OB MATERNITY HESI Practice Exam Next Gen (NGN) Guaranteed Pass 2023/2024

A 30-year-old multiparous woman who has a 3-year-old boy and a newborn girl tells the nurse, "My son is so jealous of my daughter, I don't know how I'll ever manage both children when I get home." How should the nurse respond? A. "Tell the older child that he is a big boy now and should love his new sister." B. "Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him." C. "Let the older child stay with his grandparents for the first six weeks to allow him to adjust to the newborn." D. "Regression in behaviors in the older child is a typical reaction so he needs attention at this time." A vaginally delivered infant of an HIV positive mother is admitted to the newborn nursery. What intervention should the nurse perform first? A. Bathe the infant with an antimicrobial soap B. Measure the head and chest circumference C. Obtain the infant's footprints D. Administer vitamin K A client in active labor is admitted with preeclampsia. Which assessment finding is most significant in planning this client's care? A. Patellar reflex 4+ B. Blood pressure 158/80 C. Four-hour urine output 240 ml D. Respiration 12/minute A pregnant client with mitral stenosis Class III is prescribed complete bedrest. The client asks the nurse, "Why must I stay in bed all the time?" Which response is best for the nurse to provide this client? A. "Complete bedrest decreases oxygen needs and demands on the heart muscle tissue." B. "We want your baby to be healthy, and this is the only way we can make sure that will happen." C. "I know you're upset. Would you like to talk about some things you could do while in bed?" D. "Labor is difficult and you need to use this time to rest before you have to assume all child-caring duties." The nurse is preparing a client with a term pregnancy who is in active labor for an amniotomy. What equipment should the nurse have available at the client's bedside? (Select all that apply) A. Litmus paper B. Fetal scalp electrode C. A sterile glove D. An amnihook E. Sterile vaginal speculum F. Lubricant The nurse is preparing to give an enema to a laboring client. Which client requires the most caution when carrying out this procedure? A. A gravida 6. para 5 who is 38 years of age and in early labor B. A 37-week primigravida who presents at 100% effacement, 3 cm dilatation, and a -1 station C. A gravida 2, para 1 who is at 1 cm cervical dilatation and a 0 station admitted for induction of labor due to post dates D. A 40-week primigravida who is at 6 cm cervical dilatation and the presenting part is not engaged A primigravida client who is 5 cm dilated, 90% effaced, and at 0 station is requesting an epidural for pain relief. Which assessment finding is most important for the nurse to report to the healthcare provider? A. Cervical dilation of 5 cm with 90% effacement B. White blood cell count of 12,000/mm3 C. Hemoglobin of 12 mg/dl and hematocrit of 38% D. A platelet count of 67,000/mm3 The nurse is calculating the estimated date of confinement (EDC) using Ngele's rule for a client whose last menstrual period started on December 1. Which date is most accurate? A. August 1 B. August 10 C. September 3 D. September 8 The nurse is performing a gestational age assessment on a full-term newborn during the first hour of transition using the Ballard (Dubowitz) scale. Based on this assessment, the nurse determines that the neonate has a maturity rating of 40-weeks. What findings should the nurse identify to determine if the neonate is small for gestational age (SGA)? (Select all that apply.) A. Admission weight of 4 pounds, 15 ounces (2244 grams) B. Head to heel length of 17 inches (42.5 cm) C. Frontal occipital circumference of 12.5 inches (31.25 cm) D. Skin smooth with visible veins and abundant vernix E. Anterior plantar crease and smooth heel surfaces F. full flexion of all extremities in resting supine position The nurse is assessing the umbilical cord of a newborn. Which finding constitutes a normal finding? A. Two vessels; one artery and one vein B. Two vessels; two arteries and no veins C. Three vessels; two arteries and one vein D. Three vessels; two veins and one artery A full term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms is this newborn likely to exhibit? A. Choking, coughing, and cyanosis B. Projectile vomiting and cyanosis C. Apneic spells and grunting D. Scaphoid abdomen and anorexia 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 client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation. She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the nurse implement first? A. Provide oral hydration B. Have a complete blood count (CBC) drawn C. Obtain a specimen for urine analysis D. Place the client on strict bedrest 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 client who is attending antepartum classes asks the nurse why her healthcare provider has prescribed iron tablets. The nurse's response is based on what knowledge? A. Supplementary iron is more efficiently utilized during pregnancy B. It is difficult to consume 18 mg of additional iron by diet alone C. Iron absorption is decreased in the GI tract during pregnancy D. Iron is needed to prevent megaloblastic anemia in the last trimester A female client with insulin-dependent diabetes arrives at the clinic seeking a plan to get pregnant in approximately 6 months. She tells the nurse that she wants to have an uncomplicated pregnancy and a healthy baby. What information should the nurse share with the client? A. "Your current dose of insulin should be maintained throughout your pregnancy." B. "Maintain blood sugar levels in a constant range within normal limits during pregnancy." C. "The course and outcome of your pregnancy is not an achievable goal with diabetes." D. "Expect an increase in insulin dosages by 5 units/week during the first trimester." The nurse is providing discharge