Exam (elaborations)

Hesi OB 2023

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Hesi OB 2023

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Hesi OB 2023

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Uploaded on February 24, 2023
Number of pages 5
Written in 2022/2023
Type Exam (elaborations)
Contains Questions & answers

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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

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