(Answered) Obstetrics -; OB Hesi 2020 distinction level Q&A.

OB Hesi 2020 Exam Questions & Answers Vaginal examinations reveal that a laboring client cervix is dilated 2cm, 70% effaced, with presenting part at -2 station. The client tells the nurse " I need my epidural now! Thi ...

OB Hesi 2020 Exam Questions & Answers Vaginal examinations reveal that a laboring client cervix is dilated 2cm, 70% effaced, with presenting part at -2 station. The client tells the nurse " I need my epidural now! This hurts!" The nurse response to the client should be based on which information. The client will need to be catheterized before the epidural can be administered. A client who is HIV+ is receiving zidovudine during labor. Which information should the nurse provide to the client? A newborn's head circumference is 12 inches (30.5cm), and his chest measurement is 13 inches (33cm). The nurse notes that this infant has no molding, and was at breech presentation delivery by c section. What action should the nurse take based on these data? A three hour old newborn of a gestational diabetic mother who is asymptomatic and successful breastfed after birth, heel stick glucose level is 36 mg/dL. Which intervention should the nurse do first? The nurse is caring for a female client, a primigravida with preeclampsia. Finding include +2 proteinuria, BP 172/112 mmHg, Facial and hand sweating, complaints of blurry vision, and a severe frontal headache. Which medication should the nurse anticipate for this client? When planning care for a laboring client, the nurse identifies the need to withhold solid foods while the client is in labor. What is the most important reason for this nursing intervention? Which action should the nurse take if an infant, who wa born yesterday weighing 7.5 lbs A client at 20 week gestation comes to the antepartum clinic complaining of vaginal warts. HPV What information should the nurse provide? At 34 weeks gestation, a primigravida is assessing at her bimonthly clinic visit. Which assessment finding is important for the nurse to report to the HCP. A client in preterm labor has had an infusion of magnesium sulfate running 8 hrs. Current assessment finding are: RR 14 bpm, UOP 24 the nurse notes that a newborn at 24hrs of age has a large cephalhematoma. Which intervention has the highest priority. The charge nurse working on a postpartum unit is making assignments for a staff consisting of a nurse, practical nurse and 2 unlicensed assistive personnel. which client should the charge nurse assign to the practical nurse? The nurse is providing anticipatory guidance for an African-American client who is at 24-weeks gestation. Which prenatal lab assessment, prescribed at 28-weeks, should the nurse includes A new mother asks the nurse why her infant son has a needle mark on his leg. Which response is best for the nurse to provide the mother? The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations. What priority issue should the nurse address to ensure the newborn's... An oxytocin induction was started for a gravid client 6 hours ago. When assessing the FHR on the electronic fetal monitor, the nurse notes a "U-shaped" pattern... Which intervention should the nurse implement first? A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began one hour ago. The nurse's assessment reveals approximately 30 ml of bright red vaginal bleeding, FHR of 130 to 140 beats/min, no contraction, and no complaints of pain. What is the most likely case of this client's bleeding? - A pregnant woman in the first trimester of pregnancy has a Hb 8.6 mg/dL and HCT 25.1%. What food should the nurse encourage this client to include in her diet? - A gravida 3 para 3 who is Rh-negative delivers a full-term infant at home with the assistance of a nurse-midwife. Two days later, the client calls the clinic to ask if it is necessary to see the healthcare provider since the infant is healthy, and she is not having any complications. The woman's history indicates that both previously born infants were Rh-negative. Which response should the nurse provide? Following the vaginal delivery of a 10 pound infant, the nurse assess a new mothers vaginal bleeding and finds that she has saturated two pads in 30 min and has a boggy uterus. What action should the nurse implement first? The mother of a breastfeeding 24 hr old infant is very concerned about the techniques involved in breastfeeding. She calls the nurse with each feeding to seek reassurance that she is "doing it right." She tells the nurse, "I just know my daughter is not getting enough to eat." What response would be best for the nurse to make? - When assessing a pregnant woman at 39 weeks gestation who is admitted to labor and delivery, which finding is most important to report to the HCP? A newborn with a respiratory rate of 40 bpm at one minute after birth is demonstrating cyanosis of the hands and feet. What action should the