teaching for a client who is 24 hours postpartum. The nurse explains to the client that her vaginal discharge will change from red to pink and then to white. The client asks, "What if I start having red bleeding AFTER it changes?" What should the nurse instruct the client to do? A. Reduce activity level and notify the healthcare provider B. Go to bed and assume a knee-chest position C. Massage the uterus and go to the emergency room D. Do not worry as this is a normal occurance Just after delivery, a new mother tells the nurse, "I was unsuccessful breastfeeding my first child, but I would like to try with this baby." Which intervention is best for the nurse to implement first? A. Assess the husband's feelings about his wife's decision to breastfeed their baby B. Ask the client to describe why she was unsuccessful with breastfeeding her last child C. Encourage the client to develop a positive attitude about breastfeeding to help ensure success D. Provide assistance to the mother to begin breastfeeding as soon as possible after delivery Immediately after birth a newborn infant is suctioned, dried, and placed under a radiant warmer. The infant has spontaneous respirations and the nurse assesses an apical heart rate of 80 beats/minute and respirations of 20 breaths/minute. What action should the nurse perform next? A. Initiate positive pressure ventilation B. Intervene after the one minute Apgar is assessed C. Initiate CPR on the infant D. Assess the infant's blood glucose level A 42-week gestational client is receiving an intravenous infusion of oxytocin (Pitocin) to augment early labor. the nurse should discontinue the oxytocin infusion for which pattern of contractions? A. Transition labor with contractions every 2 minutes, lasting 90 seconds each B. Early labor with contractions every 5 minutes, lasting 40 seconds each C. Active labor with contractions every 31 minutes, lasting 60 seconds each D. Active labor with contractions every 3 to 3 minutes, lasting 70 to 80 seconds each The nurse is teaching a woman how to use her basal body temperature (BBT) pattern as a tool to assist her in conceiving a child. Which temperature pattern indicates the occurrence of ovulation, and therefore, the best time for intercourse to ensure conception? A. Between the time the temperature falls and rises B. Between 36 and 48 hours after the temperature rises C. When the temperature falls and remains low for 36 hours D. Within 72 hours before the temperature falls A multigravida client at 41-weeks gestation presents in the labor and delivery unit after a non-stress test indicated that the fetus is experiencing some difficulties in utero. Which diagnostic test should the nurse prepare the client for additional information about the fetus? A. Biophysical profile (BPP) B. Ultrasound for fetal anomalies C. Maternal serum alpha-fetoprotein (AF) screening D. Percutaneous umbilical blood sampling (PUBS) 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. The client's pulse is 84 beats/minute and blood pressure is 156/96. The healthcare provider prescribes Methergine 0.2 mg IM × 1. What 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 the fundus D. Call the healthcare provider to question the prescription 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 for the woman C. Reassure the husband and try to keep him calm D. Put the newborn to breast A client with NO prenatal care arrives at the labor unit screaming, "The baby is coming!" The nurse performs a vaginal examination that reveals the cervix is 3 centimeters dilated and 75% effaced. What additional information is most important for the nurse to obtain? A. Gravidity and parity B. Time and amount of last oral intake C. Date of last normal menstrual period D. Frequency and intensity of contractions At 10 weeks gestation, a high-risk multiparous client with a family history of Down syndrome is admitted for observation following a chorionic villavilla sampling (CVS) procedure. What assessment finding requires immediate intervention? A. Uterine cramping. B. Intermittent nausea. C. Systolic blood pressure < 100 mmHg. D. Abdominal tenderness. A client states, "During the three months I've been pregnant, it seems like I have had to go to the bathroom every five minutes." Which explanation should the nurse provide to this client? A. The client may have a bladder or kidney infection. B. Bladder capacity increases during pregnancy. C. During pregnancy a woman is especially sensitive to body functions. D. The growing uterus is putting pressure on the bladder. The nurse assesses a male newborn and determines that he has the following vital signs: axillary temperature 95.1 F, heart rate 136 beats/minute and a respiratory rate of 48 breaths/minute. Based on these findings, which action should the nurse take first? A. Notify the pediatrician of the infant's vital signs. B. Encourage the infant to take the breast or sugar water. C. Assess the infant's blood glucose level. D. Check the infant's arterial blood gases. An infant in respiratory distress is placed on pulse oximetry. The oxygen saturation indicates 85%. What is the priority nursing intervention? A. Evaluate the blood pH. B. Begin humidified oxygen via hood. C. Place the infant under a radiant warmer. D. Stimulate infant crying. When assessing a newborn infant's heart rate, which technique is most important for the nurse to use? A. Count the heart rate for at least one full minute. B. Quiet the infant before counting the heart rate. C. Palpate the umbilical cord. D. Listen at the apex of the heart. The nurse prepares to administer an injection of vitamin K to a newborn infant. The mother tells the nurse, "Wait! I don't want my baby to have a shot." Which response would be best for the nurse to make? A. Inform the mother that the injection was prescribed by the healthcare provider. B. Explore the mother's concern about the infant receiving an injection of