OB 217 OB HESI Questions & Answers (2020/2021)

OB 217 OB HESI Questions & Answers (2020) 1. A 6 year old child with acute infectious diarrhea is placed on a rehydration therapy regulation. What action should the nurse instruct the parents to take if the client begins to vomit ? A. Continue giving ORS frequently small amounts B. Withhold all oral medications C. Supplement ORS with gelatin or chicken broth D. Provide only bottle water 2. 19.Pt has history of "heart damage". She has the potential to have heart failure. What is her nursing diagnosis? 3. 35 weeks gestation. Breech baby. Contractions 3-5 minutes apart and mom states "I think my water just broke". Inspection reveals umbilical cord protruding. Intervention to implement? 4. 36. Mom with warts HPV outbreak at first trimester. what to do? 5. A 38 week primigravida is admitted to labor and delivery after a non-reactive result on a non-stress test (NST) .The nurse begins contraction stress test (CST) with an oxytocin ( Pitocin ) infusion. Which finding is most important for the nurse to report to the health care provider ? A. Spontaneous rupture of membrane B. Fetal heart rate accelerations with fetal movement C. Absence of uterine contractions within 20 mins D. A pattern of late fetal decelerations 6. 48. 34 weeks gestation. Bimonthly visit. Assessment finding important to report to health care provider? 7. 52. Multigravida asks for more pain meds. Just received pain meds, Stadol 2 mg, 30 minutes ago. Action to implement? 8. 53. Postpartum patient complains of severe pain and feeling pressure in perineal area. Nurse finds hematoma beginning to form. Which assessment finding should nurse obtain first? 9. An adult woman with Graves disease is admitted with severe dehydration and malnutrion. She is currently restless and wont eat. Which action is most important for the nurse to implement ? A. keep room temperature cool B. maintain patent intravenous site C. determine clients food preference D. teach client relaxation technique 10. Artifical rupture of the membrane of laboring client reveals meconium stained fluid. What is the priority ? A. Clean perineal area to prevent infection B. Assess the mothers blood pressure to check for signs of preclampsia C. Assess mothers temperature to check for development of sepsis D. Have meconium aspirator available at delivery 11. At 0600 while admitting a woman for a scheduled repeat c-section the client tells the nurse that she had coffee at 0400 because she wanted avoid getting a headache. What action should the nurse take first? A. Ensure preoperative lab results are available B. Start IV presecribed Lactated ringers C. Inform the anesthesia care provider D. Contact the client obstetrician 12. Baby born to diabetic mother. nurses intervention? 13. Baby is showing signs of being cold. What should the nurse do first? 14. Baby was born to an HPV postmortum . What is the first thing you should do? 15. A client at 28 weeks gestation is admitted to the obstetrical unit following her involvement in a motor vehicle collision. While stabilizing the patient , the nurse obtains fetal monitor reading.Which action should the nurse take if the fetus is tachycardic is on the monitor? A. Recount the heart rate manually to confirm a monitor malfunction B. Explain that there is no indication the fetal heart rate is due to trauma C. Evaluate the presence of preterm labor by performing a vaginal D. Contact the healthcare provider after initiating oxygen per face mask 16. A client delivers a viable infant , but begins to have excessive uncontrolled vaginal .. notifying the healthcare provider of the clients condition ,What information is most important A. Maternal blood pressure B. Maternal apical pulse C. Time pitocin infusion completed D. Total amount of pitocin infused 17. A client is receiving Pitocin to augment early labor. Which assessment is most important... time the infusion rate is increased? A. Contraction pattern B. Blood pressure C. Infusion site D. Pain level 18. A client with gestational diabetes is undergoing a non-stress test at 34 weeks gestation. Fetal heart beat is 144 beats / min. The client is instructed to mark the fetal monitor paper by pressing each time the baby moves. After 20 mins the nurse evaluates the fetal monitor strip A. The mother perceives and marks at least four fetal movements B. Fetal movements must be elicited with a vibroacoustic stimulator C. Two fetal heart accelerations of 15 beats/ min x 15 seconds are recorded D. No FHR late decelerations occur in response to fetal movement 19. During a 26 week gestation prenatal exam, a client reports occasional dizziness. What intervention is best for the nurse to recommend the client? A. Elevate the head with two pillows while sleeping B. Lie on the left or right side when sleeping or resting C. Increase intake of foods that are high in iron D. Decrease the amount of carbohydrates in the diet 20. During a routine prenatal vital a client 32 weeks gestation complains of urinary frequency has increased during the day as well at night. The nurse determines the client is having irregular uterine contractions. What should the nurse implement ? A. Ask the client if she had sexual intercourse yesterday B. Determine if she has change in vaginal discharge C. Collect urine sample from dipstick analysis D. Obtain a midstream urine specimen for culture 21. 