OB HESI HINTS EXAM QUESTIONS
WITH COMPLETE SOLUTIONS
Length of the menstrual cycle? - Answer-Menstrual phase varies in length in most
women
pg. 221
Timing of ovulation? - Answer-Between ovulation + the beginning of the next menstrual
cycle, there are usually exactly 14 days
- so ovulation occurs 14 days before next menstrual period
pg. 221
Fertile period in which to avoid intercourse to prevent pregnancy? - Answer-Sperm live
approximately 3 days (48-72 hrs) + eggs live about 24 hrs
- A couple should avoid unprotected intercourse for several days before the anticipated
ovulation + for 3 days after ovulation to prevent pregnancy
pg. 221
Implantation Spotting - Answer-Because some women experience bleeding or spotting,
they do not know they are pregnant
pg. 223
Maternal-fetal bonding in pregnancy - Answer-Look for signs of maternal-fetal bonding
in pregnancy
- i.e. talking to fetus in utero, massaging abdomen, + nicknaming fetus are all healthy
psychosocial activities
pg. 227
Physical abuse in pregnancy - Answer-For many women, battering (emotional or
physical abuse) begins during pregnancy
- Women should be assessed for abuse in private, away from the male partner, by a
nurse who is familiar w/ local resources + knows how to determine the safety of the
client
pg. 227
Calculate GTPAL:
Woman is 6 weeks pregnant w/ the following maternal hx:
- Healthy 2 year old daughter
,- Had a miscarriage at 10 weeks
- Had an elective abortion at 6 weeks, 5 years earlier - Answer-GTPAL:
G41021
pg. 227
Calculate EDD:
LMP: Oct. 17 - Answer-July 24
- 3 months, + 7 days
- always give Feb 28 days
pg. 227
Changes in blood volume + components in pregnancy - Answer-At 28-32 weeks
gestation:
- Plasma volume increase of 25%-40% which results in normal hemodilution of
pregnancy + Hct values of 32-42%
High Hct values may look good but in reality represent a gestational HTN disorder + a
depleted vascular space
Use Hgb + Hct to evaulate nutritional status:
A 22 year old primigravida at 12 weeks gestation has an Hgb of 9.6 g/dL + an Hct of
31%. She has gained 3 lbs during the 1st trimester. - Answer-A weight gain of 2-4 lbs
during 1st trimester is recommended + this client is anemic
Supplemental iron + a diet higher in iron are needed
Foods high in iron:
- Fish + red meats
- Cereals + yellow veggies
- Green leafy veggies + citrus fruits
- Egg yolks + dried fruits
Supine hypotension - Answer-As pregnancy advances, the uterus presses on
abdominal vessels (vena cava + aorta)
- Teach woman that a left side lying position relieves supine hypotension + increases
perfusion to uterus, placenta, + fetus
Fetal Well being - Answer-Determined by assessing fundal height, FHTs + rate, fetal
movement, + uterine activity (contractions)
- Changes in FHR are the 1st + most important indicators of compromised blood flow to
the fetus, + these changes require action!
(normal FHR = 110-160 bpm)
, Early Danger Signs for Preeclampsia + Eclampsia: - Answer-- Visual disturbances
- Swelling of face, fingers, or sacrum
- Severe, continuous HA
- Persistent vomiting
- Epigastric pain
- Infection (chills, temp > 100.4, Dysuria, Pain in abdomen)
- Fluid discharge or bleeding from vagina (anything other than normal leukorrhea)
- Change in fetal movement or increased FHR
Teach pts. to report there immediately so early tx can optimize maternal + fetal outcome
Prenatal vitamins - Answer-Most providers prescribe prenatal vitamins to ensure the
client receives adequate intake of vitamins
- Only HCP can prescribe prenatal vitamins
- Nurses' responsibility to teach about proper diet + about taking prescribed vitamins
Calcium for Pregnant Women - Answer-It is recommended that pregnant women
consume the equivalent of 3 cups of milk or yogurt per day
- This will ensure that the daily calcium needs are met + will alleviate occurrence of leg
cramps
Neural Tube Defect Screening - Answer-In some state, screening for neural tube
defects by testing either maternal serum alpha fetoprotein (AFP) levels or amniotic fluid
AFP levels is mandated by state law
- This screening test is highly associated w/ both false positives + false negatives
Gestational Age Determination - Answer-Gestational age is best determined by an early
sonogram rather than a later one
Amniocentesis - Answer-When an amniocentesis is done in early pregnancy bladder
must be full to help support the uterus + to help push the uterus up in the abdomen for
easy access
When an amniocentesis is done in late pregnancy, the bladder must be empty so it will
not be punctured
Early Decels - Answer-Causes: Head compression + fetal descent
- Usually occur b/n 4-7cm + in the 2nd stage of labor
Nursing intervention: check for labor progress if these are noted
Cord Prolapse - Answer-If cord prolapse is detected, the examiner should position the
mother to relive pressure on the cord (i.e. knee-chest position) or push the presenting
part off the cord until immediate c-section can be accomplished
Late Decels - Answer-Indicate uteroplacental insufficiency