nurse take? - A young Ashkenazi Jewish woman is planning to become pregnant and asks the nurse if she should be tested for any genetic disorders. What action should the nurse implement? Which physical assessment data should the nurse consider a normal finding for a primigravida client who is 12 hours postpartum? A client at 30 weeks gestation is being treated in the emergency department for a broken finger. The nurse assesses the FHR while the client is in a sitting position and has a heart rate of 92 beats per minute. What intervention is most important for the nurse to perform? A postpartum who is breastfeeding arrives for her 6-week postpartum visit and reports that she is still having vaginal discharge. How should the nurse respond? – A 32-week primigravida client who is in preterm labor (PTL) receives a prescription for an infusion of D5W 500 mL with magnesium sulfate 20 g at 1g/hr. How many mL/hr should the nurse program the infusion pump? A client in the first trimester of pregnancy calls the prenatal clinic to report she is nauseated and her stools are black and thick since she started taking iron supplements last week. How should the nurse respond? Select all that apply - A primipara at 38-weeks gestation is admitted to labor and delivery for a biophysical profile (BPP). The nurse should prepare the client for what procedures? - A new mother, who is a lacto-ovo vegetarian, plans to breastfeed her infant. What information should the nurse provide prior to discharge. During a prenatal visit, a client at 30-weeks gestation reports persistent heartburn during the past two weeks. The nurse notes the client has 3+ bilateral, pitting, pedal edema. Which action should the nurse implement? The healthcare provider prescribes 10 units/L of oxytocin via IV drip to augment a clients labor because she is experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin? A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in the care plan? A 26 week gestation primigravida who is carrying twins is seen in the clinic today. Her final height is measured at 29 cm. Based on these finding, what action should the nurse implement. A client in the third trimester of pregnancy complains of frequent nasal stuffiness and occasional nosebleeds. Her chest circumference has increased by 5cm during the pregnancy. Her diaphragm is elevated and she has an increased costal angle. Which intervention should the nurse implement? A multiparous client at 38- weeks gestation is admitted to labor and delivery with a compliant of contractions 5 minutes apart. While the client is in the bathroom changing into a hospital gown, the nurse hears a baby crying. What action should the nurse take first? The nurse adds 20 units of oxytocin to 1 L of LR's which should infuse over 8 hours for a client who delivered 2 hours ago. How many mL/hr should the nurse add to the infusion pump? An unlicensed assistive personnel (UAP) reports to the charge nurse that a client who delivered a 7-pound infant 12 hours ago is reporting a severe headache. The client's blood pressure is 110/70 mm hg, respiratory rate is 18 breaths/minute, heart rate is 74 bpm, and temperature is 96.6F (37C). The client's fundus is firm and one fingerbreadth above the umbilicus. Which action should the charge nurse implement first? A client who had her first baby three months ago and is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client? The nurse is caring for a postpartum client who is complaining of severe pain and a feeling of pressure in her perineum. Her fundus is 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 32 week multipara with a history of preeclampsia arrives at the clinic for her routine appointment. The nurse observes the client has an elevated blood pressure of 155/90 resting. Which action should the nurse take? A female client arrives in the clinic for her first postpartum visit and states she does not feel that she is bonding with her baby. Which is the best response that the nurse should provide? At her first prenatal visit, a client discloses that her first child has phenylketonuria (PKU) disease, and she is concerned about her new baby being born with the same disease. Which information should the nurse provide? Following a traumatic delivery, an infant receives an initial apgar score of 3. Which intervention is most important for the nurse to implement? Which fetal heart rate pattern requires immediate nursing intervention? The nurse is caring for a newborn infant who was recently diagnosed with a congenital heart defect. Which assessment finding warrants immediate intervention by the nurse? The nurse is providing care for a client at 30-weeks gestation who is experiencing preterm labor. Which maternal prescription is most important in preventing this fetus from developing respiratory distress syndrome? Vaginal prostaglandin gel is used to induce for a women 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 