OB HESI EXAM S 1 version 1,2,3 LATEST UPDATE DETAILED SOLUTIONS WITH NGN 1. A postpartum patient who has had a vaginal birth asks the nurse, “I was wondering if my cervix will return to its previous shape before I had the baby?” Which is the best response by the nurse? Ans. The cervix will now have a slit-like shape. 2. A patient who is 6 months pregnant has sought medical attention, saying she fell down the stairs. Which scenario would cause an emergency department nurse to suspect that the woman has been battered? Ans. The woman has injuries on various parts of her body that are in different stages of healing. 3. The nurse is reviewing the principles of family -centered care with a primiparous patient. Which patient statement will the nurse need to correct? Ans. “Because childbirth is normal, after my baby’s birth our family dynamics will not change.” 4. The nurse in labor and birth is caring for a Muslim patient during the active phase of labor. The nurse notes that the patient quickly draws away when touched. Which intervention should the nurse implement? Ans. Limit touching to a minimum because physical contact may not be acceptable in her culture. 5. The clinic nurse is reviewing breastfeeding with a pregnant patient. Which hormone will the nurse explain is responsible for milk production after the birth of the placenta? Ans. Prolactin. 6. A patient tells the nurse at a prenatal interview that she has quit smoking, and only has one glass of wine with dinner. Which response by t he nurse will be most helpful in promoting a lifestyle change? Ans. “You have made some good progress toward having a healthy baby. Let’s talk about the changes you have made.” 7. A 35-year-old patient has an amniocentesis performed to identify whether her baby has a chromosomal defect. Which statement indicates that the patient understands the situation? Ans. “When all the lab results come back, my husband and I will make a decision about the pregnancy.” 8. The patient indicates to the clinic nurse that she i s trying to become pregnant. The clinic nurse reviews the patient’s chart and notes the following laboratory values: Blood type O−, RPR nonreactive, rubella non -immune, HCT 35%. Which laboratory value is most concerning to the nurse? Ans. Rubella non-immune. 9. One of the assessments performed in the birth room is checking the umbilical cord for blood vessels. Which finding is considered to be within normal limits? Ans. Two arteries and one vein. 10. The nurse is conducting a staff in -service on multifetal pregnancy. Which statement regarding dizygotic twin development should the nurse include in the teaching session? Ans. Dizygotic twins arise from two fertilized ova and may be the same sex or differe nt sexes. 11. The nurse is explaining the function of the placenta to a pregnant patient. Which statement indicates to the nurse that further clarification is necessary? Ans. “The placenta helps maintain a stable temperature for my baby.” 12. An expectant mother says to the nurse, “When my sister’s baby was born, it was covered in a cheese -like coating. What is the purpose of this coating?” The correct response by the nurse is to explain that the purpose of vernix caseosa is to Ans. protect the fetal skin from the amniotic fluid. 13.A pregnant patient asks the nurse how her baby gets oxygen to breathe. What is the nurse’s best response? Ans. “Oxygen -rich blood is delivered through the umbilical vein to the baby.” 14.During vital sign assessment of a pregnant patient in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is most appropriate? Ans. Have the patient turn to her left side and recheck her blood pre ssure in 5 minutes. 15.A pregnant woman notices that she is beginning to develop dark skin patches on her face. She denies using any different type of facial products as a cleansing solution or makeup. What would the priority nursing intervention be in response to this situation? Ans. Let the patient know that this is a common finding that occurs during pregnancy. 16. While providing education to a primiparous patient regarding the normal changes of pregnancy, what is an important information for the nurse to share regarding Braxton Hicks contractions? Ans. These occur throughout pregnancy, but you may not feel them until the third trimester. 17. Physiologic anemia often occurs during pregnancy due to Ans. Dilution of hemoglobin concentration. 18. Which comment made by a patient in her first trimester indicates ambivalent feelings? Ans. “I wanted to become pregnant, but I’m scared about being a mother.” 19. An expectant patient in her third trimester reports that she developed a strong tie to her baby from the beginning and now is really in tune to her baby’s temperament. The nurse interprets this as the development of which maternal task of pregnancy? Ans. Developing attachment with the baby. 20. The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick’s sign. When the patient asks the nurse what this means, how would the nurse respond? Ans. “This sign occurs normally in pregnan cy, when estrogen causes increased blood flow in the area of the cervix.” 21. An expected change during pregnancy is a darkly pigmented vertical midabdominal line. The nurse recognizes this alteration as Ans. Linea nigra. 22. Which finding is a positive sign of pregnancy? Ans. Visualization of fetus by ultrasound. 23. Which advice to the patient is one of the most effective methods for preventing venous stasis? Ans. Rest often with the feet elevated. 24.A gravida 1 patient at 32 weeks of gestation reports that she has severe lower back pain. What should the nurse’s assessment include? Ans. Observation of posture and body mechanics. 25. When documenting a patient encounter, which term will the nurse use to describe the woman who is in the 28th week of her first pregnancy? Ans. Primigravida. 26. Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one infant at 32 weeks’ gestation, and one infant at 38 weeks’ gestation. Ans. G5 T1 P1 A2 L2. 27. The nurse is scheduling the next appointment for a healthy primigravida currently at 28 weeks gestation. When will the nurse schedule the next prenatal visit? Ans. 2 weeks. 28. Which type of cutaneous stimulation involves massage of the abdomen? Ans. Effleurage. 29. Which patient would require additional calories and nutrients? Ans. A 20 -year-old female who had a vaginal birth 5 months ago and is breastfeeding. 30. Which effect is a common response to both smoking and cocaine use in the pregnant patient? Ans. Vasoconstriction. 31. What does a birth plan help the parents accomplish? Ans. Taking an active part in planning the birth experience. 32. When explaining the recommended weight gain to your patient, the nurse’s teaching should include which statement? Ans. “Weight gain in pregnancy is based on the patient’s prepregnant body mass index.” 33. Uncontrolled maternal hyperventilation during labor results in Ans. Respiratory alkalosis. 34.A pregnant patient asks the nurse if she can double her prenat al vitamin dose because she does not like to eat vegetables. What is the nurse’s response regarding the danger of taking excessive vitamins? Ans. Has toxic effects on the fetus. 35. Which technique would provide the best pain relief for a pregnant woman with an occiput posterior position? Ans. Sacral pressure. 36. Which fetal position may cause the laboring patient increased back discomfort? Ans. Left occiput posterior. 37. Which physiologic event is the key indicator of the commencement of true labor? Ans. Cervical dilation and effacement. 38. To improve placental blood flow immediately after the injection of an epidural anesthetic, the nurse should Ans. Place a wedge under the woman’s right hip. 39. The clinic nurse is reviewing charts on prenatal patients. Which patient histories indicate that a referral to a genetic counselor is warranted? (Select all that apply.) Ans. -A family history of unexplained stillbirths, -A patient with a family history of birth defects, -A patient who is a carrier of an X-linked disorder.
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