Maternity HESI Questions with Answers
objective signs of ovulation - ✅-abundant, thin, clear cervical mucus
-spinnbarkeit (egg white stretchiness) of cervical mucus
-open cervical os
-slight drop in BBT and then a 0.5-1˚F rise
-ferning under microscope
ovulation occurs how many days before the next menstrual period? - ✅14
4 ways to identify gestational age - ✅-10 lunar months
-9 calendar months
-40 weeks
-280 days
what maternal position provides optimal fetal and placental perfusion - ✅-side lying
(removes pressure from abdominal vessels)
-knee-chest
makor discomforts of the first trimester and one suggestion for each - ✅-nausea and
vomiting: eat crackers upon rising in the morning
-fatigue: take planned naps and sleep 7-8 hours/night
how do you calculate EDD from LMP - ✅count back 3 months from day 1 of LMP and
add 7 days (always give February 28 days)
at 20 weeks gestation the fundal height would be - ✅at the umbilicus
at 20 weeks gestation the fetus would weigh approximately - ✅300-400g
at 20 weeks gestation the fetus would look like - ✅have hair, lanugo, vernix, no
subcutaneous fat
normal psychosocial responses to pregnancy in the second trimester - ✅ambivalence
wanes, woman begins to accept pregnancy, pregnancy becomes "real", signs of
maternal-fetal bonding occur
hemodilution of pregnancy peaks at how many weeks? what happens to Hct? - ✅28-32
weeks; decreases
what happens with weight gain during pregnancy? - ✅-total weight gain should be 25-
35 lbs
-average 1 lb/week in 2nd and 3rd trimesters
how many calories should a woman add to her diet - ✅300 calories/day
,how many cups of milk should a woman drink per day - ✅2 cups or 8 ounces
FHR can be auscultated by doppler at how many weeks gestation - ✅10-12
schedule of prenatal visits - ✅every 4 weeks until 28 weeks, every 2 weeks until 36
weeks, every week until delivery
variables associated with high risk pregnancy - ✅preeclampsia, DM, cardiac disease,
<3 months between pregnancies, <17 and >34 years old, parity >5
how do you diagnose IUGR - ✅serial ultrasounds
what does BPP determine - ✅fetal well-being
necessary actions before first trimester ultrasound - ✅have patient fill bladder and don't
allow them to empty bladder until after
lay supine and elevate uterus with splint
advantage of CVS over amniocentesis - ✅CVS can be done 8-12 weeks while
amniocentesis can't be done until 14-16 weeks
CVS results come back within a week, so you can terminate pregnancy if indicated
why are serum amniotic AFP levels done prenatally - ✅elevated AFP may indicate
neural tube defects, decreased levels may indicate trisomy 21
what is the most important determinant of fetal maturity for extrauterine survival? - ✅L/S
ratio
should be 2:1
most common complications of amniocentesis - ✅spontaneous abortion, fetal injury,
infection
periodic changes of FHR and causes for each - ✅-accelerations: reassuring, require no
treatment, caused by burst of sympathetic activity
-early decelerations: caused by head compressions, benign, alert nurse to monitor labor
progress and fetal descent
-variable decelerations: caused by cord compression, change in maternal position
should be tried first
-late decelerations: caused by uteroplacental insufficiency, should be treated by turning
pt on side and administering O2
, most important indicator of fetal autonomic nervous system integrity and health - ✅FHR
variability (15 beats from baseline for 15 seconds after contraction)
four causes of decreased FHR variability - ✅-hypoxia
-acidosis
-drugs
-fetal sleep
most important action if cord prolapse occurs - ✅position mother to relieve pressure on
the cord or push presenting part off cord until emergency c/s can occur
knee to chest position
what is a reactive normal stress test - ✅FHR accelerations of 15 bpm for 15 seconds
two times in 2 minutes in response to fetal movement
dangers of nipple stimulation test - ✅inability to control oxytocin "dosage" and chance
of hyperstimulation
normal fetal scalp pH - ✅7.25-7.35
fetal pH that indicates true acidosis - ✅<7.2
prodromal signs of labor - ✅lightening
braxton hicks
increased bloody show
loss of mucus plug
burst of energy
nesting behaviors
true labor - ✅regular, rhythmic contractions that intensify with ambulation
pain in abdomen that radiates to lower back
cervical changes
false labor - ✅irregular rhythm
pain localized in abdomen that decreases with ambulation
two ways to determine membranes have truly ruptured - ✅nitrazine test: paper turns
dark blue or black
