HESI OB Final Exam with 100% Correct
Answers 2023
The nurse should be concerned after the assessment finding on what during a
magnesium sulfate infusion for preeclampsia?
A. a sleepy, sedated effect
B. a respiratory rate of 10 bpm
C. DTR of 2+
D. absence of ankle clonus - Correct answer-B should alert the nurse for respiratory
depression. The other findings are considered normal.
the most common medical complication of pregnancy - Correct answer-hypertension
preeclampsia results in what - Correct answer-decreased function of organs (placenta,
liver, kidneys, brain) due to vasospasms diminishing the diameter of blood vessels .
a woman being treated with magnesium sulfate should be considered to be treated
successfully if... - Correct answer-no seizures occur
Mag is a CNS depressant, NOT an antihypertensive medication
antidote for magnesium sulfate - Correct answer-calcium gluconate
HELLP syndrome - Correct answer-Hemolysis
Elevated Liver enzymes
Low Platelets
A pregnant woman who is at 21 weeks of gestation has an elevated blood pressure of
140/98. Past medical history reveals that the woman has been treated for hypertension.
On the basis of this information, the nurse would classify this patient as having: -
Correct answer-superimposed preeclampsia
positive ankle clonus indicates... - Correct answer-hyperactivity and is a cause for
concern
which antihypertensive medication would cause a pregnant woman to have a false
positive Coombs test? - Correct answer-methyldopa (aldomet)
lab values for preeclampsia - Correct answer-elevated hemoglobin
elevated LDH
decreased platelets (below 100,000)
increased BUN
,the most important cause of perinatal loss in diabetic pregnancy is... - Correct answer-
congenital malformations
hypothyroidism in mother could cause - Correct answer-miscarriage
preeclampsia and hypertension
placental abruption
stillbirth
low birth weight, premature
A patient who is pregnant already has Type 2 diabetes with a hemoglobin A1c value of
7. The nurse would categorize this patient as having: - Correct answer-pregestational
DM
priority assessment for pregnant woman experiencing nausea and vomiting - Correct
answer-ketonuria
A pregnant woman has maternal phenylketonuria (PKU) and is interested in whether or
not she will be able to breastfeed her baby. Which reaction by the nurse indicates
accurate information? - Correct answer-the patient should be advised to not breastfeed
the infant because her breast milk will contain large amounts of phenylalanine
what interventions would the nurse anticipate to be ordered by the physician for a
patient in a thyroid storm during delivery? - Correct answer-administer oxygen
antipyretics
PTU
preeclampsia protein levels - Correct answer-mild: 1+ on dipstick (0.3-2 g/24 hours)
severe: 3+ dipstick (more than 5 g/24 hr)
mag toxicity - Correct answer-flushing
sweating
hypotension
depressed DTR
respiratory depression
creatinine levels of severe preeclampsia - Correct answer-elevated (above 1.2)
platelet levels of severe preeclampsia - Correct answer-decreased (below 100,000)
incompetent cervix - Correct answer-premature dilation
tx: surgical placement of cervical cerclage 10-14 weeks gestation to constrict the
internal os
,provide bed rest, hydration, tocolysis (to inhibit ctx), no sex or standing for a long time
removed at 37 weeks gestation or prior to c/s
leading cause of life-threatening perinatal infections - Correct answer-GBS
can lead to sepsis, pneumonia, or meningitis causing permanent neuro disability
dx with vag and rectal cultures at 35-37 weeks
tx with antibiotics