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? Relieve hypotension A. Turn the board sideways to displace the uterus lateral B. Palpate the abdomen for contractions C. Infuse 1,000 normal saline using a large bore IV D. Obtain blood sample for a complete blood count 22. A full term infant is admitted to the newborn nursery 2 hours after delivery. The delivery record reports that the mother is positive for HIV and received AZT intravenously during labor. What action should the nurse implement first ? A. Ensure that AZT is given within 6 hours after birth B. Collect venous specimen for serum glucose level C. Asses for the presence of the Moro reflex D. Obtain consent for the Hep B vaccine 23. Good source of folic acid 24. The healthcare provider prescribe Pitocin 2milliunits / min to induce labor for a client at 41 weeks gestation. The nurse initiates an infusion of Lactated Ringer 1000 ml with Pitocin 10 units. How many ml/ hr should the nurse program the infusion pump? 25. highest risk for pregnancy 26. In determining the one minute Apgar score of a male infant the nurse asses a heart rate of 120 per min....respiration.. He has a loud cry with stimualtion, good muscle tone, color is acrocyanotic . What should the nurse assign? A. 7 B.8 C.9 D. 10 27. An infant born to a heorin addict mother is admitted to the neonatal care unit. . What behaviors can the baby exhibit? A. Lethargy and a poor suck B. Facial abnormalities and microcephaly C. Irritability and high pitched cry D. Low birth weight and intrauterine growth retardation 28. A infant is placed under a radiant warmer immediately after birth. At one hour of age , the nurse first assessment tachypneic , and hypotonic .What is the first action the nurse should take ? A. Notify the health care provider immediately B. Increase the temperature of the radiant warmer C. Assess infant heart rate D. Determine the infants blood sugar level 29. Lady girth measurement on a prenatal visit was 27 inches and 3 weeks later is 28. What should the nurse do? 30. Mom has mastitis. She is on antibiotics. Nurse advises patient to: 31. Mom in inducing labor, Pitocin is infusing. She was medicated for pain 30 minutes ago, she is asking for more pain medication. What should the nurse teach the patient? 32. Mom unsure about being a good parent. What should the nurse do? 33. A mother spontaneously delivers her infant in a taxi cab on the way to the hospital. The emergency room nurse reports that the mother has active herpes (HSVII) lesion on the vulva. What intervention should the nurse implement first when admitting the neonate in the nursery? A. Obtain blood specimen for serum glucose level B. Document the temperature on the flow sheet C. Place newborn in the isolation area of the nursery D. Administer Vitamin K injection 34. A multigravida full term , laboring client complains of back labor. Vaginal examine reveals that the client is 3cm with 50% effacement , and the fetal head is at -1 station. What action should the nurse implement first? A. Apply counter - pressure to the sacral area B. Turn the client lateral position C. Notify the scrub nurse to prepare the OR D. Ambulate the client between contractions 35. A multiparous women at 38 weeks gestation with a history of rapid progression of labor is admitted for induction due to signs and symptoms of pregnancy induced hypertension (PIH). One hour after the oxytocin infusion is initiated she complains of a headache. Her contractions are occurring every 1-2 mins , lasting 60-75 seconds and a vaginal exam reveals that her cervix is 90% and dilated 6 cm.What intervention is most important for the nurse to implement ? A. Prepare for immediate delivery B. Measure deep tendon reflexes C. Discontinue the Pitocin infusion D. Turn the client to her left side 36. New mother states her nipples are tender after breastfeeding for 2 days. intervention? 37. 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 ? A. Schedule an appointment with diabetic nurse educator B. Advise the client to breastfeed more frequently C. Counsel her to increase calorie intake D. Inform her that a decreased need for insulin occurs while breastfeeding 38. The nurse is assessing a client at 29 weeks gestation. Which assessment measure would provide the most accurate determination of fetal position? A. Ultrasound B. Vaginal examination C. Leopolds maneuver D. Doppler During fundal massage, place one hand at the fundus, what is the second hand used for – to anchor fundus There is a question that has to be put in order – isolate the baby, move mom to private room, collect u/a, start iv How do you measure the frequency of contractions – from the beginning of one to the beginning of the next Mothers Hemoglobin A1C – give her a consultation to a nutritionist Baby shows cyanosis in hands and feet and has elevated respirations – gradually warm the baby Baby is showing signs of mottling – check temperature Mom is at 20 week gestation and has gained 20 lbs, what is of most concern out of the data of mom – increased weight gain Mom asks why her baby is being screened for T4 and TSH levels – it is state protocol to monitor for metabolic abnormalities Patient is having labor back pain – counter pressure on lower back (sacrum) Woman had cleft lip, dads uncle had cleft lip – send them