OB HESI FINAL EXAM NEWEST 2026/ 2027 EXAM TEST BANK|
OB HESI FINAL EXAM REVIEW CHAMBERLAIN UNIVERSITY
Prepare for the OB HESI final exam with a comprehensive-question test bank built
for nursing students in U.S. colleges and universities. Each question includes a
verified correct answer and a detailed rationale to strengthen clinical judgment
and exam performance. This resource is organized for efficient study and is
suitable for Stuvia and Docsity sale listings.
1. A client at 32 weeks gestation is receiving magnesium sulfate for severe
preeclampsia. Which assessment finding indicates that the therapeutic drug level
has been achieved?
A. 4+ deep tendon reflexes
B. Urinary output of 50 mL/hr
C. A decrease in respiratory rate from 24 to 16
D. A decreased body temperature
Answer: C
Rationale: Magnesium sulfate is a central nervous system depressant used
to prevent seizures. A respiratory rate of 16 breaths/min reflects a
therapeutic central nervous system depressant effect without toxicity.
Deep tendon reflexes should be 2+ (not 4+). Urinary output of 30 mL/hr or
greater is required to prevent accumulation, but 50 mL/hr alone does not
confirm therapeutic drug levels. Decreased body temperature is not a
therapeutic indicator.
2. The nurse assesses a client admitted to the labor and delivery unit and obtains
the following data: dark red vaginal bleeding, uterus slightly tense between
contractions, BP 110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced.
,Based on these findings, what intervention should the nurse implement?
A. Insert an internal fetal monitor
B. Assess for cervical changes every hour
C. Monitor bleeding from IV sites
D. Perform Leopold's maneuvers
Answer: D
Rationale: Dark red vaginal bleeding with a tense uterus suggests placental
abruption, but the priority is to determine fetal position and presentation
before further invasive assessments. Leopold's maneuvers are a non-
invasive, safe first step. Internal monitoring is contraindicated with active
bleeding. Hourly cervical checks are insufficient for a potentially emergent
situation. Monitoring IV sites is relevant for DIC risk but is not the
immediate priority.
3. A client who delivered an infant an hour ago tells the nurse that she feels wet
underneath her buttock. The nurse notes that the perineal pad is saturated and
the client is lying in a 6-inch diameter pool of blood. Which action should the nurse
implement first?
A. Cleanse the perineum
B. Obtain a blood pressure
C. Palpate the firmness of the fundus
D. Inspect the perineum for lacerations
Answer: C
Rationale: A firm uterus is needed to control bleeding from the placental
site. The nurse should first assess for uterine firmness and massage the
fundus as indicated. Cleansing the perineum, obtaining a blood pressure,
and inspecting for lacerations are secondary to assessing uterine tone,
which is the most common cause of early postpartum hemorrhage.
4. A woman who thinks she could be pregnant calls her neighbor, who is a nurse,
to ask when she should use a home pregnancy test. Which response is
,appropriate?
A. "A home pregnancy test can be used right after your first missed period."
B. "These tests are most accurate after you miss your second period."
C. "Home pregnancy tests often give false positives and should not be trusted."
D. "The test can provide accurate information when used right after ovulation."
Answer: A
Rationale: Home urine tests detect human chorionic gonadotropin, which
begins to increase 6–8 days after conception. The test is best detected at
about 2 weeks gestation, or immediately after the first missed period.
Waiting until the second missed period is unnecessary. Home tests are
generally reliable. Testing right after ovulation is too early for hCG
detection.
5. One hour after giving birth to an 8-pound infant, a client's lochia rubra has
increased from small to large, and her fundus is boggy despite massage. HR is 84
bpm, BP 156/96. The provider prescribes Methergine 0.2 mg IM × 1. Which action
should the nurse take immediately?
A. Give the medication as prescribed and monitor for efficacy
B. Encourage the client to breastfeed rather than bottle feed
C. Have the client empty her bladder and massage her fundus
D. Call the healthcare provider to question the prescription
Answer: D
Rationale: Methergine (methylergonovine) is contraindicated in clients with
elevated blood pressure because it causes vasoconstriction. The nurse
should contact the provider and question the prescription. Giving the
medication could dangerously increase the blood pressure. Breastfeeding
and emptying the bladder are useful measures for uterine atony, but they
do not address the unsafe medication order.
6. The nurse should encourage the laboring patient to begin pushing when:
A. there is only an anterior or posterior lip of cervix left
, B. the client describes the need to have a bowel movement
C. the cervix is completely dilated
D. the cervix is completely effaced
Answer: C
Rationale: Pushing begins with the second stage of labor, when the cervix is
completely dilated at 10 cm. Pushing before full dilation can cause cervical
edema and operative delivery. The urge to have a bowel movement can
occur before full dilation and is not a reliable indicator. Complete
effacement alone is insufficient; dilation must also be complete.
7. When explaining "postpartum blues" to a client who is 1 day postpartum, which
symptoms should the nurse include in the teaching plan? (Select all that apply)
A. Mood swings
B. Panic attacks
C. Tearfulness
D. Decreased need for sleep
E. Disinterest in the infant
Answer: A, C
Rationale: Postpartum blues are a common emotional response related to
the rapid decrease in placental hormones after delivery and include mood
swings and tearfulness. Panic attacks, a decreased need for sleep, and
disinterest in the infant are more characteristic of postpartum depression
or psychosis and require further evaluation.
8. A client at 28 weeks of gestation calls the antepartum clinic and states that she
has just experienced a small amount of bright red vaginal bleeding, which has
subsided. She denies uterine contractions or abdominal pain. What instruction
should the nurse provide?
