OB Hesi Study Questions

Fundal Height in Pregnancy

12-13 wks: rises above symphysis pubis 18-32 wks: # of wks is # of cm above symphysis pubis

# of calories to add to diet of pregnant woman

300 8 glasses of milk per day

amount considered excessive in uterine bleeding

500mL or more during vaginal delivery loss of 1% or more of body weight

how many days to complete the process of implantation?

7-10

at what point is an embryo considered a fetus

9 weeks after fertilization

A client at 20 weeks gestation comes to the antepartum clinic complaining of vaginal warts (human papillomavirus). What information should the nurse provide this client? A. treatment options are available B. treat client with penicillin G C. treat with acyclovir D. consider termination of pregnancy

A

A client at 33- weeks gestation is admitted with a moderate amount of vaginal bleeding and no contractions are noted on the external monitor. Which intervention should the nurse implement? A. weigh perineal pads B. weight daily C. measure I&O D. ambulate 15 minutes QID

A

A mother brings her 3-week old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicated the vomiting is projectile, and the child seems listless. Which additional finding indicates a possibility of a life threatening complication? A. irregular palpable pulse B. hyperactive bowel sounds C. underweight for age D. crying without tears

A

Calculated by Naegele's rule, a primigravida client is at 28 weeks gestation. She is moderately obese and carrying twins and the nurse measures her fundal height at 27 cm. During the previous visit 3 weeks ago, the fundal height measured at 28 cm. Based on these findings, what should the nurse conclude? A. fundal height may indicate intrauterine growth retardation B. the provider needs to be notified immediately since this height is greater than expected C. confirm with another nurse D. recognize this as a reasonable fundal height measurement

A

The nurse if caring for a postpartum client who is complaining of severe pain and a feeling of pressure in her perineum. Her fundus if firm and she has a moderate lochial flow. On inspection, the nurse finds that a perineal hematoma is beginning to form. Which assessment finding should the nurse obtain first? A. HR and BP B. abdominal contour and bowel sounds C. urinary output and IV fluid intake D. hemoglobin and hematocrit

A

A 2 week old female is hospitalized for the surgical repair of an umbilical hernia. After returning to the post-op neonatal unit, her RR and HR have increased during the last hour. Which intervention should the nurse suspect?? A. notify the HCP B. administer PRN analgesics C. record the findings in the record D. wrap the infant tightly and rock in a rocking chair

B

A new infant is receiving positive pressure ventilation after delivery. Based on which assessment finding should the nurse initiate chest compressions? A. APGAR of 7 B. HR of 54 C. limp muscle tone D. central cyanosis

B

A new mother, who is lacto-ovo vegetarian, plans to breastfeed her infant. What information should the nurse provide prior to discharge? A. avoid using lanolin based nipple cream B. continue prenatal vitamins with B12 while breast feeding C. offer iron fortified supplemental formula daily D. weigh baby weekly to evaluate growth

B

A term multigravida, who is receiving oxytocin (Pitocin) for labor augmentation, is requesting pain medication. Review of the clients record indicates that she was medicated 30 minutes ago with butorphanol (Stadol) 2 mg and promethazine (Phenergan) 25 mg IV push. Vaginal examination reveals that the clients cervical dilation is 3 cm, 70% effaced, and at a 0 station. What action should the nurse implement? A. medicate with an additional 1mg of Stadol IV Push B. instruct client to use deep breathing during a contraction C. discontinue pitocin infusion D. notify healthcare provider

B

A woman who delivered a normal newborn 24 hours ago complains, " I seem to be urinarting every hour or so. Is that ok?". Which action should the nurse implement? A. cath for residual urine volume B. measure next void then palpate bladder C. evaluate for normal involution that palpate fundus D. obtain specimen for culture and sensitivity

B

After breast-feeding 10 minutes at each breast, a new mother calls the nurse to the postpartum room to help change the newborns diaper. As the mother begins the diaper change, the newborn spits up the breast milk. What action should the nurse implement first? A. wipe away spit up and assists mom B. turn newborn to their side and suction mouth and nares C. sit newborn up and burp by rubbing or patting upper back D. place the newborn in a position with the head lower than the feet

B

Instruction to include when discussing adequate nutrition in a 6 month old infant with GERD? A. alternate glucose water with formula B. mix formula with rice cereal C. add multivitamins with iron to the formula D. use water to dilute the formula

B

Most important topic in nutrition teaching for pregnant teens? A. gestational diabetes B. iron deficient anemia C. excessive weight gain D. elevated cholesterol

B

The nurse should instruct a mother to introduce solid foods when which behavior is exhibited? A. stops rooting when hungry B. opens mouth when food comes her way C. awakens once for nighttime feedings D. gives up a bottle for a cup

B

A mother brings her 3 month old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family? A. the mother is a single parent and lives with her parents B. mother states the baby is irritable during feedings C. diaper area shows severe skin breakdown D. infants formula has been changed twice

C

A multiparous woman at 38-weeks gestation with a history of rapid progression of labor is admitted for induction due to signs and symptoms of preeclampsia. One hour after the Pitocin infusion is initiated, she complains of a headache. Her contractions are occurring every 1 to 2 minutes, lasting 60 to 75 seconds, and a vaginal exam indicates that her cervix is 90% effaced and dialted to 6 cm. What intervention is most important for the nurse to implement? A. turn client to left side B. discontinue pitocin C. prep for immediate delivery D. measure DTRs

