HESI RN OB 2023 UPDATED QUESTIONS & ANSWERS

HESI RN OB 2023 UPDATED QUESTIONS & ANSWERS 1. One hour after delivery, the nurse is unable to palpate the uterine fundus of a client who had an epidural and notes a large amount of lochia on the perineal pad. The nurse massages at the umbilicus and obtains current vital signs. Which intervention should the nurse implement next? A. Document number of pad changes in the last hour B. Increase the rate of the oxytocin infusion C. Palpate the suprapubic area for bladder distention D. Provide bedpan to void if unable to ambulate 2. At 40-week gestation, a laboring client who is lying is a supine position tells the nurse that she has finally found a comfortable position. What action should the nurse take? A. Place a pillow under the client’s head and knees. B. Place a wedge under the client’s right hip. C. Encourage the client to turn on her left side. D. Explain to the client that her position is not safe. 3. After breast-feeding 10 minutes at each breast, a new mother calls the nurse to the postpartum room to help change the newborns diaper. As the mother begins the diaper change, the newborn spits up the breast milk. What action should the nurse implement first? A. Wipe away the spit-up and assist the mother with the diaper change B. Turn the newborn to the side and bulb suction the mouth and nares C. Sit the newborn up and burp by rubbing or patting the upper back D. Place the newborn in a position with the head lower than the feet 4. A young adult female presents at the emergency center with acute lower abdominal pain. Which assessment finding is most important for the nurse to report to the healthcare provider? A. History of irritable bowel syndrome (IBS) B. Pain scale rating of a “9” on a 0-10 scale. C. Last menstrual period 7 weeks ago. D. Reports white, curly vaginal discharge. 5. The nurse is teaching a mother of a newborn with a cleft lip how to bottle feed her baby using a Medela Haberman feeder, which has a valve to control the release of milk and a slit nipple opening. The nurse discusses placing the nipple’s elongated tip in the back of the oral cavity. What instruction should the nurse provide the mother about feedings? A. Alternate milk with water during the feedings. B. Squeeze the nipple base to introduce milk into the mouth. C. Position the baby in the left lateral position after feeding. D. Hold the newborn in an upright position. 6. An S3 heart sound is auscultated in a client in her third trimester of pregnancy. What intervention should the nurse take? A. Prepare the client for an echocardiogram. B. Limit the client’s fluids. C. Document in the client’s record. D. Notify the healthcare provider. 7. A client delivers a viable infant but begins to have excessive uncontrolled vaginal bleeding after the IV Pitocin is infused. When notifying the hcp of the clients condition, what information is most important for the nurse to provide? A. Total amount of Pitocin infused B. Maternal Blood pressure C. Maternal Apical Pulse rate D. Time Pitocin infusion completed 8. The nurse is caring for a newborn infant who was recently diagnosed with congenital heart defect. Which assessment finding warrants immediate intervention by the nurse? A. Sweating during feedings B. Weak peripheral pulse C. Bluish tinge to the tongue D. Increased respiratory rate 9. A client who delivered a healthy newborn an hour ago asks the nurse when can she go home. Which information is most important for the nurse to provide the client? A. When there is no significant vaginal bleeding B. When ambulating to void does not cause dizziness C. After the vitamin K injection is given to the baby D. After the baby no longer demonstrates acrocyanosis 10. A client at 33- weeks gestation is admitted with a moderate amount of vaginal bleeding and no contractions are noted on the external monitor. Which intervention should the nurse implement? A. Weight perineal pads B. Weight daily C. Measure intake and output D. Ambulate 15 minutes QID 11. The nurse is performing a gestational age assessment on a full-term newborn during the first hour of transition using the Ballard (Dubowitz) scale. Based on this assessment, the nurse determines that the neonate has a maturity rating of 40-weeks. What findings should the nurse identify to determine if the neonate is small for gestational age (SGA)? (Select all that apply.) A. Admission weight of 4 pounds, 15 ounces (2244 grams) B. Head to heel length of 17 inches (42.5 cm). C. Frontal occipital circumference of 12.5 inches (31.25 cm). D. Skin smooth with visible veins and abundant vernix. E. Anterior plantar crease and smooth heel surfaces. F. Full flexion of all extremities in resting supine position. 