fluid ferning under microscope
objective signs of ovulation - ✅-abundant, thin, clear cervical mucus
-spinnbarkeit (egg white stretchiness) of cervical mucus
-open cervical os
-slight drop in BBT and then a 0.5-1˚F rise
-ferning under microscope
ovulation occurs how many days before the next menstrual period? - ✅14
4 ways to identify gestational age - ✅-10 lunar months
-9 calendar months
-40 weeks
-280 days
what maternal position provides optimal fetal and placental perfusion - ✅-side lying
(removes pressure from abdominal vessels)
-knee-chest
makor discomforts of the first trimester and one suggestion for each - ✅-nausea and
vomiting: eat crackers upon rising in the morning
-fatigue: take planned naps and sleep 7-8 hours/night
how do you calculate EDD from LMP - ✅count back 3 months from day 1 of LMP and
add 7 days (always give February 28 days)
at 20 weeks gestation the fundal height would be - ✅at the umbilicus
at 20 weeks gestation the fetus would weigh approximately - ✅300-400g
at 20 weeks gestation the fetus would look like - ✅have hair, lanugo, vernix, no
subcutaneous fat
normal psychosocial responses to pregnancy in the second trimester - ✅ambivalence
wanes, woman begins to accept pregnancy, pregnancy becomes "real", signs of
maternal-fetal bonding occur
hemodilution of pregnancy peaks at how many weeks? what happens to Hct? - ✅28-32
weeks; decreases
what happens with weight gain during pregnancy? - ✅-total weight gain should be 25-
35 lbs
-average 1 lb/week in 2nd and 3rd trimesters
how many calories should a woman add to her diet - ✅300 calories/day
,how many cups of milk should a woman drink per day - ✅2 cups or 8 ounces
FHR can be auscultated by doppler at how many weeks gestation - ✅10-12
schedule of prenatal visits - ✅every 4 weeks until 28 weeks, every 2 weeks until 36
weeks, every week until delivery
variables associated with high risk pregnancy - ✅preeclampsia, DM, cardiac disease,
<3 months between pregnancies, <17 and >34 years old, parity >5
how do you diagnose IUGR - ✅serial ultrasounds
what does BPP determine - ✅fetal well-being
necessary actions before first trimester ultrasound - ✅have patient fill bladder and don't
allow them to empty bladder until after
lay supine and elevate uterus with splint
advantage of CVS over amniocentesis - ✅CVS can be done 8-12 weeks while
amniocentesis can't be done until 14-16 weeks
CVS results come back within a week, so you can terminate pregnancy if indicated
why are serum amniotic AFP levels done prenatally - ✅elevated AFP may indicate
neural tube defects, decreased levels may indicate trisomy 21
what is the most important determinant of fetal maturity for extrauterine survival? - ✅L/S
ratio
should be 2:1
most common complications of amniocentesis - ✅spontaneous abortion, fetal injury,
infection
periodic changes of FHR and causes for each - ✅-accelerations: reassuring, require no
treatment, caused by burst of sympathetic activity
-early decelerations: caused by head compressions, benign, alert nurse to monitor labor
progress and fetal descent
-variable decelerations: caused by cord compression, change in maternal position
should be tried first
-late decelerations: caused by uteroplacental insufficiency, should be treated by turning
pt on side and administering O2
, most important indicator of fetal autonomic nervous system integrity and health - ✅FHR
variability (15 beats from baseline for 15 seconds after contraction)
four causes of decreased FHR variability - ✅-hypoxia
-acidosis
-drugs
-fetal sleep
most important action if cord prolapse occurs - ✅position mother to relieve pressure on
the cord or push presenting part off cord until emergency c/s can occur
knee to chest position
what is a reactive normal stress test - ✅FHR accelerations of 15 bpm for 15 seconds
two times in 2 minutes in response to fetal movement
dangers of nipple stimulation test - ✅inability to control oxytocin "dosage" and chance
of hyperstimulation
normal fetal scalp pH - ✅7.25-7.35
fetal pH that indicates true acidosis - ✅<7.2
prodromal signs of labor - ✅lightening
braxton hicks
increased bloody show
loss of mucus plug
burst of energy
nesting behaviors
true labor - ✅regular, rhythmic contractions that intensify with ambulation
pain in abdomen that radiates to lower back
cervical changes
false labor - ✅irregular rhythm
pain localized in abdomen that decreases with ambulation
two ways to determine membranes have truly ruptured - ✅nitrazine test: paper turns
dark blue or black
fluid ferning under microscope
