OB HESI PRACTICE EXAM WITH RATIONALE FOR 2023

OB HESI PRACTICE EXAM WITH RATIONALE FOR 2023

Encourage the infant to take the breast or sugar water.
Rationale
The nurse should first assess the infant's blood glucose level (C), because the
infant is displaying signs of hypothermia (normal newborn axillary temperature is
96 to 98 F) and hypoglycemia may occur as glucose is metabolized in an effort to
meet cellular energy demands. The infant's respiratory and heart rates are within
normal limits, so (A) is not a priority. (B and D) would be implemented after
information regarding the blood sugar level has been obtained.
A client who is breastfeeding develops engorged breasts on the third postpartum
day. Which action should the nurse recommend to relieve breast engorgement?
Avoid pumping her breasts.
Continue breastfeeding every 2 hours.
Skip a feeding to rest the breasts.
Decrease fluid intake for at least 24 hours.
Rationale
Breastfeeding every 2 hours should decrease the engorgement (B) and promote
lactation that equals the neonate's demands. Skipping feedings (C) increases the
symptoms of engorgement and may subsequently reduce milk production. Using
a breast pump increases the amount of milk expressed which decreases
engorgement and discomfort, so the client should be encouraged to pump, not
(A). Decreasing fluid intake (D) does not alleviate the breast engorgement and is
not recommended.
A client delivers her first infant and asks the nurse if her skin changes from
pregancy are permanent. Which change should the nurse tell the client will
remain after pregnancy?
Pruritus.
Chloasma.
Vascular spiders.
Striae gravidarum.
Rationale
Striae gravidarum (D), or “stretch marks,” occur on the lower abdomen of
pregnant women during the second half of pregnancy fade after delivery but do
not disappear entirely because they reflect separation within the underlying
connective (collagen) tissue of the skin. Pruritis (A) is a temporary skin condition
most commonly caused by cholestasis. Chloasma (B), or “mask of pregnancy,” is
a temporary, blotchy, brownish hyperpigmentation caused by hormonal levels of
pregnancy. Vascular spiders (C), or “angiomas,” are small, pulsating end
arterioles, found on the upper body, that occur as a result of increased circulating
estrogen, which usually disappear soon after delivery.
The nurse notes a pattern of the fetal heart rate decreasing after each contraction.
What action should the nurse implement?
Give 10 liters of oxygen via face mask.
Prepare for an emergency cesarean section.