decelerations. What action should the nurse implement first? Prior to performing a postpartum assessment, the client tells the b nurse "I have pain in my stitches". The nurse knows that the client has a mid-line episiotomy. Which action should the nurse take first? The home health nurse visits a client who delivered a full term baby three days ago. The mother reports that the infant is waking up every 2 hours to bottle feed. The nurse notes white, curd-like patches on the newborns oral mucous membranes. What action should the nurse implement? A diabetic client delivers a full term large for gestational age infant who is jittery. What action should the nurse take first? The nurse is planning discharge teaching for 4 mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period? A 33-year-old client at 9-weeks gestation tells the nurse that while she has "cut down," she still has at least one alcoholic drink ever evening before bedtime. What intervention should the nurse implement? A new mother asks the nurse about an area of swelling on her baby's head near the posterior frontal that lies across the suture line. How should the nurse respond? - - A full-term infant is admitted to the newborn nursery 2 hours after delivery. The delivery record indicates the mother is positive for human immunodeficiency virus (HIV) and received zidovudine (AZT) intravenously during labor. What action should the nurse implement? At 6-weeks gestation, the rubella titer of a client indicates she is non-immune. When is the best time to administer a rubella vaccine to this client? At 6-weeks gestation, the rubella titer of a client indicates she is non-immune. When is the best time to administer a rubella vaccine to this client? A 3-hour-old male infant's hands and feet are cyanotic, and he has an axillary temperature of 96.5F, a respiratory rate of 40 breaths/min, and a heart rate of 165 beats/min. What nursing intervention is beast for the nurse to implement? - - Following a precipitous labor, a postpartum client has a continuous trickling of bright red blood from her vagina. Her uterus is firm, and her vital signs are within normal limits. The nurse determines that this sign may indicate which condition? A new mother who is breast feeding her 4-week-old infant and has type 1 diabetes, reports that her insulin needs have decreased since the birth of her child. What action should the nurse implement? A woman in her third trimester of pregnancy has been in active labor for the past 8 hours and has dilated 3cm. The nurse's assessment findings and electric fetal monitoring (EFM) are consistent with hypotonic dystocia, and the healthcare provider proscribes oxytocin (Pitocin) drip. Which data is most important for the nurse to monitor? A woman who delivered a normal newborn 24 hours ago complains, "I seem to be urinating every hour or so. Is that OK?" Which action should the nurse implement? - - A 39-week-gestational multigravida is admitted to the labor and delivery with spontaneous rupture of membranes (SROM) and contractions occurring every 2 to 3 minutes. A vaginal exam indicates that the cervix is dilated 6cm, 90% effaced, and the fetus is at a +2 station. During the last 45 minutes the fetal heart rate (FHR) has ranged between 170 and 180 beats/minute. What action should the nurse implement? Am obviously pregnant women walks into the hospital emergency department entrance, shouting: Help me! Help me! My baby is coming! I'm so afraid!" The nurse determines that the delivery is indeed imminent. What action is most important for the nurse to take? The nurse is preparing to draw blood from a newborn to obtain hemoglobin and hematocrit levels. What is the best method to obtain this blood sample? A woman who delivered a 9 pound baby boy by cesarean section under spinal anesthesia is recovering in the post anesthesia care unit. Her fundus is firm, at the umbilicus, and a continuous trickle of bright red blood with no clots form the vagina is observed but the nurse. Which action should the nurse implement? The nurse is discussing involution with a postpartum client. Which statement best indicates that the client understands the effect of breastfeeding on the resumption of menstrual cycle? The nurse is caring for a postpartum client who is exhibiting symptoms of a spinal headache 24 hours following delivery of a normal newborn. Prior to the anesthesiologist arrival on the unit, which action should the nurse perform? The nurse is preparing a client with type 1 diabetes who is at 35-weeks gestation for an amniocentesis. After obtaining maternal vital signs and a baseline fetal heart rate, which nursing intervention has the highest priority? Which finds of depression in the postpartum client requires additional action by the nurse? Select all that apply. When teaching a gravid client how to perform kick (fetal movement) counts, which instructions should the nurse