HESI OB RATIONAL EXAM QUESTIONS
AND ANSWERS
Newborn infant born at term gestation - answer-vernix, found in the folds of the skin, is a
characteristic of term infants. Milia are not red marks made by forceps but are white
pinpoint spots usually found over the nose and chin that represent blockage of the
sebaceous glands. Meconium is the first stool, but it is tarry black, not yellow.
Pseudostrabismus (crossed eyes) is normal at birth through the third or fourth month
and does not require surgery.
A mother who is breastfeeding her baby receives instructions from the nurse. Which
instruction is most effective in preventing nipple soreness? - answer-the most common
cause of nipple soreness is incorrect positioning of the infant on the breast for latching
on. The baby's body is in alignment with the ears, shoulders, and hips in a straight line,
with the nose, cheeks, and chin touching the breast.
The client comes to the hospital assuming she is in labor. Which assessment findings
by the nurse would indicate that the client is in true labor? (select all that apply.) -
answer-- pain in the lower back that radiates to abdomen
- progressive cervical dilation and effacement
- regular and rhythmic painful contractions
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized swelling on the right side of his head. In a newborn, what is the most
likely cause of this accumulation of blood between the periosteum and skull that does
not cross the suture line? - answer-cephalhematoma, which is caused by forceps
trauma
Cephalhematoma, a slight abnormal variation of the newborn, usually arises within the
first 24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and skull. Molding, which is caused by pressure during labor is a cranial
distortion lasting 5 to 7 days, caused by pressure on the cranium during vaginal
delivery, and is a common variation of the newborn. Subarachnoid hematoma, which
requires immediate drainage and subdural hematoma, which can result in lifelong
damage, both involve intracranial bleeding and could not be detected by physical
assessment alone.
A 41-week multigravida is receiving oxytocin (pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal heart
rate increases with each contraction and returns to baseline after the contraction. Which
action should the nurse implement? - answer-increase the rate of the oxytocin (pitocin)
infusion.
, The goal of labor augmentation is to produce firm contractions that occur every 2 to 3
minutes, with a duration of 60 to 70 seconds, and without evidence of fetal stress. Fhr
accelerations are a normal response to contractions, so the oxytocin (pitocin) infusion
should be increased per protocol to stimulate the frequency and intensity of
contractions.
A sterile vaginal examination places the client at risk for infection and should be
performed when the client exhibits signs of progressing labor, which is not indicated at
this time.
A client who delivered a healthy infant 5 days ago calls the clinic nurse and reports that
her lochia is getting lighter in color. Which action should the nurse take? - answer-
explain this is a normal finding.
Client teaching is an important part of the perinatal nurse's role. Which factor has the
greatest influence on successful teaching of the pregnant client? - answer-the client's
investment in what is being taught
When teaching any client, readiness to learn is related to how much the client has
invested in what is being taught or how important the materials are to the client's
particular life. For example, the client with severe morning sickness in the first trimester
may not be ready to learn about labor and delivery but is probably very ready to learn
about ways to relieve morning sickness.
The nurse is preparing a laboring client for an amniotomy. Immediately after the
procedure is completed, it is most important for the nurse to obtain which information? -
answer-fetal heart rate (fhr)
The fhr should be assessed before and after the procedure to detect changes that may
indicate the presence of cord compression or prolapse. An amniotomy (artificial rupture
of membranes [arom]) is used to stimulate labor when the condition of the cervix is
favorable. The fluid should be assessed for color, odor, and consistency.
A client at 30 weeks of gestation is on bed rest at home because of increased blood
pressure. The home health nurse has taught her how to take her own blood pressure
and gave her parameters to judge a significant increase in blood pressure. When the
client calls the clinic complaining of indigestion, which instruction should the nurse
provide? - answer-take your blood pressure now, and if it is seriously elevated, go to the
hospital.
Checking the blood pressure for an elevation is the best instruction to give at this time.
A blood pressure exceeding 140/90 mm hg is indicative of preeclampsia. Epigastric pain
can be a sign of an impending seizure (eclampsia), a life-threatening complication of
gestational hypertension.
