OB/MATERNITY HESI EXAM 2023/2024
LATEST UPDATE 2 DIFFERENT VERSIONS
110 QUESTIONS AND ANSWERS WITH
RATIONALES NEXT GEN
(NGN)GUARANTEED PASS
A women with Type 2 diabetes mellitus becomes pregnant, and her oral hypoglycemic agents are
discontinued. Which intervention is most important for the nurse to implement?
A. Describe diet changes that can improve the management of her diabetes
B. Inform the client that oral hypoglycemic agents are teratogenic during pregnancy
C. Demonstrate self-administration of insulin
D. Evaluate the client's ability to do glucose monitoring
A. Describe diet changes that can improve the management of her diabetes
Diet modifications are effective in managing Type 2 diabetes during pregnancy, and describing
the necessary diet changes is the most important intervention for the nurse to implement with this
client.
A healthcare provider informs the charge nurse of a labor and delivery unit that a client is
coming to the unit with suspected abruptio placentae. What findings should the charge nurse
expect the client to demonstrate? (Select all that apply)
A. Dark, red vaginal bleeding
B. Lower back pain
C. Premature rupture of membranes
D. Increased uterine irritability
E. Bilateral pitting edema
F. A rigid abdomen
A. Dark, red vaginal bleeding
D. Increased uterine irritability
F. A rigid abdomen
The nurse caring for a laboring client encourages her to void at least q2h, and records each time
the client empties her bladder. What is the primary reason for implementing this nursing
intervention?
A. Emptying the bladder during delivery is difficult because of the position of the presenting
fetal part
,B. An over-distended bladder could be traumatized during labor, as well as prolong the progress
of labor
C. Urine specimens for glucose and protein must be obtained at certain intervals throughout
labor
D. Frequent voiding minimizes the need for catheterization which increases the chance of
bladder infection
B. An over-distended bladder could be traumatized during labor, as well as prolong the progress
of labor
A full bladder can impair the efficiency of the uterine contractions and impede descent of the
fetus during labor. Also, because of the close proximity of the bladder to the uterus, the bladder
can be traumatized by the descent of the fetus.
The nurse identifies crepitus when examining the chest of a newborn who was delivered
vaginally. Which further assessment should the nurse perform?
A. Elicit a positive scarf sign on the affected side
B. Observe for an asymmetrical Moro (startle) reflex
C. Watch for swelling of fingers on the affected side
D. Note paralysis of affected extremity and muscles
B. Observe for an asymmetrical Moro (startle) reflex
The most common neonatal birth trauma due to a vaginal delivery is fracture of the clavicle.
Although an infant may be asymptomatic, a fractured clavicle should be suspected if an infant
has limited use of the affected arm, malposition of the arm, an asymmetric Moro reflex, crepitus
over the clavicle, focal swelling or tenderness, or cries when the arm is moved.
A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26-weeks gestation in preterm
labor. She is started on an IV solution of terbutaline (Brethine). Which assessment is the highest
priority for the nurse to monitor during the administration of this drug?
A. Materna blood pressure and respirations
B. Maternal and fetal heart rates
C. Hourly urinary output
D. Deep tendon relfexes
B. Maternal and fetal heart rates
Monitoring maternal and fetal heart rates is most important when terbutaline is being
administered. Terbutaline acts as a sympathomimetic agent that stimulates both beta 1 receptors
(causing tachycardia, a side effect of the drug) and stimulation of beta 2 receptors (causing
uterine relaxation, a desired effect of the drug).
, A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation in
preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25mg subcutaneously to
stop her labor contractions. The nurse plans to monitor for which primary side effect of
terbutaline sulfate?
A. Drowsiness and bradycardia
B. Depressed reflexes and increased respirations
C. Tachycardia and a feeling of nervousness
D. A flushed, warm feeling and a dry mouth
C. Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-adrenergic
receptors in the uterine muscle to stop contractions. The beta-adrenergic agonist properties of the
drug may cause tachycardia, increased cardiac output, restlessness, headache, and a feeling of
"nervousness".
A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse
knows that the most likely presenting symptom for a pediatric client with AIDS is
A. shortness of breath
B. joint pain
C. a persistent cold
D. organomegaly
C. a persistent cold
Respiratory tract infections commonly occur in the pediatric population. However, the child with
AIDS has a decreased ability to defend the body against these infections and often the presenting
symptom of a child with AIDS is a persistent cold.
A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when she could
use a home pregnancy test to diagnose pregnancy. Which response appropriate?
A. "A home pregnancy test can be used right after your missed period."
B. "These tests are most accurate after you have missed 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."
A. "A home pregnancy test can be used right after your missed period."
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood
pressure drops from 120/80 to 90/60. What action will the nurse take?
