OB HESI Exam- Possible Questions

OB HESI Exam- Possible Questions And Answers The amniotic membranes of a client in active labor spontaneously rupture. The fluid is greenish brown with a foul odor. What action is a priority for the nurse? A. Evaluate the labor pattern. B. Administer oxygen. C. Place the client into the knee-chest position. D. Apply internal fetal heart monitor and note the time of membrane rupture Ans- ANS: D Rationale: In the presence of greenish brown amniotic fluid, the fetal heart rate should be monitored continuously using an internal fetal heart rate monitor, and the time of membrane rupture should be noted since birth should occur within 24 hours of the rupture of membranes. A primigravida in labor has complete cervical dilatation. Contractions are occurring every 1 1/2 to 2 minutes lasting 60 to 90 seconds. Upon examination, the nurse determines that birth is imminent because what has occurred? A. An increase in bloody show B. Perineum is bulging. C. Perineum is flattened. D. Crowning Ans- ANS: D The nurse, assessing a client who is 32 weeks pregnant during a routine visit, is concerned that the fetus is in the breech presentation. What did the nurse assess in the client? Ans- Fetal heart rate above the umbilicus. A client in the last trimester of pregnancy is prescribed sulfonamide for a urinary tract infection. What risk will this medication be to the developing fetus? Ans- Jaundice The fetal heart rate of a client in active labor shows variable decelerations. The cervix is 7cm dilated and the membranes are intact. What intervention should the nurse implement first? Ans- Assist client with turning to the left side. An Rh negative mother and an Rh positive father are expecting a child. Screening revealed a positive indirect coombs test. Which statement regarding this result is correct? Ans- There is no need to administer RhoGAM to this woman. A client, pregnant with her first child, tells the nurse that she is vegan. When discussing the client's nutritional needs, what should the nurse include? Ans- Use fortified soy or rice milk to meet dairy needs. A woman in the first trimester of her pregnancy has a Hemoglobin level of 11 mg/dl and MCV of 113 fL. What action should the nurse take? Ans- Determine folate and Vitamin B12 levels. A woman in the active phase of labor takes slow, deep breaths at the beginning of each contraction, while increasing the rate and decreasing the depth of her breaths as she reaches the peak of the contraction. Once the contraction is over, her breathing becomes slower and deeper again. What breathing pattern does the nurse recognize this client is using? Ans- Modified-paced breathing A pregnant client at risk for preterm labor has received betamethasone (Celestone) for 2 days. What is most important for the nurse to monitor? Ans- Blood glucose level The nurse is preparing a presentation on the organs of the developing fetus for a group of expecting families. When preparing this material, the nurse will include which organ system as being the most developed by 3 weeks of gestation? Ans- Cardiovascular system The nurse suspects that a pregnant client is experiencing domestic violence. During the assessment, the client tells the nurse that this is the first time it ever happened and does not expect it to occur again. What should the nurse respond to the client? Ans- "This type of behavior can continue after the child is born and may include the child as well." A client at 28 weeks gestation reports occasional blurry vision and demonstrates clonus on exam. What action is most important for the nurse take? Ans- Check urine specimen for protein. A pregnant client's medical record shows: Gravida 6 Term 2 Preterm 1 Abortion 2. Assuming that no children passed away after birth, how should the nurse interpreted this data? Ans- The client has 3 living children. The nurse is caring for a primigravid client who is 38 weeks pregnant. During her visit, the client tells the nurse, "my belly gets really tight sometimes and I get this lightning bolt sensation that goes down my legs and even in my vagina." What is the best response by the nurse? Ans- "When your belly gets tight, does the tightness go away if you walk around or change positions?" The nurse is teaching a group of students on fetal growth and development. Which statement regarding fetal circulation is incorrect? A. The umbilical vein transports nutrient and oxygen rich blood to the fetal body. B. The foramen ovale shunts blood from the right atrium directly to the left atrium, bypassing the lungs. C. The ductus venosus shunts blood from the pulmonary artery directly to the descending aorta, bypassing the lungs. D. The umbilical cord contains one umbilical vein and two umbilical arteries. Ans- ANS: C A client at 36-week gestation is scheduled to receive Rho(D) immune globulin (RhoGAM) injection after delivery of her first child. The nurse is teaching the client about the purpose of the medication. Which statement by the client confirms that teaching has been effective? Ans- "This injection will prevent the development of antibodies that may harm my next child." A nullipara client admitted to the labor and delivery unit says "I feel like I'm going to have a bowel movement."Upon assessment, the client's cervix is dilated to 10 cm, the baby is at 1+ station, and contractions are every 2-3 minutes lasting 60-90 seconds. What is the best action for the nurse to take? Ans- Instruct the client on quality pushing. A 36-year-old primigravida at 35 weeks gestation has irregular contractions occurring 10 minutes apart. Cervical exam reveals Ans-