for genetic testing Woman in labor and they look at vagina and see cord – put woman in Trendelenburg position Pregnant woman has a diaphragm – she needs to have it refitted for another diaphragm Baby starts showing signs of respiratory difficulty (nasal flaring, expiratory grunt, cyanosis) – check O2 saturation levels Baby progressing in extrauterine life would show what signs – good vigorous cry with stimulation Baby has peri-oral cyanosis – assess the oral mucosa Before surgery mom is given an anticholinergic/atropine with anesthesia. What is the therapeutic response of the anticholinergic – increase pulse and decrease oral secretions Question about cytotec – answer is you are at an increased risk for abortion Patients uterus is above the umbilicus and to the right during postpartum, what do you do first – palpate the bladder for distention Mom feels the urge to defecate during labor – do a vagina exam What is the reason to do an ultrasound on a mother at 20 weeks gestation – ultrasound for gestation and fetal growth Patient is taking mag sulfate and urine output is 25 mL/hr, respirations 14/min, pulse is 116/min, what should the nurse do first – discontinue mag sulfate (signs of mag tox) Postpartum with bathroom privileges, what possible condition would the nurse place the patient on temporary bed rest for – possible thrombus in the leg if positive Homan’s sign is present Pregnant woman has an increased costal angle and diaphragm is elevated , how does the nurse document this – as a normal finding Moms Hgb and Hct is low, what food to tell her to eat that contains the most iron? – chicken (other sources: liver, meats, whole grains, enriched bread, cereal, dried fruits) Mom wakes up in a pool of blood and comes to emergency room. What to check first – blood pressure Nurse anticipates that the prenatal lab will be performed at 28 weeks – 1 hr glucose (140 between 24-28 weeks) What medication to give mom to prevent RDS in fetus – betamethasone Pt is induced for labor contractions begin occurring 1 ½ to 2 min apart with no resting in between contractions, what to do first – stop pitocin infusion Mom has been on mag sulfate and is now postpartum, what is she at increased risk for – uterine atony (hemorrhage) Mom is prescribed hemabate – give antiemetic before hemabate due to s/e (also cause diarrhea so give antidiarrheal) Mom says baby is trying to walk, what do you say – stepping reflex is normal reflex for babies Functions of placenta in early pregnancy – estrogen and progesterone production What does nurse do prior to administering RhoGAM injection – get second nurse to confirm med and patient Mom is having third baby at home, her two previous babies were rH negative, does she have to come get a direct coombs test dine on baby – yes Patient has been breastfeeding for 15 months and 6 weeks pregnant now, what is major assessment – nutritional intake Signs of fetal alcohol syndrome – flat nose bridge Patient is showing signs of mag toxicity (nausea, feeling of warmth, flushing) – stop infusion What is the best method to get hemoglobin and hematocrit on baby – heel stick Patient is diagnosed with eclampsia, what do you do – keep airway at bedside (immediate goal of care when during convulsion is to maintain a patent airway. When seizures do occur, turn woman on her side to prevent aspiration) Postpartum after c-section, pt is nauseated and abdominal distention, what to do first – auscultate for bowel sounds Patient is noted to have positive homan sign, what do you do – tell the patient to stay in the bed and notify the dr Mom comes to labor and delivery unit screaming “the baby is coming”, what to do first – observe the perineum Baby is given surfactant to help RDS, what assessment lets you know that the baby is Improving – increased urinary output Mom has mitral stenosis, what symptom is common with this diagnosis – persistent cough Pt is administered with anesthesia, what is the highest priority – side rails up and call bell in reach Assessment of a normal breast after delivery – expels colostrum (3-4 days) Mom is complaining that baby isn’t getting enough to eat, what do you tell her – if baby’s urine is straw colored, baby is ok A new mother asks the nurse, "How do I know that my daughter is getting enough breast milk?" Which explanation is appropriate? A. "Weigh the baby daily, and if she is gaining weight, she is getting enough to eat." B. "Your milk is sufficient if the baby is voiding pale, straw-colored urine six to ten times a day." C. "Offer the baby extra bottled milk after her feeding and see if she still seems hungry." D. "If you're concerned, you might consider bottle feeding so that you can monitor intake." Baby has total bilirubin level of 12 after 24 hrs – encourage mom to breastfeed Baby shows signs of jitteriness and other signs of hypoglycemia. What to do first – capillary glucose level In a gestational diabetic mom, what is the most important aspect for a healthy pregnancy – euglycemia Mom comes out of room screaming that her baby is missing. What do you do – initiate a lockdown Mom has post partial hemorrhage. What is most likely the cause – she is a multigravida Diaper change – use water Last trimester UTI – cause preterm labor IDDM insulin needs – less insulin needed in the first trimester Jewish lady – answer something to do with tay sachs