OB HESI FINAL EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
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 BM
C. the cervix is completely dilated
C. the cervix is completely effaced - Answer-Correct Answer: C
Pushing begins with the second stage of labor (i.e. when the cervix is completely dilated
at 10 cm). Pushing before this point could case the cervix to become edematous =
operative delivery.
A client at 32-weeks gestation is hospitalized with severe pregnancy-induced
hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms.
Which assessment finding indicates the therapeutic drug level has been achieved?
A. 4+ reflexes
B. Urinary output of 50 ml/hr
C. A decrease in RR from 24 to 16
D. A decreased body temp - Answer-Correct Answer: C
Magnesium sulfate, a CNS depressant, helps prevent seizures.** RR <12 indicate
toxicity, Urine output should be at least 30 ml/hr
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized edema on the right side of his head. The nurse knows that, in the
newborn, an accumulation of blood between the periosteum and skull which does not
cross the suture line is a newborn variation known as
A. a cephalhematoma, caused by forceps trauma and may last up to 8 weeks
B. a subarachnoid hematoma, which requires immediate drainage to prevent
complications
C. molding, caused by pressure during labor and will disappear within 2 to 3 days
D. a subdural hematoma which can result in lifelong damage - Answer-Correct Answer:
A
A slight abnormal variation of the newborn, usually arises within first 24 hours after
delivery. Trauma from delivery causes capillary bleeding between the periosteum and
the skull
(B) a cranial distortion lasting 5-7 days, caused by pressure on the cranium
(C&D) involves cranial bleeding; cannot be detected on physical exam alone
,A couple has been trying to conceive for nine months without success. Which
information obtained from the clients is most likely to have an impact on the couple's
ability to conceive a child?
A. Exercise regimen of both partners includes running four miles each morning
B. History of having sexual intercourse 2-3 times per week
C. The woman's menstrual period occurs every 35 days
D. They use lubricants with each sexual encounter to decrease friction - Answer-Correct
Answer: D
The use of lubricants has the potential to affect fertility because some lubricants
interfere with sperm motility
Which action should the nurse implement when preparing to measure the fundal height
of a pregnant client?
A. Have the client empty the bladder
B. Request the client lie on her left side
C. Perform Leopold's maneuvers first
D. Give the client some juice - Answer-Correct Answer: A
The bladder must be completely empty to accurately measure the fundal height.
An off-duty nurse finds a woman in a supermarket parking lot delivering an infant while
her husband is screaming for someone to help his wife. Which intervention has the
highest priority?
A. Use a thread to tie off the umbilical cord
B. Provide as much privacy as possible
C. Reassure the husband and try to keep him calm
D. Put the newborn to breast - Answer-Correct Answer: D
Putting the newborn to breast will help contract the uterus and prevent a postpartum
hemorrhage. Preventing hemorrhage is the highest priority.
A client at 28-weeks gestation calls the antepartal clinic and states that she is
experiencing a small amount of vaginal bleeding which she describes as bright red. She
further states that she is not experiencing any uterine contractions or abdominal pain.
Which instruction should the nurse provide?
A. Come to the clinic today for an ultrasound
B. Go immediately to the emergency room
C. Lie on your left side for about one hour and see if the bleeding stops
D. Bring a urine sample to the lab tomorrow to determine if you have a UTI - Answer-
Correct Answer: A
,Third trimester painless bleeding is characteristic of a placental previa. Bright red
bleeding may be intermittent, occur in gushes, or be continuous
**Bleeding that is sudden and accompanied by intense uterine pain indicates placental
abruption, which IS life threatening
An expectant father tells the nurse he fears that his wife "is losing her mind." He states
she is constantly rubbing her abdomen and talking to the baby, and that she actually
reprimands the baby when it moves too much. What recommendation should the nurse
make to this expectant father?
A. Reassure him that these are normal reactions to pregnancy and suggest that he
discuss his concerns with the childbirth education nurse
B. Help him to understand that his wife is experiencing normal symptoms of
ambivalence about the pregnancy and no action is needed
C. Ask him to observe his wife's behavior carefully for the next few weeks and report
any similar behavior to the nurse
D. Let him know that these are normal maternal/fetal bonding behaviors which occur
once the mother feels fetal movement - Answer-Correct Answer: D
These behaviors are positive maternal/fetal bonding
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
assessment findings, what intervention should the nurse implement?
A. Insert an internal fetal monitor
B. Assess for cervical changes q1h
C. Monitor bleeding from IV sites
D. Perform Leopold's maneuvers - Answer-Correct Answer: D
The client is presenting with signs of placental abruption so monitoring bleeding from
peripheral IV sites is priority.