A. Notify the healthcare provider or anesthesiologist immediately
B. Continue to assess the blood pressure q5 minutes
LATEST UPDATE 2 DIFFERENT VERSIONS
110 QUESTIONS AND ANSWERS WITH
RATIONALES NEXT GEN
(NGN)GUARANTEED PASS
A women with Type 2 diabetes mellitus becomes pregnant, and her oral hypoglycemic agents are
discontinued. Which intervention is most important for the nurse to implement?
A. Describe diet changes that can improve the management of her diabetes
B. Inform the client that oral hypoglycemic agents are teratogenic during pregnancy
C. Demonstrate self-administration of insulin
D. Evaluate the client's ability to do glucose monitoring
A. Describe diet changes that can improve the management of her diabetes
Diet modifications are effective in managing Type 2 diabetes during pregnancy, and describing
the necessary diet changes is the most important intervention for the nurse to implement with this
client.
A healthcare provider informs the charge nurse of a labor and delivery unit that a client is
coming to the unit with suspected abruptio placentae. What findings should the charge nurse
expect the client to demonstrate? (Select all that apply)
A. Dark, red vaginal bleeding
B. Lower back pain
C. Premature rupture of membranes
D. Increased uterine irritability
E. Bilateral pitting edema
F. A rigid abdomen
A. Dark, red vaginal bleeding
D. Increased uterine irritability
F. A rigid abdomen
The nurse caring for a laboring client encourages her to void at least q2h, and records each time
the client empties her bladder. What is the primary reason for implementing this nursing
intervention?
A. Emptying the bladder during delivery is difficult because of the position of the presenting
fetal part
,B. An over-distended bladder could be traumatized during labor, as well as prolong the progress
of labor
C. Urine specimens for glucose and protein must be obtained at certain intervals throughout
labor
D. Frequent voiding minimizes the need for catheterization which increases the chance of
bladder infection
B. An over-distended bladder could be traumatized during labor, as well as prolong the progress
of labor
A full bladder can impair the efficiency of the uterine contractions and impede descent of the
fetus during labor. Also, because of the close proximity of the bladder to the uterus, the bladder
can be traumatized by the descent of the fetus.
The nurse identifies crepitus when examining the chest of a newborn who was delivered
vaginally. Which further assessment should the nurse perform?
A. Elicit a positive scarf sign on the affected side
B. Observe for an asymmetrical Moro (startle) reflex
C. Watch for swelling of fingers on the affected side
D. Note paralysis of affected extremity and muscles
B. Observe for an asymmetrical Moro (startle) reflex
The most common neonatal birth trauma due to a vaginal delivery is fracture of the clavicle.
Although an infant may be asymptomatic, a fractured clavicle should be suspected if an infant
has limited use of the affected arm, malposition of the arm, an asymmetric Moro reflex, crepitus
over the clavicle, focal swelling or tenderness, or cries when the arm is moved.
A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26-weeks gestation in preterm
labor. She is started on an IV solution of terbutaline (Brethine). Which assessment is the highest
priority for the nurse to monitor during the administration of this drug?
A. Materna blood pressure and respirations
B. Maternal and fetal heart rates
C. Hourly urinary output
D. Deep tendon relfexes
B. Maternal and fetal heart rates
Monitoring maternal and fetal heart rates is most important when terbutaline is being
administered. Terbutaline acts as a sympathomimetic agent that stimulates both beta 1 receptors
(causing tachycardia, a side effect of the drug) and stimulation of beta 2 receptors (causing
uterine relaxation, a desired effect of the drug).
, A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation in
preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25mg subcutaneously to
stop her labor contractions. The nurse plans to monitor for which primary side effect of
terbutaline sulfate?
A. Drowsiness and bradycardia
B. Depressed reflexes and increased respirations
C. Tachycardia and a feeling of nervousness
D. A flushed, warm feeling and a dry mouth
C. Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-adrenergic
receptors in the uterine muscle to stop contractions. The beta-adrenergic agonist properties of the
drug may cause tachycardia, increased cardiac output, restlessness, headache, and a feeling of
"nervousness".
A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse
knows that the most likely presenting symptom for a pediatric client with AIDS is
A. shortness of breath
B. joint pain
C. a persistent cold
D. organomegaly
C. a persistent cold
Respiratory tract infections commonly occur in the pediatric population. However, the child with
AIDS has a decreased ability to defend the body against these infections and often the presenting
symptom of a child with AIDS is a persistent cold.
A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when she could
use a home pregnancy test to diagnose pregnancy. Which response appropriate?
A. "A home pregnancy test can be used right after your missed period."
B. "These tests are most accurate after you have missed 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."
A. "A home pregnancy test can be used right after your missed period."
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood
pressure drops from 120/80 to 90/60. What action will the nurse take?
A. Notify the healthcare provider or anesthesiologist immediately
B. Continue to assess the blood pressure q5 minutes