12. A client at 20 weeks gestation comes to the antepartum clinic complaining of vaginal warts (human papillomavirus). What information should the nurse provide this client? A. Treatment options, while limited due to the pregnancy, are available B. The client should be treated with Penicillin G C. This client should be treat with acyclovir (Zovirax) D. Termination of the pregnancy should be considered 13. One week after missing her menstrual period, a woman performs an OTC pregnancy test and it is positive. Which hormone is responsible for producing the positive result? A. Human placental lactogen B. Gonadotrophin-releasing hormone C. Human chorionic gonadotrophin D. Prostaglandin E2 Aplha 14. A new mother, who is lacto-ovo vegetarian, plans to breastfeed her infant. What information should the nurse provide prior to discharge? A. Avoid using lanolin-based nipple cream or ointment B. Continue prenatal vitamins with B12 while breast feeding C. Offer iron- fortified supplemental formula daily D. Weigh the baby weekly to evaluate the newborns growth 15. Four clients arrive on the labor and delivery unit at the same time. Which client should the nurse assess first? A. A 3-week multigravida with a prescription for serial blood pressures. B. A 39-week primigravida with biophysical profile score of 5 out of 8. C. A 38- week primigravida who reports contractions occurring every 10 minutes. D. A 41-week multigravida who is scheduled induction of labor today. 16. A primigravida at 36-weeks gestation, who is Rh negative, experienced abdominal trauma in a motor vehicle collision. Which assessment finding is most important for the nurse to report to the health care provider? A. Fetal heart rate of 162 beats/minute B. Trace of protein in the urine Positive fetal hemoglobin test Mild contractions every 10 minutes 17. The nurse is caring for a postnatal patient who is exhibiting symptoms of spinal headaches 24 hours following delivery of a normal newborn. Prior to anesthesiologist’s arrival on the unit, which action should the nurse perform? A. Place procedure equipment at bedside B. Apply an abdominal binder C. Cleanse the spinal injection site D. Insert an indwelling foley catheter 18. The nurse is counseling a client who is at 6 weeks gestation and is experiencing morning sickness but does not want to take any drugs for this discomfort. Which herbal supplement is likely to help this client with the nausea she is experiencing? A. Ginko B. Chamomile C. Peppermint D. Ginger 19. The nurse is assessing a postpartum client who delivered a 10 pound infant vaginally two hours ago. The clients fundus is 2 fingerbreadths above the umbilicus, deviated to the right side, and boggy. After the client voids 250 ml of urine using a bedpan, what action should the nurse implement? A. Re-evaluate the client in 15 minutes B. Assist the client to the bathroom to void C. Palpate the suprapubic region for distention D. Encourage the client to breastfeed 20. At 0600 while admitting a woman for a scheduled repeat c section, the client tells the nurse that she drank a cup of coffee at 0400 because she wanted to avoid getting a headache. What action should the nurse take first? A. Ensure preoperative lab results are available B. Start prescribed IV with Lactated Ringers C. Inform the anesthesia care provider D. Contact the clients obstetrician 21. A client who is in active labor is receiving magnesium sulfate and begin to experience slurred speech and decreased reflexes. Which action should the nurse implement first? A. Obtain a serum magnesium level B. Measure the clients hourly urinary output C. Provide an emesis basin for vomiting D. Turn off the magnesium sulfate infusion 22. A 3 hour old male infant’s hands are feet are cyanotic, and he has an axillary temperature of 96.5 F, a respiratory rate of 40 breaths/min, and a heart rate of 165 beats/min. Which nursing intervention is best for the nurse to implement? A. Perform a heel- stick to monitor blood glucose level B. Gradually warm the infant under a radiant heat source Administer oxygen by mask at 