WITH COMPLETE SOLUTIONS
Length of the menstrual cycle? - Answer-Menstrual phase varies in length in most
women
pg. 221
Timing of ovulation? - Answer-Between ovulation + the beginning of the next menstrual
cycle, there are usually exactly 14 days
- so ovulation occurs 14 days before next menstrual period
pg. 221
Fertile period in which to avoid intercourse to prevent pregnancy? - Answer-Sperm live
approximately 3 days (48-72 hrs) + eggs live about 24 hrs
- A couple should avoid unprotected intercourse for several days before the anticipated
ovulation + for 3 days after ovulation to prevent pregnancy
pg. 221
Implantation Spotting - Answer-Because some women experience bleeding or spotting,
they do not know they are pregnant
pg. 223
Maternal-fetal bonding in pregnancy - Answer-Look for signs of maternal-fetal bonding
in pregnancy
- i.e. talking to fetus in utero, massaging abdomen, + nicknaming fetus are all healthy
psychosocial activities
pg. 227
Physical abuse in pregnancy - Answer-For many women, battering (emotional or
physical abuse) begins during pregnancy
- Women should be assessed for abuse in private, away from the male partner, by a
nurse who is familiar w/ local resources + knows how to determine the safety of the
client
pg. 227
Calculate GTPAL:
Woman is 6 weeks pregnant w/ the following maternal hx:
- Healthy 2 year old daughter
,- Had a miscarriage at 10 weeks
- Had an elective abortion at 6 weeks, 5 years earlier - Answer-GTPAL:
G41021
pg. 227
Calculate EDD:
LMP: Oct. 17 - Answer-July 24
- 3 months, + 7 days
- always give Feb 28 days
pg. 227
Changes in blood volume + components in pregnancy - Answer-At 28-32 weeks
gestation:
- Plasma volume increase of 25%-40% which results in normal hemodilution of
pregnancy + Hct values of 32-42%
High Hct values may look good but in reality represent a gestational HTN disorder + a
depleted vascular space
Use Hgb + Hct to evaulate nutritional status:
A 22 year old primigravida at 12 weeks gestation has an Hgb of 9.6 g/dL + an Hct of
31%. She has gained 3 lbs during the 1st trimester. - Answer-A weight gain of 2-4 lbs
during 1st trimester is recommended + this client is anemic
Supplemental iron + a diet higher in iron are needed
Foods high in iron:
- Fish + red meats
- Cereals + yellow veggies
- Green leafy veggies + citrus fruits
- Egg yolks + dried fruits
Supine hypotension - Answer-As pregnancy advances, the uterus presses on
abdominal vessels (vena cava + aorta)
- Teach woman that a left side lying position relieves supine hypotension + increases
perfusion to uterus, placenta, + fetus
Fetal Well being - Answer-Determined by assessing fundal height, FHTs + rate, fetal
movement, + uterine activity (contractions)
- Changes in FHR are the 1st + most important indicators of compromised blood flow to
the fetus, + these changes require action!
(normal FHR = 110-160 bpm)
, Early Danger Signs for Preeclampsia + Eclampsia: - Answer-- Visual disturbances
- Swelling of face, fingers, or sacrum
- Severe, continuous HA
- Persistent vomiting
- Epigastric pain
- Infection (chills, temp > 100.4, Dysuria, Pain in abdomen)
- Fluid discharge or bleeding from vagina (anything other than normal leukorrhea)
- Change in fetal movement or increased FHR
Teach pts. to report there immediately so early tx can optimize maternal + fetal outcome
Prenatal vitamins - Answer-Most providers prescribe prenatal vitamins to ensure the
client receives adequate intake of vitamins
- Only HCP can prescribe prenatal vitamins
- Nurses' responsibility to teach about proper diet + about taking prescribed vitamins
Calcium for Pregnant Women - Answer-It is recommended that pregnant women
consume the equivalent of 3 cups of milk or yogurt per day
- This will ensure that the daily calcium needs are met + will alleviate occurrence of leg
cramps
Neural Tube Defect Screening - Answer-In some state, screening for neural tube
defects by testing either maternal serum alpha fetoprotein (AFP) levels or amniotic fluid
AFP levels is mandated by state law
- This screening test is highly associated w/ both false positives + false negatives
Gestational Age Determination - Answer-Gestational age is best determined by an early
sonogram rather than a later one
Amniocentesis - Answer-When an amniocentesis is done in early pregnancy bladder
must be full to help support the uterus + to help push the uterus up in the abdomen for
easy access
When an amniocentesis is done in late pregnancy, the bladder must be empty so it will
not be punctured
Early Decels - Answer-Causes: Head compression + fetal descent
- Usually occur b/n 4-7cm + in the 2nd stage of labor
Nursing intervention: check for labor progress if these are noted
Cord Prolapse - Answer-If cord prolapse is detected, the examiner should position the
mother to relive pressure on the cord (i.e. knee-chest position) or push the presenting
part off the cord until immediate c-section can be accomplished
Late Decels - Answer-Indicate uteroplacental insufficiency