AND ANSWERS
Newborn infant born at term gestation - answer-vernix, found in the folds of the skin, is a
characteristic of term infants. Milia are not red marks made by forceps but are white
pinpoint spots usually found over the nose and chin that represent blockage of the
sebaceous glands. Meconium is the first stool, but it is tarry black, not yellow.
Pseudostrabismus (crossed eyes) is normal at birth through the third or fourth month
and does not require surgery.
A mother who is breastfeeding her baby receives instructions from the nurse. Which
instruction is most effective in preventing nipple soreness? - answer-the most common
cause of nipple soreness is incorrect positioning of the infant on the breast for latching
on. The baby's body is in alignment with the ears, shoulders, and hips in a straight line,
with the nose, cheeks, and chin touching the breast.
The client comes to the hospital assuming she is in labor. Which assessment findings
by the nurse would indicate that the client is in true labor? (select all that apply.) -
answer-- pain in the lower back that radiates to abdomen
- progressive cervical dilation and effacement
- regular and rhythmic painful contractions
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized swelling on the right side of his head. In a newborn, what is the most
likely cause of this accumulation of blood between the periosteum and skull that does
not cross the suture line? - answer-cephalhematoma, which is caused by forceps
trauma
Cephalhematoma, a slight abnormal variation of the newborn, usually arises within the
first 24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and skull. Molding, which is caused by pressure during labor is a cranial
distortion lasting 5 to 7 days, caused by pressure on the cranium during vaginal
delivery, and is a common variation of the newborn. Subarachnoid hematoma, which
requires immediate drainage and subdural hematoma, which can result in lifelong
damage, both involve intracranial bleeding and could not be detected by physical
assessment alone.
A 41-week multigravida is receiving oxytocin (pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal heart
rate increases with each contraction and returns to baseline after the contraction. Which
action should the nurse implement? - answer-increase the rate of the oxytocin (pitocin)
infusion.
, The goal of labor augmentation is to produce firm contractions that occur every 2 to 3
minutes, with a duration of 60 to 70 seconds, and without evidence of fetal stress. Fhr
accelerations are a normal response to contractions, so the oxytocin (pitocin) infusion
should be increased per protocol to stimulate the frequency and intensity of
contractions.
A sterile vaginal examination places the client at risk for infection and should be
performed when the client exhibits signs of progressing labor, which is not indicated at
this time.
A client who delivered a healthy infant 5 days ago calls the clinic nurse and reports that
her lochia is getting lighter in color. Which action should the nurse take? - answer-
explain this is a normal finding.
Client teaching is an important part of the perinatal nurse's role. Which factor has the
greatest influence on successful teaching of the pregnant client? - answer-the client's
investment in what is being taught
When teaching any client, readiness to learn is related to how much the client has
invested in what is being taught or how important the materials are to the client's
particular life. For example, the client with severe morning sickness in the first trimester
may not be ready to learn about labor and delivery but is probably very ready to learn
about ways to relieve morning sickness.
The nurse is preparing a laboring client for an amniotomy. Immediately after the
procedure is completed, it is most important for the nurse to obtain which information? -
answer-fetal heart rate (fhr)
The fhr should be assessed before and after the procedure to detect changes that may
indicate the presence of cord compression or prolapse. An amniotomy (artificial rupture
of membranes [arom]) is used to stimulate labor when the condition of the cervix is
favorable. The fluid should be assessed for color, odor, and consistency.
A client at 30 weeks of gestation is on bed rest at home because of increased blood
pressure. The home health nurse has taught her how to take her own blood pressure
and gave her parameters to judge a significant increase in blood pressure. When the
client calls the clinic complaining of indigestion, which instruction should the nurse
provide? - answer-take your blood pressure now, and if it is seriously elevated, go to the
hospital.
Checking the blood pressure for an elevation is the best instruction to give at this time.
A blood pressure exceeding 140/90 mm hg is indicative of preeclampsia. Epigastric pain
can be a sign of an impending seizure (eclampsia), a life-threatening complication of
gestational hypertension.
