HESI OB Hints exams/ 148 Questions and
Answers/ Verified/ Graded A+
The menstrual phase - -Varies in most women
-Between ovulation and the beginning of the next menstrual cycle - -There are usually
exactly 14 days; in other words ovulation occurs 14 days before the next menstrual
period
-Lifespan of sperm - -Sperm live approximately three days 48 to 72 hours and eggs live
about 24 hours; couples must avoid unprotected sex for several days before anticipated
ovulation and for three days after ovulation to prevent pregnancy
-Implantation spotting or bleeding - -Because some women experience implantation
spotting or bleeding they do not know they are pregnant
-Signs of maternal fetal bonding - -Look for signs of maternal fetal bonding during
pregnancy; for example talking to fetus in utero, massaging abdomen and nicknaming
fetus are all healthy psycho social activities
-Abuse during pregnancy - -For many women battering begins during pregnancy;
women should be assessed for abuse in private, away from the male partner by nurse
who is familiar with local resources and knows how to determine the safety of a client
-At approximately 28 to 32 weeks of gestation - -A plasma volume increase of 25 to
40% occurs resulting in normal hemodilution of pregnancy and hematocrit values of 32
to 42%; high hematocrit values may look good but in reality they represent a gestation
hypertensive disorder and depleted vascular space
-Hemoglobin and hematocrit data - -Can be used to evaluate nutritional status
,-Example question; 22-year-old primigravida 12 weeks gestation has a hemoglobin of
9.6 and hematocrit of 31%; has gained 3 pounds during the first trimester - -A weight
gain of 2 to 4 pounds during the first trimester is recommended and this client is
anemic; supplemental iron and a diet high in iron are needed
-Foods high in iron - -Fish and red meats, cereal and yellow vegetables, green leafy
vegetables, citrus fruits, egg yolks and dried fruits
-As pregnancy advances - -The uterus presses on abdominal vessels for example vena
cava in aorta; teach the woman that left side lying position will relieve supine
hypotension and increases perfusion to uterus, placenta and fetus
-Fetal well-being - -Is determined by assessing fundal height, fetal heart tones and rate,
fetal movement and uterine activity; changes in FHR are the first and most important
indicators of compromise blood flow to the fetus in these changes require action
-Normal fetal heart rate - -110 to 160 Beats per minute
-Possible indications of preeclampsia and eclampsia are - -Visual disturbances,
swelling of the face, fingers are sacrum, severe, continuous headache, epigastric pain,
persistent vomiting, signs of infection, fluid discharge or bleeding from vagina and
changes in fetal movement or increased FHR
-Prenatal vitamins - -Most providers prescribe prenatal vitamins to ensure that the
client receives an adequate intake of vitamins; however only the HCP can prescribe for
natal vitamins; nurses responsibility is to teach about proper diet and about taking
prescribed vitamins
-Daily calcium needs for pregnant women - -It is recommended that pregnant women
consume the equivalent of 3 cups of milk or yogurt per day; this will ensure that the
daily calcium needs are met and help to alleviate the occurrence of leg cramps
, -Screening for neural tube defects - -In some states screening for neural tube defect's
by testing either maternal serum alpha-fetoprotein levels or amniotic fluid levels is
mandated by state law; screening test is highly associated with both false positive and
false negatives
-Gestational age - -Is best determined by an early sonogram rather then a later one
-Amniocentesis - -When amniocentesis is done in early pregnancy the bladder must be
full to help support the uterus and to help push the uterus up in the abdomen for easy
access; when an amniocentesis is done in late pregnancy the bladder must be empty so it
will not be punctured
-Early decelerations - -Caused by head compression in fetal descent, usually occur
between 4 to 7 cm and in the second stage of labor; check for labor progress if early
decels are noted
-Cord prolapse - -If cord prolapse is detected the examiner should position the mother
to relieve pressure on the cord for example knee to chest position or push the presenting
part off the court until immediate cesarean delivery can be accomplished
-Late decelerations - -Indicate UPI and are associated with conditions such as
postmaturity, preeclampsia, diabetes mellitus, cardiac disease and abruptio placentae
-Decelerations associated with decreased or absent variability and tachycardia - -When
deceleration patterns are associated with decreased or absent variability in tachycardia
the situation is ominous or potentially disastrous and requires immediate intervention
and fetal assessment
-Decrease in uteroplacental perfusion - -Results in late decelerations; cord
compression results in a pattern of very variable decelerations; nursing intervention
should include changing maternal position, discontinuing oxytocin infusion,
administering 02 and notifying HCP
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