominal pain. Which instruction should the nurse provide? ans:
Come to the clinic today for an ultrasound
(Concerned about placenta previa)
A client at 30 weeks gestation is being treated in the emergency department for a broken finger. The
nurse assesses the FHR while the client is in a sitting position and has a heart rate of 92 beats per
minute. What intervention is most important for the nurse to perform?
a. encourage the client to empty her bladder
b. determine the maternal pulse rate
c. instruct the client to drink a glass a juice
d. place the client in a supine position ans: Encourage the client to empty her bladder
A client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation.
She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination
reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the
nurse implement first?
A) Provide oral hydration
B) Have a CBC drawn
C) Obtain specimens for urinalysis
D) Place the client on strict bedrest ans: C) Obtain specimens for urinalysis
Obtained first because preterm clients with uterine irritability & contractions are often suffering from
UTI and this should be ruled out first.
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? ans: A decrease in respiratory rate from 24 to 16
(Respiratory rate BELOW 12 indiates toxicity)
A client at 33-weeks gestation is admitted with a moderate amount of vaginal bleeding & no
contractions are noted on the external monitor. Which intervention?
A) Weigh pads
B) Weight daily
C) Measure I&O
D) Ambulate 15 mins QID ans: A) Weigh pads
A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began
one hour ago. The nurse's assessment reveals approximately 30 ml of bright red vaginal bleeding, FHR of
130 to 140 beats/min, no contraction, and no complaints of pain. What is the most likely case of this
client's bleeding? ans: placenta previa
3 day old baby. Feeds every 2 hours. Nurse notes white curd patches on oral mucus membranes. Action
to implement? ans: needs medicine
3 day postpartum patient. Husband calls states wife is crying, irritable. Inform the husband? ans: contact
the clinic in 2 weeks if symptoms become worse
Baby blues are normal, he needs to bring her in if it gets severe or persists for two weeks
Review this bc the answer choices are tricky!!Not just be there with her.. WATCH her and symptoms
3 months pregnant, thin watery secretions ans: normal lochia
4 postpartum clients. Who is a priority for psychosocial distress? ans: Immigrant that just moved with
her husband, first baby, new country**
24 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 an accumulation of blood between the periosteum and
skull that does not cross suture lines is known as ans: Cephalohematoma
(Caused by forceps trauma, may last up to 8 weeks)
28 weeks gestation with twins. Fundal height 27 cm. fundal height measured 28 cm 3 weeks ago. What
does the nurse conclude from this? ans: may indicate IUGR
30 minutes postpartum, continuing to bleed. Boggy uterus. Intervention? ans: Uterine massage
30 year old primigravida delivers 9 pound vaginally after 30 hour labor. Priority nursing action? ans:
observe for signs of hemorrhage
32 weeks gestations with possible UTI. Action to implement? ans: Collect urine for culture**
35 weeks gestation. Breech baby. Contractions 3-5 minutes apart and mom states "I think my water just
broke". Inspection reveals umbilical cord protruding. Intervention to implement? ans: Place patient in
the knee-chest position
38 weeks gestation with a history of PIH. Pitocin started. 1 hour after Pitocin, patients gets a headache.
Contractions are 1-2 minutes apart lasting 60-75 seconds. Intervention most important? ans:
discontinue the Pitocin
38 weeks gestation, tachycardia, tremulous, hypertensive. Assessment action most important? ans:
obtain a drug screen
40 weeks gestation and spontaneous rupture of membranes that is meconium stained. What additional
finding should the nurse report? ans: - FHR 100-110
,A 3-day postpartum client, who is not immune to rubella, is to receive the vaccine at discharge. Which of
the following must the nurse include in her discharge teaching regarding the vaccine?
A) The woman should not become pregnant for at least 4 weeks.
B) The woman should pump and dump her breast milk for 1 week.
C) The mother must wear a surgical mask when she cares for the baby.
D) Passive antibodies transported across the placenta will protect the baby. ans: A) The woman should
not become pregnant for at least 4 weeks.
A 3-day-postpartum client questions why she is to receive the rubella vaccine before leaving the
hospital. Which of the following rationales should guide the nurse's response?
A) The client's obstetric status is optimal for receiving the vaccine.
B)The client's immune system is highly responsive during the postpartum period.
C) The client's baby will be high risk for acquiring rubella if the woman does not receive the vaccine.
D) The client's insurance company will pay for the shot if it is given during the immediate postpartum
period. ans: A) The client's obstetric status is optimal for receiving the vaccine.
A 4-day postpartum client calls the clinic and reports that her nipples are so sore that she does not know
if she can continue to breastfeed her infant. What instruction is best for the nurse to provide? ans: ---
A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of
eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in this
client's nursing care plan? ans: Monitor Blood pressure, pulse, and respirations q4h.
A 26-year old, G2 P1 client is admitted to the hospital at 28-weeks gestation in preterm labor. She is
given 3 doses of terbutaline sulfate (Brethine) 0.25 mg SQ to stop her labor contractions. The nurse
plans to monitor which primary side effect of terbutaline sulfate? ans: Tachycardia & feeling of
nervousness
A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26 weeks gestation in preterm labor.
