HESI MATERNITY OB LATEST EXAM 2025 WITH QUESTIONS
AND VERIFIED CORRECT ANSWERS/ ALREADY GRADED
A++
Antenatal glucocorticoid therapy w/Betamethasone, Dexamethasone -
ANSWER-Action: Stimulates fetal lung maturation.
-Indication: Prevent or reduce severity of resp. distress syndrome in
preterm infants between 24-34wks. gestation
-Adverse effects: Maternal infection, pulmonary edema, worsen maternal
HTN/DM
Apgar score - ANSWERHR: Absent(0) Slow<100bpm(1) >100bpm(2)
RR: Absent(0) Slow/weak cry(1) Good cry(2)
Muscle tone: Flaccid(0). Some flexion of extremities(1). Well flexed(2)
Relax irritability: No response(0) Grimace(1). Cry(2)
Color: Blue/pale(0) Body pink, digits blue(1) Completely pink(2)
Ear maturation test - ANSWER-Test: Fold the ears and note recoil.
-Full term infant have instant recoil
- preterm infants have no or slow recoil and curving of the pinna
patent ductus arteriosus (PDA) – ANSWER passageway between the aorta
and the pulmonary artery remains open after birth.
Give indomethacin(indocin) to promote closure of the ductus by inhibiting
prostaglandin synthesis
Nectrotizing enterocolitits (NEC) - ANSWER-Tissue lining the intestine
becomes inflamed, dies, and can slough off.
-Delayed gastric emptying will result in increased amounts of gastric
residuals as one of the first indications of feeding intolerance &
malabsorption
Nectrotizing enterocolitits S&S - ANSWER-Swollen, red, or tender belly.
-Trouble feeding.
-Constipation.
diarrhea and/or hematochezia
-Lethargy.
-Low or unstable body temperature.
-Green vomit (containing bile)
,-Threat of sepsis late S&S
diaphragmatic hernia - ANSWER-Birth defect where there is a hole in the
diaphragm
-Abnormal opening in the diaphragm that allows part of the abdominal
organs to migrate into the chest cavity.
-Scaphoid abdomen is most characteristic
Diaphragmatic Hernia Tx – ANSWER Immediate intubation, High flow O2,
Tx for shock, PPV
intussusception – ANSWER Common in kids with CF. Obstruction may
cause fecal emesis, current jelly stools. enema-resolution = bowel
movements
Preeclampsia and diuretics – ANSWER In the case of preeclampsia, using
diuretics is dangerous because the disease already caused a volume
deficit. The patient has severe edema but diuretics disrupt normal
electrolyte balance and stress kidneys that are already compromised by
preeclampsia. The only time they are used is if the preeclamptic client also
has heart failure.
Assessment of involution of uterus after childbirth – ANSWER A)Normal
progress, days 1 through 9.
B)Size and position of uterus 2 hours after childbirth.
C)Two days after childbirth. D)Four days after childbirth.
mild preeclampsia – ANSWER B/P (140/90 -160/110)
Proteinuria (>0.3g - <2g)
Cerebral edema (absent)
Liver enzyme (Minimal increase)
Epigastric pn (Absent)
Visual disturbances (Absent)
Pulm. edema/HF (Absent)
Severe preeclampsia – ANSWER B/P(>160/110)
Proteinuria (>5g in 24hr)
Creatinine (elevated >1.2)
Platelets (decrease <100,000)
Liver enzyme(elevated)
,Urine output (Oliguria <500)
Cerebral edema (present)
Epigastric Pn (Seizure)
Visual disturbances (common)
Pulm. edema/HF (Present)
Fetal growth(growth restriction reduces amniotic fluid VL)
HELLP – ANSWER hemolysis (elevated billirubin)
elevated liver enzymes(elevated AST/ALT) low platelets (<100,000mm3)
Blood loss after birth – ANSWER Assessed extent of perineal pad
saturation (heavy-one pad saturated w/in 2hrs)
Moderate (>10cm)
Light(<10cm)
Scant (<2.5cm)
Magnesium sulfate for preeclampsia - ANSWER-Action: Depresses the
CNS to act as an anticonvulsant; also decreases frequency and intensity of
uterine contractions.