include? The nurse is providing information to a postpartum client who is asking about the intrauterine device (IUD) for of contraception. Which statements demonstrates the client understands information about IUDs? A client who is anovulatory and has hyperprolactinemia is being treated by infertility with metformin (Glucophage), menotropins (Repronex, Menopur), and human chorionic gonadotropin (hCG). Which side effects should the nurse tell the client to report immediately? A client at 28-weeks gestation whose hemoglobin level is 10.7 mg/dl and hematocrit is 32.3%, tells the nurse that she eats plenty of green vegetables. When the client asks the nurse how the pregnancy might affect the laboratory findings, what information should the nurse provide? A 38-week primigravida client who is positive for group A beta streptococcus receives a prescription for cefazolin 2 grams IV to be infused over 30 minutes. The medication available in 2 grams/100ml of normal saline. The nurse should program the infusion pump to deliver how many ml/hour? A term multigravida, who is receiving oxytocin (Pitocin) for labor augmentation, is requesting pain medication. Review of the client's record indicates that she was medicated 30 minutes ago with butorphanol (Stadol) 2mg and promethazine (Phenergan) 25mg IV push. Vaginal examination reveals that the client's cervical dilation is 3cm, 70% effaced, and at a 0 station. What action should the nurse implement? Following the vaginal delivery of a large-for-gestation-age (LGA) infant, a woman is admitted to the intensive care unit due to post-partum hemorrhage. The clients medical record list the client's religion as Jehovah Witness. What action should the nurse take? - A female client comes into the clinic because it has been 6 weeks since her last menstrual period. Her medical history includes the birth of one set of twins at 36-weeks, a second set of twins at 28-weeks, and one miscarriage at 14-weeks, and a singleton birth at 39-weeks. How should the nurse document the client's parity? 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? During a routine prenatal health assessment for a client in her third trimester, the client reports that she had fluid leakage on her way to the appointment. Which technique should the nurse implement to calculate the leakage? The nurse is planning care for a client at 30-weeks' gestation who is experiencing preterm labor. What maternal prescription is most important in preventing this fetus from developing respiratory distress syndrome? A client at 30 weeks gestation reports that she has not felt the baby move in the last 24 hours. Concerned, she arrives in a panic at the obstetric clinic where she is immediately sent to the hospital. Which assessment finding warrants immediate intervention by the nurse ? A client at 38-weeks gestation complains of severe abdominal pain. Upon palpitation, the nurse notes that the abdomen is rigid. How should the nurse document the finding? A client at 20-weeks gestation comes to the ante partial clinic complaining of vaginal warts (human papillomavirus [HPV}). What information should the nurse provide this client? The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14 ounces, has a head circumference of 13 inches, and a chest circumference of 10 inches. Based on these physical findings, assessment for which condition has the highest priority? - Using the Ballard Gestational Age Assessment Tool, the nurse determines that a 15-minute old infant has a gestational age of 42-weeks. Based on this finding, which intervention is most important for the nurse to implement? The parent of a male newborn has signed a informed consent for circumcision. What priority intervention should the nurse implement upon completion of the circumcision? A laboring client's membranes rupture spontaneously. The nurse notices that the amniotic fluid is greenish brown. What intervention should the nurse implement first? The nurse is conducting postpartum teaching with a mother who is breastfeeding her infant. When discussing birth control methods should the nurse recommend to this client is best for to use for unwanted pregnancy? A pregnant woman who is at 10 weeks gestation and is 35 years of age tells the nurse that she is concerned about the possibility of having a baby with Down Syndrome. Which information should the nurse provide this client? a client who is anovulatory and has hyperprolactinemia is being treated for infertility with metformin (Glucophage), menotropins ( repronex, menopur) and HCG. which side effect should the nurse tell the client to report immediately? A mother spontaneously delivers her infant in a taxi cab on the way to the hospital. The emergency room nurse reports that the mother has active herpes (HSVII) lesion on the vulva. What intervention should the nurse implement first when admitting the neonate in the nursery? A client at 40-weeks gestation is