2022 HESI OB Distinction Level Guide - New Full Exam - Correct Questions and Answers Included
During the postpartum period, a client tells a nurse that she has been having leg cramps. Which foods should the nurse encourage the client to eat?
- Liver and raisins
- Cheese and broccoli
- Eggs and lean meats
- Whole-wheat bread and cereals ANSWER- B) cheese and broccoli
- need calcium for stopping leg cramps
A client arrives at the clinic in preterm labor, and terbutaline (Brethine) is prescribed. For what therapeutic effect should the nurse monitor the client?
- increased blood pressure and pulse
- Reduction of pain in the perineal area
- Gradual cervical dilation as labor progresses
- Decreased frequency and duration of contractions ANSWER- D) Decreased frequency and duration of
contractions
Terbutaline sulfate (Brethine) is a β-mimetic that acts on the smooth muscles of the uterus to reduce contractility, which in turn inhibits dilation and the frequency and duration of contractions. Although terbutaline may increase blood pressure and pulse, this is a side, not a therapeutic, effect requiring frequent assessments. Terbutaline is not an analgesic. It should stop cervical dilation rather than increase it.
A pregnant client with severe preeclampsia is receiving IV magnesium sulfate. What should the nurse keep at the bedside to prepare for the possibility of magnesium sulfate toxicity?
- Oxygen 1 / 4
- Naloxone
- Calcium gluconate
- Suction equipment ANSWER- C) Calcium gluconate
The antagonist of magnesium sulfate is calcium gluconate. Oxygen is ineffective if the action of magnesium is not reversed. Naloxone is unnecessary; it is an opioid antagonist. Suction equipment may be necessary if the client has excessive secretions after a seizure. The priority intervention is trying to prevent a seizure.
Question: greenish amniotic fluid indicates ANSWER- Meconium in amniotic fluid and MD should be notified immediately
Question: Pt on magnesium sulfide, what baseline assessment is needed? ANSWER- Respiration rate
(LOC is also affected but do not need a baseline)
Question about hydatidiform mole ANSWER- Causes extra large uterus
(Hydatidiform mole is the common type of disease arising from gestational trophoblastic disease. Tons of nonviable masses of cells divide and cause uterine enlargement)
Question: Lepolds maneuver on a patient with placental previa expects ANSWER- High floating, presenting part
(Possibly related to placenta blocking birth canal & cervical os)
A client's membranes rupture during labor. The nurse immediately assesses the electronic fetal heart rate. Variable decelerations lasting more than 90 seconds, followed by bradycardia, are observed on the monitoring strip. What does the nurse suspect is the cause of this change?
- Fetal acidosis
- Prolapsed cord 2 / 4
- Head compression
- Uteroplacental insufficiency ANSWER- B) Prolapsed cord
This variable pattern with bradycardia is an ominous sign; it is indicative of cord compression, which can result in fetal hypoxia. Immediate intervention is required. Fetal acidosis occurs with uteroplacental insufficiency, not in response to a prolapsed cord. Early decelerations are associated with head compression and are benign. Late decelerations and tachycardia are associated with uteroplacental insufficiency, not a prolapsed cord.
Question: heartburn while pregnant ANSWER- Don't take antacids with sodium
A 36-year-old woman comes to the emergency department complaining of severe abdominal cramping and heavy bleeding. She informs the nurse that she is 10 weeks pregnant. Cervical examination reveals heavy bleeding; the cervical os is open and tissue is present. Which type of miscarriage is the client experiencing?
- Missed
- Complete
- Inevitable
- Threatened ANSWER- C) Inevitable
Miscarriage is inevitable because the cervical os has opened, heavy bleeding is occurring, and tissue is present with the bleeding. In a missed miscarriage, the fetus has died but the products of conception are retained in utero for as long as several weeks. There may be no bleeding or cramping, and the os is closed. In a complete miscarriage all fetal tissue has already passed and the cervix is closed; there may be slight bleeding. Symptoms of a threatened miscarriage include spotting and a closed cervical os.There may be mild cramping.
Question: Blood in urine in catheter back during c-section indicates ANSWER- Incisional injury in the bladder
Question: Risk for hypotonic uterine dystocia ANSWER- Twin gestation 3 / 4
Question: likely to get placental previa ANSWER- Most likely to have it is a 30y/0m G6 P5
Question: Signs of a ruptured tubal pregnancy occur when ANSWER- 6 weeks into pregnancy
this is when the fallopian tube is no longer able to get any larger
Question: megaloblastic anemia in pregnancy ANSWER- Can cause neural tube defects
Mother needs to be started on folic acid supplements asap
Question: vaginal hematoma ANSWER- Pain is severe and vagina feels full and heavy
Question: Classification of magnesium sulfate ANSWER- CNS depressant
Question: Pt. receiving Lovenox for DVT, what sign is most concerning? ANSWER- Dyspnea
Question: When a patient is on magnesium sulfate ANSWER- Keep room dark and quiet
Question: magnesium sulfate and the importance of deep tendon reflexes ANSWER- indicates respiratory depression (If decreased DTR, it means CNS is too depressed, and it can lead to decreased breathing reflexes)
Question: nursing intervention for pt. with placental previa ANSWER- Document amount of bleeding
Question: after internal fetal heart monitor placement, MD listens to fetal heart rate for 1 full minute to monitor ANSWER- Uterine cord prolapse
Question: risk factor for abruptio placentae ANSWER- hypertension
Question: Positive Contraction stress test indicates ANSWER- Late decelerations of the fetal heart rate are occurring with each contraction.
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