-Indications: Prevention/control of seizures in severe preeclampsia.
-Magnesium overdose &include flushing, sweating, hypotension, DTR(0),
CNS depression
Magnesium sulfate nursing interventions - ANSWER-Monitor B/P
-Assess resp. rate
-Assess DTR
-Assess I&O prior to administration(O>30mL/hr)
-Suction/O2 on standby
-Antedote: calcium gluconate
Increase dose w/pitocin
DTR, preeclampsia and magnesium toxicity - ANSWER-Hyperreflexia
indicates increased cerebral irritability& edema.
-Hyporeflexia is associated with excess magnesium
Respiratory and magnesium sulfate - ANSWER-High risk for reps.
depression. withhold mag. if resp. rate is less than 12/min or low pulse ox
of <95%
-Auscultate breath sounds for fluid buildup
, Proteinuria and preeclampsia – ANSWER Higher protein levels suggest
greater leaking of protein secondary to glomerular damage with worsening
preeclampsia
LOC & magnesium - ANSWER-Drowsiness or dulled sensorium indicates
therapeutic effects of magnesium;
-No responsive behavior or muscle weakness is associated with
magnesium excess
Cerebral edema – ANSWER vasospasm of cerebral vessels, and liver
edema. Eclampsia may develop quickly.
Carboprost Tromethamine (Hemabate) – ANSWER prostaglandin; oxytocic
uses:
- reduce postpartum bleeding secondary to uterine atony
Adverse effects and contraindications
a. Can cause headache, nausea, vomiting, diarrhea,
fever, tachycardia, and hypertension
b. Contraindicated if the client has asthma
(other uses:)
-pregnancy termination
-induce labor in intrauterine fetal death and hydatidiform mole
Oxytocin (Pitocin) - ANSWER*class*: oxytocics
*Indication*: labor induction, postpartum bleeding
*Action*: stimulates uterine smooth muscle
*Nursing Considerations*:
- can cause ICH in fetus
- can cause asphyxia in fetus
- may cause coma and seizures in mother
- may cause painful contractions
- assess fetus
- assess contractions
- monitor blood pressure
- assess maternal electrolytes
- may cause uterine tetany
AND VERIFIED CORRECT ANSWERS/ ALREADY GRADED
A++
Antenatal glucocorticoid therapy w/Betamethasone, Dexamethasone -
ANSWER-Action: Stimulates fetal lung maturation.
-Indication: Prevent or reduce severity of resp. distress syndrome in
preterm infants between 24-34wks. gestation
-Adverse effects: Maternal infection, pulmonary edema, worsen maternal
HTN/DM
Apgar score - ANSWERHR: Absent(0) Slow<100bpm(1) >100bpm(2)
RR: Absent(0) Slow/weak cry(1) Good cry(2)
Muscle tone: Flaccid(0). Some flexion of extremities(1). Well flexed(2)
Relax irritability: No response(0) Grimace(1). Cry(2)
Color: Blue/pale(0) Body pink, digits blue(1) Completely pink(2)
Ear maturation test - ANSWER-Test: Fold the ears and note recoil.
-Full term infant have instant recoil
- preterm infants have no or slow recoil and curving of the pinna
patent ductus arteriosus (PDA) – ANSWER passageway between the aorta
and the pulmonary artery remains open after birth.
Give indomethacin(indocin) to promote closure of the ductus by inhibiting
prostaglandin synthesis
Nectrotizing enterocolitits (NEC) - ANSWER-Tissue lining the intestine
becomes inflamed, dies, and can slough off.
-Delayed gastric emptying will result in increased amounts of gastric
residuals as one of the first indications of feeding intolerance &
malabsorption
Nectrotizing enterocolitits S&S - ANSWER-Swollen, red, or tender belly.
-Trouble feeding.
-Constipation.
diarrhea and/or hematochezia
-Lethargy.
-Low or unstable body temperature.
-Green vomit (containing bile)
,-Threat of sepsis late S&S
diaphragmatic hernia - ANSWER-Birth defect where there is a hole in the
diaphragm
-Abnormal opening in the diaphragm that allows part of the abdominal
organs to migrate into the chest cavity.
