OB HESI Study Questions (taken from
HESI NCLEX-RN book) 2022
Objective signs that signify ovulation - ANS- Abundant, thin, clear cervical mucus
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(egg-white stretchiness), open cervical os, slight drop in basal body temp & then 0.5
to 1°F rise, ferning
Ovulation occurs how many days before the next menstrual period? - ANS- 14 days
3 ways to identify gestation of pregnancy - ANS- 10 lunar months, 9 calendar
months, 3 trimesters of 3 months each, 40 wk, 280 days
What maternal position provides optimum fetal and placental perfusion during
pregnancy? - ANS- Knee-chest but side-lying is most comfortable and removes
pressure from abdominal vessels
Major discomforts of first trimester and suggestions for relief for each - ANS- N/V:
crackers before rising.
Fatigue: 7-8hr sleep at night
Naegele's Rule - ANS- First day of LMP: Oct 24
Subtract 3 months: July 24
Add 7 days: July 31=Estimated Date of Delivery
(Adjust year accordingly)
Fundal height at 20 wk gestation - ANS- At the umbilicus
Approximate wt of fetus @ 20 wk gestation - ANS- 300-400g
Characteristics of fetus @ 20 wk gestation - ANS- Looks like baby with hair, lanugo,
vernix. No subcutaneous fat.
Normal psychosocial responses to pregnancy in 2nd trimester - ANS- Acceptance of
pregnancy (ambivalence wanes)
Signs of maternal-fetal bonding
Peak of hemodilution in pregnancy - ANS- 28-32 wk (decreases Hct)
3 principles relative to wt gain in pregnancy - ANS- Total gain average 24-30 lb
Gain should be consistent throughout pregnancy
Average of 0.9 lb/wk in 2nd & 3rd trimesters
How many calories should be added daily to the pregnant woman's diet? - ANS- 300
calories
How much milk should a pregnant woman consume daily during pregnancy? - ANS1 quart
At how many wks can fetal heart tones be auscultated by Doppler? - ANS- 10-12
wks
Schedule of prenatal visits for low-risk pregnant woman - ANS- Once a month until
28 wks
Every 2 wks from 28-36 wks
Once a wk until delivery
Five maternal variables associated with diagnosis of high-risk pregnancy - ANS- 1.
Age (<17, >34)
2. Parity (>5)
3. Dx of preeclampsia
4. Dx of Diabetes Mellitus
5. Dx of cardiac disease
Is one ultrasound exam useful in determining presence of IUGR? - ANS- No, serial
measurements are needed
What does the biophysical profile determine (BPP)? - ANS- Fetal well-being
List 3 nursing actions prior to ultrasound exam for woman in 1st trimester of
pregnancy - ANS- 1. Have client fill bladder
2. Don't allow client to void
3. Position client supine w/uterine wedge
Advantage of CVS over amniocentesis - ANS- -Can be done during 8-12 wks
gestation
-Results returned in 1 wk
-Allows for decision about termination in 1st trimester
Why are serum or amniotic AFP levels done prenatally? - ANS- Elevated AFP levels
may indicate presence of neural tube defects.
Low AFP levels may indicate trisomy 21
Most important determinant of fetal maturity for extrauterine survival - ANS- L:S ratio
(lung maturity, lung surfactant development)
3 most common complications of amniocentesis - ANS- 1. Spontaneous abortion
2. Fetal injury
3. Infection
4 changes of FHR - ANS- 1. Accelerations
2. Early decelerations
3. Variable decelerations
4. Late decelerations
Cause of FHR accelerations and nursing treatment - ANS- -Caused by burst of
sympathetic activity
-Reassuring and require no treatment
Cause of FHR early decelerations and nursing treatment - ANS- -Caused by head
compression
-Benign and alert nurse to monitor for labor progress and fetal descent
Cause of FHR variable decelerations and nursing treatment - ANS- -Caused by cord
compression
-Change of position should be tried first
Cause of FHR late decelerations and nursing treatment - ANS- -Caused by
uteroplacental insufficiency (UPI)
-Place client on side and administer O2
VEAL CHOP (acronym for FHR interpretation) - ANS- Variables=Cord compression
Early decel=Head compression
Accelerations=OK
Late decel=Placental insufficiency
Most important indicator of fetal autonomic nervous system integrity and health -
ANS- FHR variability
4 causes of decreased FHR variability - ANS- 1. Hypoxia
2. Acidosis
3. Drugs
4. Fetal sleep
Most important action when cord prolapse is determined - ANS- Position mother to
relieve pressure on cord or push presenting part off cord with fingers until emergency
delivery is accomplished
Reactive non-stress test - ANS- FHR acceleration of 15 bpm for 15 sec in response
to fetal movement
Dangers of nipple-stimulation stress test - ANS- -Inability to control oxytocin
"dosage"
-Tetany/hyperstimulation
Normal fetal scalp pH in labor - ANS- 7.25-7.35
Fetal scalp pH in labor of 7.2 indicates what? - ANS- True acidosis
6 prodromal signs of labor - ANS- Lightening, Braxton Hicks contractions, increased
bloody show, loss of mucous plug, burst of energy, & nesting behaviors
True labor vs. False labor - ANS- True: regular, rhythmic contractions that intensify
with ambulation, pain in abdomen sweeping around from back, cervical changes.
False: Irregular rhythm, abdominal pain (not in back) that decreases with ambulation
2 ways to determine whether membranes have truly ruptured - ANS- Nitrazine
testing paper turns dark blue or black, & Demonstration of fluid ferning under
microscope
Are psychoprophylactic breathing techniques prescribed for use according to the
stage and phase of labor? - ANS- No. Clients should use these techniques according
to their discomfort level and should change techniques when one is no longer
working for relaxation... [Show Less]