opthalmia neonatorum is caused by what organism - Correct answer-gonorrhea
(neisseria gonorrhoeae)
mechanisms of labor - Correct answer-1. engagement (lightening, dropping)
2. descent
3. flexion
5. internal rotation
6.. extension (begins after the head crowns)
7. restitution (realignment of the fetal head with the body after the head emerges)
8. external rotation (of the shoulders)
9. explusion
variable decels - Correct answer-cord compression
are not as uniform as early and late decels
could be nonperiodic (unrelated to ctx times)
they are significant when FHR repeatedly declines to less than 70 bpm and persists at
level for at least 60 seconds before returning to baseline
TX: change position, administer oxygen, d/c pit, assess mother's vitals, assist with
amnioinfusion to decompress cord as prescribed
Four Stages of Labor - Correct answer-STAGE 1
a) Latent
1-4 cm dilation w/ UC 15-30 minutes apart and 15-30 seconds duration
b) Active
4-7 cm dilation w/ UC 3-5 minutes apart for 30-60 seconds
c) Transition
8-10 cm w/ UC 2-3 min apart for 45-90 seconds
STAGE 2
exit of fetus
assess every 5 minutes
, STAGE 3
placental exit
<30 minutes after fetus
fundus remains firm 2 fingerbreadths below umbilicus
STAGE 4
about up to 4 hours after delivery
assess Q15 for first hour, Q30 for second hour, and hourly for 3rd and 4th hour
what score of the bishop scale indicates readiness for labor induction - Correct answer-
6
bishop scoring - Correct answer-0-3
dilation (0-- 1 to 2-- 3 to 4-- more than 5)
effacement (0 to 30-- 40 to 50-- 60 to 70-- 80)
consistency of cervix (firm--med--soft)
position of cervix (posterior--mid--anterior)
station (-3.. -2.. -1... +1)
when is an amniotomy performed - Correct answer-if the fetus is 0 or plus station and
membranes haven't ruptured
increases the risk of a prolapsed cord and infection
placenta previa - Correct answer-improperly implanted placenta (total, partial, marginal
in relation to the internal os)
sudden, PAINLESS, BRIGHT red vaginal discharge
SOFT, RELAXED, NONTENDER uterus
fundal height is higher than expected
abruptio placenta - Correct answer-premature separation of placenta (after 20th week
but before birth)
DARK red bleeding (or none if too high), PAINFUL, TENDER uterus w/ RIGIDITY
fetal distress with maternal shock
in which placental condition would vaginal exams be contraindicated - Correct answer-
placenta previa
anticipate what intervention for abruptio placentae - Correct answer-delivery
preterm labor - Correct answer-before 37 weeks
Answers 2023
The nurse should be concerned after the assessment finding on what during a
magnesium sulfate infusion for preeclampsia?
A. a sleepy, sedated effect
B. a respiratory rate of 10 bpm
C. DTR of 2+
D. absence of ankle clonus - Correct answer-B should alert the nurse for respiratory
depression. The other findings are considered normal.
the most common medical complication of pregnancy - Correct answer-hypertension
preeclampsia results in what - Correct answer-decreased function of organs (placenta,
liver, kidneys, brain) due to vasospasms diminishing the diameter of blood vessels .
a woman being treated with magnesium sulfate should be considered to be treated
successfully if... - Correct answer-no seizures occur
Mag is a CNS depressant, NOT an antihypertensive medication
antidote for magnesium sulfate - Correct answer-calcium gluconate
HELLP syndrome - Correct answer-Hemolysis
Elevated Liver enzymes
Low Platelets
A pregnant woman who is at 21 weeks of gestation has an elevated blood pressure of
140/98. Past medical history reveals that the woman has been treated for hypertension.