-Scaphoid abdomen is most characteristic
Diaphragmatic Hernia Tx – ANSWER Immediate intubation, High flow O2,
Tx for shock, PPV
intussusception – ANSWER Common in kids with CF. Obstruction may
cause fecal emesis, current jelly stools. enema-resolution = bowel
movements
Preeclampsia and diuretics – ANSWER In the case of preeclampsia, using
diuretics is dangerous because the disease already caused a volume
deficit. The patient has severe edema but diuretics disrupt normal
electrolyte balance and stress kidneys that are already compromised by
preeclampsia. The only time they are used is if the preeclamptic client also
has heart failure.
Assessment of involution of uterus after childbirth – ANSWER A)Normal
progress, days 1 through 9.
B)Size and position of uterus 2 hours after childbirth.
C)Two days after childbirth. D)Four days after childbirth.
mild preeclampsia – ANSWER B/P (140/90 -160/110)
Proteinuria (>0.3g - <2g)
Cerebral edema (absent)
Liver enzyme (Minimal increase)
Epigastric pn (Absent)
Visual disturbances (Absent)
Pulm. edema/HF (Absent)
Severe preeclampsia – ANSWER B/P(>160/110)
Proteinuria (>5g in 24hr)
Creatinine (elevated >1.2)
Platelets (decrease <100,000)
Liver enzyme(elevated)
,Urine output (Oliguria <500)
Cerebral edema (present)
Epigastric Pn (Seizure)
Visual disturbances (common)
Pulm. edema/HF (Present)
Fetal growth(growth restriction reduces amniotic fluid VL)
HELLP – ANSWER hemolysis (elevated billirubin)
elevated liver enzymes(elevated AST/ALT) low platelets (<100,000mm3)
Blood loss after birth – ANSWER Assessed extent of perineal pad
saturation (heavy-one pad saturated w/in 2hrs)
Moderate (>10cm)
Light(<10cm)
Scant (<2.5cm)
Magnesium sulfate for preeclampsia - ANSWER-Action: Depresses the
CNS to act as an anticonvulsant; also decreases frequency and intensity of
uterine contractions.
-Indications: Prevention/control of seizures in severe preeclampsia.
-Magnesium overdose &include flushing, sweating, hypotension, DTR(0),
CNS depression
Magnesium sulfate nursing interventions - ANSWER-Monitor B/P
-Assess resp. rate
-Assess DTR
-Assess I&O prior to administration(O>30mL/hr)
-Suction/O2 on standby
-Antedote: calcium gluconate
Increase dose w/pitocin
DTR, preeclampsia and magnesium toxicity - ANSWER-Hyperreflexia
indicates increased cerebral irritability& edema.
-Hyporeflexia is associated with excess magnesium
Respiratory and magnesium sulfate - ANSWER-High risk for reps.
depression. withhold mag. if resp. rate is less than 12/min or low pulse ox
of <95%
-Auscultate breath sounds for fluid buildup
, Proteinuria and preeclampsia – ANSWER Higher protein levels suggest
greater leaking of protein secondary to glomerular damage with worsening
preeclampsia
LOC & magnesium - ANSWER-Drowsiness or dulled sensorium indicates
therapeutic effects of magnesium;
-No responsive behavior or muscle weakness is associated with
magnesium excess
Cerebral edema – ANSWER vasospasm of cerebral vessels, and liver
edema. Eclampsia may develop quickly.
Carboprost Tromethamine (Hemabate) – ANSWER prostaglandin; oxytocic
uses:
- reduce postpartum bleeding secondary to uterine atony
Adverse effects and contraindications
a. Can cause headache, nausea, vomiting, diarrhea,
fever, tachycardia, and hypertension
b. Contraindicated if the client has asthma
(other uses:)
-pregnancy termination
-induce labor in intrauterine fetal death and hydatidiform mole
Oxytocin (Pitocin) - ANSWER*class*: oxytocics
*Indication*: labor induction, postpartum bleeding
*Action*: stimulates uterine smooth muscle
*Nursing Considerations*:
- can cause ICH in fetus
- can cause asphyxia in fetus
- may cause coma and seizures in mother
- may cause painful contractions
- assess fetus
- assess contractions
- monitor blood pressure
- assess maternal electrolytes
- may cause uterine tetany
