OB MATERNITY HESI 2024

A client who had her first baby 3 months ago & is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client? A. After ceasing breastfeeding, the diaphragm should be resized. B. Avoid intercourse during ovulation until the size of the diaphragm has been evaluated. C. If no more than 20 pounds was gained during pregnancy, the diaphragm is safe to use. D. Use an alternate form of contraceptive until a new diaphragm is obtained. - D. Use an alternate form of contraceptive until a new diaphragm is obtained. The healthcare provider prescribes zidovudine 100mg po 5x daily for a pregnant woman who is HIV positive. How much do you administer? (?) - 10 The nurse is preparing a young couple and their 24-hour-old infant for discharge from the hospital. In conducting discharge ... A. Ensure that they have the pediatric clinic's phone number. B. Provide the results of the infant's hearing test to the parents. C. Request a return demonstration of a diaper change. D. Evaluate infant feeding technique prior to discharge. - D. Evaluate infant feeding technique prior to discharge. A 30-year-old primigravida delivers a 9-pound (4082 gram) infant vaginally after a 30-hour labor. What is the priority nursing action for this client? A. Gently massage the fundus every 4 hours. B. Observe for signs of uterine hemorrhage. C. Encourage direct contact with the infant. D. Assess the blood pressure for hypertension. - A. Gently massage the fundus every 4 hours. A multiparous client with active herpes lesion is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse do first? A. Obtain blood cultures. B. Cover the lesion with a dressing. C. Administer penicillin. D. Prepare for a cesarean section. - D. Prepare for a cesarean section. The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14 ounces, has a head circumference of 13 inches, and a chest circumference of 10 inches. Based on these physical findings, assessments for which condition has the highest priority? A. Hyperbilirubinemia B. Polycythemia C. Hyperthermia D. Hypoglycemia - D. Hypoglycemia While assessing a 40-week gestation primigravida in active labor, the client's membranes rupture spontaneously and the nurse notices that the amniotic fluid is meconium stained. Which additional finding is most important for the nurse to report to the healthcare provider? A. Maternal blood pressure of 130/85 mmHg. B. Fetal heart rate of 100 to 110 bpm. C. Vaginal exam reveals a cervix 6cm dilated. D. Contractions occurring every 2-3 minutes. - A. Maternal blood pressure of 130/85 mmHg. The nurse is caring for a 35-week gestation infant delivered by cesarean section 2 hours ago. The nurse observes the infant's respiratory rate is 72 breaths/minute with nasal flaring, grunting, and retractions. The nurse should recognize these findings indicate which complication? A. Persistent pulmonary hypertension of the newborn. B. Transient tachypnea of the newborn. C. Meconium aspiration syndrome. D. Bronchopulmonary dysplasia. - B. Transient tachypnea of the newborn. A primipara client at 42 weeks gestation is admitted for induction. Within one hour after initiating an oxytocin infusion, her cervix is 100% effaced and 6 cm dilated, contractions are occurring every 1 minute with a 75 second duration. The nurse stops the oxytocin and starts oxygen. After 30 minutes of uterine rest, the contractions are occurring every 5 minutes with 20 second duration. What intervention should the nurse implement? A. Notify nursery about the client's response. B. Check for clonus in both feet. C. Stop oxygen per cannula. D. Restart oxytocin infusion rate per protocol. - D. Restart oxytocin infusion rate per protocol. At 0600 while admitting a woman for a scheduled repeat cesarean section, the client tells the nurse that she drank a cup of coffee at 0400 because she wanted to avoid getting a headache. What action would the nurse take first? A. Ensure preoperative lab results are available. B. Inform the anesthesia care provider. C. Start prescribed IV with Lactated Ringer's. D. Contact the client's obstetrician. - B. Inform the anesthesia care provider. The nurse is caring for a postpartum client who is exhibiting symptoms of a spinal headache 24 hours following delivery of a normal newborn. Prior to the anesthesiologists arrival on the unit, which action should the nurse perform? A. Cleanse the spinal injection site. B. Place procedure equipment at bedside. C. Apply an abdominal binder. D. Insert