On the basis of this information, the nurse would classify this patient as having: -
Correct answer-superimposed preeclampsia
positive ankle clonus indicates... - Correct answer-hyperactivity and is a cause for
concern
which antihypertensive medication would cause a pregnant woman to have a false
positive Coombs test? - Correct answer-methyldopa (aldomet)
lab values for preeclampsia - Correct answer-elevated hemoglobin
elevated LDH
decreased platelets (below 100,000)
increased BUN
,the most important cause of perinatal loss in diabetic pregnancy is... - Correct answer-
congenital malformations
hypothyroidism in mother could cause - Correct answer-miscarriage
preeclampsia and hypertension
placental abruption
stillbirth
low birth weight, premature
A patient who is pregnant already has Type 2 diabetes with a hemoglobin A1c value of
7. The nurse would categorize this patient as having: - Correct answer-pregestational
DM
priority assessment for pregnant woman experiencing nausea and vomiting - Correct
answer-ketonuria
A pregnant woman has maternal phenylketonuria (PKU) and is interested in whether or
not she will be able to breastfeed her baby. Which reaction by the nurse indicates
accurate information? - Correct answer-the patient should be advised to not breastfeed
the infant because her breast milk will contain large amounts of phenylalanine
what interventions would the nurse anticipate to be ordered by the physician for a
patient in a thyroid storm during delivery? - Correct answer-administer oxygen
antipyretics
PTU
preeclampsia protein levels - Correct answer-mild: 1+ on dipstick (0.3-2 g/24 hours)
severe: 3+ dipstick (more than 5 g/24 hr)
mag toxicity - Correct answer-flushing
sweating
hypotension
depressed DTR
respiratory depression
creatinine levels of severe preeclampsia - Correct answer-elevated (above 1.2)
platelet levels of severe preeclampsia - Correct answer-decreased (below 100,000)
incompetent cervix - Correct answer-premature dilation
tx: surgical placement of cervical cerclage 10-14 weeks gestation to constrict the
internal os
,provide bed rest, hydration, tocolysis (to inhibit ctx), no sex or standing for a long time
removed at 37 weeks gestation or prior to c/s
leading cause of life-threatening perinatal infections - Correct answer-GBS
can lead to sepsis, pneumonia, or meningitis causing permanent neuro disability
dx with vag and rectal cultures at 35-37 weeks
tx with antibiotics
opthalmia neonatorum is caused by what organism - Correct answer-gonorrhea
(neisseria gonorrhoeae)
mechanisms of labor - Correct answer-1. engagement (lightening, dropping)
2. descent
3. flexion
5. internal rotation
6.. extension (begins after the head crowns)
7. restitution (realignment of the fetal head with the body after the head emerges)
8. external rotation (of the shoulders)
9. explusion
variable decels - Correct answer-cord compression
are not as uniform as early and late decels
could be nonperiodic (unrelated to ctx times)
they are significant when FHR repeatedly declines to less than 70 bpm and persists at
level for at least 60 seconds before returning to baseline
TX: change position, administer oxygen, d/c pit, assess mother's vitals, assist with
amnioinfusion to decompress cord as prescribed
Four Stages of Labor - Correct answer-STAGE 1
a) Latent
1-4 cm dilation w/ UC 15-30 minutes apart and 15-30 seconds duration
b) Active
4-7 cm dilation w/ UC 3-5 minutes apart for 30-60 seconds
c) Transition
8-10 cm w/ UC 2-3 min apart for 45-90 seconds
STAGE 2
exit of fetus
assess every 5 minutes
, STAGE 3
placental exit
<30 minutes after fetus
fundus remains firm 2 fingerbreadths below umbilicus
STAGE 4
about up to 4 hours after delivery
assess Q15 for first hour, Q30 for second hour, and hourly for 3rd and 4th hour
what score of the bishop scale indicates readiness for labor induction - Correct answer-
6
bishop scoring - Correct answer-0-3
dilation (0-- 1 to 2-- 3 to 4-- more than 5)
effacement (0 to 30-- 40 to 50-- 60 to 70-- 80)
consistency of cervix (firm--med--soft)
position of cervix (posterior--mid--anterior)
station (-3.. -2.. -1... +1)
when is an amniotomy performed - Correct answer-if the fetus is 0 or plus station and
membranes haven't ruptured
increases the risk of a prolapsed cord and infection
placenta previa - Correct answer-improperly implanted placenta (total, partial, marginal
in relation to the internal os)
sudden, PAINLESS, BRIGHT red vaginal discharge
SOFT, RELAXED, NONTENDER uterus
fundal height is higher than expected
abruptio placenta - Correct answer-premature separation of placenta (after 20th week
but before birth)
DARK red bleeding (or none if too high), PAINFUL, TENDER uterus w/ RIGIDITY
fetal distress with maternal shock
in which placental condition would vaginal exams be contraindicated - Correct answer-
placenta previa
anticipate what intervention for abruptio placentae - Correct answer-delivery
preterm labor - Correct answer-before 37 weeks
