OB HESI/FINAL EXAM RATED A+
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 Ans- 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." Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 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 Ans- 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." Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- 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?
