Hesi OB 2023

Hesi OB 2023 A client at 37 weeks gestation presents to labor and delivery with contractions every two minutes the nurse observes several shallow small vesicles on her pubis labia and perineum. the nurse should recognize the clients is prohibiting symptoms of which condition? herpes simplex virus A client who had her first baby three months ago and is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client? Use alternative form of birth control until new diaphragm can be obtained. 00:0401:36 A 30- year-old primigravida delivers a 9-pound infant vaginally after a 30- hour labor. What is the priority nursing action for this client? Massage the fundus Q 4 hours At 0600 while admitting a woman for a scheduled repeat cesarean section (C Section), the client tells the nurse that she drank a cup a coffee at 0400 because she wanted to avoid getting a headache. Which action should the nurse take first? Inform the anesthesia care provider The nurse is caring for a postpartum client who is exhibiting symptoms of a spinal headache 24 hours following delivery of a normal newborn. Prior to the anesthesiologist arrival on the unit, which action should the nurse perform? - Place procedure equipment at bedside The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14 ounces, has a head circumference of 13 inches, and a chest circumference of 10 inches. Based on these physical findings, assessment for which condition has the highest priority? Hypoglycemia the nurse is caring for a 35 week gestation infant delivered by cesarean section 2 hours ago. the nurse observes the infants respiratory rate is 72 breaths minute with nasal flaring, grunting, and retractions. the nurse should recognize these finding indicate which complication? transient tachypnea of the newborn A primipara client at 42 weeks gestation is admitted for induction. within one hour after initiating an oxytocin infusion, her cervix is 100% effaced and 6 cm dilated, contractions are occuring every 1 minute with a 75 second duration. when nurse stops the oxytocin and starts oxygen. after 30 minutes of uterine rest, the contractions are occuring every 5 minutes with 20 second duration. which intervention should the nurse implement? Restart the oxytocin per oxytocin protocol A primigravida arrives at the observation unit of the maternity unit because she thinks she is in labor. the nurse applies the external fetal heart monitor and determines she is not in labor. What makes the nurse realize she is not in labor? Contractions stop when the client is walking A primigravida client with gestational hypertension and bishop score of 3 is scheduled for induction of labor. the nurse administers misoprostol at 0700 then observes regular contractions with cervical changes at 0900 which action should the nurse take? Administer oxytocin 4 hours later A multigravida client in labor is receiving oxytocin Pitocin 4mu/minute to help promote an effective contraction pattern. The available solution is Lactated Ringers 1,000 ml with Pitocin 20 units. The nurse should program the infusion pump to deliver how many ml/hr? 12 The nurse is caring for a client whose fetus died in utero at 32 weeks gestation. After the fetus is delivered vaginally, the nurse implements routine demise protocol and identification procedures. What action is most important for the nurse to take? Encourage the mother to hold and spend time with her baby Following a minor vehicle collision, a client 36 weeks gestation is brought to the emergency center. She is lying supine on a backboard , is awake , denies any complaints. Her blood pressure is 80/50 mm Hg and heart rate is 130 beats per min. What action should the nurse implement first? Infuse 1,000 Ml normal saline using a large bore IV A new mother asks the nurse about an area of swelling on her baby's head near the posterior fontanel that lies across the suture line. How should the nurse respond? "This is called caput succedaneum. It will absorb and cause no problems." A client at 35 weeks gestation complains of a "pain whenever the baby moves." On assessment, the nurse notes the client's temperature to be 101.2 F, with severe abdominal or uterine tenderness on palpation. The nurse knows that these findings are indicative of what condition? Chorioamnionitis An unlicensed assistive personnel (UAP) reports to the charge nurse that a client who delivered a 7- pound infant 12 hours ago is reporting a severe headache. The client's blood pressure is 110/70 mm hg, respiratory rate is 18 breaths/minute, heart rate is 74 bpm, and temperature is 96.6F (37C). The client's fundus is firm and one fingerbreadth above the umbilicus. Which action should the charge nurse implement first? Notify the healthcare provider of the assessment findings the nurse is preparing to administer phytonadione to a newborn. which statement made by the parents indicates understanding why the nurse is administering this medication? Prevent Hemorrhagic disorders A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis af eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in this client's nursing care plan? Keep an airway at the bedside a pregnant client presents to the antepartal clinic complaining of brownish vaginal