WHY? Disseminated intravascular coagulation (DIC) is a complication of PA
characterized by abnormal bleeding
A client in active labor is admitted with preeclampsia. Which assessment finding is most
significant in planning this client's care?
A. Ask if she takes a daily calcium tablet
B. Extend the leg and dorsiflex the foot
C. Lower the leg off the side of the bed
D. Elevate the leg above the heart - Answer-Correct Answer: B
Dorsiflexinfg the foot by pushing the sole of the foot forward or by standing is the best
means of relieving leg cramps
, Which maternal behavior is the nurse most likely to see when a new mother receives
her infant for the first time?
A. She eagerly reaches for the infant, undresses the infant, and examines the infant
completely
B. Her arms and hands receive the infant and she then traces the infant's profile with
her fingertips
C. Her arms and hands receive the infant and she then cuddles the infant to her own
body
D. She eagerly reaches for the infant and then holds the infant to her own body -
Answer-Correct Answer: B
Attachment/bonding theory indicates that most mothers will demonstrate behaviors
described in (B)
The nurse should explain to a 30-year-old gravid client that alpha fetoprotein testing is
recommended for which purpose?
A. Detect cardiovascular disorders
B. Screen for neural tube defects
C. Monitor the placental functioning
D. Assess for maternal pre-ecplamsia - Answer-Correct Answer: B
Alpha-fetoprotein (AFP) is a screening test used in pregnancy. Elevation may indicate
neural tube defect
A new mother is afraid to touch her baby's head for fear of hurting the "large soft spot."
Which explanation should the nurse give to this anxious client?
A. "Some care is required when touching the large soft spot area on top of your baby's
head until the bones fuse together"
B. "That's just an 'old wives' tale' so don't worry"
C. "The soft spot will disappear within 6 weeks and if very unlikely to cause any
problems for your baby"
D. "There's a strong, tough membrane there to protect the baby so you need not be
afraid to wash or comb their hair" - Answer-Correct Answer: D
Provides correct information and relieves any anxiety
The nurse is counseling a woman who wants to become pregnant. The woman tells the
nurse that she has a 36-day menstrual cycle and the first day of her last menstrual
period was January 8. The nurse correctly calculates that the woman's next fertile
period is
A. January 14-15
COMPLETE SOLUTIONS
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 BM
C. the cervix is completely dilated
C. the cervix is completely effaced - Answer-Correct Answer: C
Pushing begins with the second stage of labor (i.e. when the cervix is completely dilated
at 10 cm). Pushing before this point could case the cervix to become edematous =
operative delivery.
A client at 32-weeks gestation is hospitalized with severe pregnancy-induced
hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms.
Which assessment finding indicates the therapeutic drug level has been achieved?
A. 4+ reflexes
B. Urinary output of 50 ml/hr
C. A decrease in RR from 24 to 16
D. A decreased body temp - Answer-Correct Answer: C
Magnesium sulfate, a CNS depressant, helps prevent seizures.** RR <12 indicate
toxicity, Urine output should be at least 30 ml/hr
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized edema on the right side of his head. The nurse knows that, in the
newborn, an accumulation of blood between the periosteum and skull which does not
cross the suture line is a newborn variation known as
A. a cephalhematoma, caused by forceps trauma and may last up to 8 weeks
B. a subarachnoid hematoma, which requires immediate drainage to prevent
complications
C. molding, caused by pressure during labor and will disappear within 2 to 3 days
D. a subdural hematoma which can result in lifelong damage - Answer-Correct Answer:
A
A slight abnormal variation of the newborn, usually arises within first 24 hours after
delivery. Trauma from delivery causes capillary bleeding between the periosteum and
the skull
(B) a cranial distortion lasting 5-7 days, caused by pressure on the cranium
(C&D) involves cranial bleeding; cannot be detected on physical exam alone
,A couple has been trying to conceive for nine months without success. Which
information obtained from the clients is most likely to have an impact on the couple's
ability to conceive a child?
A. Exercise regimen of both partners includes running four miles each morning
B. History of having sexual intercourse 2-3 times per week
C. The woman's menstrual period occurs every 35 days
D. They use lubricants with each sexual encounter to decrease friction - Answer-Correct
Answer: D
The use of lubricants has the potential to affect fertility because some lubricants
interfere with sperm motility
Which action should the nurse implement when preparing to measure the fundal height
of a pregnant client?
A. Have the client empty the bladder
B. Request the client lie on her left side
C. Perform Leopold's maneuvers first
D. Give the client some juice - Answer-Correct Answer: A
The bladder must be completely empty to accurately measure the fundal height.