Given dose of terbutaline sulfate (Berthine) 0.25 mg SQ. Which assessment is the highest priority for the
nurse to monitor during administration of this drug? ans: Monitoring fetal & maternal heart rates!!!
A 34-week primigravida with pregnancy induced hypertension (PIH) is receiving Ringer's Lactate 500 ml
with magnesium sulfate 20 grams at the rate of 3 grams/hour. How many ml/hour should the nurse
program the infusion pump? (Enter numeric value only) ans: 75
A 36-week primigravida is admitted to labor and delivery with severe abdominal pain and bright red
vaginal bleeding. Her abdomen is rigid and tender to touch. The fetal heart rate (FHR) is 90
beats/minute, and the maternal heart rate is 120 beats/minute. What action should the nurse
implement first? ans: obtain written consent for an emergency cesarean section.
A 36-year-old woman comes to the emergency department complaining of severe abdominal cramping
and heavy bleeding. She informs the nurse that she is 10 weeks pregnant. Cervical examination reveals
heavy bleeding; the cervical os is open and tissue is present. Which type of miscarriage is the client
experiencing?
,A) Missed
B) Complete
C) Inevitable
D) Threatened ans: C) Inevitable
Miscarriage is inevitable because the cervical os has opened, heavy bleeding is occurring, and tissue is
present with the bleeding. In a missed miscarriage, the fetus has died but the products of conception are
retained in utero for as long as several weeks. There may be no bleeding or cramping, and the os is
closed. In a complete miscarriage all fetal tissue has already passed and the cervix is closed; there may
be slight bleeding. Symptoms of a threatened miscarriage include spotting and a closed cervical os.
There may be mild cramping.
A 38 week primigravida is admitted to L&D after a non-reactive result on a non-stress test (NST). The
nurse begins contraction stress test (CST) with oxytocin (Pitocin) infusion, Which finding is most
important to report to the HCP?
A) Spontaneous rupture of membranes
B) FHR accelerations with fetal movement
C) Absence of uterine contractions within 20 minutes
D) A pattern of late fetal decelerations ans: D) A pattern of late fetal decelerations
A 38-week primigravida who works as a secretary & sits at a computer for 8 hours each day tells the
nurse that her feet have begun to swell. Which instruction would be most effective in preventing pooling
of blood in lower extremities? ans: Move about every hour
A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine
(T4) and high levels of thyroid stimulating hormone (TSH). What is the best explanation for this finding?
ans: The TSH is high because of the low production of T4 by the thyroid.
A client arrives at the clinic in preterm labor, and terbutaline (Brethine) is prescribed. For what
therapeutic effect should the nurse monitor the client?
A) increased blood pressure and pulse
B) Reduction of pain in the perineal area
C) Gradual cervical dilation as labor progresses
D) Decreased frequency and duration of contractions ans: D) Decreased frequency and duration of
contractions
Terbutaline sulfate (Brethine) is a β-mimetic that acts on the smooth muscles of the uterus to reduce
contractility, which in turn inhibits dilation and the frequency and duration of contractions. Although
terbutaline may increase blood pressure and pulse, this is a side, not a therapeutic, effect requiring
frequent assessments. Terbutaline is not an analgesic. It should stop cervical dilation rather than
increase it.
A client at 28 weeks gestation admitted to unit following involvement in a motor vehicle collision. While
stabilizing the patient, the nurse obtains fetal monitor reading. Which action should the nurse take if the
fetus is tachycardic on the monitor? ans: Contact the healthcare provider after initiating oxygen per face
mask
, A client at 28-weeks gestation calls the antepartum 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 contractions or abdominal pain. Which instruction should the nurse provide? ans:
Come to the clinic today for an ultrasound
(Concerned about placenta previa)
A client at 30 weeks gestation is being treated in the emergency department for a broken finger. The
nurse assesses the FHR while the client is in a sitting position and has a heart rate of 92 beats per
minute. What intervention is most important for the nurse to perform?
a. encourage the client to empty her bladder
b. determine the maternal pulse rate
c. instruct the client to drink a glass a juice
d. place the client in a supine position ans: Encourage the client to empty her bladder
A client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation.
She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination
reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the
nurse implement first?
A) Provide oral hydration
B) Have a CBC drawn
C) Obtain specimens for urinalysis
D) Place the client on strict bedrest ans: C) Obtain specimens for urinalysis
Obtained first because preterm clients with uterine irritability & contractions are often suffering from
UTI and this should be ruled out first.
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? ans: A decrease in respiratory rate from 24 to 16
(Respiratory rate BELOW 12 indiates toxicity)
A client at 33-weeks gestation is admitted with a moderate amount of vaginal bleeding & no
contractions are noted on the external monitor. Which intervention?
A) Weigh pads
B) Weight daily
C) Measure I&O
D) Ambulate 15 mins QID ans: A) Weigh pads
A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began
one hour ago. The nurse's assessment reveals approximately 30 ml of bright red vaginal bleeding, FHR of
130 to 140 beats/min, no contraction, and no complaints of pain. What is the most likely case of this
client's bleeding? ans: placenta previa
