OB HESI/FINAL EXAM QUESTIONS AND ANSWERS ALREADY PASSED

OB HESI/FINAL EXAM QUESTIONS AND ANSWERS ALREADY PASSED A client who delivered an infant an hour ago tells the nurse the she feels wet underneath her buttock. The nurse notes that the perineal pad is saturated and the client is lying in a 6-inch diameter pool of blood. Which action should the nurse implement first? A. Cleanse the perineum B. Obtain a blood pressure C. Palpate the firmness of the fundus D. Inspect the perineum for lacerations Correct Answer: C A firm uterus is needed to control bleeding from the placental site of attachment on the uterine wall. The nurse should FIRST assess for firmness and massage the fundus as indicated. A woman who thinks she could be pregnant calls her neighbor, who is a nurse, to ask when she should use a home pregnancy test. Which response is appropriate? A. "A home pregnancy test can be used right after your first missed period." B. "These tests are most accurate after you missed your second period." C "Home pregnancy tests often give false positives and should not be trusted." D. "The test can provide accurate information when used right after ovulation." Correct Answer: A Home urine test are based on the chemical detection of human chorionic gonadotrophin, which begins to increase 6-8 days after conception. Best detected at 2 weeks gestation or immediately after first missed period. When explaining "postpartum blues" to a client who is 1 day postpartum, which symptoms should the nurse include in the teaching plan? (Select all that apply) A. Mood swings B. Panic attacks C. Tearfulness D. Decreased need for sleep E. Disinterest in the infant Correct Answers: A,C "Postpartum blues" is a common emotional response related to the rapid decrease in placental hormones after delivery and include mood swings, teaefulness, feeling low, emotional, and fatigued. B,D, and E indicate "Postpartum Depression" One hour after giving birth to an 8-pound infant, a client's lochia rubra has increased from small to large and her fundus is boggy despite massage. HR is 84 bpm, BP 156/96. The M.D. prescribe Methergine 0.2 mg IM x 1. Which action should the nurse take immediately? A. Give the medication as prescribed and monitor for efficacy B. Encourage the client to breastfeed rather than bottle feed C. Have the client empty her bladder and massage her fundus D. Call the HP to question the prescription Correct Answer: D Methergine is contraindicated for clients with elevated BP, so the nurse should contact the HP and question the prescription. The nurse should encourage the laboring patient to begin pushing when A. there is only an anterior or posterior lip of cervix left B. the client describes the need to have a BM C. the cervix is completely dilated C. the cervix is completely effaced Correct Answer: C Pushing begins with the second stage of labor (i.e. when the cervix is completely dilated at 10 cm). Pushing before this point could case the cervix to become edematous = operative delivery. A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms. Which assessment finding indicates the therapeutic drug level has been achieved? A. 4+ reflexes B. Urinary output of 50 ml/hr C. A decrease in RR from 24 to 16 D. A decreased body temp Correct Answer: C Magnesium sulfate, a CNS depressant, helps prevent seizures.** RR 12 indicate toxicity, Urine output should be at least 30 ml/hr Twenty-four hours after admission to the newborn