2L/minute Notify the pediatrician of the infants unstable vital signs 23. Calculated by Naegele’s rule, a primigravida client is at 28 weeks gestation. She is moderately obese and carrying twins and the nurse measures her fundal height at 27 cm. During the previous visit 3 weeks ago, the fundal height measured at 28 cm. Based on these findings, what should the nurse conclude? A. Fundal height measurement may indicate intrauterine growth retardation B. The healthcare provider needs to be notified immediately since this fundal height measurement is greater than expected C. Confirm the fundal height measurement with another nurse D. Recognize this as a reasonable fundal height measurement for this client 24. Following the vaginal delivery of a large for gestation age (LGA) infant, a woman is admitted to the ICU due to post-partum hemorrhaging. The client’s medical record describes Jehovah’s Witness notes as her religion. What action should the nurse take next? A. Inform the client of the critical need for a blood transfusion B. Obtain consent from the family to infuse packed red blood cells C. Clarify the clients wishes about receiving blood products D. Prepare to infuse multiple units of fresh frozen plasma 25. The nurse is assessing a 35 week primigravida with a breech presentation who is experiencing moderate uterine contraction every 3-5 minutes. During the examination the client tells the nurse, “I think my water just broke”. Inspection of the perineal area reveals the umbilical cord protruding from the vagina. After activating the call bell system for assistance, what intervention should the nurse implement? A. Administer oxygen at 10 liters via face mask B. Don gloves and push the cord back into the vagina C. Wrap the umbilical cord with sterile gauze D. Position the client into a knee-chest position 26. The nurse is discussing involution with a post-partum client. Which statement best indicates that the client understands the effect of breastfeeding on the resumption of menstrual cycle? A. “My period will most likely return in 6 to 8 months” B. “I should expect my period to return in 6 to 8 weeks” C. “My period started as soon as the baby was born” D. “While I am breastfeeding, my period may be delayed” 27. A diabetic client delivers a full term large for gestational age infant who is jittery. What action should the nurse take first? A. Obtain a blood glucose level B. Administer oxygen C. Feed the infant glucose water (10%) D. Decrease environmental stimuli 28. 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? A. Observe for signs of uterine hemorrhage B. Encourage direct contact with the infant Assess the blood pressure for hypertension Gently massage fundus every four hours 29. 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? ANS: 12 ml 30. The nurse finds a client at 33 weeks gestation in cardiac arrest. What adaptation to cardiopulmonary resuscitation (CPR) should the nurse implement? A. Position a firm wedge to support pelvis and thorax at 30 degree tilt. B. Apply oxygen by mask after opening the airway. C. Apply less compression force to reduce aspiration. D. Give continuous compression with a ventilation ration at 20:3. 31. A term multigravida, who is receiving oxytocin (Pitocin) for labor augmentation, is requesting pain medication. Review of the clients record indicates that she was medicated 30 minutes ago with butorphanol (Stadol) 2 mg and promethazine (Phenergan) 25 mg IV push. Vaginal examination reveals that the clients cervical dilation is 3 cm, 70% effaced, and at a 0 station. What action should the nurse implement? A. Medicate the client with an additional 1 mg of Stadol IV push B. Instruct the client to use deep breathing during a contraction C. Discontinue the Pitocin infusion D. Notify the healthcare provider 32. The parents of a newborn tell the nurse that their baby is already trying to walk. How should the nurse respond? A. Encourage the parents to report this to the healthcare provider B. Explain the newborns normal stepping reflex C. Acknowledge the parents observation D. Schedule the newborn for further neurological testing 33. At 34- weeks gestation, a primigravida is assessed at her bimonthly clinic visist,. Which assessment finding is important for the nurse to report to the hcp? A. Increased appetite B. Fetal heart rate of 110 beats/minute C. Fundus below the xiphoid D. Weight gain of 7 pounds