bleeding. the nurse notes a greatly enlarged uterus and is complaining of severe nausea. the client reports that period was about 2 and a half months ago vital signs are temperature 98.7 based on these findings what laboratory value should the nurse review? HcG values A women who is 38-weeks gestation is receiving magnesium sulfate for severe preeclampsia. Which assessment finding warrants immediate intervention from the nurse ? Sinus Tachycardia An ambulatory client at 39 weeks gestation presents to the emergency center with an obvious injury to her arm that occurred as a result of a fall Which concurrent symptom is a priority for the nurse? Ecchymotic knees a newborn's assessment reveals spina bifida occulta which maternal factor should the nurse identify as having the greatest impact on the development of this Folic Acid Deficiency Upon admission to the nursery, the nurse places a newborn supine under radiant warmer , an external heat source. What should the nurse implement first to ensure safe thermoregulation? Place temperature probe on the abdomen in the line with the radiant heat source A woman who is trying to get pregnant tells the nurse that she was very disappointed several months ago when she was informed that her positive pregnancy test was a false positive. which method of provides the greatest degree of accuracy? Visualization of implantation by vaginal ultrasound The nurse is planning discharge teaching for 4 mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period? A primiparous woman who has recently immigrated with her spouse. A new mother who is breastfeeding her 4 week old infant has type 1 diabetes, reports that her insulin needs have decreased after the birth of her child. What action should the nurse implement? Inform her that a decreased need for insulin occurs while breastfeeding A gravida 3 para 3 who is Rh-negative delivers a full-term infant at home with the assistance of a nursemidwife. Two days later, the client calls the clinic to ask if it is necessary to see the healthcare provider since the infant is healthy, and she is not having any complications. The woman's history indicates that both previously born infants were Rh-negative. Which response should the nurse provide? The newborn's blood type should be tested to determine the need for RhoGAM A newborn's head circumference is 12 inches (30.5cm), and his chest measurement is 13 inches (33cm). The nurse notes that this infant has no molding, and was at breech presentation delivery by c section. What action should the nurse take based on these data? Call these findings to the attention of the pediatrician. The head/chest ratio is abnormal a woman in her third trimester of pregnancy has been in active labor for the past 8 hours and has dilated 3 cm. the nurse's assessment findings and electronic fetal monitoring are consistent with hypotonic dystocia the healthcare provider prescribes an oxytocin drip. which data is most important for the nurse to monitor? Intensity, interval, and length of contractions A client at 37 weeks gestation presents to labor and delivery with contractions every two minutes the nurse observes several shallow small vesicles on her pubis labia and perineum. the nurse should recognize the clients is prohibiting symptoms of which condition? herpes simplex virus A client who had her first baby three months ago and is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client? Use alternative form of birth control until new diaphragm can be obtained. A pregnant client presents to the antepartal clinic complaining of brownish vaginal bleeding. The nurse notes that she has a greatly enlarged uterus and is complaining of severe nausea. The client reports that her period was about 2 and a half months ago. Vital signs are temp 98.7 (37 C) pulse rate 70 beats per min respiratory rate 18 breathes /min and blood pressure 190/110 mmHG. Based on these findings what laboratory value should the reviews hCG values the nurse notes on the fetal monitor that laboring client has a variable deceleration. which action should the nurse implement first Change the position A woman who is 38-Weeks gestation is receiving magnesium Sulfate for severe preclampsia. Which assessment finding warrants immediate intervention the nurse? Absent Patellar reflexes At 6-weeks gestation, the rubella titer of a client indicates she is non-immune. When is the best time to administer a rubella vaccine to this client? Early postpartum, within 72 hours of delivery. While caring for a laboratory client on continuous fetal monitoring, the nurse notes a fetal heart rate pattern that falls and rises abruptly with a v shaped appearance. What action should the nurse take first? Change the maternal position A 10 year old is admitted to the orthopedic unit with a diagnosis of slipped femoral capital epiphysis (SFCE) What focus should the nurse include in this child's plan of care? Pin and incisional care after surgery A new mother calls the nurse stating that she wants to start feeding her 6 month-old child something besides breast milk, but is concerned that the infant is too young to start eating solid foods. How should the nurse respond? Advise the mother to wait at least another month before startin