an indwelling Foley catheter. - B. Place procedure equipment at bedside. A primigravida arrives at the observation unit of the maternity unit because she thinks she is in labor. The nurse applies the external fetal heart monitor and determines that the fetal heart rate is 140 beats/minute and contractions are occurring irregularly every 10-15 minutes. Which assessment finding confirms to the nurse that the client is not in labor at this time? A. Contractions decrease with walking. B. 2+ pitting edema in lower extremities. C. Cervical dilations is 1cm. D. Membranes are intact. - A. Contractions decrease with walking. A multigravida client in labor is receiving oxytocin 4mu/minute to help promote an effective contraction pattern. The available solution is Lactacted Ringer's 1,000 mL with oxytocin 20 units. The nurse should program the infusion pump to deliver how many mL/hr? - 12 A primigravida client with gestational hypertension and a Bishop score of 3 is scheduled for induction of labor. The nurse administers misoprostol at 0700, then observes regular contractions with cervical changes at 0900. Which action should the nurse take? A. Administer misoprostol every 2hrs. B. Ambulate the client after administration of misoprostol. C. Start oxytocin infusion immediately. D. Begin oxytocin 4hrs after misoprostol is given. - D. Begin oxytocin 4hrs after misoprostol is given. The nurse is caring for a client whose fetus died in utero at 32 weeks gestation. After the fetus is delivered vaginally, the nurse implements routine fetal demise protocol and identification procedures. Which action is important for the nurse to take? A. Explain reasons consent for an infant autopsy is needed. B. Encourage the mother to hold and spend time with her baby. C. Determine if the mother desires a visit from her clergy. D. Create a memory box of baby's footprints and photographs. - B. Encourage the mother to hold and spend time with her baby. Following a minor motor vehicle collision, a client at 36-weeks gestation is brought to the emergency center. She is lying supine on a backboard, is awake, and denies any complaints. Her blood pressure is 80/50 mmHg and heart rate is 130 bpm. Which action should the nurse implement first? A. Palpate the abdomen for contractions. B. Tilt the backboard sideways to displace the uterus laterally. C. Obtain a blood sample for complete blood count. D. Infuse 1,000 mL normal saline using a large bare IV. - B. Tilt the backboard sideways to displace the uterus laterally. A new mother asks the nurse about an area of swelling on her baby's head near the posterior fontanel that lies across the suture line. How should the nurse respond? A. "That is called caput succedaneum. It will have to be drained." B. "That is called caput succedaneum. It will absorb and cause no problems." C. "That is called a cephalhematoma. It will cause no problems." D. "That is called a cephalhematoma. It can cause jaundice as it is absorbed." - B. "That is called caput succedaneum. It will absorb and cause no problems." A client at 35 weeks gestation complains of a "pain whenever the baby moves". On assessment, the nurse notes the client's temperature to be 101.2F with severe abdominal or uterine tenderness on palpation. The nurse knows that these findings are indicative of which condition? A. Round ligament strain. B. Viral infection C. Abruptio placenta D. Chorioamnionitis - D. Chorioamnionitis An unlicensed assistive personnel (UAP) reports to the charge nurse that a client who delivers a 7-pound infant 12 hours ago is reporting a severe headache. The client blood pressure is 110/70 mmHg, respiratory rate is 18 breaths/minute, heart rate is 74 bpm, and temperature is 98.6F. The client's fundus is firm and one fingerbreadth above the umbilicus. Which action should the charge nurse implement first? A. Notify the healthcare provider of the assessment findings. B. Obtain a STAT hemoglobin and hematocrit. C. Assign a practical nurse (PN) to reassess the client's vital signs. D. Determine if the client received anesthesia during delivery. - A. Notify the healthcare provider of the assessment findings. The nurse is preparing to administer phytonadione to a newborn. Which statement made by the parents indicates understanding why the nurse is administering this medication? A. Improve insufficient dietary intake. B. Stimulate the immune system. C. Prevent hemorrhagic disorders. D. Help an immature liver. - C. Prevent hemorrhagic disorders.