An off-duty nurse finds a woman in a supermarket parking lot delivering an infant while
her husband is screaming for someone to help his wife. Which intervention has the
highest priority?
A. Use a thread to tie off the umbilical cord
B. Provide as much privacy as possible
C. Reassure the husband and try to keep him calm
D. Put the newborn to breast - Answer-Correct Answer: D
Putting the newborn to breast will help contract the uterus and prevent a postpartum
hemorrhage. Preventing hemorrhage is the highest priority.
A client at 28-weeks gestation calls the antepartal clinic and states that she is
experiencing a small amount of vaginal bleeding which she describes as bright red. She
further states that she is not experiencing any uterine contractions or abdominal pain.
Which instruction should the nurse provide?
A. Come to the clinic today for an ultrasound
B. Go immediately to the emergency room
C. Lie on your left side for about one hour and see if the bleeding stops
D. Bring a urine sample to the lab tomorrow to determine if you have a UTI - Answer-
Correct Answer: A
,Third trimester painless bleeding is characteristic of a placental previa. Bright red
bleeding may be intermittent, occur in gushes, or be continuous
**Bleeding that is sudden and accompanied by intense uterine pain indicates placental
abruption, which IS life threatening
An expectant father tells the nurse he fears that his wife "is losing her mind." He states
she is constantly rubbing her abdomen and talking to the baby, and that she actually
reprimands the baby when it moves too much. What recommendation should the nurse
make to this expectant father?
A. Reassure him that these are normal reactions to pregnancy and suggest that he
discuss his concerns with the childbirth education nurse
B. Help him to understand that his wife is experiencing normal symptoms of
ambivalence about the pregnancy and no action is needed
C. Ask him to observe his wife's behavior carefully for the next few weeks and report
any similar behavior to the nurse
D. Let him know that these are normal maternal/fetal bonding behaviors which occur
once the mother feels fetal movement - Answer-Correct Answer: D
These behaviors are positive maternal/fetal bonding
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
assessment findings, what intervention should the nurse implement?
A. Insert an internal fetal monitor
B. Assess for cervical changes q1h
C. Monitor bleeding from IV sites
D. Perform Leopold's maneuvers - Answer-Correct Answer: D
The client is presenting with signs of placental abruption so monitoring bleeding from
peripheral IV sites is priority.
WHY? Disseminated intravascular coagulation (DIC) is a complication of PA
characterized by abnormal bleeding
A client in active labor is admitted with preeclampsia. Which assessment finding is most
significant in planning this client's care?
A. Ask if she takes a daily calcium tablet
B. Extend the leg and dorsiflex the foot
C. Lower the leg off the side of the bed
D. Elevate the leg above the heart - Answer-Correct Answer: B
Dorsiflexinfg the foot by pushing the sole of the foot forward or by standing is the best
means of relieving leg cramps
, Which maternal behavior is the nurse most likely to see when a new mother receives
her infant for the first time?
A. She eagerly reaches for the infant, undresses the infant, and examines the infant
completely
B. Her arms and hands receive the infant and she then traces the infant's profile with
her fingertips
C. Her arms and hands receive the infant and she then cuddles the infant to her own
body
D. She eagerly reaches for the infant and then holds the infant to her own body -
Answer-Correct Answer: B
Attachment/bonding theory indicates that most mothers will demonstrate behaviors
described in (B)
The nurse should explain to a 30-year-old gravid client that alpha fetoprotein testing is
recommended for which purpose?
A. Detect cardiovascular disorders
B. Screen for neural tube defects
C. Monitor the placental functioning
D. Assess for maternal pre-ecplamsia - Answer-Correct Answer: B
Alpha-fetoprotein (AFP) is a screening test used in pregnancy. Elevation may indicate
neural tube defect
A new mother is afraid to touch her baby's head for fear of hurting the "large soft spot."
Which explanation should the nurse give to this anxious client?
A. "Some care is required when touching the large soft spot area on top of your baby's
head until the bones fuse together"
B. "That's just an 'old wives' tale' so don't worry"
C. "The soft spot will disappear within 6 weeks and if very unlikely to cause any
problems for your baby"
D. "There's a strong, tough membrane there to protect the baby so you need not be
afraid to wash or comb their hair" - Answer-Correct Answer: D
Provides correct information and relieves any anxiety
The nurse is counseling a woman who wants to become pregnant. The woman tells the
nurse that she has a 36-day menstrual cycle and the first day of her last menstrual
period was January 8. The nurse correctly calculates that the woman's next fertile
period is
A. January 14-15