C

A primigravida at 36-weeks gestation, who is Rh negative, experienced abdominal trauma in a motor vehicle collision. Which assessment finding is most important for the nurse to report to the health care provider? A. fetal HR of 162bpm B. trace protein in urine C. positive fetal hemoglobin test D. mild contractions q10minutes

C

One hour after delivery, the nurse is unable to palpate the uterine fundus of a client who had an epidural and notes a large amount of lochia on the perineal pad. The nurse massages at the umbilicus and obtains current vital signs. Which intervention should the nurse implement next? A. document number of pads/hour B. increase the rate of the oxytocin infusion C. palpate the subrapubic area for bladder distention D. provide bedpan to void in unable to ambulate

C

The health care provider hands a newborn to the nurse after a vaginal delivery. What action is most important for the nurse to implement? A. allow mom to touch infant B. complete physical assessment C. place infant under warming unit D. determine APGAR score

C

The nurse is assessing a postpartum client who delivered a 10 pound infant vaginally two hours ago. The clients fundus is 2 fingerbreadths above the umbilicus, deviated to the right side, and boggy. After the client voids 250 ml of urine using a bedpan, what action should the nurse implement? A. re-evaluate in 15 minutes B. assist client to the bathroom to void C. palpate subrapubic region for distention D. encourage breastfeeding

C

The nurse is caring for a newborn infant who was recently diagnosed with congenital heart defect. Which assessment finding warrants immediate intervention by the nurse? A. sweating during feeds B. weak peripheral pulse C. blue tinge to the tongue D. increased respiratory rate

C

The nurse is scheduling a client with gestational diabetes for an amniocentesis because the fetus has an estimated weight of 8 pounds at 36- weeks gestation. This amniocentesis is being performed to obtain which information? A. presence of neural tube defect B. gender of the fetus C. fetal lung maturity D. chromosomal abnormalities

C

Vaginal prostaglandin gel is used to induce labor for a woman who is at 42 weeks gestation. Thirty minutes after insertion of the gel, the client complains of vaginal warmth, and is experiencing 90 second contractions with fetal heart rate decelerations. What action should the nurse implement first? A. notify HCP B. assess mom's vitals C. turn to side-lying position D. increase IV infusion rate

C

A mother brings her 8mo. baby boy to the clinic because he has been vomitting and had diarrhea for the last 3 days. Which assessment is most important for the nurse to make? A. assess infant abdomen for tenderness B. determine if the infant was exposed to a virus C. Measure infant's pulse D. evaluate infants cry

C. measure the infant's pulse

At 34- weeks gestation, a primigravida is assessed at her bimonthly clinic visist,. Which assessment finding is important for the nurse to report to the hcp? A. increased appetite B. FHR of 110bpm C. funds below the xiphoid process D. weight gain of 7lbs

D

The nurse is assessing a newborn who was precipitously delivered at 38 weeks gestation. The newborn is tremulous, tachycardic, and hypertensive. Which assessment action is most important for the nurse to implement? A. determine reactivity of reflexes B. perform gestational age assessment C. weigh and measure newborn D. obtain drug screen for cocaine

D

The nurse is counseling a client who is at 6 weeks gestation and is experiencing morning sickness, but does not want to take any drugs for this discomfort. Which herbal supplement is likely to help this client with the nausea she is experiencing? A. Ginko B. Chamomile C. Peppermint D. ginger

D

The nurse is assessing a 35 week primigravida with a breech presentation who is expericing moderate uterine contraction every 3-5 minutes. During the examination the client tells the nurse, "I think my water just broke". Inspection of the perineal area reveals the umbilical cord protruding from the vagina. After activating the call bell system for assistance, what intervention should the nurse implement? A. administer oxygen 10L via facemask B. don gloves and push the cord back into the vagina C. wrap in sterile gauze D. position patient in knees to chest position

D than C

During the admission of a newborn, the nurse identifies a localized swelling that does not cross the suture line on the posterior area of the parietal bone. What action should the nurse implement? A. assess near vitals q4h B. apply direct pressure to caput succadaneum C. submit STAT CT scan orders D. notify pediatrician of cephalohematoma

D. caput succadaneum crosses suture lines

drugs to relieve hyperemesis gravid arum

Vitamin B6 antihistamines phemothiazines metoclopramide

diet during breastfeeding

add 500 cals to pre-pregnancy intake drink 2 quarts (8 glasses) non caffeinated beverages

Pudendal Block

deadens pudendal nerve plexus of perineum and vagina does NOT provide relief from contractions

Amniocentesis & Bladder

early: full bladder late: empty bladder

Peridural Block

epidural blocks pains from T10 to S5, and deadens pain of contractions only one that can be used in all stages of labor

AFP test

highly associated with both false positive and false negatives

when is a 3-hour glucose tolerance test done?

if the glucose screen reveals a score of 140mg/dL or more

infant voiding patterns

initially within the first 4-6 hours of life should use 1 diaper for e/a day of life until 6 days minimum 6-8 diapers per day

Oxytocin's most important side effect is

its antidiuretic effect, which can cause water intoxication. Using IV fluids containing electrolytes decreases the risk for water intoxication.

if baby delivers during peak analgesic absorption time

notify provider for delivery room assistance and possible need for naloxone

deceleration patterns with decreased or absent variability and tachycardia

ominous, requires immediate intervention

persistent murmur in baby

patent ductus arteriosis

most common cause of uterine atony after initial 24 hours

retained placental fragments

Intradural Block

spinal deadens uterine and perineal pain must remain flat for 6-8 hours

women w/ hyperemesis gravidarum are often deficient in...

vitamin B6 thaimin riboflavin vitamin A retinol binding proteins