OB HESI STUDY GUIDE EXAM
QUESTIONS WITH CORRECT ANSWERS
What are the causes of fetal tachycardia? - Answer-Early sign of fetal hypoxia, fetal
anemia, dehydration, maternal infection/fever, maternal hyperthyroid disease, and
medication-induced tachycardia.
What are the nursing actions for decreased variability? - Answer-Depends on cause.
What are the nursing actions for FHR bradycardia? - Answer-Depends on cause.
What are the nursing actions for FHR tachycardia? - Answer-Depends on cause.
What are severe variable decelerations? - Answer-FHR below 70 bpm lasing longer
than 30 seconds, with a slow return to baseline and decreasing or absent variablity.
What are the nursing actions for severe variable decelerations? - Answer-Turn client to
left side, d/c oxytocin, give O2 10L by tight face mask, assist with fetal blood sampling if
indicated, maintain IV, elevate legs to increase venous return (if possible), correct any
hypotension by increasing IV or with meds, assess FHR variability, notify MD, and
document pattern and response to each nursing action.
How should cord prolapse be managed? - Answer-Position mother to relieve pressure
on the cord (knee-chest) or push presenting part off of cord until delivery is
accomplished.
What conditions might cause uteroplacental insufficiency and late decelerations? -
Answer-Preeclampsia, DM, cardiac disease, and placentae abruptio.
How is IUGR diagnosed? - Answer-With serial ultrasounds
Name two nursing interventions to be done prior to a first trimester ultrasound. -
Answer-Have client fill bladder and lie supine with uterine wedge.
What is an advantage CVS has over amniocentesis? - Answer-It can be done earlier (8-
12 weeks gestation) with results back within a week, allowing for a first trimester
termination, if warranted.
What do high or low AFP levels mean? - Answer-High could mean NTD's and low could
be trisomy 21.
What is the most important indicator of fetal autonomic nervous system integrity and
health? - Answer-FHR variability
, What is a reactive fetal nonstress test? - Answer-A normal result indicating good fetal
health where the fetus responds to its own movements with an acceleration of 15 bpm
lasting for 15 seconds after the movement, twice within a 20 minute period.
What is the normal range for fetal scalp pH during labor? - Answer-7.25-7.35
What fetal scalp pH indicates true acidosis? - Answer-7.2 or under
What is the first stage of labor? - Answer-First stage: From beginning of regular
contractions or rupture of membranes to 10 cm dilation with 100% effacement
What are the three phases of the first stage of labor? - Answer-Latent - from beginning
to 3-4 cm; Active - from 4-7 cm cervical dilation; Transition - from 8-10 cm dilation
What is the second stage of labor? - Answer-10 cm to delivery
What is the third stage of labor? - Answer-Deliver of the fetus to delivery of the placenta
What is the fourth stage? - Answer-About two hours after the delivery of the placenta
What is the most common cause of uterine atony? - Answer-Full bladder - if patient has
soft fundus displaced to the right of the umbilicus, massage uterus and then have
patient empty bladder.
What tissue to tears extend to? - Answer-1st degree - epidermis
2nd degree - dermis, muscle and fascia
3rd degree - extends into anal sphincter
4th degree - extends into rectal mucosa
What five things does APGAR assess? - Answer-Appearance, Pulse, Grimace, Activity,
Respiration
How should an IV bolus be administered during labor? - Answer-Slowly, beginning at
the start of a contraction, so that less gets to the fetus.
Name two tests that show the membranes have ruptured. - Answer-Nitrazine paper
turns dark blue or black; ferning under microscope
Name two reasons that anesthesia and analgesia should be given in the midactive
phase of stage I labor. - Answer-Given too early can retard labor; given too late can
cause fetal distress
What blood gas issues can be caused by hyperventiliaton? - Answer-Respiratory
alkalosis.
QUESTIONS WITH CORRECT ANSWERS
What are the causes of fetal tachycardia? - Answer-Early sign of fetal hypoxia, fetal
anemia, dehydration, maternal infection/fever, maternal hyperthyroid disease, and
medication-induced tachycardia.
What are the nursing actions for decreased variability? - Answer-Depends on cause.
What are the nursing actions for FHR bradycardia? - Answer-Depends on cause.
What are the nursing actions for FHR tachycardia? - Answer-Depends on cause.
What are severe variable decelerations? - Answer-FHR below 70 bpm lasing longer
than 30 seconds, with a slow return to baseline and decreasing or absent variablity.
What are the nursing actions for severe variable decelerations? - Answer-Turn client to
left side, d/c oxytocin, give O2 10L by tight face mask, assist with fetal blood sampling if
indicated, maintain IV, elevate legs to increase venous return (if possible), correct any
hypotension by increasing IV or with meds, assess FHR variability, notify MD, and
document pattern and response to each nursing action.
How should cord prolapse be managed? - Answer-Position mother to relieve pressure
on the cord (knee-chest) or push presenting part off of cord until delivery is
accomplished.
What conditions might cause uteroplacental insufficiency and late decelerations? -
Answer-Preeclampsia, DM, cardiac disease, and placentae abruptio.
How is IUGR diagnosed? - Answer-With serial ultrasounds
Name two nursing interventions to be done prior to a first trimester ultrasound. -
Answer-Have client fill bladder and lie supine with uterine wedge.
What is an advantage CVS has over amniocentesis? - Answer-It can be done earlier (8-
12 weeks gestation) with results back within a week, allowing for a first trimester
termination, if warranted.
What do high or low AFP levels mean? - Answer-High could mean NTD's and low could
be trisomy 21.
What is the most important indicator of fetal autonomic nervous system integrity and
health? - Answer-FHR variability
, What is a reactive fetal nonstress test? - Answer-A normal result indicating good fetal
health where the fetus responds to its own movements with an acceleration of 15 bpm
lasting for 15 seconds after the movement, twice within a 20 minute period.
What is the normal range for fetal scalp pH during labor? - Answer-7.25-7.35
What fetal scalp pH indicates true acidosis? - Answer-7.2 or under
What is the first stage of labor? - Answer-First stage: From beginning of regular
contractions or rupture of membranes to 10 cm dilation with 100% effacement
What are the three phases of the first stage of labor? - Answer-Latent - from beginning
to 3-4 cm; Active - from 4-7 cm cervical dilation; Transition - from 8-10 cm dilation
What is the second stage of labor? - Answer-10 cm to delivery
What is the third stage of labor? - Answer-Deliver of the fetus to delivery of the placenta
What is the fourth stage? - Answer-About two hours after the delivery of the placenta
What is the most common cause of uterine atony? - Answer-Full bladder - if patient has
soft fundus displaced to the right of the umbilicus, massage uterus and then have
patient empty bladder.
What tissue to tears extend to? - Answer-1st degree - epidermis
2nd degree - dermis, muscle and fascia
3rd degree - extends into anal sphincter
4th degree - extends into rectal mucosa
What five things does APGAR assess? - Answer-Appearance, Pulse, Grimace, Activity,
Respiration
How should an IV bolus be administered during labor? - Answer-Slowly, beginning at
the start of a contraction, so that less gets to the fetus.
Name two tests that show the membranes have ruptured. - Answer-Nitrazine paper
turns dark blue or black; ferning under microscope
Name two reasons that anesthesia and analgesia should be given in the midactive
phase of stage I labor. - Answer-Given too early can retard labor; given too late can
cause fetal distress
What blood gas issues can be caused by hyperventiliaton? - Answer-Respiratory
alkalosis.