admitted in active labor, and laboratoty finsings indicate that she is HIV positive. Which action should the nurse plan to perform ? Select ALL A women is brought to the labor and delivery unit after delivering a term infant and the placenta in the hospital parking lot 10 minutes ago. Which action should the nurse perform first? A mother asks the nurse what to use when changing her newborn diaper. What substance is best for the nurse to recommened to this mother ? The newborn nursery protocol includes a prescription for ophthalmic erythromycin 5% ointment to both eyes upon a newborns admission. What action should the nurse take to ensure adequate installation of the ophthalmic ointment? A client is admitted to the postpartum unit and tells the nurse that she had rheumatic fever as a child, which resulted in some "heart damage." The nurse knows that this client is at particular risk for developing heart failure during the immediate postpartum period. Based on this client's history, which nursing diagnosis has the highest priority? A client who is 32 weeks gestation comes to the women health clinic and reports swollen hands. On examination, the nurse notes that the client has had weight gain over six weeks. Which action should the nurse implement next? One day after vaginal delivery of a full-term baby, a postpartum client's white blood cell count is 15,000/mm3. What action should the nurse take first? A 25-year-old client who had a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit. The nurse knows that assessment for what complication has the highest priority for this client? A women who is 38-weeks gestation is receiving magnesium sulfate for severe preeclampsia. Which assessment finding warrants immediate intervention from the nurse ? The nurse receives change of shift report for four newborns. Thenurse should monitor closely which newborn for increased risk for developing sepsis ? A client at 8-weeks gestations has a hempglobin at 9.5 mg/dl. What nursing intervention has the highest priority ? A client at 35-weeks gestation comes to the clinic in the late afternoon for her regular prenatal visit. The nurse notes that the client ankle is swollen but the blood pressure is within normal limits and she has no history of complications with this pregnancy. Which instructions should the nurse prioritize ? A laboring client with gestational diabetes is receiving IV infusion with regular insulin at 5unit/hour. The IV solution contains 100 units of regular insulin in 250ml of 0.9% normal saline. The nurse should program the infusion pump to deliver how many ml/hour ? A client at 33-weeks gestation is admitted with a moderate amount of vaginal bleeding and no contractions are noted on the external monitor. What interventions should the nurse implement.? The nurse is teaching a new mother about breastfeeding. The client tells the nurse that her sister became very uncomfortable when she tried to breastfeed because she had too much milk. Which suggestions should the nurse provide to help this client deal with the discomfort associated with engorged breast ? In determining the one minute Apgar score of a male infant., the nurse assesses a heart rate of 120 beats per minute and 44 respirations per minute. He has a loud cry with stimulation, good muscle tone and his color is acrocyanotic. What Apgar score should the nurse assign The nurse is teaching a client who has gestational diabetes how to self-inject the prescribed daily insulin doses. Based on her ----- explains that she must abstain from all food and drink during the daylight hours for the next several weeks because it is a holy - the nurse implement for this client? A gravid client living alone in an apartment wishes to purchase a pet. Which choice should the nurse instruct this client to avoid ? The nurse is caring for a client following an emergency cesarean delivery under general anesthesia. Which assessment finding ---- after delivery, is most critical and requires immediate intervention ? While palpating the neck and shoulder region of a newborn infant, the nurse notices crepitus at the right clavicular area. The infant also exhibits decreased movement in the right arm. Which complications would the nurse suspect ? A client at 32- weeks gestation presentd with extreme abdominal tenderness and a small amount of bright red vaginal bleeding -mmHg, respiratory rate is 24 breaths/minute,and her heart rate is 116 beats/minute. She is dizzy, with cold, clammy skin. Upon admission to the nursery, the nurse places a newborn supine under a radiant warmer, an external heat source. What --- implement to ensure safe thermoregulation? The father of a 3-day old infant who is breastfeeding calls the postpartnumhelp line to report that his wife is acting strangely. She is irritable ----- the baby, and frequently cries for no apparent reason. What information is most important for the nurse to provide this father ?