vitamin K. C. Remind the mother that all babies receive the shot and it is relatively painless. D. Explain that vitamin K is required by state law and compliance is mandatory. The nurse is teaching a new mother about diet and breastfeeding. Which instruction is most important to include in the teaching plan? A. Double prenatal milk intake to improve vitamin D transfer to the infant. B. Increase caloric intake by approximately 500 calories/day. C. Avoid spicy foods to prevent infant colic. D. Avoid alcohol because it is excreted in breast milk. Which nursing intervention best enhances maternal-infant bonding during the fourth stage of labor? A. Brighten the lighting so the mother can view the infant. B. Provide positive reinforcement for maternal care of infant. C. Complete a newborn assessment as quickly as possible. D. Encourage early initiation of breast or formula feeding. A client at 8-weeks gestation ask the nurse about the risk for congenital heart defect (CHD) in her baby. Which response best explains when a CHD may occur? A. They usually occur in the first trimester pregnancy. B. The heart develops in the third to fifth weeks after conception. C. It depends on what the causative factors are for a CHD. D. We don't really know what or when CHDs occur. A client at 8-months gestation tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. What information should the nurse provide? A. The interaction between the mother's voice and the fetus's response ensures bonding. B. The healthcare provider should address her concerns about her baby's hearing function. C. The fetus in utero is capable of hearing and does respond to the mother's voice. D. Many women imagine what their baby is like by interpreting fetal movements. A client at 25-weeks gestation tells the nurse that she dropped a cooking utensil last week and her baby jumped in response to the noise. What information should the nurse provide? A. Report the fetus's behavior to the healthcare provider. B. The fetus can respond to sound by 24-weeks gestation. C. This is a demonstration of the fetus's acoustical reflex. D. It is a coincidence the fetus responded at the same time. A woman, whose pregnancy is confirm, asks the nurse what the function of the placenta is in early pregnancy. What information supports the explanation that the nurse should provide? A. Produces nutrients for fetal nutrition. B. Forms a protective, impenetrable barrier. C. Secretes both estrogen and progesterone. D. Excretes prolactin and insulin. Which cardiovascular findings should the nurse assess further in a client who is at 20-weeks gestation? A. Decrease in blood pressure. B. Increase in red blood cell production C. Decrease in pulse rate. D. Increase in heart sounds (S1, S2). A 31-year-old woman uses an over-the-counter (OTC) pregnancy test that is positive one week after a missed period. At the clinic, the client tells the nurse she takes phenytoin (Dilantin) for epilepsy, has a history of irregular periods, is under stress at work, and has not been sleeping well. The clients physical examination and ultrasound do not indicate that she is pregnant. How should the nurse explain the most likely cause for obtaining false-positive pregnancy test results? A. Being under too much stress at work. B. Using an anticonvulsant for epilepsy. C. Having an irregular menstrual cycle. D. Taking the pregnancy test too early. Which gastrointestinal findings should the nurse be concerned about any client at 28-weeks gestation? A. Decrease peristalsis. B. Ptyalism. C. Pyrosis. D. Pica. During a preconception counseling session for women trying to get pregnant in 3 to 6 months, what information should the nurse provide? A. Discontinue all forms of contraception. B. Make sure to include adequate folic acid in the diet. C. Continue to take any medications that are taken regularly. D. Lose weight so more weight is gained during pregnancy. Which statement by a client who is pregnant indicates to the nurse an understanding of the role of protein during pregnancy? A. "Gestational diabetes is prevented by eating protein." B. "Protein helps the fetus grow while I am pregnant." C. "My baby will develop strong teeth after he is born." D. "Anemia is averted by consuming enough protein." A client in her second trimester of pregnancy asks if it is safe for her to have a drink with dinner. How should the nurse respond to the client? A. Only one drink with the evening meal is not harmful to the fetus. B. Wine can be consumed several times a week after the first trimester. C. During second trimester beer can be consumed without harm to the fetus. D. Abstinence is strongly recommended throughout the pregnancy. A female client who wants to delivery at home asks the nurse to explain the role of a nurse-midwife in providing obstetric care. What information should the nurse provide? A. Natural childbirth without analgesia is used to manage pain during labor. B. And obstetrician should also follow the client during pregnancy. C. Birth in the home setting is the preference for using a midwife for delivery. D. The pregnancy should progress normally and be considered low risk. When discussing birth in a home setting with a group of pregnant women, which situation should the nurse include about the safety of a home birth? A. Medical back up should be available quickly in case of complications. B. The women's extended family should be allowed to attend the home birth. C. Only the woman and her midwife should be present during the delivery. D. The woman should live no more than 15 minutes from the hospital. The nurse is discussing the stages of labor with a group of women in the last month of pregnancy and provide examples of different positional techniques used during the second stage of labor. Which position should the nurse address that provides the best advantage of gravity during delivery? A. Walking. B. Squatting. C. Kneeling. D. Lithotomy.