A. Come to the clinic today for an ultrasound.
B. Go immediately to the emergency department.
C. Lie on your left side for about 1 hour and see if the bleeding stops.
OB HESI FINAL EXAM REVIEW CHAMBERLAIN UNIVERSITY
Prepare for the OB HESI final exam with a comprehensive-question test bank built
for nursing students in U.S. colleges and universities. Each question includes a
verified correct answer and a detailed rationale to strengthen clinical judgment
and exam performance. This resource is organized for efficient study and is
suitable for Stuvia and Docsity sale listings.
1. A client at 32 weeks gestation is receiving magnesium sulfate for severe
preeclampsia. Which assessment finding indicates that the therapeutic drug level
has been achieved?
A. 4+ deep tendon reflexes
B. Urinary output of 50 mL/hr
C. A decrease in respiratory rate from 24 to 16
D. A decreased body temperature
Answer: C
Rationale: Magnesium sulfate is a central nervous system depressant used
to prevent seizures. A respiratory rate of 16 breaths/min reflects a
therapeutic central nervous system depressant effect without toxicity.
Deep tendon reflexes should be 2+ (not 4+). Urinary output of 30 mL/hr or
greater is required to prevent accumulation, but 50 mL/hr alone does not
confirm therapeutic drug levels. Decreased body temperature is not a
therapeutic indicator.
2. The nurse assesses a client admitted to the labor and delivery unit and obtains
the following data: dark red vaginal bleeding, uterus slightly tense between
contractions, BP 110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced.
,Based on these findings, what intervention should the nurse implement?
A. Insert an internal fetal monitor
B. Assess for cervical changes every hour
C. Monitor bleeding from IV sites
D. Perform Leopold's maneuvers
Answer: D
Rationale: Dark red vaginal bleeding with a tense uterus suggests placental
abruption, but the priority is to determine fetal position and presentation
before further invasive assessments. Leopold's maneuvers are a non-
invasive, safe first step. Internal monitoring is contraindicated with active
bleeding. Hourly cervical checks are insufficient for a potentially emergent
situation. Monitoring IV sites is relevant for DIC risk but is not the
immediate priority.
3. A client who delivered an infant an hour ago tells the nurse that she feels wet
underneath her buttock. The nurse notes that the perineal pad is saturated and
the client is lying in a 6-inch diameter pool of blood. Which action should the nurse
implement first?
A. Cleanse the perineum
B. Obtain a blood pressure
C. Palpate the firmness of the fundus
D. Inspect the perineum for lacerations
Answer: C
Rationale: A firm uterus is needed to control bleeding from the placental
site. The nurse should first assess for uterine firmness and massage the
fundus as indicated. Cleansing the perineum, obtaining a blood pressure,
and inspecting for lacerations are secondary to assessing uterine tone,
which is the most common cause of early postpartum hemorrhage.
4. A woman who thinks she could be pregnant calls her neighbor, who is a nurse,
to ask when she should use a home pregnancy test. Which response is
,appropriate?
A. "A home pregnancy test can be used right after your first missed period."
B. "These tests are most accurate after you miss your second period."
C. "Home pregnancy tests often give false positives and should not be trusted."
D. "The test can provide accurate information when used right after ovulation."
Answer: A
Rationale: Home urine tests detect human chorionic gonadotropin, which
begins to increase 6–8 days after conception. The test is best detected at
about 2 weeks gestation, or immediately after the first missed period.
Waiting until the second missed period is unnecessary. Home tests are
generally reliable. Testing right after ovulation is too early for hCG
detection.
5. One hour after giving birth to an 8-pound infant, a client's lochia rubra has
increased from small to large, and her fundus is boggy despite massage. HR is 84
bpm, BP 156/96. The provider prescribes Methergine 0.2 mg IM × 1. Which action
should the nurse take immediately?
A. Give the medication as prescribed and monitor for efficacy
B. Encourage the client to breastfeed rather than bottle feed
C. Have the client empty her bladder and massage her fundus
D. Call the healthcare provider to question the prescription
Answer: D
Rationale: Methergine (methylergonovine) is contraindicated in clients with
elevated blood pressure because it causes vasoconstriction. The nurse
should contact the provider and question the prescription. Giving the
medication could dangerously increase the blood pressure. Breastfeeding
and emptying the bladder are useful measures for uterine atony, but they
do not address the unsafe medication order.
6. The nurse should encourage the laboring patient to begin pushing when:
A. there is only an anterior or posterior lip of cervix left
, B. the client describes the need to have a bowel movement
C. the cervix is completely dilated
D. the cervix is completely effaced
Answer: C
Rationale: Pushing begins with the second stage of labor, when the cervix is
completely dilated at 10 cm. Pushing before full dilation can cause cervical
edema and operative delivery. The urge to have a bowel movement can
occur before full dilation and is not a reliable indicator. Complete
effacement alone is insufficient; dilation must also be complete.
7. When explaining "postpartum blues" to a client who is 1 day postpartum, which
symptoms should the nurse include in the teaching plan? (Select all that apply)
A. Mood swings
B. Panic attacks
C. Tearfulness
D. Decreased need for sleep
E. Disinterest in the infant
Answer: A, C
Rationale: Postpartum blues are a common emotional response related to
the rapid decrease in placental hormones after delivery and include mood
swings and tearfulness. Panic attacks, a decreased need for sleep, and
disinterest in the infant are more characteristic of postpartum depression
or psychosis and require further evaluation.
8. A client at 28 weeks of gestation calls the antepartum clinic and states that she
has just experienced a small amount of bright red vaginal bleeding, which has
subsided. She denies uterine contractions or abdominal pain. What instruction
should the nurse provide?
A. Come to the clinic today for an ultrasound.
B. Go immediately to the emergency department.
C. Lie on your left side for about 1 hour and see if the bleeding stops.
